David Perol - Academia.edu (original) (raw)
Papers by David Perol
European journal of cancer (Oxford, England : 1990), Jan 11, 2015
The added value of tumoural genomic profiles to conventional clinico-biological factors to predic... more The added value of tumoural genomic profiles to conventional clinico-biological factors to predict progression-free survival (PFS) and overall survival (OS) was prospectively investigated in patients with advanced gastrointestinal stromal tumours (GIST) treated in the BFR14 study. Of the 434 included patients, mutational analysis was performed in 322 patients. Survival analysis was performed in patients with validated mutational status. Mutational status was validated in 228 patients. We identified 196 patients with tumours harbouring 200 KIT alterations (exon 11: 173 patients, exon 9: 22 patients, exon 17: 3 patients, exon 13: 2 patients; 4 patients had double KIT mutations), 6 patients with PDGFRA mutations and 26 patients with wild-type (WT) GIST genotype. On a median follow-up of 73 months, median PFS/OS were 12.3/54.9 months for WT GIST, 12.6/55 months for KIT exon 9, and 39.4 months/not reached (69.1% at 5 years) for KIT exon 11. Tumour size, female gender, KIT exon 11 mutatio...
Douleurs : Evaluation - Diagnostic - Traitement, 2006
Oncologie, 2006
Résumé: L’étude a pour but de tester la faisabilité d’une prise en charge précoce à domicile des... more Résumé: L’étude a pour but de tester la faisabilité d’une prise en charge précoce à domicile des aplasies fébriles sans facteurs de mauvais pronostic. Sur 517 épisodes de neutropénies fébriles enregistrés entre 07/99 et 06/01, seuls 52 cas ont bénéficié de cette prise en charge avec Céfépime 2g 2 fois par jour. Dans les autres cas, il existait des facteurs de
Oncotarget, Jan 21, 2015
Validated predictive biomarkers for multi-tyrosine kinase inhibitors (MTKI) efficacy are lacking.... more Validated predictive biomarkers for multi-tyrosine kinase inhibitors (MTKI) efficacy are lacking. We hypothesized that interindividual response variability is partially dependent on somatic DNA copy number alterations (SCNAs), particularly those of genes encoding the protein tyrosines targeted by MTKI (called target genes). Genomic alterations were investigated in MTKI responsive and non responsive patients with different histological subtypes included in the ProfiLER protocol (NCT 01774409). From March 2013 to August 2014, 58 patients with advanced cancer treated with one of 7 MTKIs were included in the ProfiLER trial and split into one discovery cohort (n = 13), and 2 validation cohorts (n = 12 and 33). An analysis of the copy number alterations of kinase-coding genes for each of 7 MTKIs was conducted. A prediction algorithm (SUMSCAN) based on the presence of specific gene gains (Tumor Target Charge, TTC) and losses (Tumor Target Losses, TTL) was conceived and validated in 2 indep...
Douleurs : Evaluation - Diagnostic - Traitement, 2008
La réglette EVA : un outil de médiation dans la relation soignant-malade ? 203 entre une mesure E... more La réglette EVA : un outil de médiation dans la relation soignant-malade ? 203 entre une mesure EVA subjective et l'analyse objective du soignant met celui-ci en difficulté. La mesure ne peut alors être validée par le soignant.
Journal of the Acoustical Society of America, 2015
ABSTRACT The objective of this clinical study was to validate the effectiveness, accuracy, tolera... more ABSTRACT The objective of this clinical study was to validate the effectiveness, accuracy, tolerance, and safety of a HIFU treatment developed for the treatment of liver metastases in a prospective, phase I-II trial. The transducer has a toroidal shape (diameter: 70 mm, radius of curvature: 70 mm) and was divided into 32 ring-shaped emitters operating at 3 MHz. HIFU was delivered immediately before scheduled hepatectomy. Ablations were performed on healthy tissue within the areas scheduled for resection. First, 30 ablations were carried out in 15 patients. These ablations were all generated within 40 seconds and on average measured 27.5 × 21.0 mm2. The phase I study (n = 6) showed that use of the HIFU device was feasible and safe and did not damage neighboring tissue. The phase IIa study (n = 9) showed that the area of ablation could be precisely targeted on a previously implanted metallic mark. Ablations were achieved with a precision of 1-2 mm. The phase IIb study (n = 10) demonstrated ablation of metastases with safety margins, again prior to planned resection. Using electronic focusing the volume of ablation was adjusted to the size of the tumor from 7 cm3 (40 s of treatment) to 50 cm3 (6 min of treatment).
