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P Rougier

Publications and source records attributed to P Rougier.

At least 37 records · Page 2Linked to original sources
PubMed2004

Loss of heterozygosity on 10q and mutational status of PTEN and BMPR1A in colorectal primary tumours and metastases.

We investigated the possible role of chromosome 10q losses in colorectal cancer metastasis by carrying out an allelic imbalance study on a series of microsatellite instability-negative (MSI-) primary tumours (n=32) and metastases (n=36) from 49 patients. Our results demonstrate that 10q allelic losses are associated with a significant proportion (25%) of MSI- colorectal tumours, but are not involved in the metastatic process. PTEN and BMPR1A, two genes located in the common deleted region, were screened for mutations in samples with loss of heterozygosity. The absence or low frequency of mutations indicates that the inactivation of these genes by deletion of one allele and mutation of the other one plays only a minor role in MSI- tumours.

Base Sequence↗
PubMed2004

Modifying the gain of the visual feedback affects undisturbed upright stance control.

OBJECTIVE: To assess the effects of visual feedback gain, which express the amplitudes of the displacements of the centre of pressure displayed on a computer screen. DESIGN: The controlling variable, the centre of pressure trajectories, recorded using a force platform, were decomposed into two elementary motions: (1) the horizontal displacements of the centre of gravity and (2) the vertical projection of the difference between centre of pressure and the centre of gravity. These motions were processed through frequency analysis and modelled as fractional Brownian motion to assess their spatio-temporal linkage and their degree of control. BACKGROUND: Although tests to modify the feedback gain have already been carried out, the specific effects from a biomechanical and motor control point of view need to be assessed. METHODS: Thirteen healthy adults were tested through various visual feedback gains performed in random order. RESULTS: By increasing the visual feedback gain, no difference is observed between centre of pressure and centre of gravity motions whereas a progressive diminution of centre of gravity horizontal motions is seen. This latter effect is principally explained by a reinforcement of control during corrective processes. CONCLUSIONS: When the control of centre of gravity constitutes the main flaw in undisturbed stance maintenance, the efficiency of a visual feedback rehabilitation protocol should be largely improved by using an enhanced gain.

Acceleration↗
PubMed2004

The doxorubicin-streptozotocin combination for the treatment of advanced well-differentiated pancreatic endocrine carcinoma; a judicious option?

Due to their rarity, only few trials have studied the role of the doxorubicin-streptozotocin (DS) combination in advanced well-differentiated pancreatic endocrine carcinomas (AWDPEC). However, the published results are inconsistent. We reviewed all AWDPEC (5-year period, 45 patients) treated in our institution with the DS combination for: objective response rate (ORR), progression-free survival, overall survival (OS) and toxicity. An ORR of 36% (95% Confidence Interval (CI) 22-49) was obtained, with 16 partial responses (PR). The mean duration of PR was of 19.7 months. Two and 3-year OS rates were 50.2 and 24.4%, respectively. Toxicities were mainly digestive (grade > or =3 vomiting, 13%) and haematological (grade > or =3 neutropenia, 24%). Previous systemic chemotherapy and malignant hepatomegaly were associated with a poorer ORR (P=0.033, P=0.016) and OS (P=0.008, P=0.045). Multivariate analysis demonstrated previous chemotherapy as the only independent predictive-factor for survival (P=0.013). In conclusion, our data confirm the sensitivity of AWDPEC to the DS combination, with an ORR of 36% and a remarkable median response duration of 19.7 months, and suggests that it could be considered as a valid option in first-line therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

[Postural control in idiopathic scoliosis: comparison between healthy and scoliotic subjects].

