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T Le Chevalier

Publications and source records attributed to T Le Chevalier.

At least 163 records · Page 9Linked to original sources
PubMed1989

Phase II trial of methotrexate-FAM (m-FAM) in adenocarcinoma of unknown primary.

Nineteen patients with adenocarcinoma of unknown primary were treated with the m-FAM regimen, consisting of methotrexate 50 mg/m2 days 0, 28; 5-fluorouracil 600 mg/m2 days 1, 8, 29, 36; Adriamycin 30 mg/m2 days 1, 29; and mitomycin-C 10 mg/m2 day 1. All drugs were recycled every 56 days. No complete responses were seen. Seven patients (37%) achieved partial remission for a median duration of 11 months. An additional nine patients (47%) had stable disease for a median duration of 6 months. Median survival for responders was 16 months and was 10 months for those with stable disease. Toxicity was acceptable. This Phase II study attempted to evaluate the clinical impact of the pharmacological modulation of 5-fluorouracil with methotrexate, the goal being improvement of the results of FAM alone in adenocarcinoma of unknown primary. However, the addition of methotrexate, at least in the schedule employed in this study, did not appear superior to FAM.

Adenocarcinoma↗
PubMed1989

Limited small cell lung cancer: possible prognostic impact of initial chemotherapy doses.

While the effect of chemotherapy dose on tumor response in small cell lung cancer has been fairly well established, the effect on survival has been retrospectively analyzed only in some series. This particular point was studied in a series of 52 consecutive patients with limited small cell lung cancer treated by an alternating radiotherapy-chemotherapy schedule. The induction treatment consisted of 6 chemotherapy cycles (the planned doses were: doxorubicin 40 mg/m2 day 1, VP16213 75 mg/m2 days 1-3, cyclophosphamide 300 mg/m2 days 3-6, and cisplatinum 100 mg/m2 day 2) alternated after the first 2 cycles with 3 courses of thoracic radiotherapy delivering a total dose of 55 Gy. Eighty-one percent of patients went into complete remission and the 3-year relapse-free survival was 24%. A multivariate analysis of prognostic factors took into account age, sex, T stage, performance status, delayed hematological toxicity to the first course of chemotherapy, actual dose/m2 of each drug during the first course and mean dose/course delivered during the induction treatment after the first cycle of chemotherapy. It was possible to identify 3 independent factors influencing overall survival and relapse-free survival: actual initial dose of cisplatinum, actual initial dose of cyclophosphamide and the T stage. The effect of the initial dose of cisplatinum and cyclophosphamide proved to be linear on relapse-free survival. The results of this analysis show a possible effect of initial doses of chemotherapy in the management of limited small cell lung cancer in terms of both distant metastasis and overall survival rates.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Role of radiotherapy in the treatment of small cell lung carcinoma].

For several years, chemotherapy has been the only treatment of small-cell carcinoma of the lung, but radiotherapy is increasingly used for its local effect in various ways. Irradiation of the chest alternating or concomitant with chemotherapy has become a basic principle in localized forms of the disease and may perhaps be useful in its diffuse forms. The so-called "prophylactic" brain irradiation is routinely performed, even though its beneficial effect on survival has not yet been demonstrated. As for extensive irradiation, it is still under study. Radiotherapy therefore plays an important role which, added to that of chemotherapy, should result in an improvement of long-term survival in patients with small-cell carcinoma of the lung.

Brain↗
PubMed1989

[Results of a phase II study of the combination of cis-platinum and 5-FU in epidermoid or undifferentiated large cell bronchial cancer].

The aim of this study was to test cisplatinum and 5-FU chemotherapy. Thirty-five patients with epidermoid or undifferentiated lung carcinoma were entered in a multicentric phase II trial, in an attempt to further define the activity and toxicity of this association. None of them had been previously treated by chemotherapy. The dosage schedule was cisplatinum 100 mg/m2 D1 and 5-FU 1 g/m2 D1 to D5 every 3 weeks for 3 courses before evaluation. There were CR: 2, PR: 10, for a total response rate of 35%. Median survival was 7 months. Tolerance was acceptable. We conclude that this association can be safely administered, but that the results are not superior to others previously reported. Further studies are required to define the activity of a cisplatinum, 5-FU and radiotherapy association.

