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Biomedical subjects

E Quoix

Publications and source records attributed to E Quoix.

At least 109 records · Page 6Linked to original sources
PubMed1991

Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients.

We report the results observed in a large, randomized study that compared the effects of radiotherapy alone (the standard therapy) with those of a combination of radiotherapy and chemotherapy in nonresectable squamous cell and large-cell lung carcinoma. The radiation dose was 65 Gy in each group, and chemotherapy included vindesine, cyclophosphamide, cisplatin, and lomustine. In this study, 177 patients received radiotherapy alone (group A), and 176 patients received the combined treatment (group B). The 2-year survival rate was 14% in group A and 21% in group B (P = .08). The distant metastasis rate was significantly lower in group B (P less than .001). Local control was poor in both groups (17% and 15%, respectively) and remained the major problem.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

ASTRO (American Society for Therapeutic Radiology and Oncology) plenary: Effect of chemotherapy on locally advanced non-small cell lung carcinoma: a randomized study of 353 patients. GETCB (Groupe d'Etude et Traitement des Cancers Bronchiques), FNCLCC (Féderation Nationale des Centres de Lutte contre le Cancer) and the CEBI trialists.

Most patients with locally advanced non small cell lung carcinoma are treated with external thoracic radiotherapy. Because of the high incidence of distant metastasis the addition of chemotherapy has been proposed. The present randomized study was conducted from June 1983 to February 1989 and included 353 patients. The trial compared arm A, thoracic megavoltage radiotherapy alone at a total dose of 65 Gy in 26 fractions and 45 days, to arm B that comprised the same radiotherapy preceded and followed by 3 monthly cycles of VCPC (vindesine 1.5 mg/m2 d 1-2, cyclophosphamide 200 mg/m2 d 2-4, cisplatinum 100 mg/m2 d 2 and lomustine 75 mg/m2 d 3). Disease was deemed unresectable but non-metastatic after bronchoscopic, radiologic, CAT, and nuclear scans and physical examinations. Only patients in clinical, radiological, endoscopic, and histological complete remission were considered as locally controlled; these patients were monitored by fiberoptic bronchoscopy and systematic biopsies to the primary site. One hundred seventy-seven patients received thoracic radiotherapy alone and 176 received the combined modality. Twenty-seven percent of arm B patients had an objective response after 2 VCPC cycles. At the time of final assessment, performed 3 months after the end of thoracic radiotherapy in both arms, there were 20% of complete responders in arm A versus 16% in arm B. The two-year survival rate was 14% in arm A versus 21% in arm B (p = 0.08, logrank test). The distant metastasis rate was 67% in arm A versus 45% in arm B (p less than 0.001). Local control at 1 year was poor in both groups (17% and 15%, respectively). The striking effect of VCPC chemotherapy on the incidence of distant metastasis did not have a significant impact on overall survival. We conclude that thoracic tumor control remains a significant problem in unresectable non small cell lung cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Is chemotherapy with cisplatin useful in non small cell bronchial cancer at staging IV? Results of a randomized study].

The benefit of chemotherapy for patients with disseminated non small cell lung cancer (NSCLC) is controversial. The introduction of cisplatinum in the combination chemotherapy for NSCLC gave rise to higher response rates. To study the question of the usefulness of cisplatinum-based chemotherapy in disseminated NSCLC we conducted a prospective randomized trial comparing best supportive care to vindesine + cisplatin. Between December 1985 and March 1988, 49 patients with stage IV NSCLC were enrolled. Of the 46 eligible patients 24 were in the chemotherapy group and 22 in the best supportive care group. The treatment groups were not significantly different in terms of age, performance status, histology. Toxicity on the chemotherapy arm grade 3 or more was observed in 17.5% for neutropenia, in 8.75% for vomiting. There was one death related to treatment. The overall response rate in the chemotherapy group was 41.7%. Patients of the chemotherapy group had a median survival time of 199 days and the patients of the best supportive care group had a median survival time of 73 days. The difference in survival is highly significant (p less than 0.001).

Adult↗
PubMed1990

Small cell lung cancer presenting as a solitary pulmonary nodule.