PURPOSE OF THE STUDY: To assess the effects of idiopathic scoliosis on undisturbed postural control in young female teenagers. MATERIAL AND METHODS: The centre of pressure (CP) displacements, measured through a force platform, were decomposed into two elementary components in order to differentiate the net postural performance, as revealed by the horizontal motions of the centre of gravity (CGh) and the level of muscular activity expressed by the vertical difference CP-CGv. The CG horizontal displacements were estimated from those of the CP with a low pass filter taking into account the subjects' anthropometry. Fifteen healthy teenagers and fifteen teenagers with idiopathic scoliosis were asked to stand still upright for three successive trials of 64s, rest periods of similar duration being allowed between each trial. RESULTS: The results indicate differences in the postural control between the two populations: scoliotic CG motions are more important than those of healthy subjects. In the medio-lateral direction, the CGh motions can be primarily explained by the concomitant increase observed at the CP-CGv level. To be more precise, one should have in mind that the CP-CGv amplitudes determine the horizontal acceleration communicated to CGh. On the other hand, despite significative increases of the CP-CGv in the antero-posterior direction, the CGh motions appear to be unaffected by these initial conditions. This feature suggests that appropriate control mechanisms can intervene in this antero-posterior direction for the scoliotic group whereas a similar organization cannot be observed in the medio-lateral direction. DISCUSSION: The differences observed in the postural performance for the healthy and scoliotic groups can be explained in various ways. The capacity of the scoliotic group to counteract huge CP-CGv motions may be linked to the location of the postural muscles involved in this control: the triceps surae for the antero-posterior direction, and the abductor-adductor hip muscles for the medio-lateral one. Only the action of the latter group can be indeed perturbed by the specific constraints occurring at the hip level and resulting from the scoliosis. On the other hand, the general increase of the CP-CGv motions, by expressing an overwhelming muscular activity in the whole set of postural muscles, does suggest that the drive of the descending motor commands is largely modulated and is likely the consequence of a central disfunctionning.

Adolescent↗
PubMed2004

Optimising the visual feedback technique for improving upright stance maintenance by delaying its display: behavioural effects on healthy adults.

The visual feedback technique (VFB) is recognized by several studies as a valuable tool for re-establishing the balance functions. However, one former study has highlighted the fact that the increased control induced by this technique infer both favourable (the amplitudes of the horizontal motions of the centre of gravity (CoG(h)) are diminished) and unfavourable features (the vertical difference between the CoG(h) motions and centre of pressure (CoP) trajectories are enhanced). One means to decrease these CoP-CoG(v) motions is to delay their display on the screen of the monitor. To assess these behavioural effects, 16 healthy adults were evaluated with various delays from 0 to 1200 ms. CoP displacements, measured through a force platform, were decomposed into two elementary motions: CoG(h) and the difference CoP-CoG(v). A fractional Brownian motion modelling of these motions allowed to determine from which distance and for how long the corrective process takes over and to what extent the motion is controlled. Compared to the VFB real time condition, increasing the delay induces some effects mainly on the CoP-CoG(v) motions which are largely diminished, the most striking effect appearing for delays exceeding 600 ms. Despite the lower forces these reduced amplitudes infer to control body sways, the amplitudes of the CoG(h) motions tend to increase slightly. Considered as a whole, whilst retaining the beneficial aspects of VFB without delay and significantly suppressing the unfavourable features, the data suggests that the method of delaying the screen display optimises the VFB technique.

Adult↗
PubMed2004

Randomized phase II study evaluating oxaliplatin alone, oxaliplatin combined with infusional 5-FU, and infusional 5-FU alone in advanced pancreatic carcinoma patients.

BACKGROUND: A randomized phase II, open-label multicenter study evaluating oxaliplatin alone (OXA), infusional 5-fluorouracil alone (5-FU) and an oxaliplatin/infusional 5-FU combination (OXFU) in untreated, advanced pancreatic carcinoma (APC). PATIENTS AND METHODS: Chemotherapy-naïve patients with advanced or metastatic, histologically/cytologically proven pancreatic carcinoma with measurable disease, received OXA [130 mg/m2, 2-h intravenous (i.v.) infusion] alone, OXA combined with 5-FU (1000 mg/m2/day, continuous i.v., days 1-4), or 5-FU alone, every 3 weeks. RESULTS: Sixty-three patients (42 males/21 females) were treated: 17 patients/52 cycles OXA, 31 patients/ 175 cycles OXFU, 15 patients/41 cycles 5-FU, with a median of three, six and two cycles/patient, respectively. Patient characteristics were similar in all arms. Median age was 57 years (range 21-75), and 83% of patients had PS 0-1. Most patients (62%) had moderate to well-differentiated tumors, 90% had metastatic disease, 81% with liver metastases. All responses (three partial responses; WHO) occurred in the OXFU arm (10% response rate). Five of 32 patients evaluable for clinical benefit were responders (OXA, 14%; OXFU, 21%). Median time to progression and overall survival were higher in the combination arm (4.2 and 9.0 months, respectively) than either single-agent arm (OXA, 2.0 and 3.4 months; 5-FU, 1.5 and 2.4 months, respectively). Moderate hematotoxicity without morbidity was seen in all arms. Two OXFU patients had grade 3 oxaliplatin neurosensory toxicity. CONCLUSIONS: With a 10% response rate, median overall survival of 9 months and an encouraging safety profile, the OXFU combination is effective, appears superior to infusional 5-FU and warrants further studies in APC patients.

