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David JM, Barthelemy I, Bonnet F, Mihura J, Daly-Schveitzer N. [Results of the surgical treatment of epidermoid carcinoma of the mobile tongue and mouth floor. Apropos of 157 patients]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 1997; 98:306-11. [PMID: 9471676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Squamous cell carcinomas of the oral cavity were treated in 157 patients by surgery as first-line (104) or salvage (53) treatment. Postoperative irradiation delivered either for locally advanced tumors (stade III-IV) or for unfavorable histological data (nodal or surgical margins involvement). The retrospective study with a mean time of follow-up of 2.5 years shows a loco-regional control rate of 75% statistically influenced by histological nodal status (p < 0.01). Cumulative and cause specific survival rates at 5 years are 41.1% and 57.2% respectively. T stage was found to be a prognostic factor of survival (p < 0.01) as bone involvement (p < 0.05). Surgical margins are influent on local control and survival only in absence of radiation.
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De Haro L, Prost N, Arditti J, David JM, Jouglard J. [Scombroid poisoning. Experience of the Anti-Poison Center of Marseilles]. Presse Med 1997; 26:1294. [PMID: 9380642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Chávez JP, David JM, Yang SW, Cordell GA. 24-norhopene derivatives from Diatenopteryx sorbifolia. JOURNAL OF NATURAL PRODUCTS 1997; 60:909-911. [PMID: 9322363 DOI: 10.1021/np970238+] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Two new hopene derivatives, 3 beta,6 beta-dihydroxy-21 alpha H-24-norhopa-4(23),22(29)-diene (1) and 3 beta,5 beta-dihydroxy-6 beta-[(4-hydroxybenzoyl)oxy]-21 alpha H-24-norhopa-4(23),22(29)-diene (2), together with cleomiscosin B (3) and 5,6-dimethoxy-7-hydroxycoumarin (umckalin), were isolated from the timber of Diatenopteryx sorbifolia. This is the first isolation of the norhopene skeleton from nature. The structures of the isolates were established by spectroscopic analysis.
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Bachaud JM, Chatelut E, Canal P, Albin N, Yardeni E, David JM, Serrano E, Daly-Schveitzer N. Radiotherapy with concomitant continuous cisplatin infusion for unresectable tumors of the upper aerodigestive tract: results of a phase I study. Am J Clin Oncol 1997; 20:1-5. [PMID: 9020278 DOI: 10.1097/00000421-199702000-00001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A phase I-II study was initiated in February 1991 of concomitant radiation and cisplatin (CDDP) in the treatment of unresectable head and neck squamous cell carcinomas (n = 12). The first patient was treated palliatively for a cervical recurrence of laryngeal cancer. The 11 other patients had locally advanced (stage IV) previously untreated carcinomas of the oropharynx (n = 9), hypopharynx (n = 1), or cervical node with unknown primary site (n = 1). Standard external radiation was carried out up to a total dose of 60 Gy/6 weeks (7 MeV electron beam) for the first patient and 72 Gy/8 weeks (Co60 beam) for the other 11 patients. CDDP was infused continuously during the entire radiation treatment, 5 days/week. The starting dose was 4 mg/m2/day and was escalated by increments of 1 mg/m2/day; dose-limiting toxicity was observed at 7 mg/m2/day. Neutropenia (grade 4, one patient; grade 3, three patients) and thrombocytopenia (grade 3, one patient; grade 2, one patient) were the limiting factors. Therefore, the recommended dose of CDDP is 6 mg/m2/day. All patients but one completed the scheduled radiation. For the entire group, mucositis was not more severe than that observed with radiotherapy alone. There was no nephro-, oto-, or neurotoxicity. A complete response was obtained in eight (66%) patients. Of these, four were free of disease 12-34 months after completion of treatment and one had a total glossectomy for a tongue necrosis. For the whole series, the mean overall survival was 16 months posttreatment. Pharmacokinetic analysis indicated the total cisplatin accumulation at the end of treatment to be 743-1551 ng/ml. Accumulation of ultrafilterable platin was noted in only one patient (137 ng/ml at the end of treatment).
