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A Cavalot

Publications and source records attributed to A Cavalot.

At least 19 recordsLinked to original sources
PubMed2003

Update and perspectives on non-surgical treatment of salivary gland malignancies.

Surgery is the treatment of choice for major and minor salivary gland malignancies. Herein, the role of radiation and medical treatment in the multidisciplinary management of salivary gland tumours is discussed. Neutron irradiation and hyperfractionated external beam mega voltage irradiation improve local control. Combination of three dimensional conformal radiotherapy and intensive-modulated radiation therapy provide better local tumour delineation, better field design to encompass the tumour allowing dose escalation to target while sparing the surrounding normal tissue. Cisplatin-based chemotherapy provides a response rate > or = 45%, in a palliative setting. Concomitant chemo-radiotherapy could improve local control. Recent studies evaluated the expression of molecular targets in salivary gland carcinomas (c-kit = 53-90%, EGFR = 25-85%, c-erb-B2 = 11-58%, p53 = 11-67%, H ras = 18%); these targets are very important since new targeted drugs are now available. Anti-androgen therapy might have a role in the management of patients with ductal carcinoma. These new targeted drugs could be integrated with chemotherapy and radiotherapy in the treatment of locally advanced/metastatic salivary gland malignancies.

Adult↗
PubMed2002

[Balance disorders: a proposal of a new diagnostic methodology from the medico-legal standpoint].

Balance impairment is the object of requests for remuneration in 20-50% of the cases of cranial trauma. Most patients present slight disequilibrium following cranial traumas not involving concussion or cervical distraction. The various methods used in Italy to evaluate the biological damage score balance annoyances on a percentage basis ranging from 1% to 25% and base evaluation on vestibular testing results. The Authors feel that such evaluation approaches are limited. Indeed, since compensation mechanisms come into play, vestibular lesions are not always symptomatic. This means that the lesions detected solely through vestibular testing are not necessarily indicative of the extent to which the subject is affected. Furthermore, some extravestibular lesions can give rise to balance impairments which will go undetected by vestibular examination. Finally, an universally accepted diagnostic protocol still doesn't exist. In this work the Authors present a new method for balance impairments evaluation. While this technique still involves the normal evaluation range for vestibular damage (1-25%), it is based on the disturbance indicated by the patient rather than on the instrumentally detected damage. To objectively determine the real existence of the symptom, the Authors also propose a specific diagnostic strategy for each symptom, thus overcoming the problem of a diagnostic standard. The initial results, obtained on 56 subjects evaluated for post-traumatic balance impairment, show substantial agreement with previous methods. Our method allows to better recognize modest damage--for the most part extravestibular which go unrecognized with the conventional methods--and significantly modify the amount of more extensive damage, expression of vestibular damage which does not correspond to equally significant symptoms.

Craniocerebral Trauma↗
PubMed2000

Current role of radiotherapy in the treatment of locally advanced laryngeal carcinomas.

BACKGROUND AND OBJECTIVES: During the past few years, radiotherapy (RT) has been increasingly used in combination with surgery in the treatment of locally advanced laryngeal carcinomas to improve survival rates in patients with more extensive tumors. METHODS: This is a retrospective study of a large series of stage III and IV laryngeal carcinomas, and postoperative RT was indicated for some of these cases. We retrospectively reviewed the medical records of 380 patients with stage III and IV tumors, of which 163 (43%) underwent surgery only and 217 (57%) received surgery and postoperative RT. RESULTS: The survival rates of patients who underwent surgery and RT were comparable to those of patients who underwent surgery only, but the former group was composed of subjects suffering from negative prognostic factors. CONCLUSIONS: The indications for combined treatment should be correlated with the prognostic factors to increase the survival rate of patients with stage III and IV laryngeal carcinoma.

Adult↗
PubMed2000

Adjuvant radiotherapy influences the survival of patients with squamous carcinoma of the head and neck who have poor prognoses.

