Search PubMed⌕ Search

Biomedical subjects

A Thyss

Publications and source records attributed to A Thyss.

At least 145 records · Page 8Linked to original sources
PubMed1988

Toxicity of a combination of ABVD chemotherapy and mediastinal irradiation for Hodgkin's disease patients with massive initial mediastinal involvement.

The authors report on 5 Hodgkin's disease (HD) patients with a mediastinothoracic ratio greater than or equal to 0.35 treated by ABVD chemotherapy (adriamycin, bleomycin, vindesine, DTIC) and irradiation. All 5 patients developed complications and there was 1 death. Administration of adriamycin and bleomycin in combination with irradiation may have been responsible for this poor treatment tolerance. Use of such protocols, and especially use of ABVD after mediastinal irradiation, should probably be avoided in the management of patients with massive mediastinal involvement.

Adolescent↗
PubMed1988

[Combination transurethral resection and systematic chemotherapy as primary treatment of infiltrating bladder tumors (pT2-pT4 NxM0)].

From Sept. 83 to Sept. 86, 20 patients (pts), mean age 65 yr, with a muscle-infiltrating bladder tumor would normally have been treated by total cystectomy. Pts were staged by intravenous urography, pelvic and abdominal CT, physical examination under general anesthesia, and deep TUR, then given neoadjuvant chemotherapy: cisplatinum and 5-FU. Courses were given every 28 days. Results were evaluated after the 3rd and 6th courses by CT, IVP and TUR. 9 pts had a histologically confirmed complete clinical response (pCR: 6 pT2, 2 pT3, 1 pT4). Median follow-up in Jan. 1988 was 30 mo. (17-52). This protocol was objectively active and well tolerated, even by elderly pts. Problems remain concerning pCR pts: (1) the respective roles of chemotherapy and TUR on the outcome; (2) prevention of recurrence (5/9 pCR).

Adult↗
PubMed1988

[Subcutaneous rhabdomyosarcoma in children. Clinical, immunologic and ultrastructural aspects].

Embryonal rhabdomyosarcoma is the most frequent of tissue sarcomas in children. Its location in the subcutaneous tissue makes it a dermatological diagnosis. In childhood, the exact histological type of the tumour, sometimes difficult to determine, is absolutely necessary since prognosis and treatment differ according to the histogenetic form. Rhabdomyosarcoma is rare in adults. One must rule out malignant pleomorphic histiocytoma which has a more favourable prognosis. Among the antisera recently made available, those directed against desmin, foetal skeletal myosin and/or specific skeletal muscle myofilament seem to be most useful when associated with the anti-myoglobin antibody.

Child↗
PubMed1988

[Metastatic neuroblastoma: consolidation treatment with 2 courses of high-dose chemotherapy followed by a bone marrow autograft].

Among 62 children over 1 year of age at diagnosis who were treated for stage IV neuroblastoma, 33 entered remission after conventional therapy. They received high-dose chemotherapy and in vitro purged bone marrow transplantation as consolidation therapy. Fifteen patients received one course and 18 two courses. At present, 16/33 grafted patients are alive in CR with a median follow-up of 28 months. Toxicity of this regimen was tolerable. Under this treatment, actuarial disease free survival is improved compared with that observed under conventional therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Relationship between systemic 5-FU passage and response in colorectal cancer patients treated with intrahepatic chemotherapy.

The study described herein was conducted to analyze the relationship between tumor exposure to 5-FU and clinical response. Six patients were placed on continuous 5-day intrahepatic 5-FU chemotherapy for colorectal cancer metastasized to the liver. The starting dose was 600-800 mg/m2 per day; cycles were repeated at 4-week intervals. The 5-FU dose was increased by 250 mg/day at each cycle. All six patients received 3 or more cycles, for a total of 37 cycles. Response was evaluated after each cycle by ultrasonography or computed tomography (CT). Pharmacokinetic data revealed a high individual cycle-to-cycle variability for all six patients in the 5-FU area under the curve (AUC day 1 to day 5) corrected for the dose. These variations in drug biodisposition, reflecting hepatic 5-FU uptake, were significantly related to measurable modifications in the tumor mass in 71% of cycles. The correlation between the reduction in local drug exposure and tumor regrowth was better than that between the increase in local drug exposure and tumor reduction. These findings constitute an original illustration in humans of the experimental concept of the drug exposure/tumor response relationship for 5-FU.

