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Biomedical subjects

C Jacquillat

Publications and source records attributed to C Jacquillat.

At least 55 records · Page 3Linked to original sources
PubMed1986

Short-term results of the combination of cis-platinum, 5-fluorouracil and bleomycin in advanced upper aerodigestive tract cancers.

Randomized trials comparing radiotherapy alone with combined radio- and chemotherapy are reviewed. Some 184 patients with advanced upper aerodigestive tract cancers were treated between November 1982 and December 1983 before any loco-regional treatment by three courses of the combination of cis-platinum, 5-fluorouracil and bleomycin, given every three weeks. At the end of three courses 88% of patients (162/184) were evaluable. Among these 162 patients, 102 achieved complete macroscopic remission or over 50% regression. Oropharyngeal cancers were most responsive, whereas results were less satisfactory for oral cancers. Histological sterilization was observed in 30% of patients with complete macroscopic regression. Toxicity was moderate. It is too early to appreciate the the survival benefit.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Neoadjuvant chemotherapy of breast cancer.

About 80% of patients with breast cancer ultimately die of metastatic disease at 20 years. Distant metastases are more important as a cause of death than local or regional relapses. It is for this reason that adjuvant chemotherapy is necessary, especially in young patients and those with extensive disease. Initial chemotherapy preceding any local or regional treatment is justified on the grounds that both surgery and anaesthesia lead to immunodepression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials by Nissen-Meyer, Bonadonna and Cooper (1-3). In the present study 145 patients, including 67 with inflammatory breast cancer (IBC), were treated with 4-6 weeks of Velbe, thiotepa, methotrexate, fluorouracil and prednisone, with Adriblastin added for patients with IBC, T greater than 7 cm, or N2, N3. Because of tumour regression of greater than 50% observed in 80% of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium), resulting in complete remission in all these cases. Maintenance treatment with the same drugs was prescribed for 6-18 months depending on the initial stage. Tumour regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest being 42 months. Overall survival at 2 years for IBC is 90%, with a disease-free survival of 80%. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Chemotherapy at home. A new methodology].

Evolution in concepts relative to administration of cytotoxic drugs has reinforced interest in the use of continuous infusion therapy, a method providing a twofold increase in upper respiratory and digestive tract cancer response. A new method, developed by the authors since early 1985 allows the use of chemotherapy over 5 to 10 days in the patient's home. Preliminary results show an increase in efficacy of the therapy, and a marked improvement in the patient's comfort, suggesting that the indications for this new method should be enlarged.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Malignant melanoma in children and adolescents. Apropos of 37 cases].

Thirty seven cases of malignant melanoma, all before 20 years old people were reviewed from the records of the Lariboisière-Saint Louis Melanoma Group. Clinical characteristics were similar to those encountered in adults. However, the incidence was higher around puberty and in a pre-existing naevus (20 patients, 54%). Histologically, it was often difficult to differentiate between Spitz melanoma and a common naevus. Prognostic factors appear to be similar to those in adults. No case of naevus of less than 2 mm thickness metastasized, relapse occurring in nodular melanoma (8/14) and when the level in invasion was deep (6/13). Overall survival of 70% at 5 years is comparable to that in over 20 years old group (58%) but better than in other studies on children who did no received chemotherapy. Early detection (difficult in children) offers the best chance of cure.

Adolescent↗
PubMed1985

[Induction chemotherapy of cancers of the upper respiratory and digestive tract. Analysis of tumor response in 176 patients].

Tumoral responses to 3 courses of induction chemotherapy were investigated in 176 patients with squamous cell carcinomas of the head and neck previously untreated. The number of responses increased with the number of courses. Thus, out of 79 patients with a more than 50% response after the 3 courses, almost one third had no response after the first course, and 98.8% had a less than 50% response after the second course. In consequence, it may be stated that a 3rd and perhaps a 4th course is justified in patients who responded after 2 courses. There seems to be a poor correlation in responders between clinical and histological results: 68.5% of patients with complete response still had a tumour on the excised tissue. No correlation was found between the influence of T in the TNM clinical classification and that of squamous cell differentiation on the one hand and the macroscopic character of the tumour during response on the other hand.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Malignant pheochromocytoma. A case].

