Senlis

This research aims to understand how doctors decide when extremely premature infants, born before 28 weeks of gestational age, are ready to be taken off mechanical ventilation in the first two weeks of life. The study explores doctors' views on extubation readiness, reasons for extubation or continuing ventilation, and how these decisions relate to successful extubation, defined as not needing reintubation within seven days. It also investigates which factors, including clinical status and ventilator settings, are linked to readiness for extubation and outcomes like respiratory health. The study collects daily data from attending physicians who complete questionnaires about their decisions to extubate or not during the first 15 days of life for infants on mechanical ventilation. No experimental treatments are given, as this is an observational study conducted across several neonatal intensive care units in France. The research focuses on routine clinical care and tracks respiratory support practices during the newborns' hospital stay. Participants' health details, respiratory outcomes, and survival are recorded until they are discharged or no longer need any breathing support or oxygen. Researchers monitor reasons for continued ventilation or extubation attempts every 12 hours for the first two days and daily up to day 15. This detailed data collection helps understand extubation practices and outcomes in extremely premature infants.

Colorectal cancer mainly affects elderly patients, with over half of new cases in France occurring in those aged 70 or older. Adjuvant chemotherapy has shown benefits in disease-free and overall survival after stage III colon cancer surgery, but its use in elderly patients remains limited. This phase III randomized study explores whether adjuvant chemotherapy improves disease-free survival in elderly patients and which chemotherapy regimen is most effective, addressing concerns about benefits for both unfit and fit elderly patients. Participants will be divided into two groups based on a multidisciplinary evaluation including a geriatrician. One group will receive fluoropyrimidine-based chemotherapy (LV5FU2 or capecitabine), and the other will receive oxaliplatin-based chemotherapy (FOLFOX4 or XELOX). Some patients may be assigned to observation only. Treatments will begin within 12 weeks after surgery. The study also evaluates specific biological markers common in elderly tumors, such as mismatch repair deficiency. During the study, participants will undergo assessments including geriatric questionnaires and medical monitoring. Researchers will track disease-free survival over three years following the last patient's enrollment. Safety and treatment effects will be monitored, with exclusion of patients expected to live less than four years or those unable to comply with follow-up. The study aims to better understand chemotherapy benefits in an elderly population after colon cancer surgery.

Researchers are evaluating two different first-line treatment strategies for women with advanced epithelial ovarian cancer, primary peritoneal cancer, or fallopian-tube cancer. This is a randomized phase II, open-label, and multicenter study. Patients are assigned to treatment groups based on the completeness of their tumor removal surgery, known as the Completeness of Cytoreduction (CC) score, to determine the best therapeutic approach for these cancers. The study aims to compare outcomes, including pathological complete peritoneal response over two years. The treatments involve different chemotherapy regimens given intravenously or intraperitoneally depending on the CC score. Patients with a CC0 score receive either carboplatin and paclitaxel intravenously for six cycles or cisplatin intraperitoneally combined with epirubicin intravenously for six cycles. Patients with CC>0 receive three cycles of carboplatin and paclitaxel intravenously, followed by interval surgery, then another three cycles of the same drugs. Alternatively, they receive three cycles of cisplatin and epirubicin intravenously, followed by interval surgery, and depending on surgical results, further cisplatin intraperitoneally or intravenously with epirubicin for three cycles. Participants will undergo initial surgery before enrollment and regular assessments including blood tests and performance status evaluations. Researchers will monitor treatment effects, safety, and pathological responses over time. The study includes women aged 18 to 74 years with adequate organ function and consent. Follow-up includes monitoring chemotherapy responses and adverse events to identify the most effective treatment strategy for advanced ovarian cancer.