Biomedical subjects
Publications and source records attributed to L Denis.
Explore the source record for details and available documents.
Treatment of advanced prostate cancer with a combination of luteinising hormone-releasing hormone analogues and anti-androgens is advisable for the initial 2 weeks, in patients with newly diagnosed, extensive disease. Advances in long-term combination treatment are questionable until results of phase III studies become available. Reference is made to poster presentations at the International Symposium on Endocrine Therapy.
A questionnaire, filled in by the patient, was used to assess the quality of life of 65 patients with previously untreated T2-T4 NX MO bladder cancer and of 67 patients with hormone-resistant prostatic cancer. This study examines the initial questionnaire filled in before any nonsurgical treatment had been started in the patients referred to an oncological ward. The aim was to identify domains in which distress was frequent, in the hope of indicating where treatment directed forward improving the patients' quality of life should be directed. The questionnaires yielded reliable and valid data. Among bladder cancer patients micturition disturbances and sexual problems dominated. Bone pain, fatigue, sexual disturbances and interruption of social relationships were the most frequent and most severe complaints of prostatic cancer patients. It was concluded that routine quality of life evaluation by self-assessment questionnaires is possible in a clinical ward provided some assistance by the nursing staff is available. Future treatment in patients for whom palliation is the main goal of therapy should be concentrated on improving the quality of life in areas where distress is evident. The effect of treatment on quality of life could be monitored by similar questionnaires.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Amiodarone (Cordarone) is an antiarrhythmic drug that may cause toxic pulmonary reactions. Clinical symptoms include dyspnea on exertion, cough and weight-loss. On chest X-ray diffuse interstitial and patchy alveolar disease are noted. The patient's condition improves after discontinuation of amiodarone and administration of corticosteroids.
We treated 191 patients with histologically proved locally advanced stage (T3 or T4) and/or metastatic prostate cancer with a biodegradable depot formulation of a luteinizing hormone-releasing hormone analogue (Zoladex). After an initial increase in serum testosterone in week 1 of therapy a continuous decrease of testosterone to castrate levels was obtained. With a monthly injection of the luteinizing hormone-releasing hormone analogue 4 patients (2 per cent) experienced a transient increase in bone pain, 1 had ureteral obstruction and 1 suffered paraplegia during the first few weeks of therapy. Over-all objective and subjective responses were similar to those obtained by castration or estrogen therapy. The absence of local and systemic (long-term) side effects proves the validity of this approach for patients with advanced prostatic cancer.
We report 2 rare cases of a spontaneous nephrocutaneous fistula. The diagnosis was made incidentally during hospitalization for other reasons. The role of calculus in the etiological pathogenesis of nephrocutaneous fistula is emphasized. Although classically surgical treatment is indicated a more conservative approach can be advocated in some asymptomatic cases.
It is well known that the first administration of luteinizing hormone releasing hormone (LH-RH) analogues induces an initial increase of luteinizing hormone (LH) release and a subsequent rise in testosterone (T). This rise is maximal after 3-4 days and is followed by a steady fall of LH and T. Several investigators have reported flare-up symptoms in patients with advanced prostatic cancer, associated with the rise of T, when treated by LH-RH analogue alone. In order to prevent these flare-up symptoms, we treated 20 patients with advanced prostatic cancer with an association of a LH-RH analogue (Zoladex Depot) and diethylstilbestrol (DES) 1 mg/day. DES was given for 14 days, starting 7 days before the first Zoladex Depot injection. T fell to near castrate levels within a few days, but rose again 3-4 days after the administration of the LH-RH analogue to pretreatment values before returning to castrate levels. No clinical flare-up manifestations were recorded. We conclude that combination treatment with DES can prevent the flare-up symptoms induced by LH-RH analogue in patients with prostatic cancer.
This report analyses the changes in the classification of the genitourinary tumours introduced by the 1987 edition of the TNM system. Criticism and suggestions for improvement are given. These are based on the extensive experience of the EORTC GU Group with clinical trial work particularly the identification of prognostic factors, on their success in reaching international consensus on tumour classification, and on information from the literature. Many of the changes introduced in the 1987 system are not considered to be strictly necessary. These include the introduction of the new additional descriptors, including "C" and "R", the changes in the T classification of prostatic and renal cancer, and the introduction of uniform N categories for all tumours and other features. We regret the omission of minimal requirements, the omission of the V classification for macroscopic or microscopic vascular invasion, the changes in the T categories of carcinoma of the bladder and the introduction of stage groupings for all urological tumours. Some of these changes are considered unacceptable. The attitude of the EORTC GU Group toward the use of the new TNM classification is indicated in detail.
The authors report the preliminary data concerning a multicentric study on ablative effects of 4'-epi-doxorubicin (EPR) on superficial bladder cancer. Forty-six patients affected by multiple transitional cell superficial bladder carcinoma were treated by transurethral resection of all but one tumor, left as a marker lesion. Subsequently, an intensive local treatment with EPR and 3-month control cystoscopies with biopsies were performed. In the 47% of cases the control cystoscopy and pathology assessed the complete disappearance of marker lesions without any new occurrence whereas it is interesting to observe that the breakdown of the complete remissions into primary (67%) versus recurrent (37%) and in intravesical unpretreated (55%) versus pretreated (31%) showed important differences. It may be concluded that EPR shows a real activity against transitional cell superficial bladder carcinoma.
Explore the source record for details and available documents.
The rationale for adjuvant chemoprophylaxis in superficial bladder cancer treated by transurethral resection is discussed. Many questions remain unsolved as far as chemoprophylaxis in concerned. The authors try to answer them through an analysis of the results of prospective and randomized studies undertaken by the EORTC genito-urinary group for 12 years. Advantages and disadvantages of the most common agents (Adriamycin, Epodyl, Mitomycin, Thiotepa, BCG) are analyzed; an attempt is done to define instillations regimens; indications and results of these adjuvant treatments are studied.