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Biomedical subjects

S Schraub

Publications and source records attributed to S Schraub.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Primary cerebral lymphoma. Diagnostic and therapeutic values. Apropos of 4 cases].

The authors report four recent cases, of primary cerebral Lymphoma discovered since the use of the C.T. scan. Even though rare, the incidence of this tumor seems to be in slowly increase. The lesions on the C.T. scan are too variables and the surgical biopsy is necessary for the diagnosis. The primary cerebral Lymphoma should be considered more and more like the others Lymphomas. For this reason, they have started the treatment after surgical biopsy, with chemotherapy followed by radiotherapy associated with corticotherapy. The two last patients, are still alive with a follow up of 36 months for one of them. The prognosis seems to us, better as much as the diagnosis and the treatment was started early.

Adult↗
PubMed1986

Early results of the EORTC randomized clinical trial on multiple fractions per day (MFD) and misonidazole in advanced head and neck cancer.

From Feb. 1981 to Oct. 1984, a randomized clinical trial was carried out in the EORTC Radiotherapy Group, comparing classical radiotherapy 70 Gy/7 weeks to MFD (3 X 1.6 Gy/day for 10 days, 3 weeks rest, followed by a boost to 67.2 or 72 Gy), with or without Misonidazole (1 g/m2 every irradiation day, total 12 to 14 g/m2) in advanced head and neck cancer (all T3 and T4, all N2, N3 and N1 greater than 3 cm). A total of 523 patients were entered in the study. At the time of analysis (4/85), the median follow-up time was 64 weeks. No significant differences in survival or locoregional control could be demonstrated between the three treatment arms at this time. Whereas early mucosal reactions were heavier in the MFD-arms, no differences in late effects (fibrosis, edema, xerostomy) were found between the three treatment arms. Five patients (all MFD + Misonidazole) died with local complications (edema, necrosis). All five had cancer of the laryngopharynx and 3 of them died from a hemorrhage. Factors affecting prognosis were tumor site, tumor stage, nodal status, and histological differentiation.

Adult↗
PubMed1986

Surgical treatment of vertebral metastasis.

Fifty-seven patients with spinal metastases underwent 60 operations. 36 patients were operated on by anterior approach with decompressive coporectomy and stabilization by metal and methylmetacrylate and 24 patients by laminectomy and/or stabilization by osteosynthesis. Postoperative improvement of the pain syndrome was observed after 56 operations. Neurologic signs were present in 23 patients with paraplegia (5 patients) or paraparesis (18 patients); 15 of the latter patients improved and recovered walking capacity. Two types of metastasis were distinguished: corporal metastasis, in which vertebral wedging and posterior protrusion led to neural deficit, with a good prognosis if treated by anterior surgery, and pericordal metastasis in which the cord compression is due to metastatic proliferation into the spinal canal. Results after decompressive surgery, either by posterior or anterior approaches are more doubtful. Surgery is beneficial and should be preferred to radiation when there is medullary compression by corporal metastasis and also in the presence of intense pain or potential instability of the spine.

Activities of Daily Living↗
PubMed1986

Phase II clinical evaluation of doxifluridine.

