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Biomedical subjects

D Brune

Publications and source records attributed to D Brune.

100 records · Page 6Linked to original sources

[Radiotherapy of stage T1-T2 M0 prostatic adenocarcinoma. Analysis of the carcinologic results of a multicenter study of 610 patients. Groupe Radiothérapie de la Commission de Coopération Médicale Intercentres (CCMI)].

PURPOSE: Retrospective analysis of the results of radiotherapy in localized prostatic adenocarcinoma. Complications were excluded. PATIENTS AND METHODS: Six-hundred-and-ten T1-T2 adenocarcinomas of the prostate were treated with continuous courses of external beam radiation therapy in 19 participating Institutes between January 1983 and January 1988. The mean follow-up was 10.4 years; the mean age of patients at the beginning of radiotherapy was 68.5 years. RESULTS: A 10-year, local control had been achieved in 86% of T1-T2 (81.4% for T2). The 5- and 10-year metastatic relapse rates were 25.3% and 30% (29% and 38.1% for T2), respectively. At 10 years, 62.4% of T1-T2 were recurrence-free; overall survival rate was 45.8% and cause-specific survival rate was 70.5%; 29.9% of T1-T2 patients were alive and disease-free. T category (TNM), pathologic grade, pelvic lymph node status, local tumor control, and obstructive ureteral symptoms were correlated with survival. The influence of pelvic nodes radiation, dose, overall treatment time, previous endocrine treatment, and transuretral resection was not significant for disease-free survival (alive and disease-free) and other endpoints. CONCLUSION: There was no difference between the French series (1975-1982 and 1983-1988). The results of the literature are comparable to ours. As far as prognostic factors are concerned, this report provides evidence that the explainable variables which influence survival depend on the tumor and patient status.

Adenocarcinoma↗

[Age at the time of the first birth: a variable with simple, double, or triple significance in breast cancer studies].

I.--The inverse relationship of risk with parity is one of the earliest known features of the epidemiology of human mammary cancer. But recently knowledge of this relationship was refined when Mac Mahon and his colleagues found that the protective effect is actually correlated to the age of the mother at the first birth rather than to the total number of children, so that a woman who has a child before the age of 18 is one third as likely to suffer breast cancer in later life as a woman first delivered at 35. II.--A study was undertaken in the Centre Francois Baclesse on the hypothesis that age at first birth may also be related to the age of the patient at clinical onset of the mammary malignancy. One would expect to find a retardative effect of early delivery since this factor was found to be protective as far as mammary cancer risk is concerned. The conclusions of our investigations are in complete opposition to the original hypothesis: in our series, breast cancer appears to occur significantly earlier in women whose first delivery occurred early. III.--Thus the same process appears to be protective as far as total mammary cancer risk is concerned but accelerating as far as age at tumor onset is concerned. These apparently inconsistent observations led to the hypothesis that both studies might express the same biologic process which, in the case of early delivery, inhibits the mechanism of carcinogenic induction and therefore reduces the total number of cancer but which subsequently quickens the evolution of the inducted disease. Such a conjecture implies that breast cancer should be more severe following early first birth. The analysis of our series, as well as the series of Ontario Cancer Clinics, substantiates this hypothesis. But these conclusions are built on indirect proofs or direct proofs which are still short of statistical significance.

Adolescent↗