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Marseille, France

Lombardi G.,Veneto Institute of Oncology IOV | Di Stefano A.L.,AP HP | Di Stefano A.L.,University of Pavia | Farina P.,Veneto Institute of Oncology IOV | And 3 more authors.
Cancer Treatment Reviews | Year: 2014

The frequency of metastatic brain tumors has increased over recent years; the primary tumors most involved are breast cancer, lung cancer, melanoma and renal cell carcinoma. While radiation therapy and surgery remain the mainstay treatment in selected patients, new molecular drugs have been developed for brain metastases. Studies so far report interesting results.This review focuses on systemic cytotoxic drugs and, in particular, on new targeted therapies and their clinically relevant activities in brain metastases from solid tumors in adults. © 2014 Elsevier Ltd. Source


Tabouret E.,Institute Paoli Calmettes | Gravis G.,Institute Paoli Calmettes | Cauvin C.,Institute Paoli Calmettes | Loundou A.,Aix - Marseille University | And 2 more authors.
European Spine Journal | Year: 2014

Results: Median OS was 7.8 months (95 % confidence interval 4.4–11.2). Thirty-nine patients presented with OS ≥2 years. A comparative analysis found significant differences concerning the delay (first symptom–surgery, p < 0.001), number of systemic (p = 0.001) or bone metastases (p = 0.013), Karnofsky performance status (KPS) (p = 0.006), Frankel (p = 0.025), ASA scores (p < 0.001), weight loss (p = 0.003), hyperalgia (p = 0.002), chemotherapy use (p = 0.034), and primary tumor (p < 0.001). RPA classification identified six prognostic classes based on the ASA score, primary type, KPS, and systemic metastases.Conclusion: Long-term metastatic cancer survivor patients are an increasing population with specific characteristics.Purpose: Metastatic spinal cord compression (MSCC) incidences are increasing. Our objective was to identify predictive factors involved in long-term survival after use of a surgical approach.Methods: We retrospectively analyzed all patients referred to our institution for MSCC who underwent surgery (N = 138). We identified patients with an overall survival (OS) rate greater than 2 years, compared their characteristics to the remaining patients, and performed recursive partitioning analysis (RPA). © 2014, Springer-Verlag Berlin Heidelberg. Source


Chambost H.,APHM | Chambost H.,Aix - Marseille University | Santagostino E.,Hemophilia and Thrombosis Center | Laffan M.,Imperial College London | Kavakli K.,Ege University
Haemophilia | Year: 2013

The ONE Registry (OR) was an international prospective observational study of on-demand recombinant factor VIIa (rFVIIa) treatment for mild to moderate bleeds in haemophilia A/B patients with inhibitors. To describe real-world use of single and multi dose rFVIIa and to compare outcomes, including effectiveness, safety, quality of life and treatment satisfaction associated with treatment. Baseline data included demographics, treatment, medical and bleed history and patient/caregiver-reported outcomes regarding bleeds. rFVIIa was prescribed according to routine practice; regimens varied and initial dose was categorized as low (LD, ≤120 μg kg-1), intermediate (ID, >120 and <250 μg kg-1) or high (HD, ≥250 μg kg-1). OR included 102 patients and 85 (83%) reported 494 bleeds overall. Mean age was 23 years (SD 16.4), with 52% ≥18 years. Majority of bleeds (n = 350, 71%) involved ≥1 joints; 46% involved a target joint. Median initial dose was 90 μg kg-1 in LD (range 87-120, n = 156), 174 μg kg-1 in ID, (range 121-249, n = 127) and 270 μg kg-1 in HD, (range 250-375, n = 211). For spontaneous bleeds, effective haemostasis rate at 9 h was 63% LD, 60% ID and 56% HD. Rates of combined partially effective/effective haemostasis was 85% LD, 96% ID and 86% HD. Median number of doses in HD was one (range 1-7), compared with two in LD (range 1-17) and ID (range 1-23). No thromboembolic events were reported in 1145 doses given. These observational data in real life are consistent with previous studies which have shown similar overall effectiveness of rFVIIa and similar effectiveness and safety across different patterns of standard initial dosing. © 2013 John Wiley & Sons Ltd. Source


Bisbal M.,Aix - Marseille University | Jouve E.,APHM | Papazian L.,Aix - Marseille University | de Bourmont S.,Aix - Marseille University | And 3 more authors.
Resuscitation | Year: 2014

Purpose: The mortality for patients admitted to intensive care unit (ICU) after cardiac arrest (CA) remains high despite advances in resuscitation and post-resuscitation care. The Simplified Acute Physiology Score (SAPS) III is the only score that can predict hospital mortality within an hour of admission to ICU. The objective was to evaluate the performance of SAPS III to predict mortality for post-CA patients. Methods: This retrospective single-center observational study included all patients admitted to ICU after CA between August 2010 and March 2013. The calibration (standardized mortality ratio [SMR]) and the discrimination of SAPS III (area under the curve [AUC] for receiver operating characteristic [ROC]) were measured. Univariate logistic regression tested the relationship between death and scores for SAPS III, SAPS II, Sequential Organ Failure Assessment (SOFA) Score and Out-of-Hospital Cardiac Arrests (OHCA) score. Independent factors associated with mortality were determined. Results: One-hundred twenty-four patients including 97 out-of-hospital CA were included. In-hospital mortality was 69%. The SAPS III was unable to predict mortality (SMRSAPS III: 1.26) and was less discriminating than other scores (AUCSAPSIII: 0.62 [0.51, 0.73] vs. AUCSAPSII: 0.75 [0.66, 0.84], AUCSOFA: 0.72 [0.63, 0.81], AUCOHCA: 0.84 [0.77, 0.91]). An early return of spontaneous circulation, early resuscitation care and initial ventricular arrhythmia were associated with a better prognosis. Conclusions: The SAPS III did not predict mortality in patients admitted to ICU after CA. The amount of time before specialized CPR, the low-flow interval and the absence of an initial ventricular arrhythmia appeared to be independently associated with mortality and these factors should be used to predict mortality for these patients. © 2014 Elsevier Ireland Ltd. Source


Lombardi G.,Veneto Institute of Oncology IOV IRCCS | Di Stefano A.L.,AP HP | Farina P.,Veneto Institute of Oncology IOV IRCCS | Zagonel V.,Veneto Institute of Oncology IOV IRCCS | Tabouret E.,APHM
Cancer treatment reviews | Year: 2014

The frequency of metastatic brain tumors has increased over recent years; the primary tumors most involved are breast cancer, lung cancer, melanoma and renal cell carcinoma. While radiation therapy and surgery remain the mainstay treatment in selected patients, new molecular drugs have been developed for brain metastases. Studies so far report interesting results. This review focuses on systemic cytotoxic drugs and, in particular, on new targeted therapies and their clinically relevant activities in brain metastases from solid tumors in adults. Copyright © 2014 Elsevier Ltd. All rights reserved. Source

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