The treatment of carcinoma of the head and neck in recent years has improved significantly, chiefly thanks to progress in surgery and radiotherapy. Despite these advances, the survival statistics reported in the literature show no appreciable evidence of radical improvement. The aims of this study were to evaluate the impact on survival achieved with the combination of surgical and postoperative radiotherapy in patients with advanced head and neck carcinomas and to identify the prognostic value of several host- and tumor-related factors that can influence the results of combined treatment. We retrospectively reviewed the medical records of 394 patients with stage III and IV carcinoma of the head and neck, of whom 170 (43%) underwent surgery alone and 224 (57%) received combined surgery and postoperative radiotherapy. The 394 patients were stratified for a set of variables including the patient's condition, the characteristics of the tumor, and the modality of treatment. Univariate analysis revealed that coexistent medical diseases, the size and site of the primary lesion, the stage of the tumor, and certain pathologic features had a negative impact on survival. Multivariate analysis showed that the removal of lymph nodes and postoperative radiotherapy can have a positive influence and can improve the prognosis. We compared the survival rates of the patients treated with surgery alone with those of the patients who underwent combined treatment, and we observed that the two survival curves were comparable, even if there was a bias because the combined treatment group consisted of patients with negative prognostic factors. The meaning of these results, compared with data from the literature, has been discussed.

Adult↗
PubMed1998

[Laryngeal myoblastoma in childhood].

Laryngeal tumors originating in the nerves are extremely rare, particularly in infants. Indeed, this type of neoplasm normally arises in adult males. Only 10 cases have been described in the 5 to 17 year age range. The present work reports a clinical case of granulous tumor of the larynx in an 11-year-old boy. Histologically this tumor showed cells which preserved their original structure and were in close relation with the nerve fibers, but not with the myocytes. Their metabolic activity was similar to that of the nerve cells. The neurogenic origin of the neoplastic granulous cells shows the presence of neuroectodermic cytoplasmic S-100 specific for cells derived from the neural crest. The boy manifested ingravescent dyspnea due to the presence of a myoblastoma in the right laryngeal ventricle. A thyrotomic approach was adopted because of the significant size of the neoplasm although it was possible to perform conservative surgery given that the lesion was benign. The authors underline the polymorphic histology of this neoplasm and the importance of the type of surgery which should both avoid widespread demolition since the neoplasm is benign and, at the same time, prevent recurrences.

Child↗
PubMed1997

[Chemotherapy of head and neck carcinomas].

In most cases head and neck tumors manifest themselves on a local-regional level giving rise to highly mutilating pathologies with psycho-social repercussions. Surgery and radiotherapy are effective treatments for limited neoplasms (stage I-II). On the other hand, after surgery and/or radiotherapy, the treatment of locally advanced tumors (stage III-IV) or local recurrences and/or distant metastases is still problematic. For this reason chemotherapy, initially used only as a palliative, is today associated with other treatments to achieve better results both in terms of survival and disease-free time spans. Hence chemotherapy must be considered part of any multimodal primary treatment for advanced squamous cell carcinoma of the head and neck. In fact, numerous clinical studies have clearly demonstrated that adjuvant or neoadjuvant chemotherapy has a highly relative affect on survival in locally advanced diseases and that the incidence of distant metastases is reduced. This is not, however, followed by a similar reduction in local recurrences which are often the cause of death in such patients. It would, on the other hand, appear that survival is improved with integrated radio-chemotherapy. Immunochemotherapy, which has not as yet provided significant clinical results in cases of advanced tumors and/or metastases, must still be evaluated in the treatment of locally limited neoplasms. Organ preservation, which proves feasible in the larynx, leads one to hope it can be applied in other head and neck sites. The future balance leans in favor of the multidisciplinary approach and multi-center studies must be performed so that an adequate number of cases can be gathered over a brief period. This will make it possible to answer those questions and, at times, illusions which accompany chemotherapy in the treatment of advanced head and neck tumors.

Adult↗
PubMed1997

[Identification of clinical, biological and prognostic factors in recurring squamous cell carcinoma of the head and neck].

