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Germ cell tumors of the testes represent a unique paradigm of diseases which can be cured even in extremely advanced phase.
Unfortunately, this makes them unique among adult solid tumors. Seminoma and non seminoma are relatively rare with approximatively
25,000 patients in Europe per year, but numbers are increasing world wide. Different strategies are needed depending on stage
and prognostic scores. Seminoma is extremely sensitive to radiation therapy and chemotherapy, while all germ cell tumors show
a very good response to chemotherapy. Clinical stage I seminoma is currently treated with radiation, single course carboplatin
or surveillance policy. Clinical stage I non seminoma can also be approached with different strategies such as retroperitoneal
lymph node dissection, observation or one-two courses of standard chemotherapy. Stage II seminoma may be treated with either
radiation or chemotherapy, while for all advanced stages chemotherapy is mandatory. Since the mid-eighties PEB (Cisplatin,
Etoposide and Bleomycin) is the regimen of choice and no other schedule has proved superior in terms of efficacy. Surgery
on the residual disease is crucial to the whole strategy and should be performed or attempted in all cases. Consequently,
the correct treatment strategy for these tumors does not depend only on the ability of a single physician, but on a skilled
team specialized in this particular tumor. Second line therapies (VeIP, PEI, TIP) can cure 25%–40% of patients, but improved
strategies for resistant tumors are desperately needed. High-dose chemotherapy has shown very good results in some studies
while being less impressive in others. In any case, it should remain an option for relapsing patients and could be used in
some cases of upfront chemotherapy in patients with slow marker decline, but this should only be considered in referring centers. 相似文献
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Dr. Franco Zunino Brunella Barbieri Ornella Bellini Anna Maria Casazza Cristina Geroni Fernando Giuliani Antonio Ciana Giorgio Manzini Franco Quadrifoglio 《Investigational new drugs》1986,4(1):17-23
Summary The chromophore-modified derivative of doxorubicin, 4-demethyl-6-0-methyl-doxorubicin, has been tested for antitumor activity in a range of experimental murine tumor systems. In contrast to the inactive 6-0-methyl derivative of daunorubicin, 4-demethyl-6-0-methyl-doxorubicin provided antitumor effects comparable to that of the parent compound. In addition, detailed DNA-interaction studies showed that the doxorubicin derivative retains the ability to bind DNA by the intercalation mechanism. However, the binding affinity was appreciably reduced following structural modification in the anthraquinone chromophore. On the basis of the proposed models of intercalation, these results could be rationalized in terms of steric influence of the bulky methoxy group. The results of this study are in agreement with the correlation already observed between DNA binding and relative antitumor activity of anthracyclines. 相似文献
5.
M. Piotin F. Cattin B. Kantelip S. Miralbès J. Godard J. F. Bonneville 《Neuroradiology》1997,39(6):431-433
Cerebral alveolar echinococcosis is rare and has a poor prognosis. We report an unusual case presenting with disseminated
intracranial lesions secondary to primary hepatic infection.
Received: 2 May 1996 Accepted: 23 August 1996 相似文献
6.
R Steimlé G Jacquet J Godard C Billerey R el Mohamad 《Chirurgie; mémoires de l'Académie de chirurgie》1992,118(8):464-8; discussion 469
One case of a cervical osteoid osteoma is presented and compared with infrequent similar cases from the literature. The authors recall the diagnosis difficulties, facing a long standing not explained neck pain due to poor neurological and current radiological informations. The interest of the bone scintigraphy, CT scan and M.R.I. are emphasized. Like in other cases, the pain disappeared after surgical removal of the tumor. The eventually associated scoliosis often rectify too. 相似文献
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The value of C-reactive protein in the detection of chorioamnionitis in cases of premature rupture of membranes] 总被引:1,自引:0,他引:1
J C Berardi S Hutin J Godard V Madinier A Delanete L Berardi-Grassias 《Revue fran?aise de gynécologie et d'obstétrique》1991,86(3):229-232
In a context of premature rupture of the membranes, the authors compare the sensitivity and ability to predict the onset of chorio-amnionitis of the conventional clinical signs (hyperthermia, fetal tachycardia, discolored amniotic fluid) and paraclinical signs (hyperleukocytosis and bacteriology of the amniotic fluid) with those of the assay of C reacting protein in the maternal plasma. The latter test is apparently more sensitive and of greater positive predictive value in this disorder. 相似文献
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