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C Maylin

Publications and source records attributed to C Maylin.

At least 37 records · Page 2Linked to original sources

Split course interstitial brachytherapy with a source shift: the results of a new iridium implant technique versus single course implants for salvage irradiation of base of tongue cancers in 55 patients.

Between January 1973 and December 1984, 55 patients with prior irradiation of the oropharynx underwent salvage irradiation for recurrent (26 patients) or second cancers (29 patients) of the base of tongue. The initial irradiation had delivered from 45 to 80 Gy to the base of tongue. One of two techniques of Iridium implantation was used for salvage. Single course implants, delivering 60 Gy, were used until June 1981 in a total of 31 patients. After June 1981, split course implants with a source shift were used in 24 patients in the hope of decreasing treatment complications. The first and second course of the split course implants delivered 35 and 30 Gy, respectively, at a 1-month interval. The active lines of the second implant were placed parallel to and between the position of the lines of the first implant. This shift in the source position resulted in a more uniform dose within the treated volume with a 60% reduction in the high dose sleeves. The overall 3-year survival was 19% (28% T less than or equal to 3 cm). The overall local failure rate was 45.5% (25/55). The difference between the local failure rate after single course implants (52%) and after split course implants (37.5%) was not statistically significative. The response observed after the first course of a split course implant proved to be a reliable indication of the probability of achieving local control after a full course of treatment: 2/14 failures (14%) if the response was greater than or equal to 75% versus 7/10 (70%) if the response was less than 75% (p less than 0.01). The only complication noted in the 40 patients achieving immediate local control after either implant technique was mucosal necrosis. The introduction of split course implants was followed by a two and a half fold decrease in the incidence of necrosis: 43% (9/21) in the single course group and 16% (3/19) in the split course group (p = 0.05). Interstitial brachytherapy offers an effective and reasonable option for salvage therapy in patients with recurrent and second cancers occurring in the base of tongue even when the tumor arises in a zone that has previously received high dose irradiation. The use of split course implants with a shift in the position of the active lines at the time of the second implant significantly decreases the risk of radionecrosis.

Aged↗

The use of a specific hypofractionated radiation therapy regimen versus classical fractionation in the treatment of breast cancer: a randomized study of 230 patients.

An ongoing randomized study of a specific regimen of hypofractionated radiation therapy (IHF) versus classical or standard radiation therapy (IC) for breast cancer was begun in the Department of Radiation Therapy of the Necker Hospital, Paris France, in January 1982. Breast cancer patients entered into this study received either IC to deliver 45 Gy in 25 fractions over 33 days or a specific IHF regimen to deliver 23 Gy in 4 fractions over 17 days. As of June 1989, 525 patients had been entered into the study. The first 230 patients treated from 1982 through December 1984 had a minimum follow-up of 4 years (range: 4 to 7 years). Preliminary analysis of the results in these first 230 patients are presented. The distribution of patients in this initial group according to clinical staging, associated treatments, and pathological nodes is as follows: T1 = 22%, T2 = 61%, T3 + T4 = 17%, palpable nodes = 28%, inflammatory signs = 7%, surgical treatment = 79% (mastectomy = 35%, tumorectomy + Ir.192 = 44%), radiation alone + neoadjuvant chemotherapy = 21%, N+ = 50% of patients undergoing surgery. Loco-regional recurrences developed in 7% (9/125) of patients in the IHF group and in 5% (5/105) of patients in the IC group. Complications were minor. The addition of the percentage of each complication noted results in a total of 23% for the IHF group and 19% for the IC group (one patient could present several complications). As we had previously observed when comparing these two fractionation regimens in other studies with other tumors, these preliminary results showed no evident difference in the effectiveness and rate of complications whether IHF or IC was used to treat patients with breast cancer.

Adenocarcinoma↗

[Primary chemotherapy in breast cancer. Preliminary results].

