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D Sarrazin

Publications and source records attributed to D Sarrazin.

At least 73 records · Page 4Linked to original sources
PubMed1984

[2nd malignant tumors in children. Study of 38 cases].

Thirty-eight children, followed in the pediatric Department of Institut Gustave-Roussy, developed second malignant neoplasms. Intervals between the two neoplasms ranged from 1 to 26 years. The second neoplasms were defined as having a different histologic diagnosis than the first ones: osteosarcoma, fibrosarcoma, thyroid carcinoma, leukemia were the most frequent second neoplasms. The potential carcinogenic part of chemotherapy and radiotherapy is emphasized. In addition, some genetic susceptibility may enhance the carcinogenic effects of therapy. Nevertheless the incidence of second malignant neoplasms is low. Its estimation is discussed here.

Adolescent↗
PubMed1984

[Role of radiotherapy in the treatment of medullary cancer of the thyroid].

Medullary thyroid carcinoma (MTC) is a rare tumor for which the main treatment is surgery. However, external radiation therapy (RT) plays an important part in well-defined patients. Out of the 115 patients with MTC treated at the Institute Gustave Roussy: Thirty-five MTC patients with residual cervical disease and without distant metastases had their thyroid region irradiated (60Co, 45 to 50 Gy in 5 weeks). The overall survival of these patients is similar to that of patients with limited cervical extension (n = 57) treated by surgery alone. The results of this study show the effectiveness of cervico-mediastinal irradiation treatment for MTC with extensive local tumor after incomplete surgery. Eight MTCs with inoperable cervical tumor were treated only by external RT. Median survival was 44 months. In six of them, long-term local control was observed: three are alive at 52, 62 and 70 months and 3 died from distant metastases at 36, 36, and 117 months after treatment. Sixteen MTCs with distant metastases were treated with RT on bone metastases (n = 10) or compressive lymph node metastases (n = 6) with good palliative effect. This study shows the efficacy of post-operative external RT in MTCs with extensive cervical tumors, as a curative treatment in non-surgically eradicable cervical tumors and as a palliative treatment for metastatic localisations. The technique of cervico-mediastinal RT is discussed.

Bone Neoplasms↗
PubMed1983

Intensive systemic chemotherapy in localized Ewing's sarcoma in childhood. A historical trial.

To assess the value in Ewing's sarcoma of a new multiagent therapy (vincristine, cyclophosphamide, Adriamycin, (doxorubicin) procarbazine), 30 children with a localized tumor (eight distal, nine proximal, 13 central lesions) treated at the Institut Gustave-Roussy between 1973 and 1976 (E3), were pair-matched by site of primary with 30 control patients treated without intensive chemotherapy between 1967 and 1972 (E1) at the same institution, both groups having the same local radiotherapy. Actuarial survival and disease-free survival rates at six years were significantly higher in E3 at P less than 0.01, respectively, 58% and 49% versus 25% in E1. The prognostic value of the primary site was ascertained only in children under chemotherapy. In this group there were six early relapses with death within 14 months and nine late relapses at 21 to 38 months. Among these nine patients, six died, one is living with disease, and two are currently alive in second remission. Fifteen patients are continuously free of disease 50 to 90 months after first treatment (median, 69 months): functional sequelae are minimal in six, moderate in seven, and severe in two children with limb amputation. It is concluded that in future treatments chemotherapy must be intensified and begun prior to local treatment which has to be reevaluated for radiation modalities and for radical surgery indication.

Adolescent↗
PubMed1983

[Primary chemotherapy in soft tissue sarcomas considered inoperable].

Fourteen adult patients with inoperable soft tissue sarcoma (with metastases in 4 cases) received chemotherapy as primary treatment. Nine cases were treated by CYVADIC (cyclophosphamide, vincristin, doxorubicin, DTIC) and five cases by DECAV (DTIC, cyclophosphamide, cis-platinum, doxorubicin, vindesine). An objective response was obtained in 7 cases (1 complete remission and 6 regressions greater than 50%) and stabilization in 4 cases. Seven patients became operable after 2 to 6 courses of chemotherapy and a complete resection could be performed in 6 cases. The duration of the response was 2 to 39 months. Toxicity with both combinations was acceptable. We conclude that chemotherapy can provide initial tumor reduction and permit subsequently less radical surgery.

Adolescent↗
PubMed1983

Effectiveness of preoperative chemotherapy in Wilms' tumor: results of an International Society of Paediatric Oncology (SIOP) clinical trial.

The results of a controlled clinical trial of preoperative radiotherapy compared to chemotherapy in patients with nephroblastoma are presented. Of 397 histologically proven cases of Wilms' tumor registered at 34 centers between January 1977 and July 1979, 164 were eligible for the trial and were randomized to receive preoperative radiotherapy and chemotherapy (group R, 76 patients) or preoperative chemotherapy (group C, 88 patients). The results were evaluated in terms of the number of surgical tumor ruptures and of local tumor extent at pathologic examination, reflecting the effectiveness of the preoperative treatment. Survival and recurrence-free survival in the two treatment groups were also taken into account. The stage distribution was comparable in the two groups, with 52% stage I tumors in group R, and 43% in group C. Significant changes in the pathologic pattern were more frequent in group R than in group C (53% versus 17%). From these data it is concluded that preoperative chemotherapy is as good as preoperative radiotherapy in terms of prevention of tumor rupture. In addition, it was shown that 43% of an unselected population of patients with Wilms' tumor could be treated without any radiotherapy when chemotherapy had been given preoperatively.