Cancer/Radiothérapie, 2007
tochimie sur biopsie tumorale avant traitement déterminait un niveau d'expression de FGF-2 en fon... more tochimie sur biopsie tumorale avant traitement déterminait un niveau d'expression de FGF-2 en fonction du pourcentage de cellules tumorales marquées par l'anticorps anti-FGF-2 (seuil de positivité : 80 %).
Journal De Gestion Et D Economie Medicales, Dec 1, 2010
ABSTRACT Objectif : Le bénéfice de survie d’une prescription de chimiothérapie comparée aux meill... more ABSTRACT Objectif : Le bénéfice de survie d’une prescription de chimiothérapie comparée aux meilleurs soins de support dans le traitement des cancers avancés ou métastatiques du poumon a été amplement démontré dans la littérature. toutefois, l’impact du type de chimiothérapies prescrites et de leurs coûts sur la durée de survie reste controversé. La présente étude donne un éclairage sur ce questionnement dans la vraie vie, afin d’aider la prise de décision. matériel et méthodes : Les données ont été collectées rétrospectivement à partir des dossiers de 173 patients traités entre 2000 et 2004 au centre régional de lutte contre le cancer de Lyon, France. Les données de survie ont été modélisées en utilisant des modèles multivariés de cox. La question de l’endogénéité a été traitée dans le cadre d’une approche de type « variable instrumentale ». résultats : La médiane de survie pour la cohorte était de 285 jours. Le coût total moyen des médicaments de chimiothérapie atteint 5167 € (6675 € Sd). toutes autres choses égales par ailleurs, la durée de survie n’a pas été affectée par le coût des chimiothérapies administrées (p=0,35). toutefois, une prescription plus large de chimiothérapies augmentait la durée de survie (p=0,001). La survie était significativement plus courte pour les patients de stade iv comparativement à la phase iiiB et pour les patients présentant des co-morbidités cardiovasculaire et / ou diabétiques. conclusion : Prescrire des traitements cytotoxiques plus courts afin de maintenir autant que possible la qualité de vie et adapter les traitements notamment en fonction du stade et des comorbidités associées pourrait être une démarche à privilégier.
BMC cancer, 2014
The IFCT-GFPC 0502 phase III study reported prolongation of progression-free survival with gemcit... more The IFCT-GFPC 0502 phase III study reported prolongation of progression-free survival with gemcitabine or erlotinib maintenance vs. observation after cisplatin-gemcitabine induction chemotherapy for advanced non-small-cell lung cancer (NSCLC). This analysis was undertaken to assess the incremental cost-effectiveness ratio (ICER) of these strategies for the global population and pre-specified subgroups. A cost-utility analysis evaluated the ICER of gemcitabine or erlotinib maintenance therapy vs. observation, from randomization until the end of follow-up. Direct medical costs (including drugs, hospitalization, follow-up examinations, second-line treatments and palliative care) were prospectively collected per patient during the trial, until death, from the primary health-insurance provider's perspective. Utility data were extracted from literature. Sensitivity analyses were conducted. The ICERs for gemcitabine or erlotinib maintenance therapy were respectively 76,625 and 184,733 ...
