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Biomedical subjects

R Riou

Publications and source records attributed to R Riou.

16 recordsLinked to original sources
PubMed1996

The limits of chemotherapy dose intensification using granulocyte colony stimulating factor alone in extensive small cell lung cancer.

Human Recombinant Granulocyte Colony Stimulating Factor (G-CSF) allows rapid neutrophil recovery after chemotherapy-induced leukopenia. In a prospective series of 54 patients with extensive small cell lung cancer, we evaluated the feasibility and efficacy of accelerated delivery of the AVI chemotherapy regimen. Treatment consisted of Doxorubicin 50 mg/m2 day 1, Etoposide 120 mg/m2 day 1-3 and Ifosfamide 2 g/m2 (+ Mesna 4 g) day 1 and 2 given every 2 weeks and followed by G-CSF (Neupogen, Amgen Roche 5 micrograms/kg/day s.c. day 4-14). Twenty-seven (50%) patients could not receive the total of six courses, seven because of severe septic complication, 10 because of Grade 4 thrombopenia, seven because of non-response and three because of patient refusal. Chemotherapy had to be delayed in 58 out of the 244 administered courses and this was due to thrombopenia in 48% of cases. The probability of optimal dose-on-time administration was 64% at three courses. The mean actually received dose intensity was 93% at six courses (27 patients treated). It was increased by 76% compared to our previously published conventional 3-week interval chemotherapy. The median neutrophil nadirs were stable during the successive treatment courses while haemoglobin and platelet values significantly worsened from cycle 1 to cycle 6. The overall response rate after three courses was 77% in the 48 evaluable patients. The median survival is 8 months overall and 5 months disease free. The actuarial survival is 22% at 2 years. We conclude that substantial dose intensification with accelerated chemotherapy and G-CSF support is feasible. However, the rate of severe infectious episodes is too high and thrombopenia is the main limiting factor. Either growth factors active on the megacaryocytic lineage or haematological rescue with peripheral blood stem cells might be useful in this setting.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

A phase II trial of fotemustine and cisplatin in central nervous system metastases from non-small cell lung cancer.

A phase II study was conducted in order to determine the feasibility and toxicity of cisplatin combined with the nitrosourea fotemustine in central nervous system metastases from non-small cell lung cancer. 31 chemotherapy-naïve patients were included between November 1990 and April 1993. Computed tomography scan-documented tumour regression in brain metastases was observed in 7 of the 25 evaluable patients, but only 4 of these (16%) lasted more than 4 weeks. In 2 of these 4 patients, the response on central nervous system metastases was considered as complete. The median duration of response was 20.5 weeks and the median survival was 16 weeks overall and 28.5 weeks for responding patients. The limiting toxicity of this regimen was haematological. 2 patients died from infectious pneumonitis while in neutropenia. Treatment delays due to haematological toxicity occurred in 57% of patients. Despite the rather encouraging response rate, such toxicity appears too high when compared to the overall bad prognosis of this population of patients. Cranial radiotherapy remains the standard treatment in this setting and should only be compared in the future to less aggressive schedules.

Adult↗
PubMed1993

[Value of C-reactive protein determination in small cell lung cancer].

A prospective analysis of serum levels of C-reactive protein (CRP) has been conducted on a series of 39 small cell lung cancer (SCLC) patients during the first course of chemotherapy in order to evaluate the predictive value of this marker on tumoral extension at diagnosis and response to therapy. Serum levels of CRP were measured before chemotherapy (day 0) and during the first two days of treatment (day 1, day 2). Twenty-three of 32 evaluable patients (71%) had extensive disease. The mean pre-treatment CRP level was significantly higher in this group than in the group of patients with limited disease (52.3 mg/l vs 15.8 mg/l, P = 0.02). Twenty-three patients responded to treatment and nine did not. The evolution of serum CRP levels in both groups was compared between day 0 and day 2. A more than two-fold increase of initial CRP levels showed a 100% predictive value for response. On the other hand, a decrease by more than 50% of initial serum levels was associated with a negative predictive value of 75% for response. We conclude that the follow-up of CRP levels during initial chemotherapy of SCLC might be useful in the initial evaluation of tumoral extension and in the early prediction of response to therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Comparison of 2 cisplatin and etoposide dosages in relapsing small cell lung cancer].

