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E Haddad

Publications and source records attributed to E Haddad.

82 records · Page 5Linked to original sources
PubMed1989

[Efficacy and toxicity of intrapleural mitoxantrone: apropos of 18 cases of pleural metastases of breast cancer].

Mitoxantrone, an anthracenedione, has been shown to be as effective as doxorubicin, but with less local or systemic toxicity, when used for the treatment of advanced breast cancer. As the high molecular weight and hydrophilic property of this drug let us predict a slow intracavity resorption, we tested its use in the treatment of malignant effusions refractory to systemic chemotherapy. 18 women, 43 to 83 years old, with cytologically demonstrated metastatic pleural effusions, and with prominent clinical symptoms, were included in the study. All these patients were refractory to hormonotherapy and combination chemotherapy (previous regimens included anthracyclines in 17 patients but none had received systemic mitoxantrone). No previous local treatment had been attempted. During the study period, no other treatment has been given. Mitoxantrone (6 mg/m2) has been administrated after effusion aspiration. A complete response was seen in 8 patients, a partial response in 5, and no change in the 5 others but one had received only one injection on account of a transitory shock immediately after. No others side effects were reported (fever, local pain, alopecia, vomiting). No patient had evidence of myelosuppression. These results suggest that intracavity injection of mitoxantrone is feasible and generally safe in most patients. Some efficiency has been seen in previously heavily treated patients refractory to systemic chemotherapy. Local administration of mitoxantrone deserves further investigation.

Adult↗
PubMed1989

[Radiotherapy of Kaposi's sarcoma in AIDS].

Between June 1986 and August 1988, 129 patients with AIDS-related Kaposi's sarcoma were treated by cutaneous irradiation in our department. According to Mitsuyasu's staging, 25 patients (19%) were stage 1.76 (59%) stage II, no stage III was reported and 28 (22%) stage IV. Fifty four patients (42%) had previously presented with one or multiple opportunistic infections. Eighty six (66%) had previously received treatment: by interferon in 80 patients (62%) and/or Velbe in 40 (31%). Seventy six patients (59%) were treated by extensive cutaneous irradiation using 4 and/or 8 MeV electron beam energy and 53 patients (41%) by localized irradiation using 45 kV X-ray energy, 2.5 Gy/fraction, 4 times/week by split course 20 Gy then 10 Gy two weeks later. Only 111 patients were evaluable; 61% obtained complete remission and 33% partial remission after a mean period of 1.5 months (0.5-3 months). The overall tolerance was acceptable. The complications were epidermitis with some necrosis (8%), exudative epidermitis (26%) moderate epidermitis (63%) and slight reactions in 4%. The mean recurrence time was 5 1/2 months.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The indications for total cutaneous electron beam radiation therapy of mycosis fungoides.

From 1977 to 1984, we treated 34 patients with mycosis fungoides and 9 patients with B cutaneous lymphomas. Eighteen patients with mycosis fungoides were treated with total skin electron irradiation (TSEI) and had a minimum follow-up of 15 months (range 15 months to 7 years). The lowest electron energy of the linear accelerator was 8 MeV therefore we placed a plexiglas screen between the patient and the machine; the resulting electron energy was 4 MeV. The total dose was 30 Gy delivered in 12 fractions over 40 days. There were 8 males and 10 females. The median age was 48 years (ranging from 13 to 78 years). All patients were staged as follows: Stage A = superficial lesions covering less than 50% of the body surface; Stage B = superficial lesions covering more than 50% of the body surface; Stage C = tumors involving the skin, lymph nodes and/or visceral organs. Five patients with Stage A (5/5) and 5 patients with Stage B (5/5) had a complete remission, 1 stage A patient relapsed 6 months after completion of treatment. All the Stage B patients recurred between 3 and 15 months. The recurrences were localized to the skin and were well controlled with topical nitrogen mustard or puvatherapy. Among the Stage C patients, 3 did not respond to treatment and died of their disease; the remaining 5 patients achieved complete remission but they all relapsed from 2 to 9 months following completion of treatment. The median follow-up was 32 months and the average time for relapse was 6.5 months. All relapses except one (15 months) occurred within the first year. We feel that total skin electron irradiation is indicated in Stage A and B patients. However, we feel Stage C patients should receive TSEI for palliative purposes only.

Adolescent↗
PubMed1985

External radiotherapy in thyroid cancers.

Surgery is the most effective treatment for thyroid cancer; however, in some subsets of patients, the role of radiotherapy (RT) is important. The main indication for external-beam RT is incomplete surgery. When neoplastic tissue is left behind at operation, RT must be considered, but only if an experienced surgeon feels that everything that can be done has been done. Generally, in those patients, the neoplastic tissue involves the larynx, trachea, esophagus, blood vessels or mediastinum. Of 539 patients with differentiated thyroid cancer treated at Villejuif, France, until 1976, 97 were treated by external radiotherapy after an incomplete surgical excision. Fifteen years after irradiation, the survival rate is 57% and is approximately 40% at 25 years. The relapse-free survival is lower (39% at 15 years). In patients irradiated with an adequate dose (greater than or equal to 50 Gy) to residual neoplastic tissue after incomplete surgery, the incidence of local recurrence is low (actuarial probability of local recurrence 11% at 15 years versus 23% for patients treated by surgery alone, although the irradiated patients had larger and more extensive tumors). This demonstrates the efficacy of external-beam radiotherapy. The effects of radiotherapy on a residual tumor can be monitored by a serum thyroglobulin assay. With regard to local control of tumors, the effectiveness of radioiodine administration is clearly lower. However, since radioiodine facilitates early detection of distant metastases, a combination of external RT and radioiodine is indicated and is well-tolerated. For inoperable patients, the results of RT are limited: although complete remissions are sometimes obtained, the incidence of local recurrence is high. External RT is effective in medullary carcinoma despite the slow shrinkage of the tumor after irradiation. Assay of the calcitonin level helps to monitor the effects of the treatment during follow-up and has demonstrated in some patients the efficacy of cervical RT. In undifferentiated cancers, the results of RT are poor. Combination of RT and chemotherapy are being explored despite the disappointing preliminary results of this combination.