Adult↗
PubMed2004

Combination of folinic acid, 5-fluorouracil bolus and infusion, and cisplatin (LV5FU2-P regimen) in patients with advanced gastric or gastroesophageal junction carcinoma.

BACKGROUND: Combination chemotherapy with continuous 5-fluorouracil (5-FU) and cisplatin in a monthly regimen is one of the standard treatments for advanced gastric carcinoma. This study evaluated the new LV5FU2-P regimen, designed to improve efficacy and tolerance of the 5-FU plus cisplatin combination. PATIENTS AND METHODS: Forty-three patients with advanced or metastatic gastroesophageal junction or gastric carcinoma were prospectively included in the study. They were treated every 14 days with cisplatin 50 mg/m(2) on day 2 plus folinic acid 200 mg/m(2)/day as a 2-h intravenous (i.v.) infusion on days 1 and 2, plus bolus 5-FU 400 mg/m(2)/day on days 1 and 2, plus continuous 5-FU 600 mg/m(2)/day as a 22-h i.v. infusion on days 1 and 2. Ten patients received a simplified regimen (folinic acid 40 mg/m(2) day 1 + bolus 5-FU 400 mg/m(2) day 1 + continuous 5-FU 2400 mg/m(2) on days 1 and 2 with cisplatin 50 mg/m(2) on day 2). RESULTS: All the patients were assessable for response and 42 for toxicity. One patient achieved a complete response and 15 a partial response, for an overall response rate of 37.2% [95% confidence interval (CI) 22.1% to 52.3%]. The median progression-free survival was 7.2 months (95% CI 5.4-10.9) and the overall survival was 13.3 months (95% CI 10.1-16.4). There were no treatment-related deaths. Hematological and gastrointestinal toxicities were the most common severe toxicities. CONCLUSIONS: LV5FU2-P is an active and well tolerated regimen in the treatment of advanced gastroesophageal junction or gastric carcinomas. It warrants evaluation comparatively with other active regimens.

Adult↗
PubMed2004

Predictive factors of survival in patients with advanced colorectal cancer: an individual data analysis of 602 patients included in irinotecan phase III trials.

BACKGROUND: The infusional LV5FU2 and Arbeitsgemeinschaft Internische Onkologie (AIO) regimens are used widely in the treatment of advanced colorectal cancer. Irinotecan combined with these regimens increases survival in front-line treatment. Irinotecan also improves survival in second-line treatment. PATIENTS AND METHODS: Univariate and multivariate analyses based on the individual data of 602 patients included in two phase III trials were performed to determine predictive factors of survival in advanced colorectal cancer. RESULTS: Three factors were independently associated with a better progression-free survival: weight loss <5% [hazard ratio (HR) 1.25; 95% confidence interval (CI) 1.00-1.58], World Health Organization performance status (WHO PS) 0-1 (HR 1.29; 95% CI 1.08-1.54) and irinotecan (CPT-11)-containing regimens (HR 1.48; 95% CI 1.03-2.13). Five factors were independently associated with a better overall survival: weight loss <5% (HR 1.67; 95% CI 1.29-2.14), WHO PS 0-1 (HR 1.88; 95% CI 1.27-2.75), one or two metastatic sites (HR 1.24; 95% CI 1.01-1.53), alkaline phosphatase values not over twice the normal range (HR 1.71; 95% CI 1.30-2.24) and CPT-11-containing regimens (HR 1.31; 95% CI 1.07-1.61). CONCLUSIONS: The present analysis confirms that CPT-11-based chemotherapy regimens are independently associated with a better survival in patients with advanced colorectal cancer. Age was not identified as a prognostic factor in this analysis.

