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Biomedical subjects

C Bouffioux

Publications and source records attributed to C Bouffioux.

At least 19 recordsLinked to original sources

Adjuvant chemotherapy of recurrent superficial transitional cell carcinoma: results of a European organization for research on treatment of cancer randomized trial comparing intravesical instillation of thiotepa, doxorubicin and cisplatin. The European Organization for Research on Treatment of Cancer Genitourinary Group.

A total of 356 patients with recurrent superficial transitional cell carcinoma of the bladder was entered in a randomized clinical trial to compare intravesical thiotepa, doxorubicin and cisplatin with respect to the recurrence rate and disease-free interval. After complete transurethral resection of all visible lesions, the drugs were administered weekly for 4 weeks and monthly for 11 months. The recurrence rates per year were 0.50 for thiotepa, 0.54 for doxorubicin and 0.58 for cisplatin. Of 266 patients (mean followup 41 months) 35 reported an increase in T category and 19 of them had distant metastases. No association between treatment and progression was noted. Thus, there is no difference among treatments with respect to efficacy. However, severe anaphylactic reactions were observed in the cisplatin arm and chemical cystitis was more frequently reported in patients who received doxorubicin.

Administration, Intravesical

Original lithotomy positioning for transperineal extracorporeal shockwave lithotripsy for distal ureteric calculi with Tripter X1.

Extracorporeal shockwave lithotripsy (ESWL) has been initially designed for stones located in the kidney and the upper ureter. Our lithotripter is no exception. Its components (the table and the orientation of the semi-ellipsoid reflector) are adapted for the treatment of kidney or lumbar ureter stones. However, the elements forming the unit of treatment (the table, the C-arm and the Tripter) can be modified in such a way that focalization of stones of the lower ureter becomes possible through a perineal exposure. The aim is to avoid the pelvic bone shield while a good focalization of the stone is realized. From June 1989 to March 1991, 35 patients were treated for distal ureteric stones by ESWL in this original positioning.

Adolescent

The staging of M+ disease.

Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by: (1) Clinical history especially of weight loss, recent pain, or analgesics intake. (2) Physical examination, looking especially for hepatic enlargement, peripheral lymph nodes, local bone tenderness. (3) Performance status. (4) Hemoglobin, creatinine, PSA and/or PAP, alkaline phosphatases, liver tests, testosterone. (5) Bone scan with X-ray of doubtful hot spots. (6) Chest X-ray. (7) Ultrasound scans (liver, kidney, lymph nodes) or CT scan may be indicated if abnormal blood parameters or in specific situations. (8) Other investigations are only indicated in special circumstances. Follow-up should include: (1), (2), (3), (4) every 3 months. For patients in clinical trials, depending on the end point, bone scan should be repeated every 6 months or possibly depending on the prognostic group (good: every 12 months; bad: 3 to 6 months). For routine clinical management, it could be repeated only when markers (PAP, PSA, alkaline phosphatase) show significant (25-50%) increase and provided the result will influence treatment. Other investigations should only be repeated or performed if abnormal at the start of if clinical data require them.

Biomarkers, Tumor

Total androgen blockade in advanced prostatic cancer. Critical review and personal experience.

The theoretical basis of 'total androgen blockade' in the treatment of advanced prostatic cancer is reviewed. The results of experimental and clinical data in the literature comparing medical or surgical castration alone versus castration plus peripheral antiandrogens are discussed. Most of these studies could not reproduce Labrie's results and do not establish the benefit of total androgen blockade. The author produces his own experience with LHRH analogs alone (Depot Zoladex; 30 patients) compared to orchidectomy plus antiandrogens (17 patients). After 2 years, there is no difference in the progression and death rates between the two groups. Moreover, the administration of an antiandrogen in 15 patients relapsing after first-line hormonal treatment (Zoladex or orchidectomy) produced an objective response in only 2 of them. 9 patients experienced a subjective response but the duration of response was very short (medium 3 months).

Androgen Antagonists

[Which intravesical chemotherapy for what tumor of the bladder?].

The rationale for adjuvant chemoprophylaxis in superficial bladder cancer treated by transurethral resection is discussed. Many questions remain unsolved as far as chemoprophylaxis in concerned. The authors try to answer them through an analysis of the results of prospective and randomized studies undertaken by the EORTC genito-urinary group for 12 years. Advantages and disadvantages of the most common agents (Adriamycin, Epodyl, Mitomycin, Thiotepa, BCG) are analyzed; an attempt is done to define instillations regimens; indications and results of these adjuvant treatments are studied.

Administration, Intravesical

[Urethritis].

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Female