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E Gamelin

Publications and source records attributed to E Gamelin.

63 records · Page 4Linked to original sources
PubMed1995

[Treatment of acute chemically induced diarrhea by inhibition of enkephalinase. Results of a pilot study].

BACKGROUND AND OBJECTIVES: Acute chemotherapy-induced diarrhoea may require reducing or even stopping subsequent therapy. Antidiarrhoeal drug efficiency has not been extensively studied and the effects of the new antisecretory compound acetorphan--a potent enkephalinase inhibitor active in acute diarrhoea--are unknown. The aim of this study was to investigate the possible effects of acetorphan on 5 FU-induced diarrhoea in man. MATERIAL AND METHODS: Fifteen patients reporting acute diarrhoea following chemotherapy were included in this study. They presented with metastatic colo-rectal cancer (n = 14) or pancreatic carcinoma (n = 1) and were treated, once weekly, by an 8-hour IV infusion of folinic acid 200 mg/m2 and 5 FU 1,800 to 3,000 mg/m2. In each patient, number and consistency of stools were assessed every day during the week following chemotherapy, once without (control period) and once with acetorphan p.o. 300 mg/d/7d. RESULTS: During the control period, 3 out of 15 patients did not have significant diarrhoea, but 2 out of 3 patients had abdominal pain which was relieved by acetorphan without appearance of constipation. Twelve out of 15 patients presented with diarrhoea (> 3 stools/day for > 2 days: WHO grades 2 and 3); with acetorphan, the number of stools per day was reduced in all cases from 6.3 (range: 3-10.6) to 4.9 (range: 2.6-8.9) (P < 0.002), and the number of days with liquid stools dropped from 4.7 (range: 2-7) to 2.4 (range: 0-7) (P < 0.02). In addition, during treatment with acetorphan, there was a close positive linear relationship between the percent reduction in the number of stools and the number of stools during control period up to a 8 stools/day level (8 patients) above which efficiency decreased (4 patients). CONCLUSION: These results suggest the efficacy of acetorphan on chemotherapy-induced diarrhoea and urgent need for a randomized controlled trial.

Acute Disease↗
PubMed1995

[Implantable sites in cancerology. The percutaneous technique. Results of a homogeneous series of 141 cases].

Percutaneous implantation sites were used by the same operator in 141 patients (87 females and 54 males) with usually metastatic cancer. A titanium Districath implantable chamber and a 1.1 mm inner diameter silicone catheter were used. Percutaneous venous access was via the subclavian vein in 139 cases (98.6%). Mandatory safety measures were emphasized. Insertion was complicated by puncture of the subclavian artery in 6 cases (4.2%). There were no case with abscess, disunion, infection or death due to the method. The chamber was removed in 7 cases due to: 3 ruptures of the catheter, 2 septicaemias, 1 rejection reaction and 1 psychological intolerance. In our series, percutaneous implantation via the subclavian vein has been a reliable and rapid technique with little morbidity.

Adult↗
PubMed1993

[Bone metastases of colorectal cancers: apropos of 8 cases].

Having found, in the same medical centre, an abnormally high (15%) frequency of bone metastases from colorectal carcinoma, the authors report a series of 8 cases and review what is now known of this reputed rare (4%) metastases. Their clinical and imaging features are not very different from secondary bone lesions of other origins. They usually appear approximately 5 years after the primary tumour has been diagnosed; and they are rarely isolated, being part of a diffuse metastatic disease; their prognosis is in fact conditioned by visceral metastases (liver, lung, peritoneum). Concerning treatment, pain relieving radiotherapy is crucial, as witnesses by the authors. Chemotherapy must always be prescribed for its proven effectiveness against visceral lesions. The other medicinal treatments (e.g. analgesics, bisphosphonates) are very useful. Surgery must be reserved to emergency situations (spinal cord compression) and to patients in good general condition. To our 8 patients these treatments brought comfort and increased survival. Survivals of at least 6 to 9 months were obtained, and one patient is still alive 14 months after the diagnosis of bone metastasis. These results compare favourably with the 4 months median survival observed in other series.

Adult↗
PubMed1993

[Paraneoplastic syndromes (1)].

