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Biomedical subjects

F Baillet

Publications and source records attributed to F Baillet.

At least 91 records · Page 5Linked to original sources

Treatment of radiofibrosis with liposomal superoxide dismutase. Preliminary results of 50 cases.

Well and long established radio-fibroses have been treated successfully with a liposomal encapsulated bovine copper superoxide dismutase. After a short treatment (three weeks intramuscular injection of 5 mg twice a week) regression of the fibrosis is stable. The average size is reduced by one third and significant softening occurs in 82% of the cases. Efficiency is independent of the time between radiotherapy (origin of the fibrosis) and treatment with liposomal SOD. Complete regression even after this limited treatment is seen in cases of chronic prefibrotic inflammatory syndromes and prophylactic action in cases where the probability of fibrosis formation is certain appears to be successful. The roles of superoxide and superoxide dismutase are discussed.

Copper↗

Neoadjuvant chemotherapy of breast cancer.

About 80% of patients with breast cancer ultimately die of metastatic disease at 20 years. Distant metastases are more important as a cause of death than local or regional relapses. It is for this reason that adjuvant chemotherapy is necessary, especially in young patients and those with extensive disease. Initial chemotherapy preceding any local or regional treatment is justified on the grounds that both surgery and anaesthesia lead to immunodepression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials by Nissen-Meyer, Bonadonna and Cooper (1-3). In the present study 145 patients, including 67 with inflammatory breast cancer (IBC), were treated with 4-6 weeks of Velbe, thiotepa, methotrexate, fluorouracil and prednisone, with Adriblastin added for patients with IBC, T greater than 7 cm, or N2, N3. Because of tumour regression of greater than 50% observed in 80% of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium), resulting in complete remission in all these cases. Maintenance treatment with the same drugs was prescribed for 6-18 months depending on the initial stage. Tumour regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest being 42 months. Overall survival at 2 years for IBC is 90%, with a disease-free survival of 80%. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗

[Breast cancer: chemotherapy preceding locoregional treatment with extension of the indications for conservative treatment].

About 80 per cent of patients with breast cancer ultimately die of metastatic disease in the following twenty years. Distant metastases are more important as cause of death than loco-regional relapses, it is why adjuvant chemotherapy is necessary, especially in young patients and in those with extensive disease. Initial chemotherapy preceding any locoregional treatment is justified on the basis that both surgery and anesthesia lead to immuno-depression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials of Nissen-Meyer, Bonadonna and Cooper. We have treated 145 patients, including 67 with inflammatory breast cancer (IBC), with 4 to 6 weeks of Velbe, Thiotepa, Methotrexate Fluorouracil and Prednisone with Adriblastine added for those patients with IBC or T greater than 7 cm, or N2 N3. Because of tumor regression of more than 50 per cent observed in 80 per cent of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium) and are in a complete remission in all these cases after curietherapy. Maintenance treatment with the same drugs was prescribed for 6 to 18 months depending on the initial staging. Tumor regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest one being 42 months. The overall survival at 2 years for IBC, is 90 per cent with a disease-free survival of 80 per cent. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.

Antineoplastic Combined Chemotherapy Protocols↗

[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↗

Endocurietherapy of penis cancer.

Forty-five carcinomas of the penis have been treated with curietherapy using 192Ir to a dose of 6500 rad. With a minimum follow-up of 4 years, it appears that small lesions (less than 30 mm) have excellent local results (2 recurrences in 14 cases). With only a slight potential for lympatic extension, these patients are alive without evidence of disease after 4 years. The lesions of moderate size (30-40 mm) have a poorer prognosis because of more frequent lymphatic extention and disseminated metastases; in contrast, the local results are still quite satisfactory (4 recurrences in 24 cases). The large lesions (more than 40 mm) recur or necrotize (5 recurrences and 2 necroses in 7 cases). In conclusion, curietherapy of epidermoid carcinomas of the penis is an excellent primary treatment for small or moderate lesions (T1, T2, and T3a) if one wishes to avoid surgical mutilation.