Disease-oriented phase II trials of doxifluridine were performed in advanced colorectal, breast, renal, endometrial, stomach, and ovarian carcinomas. The dose schedule recommended by the phase I trial (12.5 g/m2 by continuous iv infusion over 6 hours once a week for 3 weeks followed by a 1-week rest) was chosen first: the initial dose was later decreased to 10 g/m2 due to the fact that several neurotoxic effects were reported. A total of 207 patients were entered: 137 patients who received at least two courses of treatment were evaluable for response. Therapeutic activity was demonstrated in breast cancer [two complete responses (CR) and 13 partial responses (PR) among 42 patients], colon cancer (seven PRs among 35 patients), and rectal cancer (six PRs among 23 patients). Some therapeutic activity was detected in ovarian cancer (one CR among nine patients), endometrial cancer (one PR among five patients), and stomach cancer (one PR among five patients). No significant activity was noticed in renal cancer (one PR among 18 patients). Nonhematological toxicity was evaluated according to World Health Organization criteria. Nausea and vomiting were recorded in 50% of the patients (Grade 3-4 in 5%), diarrhea was recorded in 20% (Grade 3-4 in 5%), and cutaneous and allergic reactions were recorded in 10% (Grade 3-4 in 2%). Myelotoxicity during the first treatment course was mild; median wbc and platelet count nadirs (x 10(9) cells/L) were 4.1 (range, 0.1-11) and 194 (range, 20-482), respectively. Nevertheless, some cases of acute leukopenia and thrombopenia were reported. Consciousness alterations and neurologic symptoms were the major side effects (72 of 173 evaluable patients), since treatment had to be interrupted in 34 patients and four lethal neurotoxic effects occurred. At the same total dose of doxifluridine, the risk of neurotoxicity significantly increases with age and with the weekly dose and to the contrary it decreases with increasing bilirubin level. Although activity was demonstrated, this treatment cannot be recommended because of major neurotoxicity. Further pharmacological studies seem warranted to define the optimal dosage schedule and to obtain a better therapeutic index.

Adult↗
PubMed1986

[Anatomo-pathological factors in the prognosis of rectal cancers. A mono- and multifactorial study].

Pathological prognostic factors of rectal adenocarcinoma were studied retrospectively in 173 patients who underwent curative resection between 1970 and 1980. Analysis was mono- and multifactorial. Minimal and median follow-up were 24 and 66 months respectively. Three factors had a favorable influence on the local failure (LF) and distant metastasis (DM) risks: length of the tumor less than 2 cm; polypoid aspect; Astler-Coller's stage A. Four factors increased the LF risks: perineural invasion (LF = 57 p. 100); poorly differentiated or colloid tumors (LF = 50 p. 100); lymph node metastasis (LF: 43 p. 100); lymphatic invasion (LF = 36 p. 100). Two factors increased the DM risks: perineural invasion (DM = 43 p. 100); lymph node metastasis (DM = 37 p. 100). The multifactorial analysis showed that the risk factors were the same for LF as for DM. Perineural invasion (p less than 0.001), lymph node metastasis (p less than 0.002), level of extension of the tumor in the rectal wall (p = 0.005) were the most important factors for local recurrences. Lymph node metastasis (p less than 0.001), perineural invasion (p = 0.03) and level of extension in the wall (p = 0.05) were the most important factors for DM. These data suggest that a failure risks scale may be established and can be of help in stratifying patients in adjuvant treatment studies.

Adenocarcinoma↗
PubMed1985

Bronchial carcinoma after cervical carcinoma.

In a series of more than 2500 patients with cervical carcinoma who were regularly surveyed after treatment, ten cases of bronchial carcinoma confirmed by biopsy were found. The mean delay between the diagnosis of the cervical carcinoma and bronchial carcinoma was 28 months. This long interval, particularly when there was no distant metastases, raises questions about whether bronchial metastasis of cervical carcinoma or a second primary occurred. Comparisons with data of population cancer registries argue in favor of metastasis.

Adult↗
PubMed1985

Results of radiotherapy alone in 581 patients with Stage II carcinoma of the uterine cervix.

From January 1976 to December 1978, 581 previously untreated patients with Stage II carcinoma of the uterine cervix were treated by radiotherapy alone in nine departments of radiotherapy in France. This retrospective analysis was undertaken in an attempt to evaluate the therapeutic results and prognostically significant factors. The initial clinical staging and the therapeutic guidelines were as outlined at the U.T. M. D. Anderson Hospital in Houston; all our patients were treated by standardized protocols combining external beam irradiation and intracavitary irradiation with cesium sources. The overall locoregional control rate was 83.2%, with total disease control of 74.5%. Uncorrected actuarial survival rates are 76% at 3 years and 68% at 5 years. The incidence of severe posttherapeutic complications is 7.2%. Clinical substaging, patient's age at the time of the diagnosis, lymphangiogram findings, and tolerance to external irradiation were all found to have prognostic significance. According to those findings, the possibilities of improving the results are discussed.