British journal of cancer, Jan 10, 2010
Imatinib induces responses and disease stabilisations in non-resectable patients with aggressive ... more Imatinib induces responses and disease stabilisations in non-resectable patients with aggressive fibromatosis (AF). The precise target of imatinib in AF and predictive factors for response to treatment are unknown. We investigated factors potentially predictive of response to imatinib in a series of 40 patients with progressive AF included in a phase II trial of imatinib: we tested the presence of KIT exon 10 variant (M541L), the expression of imatinib-sensitive kinases and cell cycle proteins by immunohistochemistry (IHC), and other clinical and biological factors. Of 10 patients for whom DNA could be extracted, 3 had a KIT exon 10 variant (30%), with no correlation with response or progression-free survival (PFS). The expression of other imatinib targets (PDGFRA/B, macrophage colony-stimulating factor receptor (M-CSFR)) and of downstream components of the cell cycle, cell proliferation and proliferation pathway (cyclin D1, ERK, MEK 1-2) did not correlate with PFS. Pre-treatment ly...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
This paper presents an exploratory fixed time study to identify the most significant covariates a... more This paper presents an exploratory fixed time study to identify the most significant covariates as a precursor to a longitudinal study of specific mortality, disease free survival and disease recurrences. The data comprise consecutive patients diagnosed with primary breast cancer and entered into the study from 1996 at a single French clinical center, Centre Léon Bérard, based in Lyon, where they received standard treatment. The methodology was to compare and contrast multi-layer perceptron neural networks (NN) with logistic regression (LR), to identify key covariates and their interactions and to compare the selected variables with those routinely used in clinical severity of illness indices for breast cancer. The Logistic regression in this work was chosen as an accepted standard for prediction by biostatisticians in order to evaluate the neural network. Only covariates available at the time of diagnosis and immediately following surgery were used. We used for comparison classific...
Bulletin du cancer, 2007
The notion of therapeutic education was only recently introduced in cancer. Although the term is ... more The notion of therapeutic education was only recently introduced in cancer. Although the term is commonly used, no standard definition exists for the concept and principles of therapeutic education and its efficacy remains to be assessed. Therapeutic education is complementary to the healthcare approach and aims to get the patients more involved in their disease and the treatment decision-making process. This discipline, placed at the interface of human and social sciences, was first developed for the management of chronic diseases (diabetes, asthma). It derives from the principle that involving patients in their own care and management can help them better adjust to life with a chronic disease. The lengthening survival time of cancer patients, which contributes to making cancer a chronic disease, as well as changes in the patient-caregiver relationship contribute to the development of therapeutic education in cancer. Pilot studies, conducted principally in the United States, evalua...
The journal of vascular access
To determine predictors for failure and early complications of percutaneous internal jugular cath... more To determine predictors for failure and early complications of percutaneous internal jugular catheterization (IJC) in cancer patients. Six hundred and thirty consecutive cancer patients who required central venous catheterization were included in a prospective observational study. The rates of failure (defined as the intervention of a second physician and/or failure at initial insertion site) and of early complications were prospectively ascertained. Logistic regression analysis estimated odds ratio (OR) and 95% confidence intervals (95% CI) for independent predictors for failure and early complications of percutaneous IJC. The failure rate was 6.7%, and the early complication rate was 6.7%. In multivariate analysis, left-side initial catheterization (p<0.01), prior catheterization at the same site (p=0.001) and physician inexperience (p<0.0001) were independently associated with failure. Placement requiring more than one needle pass (p<0.01 for two and p<0.0001 for thre...
Bulletin du cancer, 2006
The preferences of advanced cancer patients and the impact of cancer management on relatives rema... more The preferences of advanced cancer patients and the impact of cancer management on relatives remain partly unknown. We present the preliminary results of a prospective study evaluating quality of care (QC), quality of life (QoL) and family impact (FI) in advanced cancer patients treated at home or in hospital, depending on their own choice. QC is evaluated using STAS questionnaire, and QoL and symptom control using EORTC QLQ-C30, Spielberger questionnaire and VAS for pain evaluation. FI is evaluated using GHQ28 and semi-structured interviews conducted at days 0, 15, 30, then monthly until death. Intermediate analysis of 52 patients (100 expected) of whom 63 % had chosen home care, 26 % in-hospital care. Actual assignment is home care: 56 %, in-hospital care: 44 %. Place of death is home: 15 %, hospital: 85 %. In the QC study, the two symptoms most frequently rated by nurses are anxiety and pain, in either group. Patient information and communication are also similar in both groups. ...