Many studies have been performed to determine some prognostic factors for malignant head and neck tumors. Defining the clinical and biological features would enable one to predict the progression of the disease and plan treatment. The aim of the present study has been to identify what host and neoplasm characteristics provide prognostic indication of possible recurrences. A group of 380 patients with squamous cell carcinoma of the head and neck was studied. The neoplasm was located in the following sites: 257 larynx-hypopharynx, 69 oropharynx, 54 oral cavity. At the present time 309 of these subjects are still alive and disease free while 71 have had recurrences. Analyses were performed on various variables regarding the patient, neoplasm and histology. Multivariante analysis of these prognostic factors was performed using the PLR-BMDP program. The time of recurrence in the primary tumor site and at the lymph node level was evaluated using the Kaplan-Meier method. Of the 28 variables analyzed 16 had no effect on the probability of recurrence. Two variables reduced the risk of recurrence: age over 61 years (p < 0.05) and primarily intra and peritumoral lymphocyte infiltration (p = 0.06). Of the data regarding the patient, age lower than 61 years and presence of associated internal pathologies (i.e. bronchial pneumonia and hepatitis) appeared to significantly facilitate the appearance of recurrence. The characteristics of the neoplasm which appear to effect recurrences are: tumor site (hypopharynx), presence of lymph node metastases, morphological elements of tissue spread (vascular invasion, plasmocyte infiltration), capsular breakdown, positive margins and post-operative infection. In conclusion, it can be asserted that technical development of multifactorial analysis has made it possible to identify important prognostic factors and quantify their impact on the evolution of a neoplasm.

Adult↗
PubMed1994

Concomitant radiotherapy and daily low-dose carboplatin in locally advanced, unresectable head and neck cancer. Definitive results of a phase I-II study.

The combination of daily low-dose carboplatin and radiotherapy was studied in 55 patients with inoperable head and neck cancer. All patients were planned to receive 70 Gy plus carboplatin i.v. daily, 45-60 min before radiotherapy. A starting schedule of 30 mg/m2 on days 1 through 5, weeks 1, 3, 5 and 7 was administered to 17 patients; an escalating daily dose, up to 55 mg/m2, was given to 38 additional patients. Up to a daily dose of 45 mg/m2, only 4.4% of the patients developed grade 3 leukopenia; on the contrary, grade 3 and 4 leukopenia was seen in 62.5% of patients receiving 50 mg/m2 or more. Mucositis was the major nonhaematologic toxicity and seemed to be dose-dependent. At the end of the loco-regional treatment there were 33 (61.1%) CR and 17 PR; the most effective total carboplatin dose seemed to be 40-45 mg/m2. After surgical salvage the number of CRs increased to 37 (68.5%). One- and 2-year loco-regional control rates were 64% and 53% respectively. One- and 2-year actuarial survival rates were 71% and 53% respectively; the corresponding rates of disease-free survival were 60% and 43%. There was a strong correlation nodal status and both survival and disease-free survival.

Adult↗
PubMed1992

Results of chemotherapy plus external reirradiation in the treatment of locally advanced recurrences of nasopharyngeal carcinoma.

Between 1982 and 1991, 16 patients with recurrent cancer of the nasopharynx were treated with chemotherapy (CT) and radiotherapy (RT). All patients had received prior RT (45-69, 30 Gy). According to rTNM there were three rT2, one rT3 and 12 rT4. 5 patients were N1. Reirradiation (12-46 Gy, mean: 28) started 3-4 weeks after CT (2-6 cycles of different combinations), but 2 cases involved concomitant therapy. Out of 16 patients 7 had complete response (CR) (43.7%), 7 partial response and 2 no response. Statistically significant prognostic factors for obtaining CR were time of relapse and response to initial CT. Median duration of CR was 22+ months (9-64+). Failures at primary site occurred in 3 patients, 2/2 of those receiving CT without platinum compounds and 1/5 of other ones, with statistically significant difference in local recurrence free-survival between the two groups. Two- and 3-year actuarial overall survival were 28% and 10%. Rates of disease-free survival were 17% and 8%, respectively. The acute toxicity was generally mild. No central nervous system damage or radiation-induced myelitis were observed in survivors.

