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Biomedical subjects

B Pierquin

Publications and source records attributed to B Pierquin.

At least 73 records · Page 4Linked to original sources
PubMed1985

Treatment of bladder tumors by iridium 192 implantation. The Créteil technique.

The technique and results of a treatment protocol for bladder cancer combining low dose pre-operative external beam irradiation followed by external iliac nodal dissection, limited partial cystectomy and curietherapy with iridium 192 are described. In 55 patients treated from 1971 to 1979, 37/45 (67%) are alive NED at 5 years--23/31 pT1, 10/14 pT2, 4/10 pT3--with 9/55 bladder recurrences at 5 years--7/31 pT1, 1/14 pT2, 1/10 pT3. Only two patients (total cystectomy) have not retained a functional bladder. These favorable results have been obtained in a carefully selected population; our indications for the technique being T1, T2, T3a tumors with a total surface area not exceeding 5 cm, not involving the bladder neck and unifocal or in some cases plurifocal, but closely grouped. The advantages and precise details of each stage of the technique will be described and compared with large series in which radium 226 is utilized and results of curietherapy will be compared with other modalities of treatment employed under similar circumstances for similar patient groups. We feel that curietherapy has certain advantages over other methods in the treatment of bladder cancer and that an afterloading technique employing iridium 192 wires permits the curietherapy to proceed under optimal conditions, allowing combination with partial cystectomy, optimal placement of sources, precise radiographic control and dosimetry, dose reduction in many cases, optimal conditions of radioprotection and widening of the indications for the technique.

Brachytherapy↗
PubMed1984

Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979).

From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (N0), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4T3) developed local recurrences; 10 of these 11 patients underwent penile amputation which controlled the tumor in 7 of the patients. One patient refused amputation. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Overall, at their last follow-up examinations, 74% of the patients were free of disease with conservation of penile morphology and function. Most patients without metastatic nodes (37/45) at diagnosis did not receive prophylatic treatment of the groin. Two of these patients developed delayed metastatic nodes; one was successfully salvaged. All 5 patients presenting with metastatic nodes at diagnosis died, four with uncontrolled regional disease. Twenty-one percent of the patients died of their disease. We advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does not exceed 4 cm. Pre-implant circumcision and regular long-term follow-up are necessary. More extensive tumors are better managed surgically. When regular follow-up can be assured, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis.

Adult↗
PubMed1984

The role of radiation therapy in the treatment of adenocarcinoma of the corpus uteri stage I. A ten year experience (1970-1979).

A series of 93 cases of endometrial adenocarcinoma stage I, of which 87 were treated by surgery in combination with pre- or postoperative irradiation, is analysed with respect to recurrence rate, survival and effect of preoperative irradiation on myometrial invasion. According to the authors, the treatment of choice remains a combination of surgery and radiation therapy in order to control the primary tumor and prevent vaginal recurrence. The authors recommend uterovaginal intracavitary irradiation followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy, and with adjunctive postoperative external irradiation reserved for the rare cases at high risk for locoregional failure (persistence of deep myometrial invasion, lymph node involvement).

Adenocarcinoma↗
PubMed1984

[Initial polychemotherapy in the treatment of cancers of the head and neck. The efficacy and tolerance of 2 nonrandomized combinations in 48 patients].

Before loco regional treatment for head and neck cancer forty eight patients received one or the other of the following combined chemotherapy regimens: Regimen A (28 patients): high dosage methotrexate, bleomycin, cis-platin; regimen B (20 patients): common dosage methotrexate, bleomycin, hydroxyurea, vincristin. The effectiveness of regimen A seemed better than that of regimen B (46% responses versus 20%). This assessment must be accepted with caution, since, although the organization of treatment was strictly similar in the two groups, the study was not randomized, and there were noticeable differences between the two groups. Regimen B was associated with no toxicity. Regimen A was responsible for two fatalities. These two cases were linked to high dosage methotrexate. However, a combined chemotherapy regimen of type A with the high dosage methotrexate replaced by intermediate dosage methotrexate, seems feasible to us. Loco regional treatment was not impaired by initial chemotherapy with either regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Role of iridium-192 endocurietherapy in the treatment of T1 and T2 tumors of the tonsillar region].

From July 1971 to August 1981, 31 selected patients with T1, T2 tumours of the Tonsillar region were treated according to the following protocol: Telecobalt therapy to the primary site and to neck nodes to a dose of 45 Gy, Brachytherapy to the primary site to a dose of 25-30 Gy using iridium 192, Boost dose to involved neck nodes, with electrons, or radical neck dissection, wether N1, N2 or N3. The actuarial survival free of disease is 76% for the whole group and 86% for the NO group. The local control rate is 100% without any recurrences at the primary site having been observed. Disease control in the neck is 94% overall and 100% for the NO group. The effects on salivary function were reduced in comparison with telecobalt therapy alone. These favourable results favour the use of this protocol for superficial, minimally infiltrating tumours less than 4 cm in diameter without obvious extension to the base of the tongue or retromolar trigone.

Adult↗
PubMed1984

Iridium-192 wiring after partial cystectomy as a treatment of small malignant bladder tumors.

Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Forty-four tumors (mostly T1, but also T2 and T3) were treated by this procedure and followed over five years. Good results are attained in 66 per cent of the cases. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed. Supplementary treatment by irradiation has to be considered in view of frequent recurrences of malignant bladder tumors after transurethral resection of partial cystectomy. In small cancers slightly infiltrating the bladder wall, many attempts have been made to replace tele-irradiation by interstitial irradiation. The latter delivers specifically high rad dosage to the involved area. Radium needles has been used in France by Darget before 1951 but evaluation of accurate dosage proved difficult. This material was dangerous to the surgeon's hands, and the procedure lead frequently to bladder sclerosis. This technique is currently used by Van der Werf-Messing in Rotterdam. She strongly advises preoperative tele-irradiation (3 X: 350 rads) to prevent tumor implants in the scar. An intravesical balloon filled with fluid radioisotope of gold-198 or cobalt-60 has been used for diffuse malignant papillary epithelioma. It was discontinued because of radiation cystitis and subsequent contraction of the bladder. Recently in well-limited tumors, Bloom and Wallace have used Tantalum-182 needles which have interesting physical properties (high energy and short half-life period) (2).

Brachytherapy↗
PubMed1984

[10-year retrospective analysis of the sequelae of loco-regional treatment of breast cancer].

With a minimum follow-up period of 10 years, the incidence of sequelae after loco-regional treatment of 349 breast cancers remains low, being dominated by lymphoedema. Rare after treatment by irradiation alone, lymphoedema appears more frequently in patients treated by radio-surgical association, in spite of a moderate dose of radiation. If a rigorous technique is carried out, the possibility of achieving satisfactory local control in the axilla with radiation alone without neurological sequelae, therefore brings into question the need for axillary dissection without clinically significant adenopathy.

Adult↗
PubMed1983

Intercomparison of iridium-192 wire used in interstitial radiation therapy.

The results of an intercomparison which took place in 1976 when 2 sets of 192Ir wire, one English, the other French, were exchanged and their activities measured by the producers, one standardizing laboratory and two radiation therapy centres. The average differences ranged from 0.7 to 3.2 per cent. The differences in the derivation of basal dose rate as defined in the Paris system, by the two radiation therapy centres, were also investigated.

Brachytherapy↗
PubMed1983

Conservative management of breast carcinoma. The Créteil experience.

The results of conservative management of breast carcinoma are presented. The disease free survival for patients with T1 lesions was 84 per cent at 5 years, 76 per cent at 7 years and 65 per cent at 10 years, for T2 75, 71 and 64 per cent, and for T3 65, 51 and 45 per cent. The proportion of breast conserved amongst the patients free of disease at 10 years was 94 per cent for T1, 93 per cent for T2 and 80 per cent for patients with T3 lesions. The cosmetic results were very good for T1 lesions, good for T2 and quite good for T3 lesions. Up to 1981 a simple tumorectomy was carried out in most of the T1 lesions and some of the T2 lesions, followed by radical irradiation. Most of the T2 and T3 lesions were exclusively treated with radical irradiation. In an attempt to improve the cosmetic results, since 1981, the indications for tumorectomy were extended to include some of the T2 lesions, and when possible also some of the T3 lesions, where a tumorectomy is performed before or after irradiation, together with a limited axillary dissection.

Brachytherapy↗
PubMed1983

[Acute leukemia and breast cancer : apropos of 12 cases observed in the Department of Oncology at the Henri Mondor Hospital].

The authors report 12 cases of acute leukemia observed after breast cancer. 4 patients received only adjuvant radiotherapy, whereas the other eight received both chemotherapy and radiotherapy. Acute leukemia appeared with a mean time of 5.5 years after the detection of breast cancer and was preceded in 7 cases by isolated pancytopenia during 4 months. Acute leukemias were always non lymphoblastic and myelofibrosis was very frequent. A complete remission was obtained at three patients out of the seven treated. The mean survival time was 5.6 months. The existence of acute leukemia after chemo-and/or radiotherapy poses several problems. The detection of patients with a high risk of leukemia by different methods such as cytogenetic, studies of dysmyelopoietic symptoms, is actually often too late occurring during preleukemia states of bad prognosis. We also need to know the exact incidence of secondary leukemia after treatment of breast carcinoma and the real benefit of such treatment.

Acute Disease↗
PubMed1982

[Cancer of the oropharynx and oral cavity : results of low dose telecobalt irradiation (author's transl)].

A study has been conducted from August 1977 to compare the results of conventional fractionated irradiation (CFI) and low dose irradiation (LDI) in cancer of the oropharynx and oral cavity. Skin tolerance was perfect and mucusal tolerance satisfactory after LDI whatever the dose, and tumoral and lymph node regression and the 1-year survival rate comparable with those obtained after CFI. A dose of 1.5 Gy/h is suggested for future application, oropharyngeal tumors responding best to this type of irradiation.

Cobalt Radioisotopes↗
PubMed1980

Treatment of malignant bladder tumors by iridium-192 wiring.

Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Twenty-six tumors (mostly T1, but also T2 and T3) were treated by this procedure. Good results are attained in 89 per cent of 19 cases followed over three years. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed.

Brachytherapy↗