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Benchalal M, Bachaud JM, François P, Alzieu C, Giraud P, David JM, Daly-Schveitzer N. [Hyperfractionated reirradiation after salvage surgery in cervico-facial carcinoma. Result of a pilot study in 14 patients]. Cancer Radiother 1997; 1:68-73. [PMID: 9265536 DOI: 10.1016/s1278-3218(97)84058-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Between November 1988 and May 1992, 14 patients were enrolled in a pilot study to evaluate the feasibility and results of hyperfractionated reirradiation for the treatment of head and neck recurrences or of second primary tumors developed in a previously irradiated volume. MATERIALS AND METHODS All patients underwent a surgical resection for the treatment of their recurrence or second cancer. Reirradiation was proposed because of positive margins and/or lymph node metastasis with extra-capsular spread. The planned reirradiation dose was 60 Gy over 5 weeks, with two daily fractions of 1.2 Gy delivered 6-8 hours apart. RESULTS Of the 14 patients, 10 received the reirradiation scheduled dose (ie, 60 Gy). All patients experienced an acute mucositis that never led to disruption of the treatment. Ten patients died 3 to 41 months after reirradiation (mean: 14 months), three were disease-free 48 to 71 months after reirradiation and one was alive with local progressive disease 74 months after reirradiation. The overall local control rate within the reirradiated volume was 43%. The 24- and 36-month overall survival rates were 50 and 35%, respectively. Overall, 13 late complications were noted: four were grade 1, seven were grade 2, and two were grade 3. Three patients still alive in September 1993 and whose initial files were available were enrolled in an additional study to assess from dose-volume histograms the cumulative doses delivered by the two irradiations. CONCLUSION Despite poor local control, reirradiation using a hyperfractionation schedule with high dose level is feasible in terms of acute and late toxicity.
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Bachaud JM, Cohen-Jonathan E, Alzieu C, David JM, Serrano E, Daly-Schveitzer N. Combined postoperative radiotherapy and weekly cisplatin infusion for locally advanced head and neck carcinoma: final report of a randomized trial. Int J Radiat Oncol Biol Phys 1996; 36:999-1004. [PMID: 8985019 DOI: 10.1016/s0360-3016(96)00430-0] [Citation(s) in RCA: 282] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To report the final results of a prospective randomized trial that aimed to evaluate efficacy and toxicity of concomitant postoperative radiotherapy and Cisplatin infusion in patients with Stage III or IV squamous cell carcinoma of the head and neck and histological evidence of extracapsular spread of tumor in lymph node metastase(s). METHODS AND MATERIALS Radiotherapy was delivered using a daily dose of 1.7 Gy for the first 54 Gy and 1.8 to 2 Gy until the completion of the treatment. Cisplatin 50 mg i.v. with forced hydratation was given or not every week (i.e., seven to nine cycles) concurrently with radiotherapy. A total of 44 patients were treated by irradiation only (RT group) and 39 by irradiation with chemotherapy (CM group). RESULTS The RT group displayed a higher rate of loco-regional failures as compared to CM group (41 vs. 23%; p = 0.08). The overall survival, the survival corrected for deaths by intercurrent disease, and the disease-free survival were better in CM group as compared to RT group with statistically significant differences. Survival without loco-regional treatment failure was better in the CM group, the difference being close to the level of significance (p = 0.05). Survival without distant metastases were comparable in the two therapeutic groups. Ten severe late complications were observed, four in the RT group (17%) and six in the CM group (22%). Cox univariate analysis confirmed the importance of the therapeutic modality in predicting the overall survival, the survival corrected for deaths by intercurrent disease, and the disease-free survival. CONCLUSIONS The present final report of this phase III study confirms preliminary results. The concomitant use of 50 mg weekly Cisplatin infusion and postoperative radiation improved loco-regional control and survival. No significant increase of late radiation complications was observed in the CM group.
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Jouglard J, Perringue C, Goujard J, Servetti A, David JM. [Evaluation by poison control centers of minaprine from the modification of tablet dosages]. Therapie 1996; 51:582-5. [PMID: 9138401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
By 1990, the Clin Midy (SANOFI) laboratory had modified the dose of Cantor tablets: the content of active drug (minaprine) increased (50 to 100 mg). Therefore, acute intoxication by minaprine can be serious, with generalized seizures, resisting the classic treatment. We tried to evaluate the possible consequences of this change of dose for the gravity of suicide attempts. 1091 voluntary acute intoxications have been collected by the national French Poisons Centres data bank, 226 of them by the Poisons center of Marseilles. We have compared, by the chi 2 method, the frequencies of seizure and death, before and after 1990. Results are significant, confirming an increased gravity of these intoxications since the modification of dosage. Then, the laboratory reduced the number of tablets per box. We don't know if this measure will be efficient.