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2006
Algorithms for nutritional pediatric support have been proposed in a French national nutritional ... more Algorithms for nutritional pediatric support have been proposed in a French national nutritional framework program. However, they are not specific for oncology. With the pediatric nutritional risk score (PNRS) all children with cancer have a high risk of malnutrition, but a systematic nutritional support is not possible for all of them. Estimation of malnutrition prevalence and identification of predictive factors of major weight loss during treatment defined by a weight loss more than 5% within 1 month, 7.5% within 3 months, 10% within 6 months. This historical study included children registered with a solid tumor in 2002 in an oncology pediatric unit. Data collected at diagnosis were weight, height, PNRS, the Lansky functional score, tumor type. Furthermore weight, height, and major weight loss were collected at each cure of chemotherapy and during evolution. Malnutrition at diagnosis was defined using the weight for height ratio. Relations between major weight loss and risks fact...
British journal of cancer, Jan 18, 2002
The Lyon-Marseille-Curie-Est (LMCE) of France cooperative group has previously reported successiv... more The Lyon-Marseille-Curie-Est (LMCE) of France cooperative group has previously reported successive series of unselected stage four children older than 1 year at diagnosis with metastatic neuroblastoma (LMCE 1 and 3). The goal of LMCE 5 study was to increase progression free survival rate as compared to LMCE 1 and 3. Based on improvements reported with post induction chemotherapy, the LMCE 5 used post induction for all children, but omitted total body irradiation and immunomagnetic purging in megatherapy regimen for all children. Twenty-five sequentially diagnosed children received an induction regimen which compared with previous induction included an increased dose of etoposide and cyclophosphamide, delivered similar dose of cisplatinum, and deleted doxorubicin and vincristin. After surgery treatment was stratified based on response and eligible children received etoposide carboplatin (LMCE 5A : n=10)+/-doxorubicin (LMCE 5B-C n=13) followed by megatherapy (melphalan without total b...
European journal of cancer (Oxford, England : 1990), Jan 11, 2015
The added value of tumoural genomic profiles to conventional clinico-biological factors to predic... more The added value of tumoural genomic profiles to conventional clinico-biological factors to predict progression-free survival (PFS) and overall survival (OS) was prospectively investigated in patients with advanced gastrointestinal stromal tumours (GIST) treated in the BFR14 study. Of the 434 included patients, mutational analysis was performed in 322 patients. Survival analysis was performed in patients with validated mutational status. Mutational status was validated in 228 patients. We identified 196 patients with tumours harbouring 200 KIT alterations (exon 11: 173 patients, exon 9: 22 patients, exon 17: 3 patients, exon 13: 2 patients; 4 patients had double KIT mutations), 6 patients with PDGFRA mutations and 26 patients with wild-type (WT) GIST genotype. On a median follow-up of 73 months, median PFS/OS were 12.3/54.9 months for WT GIST, 12.6/55 months for KIT exon 9, and 39.4 months/not reached (69.1% at 5 years) for KIT exon 11. Tumour size, female gender, KIT exon 11 mutatio...
Douleurs : Evaluation - Diagnostic - Traitement, 2006
Oncologie, 2006
Résumé: L’étude a pour but de tester la faisabilité d’une prise en charge précoce à domicile des... more Résumé: L’étude a pour but de tester la faisabilité d’une prise en charge précoce à domicile des aplasies fébriles sans facteurs de mauvais pronostic. Sur 517 épisodes de neutropénies fébriles enregistrés entre 07/99 et 06/01, seuls 52 cas ont bénéficié de cette prise en charge avec Céfépime 2g 2 fois par jour. Dans les autres cas, il existait des facteurs de
Oncotarget, Jan 21, 2015
Validated predictive biomarkers for multi-tyrosine kinase inhibitors (MTKI) efficacy are lacking.... more Validated predictive biomarkers for multi-tyrosine kinase inhibitors (MTKI) efficacy are lacking. We hypothesized that interindividual response variability is partially dependent on somatic DNA copy number alterations (SCNAs), particularly those of genes encoding the protein tyrosines targeted by MTKI (called target genes). Genomic alterations were investigated in MTKI responsive and non responsive patients with different histological subtypes included in the ProfiLER protocol (NCT 01774409). From March 2013 to August 2014, 58 patients with advanced cancer treated with one of 7 MTKIs were included in the ProfiLER trial and split into one discovery cohort (n = 13), and 2 validation cohorts (n = 12 and 33). An analysis of the copy number alterations of kinase-coding genes for each of 7 MTKIs was conducted. A prediction algorithm (SUMSCAN) based on the presence of specific gene gains (Tumor Target Charge, TTC) and losses (Tumor Target Losses, TTL) was conceived and validated in 2 indep...
