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Biomedical subjects

M Weil

Publications and source records attributed to M Weil.

At least 109 records · Page 6Linked to original sources
PubMed1986

Short-term results of the combination of cis-platinum, 5-fluorouracil and bleomycin in advanced upper aerodigestive tract cancers.

Randomized trials comparing radiotherapy alone with combined radio- and chemotherapy are reviewed. Some 184 patients with advanced upper aerodigestive tract cancers were treated between November 1982 and December 1983 before any loco-regional treatment by three courses of the combination of cis-platinum, 5-fluorouracil and bleomycin, given every three weeks. At the end of three courses 88% of patients (162/184) were evaluable. Among these 162 patients, 102 achieved complete macroscopic remission or over 50% regression. Oropharyngeal cancers were most responsive, whereas results were less satisfactory for oral cancers. Histological sterilization was observed in 30% of patients with complete macroscopic regression. Toxicity was moderate. It is too early to appreciate the the survival benefit.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Neoadjuvant chemotherapy of breast cancer.

About 80% of patients with breast cancer ultimately die of metastatic disease at 20 years. Distant metastases are more important as a cause of death than local or regional relapses. It is for this reason that adjuvant chemotherapy is necessary, especially in young patients and those with extensive disease. Initial chemotherapy preceding any local or regional treatment is justified on the grounds that both surgery and anaesthesia lead to immunodepression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials by Nissen-Meyer, Bonadonna and Cooper (1-3). In the present study 145 patients, including 67 with inflammatory breast cancer (IBC), were treated with 4-6 weeks of Velbe, thiotepa, methotrexate, fluorouracil and prednisone, with Adriblastin added for patients with IBC, T greater than 7 cm, or N2, N3. Because of tumour regression of greater than 50% observed in 80% of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium), resulting in complete remission in all these cases. Maintenance treatment with the same drugs was prescribed for 6-18 months depending on the initial stage. Tumour regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest being 42 months. Overall survival at 2 years for IBC is 90%, with a disease-free survival of 80%. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Malignant melanoma in children and adolescents. Apropos of 37 cases].

Thirty seven cases of malignant melanoma, all before 20 years old people were reviewed from the records of the Lariboisière-Saint Louis Melanoma Group. Clinical characteristics were similar to those encountered in adults. However, the incidence was higher around puberty and in a pre-existing naevus (20 patients, 54%). Histologically, it was often difficult to differentiate between Spitz melanoma and a common naevus. Prognostic factors appear to be similar to those in adults. No case of naevus of less than 2 mm thickness metastasized, relapse occurring in nodular melanoma (8/14) and when the level in invasion was deep (6/13). Overall survival of 70% at 5 years is comparable to that in over 20 years old group (58%) but better than in other studies on children who did no received chemotherapy. Early detection (difficult in children) offers the best chance of cure.

Adolescent↗
PubMed1985

Intra-blood-brain barrier IgG synthesis in cerebral cysticercosis.

Patients with central nervous system cysticercosis show elevated binding of cerebrospinal fluid (CSF) IgG to homogenized cysticercus. To determine whether any of the CSF IgG was the result of de novo intra-blood-brain barrier (BBB) synthesis, CSF and serum samples from six patients were examined for elevated rate of synthesis and oligoclonal bands. Five of the six patients had increased intra-BBB IgG synthesis rate and four of these patients also had oligoclonal IgG bands present in the CSF that were absent in the serum. These results demonstrate intra-BBB IgG synthesis similar to that observed in other infectious and inflammatory diseases of the central nervous system.

Blood-Brain Barrier↗
PubMed1985

Phase II evaluation of diaziquone (CI-904, AZQ) in the treatment of human malignant glioma.

Diaziquone, a new alkylating agent which crosses the blood brain barrier, has shown a 20% response rate in phase II studies in heavily pretreated patients. We have treated 23 patients at our institution as part of a multicentric phase II European trial of diaziquone. All had histologically proven malignant glioma unequivocally progressing on CT scan. Prior therapy had consisted of surgical excision (13 patients), cobalt radiotherapy to CNS (13 patients), and chemotherapy with nitrosourea derivatives (11 patients). Six patients had no prior therapy. Median age was 42 years (range 22-69) and performance status was 3+ or better. They were treated with monthly courses of diaziquone 5.5 mg/m2 I.V. (10 min.) X 5 days. Dosage adjustments were made according to leucocyte and platelet nadirs. Thrombocytopenia was the dose limiting toxicity. Very mild gastrointestinal toxicity was observed. One patient developed hemolytic anemia. One complete response (clinical and CT scan), 7 partial clinical responses (3: greater than 50%, 4: 25-50%), and 1 disease stabilization (less than 25%) were documented. The longest response has now lasted over 26 months. These preliminary results show that chemotherapy with diaziquone can achieve a response rate as high as 35% in malignant glioma even in patients previously treated with a chemotherapy regimen including a nitrosourea (four of the seven objective responses were seen in such patients). Diaziquone is well tolerated and deserves further study in the management of malignant glioma.

Adult↗
PubMed1985

[Adjuvant chemotherapy of intraocular malignant melanoma. Apropos of 20 cases].

The frequency of haematogenously propagated hepatic metastases occurring from intra-ocular melanoma led us to treat 20 patients with adjuvant chemotherapy. 19 patients starting chemotherapy during the month following enucleation and one patient, a year after enucleation. With a median follow-up of 6 years, 17 patients (80%) are disease-free. Three patients developed hepatic metastases at 24, 24 and 30 months respectively. The résults suggest that adjuvant chemotherapy is effective in preventing metastases from intra-ocular melanoma.

Adolescent↗
PubMed1984

[Hepatic metastases. Value of chemotherapy by the intra-arterial route].