Small cell lung cancer (SCLC) rarely presents radiographically as a solitary pulmonary nodule (SPN). Twenty-five patients with this feature were identified among 408 individuals with SCLC at McGill University (Montreal, Quebec) from 1979 through 1984. Of these, 15 (60%) were confirmed on pathologic review as SCLC (ten intermediate cell, four oat cell, one indeterminate). Pathologic review of a control group comprising 24 other limited-disease patients who were long-term survivors (greater than 20 months) confirmed 20 (84%) as SCLC (eight intermediate cell, 12 oat cell). Ten of the 15 patients with SPN were resected whereas five had chemotherapy and/or radiotherapy as primary treatment. Postoperative chemotherapy was administered to most of the resected patients. The median survival of the 15 patients with SPN was 24 months, a significantly longer survival than the other patients with SCLC. This improved prognosis in patients with SPN may be due to smaller initial tumor burden or to a fundamental biologic difference between SPN and other forms of SCLC.

Actuarial Analysis↗
PubMed1990

[Survey of the attitude of specialists faced with bronchial small cell carcinoma].

The practice of therapeutic trials is indispensable in the management of bronchial carcinoma if one hopes to improve the results. We have questioned 134 doctors in the Alsace region who are involved in the diagnosis and treatment of bronchial cancer. We asked how they would wish to be treated if they had a small cell cancer, and if they would agree to participate in a therapeutic trial should the occasion arise. Four different clinical situations of small cell carcinoma localised to the hemithorax were presented, illustrating current controversy on the best treatment or treatments to apply. The 4 proposed protocols were refused by 50% to 84% of the doctors questioned in different cases. The greater the level of consensus on a therapeutic treatment in a given clinical situation the greater the level of refusal to participate in a randomised protocol was. The fact that at least half of the specialist doctors questioned would refuse to be included in a current therapeutic protocol which is underway for patients in Europe leads to the suggestion that before the application for new protocols experts surrogates should give their opinion in association with ethical committee.

Adult↗
PubMed1990

[Endobronchial aspergillosis associated with a carcinoid tumor].

We report a case of a 62 year old man who presented with effort dyspnoea accompanied by a cough and haemoptysis. The chest radiograph of the thorax showed atelectasis of the right upper lobe. Bronchoscopy showed evidence of a tumour like mass obstructing the right bronchus and this revealed itself to be a mass of organised fibrinous deposit in granulation tissue containing numerous colonies of Aspergillus. In fact it appeared to be an obstructive Aspergillus bronchitis, with a pseudo-tumour appearance attached to a carcinoid tumour which was obstructing the apical segment of the right upper lobe. Obstructive Aspergillus bronchitis makes up only a small percentage of overall respiratory disease caused by Aspergillus. They pose a problem of differential diagnosis with bronchopulmonary aspergillosis which is much more frequent.

Aspergillosis↗
PubMed1989

[Effect of the environment on the development of respiratory allergies].

Allergy reactions may be regarded as resulting from exposure to allergens of subjects who are genetically predisposed to synthesize IgE. The presence of allergens in the environment is necessary to acquire sensitization. With some allergens, sensitization seems to develop very rapidly. The introduction or presence in the environment of certain allergens, such as house dust mites, may increase the prevalence of asthma. Despite conflicting reports, in atopic subjects exposure to pet animals also is a risk factor. Introducing foreign proteins prematurely into infant's food has been considered a factor that facilitates the development of allergic diseases. Contact with occupational allergens results in allergic manifestations in less than one-third of the subjects exposed, which suggests that genetic factors play a predisposing role. Beside exposure to allergens, non-specific environmental factors, such as chronic inhalation of tobacco smoke or atmospheric pollutants (e.g. ozone, SO2, NO2, particles of burnt fuels) might contribute to sensitization. The part played by viral infections (RSV or influenza virus) in the triggering of allergic diseases has often been reported. Interactions between irritants and allergens may encourage the development of respiratory allergy.

Acari↗
PubMed1988

Problems in radiographic estimation of response to chemotherapy and radiotherapy in small cell lung cancer.