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De Haro L, Jouglard J, David JM. [Scorpion bites in southern France: experience at the poison-control centre of Marseilles]. Presse Med 1996; 25:600. [PMID: 8657679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Brugère JM, Mosseri VF, Mamelle G, David JM, Buisset E, Vallicioni J, de Raucourt D, Szpirglas HJ, Asselain BJ. Nodal failures in patients with NO N+ oral squamous cell carcinoma without capsular rupture. Head Neck 1996; 18:133-7. [PMID: 8647678 DOI: 10.1002/(sici)1097-0347(199603/04)18:2<133::aid-hed4>3.0.co;2-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The efficacy of postoperative irradiation of the neck after lymph node dissection in terms of prevention of cervical node recurrence (NR) has not been demonstrated in patients with NO squamous cell carcinoma of the oral cavity. METHODS This multicenter retrospective analysis comprises 826 patients with squamous cell carcinoma of the oral cavity, all clinically NO. The primary tumor was treated by resection or brachytherapy. All patients underwent cervical dissection adapted to the site of the tumor. Fourty seven N+ patients with capsular rupture were excluded; 160 patients were N+ without capsular rupture (N+ CR-), and 619 were N-. Postoperative cervical irradiation was performed in 67 of 160 N+ CR- patients and in 49 of 619 N- patients. RESULTS NR developed in 78 patients, associated with local recurrence in 33 cases and isolated in 45 cases. Twenty-six of the 45 cases of isolated NR occurred in the 619 N- patients (4%), and 19 occurred in the 160 N+ CR- patients (12%, p = .001). The 26 NR observed in the N- patients occurred in nonirradiated patients. Among the 19 NR observed in the N+ CR- patients, the incidence of recurrence was not significantly different between irradiated patients (6 NR of 67.9%) and nonirradiated patients (13 NR of 93, 14%). NR rates also did not differ according to the number of lymph nodes invaded nor according to the level of the positive nodes; 14 of 45 isolated NR occurred in a nondissected suprahyoid region. Of 779 patients, 255 (33%) subsequently developed a metachronous cancer; 153 upper respiratory and digestive tract tumors, 37 lung tumors, 33 esophageal tumors, and 32 other tumors. Isolated cervical failure was responsible for 40 deaths. CONCLUSION The low NR rate in NO N+ CR- patients means that postoperative irradiation can be confined to N+ CR+ patients and, as a precautionary measure, to patients with more than 3 N+ CR-. Keeping irradiation in reserve allows the treatment of metachronous cancers, which are particularly frequent in these patients, in whom the 5-year survival rate is 54% in N+ CR- and 69% in N-.
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Benchalal M, Bachaud JM, François P, Alzieu C, Giraud P, David JM, Daly-Schveitzer N. Hyperfractionation in the reirradiation of head and neck cancers. Result of a pilot study. Radiother Oncol 1995; 36:203-10. [PMID: 8532907 DOI: 10.1016/0167-8140(95)01620-v] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Between November 1988 and May 1992, 19 patients were enrolled in a pilot study to evaluate feasibility and results of a hyperfractionated reirradiation in the treatment of head and neck recurrences or second primary tumors developed in previously irradiated volume. Patients were divided in two groups according to the initial treatment before reirradiation: group 1 included 14 patients treated with radical surgery and reirradiated because histological evidence of positive margins and/or extra capsular spread of tumor in lymph node metastases; group 2 included five patients treated with three cycles of CDDP-5FU for unresectable tumors and reirradiated because they experienced a complete or good partial (> or = 80%) response after chemotherapy. The reirradiation planned dose was 60 Gy in 5 weeks, with two daily fractions of 1.2 Gy spaced by 6-8 h intervals. Reirradiation was delivered exclusively with photon beams in 17 cases and with a combination of photon and electron beams in two cases. Follow-up ranged from 3 to 45 months with a median of 17 months. Of the 19 patients, 13 received the reirradiation scheduled dose of 60 Gy. For the six remaining patients, the reirradiation doses ranged from 45.6 to 57.6 Gy. All patients experienced an acute mucositis which never led to interruption of treatment. Of the 14 patients of group 1, 10 died 3-41 months after reirradiation (mean: 14 months), three were disease-free 16-37 months after reirradiation and one patient was alive with local progressive disease 39 months after the reirradiation. The overall local control within reirradiated volume was 36% before and 43% after salvage surgery. For all group 1 patients, 12- and 24-month overall survival was 64 and 36%, respectively (mean: 21 months). All patients of group 2 presented a local failure within the reirradiated volume. Three of them died 12, 16 and 25 months after reirradiation, while two of them were alive with progressive disease 25 and 30 months after reirradiation, respectively. The mean survival was 22 months. Overall, 15 late complications were noted: five grade 1, eight grade 2 and two grade 3. There was no lethal complication. Four patients alive in September 1993, and whose initial technical files were available, were enrolled in an additional study to assess the cumulative doses delivered by the two irradiations. Despite disappointing loco-regional control rates, a reirradiation of 60 Gy using a hyperfractionated schedule is feasible in terms of acute and late toxicity.