Aged↗
PubMed1987

Effect of dose and repeat intravenous 24 hr infusions of methotrexate on cerebrospinal fluid availability in children with hematological malignancies.

This pharmacokinetic study examined the relationship between methotrexate (MTX) dose and drug concentrations in blood and cerebrospinal fluid (CSF) during repeated 24 hr infusions. Two regimens were used: an intermediate dose (ID) of 0.5 g/m2 (7 patients, 23 cycles) and a high dose (HD) of 2.5 g/m2 (8 patients, 39 cycles). Inter-patient variability in the drug concentration was apparent in serum and CSF for both doses. The dispersion was particularly wide in CSF for HD MTX. Considering median values, serum and CSF MTX were linked to dose escalation. Individual CSF/serum drug ratios were not modified by the dose (1.1% for ID MTX versus 1.4% for HD MTX). A potentially cytotoxic drug level in CSF (10(-6) M) was never obtained for ID MTX cycles, but was achieved in 44% of HD MTX cycles: for HD MTX, this corresponded to 88% of patients (7/8). Total body clearance did not modify the degree of CSF MTX passage. A positive, significant correlation (r = 0.62, P less than 0.05) was observed for ID MTX between individual serum and CSF MTX; no such relationship was seen with HD MTX. Individual cycle-to-cycle variations in the MTX concentration were particularly marked in CSF and for HD MTX, without strict concordance with blood levels.

Adolescent↗
PubMed1987

Non-renal urological lymphomas.

IVP, US and CT findings for 5 rare cases of non-renal lymphomas of the urinary tract are discussed. The 4 non-Hodgkin lymphomas (NHL) and 1 Hodgkin's disease (HD) involved the ureter (2 cases), bladder (2 cases) and renal pelvis (1 case). US and CT visualised the pyelic lesion (undetected by urography) as wall thickening and detected the two ureteral lesions (which were also revealed by antegrade pyelography for the 1 HD and by retrograde pyelography for an ureteral NHL). One bladder lesion was associated with a renal lesion (CT demonstrated retroperitoneal lymph nodes); the other was a multinodular form infiltrating the entire bladder.

Adult↗
PubMed1987

Lymphomatous superficial lymph nodes: US detection.

Superficial adenopathy is the most frequent clinical manifestation of lymphoma, both at initial workup and later when disease recurs. Data obtained by means of physical examination and ultrasonography (US) of the cervicosupraclavicular, axillary, and inguinal regions were compared for 120 patients, 60 at the time of initial staging and 60 during follow-up for a previously treated lymphoma. Twenty-nine in the second group had recurrent disease, as confirmed with histologic examination. For all 120 patients, US revealed clinically impalpable lesions in an average of 10.8% of cases for the cervicosupraclavicular region, 17.9% for the axillary region, and 4.1% for the inguinal region. Eight of the 29 relapses were not detected at physical examination, and three were demonstrated solely with US. These findings emphasize the value of US exploration of the superficial node-bearing regions in patients with lymphoma, during both initial staging and follow-up.

Biopsy, Needle↗
PubMed1987

Repeated high-dose chemotherapy followed by purged autologous bone marrow transplantation as consolidation therapy in metastatic neuroblastoma.

Among 62 children over 1 year of age at diagnosis, who were treated for stage IV neuroblastoma, 33 entered complete remission (CR) or good partial remission (GPR) after conventional therapy and received high-dose chemotherapy (HDC) with in vitro purged autologous bone marrow transplantation (ABMT) as consolidation therapy. The HDC was a combination of carmustine (BCNU), teniposide (VM-26), and melphalan. Thirty-three patients received one course of this regimen, and 18 received two courses. At present, 16 of the 33 grafted patients are alive in continuous CR, with a median follow-up of 28 months. Toxicity of this regimen was tolerable, principally marked by bone marrow depression and gastrointestinal (GI) tract complications. Four complication-related deaths were observed. Relapse post-ABMT occurred most often in the bone marrow. Under this treatment, actuarial disease-free survival is improved compared with that observed under conventional therapy.