Douleurs : Evaluation - Diagnostic - Traitement, 2008
La réglette EVA : un outil de médiation dans la relation soignant-malade ? 203 entre une mesure E... more La réglette EVA : un outil de médiation dans la relation soignant-malade ? 203 entre une mesure EVA subjective et l'analyse objective du soignant met celui-ci en difficulté. La mesure ne peut alors être validée par le soignant.
Journal of the Acoustical Society of America, 2015
ABSTRACT The objective of this clinical study was to validate the effectiveness, accuracy, tolera... more ABSTRACT The objective of this clinical study was to validate the effectiveness, accuracy, tolerance, and safety of a HIFU treatment developed for the treatment of liver metastases in a prospective, phase I-II trial. The transducer has a toroidal shape (diameter: 70 mm, radius of curvature: 70 mm) and was divided into 32 ring-shaped emitters operating at 3 MHz. HIFU was delivered immediately before scheduled hepatectomy. Ablations were performed on healthy tissue within the areas scheduled for resection. First, 30 ablations were carried out in 15 patients. These ablations were all generated within 40 seconds and on average measured 27.5 × 21.0 mm2. The phase I study (n = 6) showed that use of the HIFU device was feasible and safe and did not damage neighboring tissue. The phase IIa study (n = 9) showed that the area of ablation could be precisely targeted on a previously implanted metallic mark. Ablations were achieved with a precision of 1-2 mm. The phase IIb study (n = 10) demonstrated ablation of metastases with safety margins, again prior to planned resection. Using electronic focusing the volume of ablation was adjusted to the size of the tumor from 7 cm3 (40 s of treatment) to 50 cm3 (6 min of treatment).
Cancer/Radiothérapie, 2007
tochimie sur biopsie tumorale avant traitement déterminait un niveau d'expression de FGF-2 en fon... more tochimie sur biopsie tumorale avant traitement déterminait un niveau d'expression de FGF-2 en fonction du pourcentage de cellules tumorales marquées par l'anticorps anti-FGF-2 (seuil de positivité : 80 %).
Journal De Gestion Et D Economie Medicales, Dec 1, 2010
ABSTRACT Objectif : Le bénéfice de survie d’une prescription de chimiothérapie comparée aux meill... more ABSTRACT Objectif : Le bénéfice de survie d’une prescription de chimiothérapie comparée aux meilleurs soins de support dans le traitement des cancers avancés ou métastatiques du poumon a été amplement démontré dans la littérature. toutefois, l’impact du type de chimiothérapies prescrites et de leurs coûts sur la durée de survie reste controversé. La présente étude donne un éclairage sur ce questionnement dans la vraie vie, afin d’aider la prise de décision. matériel et méthodes : Les données ont été collectées rétrospectivement à partir des dossiers de 173 patients traités entre 2000 et 2004 au centre régional de lutte contre le cancer de Lyon, France. Les données de survie ont été modélisées en utilisant des modèles multivariés de cox. La question de l’endogénéité a été traitée dans le cadre d’une approche de type « variable instrumentale ». résultats : La médiane de survie pour la cohorte était de 285 jours. Le coût total moyen des médicaments de chimiothérapie atteint 5167 € (6675 € Sd). toutes autres choses égales par ailleurs, la durée de survie n’a pas été affectée par le coût des chimiothérapies administrées (p=0,35). toutefois, une prescription plus large de chimiothérapies augmentait la durée de survie (p=0,001). La survie était significativement plus courte pour les patients de stade iv comparativement à la phase iiiB et pour les patients présentant des co-morbidités cardiovasculaire et / ou diabétiques. conclusion : Prescrire des traitements cytotoxiques plus courts afin de maintenir autant que possible la qualité de vie et adapter les traitements notamment en fonction du stade et des comorbidités associées pourrait être une démarche à privilégier.