Adult↗
PubMed2004

Efficacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials.

BACKGROUND: Recently published population-based investigations showed elderly patients to be underrepresented in clinical trials and less often treated according to the standard therapy. Although there is evidence that elderly patients benefit from adjuvant (radio-) chemotherapy to the same extent as younger patients, no large series describes the influence of age on efficacy of chemotherapy in metastatic colorectal cancer. PATIENTS AND METHODS: We carried out a retrospective analysis using source data of 3825 patients who received 5-fluorouracil (5-FU)-containing treatment in 22 European trials and identified 629 patients with an age of > or = 70 years. RESULTS: We found an equal overall survival in elderly patients [10.8 months, 95% confidence interval (CI) 9.7-11.8] and in younger patients (11.3 months, 95% CI 10.9-11.7; P = 0.31). Response rate did not differ between age groups > or = 70 and <70 years (23.9% and 21.1%; respectively; P = 0.14). Progression-free survival was marginally prolonged in elderly patients (5.5 months, 95% CI 5.2-5.8; compared with 5.3 months, 95% CI 5.1-5.5; P = 0.01). In both age groups, infusional 5-FU resulted in significantly increased response rates, overall survival and progression-free survival compared with bolus 5-FU. CONCLUSIONS: 'Fit' elderly patients benefit at least to the same extent from palliative chemotherapy with 5-FU as younger patients. Infusional 5-FU was shown to be more effective than bolus 5-FU in both age groups. Therefore, standardized palliative chemotherapy should generally be offered to elderly patients and they should not be excluded from clinical trials.

Age Factors↗
PubMed2004

Recalibration of somesthetic plantar information in the control of undisturbed upright stance maintenance.

To assess the effects of changes in somesthetic plantar information on upright quiet stance, a rotary plantar massage was applied under the feet of healthy subjects for ten minutes. The controlling variable, the centre of pressure (CP) displacements, were recorded, before and after massage, through a force platform and decomposed into two elementary motions: the vertical projection of the centre of gravity (CG(v)) and the difference between the latter and the CP (CP-CG(v)) along medio-lateral ML and antero-posterior AP directions. These motions were processed through frequency analysis and modelled as fractional Brownian motion. For CP-CG(v) motions, the frequency analysis shows that massage under the plantar soles induces a decrease of the amplitudes along the ML direction suggesting reduced overall muscular activity (abductor-adductor muscles of the hip according to Winter et al.). A general trend is that the CG(v) amplitudes are also diminished after massage especially in the ML direction, indicating a better distribution of the body weight on the two supports. On the other hand, the effects tend to vanish after about 8 minutes. Conversely, when the massage was given under the toes, no particular effect on any elementary motion was observed, suggesting that the plantar mechanoreceptors under the toes necessitate stronger stimulation to respond significantly and/or that the greater sensitivity obtained was not used by the CNS. Overall, this data emphasises the fact that a recalibration of somesthetic cues may occur when enhanced afferent information is fed to the postural system.

Adolescent↗
PubMed2003

The influence of having the eyelids open or closed on undisturbed postural control.

To assess the possible interactions between the physiological mechanisms involved in eyelid closure and stance maintenance, 20 healthy adults were required to keep their eyes open in the dark (EOd), in daylight (EO), or to close them normally (EC), respectively and in random order. The analysis was focused on elementary motions computed from the complex centre of pressure (CP) trajectories, that is to say the vertical projection of the centre of gravity (CGv) and the difference between CP and CGv (CP-CGv). The results indicate that the mean amplitudes of the CP-CGv spectra are statistically reduced in EOd when compared to the EC condition. This diminution is thought to express a decrease in the level of activity of lower limb muscles involved in stance control. Interestingly, the CNS does not really seem to gain from these reduced horizontal accelerations at the CG level since the CGv amplitudes are in turn only slightly reduced. It can thus be hypothesised that, despite the fact that visual information in the EOd condition remains unavailable, the somesthetic cues continue to play a minor role in the detection-correction process aimed at controlling undisturbed stance.