Calcitonin↗
PubMed1985

Short term effect of a low fat diet on plasma retinol and alpha-tocopherol and red cell alpha-tocopherol levels in hyperlipidemic men.

The effect of a low fat, low cholesterol diet on plasma alpha-tocopherol and retinol and erythrocyte alpha-tocopherol levels was studied in fourteen hyperlipidemic men for a period of 28 days. Plasma alpha-tocopherol decreased with decreasing plasma cholesterol levels while the ratio of plasma alpha-tocopherol to cholesterol remained constant. There was a tendency for plasma retinol levels to decrease but the change was not significant. As plasma alpha-tocopherol levels decreased there was a consistent and significant increase in alpha-tocopherol content of red cells (p less than 0.001). These findings indicate that fat soluble vitamin status is maintained with low fat diets during a short time period.

Adult↗
PubMed1983

Liver complications in lymphomas treated with a combination of chemotherapy and radiotherapy: preliminary results.

From May 1978 to May 1981, a total of 20 patients (18 patients with Non Hodgkin Lymphomas + 2 patients with Stage IV Hodgkin's disease) were treated with chemotherapy and whole or upper abdominal radiotherapy. All the patients were in complete remission at the time of irradiation. Shielding of the kidneys was effected at the start of treatment and the right lobe of the liver was shielded after a dose of 20 Gy was delivered. As of January 1982, 17 of the patients were alive and free of disease with a follow-up ranging from 6 to 32 months (mean follow-up of 18.5 months). Two patients were dead from their disease. Alterations in liver chemistry were observed in 5 patients, clinical jaundice or transient hepatomegaly along with changes in liver chemistry in 4 patients, classical veno-occlusive disease in 2 patients and 7 of the patients did not develop any complication. No death from complications were observed. The contribution of the following factors such as radiotherapy dose to the liver, drugs, nutritional status and associated medical conditions, towards the development of complications have been analyzed in detail.

Adult↗
PubMedDate not supplied

Induction chemotherapy in head and neck cancer: results of a phase III trial.

Between December 1982 and October 1986, 131 patients with stage II-III-IV squamous cell carcinoma of the oropharynx or oral cavity were randomized to induction chemotherapy, consisting of bleomycin (10 mg/m2/day in continuous infusion from day 1 to day 5), methotrexate (120 mg/m2 on day 2) followed by folinic acid, 5-fluorouracil (5 FU) (600 mg/m2 on day 2), and cisplatin (120 mg/m2 on day 4) every 4 weeks for a total of three cycles followed by definitive locoregional treatment versus locoregional treatment alone. The modalities of definitive treatment (radiotherapy +/- surgery) were chosen prior to randomization. A total of 116 patients were evaluable. Of 55 patients in the chemotherapy arm, four (7%) had a complete response (CR) and 23 (42%) a partial response (PR) following the induction regimen. At the completion of locoregional treatment, 76% (42 of 55) of patients in the experimental group were in CR compared to 89% (54 of 61) in the control group. There was no difference in survival, cause-specific survival, and pattern of relapse between both groups. The median survival was 22 months in the chemotherapy group and 29 months in the control group. Responders to chemotherapy did not fare better than nonresponders. Chemotherapy-related toxicities were few and most of them related to cisplatin which was reduced to 100 mg/m2 for 35 patients. There were no treatment-related deaths and, in the experimental arm of the trial, no increased morbidity from locoregional treatment. This induction regimen does not offer any advantages over standard treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

The effect of menopause on the relation between weight gain and mortality among women.

OBJECTIVE: To examine the effect of menopause on the relation between weight gain and all-cause mortality. DESIGN: Prospective cohort study of 6,030 adults (ages 25-82 years) who never smoked cigarettes, had no history of coronary heart disease, cancer, or stroke, and were enrolled in a 29-year follow-up in which anthropometric data were given at baseline and at 17 years after baseline. RESULTS: Weight gain that occurred over a 17-year interval (baseline to 17 years after baseline) increased the mortality risk of men and middle-aged women, but decreased the mortality risk of older women. Further study of the women revealed that a strong protective effect of weight gains was only evident among the leanest ( 25 kg/m2) postmenopausal women [HR (95% CI) = 0.81 (0.41, 1.58)] or for premenopausal women [HR (95% CI) = 1.05 (0.49, 2.25) for 25 kg/m2]. We found that the protective effect of weight gain among the leanest postmenopausal women was primarily due to a more than threefold decrease in cardiovascular disease mortality risk. One possible explanation for these findings is that weight gain increases the level of adipose-tissue-derived estrogen among lean postmenopausal women. CONCLUSION: Moderate menopausal weight gain may be well tolerated in lean women.

Adult↗
PubMedDate not supplied

Assessment of surgical residents' competence based on postoperative complications.

The aim of this prospective study was to evaluate surgical residents' operative skills on the assumption that differences in training might have a significant effect on postoperative complications, their type and incidence. This was accomplished using a departmental microcomputer and special non-commercial personally-developed software. There was no significant clinical difference found in the postoperative complication rate in matched groups of patients treated by senior staff and resident staff of the Department. It is suggested that the close supervision by the senior staff might play a role in this outcome. Although analysis of subgroups of patients sustaining moderate to severe postoperative complications showed a statistically significant difference between these surgeon categories, we may consider this difference attributable to the more complex operative problems handled by the senior staff in the same circumstances.

Female↗