Carcinoma, Squamous Cell↗

[Breakdown of the energy of a fixed 7 MeV electron bundle in the treatment of mycosis fungoides (author's transl)].

In order to treat patients with mycosis fungoides, the authors were led to breakdown the energy of a 7 MeV electron bundle emitted by a linear accelerator. With this aim, they sought to determine the nature, thickness and position of the decelerating which should be used to obtain adequate flow and energy of the electron bundle. They then explain the technique of total body irradiation of the patients, and in particular the way in which the functions of the bundle are effected. Finally, in order to diminish under-dosage in regions of the human body irradiated tangentially, they suggest the use of a perspex screen of variable thickness.

Electrons↗

[Radical radiotherapy of breast cancer. Experience of Créteil].

Since 1961, we have treated 400 cases of breast cancers by radical radiotherapy (December 1976). The TNM classification of cases is: 25 per cent T1, 55 per cent T2, 20 per cent T3. 80 per cent of patients are N0 or N1a, 20 per cent are N1b. The therapeutic protocal is: for T1 lesions, lumpectomy plus radical radiotherapy, then boost dose with electrons to the axilla (24 Gy) and to the internal mammaryzone (15 Gy), and finally boost dose to the zone of the breast tumor by Iridium 192 implant therapy (25 Gy);--for T2 and T3 lesions, radiotherapy alone with a higher boost dose to the breast tumoral zone (37 Gy). The mammary tumor (or the tumoral zone) receives a total dose between 70 Gy (T1) and 90 Gy (T2 and T3). The five year results for 328 patients with at least one year follow up (actuarial calculations) yield a survival of 89 per cent T1, 84 per cent T2, and 66 per cent T3. The local recurrences are 8 per cent T1, 10 per cent T2, and 26 per cent T3; they can be rectified, under the condition of regular surveillance, by radical surgery. As to the cosmetic results, they are in one half of the cases quite good, in most others satisfactory, in a few poor. We add a prophylactic chemotherapy in the cases with high metastatic risk, i.e. T3 or N1b cases. This therapeutic protocol seems to be highly recommendable for T1 tumors, acceptable for T2, disputable for T3.

Breast Neoplasms↗

[81 cases of Hodgkin's disease treated with extensive radiotherapy, including 65 with primary MOPP chemiotherapy (author's transl)].

Study 81 cases of Hodgkin's disease at stages I, II or III led to the following conclusions from a therapeutic standpoint (in relation to the apparent results obtained): The addition of chemotherapy on the form of three courses of MOPP before irradiation improved the results of the latter on the one hand and, principally, by reducing the number of failures and, secondly, by reducing the complications. The addition of chemoprophylaxis by MOPP in patients in complete remission as a result of initial treatment, involving an association of 3 courses of MOPP followed by radiotherapy, was not shown to be useful. A major factor in prognosis would to be the clinical and radiological situation after the first three courses of MOPP (in the context of combined MOPP and radiotherapy) since, despite the later radiotherapy, numerous failures were noted in the absence of remission after the three MOPP treatments, whilst failure rarely occurred under the opposite set of circumstances. This is important, since modest treatment would seem to suffice in patients reacting well to three initial MOPP treatments, whilst it is essential to reinforce it when this is not the case.

Drug Therapy, Combination↗

[Chemotherapy-radiotherapy association in the treatment of localized forms of Hodgkin's disease. Prognosis of polychemotherapy after three trials of M.O.P.P].

63 patients with Hodgkin disease of limited extent (I, II, III) are treated with two protocols: extended field irradiation versus chemotherapy (M.O.P.P.) + extended field irradiation. Three points are suggested by analysis of the results: 1) Advantage from the combination of chemotherapy-radiotherapy. 2) Resistance to chemotherapy frequent innodular sclerosis. 3) In patients treated with chemotherapy the reaction has a prognostic value: failure of treatment being seen only in patients who did not obtain a complete remission.

Drug Therapy, Combination↗