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Biomedical subjects

F N Gilly

Publications and source records attributed to F N Gilly.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia with mitomycin C. Initial experience].

Intra-peritoneal chemo-hyperthermia with mitomycin C was used to treat 9 patients with very advanced gastrointestinal cancers with peritoneal seedings. Resection of the primary tumor was possible in 3 cases. After temporary of closure of the abdominal wall, 90 to 120 minutes of intra-peritoneal chemo-hyperthermia was performed under general anaesthesia with 32 degrees C of systemic hypothermia, via 3 intra-peritoneal drains forming a closed circuit, using 10 mg/l of mitomycin C in 61 of peritoneal dialysate warmed at the inflow temperature of 46 to 49 degrees C. We observed no mortality or morbidity. There were only minor and temporary laboratory side effects and for 6 patients, no malignant cells could be found in the ascitic fluid after intra-peritoneal chemo-hyperthermia. In six patients, we conserved an improvement in the Karnofsky index 3 to 7 months after intra-peritoneal chemo-hyperthermia. These results show that intraperitoneal chemo-hyperthermia with mitomycin C is a safe and reliable treatment for peritoneal seedings in severely advanced gastrointestinal cancers and encourage us to proceed with this new therapeutic modality.

Adult↗
PubMed1990

[Post-traumatic hemobilia caused by arteriobiliary fistula. A case report and review of the literature].

One new case of post-traumatic hematobilia due to an arteriobilary fistula is reported. This etiology is relatively rare, and its diagnosis is sometimes difficult if the three signs: pain, bleeding and jaundice are not observed. The most effective paraclinical examination still is selective arteriogrpahy, which makes the diagnosis possible, accurately locates the fistula and sometimes allows hyperselective embolization, as it did in this case. The use of embolization for the treatment of post-traumatic hematobilia due to an arteriobiliary fistula reduces operative mortality for this disease, which still has a poor prognosis.

Adult↗
PubMed1990

[Intraperitoneal hyperthermic chemotherapy in the treatment of peritoneal carcinosis of digestive origin. A case report and physiopathology].

The authors describe their first experience of IP hyperthermochemiotherapy using mitomycin C under hypothermic coverage at 32 degrees C, in a female patient with peritoneal carcinosis secondary to stomach cancer. Postoperative complications were not observed. Tested mitomycin blood levels evidenced good absorption via the peritoneal route. 4 months later, the patient is doing well and the authors are propounding the method be started in a series of patients, in order to assess its long-term efficacy.

Adult↗
PubMedDate not supplied

Peritoneal carcinomatosis in digestive cancers: cytoreductive surgery combined with intraperitoneal chemohyperthermia. The experience in Centre Hospitalier et Universitaire Lyon Sud (CHLS).

Intraperitoneal chemohyperthermia (IPCH) with Cytoreductive surgery (CS) has been used in Centre Hospitalier et Universitaire Lyon Sud (CHLS) since 1989. Up to 2005, 420 patients were involved in different phase II studies for peritoneal carcinomatosis (PC) from colorectal, gastric or ovarian origin, as well as for pseudomyxoma peritonei and peritoneal mesothelioma. Encouraging results were achieved in case of optimal PC cytoreduction. The CHLS experience, as well as the Dutch randomized trial and the international registration, underline the advantage of such an aggressive combined therapy for selected patients in experienced multidisciplinary centers.

Adult↗
PubMedDate not supplied

A new device for the treatment of pleural malignancies: intrapleural chemohyperthermia preliminary report.

The prognosis of malignant pleural tumors remains extremely unfavorable. The aim of this study is to evaluate the combination of intrathoracic intrapleural chemotherapy and intrapleural hyperthermia (ITCH) in these diseases. Under anesthesia, 5 men were studied. After pleurectomy for mesothelioma (3/5) or adenocarcinoma (2/5), ITCH is carried out for over 60 min, either with mitomycin C (4/5) or cisplatin (1/5). No pre- or postoperative death occurred. The maximal pleural temperature is 42.6 degrees C. The blood level of mitomycin C never reached the systemic toxic level. All the patients were discharged from the surgical ward, 3 are still alive 15 months later. Therefore, ITCH appears to be a safe and reliable therapy.

Adenocarcinoma↗
PubMedDate not supplied

Biochemical modifications in the blood and the heated fluids during intraperitoneal chemohyperthermia.