A case of malignant phaeochromocytoma is reported. The primary tumour was removed in 1970. Metastases were diagnosed in 1979 and management of the condition included antihypertensive treatment with alphamethylparatyrosine, antitumoral chemotherapy and surgical reduction of secreting tissue. In these rare tumours malignancy can only be confirmed by metastases, i.e. presence of chromaffin cells in loci where they are not usually found. Histology is of little value. High levels of catecholamine precursors or their metabolites in the urine may be a sign of malignancy, but some asymptomatic tumours are only revealed by metastases. Computerized tomography and radioisotope scanning with I131 metaiodobenzylguanidine are the best available methods to locate the lesions. In view of the small number of cases and of the unpredictable course (sometimes spread over many years) of malignant phaeochromocytomas, the effectiveness of treatments with alphamethylparatyrosine, chemotherapy and radiotherapy is difficult to evaluate.

Adrenal Gland Neoplasms↗
PubMed1985

Phase II evaluation of diaziquone (CI-904, AZQ) in the treatment of human malignant glioma.

Diaziquone, a new alkylating agent which crosses the blood brain barrier, has shown a 20% response rate in phase II studies in heavily pretreated patients. We have treated 23 patients at our institution as part of a multicentric phase II European trial of diaziquone. All had histologically proven malignant glioma unequivocally progressing on CT scan. Prior therapy had consisted of surgical excision (13 patients), cobalt radiotherapy to CNS (13 patients), and chemotherapy with nitrosourea derivatives (11 patients). Six patients had no prior therapy. Median age was 42 years (range 22-69) and performance status was 3+ or better. They were treated with monthly courses of diaziquone 5.5 mg/m2 I.V. (10 min.) X 5 days. Dosage adjustments were made according to leucocyte and platelet nadirs. Thrombocytopenia was the dose limiting toxicity. Very mild gastrointestinal toxicity was observed. One patient developed hemolytic anemia. One complete response (clinical and CT scan), 7 partial clinical responses (3: greater than 50%, 4: 25-50%), and 1 disease stabilization (less than 25%) were documented. The longest response has now lasted over 26 months. These preliminary results show that chemotherapy with diaziquone can achieve a response rate as high as 35% in malignant glioma even in patients previously treated with a chemotherapy regimen including a nitrosourea (four of the seven objective responses were seen in such patients). Diaziquone is well tolerated and deserves further study in the management of malignant glioma.

Adult↗
PubMed1985

The association of chronic lymphocytic leukaemia and multiple myeloma: a study of eleven patients.

We present haematological and immunological data obtained in 11 patients with the rare association of chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM). CLL occurred before MM in six cases and both diseases were diagnosed simultaneously in five. With regard to CLL, no peculiar clinical feature was found; in six patients, MM was characterized by extra-osseous lesions. A significant remission (3-7 years) was obtained in three patients. In six patients, CLL and plasma cells synthesized Ig molecules with different light chains, probably indicating the coexistence of two distinct clonal proliferations. In two cases where monoclonal Ig synthesized by both types of cells had the same type of light chains, studies with anti-idiotypic antibodies showed that the two proliferations were also distinct. The pathophysiology of this rare association is discussed in the light of these findings and of data from the literature.

Aged↗
PubMed1985

[Induction chemotherapy in cancer of the upper respiratory and digestive tract. Preliminary results of the protocol combining cisplatin, 5-fluorouracil and bleomycin (CFB)].