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Daly-Schveitzer N, David JM, Bachaud JM. [Palliative treatments of cancers of upper respiratory and digestive tracts]. LA REVUE DU PRATICIEN 1995; 45:865-8. [PMID: 7539153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Palliative treatment of head and neck cancers needs an initial evaluation based upon clinical symptoms and tumoral behaviour. Local recurrences are the most frequent presentation of tumoral failures. The therapeutic management of these local recurrences requires a mixture of unspecific and specific oncologic procedures. Radiotherapy and chemotherapy are frequently used in those circumstances in order to reduce the tumoral volume and to facilitate the effectiveness of unspecific treatments. Management of metastatic disease is often impaired by the moderate efficiency of chemotherapy while this treatment leads to marked side effects. Basically, the best therapeutic choice depends on the expected positive balance between the improvement of symptoms and the level of treatment-related side effects. However, daily clinical approach is a better way to care these patients than predefined rigid protocols.
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de Haro L, David JM, Jouglard J. [Latrodectism in southern France. A series of cases from the poisoning center of Marseille]. Presse Med 1994; 23:1121-3. [PMID: 7971832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Black widows, which belong to the genus Latrodectus, are particularly dangerous spiders. The clinical syndrome caused by their bite is known as latrodectism. In Provence and in Corsica, there is a locally-found species, Latrodectus mactans tredecimguttatus called "malmignate". A series of 30 cases were collected by the Marseille Poison centre between 1973 and 1993 inclusive. RESULTS The cases of poisoning involved patients bitten in the summer, mostly in Corsica (only 5 of the cases were from Provence) in rural areas. The symptoms were generally widespread pain and muscle contractions, sometimes associated with neurosomatic symptoms, such as increased sweating, or alterations in the blood pressure or body temperature. On the other hand, local signs remained benign or were absent, this sometimes causing confusion with the diagnosis: in 5 of the cases were surprisingly severe, the outcome of the poisoning was always favourable, using symptomatic treatment including infusions of calcium salts, which combat the effects of toxins (disturbance of presynaptic ion exchange).
