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Biomedical subjects

F Baillet

Publications and source records attributed to F Baillet.

At least 73 records · Page 4Linked to original sources
PubMed1989

Positive clinical experience with misonidazole in brachytherapy and external radiotherapy.

We performed a clinical evaluation of Misonidazole (MISO) radiosensitization in brachytherapy and two schedules of hypofractionated external radiotherapy in 3 non randomized studies. MISO (1 g/m2/d) was administered to patients with ENT tumors treated by brachytherapy, two applications of 35 Gy each with an interval of 1 month. For 46 patients with tumor responses less than 50% (in the largest dimension) at time of second application, 21 received MISO and 25 did not. For these poorly radiosensitive tumors, the addition of MISO significantly increased the rate of complete remission from 9/25 (36%) in controls to 14/21 (67%) (p less than 0.05). We studied MISO with radiation hypofractionation for conservative breast cancer with 4 fractions over 17 days (5 Gy on days 1, 3 and 6.5 Gy on days 15 and 17). Brachytherapy alone was delivered three weeks later. MISO (1 g/m2/d) was given to 38 patients with 87 acting as controls. Radiosensitization was measured by mean tumor diameter at brachytherapy, which showed a residual mass of 33% in the group without MISO and only 17% in the group with MISO (p less than 0.05). We also studied MISO with radiation hypofractionation for large ENT tumors with 14 fractions over 45 days, 2 sessions with a 4 hour interval per day for totals of 6 Gy on days 1 and 3; 8 Gy on days 15, 17, 29, 31; and 6 Gy on day 45. MISO (1 g/m2/d) was given to 49 patients with 21 acting as controls. MISO increased the rate of complete remission from 7/21 (33%) in controls to 32/49 (65%) (p less than 0.02).

Brachytherapy↗
PubMed1989

[Radiotherapy with neoadjuvant chemotherapy].

Neoadjuvant chemotherapy can be used before radiotherapy to combat microscopic metastatic loci and to facilitate irradiation. Improvement in the survival time by impeding the dissemination of metastases seems to be real for breast cancer, but has not been observed to date in randomized studies of ENT cancers. Neoadjuvant chemotherapy in Hodgkin's disease has improved survival time and tolerance to irradiation, allowing a lowering of the total doses used and the volumes irradiated. In breast and ENT cancers, it has become possible, due to tumor regression, to replace mutilating treatments with more conservative ones consisting of radiotherapy alone, without increasing the risk of local relapse. Indeed, it is in this domain that neoadjuvant chemotherapy is the most useful. Two important conditions must be met for its successful application: a) a sufficiently effective regimen must be chosen, in order to prevent tumor growth prior to irradiation (which would aggravate the prognosis); and b) an accurate identification and localization of the tumor before undertaking any treatment so as to not detract from the effectiveness of the radiotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Curative radiotherapy of unresectable bronchial cancer. Apropos of 266 cases without metastasis with 4 to 6 years follow-up (oat cell carcinoma excluded)].

Two hundred and sixty-six patients with inoperable bronchial carcinomas (oat cell excluded) without apparent metastases were treated with curative doses of radiotherapy. The malignancies were: 72% epidermoid epitheliomas, 11.5% adenocarcinomas, 10% large anaplastic cells and 6.5% without histology. According to the TNM classification, 3.5% were T1, 44% were T2 and 52% were T3. Mediastinal invasion was found in 44% of the cases. The mean age of the patients was 65 years (range 31-90 years). The Karnofsky index was less than or equal to 70 in 40% of the subjects. Unoperability was linked to the extent of local involvement in 59% of the cases and to age, general condition or an insufficient forced expiratory volume in 55% of the patients. Sixty to 65 Gy were administered, either classically fractionated or hypofractionated. After irradiation, 43% of the subjects underwent complete radiological remissions. Fifty-five percent of the patients died with local tumor evolution, 40% with isolated local evolution without associated metastases. The overall survival rate at 5 years was 7%; it was 16% for patients with a normal mediastinum and a Karnofsky index greater than 70 (51 cases); if these parameters were inversed, it was 2.5%. The fractionation protocol, the histological type, the use of chemotherapy (48 cases) did not affect the local control rate nor survival. There were almost no complications with this therapy. Patients frequently experienced functional improvement when curative doses of radiotherapy were applied to all the inoperable, non-metastatic cancers and the percentage of survivors at 5 years was non-negligible.

Actuarial Analysis↗
PubMed1989

[Action of liposomal superoxide dismutase on measurable radiation-induced fibrosis].