Adolescent↗
PubMed1983

[Neuroblastomas treated at the Gustave-Roussy Institute from 1975 to 1979. 173 cases].

From 1975 to 1979, 173 children with neuroblastoma were treated according to the same protocol at the Institut Gustave-Roussy. They were classified according to the site of the primary tumor (abdominal: 122; thoracic: 29; others: 22) and according to TNM staging (stage I: 8; stage II: 24; stage III: 35; stage IV: 99; stage V: 2). Depending on stage and age, treatment consisted of surgery and radiotherapy associated with cyclic multiagent chemotherapy (vincristine, Adriamycin, cyclophosphamide). It resulted in a significant improvement of prognosis in stage III patients, especially those with abdominal tumors. In the latter group, prognosis depended mainly on the possibilities of resection of the tumors. Therefore, making these tumors operable remains the major goal of therapy in such patients. Radiotherapy is quite efficient in sterilizing the small post-surgical residual tumors. Prognosis in children over 1 year of age with metastases still remains very poor, even though the quality of the survival is improved.

Abdominal Neoplasms↗
PubMed1983

[Postradiotherapy brachial plexitis: the experience of the Institut Gustave-Roussy].

Twenty-five cases of presumed radiation-induced brachial plexopathy were identified out of a population treated at the Institut Gustave-Roussy, in 3 different ways, during the period 1967-1980. The incidence of this complication is given for each group, and the radiation dosage and natural history is described, with results of neurolysis when it was possible. The absence of successful treatment methods makes prevention of this complication crucial. The use of fraction sizes no greater than 2.5 Gy, and the avoidance of radiation treatment to the completely dissected axilla, are advocated.

Brachial Plexus↗
PubMed1982

[Management of pulmonary metastases from osteosarcomas].

The management of pulmonary metastases from osteosarcomas rests at present on thoracic surgery combined with chemotherapy. Until the beginning of the seventies chemotherapy proved very disappointing. With adriamycin, methotrexate in high doses followed by folinic acid and, more recently, platinum cis-dichlorodiamine, remissions, which are usually partial, are obtained in a significant proportion of patients (at least 30%). The addition of less active agents such as vincristine, cyclophosphamide, actinomycin D and bleomycin is helpful. Among 31 patients with pulmonary metastases from treated osteosarcomas seen at the Gustave Roussy Institute, 18 underwent thoracic surgery as the first treatment; in 10, surgery was followed by chemotherapy with adriamycin, vincristine, methotrexate in high doses + folinic acid + cyclophosphamide. Five patients are in complete remission 27, 30, 49, 50 and 77 months after the surgical procedure. 12 patients were initially treated with a similar chemotherapeutic regimen; a subsequent thoracic surgical procedure was undertaken in two patients who died 18 and 30 months after the pulmonary metastases had appeared. In one patient, the metastases were treated by irradiation. These results are compared to previous reports in the medical literature.

Humans↗
PubMed1982

[Osteogenic sarcomas of the limbs. Radical treatment of the primary tumor: choosing between irradiation and amputation ].

In osteogenic sarcomas of the extremities, radical therapy of the primary tumor now seems more precisely delineated. In most cases, especially in large tumors with lytic lesions or fractures, and in children. Irradiation is indicated only in small tumors with condensation, and in tumors of the proximal metaphysis of the humerus. Conservative surgical treatment with carcinologically satisfactory resection of involved bone followed by reconstruction, is currently under evaluation. Such treatment is indicated in specific cases: children in the final stage of growth, and small tumors without major involvement of soft tissues that respond to preoperative chemotherapy.

Adolescent↗
PubMed1982

[Adjuvant therapy in the management of osteosarcomas: the O3 trial (EORTC and ISPO) ].

The European Organization for Research on the Treatment of Cancer (EORTC) and the international Society of Pediatric Oncology (ISPO) have set up a randomized controlled trial designed to compare three different regimens of adjuvant therapy applied after treatment of the primary tumor (usually by radical surgery): a prolonged course of chemotherapy (41 weeks) combining adriamycin, methotrexate in high doses followed by folinic acid, vincristine, and cyclophosphamide; radiotherapy delivering 20 grays to the lungs; and a short course of chemotherapy (8 weeks) combining adriamycin, methotrexate in high doses, folinic acid and vincristine, associated with irradiation of the lungs as in the preceding protocol. At the time being, 156 patients have been included in this study. If conclusions are to be drawn from this trial, a total of 300 patients seems necessary.

Antineoplastic Agents↗
PubMed1982

Computed tomography in the evaluation of 41 cases of Ewing's sarcoma.