Forty-three patients with metastatic liver cancer were treated with multiple chemotherapy by the intra-arterial route. Metastases originated from primary cancer of the breast (16) or colon (10), melanoma (7) and miscellaneous tumours (10). In 35 patients chemotherapy was administered by selective catheterization of the hepatic artery via the axillary artery; it usually (31 cases) consisted of doxorubicin (60 mg/m2) and mitomycin (10 mg/m2) injections, and continuous infusion of 5-fluorouracil (1 g/24 or 72 hours). In 14 patients (10 responders to the above method and 4 new cases), a catheter with subcutaneous chamber was implanted surgically so that chemotherapy could be continued through the chamber. Blood toxicity was usually moderate. The main complication of injections through the catheter (114) or through the chamber (60) was thrombosis. However, except for 1 lethal cerebral thrombosis, the others (axillary artery 3, hepatic artery 5) were unattended by functional symptoms. Transient biochemical signs of hepatic cytolysis were frequent after each course. Hepatic insufficiency was severely aggravated in 2 cases. Painful digestive disorders were relieved by symptomatic treatments. Four complete responses, 16 partial responses, 8 stabilizations and 10 failures were observed; 5 patients died soon after one single course of intra-arterial therapy. The high response rates (greater than 50%) in metastases from cancer of the breast and colon, and chiefly the 3 complete responses obtained in patients with mammary carcinoma were most encouraging, bearing in mind that one of these 3 patients had not responded to intravenous chemotherapy.

Adult↗
PubMed1984

Prognostic value of lymphograms in chronic lymphatic leukemia.

Chronic lymphatic leukemia (CLL) is a disease with a prognosis that has previously been difficult to assess. In recent years, this problem has largely been overcome by various classifications based on clinical and hematologic findings. This article presents the results of a study designed to show the value of lymphograms in assessing the prognosis. These results show that prognosis is associated with lymph node structure, as assessed by lymphography. Lymphography, as an investigation is superior to scanning or echography, since these give information merely on nodal size. It is proposed that lymphograms should be used for assessing the gravity of the disease and help in the choice of therapy.

Chronic Disease↗
PubMed1984

Non-Hodgkin's lymphoma occurring after Hodgkin's disease. Four new cases and a review of the literature.

This article describes four cases of non-Hodgkin's lymphomas occurring after successful treatment of Hodgkin's disease (HD). The clinical symptoms consisted of digestive disorders, and the histology confirmed an intestinal involvement in these four patients. In all cases patients had diffuse large cell types (intermediate or high grade). The respective role of HD treatment (combination chemotherapy in 3 of 4 patients with irradiation in 3 of 4 patients) and of other pathogenic hypotheses, are discussed.

Adolescent↗
PubMed1984

The treatment of melanoma with m-AMSA. A Cancer and Leukemia Group B phase II study.

The activity of m-AMSA was evaluated IN 39 patients with advanced malignant melanoma. Seventy-nine percent of the patients had some prior chemotherapy. The others had some combination of surgery, radiotherapy, and immunotherapy prior to this study. Patients were treated every 3 weeks starting with 60 or 120 mg/m2 of m-AMSA depending on the extent of prior treatment. Doses were escalated if nadir WBC counts were greater than 2500/microliter. Leukopenia was the dose-limiting toxicity with 7.5% of patients having nadir WBC counts less than 1000/microliter. Of the 39 patients evaluable for response, all had progressive disease. In this study, m-AMSA in myelosuppressive doses was not active in malignant melanoma.

Adult↗
PubMed1984

[Breast cancer: chemotherapy preceding locoregional treatment with extension of the indications for conservative treatment].

About 80 per cent of patients with breast cancer ultimately die of metastatic disease in the following twenty years. Distant metastases are more important as cause of death than loco-regional relapses, it is why adjuvant chemotherapy is necessary, especially in young patients and in those with extensive disease. Initial chemotherapy preceding any locoregional treatment is justified on the basis that both surgery and anesthesia lead to immuno-depression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials of Nissen-Meyer, Bonadonna and Cooper. We have treated 145 patients, including 67 with inflammatory breast cancer (IBC), with 4 to 6 weeks of Velbe, Thiotepa, Methotrexate Fluorouracil and Prednisone with Adriblastine added for those patients with IBC or T greater than 7 cm, or N2 N3. Because of tumor regression of more than 50 per cent observed in 80 per cent of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium) and are in a complete remission in all these cases after curietherapy. Maintenance treatment with the same drugs was prescribed for 6 to 18 months depending on the initial staging. Tumor regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest one being 42 months. The overall survival at 2 years for IBC, is 90 per cent with a disease-free survival of 80 per cent. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Primary chemotherapy in breast cancer. Preliminary results].

Primary chemotherapy in carcinoma of the breast is justified by the high risk of distant metastases, immunodepression related to surgery and the experimental studies and clinical trials of Nissen-Meyer in 1967, and Fisher in 1968. Chemotherapy was associated with loco-regional Patey-type surgery (20 patients) or radiotherapy with cobalt and irridium (43 patients) in 63 cases of breast cancer, 33 of which were T4 or in exarcerbation. Initial chemotherapy comprised 3 to 6 infusions of Velbe, Thiotepa, Methotrexate, 5-Fluoro-uracil, prednisone plus adriamycine in the severe forms. Over 50 p. 100 tumour regression was observed in 80 p. 100 of patients without major toxicity reactions. In all cases of radiotherapy alone, the tumour disappeared completely in the two months after the end of radiotherapy. Only one of the 63 patients relapsed at the 8th month and she died. The follow-up period now ranges from 3 to 29 months (average 12 months). These results are encouraging but only a larger series will allow definite conclusions to be drawn.

Antineoplastic Combined Chemotherapy Protocols↗