Abdominal Neoplasms↗
PubMed1987

[Lymphoma of nasal and sinus cavities].

Seven cases of non-Hodgkin lymphoma of the nasal cavities and paranasal sinuses are reported. All but one were primary lesions. Five of the 7 cases involved only the facial structures. Sites of involvement were the maxillary sinus (4 cases), the nasal fossae (2 cases), and one case in which lesions of both the ethmoid and sphenoid sinuses were associated with intracranial extension. CT studies showed sinus opacification and invasion of adjacent structures, but bone destruction was inconstant. Follow-up studies during treatment revealed rapid tumor regression with non specific images of mucosal hypertrophy.

Aged↗
PubMed1987

[Subcutaneous sacrococcygeal ependymoma].

The main clinical manifestations and the natural course of subcutaneous ependymoma are reviewed in connection with a sacrococcygeal lesion in a 12 year-old girl. After complete resection, the outcome is usually favorable but the 20% risk of metastasis justifies a close surveillance.

Child↗
PubMed1987

[Cardiotoxicity of 5-fluorouracil. Spasm or direct myocardial toxicity?].

The authors report on a case of cardiotoxicity observed during a protocol including a 5-day continuous infusion of 5-fluorouracil; anginal manifestations recurred during a second treatment course. Coronary angiography, thallium scintigraphy and methergine test were all normal. An attempt to prevent the recurrence of such manifestations using a calcium inhibitor and nitroderivatives was unsuccessful. In connection with this case, six other with anginal manifestation and four sudden deaths under the same protocol, a review of the relevant literature is included in the discussion on the factors that may favor cardiotoxicity and the different etiopathogenic hypothesis. The generally accepted hypothesis is a coronary spasm but a direct cardiotoxicity of 5-FU cannot be. The only therapeutic possibility appears to be the definitive halt of 5-FU after the onset of such manifestations.

Aged↗
PubMed1986

[Adriamycin in low weekly doses. Latest therapy of advanced cancer of the breast].

Thirty-four patients with heavily pretreated advanced breast cancer received adriamycin in weekly doses of 12 mg/m2. Twenty-two patients (18 assessable) had a performance status greater than or equal to 3 (WHO scale). There were 5 (28%) partial responses, 7 (39%) minimal responses, 3 cases (17%) with no change and 3 (17%) with progressive disease; the mean duration of response was superior to 9 months (range: 3-12 months). In the remaining 12 patients, who had resisted a previous multidrug regimen containing adriamycin, there were 3 (25%) partial responses, 2 (17%) minimal responses, 4 cases (33%) with no change and 3 (25%) with progressive disease; the mean duration of response was superior to 5 months (range: 3-11 months). More than 600 weekly injections were administered with only minor blood and digestive tract toxicities. No alopecia was recorded. The total cumulative dose of adriamycin was superior to 900 mg/m2 in 8 patients; none had clinically evident cardiac toxicity. Adriamycin extravasation with subsequent tissue necrosis occurred on 10 occasions due to the frequency of administration; this problem was solved by the systematic installation of central venous catheters.

Adult↗
PubMed1986

Clinical and pharmacokinetic evidence of a life-threatening interaction between methotrexate and ketoprofen.

Co-administration of ketoprofen was found in 4 of 118 cycles of high-dose methotrexate (MTX) analysed retrospectively in thirty-six patients. All 4 cycles were characterised by severe MTX toxicity, which was fatal in three cases. Simultaneous administration of ketoprofen was associated with prolonged and striking enhancement of serum MTX levels. There were no abnormalities in MTX kinetics or evidence of MTX toxicity when ketoprofen was given at least 12 h after completion of high-dose MTX infusion. The kidney may be the site of drug interaction. This high-risk association between MTX toxicity and ketoprofen may also apply to other non-steroidal anti-inflammatory drugs.

Adolescent↗