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Bachaud JM, Delannes M, Allouache N, Benchalal M, Alzieu C, David JM, Serrano E, Daly-Schveitzer NJ. Radiotherapy of stage I and II carcinomas of the mobile tongue and/or floor of the mouth. Radiother Oncol 1994; 31:199-206. [PMID: 8066202 DOI: 10.1016/0167-8140(94)90424-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
From 1977 to 1990, 94 evaluable patients were treated with iridium-192 implantation in the Centre Claudius Regaud for a Stage I (52 patients) or a Stage II (42 patients) squamous cell carcinoma of the mobile tongue and/or the floor of the mouth. Interstitial brachytherapy was associated with external irradiation in 68 patients (group 1; mean dose, 48 Gy for external irradiation, 26 Gy for brachytherapy) or was exclusive in 26 patients (group 2; mean dose, 66 Gy). The mean follow-up was 44 months. Eleven acute complications were noted during or immediately after the implant (1 lethal myocardial infarction, 6 hematomas of the tongue which spontaneously resolved, 3 local sepsis). The mean duration of the mucositis was 9 weeks (from 4 to 20 weeks). Ten patients (17%) experienced a late complication (8 in group 1, 2 in group 2): 3 bone necroses requiring hemimandibulectomy (1 post-operative death), 1 tongue necrosis treated by a transoral mucosal excision, 6 bone expositions which recovered after medical treatment. Local control rates for T1 and T2 tumors were 75% (39/52) and 51% (21/41), respectively. Sixteen patients (17%) presented a nodal relapse which was associated in 6 cases with a concomitant local relapse. The local control rate of T1 tumors was 64% (23/36) in group 1 versus 100% (16/16) in group 2 (p < 0.01). For T2 tumors, these figures were 45% (14/31) and 70% (7/10), respectively (p > 0.3). The influence of 13 parameters on the local control was studied in analysis. In the one model analysis, a cox regression tumor size was significantly predictive of actuarial local recurrence (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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David JM. Use of GoLYTELY. Am J Gastroenterol 1994; 89:640. [PMID: 8147378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Bachaud JM, Albin N, Gay C, Chatelut E, Benchalal M, David JM, Boneu A, Serrano E, Canal P, Daly-Schveitzer N. [Concomitant association of radiotherapy and chemotherapy (CDDP 4-6 mg/m2/daily in continuous i.v. administration) in locally advanced ORL tumors]. Bull Cancer 1994; 81:212-8. [PMID: 7894129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In order to enhance radiation effects in the treatment of unresectable Head and Neck squamous cell carcinoma, we initiated a phase I-II study in February 1991 with concomitant radiation and cisplatin in the treatment of resectable Head and Neck squamous cell carcinoma. The first patient was treated in a palliative intend for a cervical recurrence (cutaneous metastatic lymphangitis) of laryngeal cancer. The seven other patients had a Stage IV M0, previously untreated, oropharyngeal carcinoma. Standard external radiation was carried out up to a total dose of 60 Gy/6 weeks (7 MeV electron beam) for the 1st patient and 72 Gy/8 weeks (Co60 beam) for the 7 other patients. Cisplatin was given during the entire radiation treatment, by continuous infusion, 5 days a week, at doses of 4 mg/m2/d for the 1st patient, 5 mg/m2/d for the two following patients and 6 mg/m2/d for the last five patients. One patient with a poor initial performance status (three in the WHO scale) stopped his treatment on the 6th week due to a grade 3 mucositis with deglutition pneumonia. He died 2 months later with progressive carcinoma. For one other patient, treatment was discontinued for 1 week after 48 Gy, due to a grade 3 mucositis. The other patients completed the planned protocol without any interruption. Mucositis (grade 3 in two cases, grade 2 in four cases), dermitis (grade 3 in two cases, grade 2 in four cases) and neutropenia (grade 2 in two cases) were the most frequent acute toxicity. Of the seven patients treated with a curative intend, six are free of disease at 6 to 28 months after completion of treatment. A pharmacokinetic study showed a total platinum accumulation. The mean value at the end of treatment reached 1157 ng/ml. Only one patient experienced an accumulation of the ultrafilterable platinum (137 ng/ml at the end of treatment).