Adult↗
PubMed2003

[Adaptation of control mechanisms involved in upright undisturbed stance maintenance during prolonged darkness].

AIMS OF THE STUDY: To assess to which extent the non visual somato-sensorial information may, through a recalibration process, induce a reorganisation by the central nervous system to control undisturbed upright stance. MATERIALS AND METHODS: Ten healthy adults were placed in complete darkness for a 24 min period. Their postural performance was recorded through a force platform on which they were required to stand still at regular intervals. Centre of Pressure (CP) displacements, recorded from the platform, were modelled as fractional brownian motion. Through this analysis, one may objectively assess from which distance and for how long the corrective process is initiated with the aim of slowing and retrace its steps. In addition, the degree to which the CP trajectories are successively controlled was determined. RESULTS: Once in complete darkness, an increase of the mean time intervals (Delta(t)) before the corrective process intervenes was observed, the effect being mostly significant for the mediolateral direction. In parallel, the mean distances covered at this Delta(t) were slightly affected for both mediolateral and anteroposterior directions. Lastly, the degree to which the CP trajectories are controlled tended to decrease. CONCLUSION: These data suggest a reorganisation of the control mechanisms called into play for maintaining an undisturbed upright stance, thus implying participation of the central nervous system. This short-term adaptation is discussed on the basis of our knowledge of long term adaptations previously observed in blind individuals, and also in a rehabilitation perspective.

Adaptation, Physiological↗
PubMed2003

Hepatic arterial infusion using pirarubicin combined with systemic chemotherapy: a phase II study in patients with nonresectable liver metastases from colorectal cancer.

BACKGROUND: A prospective phase II study was performed to determine the feasibility, efficacy and safety of arterial hepatic infusion (HAI) using pirarubicin combined with intravenous chemotherapy. PATIENTS AND METHODS: From December 1991 to April 1994, 75 patients with unresectable colorectal metastases confined to the liver were included in this multicenter study to receive intra-arterial hepatic pirarubicin and a systemic monthly regimen of 5-fluorouracil (5-FU) and folinic acid. Sixty-four patients were analyzed in the intention-to-treat analysis and 61 in the per-protocol analysis. RESULTS: Tolerance of this regimen was rather good; however, functional catheter problems were observed in 29 patients (45%) resulting in failure of HAI in 21 cases (33%) after a median of three cycles; vomiting grade 3 was present in 12.5% of patients, neutropenia grade 4 in 23% and alopecia grade 3 in 19%. The overall response rate was 31.9% in intention-to-treat analysis, and 39.3% in per-protocol analysis. Extrahepatic progression was reported in only 21.7% of patients. Time to hepatic progression and extra-hepatic progression was 8.3 and 15 months, respectively, in intention-to-treat analysis, and 11 and 18 months, respectively, in per-protocol analysis. Median survival was 19 and 20 months in intention-to-treat analysis and per-protocol, respectively. CONCLUSIONS: In our study, the combination of intra-arterial pirarubicin and intravenous chemotherapy demonstrated some efficacy and good tolerance in the treatment of isolated colorectal liver metastases. This treatment seems to prevent extra-hepatic spread and prolong survival time. The results of this study have to be confirmed by new trials using more active systemic chemotherapy.

Adolescent↗
PubMed2003

Epidemiology, treatment and chemoprevention in colorectal cancer.

In Western countries, colorectal cancer (CRC) is second only to cancer of the lung as a cause of death from malignancy, and affects perhaps one in 20 of the population. In the pre-chemotherapy era, advances in surgery and earlier presentation led to some improvement in survival. However, no more than 60% of CRC patients can expect to be alive at 5 years. Adjuvant chemotherapy in stage III disease is of proven benefit. In metastatic CRC, chemotherapy extends disease-free and overall survival compared with best supportive care alone, and improves quality of life. In palliation, infusional 5-fluorouracil (5-FU) is more active than bolus regimens and is less toxic. Several new cytotoxic agents show promise in CRC. Notable among them is irinotecan, which extends survival both when used as a single agent second-line versus best supportive care alone, and when added to 5-FU/folinic acid in the first-line setting. Much CRC is familial, raising the prospect of targeted screening to aid early detection. Since the molecular events leading to CRC have become better characterized, there is also the possibility of developing chemoprotective agents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

[Influence of visual cues on upright postural control: differentiated effects of eyelids closure].