BMC cancer, 2014
The IFCT-GFPC 0502 phase III study reported prolongation of progression-free survival with gemcit... more The IFCT-GFPC 0502 phase III study reported prolongation of progression-free survival with gemcitabine or erlotinib maintenance vs. observation after cisplatin-gemcitabine induction chemotherapy for advanced non-small-cell lung cancer (NSCLC). This analysis was undertaken to assess the incremental cost-effectiveness ratio (ICER) of these strategies for the global population and pre-specified subgroups. A cost-utility analysis evaluated the ICER of gemcitabine or erlotinib maintenance therapy vs. observation, from randomization until the end of follow-up. Direct medical costs (including drugs, hospitalization, follow-up examinations, second-line treatments and palliative care) were prospectively collected per patient during the trial, until death, from the primary health-insurance provider's perspective. Utility data were extracted from literature. Sensitivity analyses were conducted. The ICERs for gemcitabine or erlotinib maintenance therapy were respectively 76,625 and 184,733 ...
British journal of cancer, Jan 10, 2010
Imatinib induces responses and disease stabilisations in non-resectable patients with aggressive ... more Imatinib induces responses and disease stabilisations in non-resectable patients with aggressive fibromatosis (AF). The precise target of imatinib in AF and predictive factors for response to treatment are unknown. We investigated factors potentially predictive of response to imatinib in a series of 40 patients with progressive AF included in a phase II trial of imatinib: we tested the presence of KIT exon 10 variant (M541L), the expression of imatinib-sensitive kinases and cell cycle proteins by immunohistochemistry (IHC), and other clinical and biological factors. Of 10 patients for whom DNA could be extracted, 3 had a KIT exon 10 variant (30%), with no correlation with response or progression-free survival (PFS). The expression of other imatinib targets (PDGFRA/B, macrophage colony-stimulating factor receptor (M-CSFR)) and of downstream components of the cell cycle, cell proliferation and proliferation pathway (cyclin D1, ERK, MEK 1-2) did not correlate with PFS. Pre-treatment ly...
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2007
This paper presents an exploratory fixed time study to identify the most significant covariates a... more This paper presents an exploratory fixed time study to identify the most significant covariates as a precursor to a longitudinal study of specific mortality, disease free survival and disease recurrences. The data comprise consecutive patients diagnosed with primary breast cancer and entered into the study from 1996 at a single French clinical center, Centre Léon Bérard, based in Lyon, where they received standard treatment. The methodology was to compare and contrast multi-layer perceptron neural networks (NN) with logistic regression (LR), to identify key covariates and their interactions and to compare the selected variables with those routinely used in clinical severity of illness indices for breast cancer. The Logistic regression in this work was chosen as an accepted standard for prediction by biostatisticians in order to evaluate the neural network. Only covariates available at the time of diagnosis and immediately following surgery were used. We used for comparison classific...
Bulletin du cancer, 2007
The notion of therapeutic education was only recently introduced in cancer. Although the term is ... more The notion of therapeutic education was only recently introduced in cancer. Although the term is commonly used, no standard definition exists for the concept and principles of therapeutic education and its efficacy remains to be assessed. Therapeutic education is complementary to the healthcare approach and aims to get the patients more involved in their disease and the treatment decision-making process. This discipline, placed at the interface of human and social sciences, was first developed for the management of chronic diseases (diabetes, asthma). It derives from the principle that involving patients in their own care and management can help them better adjust to life with a chronic disease. The lengthening survival time of cancer patients, which contributes to making cancer a chronic disease, as well as changes in the patient-caregiver relationship contribute to the development of therapeutic education in cancer. Pilot studies, conducted principally in the United States, evalua...
