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Biomedical subjects

B Prevost

Publications and source records attributed to B Prevost.

9 recordsLinked to original sources

Management of early oral cavity cancer. Experience of Centre Oscar Lambret.

From 1974 to 1983, 579 patients presenting with early oral cancer (excluding lip tumours) were treated at Centre Oscar Lambret. Of these, 429 were treated locally by brachytherapy with local control achieved in 82% of the cases (90% after salvage surgery). Treatment-related complications occurred in 19% of the cases, requiring surgical management in 13 patients. In contrast, only 51% of the 35 patients treated by external radiotherapy and brachytherapy were controlled, resulting in a poor 5-year survival (14%). Results for the 24 patients treated surgically were similar to those of brachytherapy alone. Finally, for T1 T2 N0 patients, the advantages of an elective neck dissection are not clear and could be clarified by a randomised trial. Indeed, this retrospective study failed to find a significant difference in the incidence of death due to an uncontrolled neck evolution whatever the neck management.

Adult

Composite resection with mandibulectomy in the treatment of posterolateral oral cavity and lateral oropharynx squamous cell carcinoma.

From 1972 to 1987, 403 patients underwent a composite resection consisting of segmental mandibulectomy and neck dissection for the treatment of bucco-pharynx squamous cell carcinoma (303 patients had postoperative radiotherapy [XRT], 29 patients had preoperative XRT, and 100 patients had tissue salvage performed after XRT). Of the 303 patients who received preoperative XRT, 32 were clinically staged T2, 149 were staged T3, and 122 were staged T4; 194 of the 303 patients were staged N0. In the 100 patients who experienced relapse and who required "salvage surgery," the restaging found 20 patients staged T2, 39 staged T3, and 41 staged T4; 73 of the 100 patients were staged N0. The patients' mean postoperative stay was 15 days for those who had prior surgery and 21 days for those who had salvage surgery. With a minimum follow-up of 5 years, locoregional recurrences and postoperative death occurred in 86 of 274 patients (31%) in whom surgery and postoperative XRT were performed; in 17 of 29 patients (59%) who had preoperative XRT performed; and in 61 of 100 patients (61%) who had salvage surgery performed. In addition, in terms of functional results, only 61% of patients (206) were able to maintain normal speech function, and only 23% (91) were able to maintain normal oral feeding. Of the 403 patients, the 5-year survival rates were 33% for the overall population, 42% for patients with postoperative XRT, 16% for patients in whom operation was performed after preoperative XRT, and 17% for patients who underwent salvage surgery.

Adult

Results of postoperative radiation therapy in medullary carcinoma of the thyroid: a retrospective study by the French Federation of Cancer Institutes--the Radiotherapy Cooperative Group.

Between 1971 and 1989, 59 patients received external radiation therapy with a curative intent. There were 25 females and 34 males, ranging in age from 19 to 87. No patients had distant metastasis at the onset of treatment. The majority of patients had a total thyroidectomy (55/59), generally combined with neck dissection. Residual tumour was left in 11 cases, and 44 patients had positive cervical nodes. Using megavoltage radiotherapy, the whole neck and the upper mediastinum area were most often irradiated through a large anterior Y-shaped field without laryngeal shielding. The mean dose to the tumoral bed was 54 Gy. Dysphagia was observed in 32 patients (11, 17 and 5 scores were grade 1, 2 and 3, respectively). Dyspnea occurred in five cases and in two of these cases, it was considered to be severe. Local recurrences were noted in 18 (30%) patients, most of them occurring within the fields of irradiation. Parameters such as age, sex, total dose, irradiated volumes or cervical node enlargement did not modify the local control rate. The same conclusions can be drawn for distant failures. Thirty five patients are still alive and among them, 24 have no evidence of disease. The average length of survival is 70.5 months and is shortened by the occurrence of distant failures except in patients with bone metastases.

Adult

[Cancer of the upper aerodigestive tract. Global study of 2418 cases].

The authors present the general results of a retrospective study on 2418 patients treated between 1976 and 1980. Primaries were located on buccopharynx in 51% of cases, pharyngolarynx in 45% and nasopharynx or nasal and paranasal cavities in 4%. Two out of 3 tumours were classified T3 T4 (UICC 1979) and 1 out of 2 patients presented with palpable cervical lymph nodes. Taking into account persistent diseases and recurrences, failure at primary sites occurred in 40% of patients, in the neck in 20%, distant metastases in 10%. Synchronous and/or metachronous cancers were observed in 1 out of 3 patients. Actuarial survival rates were 2/3 at 1 year, 1/3 at 3 years, 1/4 at 5 years and 1/7 at 8 years. Endolaryngeal tumours had the best prognosis while hypopharyngeal tumours had the worst prognosis.

Adult

Interstitial brachytherapy and early tongue squamous cell carcinoma management.

The results of treatment of 341 previously untreated patients with early squamous cell carcinoma (SCC) of the anterior two thirds of the tongue using iridium 192 implants (January 1974-December 1983) are presented. Furthermore, 265 patients underwent neck dissection, followed, in 102 cases, by radiotherapy. Incidence of local treatment complications was 19% (66 patients; however, only 3% (11 patients) needed more than a single medical treatment. Two months after completion of overall treatment, 326 patients (96%) were free of disease. Local failures occurred in 18% of cases; however, after successful salvage surgery this rate was reduced to 11%. Neck failures occurred in 18% of cases, but after successful salvage were reduced to 12%. Distant metastases were rare (1.5%), whereas metachronous cancers were frequent (102 patients). Survival rates were 61% (56% to 66%) at 3 years, 46% (41% to 51%) at 5 years, and 26% (23% to 34%) at 10 years. Deaths due to tongue cancer evolution (20%) equalled those due to metachronous cancers (18.5%) and intercurrent diseases (21%).

Adult

A new method for thermal dosimetry in microwave hyperthermia using microwave radiometry for temperature control.

Microwave radiometry has been used during the last few years in some clinical centres (Lille, Freiburg, Strasbourg, Brussels) for the non-invasive control of temperature during microwave hyperthermia. The principal objective of this paper is to present an atraumatic thermal dosimetry system based on numerical simulations of hyperthermia and radiometric temperature measurements for TEM propagation. To gauge the feasibility and performance of the method, a one-dimensional model in a homogeneous medium is considered, neglecting the curvature of the tissue layer. The good correlation between the theoretical and experimental values obtained allowed the likely thermal profile on the probe axis to be computed using the dielectric and thermal properties of the medium and measurement of the radiometric and cutaneous temperatures.

Computer Simulation