Postoperative nonspecific immunotherapy in primary bronchogenic carcinoma.

A postoperative active nonspecific immunotherapy has been conducted in 54 patients operated on for primary bronchogenic carcinoma. The immunopotentiator used is an original product prepared from a transformed strain of a saprophytic mycobacterium: M. smegmatis ATCC 607. The patients treated show an increase in postoperative survival rates of 60% at 1 year and 50% at 2 years, with regard to the survival rates of a control group and 21 surgical series available totaling over 20,000 patients. This important increase in the survival rates is accompanied by an appreciable improvement in patient comfort.

[Prognostic factors in operated non-small cell cancer of the lung. Study from a randomized therapeutic trial]. / Facteurs pronostiques du cancer du poumon opéré non à petites cellules: étude à partir d'un essai thérapeutique randomisé.

This article presents the results of a prognostic study of primary resected lung cancer (non-small cell). The data result from a randomised clinical trial of immunotherapy with a non-specific adjuvant; the follow-up was between four to seven years. Thirty-five clinical, biological and anatomo-pathological parameters were gathered at the time of inclusion in the trial. The response criteria used were survival without recurrence and total survival. A multivariate analysis using the Cox's model was carried out for each criterion. At the reference date of the 1st April 1985, 125 relapses and 132 deaths were counted amongst 219 patients; there was only one patient lost to follow-up and only 39 missing data were observed. The negative therapeutic results of the immunotherapy used were confirmed by this new intermediate analysis. The rate of survival without recurrence at 5 years was 43% and the overall survival at five years was 42%. The use of Cox's model to show the prognostic information at the 5% level for survival without recurrence could be summarised by five factors: main staging (the prognostic factor), leucocytosis, the cutaneous reaction to proteus, Karnofsky index and presence of physical signs. For stages I and II the outcome was identical and no factor was predictive at the 5% level. For stage III the cutaneous reaction to proteus and leucocytosis were prognostic. For overall survival, the prognostic information at the 5% level could be summarised by five factors: staging (main prognostic factor), leucocytosis, Karnofsky index, presence of physical signs and lymphocytosis. For stages I and II whose outcome was identical only Karnofsky index and lymphocytosis were predictive at the 5% level.(ABSTRACT TRUNCATED AT 250 WORDS)

[Therapeutic importance and tolerance of coated 50 mg Vectarion tablets (almitrine bismesylate) at a dosage of 100 mg/day. Study of blood gas, clinical and biological results after a year of long-term treatment]. / Intérêt thérapeutique et acceptabilité du Vectarion 50 mg comprimés enrobés (bismésilate d'almitrine) à la dose de 100 mg/jour. Etude des résultats gazométriques, cliniques et biologiques en traitement prolongé pendant 1 an.

The objectives of this study, in which Almitrine bismesylate was administered for one year in chronic bronchitics with obstructive hypoxia, were to assess its clinical and gasometric efficacy and its clinical, laboratory, spirometric and electrocardiac acceptability. The blood gas results show a significant rise in PaO2 (p less than 0.001) rising by 5.5 mmHg after 6 months (T6) and by 6.0 mmHg after 12 months (T12) in comparison with the value at the study's onset. The PaCO2 fell by 3.3 mmHg at T6 and 2.7 mmHg at T12 (p less than 0.001). The dyspnoea of the patient, scored by the doctor on a scale of severity from 0 to 5 was situated on a mean of 3.3 points at the beginning of the study. It was significantly reduced by 0.8 points at T6 and by 0.9 points at T12 (p less than 0.001). The percentage of patients hospitalised during the course of the study fell significantly in comparison with the previous year, from 68% to 49% (p less than 0.001). The improvement in clinical status and in blood gases bore no relation to changes in respiratory function. The clinical acceptability of the product was good; few side effects were observed and the respiratory, digestive and neurological problems were often pre-existing. They only led to cessation of treatment in three cases. The electrocardiogram was unchanged. The laboratory investigations was unchanged, with the exception of a fall in red blood cells in relation to the correction of the hypoxaemia in polycythaemic patients.

[Negative results of a randomized therapeutic trial of nonspecific immunotherapy in primary, surgically-treated non-small cell bronchial cancer]. / Résultats négatifs d'un essai thérapeutique randomisé d'immunothérapie non spécifique dans le cancer bronchique primitif non microcellulaire opéré.

Between March 1978 and May 1981, 219 patients suffering from non-small cell primary bronchial carcinoma underwent surgical excision which was intended to be curative. Three weeks later the patients were randomised into two groups: 1. A control group, with no other treatment following excision (110 patients). 2. A non-specific immunotherapy group (109 patients). The immunostimulant used was an aqueous suspension of heat killed mycobacterium smegmatis administered subcutaneously once a month. The trial was analysed on December 1, 1982. There were 117 recurrences and 112 deceased. There was no significant difference as regard survival without relapse or overall survival; all causes of death were included.

[Epidermoid cysts of the mandible (author's transl)]. / Kystes épidermoïdes du maxillaire inférieur.

The authors present three cases of epidermoid cyst of the mandible, one of which had undergone malignant change. These cysts are rare. They are most often situated at the angle of the jaw and present as a deep swelling of the cheek. The only treatment is excision, the authors advising the external approach which gave them the best results.

[Nasopharyngeal fibroma (author's transl)]. / Le fibrome naso-pharyngien.

The authors report 17 cases nasopharyngeal fibroma treated between 1966 and 1978. Half of the cases developed before the age of 16, the other half occurring between 16 and 28 years. Arteriography was performed in only 8 cases and embolisation in 4 cases with 2 vascular accidents. Surgery was performed in 16 cases (15 Rouge Denker, 1 paralatero nasal). Invasion of the pterygomaxillary fossa was invariably found at operation. Amongst the patients treated by surgery, there was only one local recurrence and reoperation was successful. Finally, one patient with a very large fibroma with invasion of the temporal fossa was successfully treated by radiotherapy at a dose of 4 000 R.

[The surgical treatment of thyrotoxic exophthalmos using Ogura's operation (author's transl)]. / Le traitement chirurgical de l'exophtalmie basedowienne par l'intervention d'Ogura.

Ogura's operation consists of resection via De Lima's approach of the bony floor of the orbit and the lateral wall of the ethmoid. The orbital periosteum is then incised in order to allow the orbital fat to enter the sinuses and thus decompress the orbit. In most cases the operation is performed on both sides at the same time. It is used in cases of malignant or severe thyrotoxic exophthalmos, or in the presence of optic neuritis. The results obtained were good in 9 cases with a marked reduction in exophthalmos and rapid cure of optic neuritis. An additional ophthalmological procedure is sometimes necessary in order to perfect the anesthetic result.

[Phonation following reconstructive laryngectomy]. / Etude de la phonation après laryngectomie reconstructive

The authors describe the results obtained, from the point of view of vocal function in 43 cases of patients who underwent various types of reconstructive laryngectomy: trachio-hyoido-epiglotto-pexy (Arslan and Serafini), crico-hyoido-pexy (Labayle), crico-hyoido-epiglotto-pexy (J.J.Piquet). These operations have as their main aim the preservation of vocal function, for social particularly as it is, increasingly, young people who are affected. The survey was carried out by means of measurement of volume, sonagraph recordings, recordings of movements of the neoglottis by accelerometer and integrating amplification. This method makes it possible to classify voices more objectively. The survey shows the importance of surgical methods and the prime importance of post-operative orthophonic re-education; results have proved very satisfactory three to six months after the operation.