Radiation-induced fibroses are a classical complication of radiotherapy. We have studied the effect of liposomal superoxide dismutase (Lipsod) on 45 radiation-induced fibroses of measurable volume and hardness in 34 patients. Over 3 weeks, 6 injections of Lipsod were given intramuscularly: 5 mg for 28 patients and 2 mg for 6 patients. On the average, the volume decreased by 32%. A marked or moderate softening was observed in 80% of the fibroses; it was accompanied by functional improvement in 75% of the patients (in cases of preexisting difficulties). The effectiveness was independent of the time lag between the Lipsod treatment and irradiation. The decreases noted in the volume and hardness of the fibroses remained stable during a follow-up of 5-24 months. This systematic study shows the interest of Lipsod treatment of quasi-experimental fibroses where no other effective therapy exists.

Drug Carriers↗
PubMed1989

[Initial chemotherapy with conservative treatment in locally advanced cancers of breast (stages IIIa-IIIb). Apropos of 98 cases].

Ninety-eight patients with locally advanced cancer of the breast (stages IIIa-IIIb) observed between March 1981 and March 1986 were included in a study associating initial (neoadjuvant) intensive chemotherapy with or without hormone therapy, in all cases followed by external irradiation and then by maintenance radiotherapy and chemotherapy. A greater than 50% regression in the volume of the tumour was observed in 91% of patients after the initial chemotherapy, a result which was improved by hormone therapy with a complete clinical remission in 100% of cases after external and interstitial irradiation. The incidence of local recurrence was 11%. The 3 and 5 year survival rates without recurrence were 63% and 56% respectively and the global survival rate was 78% and 65% respectively. The degree of tumoral regression after the initial chemotherapy appeared to be the major prognostic factor.

Adult↗
PubMed1988

Results of a conservative treatment combining induction (neoadjuvant) and consolidation chemotherapy, hormonotherapy, and external and interstitial irradiation in 98 patients with locally advanced breast cancer (IIIA-IIIB).

Ninety-eight patients with locally advanced breast cancer (Stage IIIA-IIIB) were entered into a pilot study combining intensive induction (neoadjuvant) chemotherapy (VTMFAP) with or without hormonochemotherapy, external and interstitial radiotherapy, and consolidation chemotherapy with or without hormonochemotherapy. Tumor regression over 50% was observed in 91% patients after chemotherapy, and complete clinical remission occurred in 100% patients after irradiation. The rate of local relapse is 13%. The 3-year disease-free survival is 62% and 3-year global survival is 77%. Initial chemotherapeutic tumor regression greater than 75% is the main predictive factor for disease-free survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Value of postoperative radiotherapy in T3 or N+ bronchial cancer. Apropos of 113 cases].

Post-operative radiotherapy was applied in a series of 113 patients with bronchial cancer (T3 or N+) between 1977 and 1983, lesions being classified T1 in 24 cases, T2 in 44, T3 in 45, N0 in 23, N1 in 51 and N2 in 39, one out of two T3 cases being N+. Pneumonectomy has been performed in 64 cases (58%) and limited surgery in 49 (42%). An incomplete exeresis was carried out in 21% of cases. Radiotherapy dose 45 Gy in cases with macroscopically complete resection and 65 Gy in other cases. Fractioning was conventional (CI) 72 times with 5 sessions of 1.8 Gy per week, and hypofractionated (HFI) 41 times as 5 Gy on D1 and D3 and 6.5 Gy on D15 and D17 for an equivalent dose at 45 Gy in CI and with, in addition, 5 Gy on D29 and D31 for an equivalent dose at 65 Gy in CI. Overall actuarial survival at 5 years was 38%, and 42% for N+, with 54% for N1 (pedicular N+) and 28% for N2 (mediastinal N+). The 3-year actuarial survival for T3 N0 was 53%. Frequency of local and regional recurrence was 18% and was equal for N1 and N2. In contrast, metastases occurred in 33% of N2 and only 12% of N1. No apparent difference was noted in incidence of local and regional recurrence or survival as a function of histopathologic type, operation performed, quality of surgical resection, or irradiation fractioning. No serious complication of radiotherapy was reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1988

[Salvage treatment with a view to recovery in a group of 1700 otorhinolaryngologic cancers treated by radiotherapy].

Results after radiotherapy, alone or combined with surgery, applied prior to 1982 in 1700 patients with localized ENT tumors showed 669 (39%) of T and/or N failures and isolated second ENT localizations. Therapeutic recovery operation was performed in 263 of these 669 cases (39%). For the 324 cases of isolated T failures, 31% had recovery treatment, with a level varying between 15% for base of tongue and 55% for laryngeal tumors. Frequency of treatments varied with initial TNM (18% for T3-T4 and 47% for T1-T2) and initial treatment (26% after combined radiotherapy-surgery and 32% after radiotherapy alone). Surgery had been the main treatment (74%) followed by curietherapy (19%). Overall control rate was 55.5%. The 3 year survival rate for all isolated T failures treated was 31%, with survival medians of between 8 and 44 months as a function of initial localization. For the 156 cases of isolated N failures, 62% had recovery treatment, results varying according to whether it was a case of immediate N failure or a lymph node recurrence. The local control rate was 62.5% globally, the 3 year survival for isolated N failures treated 17.5%. For the 115 T + N failures, recovery treatment was attempted in only 9 cases (7%) but all patients died within 2 years of evolution of the local and regional disease. For the 74 second ENT localizations, 80% had recovery treatment with a global local control of 73% and a 3 years survival of 35%. Recovery treatment for therapeutic ends is therefore a frequently practised procedure (39% of cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1987

A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: surgery plus postoperative radiation, external radiation plus interstitial implantation and external radiation alone.