Although not rare, paraneoplastic syndromes develop in a minority of cancer patients. Their exact frequency seems to be underestimated. These syndromes are hereby described. Their clinical usefulness is of great importance: they can be the first sign of a malignancy and can be used as tumor markers. The diagnosis of paraneoplastic syndromes is often difficult. A "diagnosis score" is proposed in order to make the diagnosis easier.

Carcinoid Heart Disease↗
PubMed1993

[Paraneoplastic syndromes (2)].

Although not rare, paraneoplastic syndromes develop in a minority of cancer patients. Their exact frequency seems to be under estimated. These syndromes are hereby described. Their clinical usefulness is of great importance: they can be the first sign of a malignancy and can be used as tumor markers. The diagnosis of paraneoplastic syndromes is often difficult. A "diagnosis score" is proposed to establish this diagnosis easier.

Amyloidosis↗
PubMed1992

Non-Hodgkin's lymphoma presenting with primary adrenal insufficiency. A disease with an underestimated frequency?

Adrenal involvement in the course of a non-Hodgkin's lymphoma (NHL) appears to occur relatively often, but only seven cases of NHL-induced adrenal insufficiency were found in a recent review of the literature. The authors report four cases of hypoadrenalism in 127 patients treated for NHL; the cases were staged and classified according to the Working Formulation and were investigated for endocrine function by the cosyntropin stimulation test. The involvement was bilateral in four patients; all of the patients had high grade, mostly widespread NHL. These observations suggest that adrenal insufficiency may be underestimated in NHL. Basal hormonal serum levels may be borderline; consequently, only stimulation tests can prove the hormonal failure. The authors suggest that such tests are essential if the staging of the NHL shows bilateral adrenal enlargement, and that the tests should be performed before chemotherapy begins because of the risk of acute adrenal insufficiency.

Adrenal Gland Neoplasms↗
PubMed1991

[Acute cardiac toxicity of 5-fluorouracil: pharmacokinetic correlation].

High-dose 5-fluorouracil (5-FU) continuous infusion over a 4-day period seems to dramatically increase the frequency of cardiac complications, which were however extremely rare in the past when it was injected in bolus form (1.6%). In order to evaluate their real incidence we looked for a relation between cardiac toxicity and clinical or 5 FU pharmacokinetic parameters. One hundred and thirty-three patients were followed up from January 1989 to March 1990, treated for head and neck, breast and colorectal cancers by high-dose 5-FU infusion (1,000 mg/sqm/d x 4 d) and cis-platinum (20 mg/sqm/d x 4 d). During each treatment course, daily electrocardiogram and 5 FU plasma assays were performed by high performance liquid chromatography, at 8 am and 8 pm. Twenty-eight patients presented 36 ischemic cardiac manifestations which were sometimes severe. Of these, 29 were asymptomatic. Cardiac toxicity frequency was not increased in the group treated for head and neck cancers. Pharmacokinetic analysis showed wide variations in 5-FU plasma levels in the 133 patients under study (from 20 to 1,200 ng/ml). Cardiac manifestations always appeared during the hours following very high 5-FU plasma levels (greater than 450 ng/ml). Cardiotoxicity seems to be linked to 5-FU plasma levels. Cis-platinum probably increases toxicity in this regimen. These findings indicate the advisability of a close follow-up by daily ECG when 5-FU is administered at high doses in continuous infusion and associated with cis-platinum. We are continuing to study 5 FU cardiac toxicity, especially in other regimens containing 5 FU and aim to evaluate the contribution of cardiac isotopic exams.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Computed tomography in radiotherapy of prostatic carcinoma.

Hundred forty-four correlations are reported between radiological simulation and CT-scan in cases of prostate adenocarcinoma without metastases treated from 1980 to 1986 exclusively by transcutaneous radiotherapy using the box technique with 25 MV photons. Forty-eight percent of the cases were intracapsular forms. On the basis of correlation criteria defined, the prostatic boost volume was shifted in the sagittal plan in 18% of the cases. Suspect seminal vesicles were found in 60% of the cases. Our treatment plans were considered "correct" in 65% of the cases, "acceptable" in 26% of the cases and "unsatisfactory" in 29% of the cases. The corrections applied to the treatment plan do not vary according to grade but according to stage and concern mainly the posterior limit of the boost volume and to a lesser extent the superior and anterior limits. The boost volume should be determined specifically for each case. CT-scans thus seem indispensable in establishing treatment plans in prostate cancer.

Carcinoma↗