Prognosis in cancer of the upper respiratory-digestive tract (URDT) is dominated by the importance of local and regional spread, of second localizations or metastases and of any underlying clinical condition. Stable results are obtained using local and regional treatment (surgery and/or chemotherapy) alone, and the use of chemotherapy has been evaluated since 1965, neo-adjuvant cancer chemotherapy being adapted in 1970 for cancer of URDT. From november 1982 to december 1983, 184 patients with epidermoid cancer of URDT were treated by combined therapy with Cisplatin, 5 Fluoro-uracil, Bleomycin as a continuous infusion. Results are presented of the different tumoral responses as a function of localization and stage, excluding any glandular responses.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Adjuvant chemotherapy of intraocular malignant melanoma. Apropos of 20 cases].

The frequency of haematogenously propagated hepatic metastases occurring from intra-ocular melanoma led us to treat 20 patients with adjuvant chemotherapy. 19 patients starting chemotherapy during the month following enucleation and one patient, a year after enucleation. With a median follow-up of 6 years, 17 patients (80%) are disease-free. Three patients developed hepatic metastases at 24, 24 and 30 months respectively. The résults suggest that adjuvant chemotherapy is effective in preventing metastases from intra-ocular melanoma.

Adolescent↗
PubMed1984

[Role of chemotherapy in the treatment of bone metastases of breast cancer].

This study was made on 98 patients with breast cancer, whose first discovered metastasis was to the bone, a mean of 2.8 years following the initial diagnosis. It is most often a lytic lesion, and the majority of patients have more than two areas on bone scintiscan. About half of the patients received palliative radiotherapy; 16 had to undergo surgery for or to prevent pathologic fractures. All patients underwent chemotherapy with vincristine or vinblastine, methotrexate or cyclophosphamide, 5-fluorouracil and, in 37 cases, the addition of adriamycin. Half of the patients also received tamoxifen. Present studies show a mean survival of 31 months with 24% survival at five years. Age, the interval to the discovery of the first metastasis, the use of additional chemotherapy following surgery for the breast lesion, the sedimentation rate, and the number of bony metastases do not play any prognostic role. However, the prognosis is significantly improved by adding tamoxifen, and even more so by adding adriamycin to the chemotherapeutic protocol since mean survival improves from 26 to 52 months. The reduced incidence of bony metastases with chemotherapy following surgery had led some authors to believe that prevention is the best method of treating bony metastases from breast cancer.

Adult↗
PubMed1984

[Hepatic metastases. Value of chemotherapy by the intra-arterial route].

Forty-three patients with metastatic liver cancer were treated with multiple chemotherapy by the intra-arterial route. Metastases originated from primary cancer of the breast (16) or colon (10), melanoma (7) and miscellaneous tumours (10). In 35 patients chemotherapy was administered by selective catheterization of the hepatic artery via the axillary artery; it usually (31 cases) consisted of doxorubicin (60 mg/m2) and mitomycin (10 mg/m2) injections, and continuous infusion of 5-fluorouracil (1 g/24 or 72 hours). In 14 patients (10 responders to the above method and 4 new cases), a catheter with subcutaneous chamber was implanted surgically so that chemotherapy could be continued through the chamber. Blood toxicity was usually moderate. The main complication of injections through the catheter (114) or through the chamber (60) was thrombosis. However, except for 1 lethal cerebral thrombosis, the others (axillary artery 3, hepatic artery 5) were unattended by functional symptoms. Transient biochemical signs of hepatic cytolysis were frequent after each course. Hepatic insufficiency was severely aggravated in 2 cases. Painful digestive disorders were relieved by symptomatic treatments. Four complete responses, 16 partial responses, 8 stabilizations and 10 failures were observed; 5 patients died soon after one single course of intra-arterial therapy. The high response rates (greater than 50%) in metastases from cancer of the breast and colon, and chiefly the 3 complete responses obtained in patients with mammary carcinoma were most encouraging, bearing in mind that one of these 3 patients had not responded to intravenous chemotherapy.

Adult↗