Assessment of the response to therapy in small cell lung cancer requires serial tumor measurements with chest radiographs before and after treatment. Those lesions that are not measurable may be evaluated for response using subjective criteria. We studied interobserver variability in tumor measurement in 21 patients with small cell lung cancer. In addition, we analyzed the effect that the variability in measurement had on the estimation of response to combination chemotherapy with and without chest radiotherapy. Half the readers agreed that pretreatment radiographs were measurable. Posttreatment, they were more often unmeasurable. Starting from a base of 100%, representing all measurable pretreatment films, posttreatment measurability rates fell to 78% and 53% on the 2-month and 4-month films. After radiotherapy, changes particularly reduced the readers' ability to measure the tumors. There was also less interobserver agreement on response after radiotherapy. The intraclass correlation coefficient for partial or complete response versus no response was 0.42 where no chest radiotherapy had been administered and 0.17 after radiotherapy. A measurable lesion on the initial radiograph was important in improving the consistency of evaluation of complete versus partial response particularly in films taken after chemotherapy alone. These data indicate that there is only fair agreement as to whether tumors were measurable and whether a response had occurred. More consistent results were seen in films taken before administration of radiotherapy. A measurable pretreatment film was important in improving interobserver consistency in differentiating a complete from a partial response.

Carcinoma, Small Cell↗
PubMed1988

Positive skin tests to aero-allergens and month of birth.

The month of birth distribution for 1301 French patients born between 1953 and 1975 with at least one positive skin test was compared to that of the whole population. A chi-square test was performed, and the expected birth month distribution of the groups calculated from the INSEE* data for 1953-1975. All patients underwent skin testing with house dust, Dermatophagoides pternyssinus (Dpt), cat and dog allergens, grass, tree and weed pollens, and moulds. The only study criterion was a positive skin test unrelated to any specific disorder. A significant difference in month of birth distribution was observed 1) for patients with positive skin test to grass pollen, with a high rate of births from January to May, and 2) for patients with mould sensitization, with a low rate of births in April, May and December. Tree and weed pollens, house dust and Dpt showed no significant relation with month of birth. For cat and dog allergens, the observed and expected distributions of birth month were similar. For the whole sensitized population the birth rate tended to be low in December except for the cat and dog sensitized. Our study confirms the well-known seasonal peak of births in the first 5 months of the year for grass pollen sensitized patients. No consistent monthly or seasonal tendency could be statistically demonstrated for other allergens except moulds.

Air Pollution↗
PubMed1987

[Hypoxia in cirrhotic patients. Apropos of a case].

The authors report a case of hypoxia in a non-smoking cirrhotic patient. The pathophysiological hypotheses proposed to date to explain this hypoxia without pulmonary artery hypertension, but accompanied by disturbances of carbon monoxide transport, reveal a common element which is difficult to diagnose and quantify: intra-pulmonary shunts. The authors consider gamma-angiocardiography to be a simple diagnostic procedure.

Dilatation, Pathologic↗
PubMed1987

[Profile of a respiratory allergy department from computerized data collected between 1968 and 1984 (3962 cases)].

A prospective study of clinical, cutaneous and biological sensitivity to the common air-borne allergens was conducted over a 16-year period in a total of 3,962 patients who reported to a hospital consultation for respiratory allergy. The study confirmed certain widely recognized semiological features, but it did it on the basis of a real population with a large number of subjects and therefore was a true textbook of allergology with a live material. In addition, the study benefited from the major advantage of computer data processing: an accurate and rapid analysis. Yet some uncertainties and omissions remained concerning answers to certain questions, but such gaps are inherent in the natural subjectivity of allergic patients and their doctors.

Adolescent↗
PubMed1986

Treatment of small-cell lung cancer on protocol: potential bias of results.

During a 27-month period, 215 new cases of lung cancer were diagnosed at five McGill University hospitals. Only 44 patients (20%) so diagnosed were treated on available chemotherapy protocols. Six categories were used to define reasons for nonparticipation. The most important were medical reasons (MRs), 46%; non-medical reasons (NMRs), 20%; and physician preference (PP), 16%. The three remaining categories, representing 18% of exclusions, were death before diagnosis (DBD), surgical treatment (S), and a miscellaneous group (M). Median survival of patients on and off protocol was 10 and 7 months, respectively. Patients with limited disease treated off protocol for NMR and those treated with surgery did better than patients on protocol. Patients with extensive disease not enrolled because of MR did worse, and those excluded because of PP did better than patients treated on protocol. The implication of these findings for other cancer studies is that analysis of chemotherapy trials often represents treatment results in a small proportion of all patients with a given neoplasm. As such, caution must be exercised when extrapolating results to the group as a whole. We suggest that complete demographic data, including proportion of patients participating and reasons for exclusion, be included in all chemotherapeutic trial reports.

Adult↗