The journal of vascular access
To determine predictors for failure and early complications of percutaneous internal jugular cath... more To determine predictors for failure and early complications of percutaneous internal jugular catheterization (IJC) in cancer patients. Six hundred and thirty consecutive cancer patients who required central venous catheterization were included in a prospective observational study. The rates of failure (defined as the intervention of a second physician and/or failure at initial insertion site) and of early complications were prospectively ascertained. Logistic regression analysis estimated odds ratio (OR) and 95% confidence intervals (95% CI) for independent predictors for failure and early complications of percutaneous IJC. The failure rate was 6.7%, and the early complication rate was 6.7%. In multivariate analysis, left-side initial catheterization (p<0.01), prior catheterization at the same site (p=0.001) and physician inexperience (p<0.0001) were independently associated with failure. Placement requiring more than one needle pass (p<0.01 for two and p<0.0001 for thre...
Bulletin du cancer, 2006
The preferences of advanced cancer patients and the impact of cancer management on relatives rema... more The preferences of advanced cancer patients and the impact of cancer management on relatives remain partly unknown. We present the preliminary results of a prospective study evaluating quality of care (QC), quality of life (QoL) and family impact (FI) in advanced cancer patients treated at home or in hospital, depending on their own choice. QC is evaluated using STAS questionnaire, and QoL and symptom control using EORTC QLQ-C30, Spielberger questionnaire and VAS for pain evaluation. FI is evaluated using GHQ28 and semi-structured interviews conducted at days 0, 15, 30, then monthly until death. Intermediate analysis of 52 patients (100 expected) of whom 63 % had chosen home care, 26 % in-hospital care. Actual assignment is home care: 56 %, in-hospital care: 44 %. Place of death is home: 15 %, hospital: 85 %. In the QC study, the two symptoms most frequently rated by nurses are anxiety and pain, in either group. Patient information and communication are also similar in both groups. ...
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2006
Algorithms for nutritional pediatric support have been proposed in a French national nutritional ... more Algorithms for nutritional pediatric support have been proposed in a French national nutritional framework program. However, they are not specific for oncology. With the pediatric nutritional risk score (PNRS) all children with cancer have a high risk of malnutrition, but a systematic nutritional support is not possible for all of them. Estimation of malnutrition prevalence and identification of predictive factors of major weight loss during treatment defined by a weight loss more than 5% within 1 month, 7.5% within 3 months, 10% within 6 months. This historical study included children registered with a solid tumor in 2002 in an oncology pediatric unit. Data collected at diagnosis were weight, height, PNRS, the Lansky functional score, tumor type. Furthermore weight, height, and major weight loss were collected at each cure of chemotherapy and during evolution. Malnutrition at diagnosis was defined using the weight for height ratio. Relations between major weight loss and risks fact...
British journal of cancer, Jan 18, 2002
The Lyon-Marseille-Curie-Est (LMCE) of France cooperative group has previously reported successiv... more The Lyon-Marseille-Curie-Est (LMCE) of France cooperative group has previously reported successive series of unselected stage four children older than 1 year at diagnosis with metastatic neuroblastoma (LMCE 1 and 3). The goal of LMCE 5 study was to increase progression free survival rate as compared to LMCE 1 and 3. Based on improvements reported with post induction chemotherapy, the LMCE 5 used post induction for all children, but omitted total body irradiation and immunomagnetic purging in megatherapy regimen for all children. Twenty-five sequentially diagnosed children received an induction regimen which compared with previous induction included an increased dose of etoposide and cyclophosphamide, delivered similar dose of cisplatinum, and deleted doxorubicin and vincristin. After surgery treatment was stratified based on response and eligible children received etoposide carboplatin (LMCE 5A : n=10)+/-doxorubicin (LMCE 5B-C n=13) followed by megatherapy (melphalan without total b...