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Bachaud JM, David JM, Shubinski RE, Perineau D, Boussin G, Serrano E, De Forni M, Pessey JJ, Daly-Schveitzer NJ. Predictive factors of a complete response to and adverse effects of a CDDP-5FU combination as primary therapy for head and neck squamous carcinomas. J Laryngol Otol 1993; 107:924-30. [PMID: 8263392 DOI: 10.1017/s0022215100124806] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Retrospective analysis of detailed patient and tumour factors associated with a complete response to combination inductive chemotherapy with CDDP-5FU (96 or 120 hour continuous infusion) was performed using data from 147 patients with a previously untreated squamous cell carcinoma of the oral cavity, oropharynx or pharyngo-larynx following completion of two (29 patients) or three (118 patients) cycles. Adverse reactions to chemotherapy were documented for all 164 patients included in the study. Eight drug-related deaths occurred due to: acute myocardial infarction (five patients), peptic ulcer disease (two patients) and severe neutropenia with sepsis (one patient). Severe non-lethal complications included marrow depletion (14 patients), peptic ulcer (two patients), thrombophlebitis (seven patients), angina pectoris (two patients), stroke (one patient), pulmonary oedema (one patient) and convulsions (one patient). Six patients refused further treatment because of untoward side effects and tumoral progression was observed in three cases. Separate response rates for the primary site and nodes were determined and analysis of respective predictive factors of response was performed. Complete response was obtained in 31 per cent at the primary site versus 18 per cent for the nodes (p < 0.05). The combined (primary site + nodes) overall complete response rate was 22 per cent. Among 11 factors studied (age, sex, performance status, primary site, tumour differentiation, initial resectability, 5FU dosage per cycle, number of cycles, T, N and TN stages), only performance status, N stage, resectability and number of cycles were associated with a combined complete response. Multivariate analysis showed performance status, N stage, TN stage and resectability to be significant predictive factors of a combined complete response.(ABSTRACT TRUNCATED AT 250 WORDS)
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Arditti J, Bourdon JH, David JM, Lanze L, Thirion X, Jouglard J. [Benzodiazepine levels in drivers involved in traffic accidents]. Presse Med 1993; 22:765-6. [PMID: 8100359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A study of benzodiazepine impregnation of 234 drivers involved in road accidents showed a higher level of impregnation than that usually observed in the general population and a different frequency of this impregnation in the two populations. Although a significant correlation was found between responsibility of the driver and positivity of benzodiazepine assays, this result must be interpreted with caution and does not permit to attribute the responsibility for the accident to the presence of benzodiazepine in blood.
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David JM, Paoli J, Bonnet F, Bejjani W, Bachaud JM. Value of transmandibular resection (commando) as first or salvage treatment in 78 oropharyngeal carcinomas. Eur J Cancer 1993. [DOI: 10.1016/0959-8049(93)91408-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bachaud JM, Shubinski R, Boussin G, Chevreau C, David JM, Viraben R, Bonafé JL, Daly NJ. Stage I cutaneous malignant melanoma: risk factors of loco-regional recurrence after wide local excision and clinical perspectives. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 1992; 18:442-8. [PMID: 1426294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Two hundred and nineteen patients admitted to the Centre Claudius Regaud over a 14-year period for a stage I cutaneous malignant melanoma were retrospectively evaluated for loco-regional recurrence rates, risk factors and survival rates following wide primary excision. Five and 8 year survival rates corrected for deaths owing to concurrent illness were 77% and 73%. The loco-regional control rate was 69% (151/219). Distant metastases occurred in 59% (40/68) of patients who had a loco-regional recurrence, versus 11% (16/151) of patients when loco-regional control was obtained (P < 0.001). Multivariate analysis was used to ascertain which risk factors act independently as predictors of poor loco-regional control. Anatomical location of the primary ('head and neck-trunk-hands and feet' vs 'proximal limb') and thickness formed the best model in this respect among 11 prognostic factors studied. Since loco-regional recurrence may be associated with an increased risk of distant metastatic disease, we advocate the use of elective regional lymph node dissection in stage I patients at high risk of loco-regional recurrence in the hope that a portion of these patients may have increased survival owing to lack of development of widespread metastases.
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Jean-Pastor MJ, Morange-Sala S, Rodor F, Gambini D, Galland MC, David JM, Jouglard J. [Role of pharmacovigilance center in information for the public on drugs. Experience in Marseille on 9 month]. Therapie 1992; 47:429-32. [PMID: 1299984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We analyzed the role of the Marseille pharmacovigilance center (working in collaboration with the local poison treatment center) in informing the general public on medicinal drugs. Over a 9-month period, the center received 115 requests from members of the public for information. 82.6% of callers were not members of the health professions and wanted information for themselves (61.7%, 67.6% women) or their children (26.08%). The questions mainly involved drug interactions (28.7%), side-effects (26%) and precautions for use in particular circumstances (20%). 178 proprietary drugs (47 of which had been bought over the counter) were mentioned. The main therapeutic classes were neuropsychiatric drugs (n = 41), cardiovascular drugs (n = 17) and analgesics (n = 16). A number of communication difficulties and problems of a deontological nature were encountered. Full information was provided in every case, together with advice on prevention to about half the callers.