Adult↗
PubMed1989

[Treatment of inflammatory cancer of the breast. Combined chemotherapy and radiotherapy. Apropos of 270 women treated at the Institut Gustave-Roussy].

From January 1976 to January 1985, 210 patients (less than 70 years old) with unilateral inflammatory breast carcinoma M0 were treated, under protocol way, by chemotherapy, hormonotherapy and radiotherapy association. Results of these protocols are compared to those of an historical control group T (60 patients treated from 1973 to 1975 by radiotherapy alone, with castration for pre-menopausal women). From 1976 to 1980, 91 patients (group A) were treated by induction chemotherapy first with adriamycin, vincristine and methotrexate (AVM), loco-regional radiotherapy and maintenance chemotherapy with vincristine, cyclophosphamide and 5 fluorouracil (VCF). From 1980 to 1982, 79 patients (group B) were treated under a similar protocol, but the 3 first sequences were reinforced with the association of five drugs: adriamycin, vincristine, cyclophosphamide, methotrexate, 5 FU (AVCMF). From 1983 to 1985, 40 patients (group C) were treated under the same schedule AVCMF, AVM, VCF, but radiotherapy was delivered on a different schedule to shorten the intervals between the 3, 4, 5 and 6th chemotherapy sequences. All patients form the groups A, B and C had received hormonotherapy: castration for premenopausal patients or on-going menopause, or tamoxifen for post-menopausal patients. Disease-free survival rates at 30 months are respectively 19, 37, 61 and 64% for groups T, A, B and C and for groups T, A and B: 8, 22 and 40% at 5 years, and total survival rates at 5 years: 28, 40 and 55% for these groups. The benefit of chemotherapy in addition to radiotherapy is highly statistically significant. The improvement of these results seems partially linked to the increasing dosage of the induction chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Therapeutic advances in small cell bronchial cancers].

Small cell lung cancer is one of the most chemo and radiosensitive adult solid malignancies. The effects of treatment should be evaluated according to standardized rules to ensure reproducibility. Recent randomized clinical trials have shown that combined chemo and radiotherapy can improve survival. A 5-year survival rate of 20 per cent can be obtained for an initially limited disease. However, further improvement of results requires optimized drug combinations and multimodality approaches as well as a better integration of new biological concepts in therapeutic trials.

Carcinoma, Small Cell↗
PubMed1988

Radical radiotherapy alone in non-operable breast cancer: the major impact of tumor size and histological grade on prognosis.

This retrospective study involved 319 non-operable breast cancer patients treated by radiotherapy alone with doses of 65 Gy at the Institut Gustave-Roussy (IGR). These patients either had operable tumors but were unfit for general anesthesia or had inoperable tumors due to local contraindications. Most of them had advanced tumors: 21% less than 7 cm; 30% N2 or N3; 30% with inflammatory carcinomas. The 5- and 10-year survival was 40 and 19%, respectively. The local and distant relapse-free rate was 56 and 33% at 5 years and 44 and 28% at 10 years respectively. Results were analyzed according to tumor size, clinical node involvement, histologic grade, age, skin invasion and tumor dose. A multivariate analysis demonstrated that tumor size (p = 10(-3)) and histological grade (HG) (p = 10(-2)) were both significant factors predicting local relapse. Histological grade (p = 10(-3)), tumor size (p = 10(-2)) and clinical node involvement (p = 10(-2)) were the most significant factors predicting distant relapses. An individual risk (IR) of local recurrence and of distant recurrence was defined according to the above factors and was demonstrated to be good prognostic index. Tumor doses above 80 Gy did not increase local control. We recommend the general use of histological grading as it seems important for prediction of local and distant control in patients treated by radiotherapy alone.