Adult↗
PubMed1989

Combined chemotherapy for recurrent and metastatic nasopharyngeal carcinoma.

Thirty-two patients (24 males, 8 females; median age 54 yrs) with recurrent and/or metastatic undifferentiated carcinoma of the nasopharyngeal type were treated with chemotherapy. Remissions were observed in 17 of 32 (53.2%) with 5 complete (CR) (15.6%) and 12 partial responses (PR) (37.6%). A combination of cisplatin and 5-fluorouracil was the most effective regimen (CR + PR = 83.3%). Objective responses. (CR + PR) were 47% (CR = 11.7%) in schemes without cisplatin and 60% (CR = 20%) in cisplatin-based combinations. The median overall duration of response was 7.2 months. The median overall survival time was 10.3 months: 15.1 months for responders and 5.2 for non-responders. No important toxicity was observed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Computerized tomographic evaluation of latero-cervical lymphatic metastasis of carcinoma of the larynx. Personal experience in 170 cases].

CT can be considered the most reliable technique in detecting nodal metastases of the cervical district. The Authors have studied 170 patients with laryngeal cancer (104 N0, 21 N1, 21 N2 and 24 N3 clinically) with CT of the cervical region during infusion of contrast material. All patients underwent radical neck dissection with pathological examination of the nodes. CT diagnosis and pathological findings were correlated. Our findings show that CT has an overall accuracy of 91.8% (100% in groups N2 and N3) and fed false positives and false negatives.

Adult↗
PubMedDate not supplied

Chondrosarcoma of the larynx. Case report and review of the literature.

Chondrosarcoma of the larynx is a rare tumor; worldwide only about 250-300 cases have been described in the literature. We present a clinical case of laryngeal chondrosarcoma manifesting as a swollen mass of 10 x 7 x 6 cm in the infrahyoid and left lateral cervical region. The patient underwent total laryngectomy, thyroidectomy and bilateral neck dissection. A review of the literature on this disease is also reported.

Aged↗
PubMedDate not supplied

Head and neck metastases of renal cancer after nephrectomy: a report of 2 cases.

Two cases of metachronous metastases of renal cell adenocarcinoma are reported. One case presented a solitary metastasis of the ethmoid-orbit which was resected. The patient has remained well for the following 12 months. The second case presented with a secondary to the tongue and multiple metastases elsewhere. Electrodissection achieved a good palliative result.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Squamous cell carcinoma of the lacrimal drainage system: case report and literature review.

AIMS AND BACKGROUND: Epithelial malignant tumors of the lacrimal drainage system are rare. The most prevalent type is squamous cell carcinoma. These tumors generally present with aspecific symptoms suggestive of chronic dacryocystitis, with the result that diagnosis and treatment are often delayed. METHODS AND STUDY DESIGN: We present the case of a patient with a squamous cell carcinoma of the lacrimal ducts and discuss the clinical and pathological features of these neoplasms, together with diagnostic and therapeutic strategies according to the data available in the literature. RESULTS AND CONCLUSIONS: The diagnostic and therapeutic approach to this kind of rare tumors has to be planned carefully. Radiographic examination of all masses arising in the medial canthus is essential. Dacryocystography allows the identification of space-occupying tumors in the lacrimal sac. Computed tomography and magnetic resonance imaging provide the most useful information about the extent of the neoplasm and its relationship with surrounding bone structures and soft tissues. Histological examination of a biopsy sample obtained by standard dacryocystectomy is essential to confirm the diagnosis. The treatment of choice is primarily surgical, consisting of complete resection with long-term follow-up. A number of surgical procedures have been described, which are more or less aggressive depending on the extension of the tumor. Radiotherapy is indicated when bone or lymphatic invasion is evident, and when neoplastic cells are present in the resection margins. Radiotherapy alone is not considered a treatment of choice, but only a palliative option in selected cases. The follow-up data available in the literature are incomplete. In most of the literature reports, relapse occurs in 50% of patients within 5 years.

Carcinoma, Squamous Cell↗