One hundred and ten patients with base of tongue tumors less than or equal to 4 cm in diameter (T1 and T2 by the UICC staging system) were treated according to three different methods; surgery followed by external radiation in 27 cases, external radiation followed by interstitial implantation in 29 cases, and external radiation alone in 54 cases. The median follow-up is 8 years with a minimum of 4 years. Local failure occurred twice as often in patients treated by external radiation alone (43%) compared to the other two therapeutic modalities (20.5% for external radiation plus implantation and 18.5% for surgery plus radiation). Ninety per cent of recurrences occurred within the first 2 years. The 5-year survival rate for N0 and N1 nodal disease is 30.5% for patients treated by external radiation alone and 50% for the other two methods. This survival difference is related to poorer local control. Surgery plus external radiation gives identical results to those of external radiation and interstitial implantation, but surgery is only practical for peripheral base of tongue tumors and it has poorer functional results. External radiation followed by interstitial implantation is, in our opinion, the best of the three therapeutic techniques for T1 and T2 base of tongue tumors.

Adult↗
PubMed1987

[Salvage irradiation of epidermoid carcinoma of the oropharynx by iridium 192].

Between May 1971 and March 1982, 73 patients with either recurrent or subsequent squamous cell carcinomas arising in a previously irradiated oropharynx were treated using iridium 192 wires. Although local control was achieved in 72% of these patients, only 10 remained alive at 5 years (14%). Local control was best for tonsillar arch lesions (96%), while base of tongue and glosso-tonsillar sulcus tumors were controlled in only 60%. One of the two patients with a posterior pharyngeal wall lesion is alive and well at 5 years, while the other died of an unknown cause at 20 months. Salvage implantation produced soft tissue necrosis in 36% of base of tongue implants, but only 18% of those involving the tonsillar arch. Although one necrosis was fatal, the others were successfully managed medically. Since these results compare favorably with those of previously published series, we recommend re-irradiation with iridium 192 for recurrent or new malignancies arising in a previously irradiated oropharynx. For tonsillar arch lesions, brachytherapy is the treatment of choice while in the base of tongue, it is reasonable option.

Adult↗
PubMed1987

[Adjunct radiotherapeutic treatment following excision of rectal cancers].

As a whole, one out of 3 rectal cancers recurs after radical surgery. With or without metastases this recurrence causes the death of the patient because, with certain exceptions, surgery and radiotherapy are not effective. Post-operative radiotherapy, if effective locally and well tolerated, should improve the results. We have treated in this fashion 50 cases (with 45 Gy in standard spread) including A 2, 3 B1, 21 B2, 1 C1 and 23 C2 of Astler-Coller classification. With a follow-up of 40 to 100 months the recurrences concern 10% of B2 and 24% of C. The actuarial survival at 5 years is 66% with 75% for B2 and 54% for C. There are 4% of severe complications in the form of 2 perineal fistulae which required surgery. There are no small bowel complications due to the precautions to protect it. A review of the literature comparing 1,366 surgical procedures alone with 339 surgical procedures combined with post-operative radiotherapy in sufficient doses, shows that the recurrence rate decreases from 34% to 12% in case of irradiation. The survivals (actuarial, gross aggregate, or without evolutive disease) show practically in all cases an improvement of survival in case of irradiation.

Adenocarcinoma↗
PubMed1986

Interstitial radiation therapy for squamous cell carcinoma of the tonsillar region: the Creteil experience (1971-1981).

From July 1971 to December 1981, 33 selected patients with T1, T2 tumors of the tonsillar region were treated according to the following protocol: 1. Telecobalt therapy to the primary site and to neck nodes to a dose of 45 Gy. 2. Brachytherapy to the primary site to a dose of 30 Gy using iridium 192. 3. Boost dose to involved neck nodes with electrons, or radical neck dissection, whether N1, N2, or N3. The actuarial disease-free survival was 76% when all patient groups were included and 80% for the N0 patients. The local control rate was 100%. Disease control in the neck was 94% overall and 100% for the N0 group. These results favor the use of this protocol for superficial, minimally infiltrating tumors less than 4 cm in diameter, without obvious extension to the base of the tongue or retromolar trigone.

Adult↗