In most protocols aimed at testing balance abilities, patients are generally required to close their eyes in order to gain insight about proprioceptive cues and the way the central nervous system (CNS) uses this information. However, one should not exclude possible interaction with the physiological mechanisms involved in eyelid closure, thus leading to a biased neurological evaluation. To assess this possible involvement, 15 healthy adults were required to keep their eyes open in the dark (YOn), to close normally (YF) and forcibly their eyelids (YFF), respectively in random order. The analysis was focused on elementary motions computed from the complex center of pressure (CP) trajectories, i.e. the horizontal motions of the center of gravity (CG(h)) and the difference between the CP and the vertical projection of the center of gravity (CP-CG(v)). The former is recognized as the main variable in postural control whilst several interesting features can be extracted from the latter: their link with the horizontal accelerations communicated to the CG, the level of muscular activity and the implied ankle stiffness expressed by their frequential distribution. The results indicate that the amplitudes of the CP-CG(v) spectra are statistically reduced in YOn when compared to the YF condition, especially in the antero-posterior direction. On the other hand, no shift in the frequential bandwidth was observed on these spectra, signifying a constancy in ankle stiffness over all conditions. Interestingly, the CNS does not really seem to gain from these reduced horizontal accelerations at the CG level since the CG(h) amplitudes are only slightly reduced. However, it is important to emphasize that the CP trajectories alone are not able to demonstrate any statistical trend. It can thus be hypothesized that, despite the fact that visual information is still unavailable, the proprioceptive cues nonetheless continue to play a minor role in the detection-correction process aimed at controlling body sway. Past studies on the physiology of eyes blinking have suggested the probability that the cerebellar cortex or brain stem structures (such as the reticular formation) are involved in these commands. Because of its dual facilitating-inhibiting function, the latter is indeed a fair candidate for modulating the descending command operating through the postural muscles. These data are of interest for the practician in order to assess with precision the role played by proprioceptive and visual cues in possible balance disfunctioning.

Adult↗
PubMed2002

Phase II study of oxaliplatin, fluorouracil, and folinic acid in locally advanced or metastatic gastric cancer patients.

PURPOSE: To evaluate the efficacy and safety of an oxaliplatin, fluorouracil (5-FU), and folinic acid (FA) combination in patients with metastatic or advanced gastric cancer (M/AGC). PATIENTS AND METHODS: Of the 54 eligible patients with measurable or assessable M/AGC, 53 received oxaliplatin 100 mg/m(2) and FA 400 mg/m(2) (2-hour intravenous infusion) followed by 5-FU bolus 400 mg/m(2) (10-minute infusion) and then 5-FU 3,000 mg/m(2) (46-hour continuous infusion) every 14 days. RESULTS: Patients (69% male, 31% female) had a median age of 61 years (range, 31 to 75 years), 89% had a performance status of 0 or 1, 70% had newly diagnosed disease, and 87% had metastatic disease. All had histologically confirmed adenocarcinoma. With a median of three involved organs, disease sites included the lymph nodes (67%), stomach (65%), and liver (61%). A median of 10 cycles per patient and 468 complete cycles were administered. Best responses in the 49 assessable patients were two complete responses and 20 partial responses, giving an overall best response rate of 44.9%. Eight patients underwent complementary treatment with curative intent (six with surgery and two with chemoradiotherapy). Median follow-up, time to progression, and overall survival were 18.6 months, 6.2 months, and 8.6 months, respectively. Grade 3/4 neutropenia, leukopenia, thrombocytopenia, and anemia occurred in 38%, 19%, 4%, and 11% of patients, respectively, and febrile neutropenia occurred in six patients (one episode each). Grade 3 peripheral neuropathy occurred in 21% of patients (oxaliplatin-specific scale). Seven patients withdrew because of treatment-related toxicity. CONCLUSION: This oxaliplatin/5-FU/FA regimen shows good efficacy and an acceptable safety profile in M/AGC patients, and may prove to be a suitable alternative regimen in this indication.

Adenocarcinoma↗