The synergistic combination of cisplatinum and etoposide appears as the best second line treatment in patients relapsing from small cell lung carcinoma (SCLC). In order to test the dose-effect relationship of cisplatinum and etoposide in this situation, we have performed a randomised phase II trial comparing 2 five-day regimens: cisplatinum 20 mg/m2/day+etoposide 60 mg/m2/day (arm A) versus cisplatinum 40 mg/m2/day+etoposide 100 mg/m2/day (arm B) every 4 weeks. Thirty-seven patients were included (arm A: 18, arm B: 19), and 32 were considered to be eligible (arm A: 15, arm B: 17). Eight patients were non evaluable, five of them because of toxic death occurring prior to the second course (arm A: one from neutropenia; arm B: three from neutropenia and one from thrombopenia). The two groups were well balanced with regard to the main prognostic factors (age, sex, performance status, LDH level, response to induction chemotherapy). An objective response was observed in 10/24 evaluable patients (arm A: 4, arm B: 6) and was considered as complete in one patient in arm A and in 2 pts in arm B; these two patients presented with cerebral metastases and their response lasted 9 and 15 weeks respectively. The mean duration of response was 11 weeks in arm A and 10.5 weeks in arm B. The median actuarial survival of the overall population of eligible patients was 15 weeks: 13 weeks in arm A and 16.5 weeks in arm B. The study was discontinued because of the 23.5% toxic deaths rate in the high doses arm in this heavily pre-treated population of patients. However, the high response rate (54% overall, 35% considering toxic death as a failure) is impressive and presents evidence for the dose/effect relationship in SCLC.

Aged↗
PubMed1985

[Chronic idiopathic eosinophilic pneumopathies. A study of 16 cases].

We report 16 cases of chronic idiopathic interstitial pneumonia (P.C.I.E.). P.C.I.E. has well defined clinical, radiological and biological characteristics which enable the eosinophilic pulmonary infiltrates to be recognised and the diagnosis to be confirmed without histological proof. The data from broncho-alveolar lavage (L.B.A.) show that besides the radiological infiltrates, there is a diffuse alveolar eosinophilia; sometimes confirming the pulmonary function results, which show a similar pattern to diffuse interstitial pneumonia (P.I.D.). The frequent association of asthma (50%) and extra-pulmonary signs (30%) may suggest a vasculitis or more particularly the Churg-Strauss syndrome, all the more so without a lung biopsy; however the evolution of the disease and the response to low dose steroid therapy is against the latter two being considered in the differential diagnosis. The prognosis for P.C.I.E. is good in the short and medium term; nevertheless during the period under observation (mean 6.3 years) steroid therapy could only be stopped in 3 out of 16 patients. The other patients were stable with a low dose of Cortisone. No patient with P.C.I.E. associated with asthma or hypergammaglobulinaemia or extra-pulmonary signs could be weaned from steroids. The authors advocate that the dose of steroids should be adjusted as low as possible to maintain an eosinophilia below 500/mm3.

Adult↗
PubMed1984

[Extensive venous thrombosis disclosing an aneurysm of the common iliac artery].

Although aneurysms of the common iliac artery are a rare occurrence they should be investigated routinely in patients with urinary or thrombo-embolic venous manifestations in the pelvis minor. Clinical signs are inconstant and diagnosis requires the use of abdominopelvic ultrasound tomography. Venous and urinary complications constitute warning signals suggesting the need for surgery to avoid sudden or untimely rupture. Operation in patients with a poor general condition should be performed as a function of the course of the lesion.

Aged↗
PubMed1982

[Drug induced pulmonary disease. Diffuse interstitial pneumonitis during chemoradiotherapy for small cell carcinoma of the lung. Two cases (author's transl)].

Two patients with small cell carcinoma of the lung treated by chemoradiotherapy developed, diffuse interstitial pneumonitis after 7 and 21 months of treatment while in complete remission of their malignant disease. One patient died after an acute respiratory distress syndrome, but the second improved after steroid therapy and discontinuation of cytotoxic therapy. Pulmonary toxicity appeared to be related to cyclophosphamide therapy, but radiation therapy could have potentiated cyclophosphamide toxicity as it has been shown in bleomycin lung disease.

Aged↗
PubMedDate not supplied

[Thrombophlebitis].

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Adrenal Cortex Hormones↗
PubMedDate not supplied

[Pleural effusion in rheumatoid arthritis (R.A.). Biochemical study of the pleural fluid (author's transl)].

The diagnosis of pleural effusion in R.A. is largely done by exclusion. Histopathological data, obtained by pleural punch-biopsy, are unreliable. It is generally a serofibrinous pleural effusion. Biochemical study of the pleural fluid shows a high protein level (> 40 g/l), high latex factor (larger than or equal to 1/2560) and, predominantly, low sugar rate in pleural fluid (< 0,35 g/l) and low complement level (whole hemolytic complement C3 and C4).

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Rheumatoid pleurisy with cholesterol pleural effusion. A single case. Literature review (author's transl)].

The authors report a new case of rheumatoid pleurisy proved by the clinical contest and the biological samplings of pleural fluid: a pleurisy with cholesterol pleural effusion. Six observations of rheumatoid pleurisy with cholesterol pleural effusion were found in the literature. This new case confirms this biological peculiarity of rheumatoid pleurisies and the authors insist on the existence of acute pleurisies with cholesterol pleural effusion.

Acute Disease↗