Actuarial Analysis↗
PubMed1985

[Cancer and suicide].

The risk of suicide seems to be higher among cancer patients than in the general public. The four large studies available on this subject concern either the prevalence of cancer among death by suicide or the rate of death by suicide among cancer patients collected by a population cancer registry compared to the rate of suicide in the general population. In these studies an increased risk of suicide has been noted especially among men over 60 with advanced tumors and in whom the diagnosis of cancer has been made recently.

Adult↗
PubMed1985

[Treatment of secondary cancer of the spine].

Sixty spinal metastases have been treated surgically. In 22 cases a posterior approach was made with decompression laminectomy and internal fixation. In 38 others an anterior approach was made to resect the vertebral body and replace it by cement. In the thoracic and lumbar spines, internal fixation after a posterior approach led to secondary displacement in five cases out of nine. In contrast, spines approached anteriorly remain stable. The results were analysed after a follow-up period ranging from six months to four years. In most of the cases there was a dramatic improvement in spinal and radicular pain. Twenty-three cases had neurological impairment and in 15 of them this was improved, sometimes with complete recovery. The authors consider that surgery is indicated in metastasis of the vertebral body with collapse of the vertebra and bony compression of the spinal canal. In these cases radiotherapy is relatively ineffective. In contrast the results obtained after surgery in cases with epidural involvement are not better than those obtained by radiotherapy. Surgery should therefore be used only in radioresistant tumours.

Adult↗
PubMed1983

Dental preservation in patients irradiated for head and neck tumours: A 10-year experience with topical fluoride and a randomized trial between two fluoridation methods.

Since 1972, the dentures of 935 patients irradiated for head and neck carcinoma have been preserved after careful selection and according to well-defined criteria, using a prospective programme of daily applications of topical sodium fluoride gel. The results of 1-10 years follow-up are given. Four percent of the patients developed a diffuse dental decay and 1% a bone necrosis which can be related to the dental preservation. None of these complications occurred with careful patient selections nor when programme compliance was maintained. Post-irradiation dental extractions were performed in 29 cases with subsequent healing in all cases but one. The surgical technique of such extractions is described. In March 1980, a randomized protocol was activated to compare the use of the sodium fluoride gel to high content fluoride toothpaste (1350 ppm F-). Two hundred and twenty patients were entered. At 12-36 months follow-up, dental caries were observed in 3% of the patients receiving the fluoride gel as compared to 11% receiving the toothpaste (p = 0.1). However, none of the patients adhering to the programme instructions failed in either arm. Currently, it seems reasonable to state that preservation of teeth in irradiated patients should be the rule and not the exception, given good dental condition prior to treatment and patient cooperation. The 5 min daily application of fluoride gel is the most reliable method for prevention of post-irradiation dental caries. The twice daily use of high content fluoride toothpaste is a good alternative provided its limitations are well understood by the clinician and patient.

Administration, Topical↗
PubMed1983

Cancer registries: their interest and practical problems.

Cancer registries record all new cases of cancer within the population they survey. Thus they provide accurate regional measurements of cancer morbidity and mortality and their geographical distribution. This form of epidemiology allows the study of regional variations and alterations with the passage of time. It also allows the study of environmental factors that might cause cancer. The work of the French regional cancer registries is described to illustrate these points. The problems of running a cancer registry are also set out and suggestions are made for future organization. The statistics gathered by such registries indicate possible methods for the early detection and treatment of some cancers and provide evidence of the long-term effects of all kinds of therapy. The socio-economic aspects of cancer can also be measured by the registry, thus providing valuable data for use in the planning of health care in any community.

Epidemiologic Methods↗
PubMed1982

Ossification of the posterior longitudinal ligament after cervical irradiation.

A case of ossification of the posterior longitudinal ligament (PLL) at the cervical level one year after cervical irradiation is reported. This condition is rare in Caucasian people. The cause is unknown. The particular circumstances of ossification occurrence in the case reported allow us to propose a new etiological hypothesis.

Adult↗