Computed tomography (CT) has already proved extremely effective both in cerebral and abdominal pathology. Several recent publications describing first heterogeneous series [1, 2, 7, 11-17], then studies of a single type of lesion [3-6, 8] have illustrated its usefulness in the study of bone lesions. This report deals with 41 cases of Ewing's sarcoma studied by CT at the Institut Gustave Roussy from October 1977 to July 1981, and tries to show both the limitations and indications of this technique for the diagnosis, treatment, and follow-up of Ewing's sarcoma as well as in the diagnosis of any eventual recurrence.

Adolescent↗
PubMed1981

[Liposarcoma in adults. Prognostic factors in a series of 84 cases (author's transl)].

A retrospective study of 84 patients with liposarcoma treated at the Gustave Roussy Institute between 1956 and 1978 has elicited a number of factors which influence the prognosis, namely: (1) the site of the initial tumour: patients with liposarcoma of the head, trunk and extremities have a better survival rate than those with retroperitoneal tumours or tumours of the pelvic and pectoral girdles; (2) the histological type: differentiated forms have a brighter prognosis than undifferentiated forms; (3) the size of the tumour: tumours of less than 10 cm in diameter have a more favourable prognosis than larger tumours; and (4) the patient's age, which in fact correlates with the histological type. Local recurrences are common but do not seem to worsen the prognosis. The only curative treatment is surgery, but radiotherapy reduces the risk of local recurrences and chemotherapy may be considered in cases with poor prognosis.

Adult↗
PubMed1981

[The treatment of Wilm's tumor, improvements and new trends. A study of 724 cases treated at the Gustave-Roussy Institute. 1952-1980 (author's transl)].

Study of 724 cases of Wilm's tumor treated between 1952 and 1980 at the Gustave-Roussy Institute, according to 5 successive therapeutic protocols with or without chemotherapy (Actinomycin alone or Actinomycin and Vincristine). Recovery rates change from 44 to over 90% during this period. Improvement of survival was first obtained by the efficient treatment of metastases, then by preventing their development with systematic chemotherapy with Actinomycin and Vincristine. Rate of survival without relapse changed from 38 to 71 and 86%. Thus, the decrease in the number of patent metastases subjected to heavy treatments responsible for severe respiratory and orthopedic sequelae improved the quality of survival of these children.

Adolescent↗
PubMed1981

[Optic glioma in children. A retrospective study of 57 cases treated by irradiation (author's transl)].

57 children presenting with optic glioma, 30 of which with neurofibromatosis, were treated from 1956 to 1978 at the Institute Gustave-Roussy. In 3, the tumor was confined to a single optic nerve; 18 had a chiasm-infiltrating tumor and 36 a large tumor invading adjacent structures. At the time of diagnosis, all but 2 had visual deficit, 5 had endocrine dysfunction and 27 had symptoms of increased intracranial pressure. X-ray examinations showed an enlargement of the sella turcica in 28 out of 37 patients and enlarged optic canals in 39 out of 41 investigated cases. 25 patients were operated on (most often exploratory operation only) and all received a 50 to 60 grays irradiation. 42 patients are alive but 20 are blind and 26 present with important mental retardation.

Adolescent↗
PubMed1981

[Results of treatment of 178 pediatric non Hodgkin's malignant lymphomas between 1973 and 1978 (author's transl)].

178 children presenting with non Hodgkin's lymphomas (NHL) were treated using the same protocol from 1973 to 1978 at the Institut Gustave-Roussy. They were classified according to stages (13 stage I, 21 stage II, 80 stage III, 50 stage IV, 6 undetermined stage), according to initial site of involvement (abdomen: 68, mediastineum 55, ORL: 32, lymph glands: 13, "others": 10) and according to histology. They were given combination chemotherapy (Vincristinee-adriamycin-cyclophosphamide-prednisone), preventive CNS therapy by cranial irradiation and intrathecal methotrexate (except in stage I patients) and maintenance therapy by cyclic multiple agents regimens including vincristin-adriamycin, vincristin-cyclophosphamide and cytarabine-asparaginase. Radiation therapy was carried out up to 1977 in stage I and II patients only. Combination chemotherapy improved global survival of pediatric NHL (40% at 4 years, all staged added); however improvements remain to be done in patients with widespread disease.

Adolescent↗
PubMed1980

Adjuvant treatment with polyadenylic-polyuridylic acid (Polya.Polyu) in operable breast cancer.

Adjuvant immunotherapy with polyadenylic-polyuridylic acid (PolyA.PolyU) was tested in a randomised trial on 300 patients with operable breast cancer, all of whom were treated by surgery with or without radiotherapy. They were randomly divided into an experimental group of 155 patients who were treated with 30 mg PolyA.PolyU intravenously per week for 6 weeks and a control group of 145 patients who received normal saline intravenously on the same schedule. The mean follow-up time was more than 50 months in both groups. The overall survival was significantly higher in the treated group (p less than or equal to 0.05), in whom the 5-year "relapse-free" surival was also increased. In node-positive patients, treatment increased the relapse-free survival (p less than or equal to 0.03) and overall survival (p less than or equal to 0.07). No side-effects were noted. Thus, immunotherapy with PolyA.PolyU appears to be a simple, non-toxic, and efficient adjuvant treatment in operable breast cancer.

Breast Neoplasms↗