Actuarial Analysis↗
PubMed1988

Combination of chemotherapy and radiotherapy in limited small cell lung carcinoma: results of alternating schedule in 109 patients.

One hundred nine patients with limited small cell lung carcinoma were entered in a phase II study of treatment consisting of alternating 6 cycles of combination chemotherapy and 3 courses of mediastinal radiotherapy. Chemotherapy consisted of 40 mg doxorubicin/m2 on day 1; 75 mg etoposide/m2 on days 1, 2, and 3; 300 mg cyclophosphamide/m2 on days 3, 4, 5, and 6; and 400 mg methotrexate/m2 on day 2 (plus folinic acid rescue) or 100 mg cisplatin/m2 on day 2. The total mediastinal radiation dose was 45 or 55 Gy. A 6- to 8-cycle maintenance chemotherapy followed this induction protocol. The complete remission rate at the end of the induction therapy was 79%. The local recurrence rate was 25%, and the distant metastases rate was 52%. Median survival is 17.2 +/- 1.2 months and survival rate at 3 years is 26%. Lethal toxicity occurred in 3% of the patients, and long-term survivors are being evaluated. Our results justify further investigations with this alternating schedule.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Recent progress in the biology of small cell bronchial carcinoma].

Progress achieved in the understanding of small cell lung cancer (SCLC) include: the establishment and characterization of cell lines with the identification of a variant type with poor prognosis; the use of non-specific biochemical markers such as neuron specific enolase (NSE) and calcitonin; the generation of monoclonal antibodies (MoAbs) directed against SCLC antigens; growth factors including GRP and IGF. GRP or human bombesin produced by the tumor cells favours their own growths; in cytogenetics, with the observation of a characteristic chromosomal abnormality: the deletion of the short arm of chromosome 3 (3p 14-23). The region deleted is currently under study to identify the genes potentially involved in the oncogenesis of SCLC. the activation of several oncogenes: C-myc, N-myc, L-myc, Myb, Raf-1. The amplification of C-myc favors the tumor cell progression and is related to a bad prognosis. This biological approach has confirmed the neuroendocrine origin of these tumor cells (as a result of protein studies of the cytoskeleton and of MoAbs); it has allowed the use of tumor markers in the diagnosis and work-up of SCLC and the consideration of new therapeutic approaches. Current studies concern the deletion of 3p- and the integration of the cytogenetic data, growth factors and oncogenes in a coherent model of the genesis of SCLC.

Biomarkers, Tumor↗
PubMed1988

Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients.

We studied 302 consecutive autopsied patients who presented with carcinoma of unknown primary origin. The most frequent metastatic sites were the nodes, lung, and bone. The primary site was identified while patients were alive in 27% and at autopsy in 57%; the site remained unidentified in 16%. The pancreas (26.5%), lung (17.2%), kidney (4.6%), and colorectum (3.6%) were the most frequent primary sites, but the reliability of diagnostic tests used in the search for this site was disappointing. Survival was identical in patients whose primary site was discovered while alive, at autopsy, or remained unknown. The number of metastases at presentation was the major prognostic factor. Analysis of autopsy data demonstrated that patients with carcinoma of unknown primary origin pursue a different course than expected when the primary site is the first manifestation of the disease. On the basis of these results and the results of other modern series, we suggest an approach consisting of a limited initial workup but with greater emphasis on modern histochemistry studies and immunohistopathologic and other kinetic and morphologic parameters to understand the patient tumor characteristics better and base the clinical management on an individual basis.

Actuarial Analysis↗
PubMed1988

Epithelioid sarcoma of soft tissues: a case of extrarenal renin-secreting tumour.

The case of a young woman presenting with a renin-secreting soft tissue sarcoma is described. The primary extrarenal tumour as well as metastatic disease were associated with severe hypertension and both required surgical treatment. The location of these rare malignant tumours and their association with renin-dependent hypertension is discussed. In cases of this type, reappearance of hypertension suggests tumour recurrence.

Adolescent↗