Primary chemotherapy in carcinoma of the breast is justified by the high risk of distant metastases, immunodepression related to surgery and the experimental studies and clinical trials of Nissen-Meyer in 1967, and Fisher in 1968. Chemotherapy was associated with loco-regional Patey-type surgery (20 patients) or radiotherapy with cobalt and irridium (43 patients) in 63 cases of breast cancer, 33 of which were T4 or in exarcerbation. Initial chemotherapy comprised 3 to 6 infusions of Velbe, Thiotepa, Methotrexate, 5-Fluoro-uracil, prednisone plus adriamycine in the severe forms. Over 50 p. 100 tumour regression was observed in 80 p. 100 of patients without major toxicity reactions. In all cases of radiotherapy alone, the tumour disappeared completely in the two months after the end of radiotherapy. Only one of the 63 patients relapsed at the 8th month and she died. The follow-up period now ranges from 3 to 29 months (average 12 months). These results are encouraging but only a larger series will allow definite conclusions to be drawn.

Antineoplastic Combined Chemotherapy Protocols↗

[Comments about use of polychemotherapy MOPP associated with radiotherapy in the treatment of early stages of Hodgkin's disease. Preliminary report of 58 patients (author's transl)].

58 patients with early stages of Hodgkin's disease (I, II, III l) were treated by 3 courses of MOPP chemotherapy followed by extended field irradiation. After 31 to 72 months follow up 87,8 p. 100 of patients are alive in complete remission. The study of the group deserves two comments: 1. Adjuvant MOPP polychemotherapy may be useful, only when a complete response is obtained after 3 courses, when it is so a complete remission of long duration may be hoped in nearly 100 p. 100 of cases. 2 After complete remission induced by combined chemotherapy and radiotherapy, maintenance chemotherapy seems to be useless.

Adolescent↗

[Prevention of sequelae after transcutaneous radiotherapy for epitheliomas of the oral cavity (author's transl)].

Close cooperation between the radiotherapist, surgeon, and patient is necessary in order to prevent sequelae following transcutaneous radiotherapy for epitheliomas of the oral cavity. The most effective therapeutic results combined with a minimum of sequelae are obtained by the use of a good irradiation technique, close supervision, careful treatment of any oral or dental affection, prescribing simple medications only, and stopping the use of tobacco and alcohol.

Humans↗

[Factors favouring necrosis after curietherapy for oral cavity epitheliomas (author's transl)].

The authors studied the factors which favour necrosis after curietherapy, in a series of 82 patients with epithelioma of the oral cavity and a previous series of 280 cases. The principal factor is the size of the tumor. The other factors (macroscopic appearance, dose, quantity of radioactive material, degree of inhomogeneity, distance between the lines, association with external irradiation), are or only moderate importance, as shown by the variations observed, though they are difficult to evaluate in an exact manner, partly for methodological reasons. The frequency of necrosis of bone tissue is directly relaxed to the number of radioactive lines in contact with the maxilla. Alcohol and tabacco abuse have a definite influence but this cannot be calculated. In conclusion, therefore, it would appear possible to reduce the frequency of necrotic lesions by reducing the tumoral size by curietherapy, by applying no more than 2 lines in contact with the mandible for bony necrotic lesions, and by stopping the abuse of alcohol and tobacco.

Humans↗

[Iridium 192 interstitial radiotherapy of carcinoma of the penis. Carcinologic results, dermatologic evaluation (about 87 cases) (author's transl)].

87 cases of epidermoid carcinoma of the penis treated by Ir 192 interstitial radiotherapy are studied. The 5 years survival rate, estimated on a 51 patients group, is 61 p. 100. Among these 51 patients, 12 had a local recurrence. The post-radiotherapy early reaction is estimated on a 79 patients group, with a mean duration of 3, 4 months. The early reaction is correlated to tumor size and not correlated to number of radio-active lines. The later dermatologic evolution is studied in 59 patients. In 22 cases, the scar remained supple, without any further local change. Local changes occurring in the 37 other cases are studied in their clinical aspect, signification and frequency. Of 34 patients followed longer than 40 months, 14 had local complications with 4 cases of local recurrence. The carcinologic reliability of this method is similar to that by surgery. It seems however it must be restricted to tumors limited to glans penis.

Adult↗