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Bachaud JM, Fu RC, Delannes M, Izar F, Martel P, David JM, Shubinski RE, Daly NJ, Montana GS. Non-randomized comparative study of irradiation alone or in combination with surgery in stage Ib, IIa and "proximal" IIb carcinoma of the cervix. Radiother Oncol 1991; 22:104-10. [PMID: 1957000 DOI: 10.1016/0167-8140(91)90005-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
252 evaluable patients were treated in the Centre Claudius Regaud from January 1974 to December 1983 for stage Ib, IIa or proximal IIb carcinoma of the uterine cervix. This retrospective analysis compares results obtained either by radio-surgical combination therapy (113 patients = RS group) or by exclusive irradiation (139 patients = RT group). The comparison of the two groups in terms of patient age, obesity, associated vascular pathology and previous abdomino-pelvic surgery favored the RS group significantly. The distribution according to clinical stage also significantly favored the RS group. The proportion of patients with stage IIb disease was 12% in the RS group as opposed to 25% for the RT group. Despite unfavorable patient and tumor characteristics, therapeutic results in the RT group were similar to those of the RS group. Pelvic recurrences developed in 18/110 (16%) and 18/139 (13%) of the patients in the RS and RT groups, respectively. Distant metastases occurred in 5/92 (5%) patients in the RS group and 13/121 (11%) patients in the RT group, but the difference was not significant (p less than 0.1). Five year corrected actuarial disease-free survival was 82% in both groups. There were no major early complications in the RT group while four were found in the RS group, of which three were fatal. 2% of patients had major late complications in the RS group versus 6% in the RT group and none were lethal. 25% of the RT group patients had a moderate or mild complication versus 10% in the RS group but 2/3 of these complications recovered without sequellae.
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Bachaud JM, David JM, Boussin G, Daly N. Combined postoperative radiotherapy and weekly cisplatin infusion for locally advanced squamous cell carcinoma of the head and neck: preliminary report of a randomized trial. Int J Radiat Oncol Biol Phys 1991; 20:243-6. [PMID: 1991685 DOI: 10.1016/0360-3016(91)90098-o] [Citation(s) in RCA: 93] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A prospective clinical trial was designed to evaluate efficacy, toxicity, and patient compliance of concomitant postoperative radiotherapy and Cisplatin infusion in patients with Stage III or IV S.C.C. of the head and neck and histological evidence of extra-capsular spread of tumor in lymph node metastase(s). Cisplatin 50 mg IV with forced hydration was given or not every week (i.e., 7 to 9 cycles) concurrently with radiotherapy. Between 1984 and 1988, 83 patients were randomized: 44 were treated by irradiation without chemotherapy (RT group) and 39 by the combined modality (CM group). There was no significant difference between the two groups in terms of patient characteristics, primary sites, tumor differentiation, T.N. stages, or postoperative prognostic factors. All patients completed the planned radiotherapy. There were seven severe toxicities (greater than grade 3) in the RT group. In the CM group, 30 severe toxicities occurred in 16/39 (41%) patients but none was life-threatening. Seven of 39 (18%) patients received less than two-thirds of the scheduled Cisplatin courses because of intolerance, mainly nausea and vomiting. Preliminary results show a better disease-free survival for the CM group (65% at 24 months) than for the RT group (41% at 24 months). This significant difference is largely due to increased loco-regional control in the CM group (79% vs 59%), the actuarial distant metastasis rates in patients controlled above the clavicles not being statistically different in the two groups.
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David JM. [Poison Control Centers. Deontological and medico-legal aspects]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 1990:11-6. [PMID: 2389159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jouglard J, David JM, Rodor F, Jean P, Arditti J, Benhain JJ, Bouchacourt M, Cremieux M, Gastaut JL, Pellissier JF. [Peripheral neuropathies (P.N.) in a medical toxicology center--results obtained by a sample of 120 cases, of presumed toxic origin]. JOURNAL DE TOXICOLOGIE CLINIQUE ET EXPERIMENTALE 1989; 9:393-407. [PMID: 2561369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Perringue C, David JM, Jouglard J. [Acute poisoning by maprotiline--experience of Marseille Poison Control Center]. JOURNAL DE TOXICOLOGIE CLINIQUE ET EXPERIMENTALE 1989; 9:338-9. [PMID: 2632788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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