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Biomedical subjects

D Goffinet

Publications and source records attributed to D Goffinet.

8 recordsLinked to original sources
PubMed1990

Nasopharyngeal carcinoma in the young: a combined M.D. Anderson and Stanford experience.

From 1956 to 1988, 57 children and young adults (age 4-21 years) with a diagnosis of nasopharyngeal carcinoma were treated at The University of Texas M.D. Anderson Cancer Center (42 patients) and Stanford University Medical Center (15 patients). The male to female ratio was 2:1. Forty-three patients had lymphoepithelioma, seven had undifferentiated neoplasms, and seven had squamous cell carcinoma. Two patients had Stage III disease and the remainder had Stage IV disease at the time of presentation. All patients were treated with primary radiotherapy, and 14 patients also had chemotherapy with combinations of the following drugs: dactinomycin, doxorubicin, bleomycin, cisplatin, cyclophosphamide, fluorouracil, methotrexate, and vincristine. Twenty-six patients are alive 6 to 178 months from the first day of treatment (median 93 months). The 5- and 10-year actuarial survival rates are 51% and 36%, respectively, and the corresponding disease specific survival rates were 51% and 51%. There were no recurrences after 42 months. The patterns of failure were as follows: distant metastasis only, 21 patients; locoregional metastasis only, 1; both, 5. Distant metastases most commonly occurred in bones, lungs, liver, and mediastinal lymph nodes. Chronic treatment-related morbidity was encountered in a significant number of long term survivors. Trends in the data not reaching statistical significance suggest a more favorable prognosis for a) females, b) patients less than or equal to 15 years of age, c) lymphoepithelioma or undifferentiated histologies, d) stages T3-4 NO-1 vs T1-2 N2-3 vs T3-4 N2-3, e) primary tumor dose greater than or equal to 65 Gy and f) patients who received chemotherapy.

Adolescent↗
PubMed1988

Improved dose distribution with customized I-125 source loading in temporary interstitial implants.

I-125 sources are being used in temporary interstitial implants of various sites. Radiation safety considerations favor its use over other available radioisotopes. Cost containment is achieved by using the same sources for a number of patients. Loading I-125 seeds into implant catheters at our institutions permit customized source arrangement to optimize the implant dose patterns. Clinical examples are given for which the dose distributions achieved with customized source loading are superior to those achievable with standard Ir-192 ribbons.

Brachytherapy↗
PubMed1983

Fat necrosis of the breast simulating recurrent carcinoma after primary radiotherapy in the management of early stage breast carcinoma.

Between March 1973 and December 1980, 76 patients with Stage I or II breast carcinoma were treated by biopsy and definitive radiation therapy at Stanford University Medical Center. There were 78 treated breasts since two patients had bilateral carcinomas at presentation. During a median follow-up period of 29 months, eight patients developed discrete masses in the treated breast. In four of these patients biopsied tissue revealed recurrent carcinoma yielding a local control rate of 95%. Four additional patients had lesions which were clinically indistinguishable from recurrent cancer. Biopsy specimens, however, revealed fat necrosis of the breast. The clinical and pathologic features of this entity are described. It is imperative that clinicians be aware of this treatment sequelae so that conservative diagnostic procedures may be used and breast deformity minimized. If postirradiation fat necrosis is considered, mastectomy for suspected persistent or recurrent disease may be avoided.

Biopsy↗
PubMed1983

Squamous cell carcinoma of the base of the tongue.

The squamous cell carcinomas of 119 patients treated between 1958 and 1980 were retrospectively reclassified according to the 1977 American Joint Committee for Cancer Staging-End Results Reporting guidelines. Analysis of the information was performed with an interactive computer program that allows the analysis of a large number of medical factors with numerous variables. The following factors show the statistically significant improved survival rates: well-differentiated histopathologic findings, small T-stage lesions, and clinically negative neck disease. Although the survival curve was similar in the planned combined therapy and radiation therapy groups, local control was statistically superior in the combined therapy group. A similar trend is seen in those patients who receive interstitial implants in addition to external beam therapy. A randomized prospective study is needed to determine the optimum mode of therapy.

Adult↗
PubMed1981

Irradiation with external beam and interstitial radioactive implant as primary treatment for early carcinoma of the breast.

The locoregional control of 60 to 61 patients supports the results published by other centers and compares favorably with results of any surgical series. The cosmetic results are excellent with only three of 61 patients having severe fibrosis of the breast develop. No rib fractures, skin ulcerations, symptomatic radiation pneumonitis, edema of the arm or limitation of arm movement have been observed as complications. Ten of the 28 patients who have had axillary dissection had transient edema of the breast develop. Results of numerous studies suggest that primary radiotherapy without mastectomy is appropriate treatment for early carcinoma of the breast. The accessibility of the breast makes it relatively easy to deliver curative doses of radiation with minimal damage to surrounding normal tissues. The cumulative radiotherapy experience has demonstrated the gratifying results of not only maintaining a rather normal breast but also avoiding the negative physical and psychologic repercussions of the mastectomy. Radiation therapy is an alternative to Halsted's radical mastectomy.

Brachytherapy↗
PubMed1979

Radioactive suture in the treatment of head an neck cancer.

I-125 seeds in Vicryl suture have been used as a radioactive suture in 24 cases of advanced malignancy of the head and neck. Twelve cases had metastatic carcinoma attached to the internal or common carotid artery. The goal was to excise surgically as much tumor as possible, then implant any residual tumor with this radioactive suture which remains as a permanent implant (half-life of 60 days). This preliminary study shows that use of I-125 impregnated Vicryl suture in this manner appears to produce improved long-term palliation and may increase local cure rates.

Follow-Up Studies↗
PubMed1978

[Myocardial infarct before the age of 36: 20 cases].

Twenty cases of myocardial infarction in 16 males and 4 females and less than 36 are reported. The number of heavy smokers was greater than in other age groups (86%), and an association between tobacco consumption and lipid abnormalities was found in 3/4 of cases. All the females were on contraceptive treatment, one recurring during pregnancy. The clinical features of the infarctions were an onset which was usually unexpected (n=14), ar attack which was sometimes precipitated by exercise (n=3), and the infrequency of residual angina. The exercise test (n=16) showed up an associated abnormality in only one case out of four, but the fact that the rate-pressure product was normal suggests that the coronary artery networks were in a satisfactory state of function. Ventriculography (n=14) was normal in 35% of cases. Coronary arteriography (n=18) showed significant lesions in 12 cases, one trunk being affected in 6, two trunks in 5, and 3 trunks in one; the lesion index was 1.6. In 6 cases there were few changes in the coronary arteries, and the probable mechanism of the infarct is discussed: besides the possibility of a recanalised thrombus, which appears to be the likely one in two of our patients, spasm played a possible role even though the ergonovine provocation test was negative. The mortality during the first month was zero; as a secondary event over a follow-up period of 38 months, there were two deaths and four recurrences, one of which occurred in a healthy coronary vascular tree.

Adult↗