The biochemical changes in blood during intraperitoneal chemohyperthermia (IPCH) were examined by carrying out complete assessments before and after the operation. These assessments were made up of 23 parameters: Na, K, Cl, CO2, urea, creatinine, proteins, glucose, calcium, phosphates, magnesium, bilirubin, uric acid, lactic acid, CRP, ASAT, ALAT, CK, LDH, gamma-GT, ALP, lipase, and amylase. Only 5 of these parameters showed significant changes: proteins, urea, ALP, gamma-GT, lactic acid. The protein and urea levels decreased due to hemodilution induced by the perfusion of fluids. ALP and gamma-GT levels decreased, possibly due to localized inhibition of secretion. Lactic acid levels increased due to the movement of lactates from the heated fluid into the blood. The study of biochemical changes within the heated fluids was made using the following parameters: CA 125, CA 19-9, CEA, ASAT, ALAT, CK, LDH, gamma-GT, ALP, lipase, uric acid, phosphates, proteins, Na, K, Cl, urea, creatinine, and magnesium. Between the beginning and the end of IPCH, significant increases were found in the levels of CA 125 (+173%), proteins (+190%), ASAT (+130%), LDH (+103%), K+ (+232%), PO4 (+134%), and uric acid (+99%). These increases indicate the existence of a significant degree of cellular lysis.

Abdominal Neoplasms↗
PubMedDate not supplied

Study of the pharmacokinetics of mitomycin C in humans during intraperitoneal chemohyperthermia with special mention of the concentration in local tissues.

The aim of this work is to estimate the 24-hour distribution and elimination of mitomycin C (MMC) during and after intraperitoneal chemohyperthermia (IPCH) in 18 patients (13 gastric adenocarcinoma, 3 pancreatic adenocarcinoma, 2 malignant mesothelioma) who received 60 mg MMC during 90-120 min in 6 liters of heating solution HS; (42 degrees C) or HS flowing at 0.4 liters/min in a closed circuit. MMC assay in the serum, urine, HS and in local biopsies were performed by high performance liquid chromatography. The amount of MMC in HS decreased by 54.1 +/- 13.6% during IPCH. The maximum MMC levels in serum reached 0.4 +/- 0.18 mg/l 45 min after the start of IPCH, then rapidly decreased. Only 1.77 +/- 0.93 mg were recovered in urine in 24 h. These data are consistent with a large and rapid absorption, mostly in local tissue, demonstrated by the level in 7 post-IPCH biopsies (8.3 +/- 7.6 mg/kg).

Absorption↗
PubMedDate not supplied

Cytokine production during intraperitoneal chemohyperthermia.

The aim of the present work is to investigate in vivo cytokine production during chemohyperthermia. 11 patients suffering from gastric adenocarcinoma (n = 6), ovarian adenocarcinoma (n = 4) or malignant mesothelioma (n = 1) were studied. Patients received 60 mg mitomycin or 100 mg cisplatin per square meter during 2 h in 6 liters of a heating solution (temperature 42 degrees C, flow rate 200 ml/min in a closed circuit) after previous surgical resection. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured at 0, 30, 45, 60 and 90 min, both in the blood stream and in the heating solution circulating intraperitoneally. We observed a slight increase in plasma IL-6 occurring as soon as 30 min, a dramatic rise in IL-6 in the heating solution. TNF-alpha values were only slightly augmented. In addition, the importance of various factors in the induction of IL-6 and TNF-alpha production during chemohyperthermia (temperature, mitomycin C, cisplatin) were studied using a whole blood ex vivo model.

Adenocarcinoma↗
PubMedDate not supplied

Adenocarcinoma of the body and tail of the pancreas: is there room for adjuvant radiotherapy?

AIMS AND BACKGROUND: Adenocarcinoma of the body and tail of the pancreas is a rare malignancy with a poor prognosis. Few long-term survivors have been reported in the literature. The role of adjuvant treatment after curative resection has not yet been assessed. This retrospective study aims to describe the patterns of failure and the survival of 10 patients treated with resection and adjuvant radiotherapy. MATERIALS AND METHODS: From 1982 to June 1994, 10 patients with adenocarcinoma of the body and tail of the pancreas received adjuvant radiotherapy in our department. There were 4 females and 6 males, with a median age of 63 years (range, 45-77). The pT distribution was 2 pT1, 4 pT2, 4 pT3 and for pN it was 7 pN0 and 3 pN1. Four patients had stage I, 3 stage II and 3 stage III disease. All the patients underwent a resection: distal pancreatectomy in 7, partial resection of the body in 1, and total pancreatectomy in 2. Gross residual disease was present in 2 cases. Three patients received intraoperative radiotherapy up to a dose of 12-15 Gy. Postoperative radiotherapy was given in 9 patients with a dose ranging from 40 to 50 Gy (median, 45). One patient who received intraoperative radiotherapy had no postoperative radiotherapy. In 4 patients, chemotherapy with 5-fluorouracil was given during the first week of irradiation. RESULTS: Six patients experienced a local-regional relapse and 3 developed metastases. The median survival was 21 months. The 5-year overall survival was 15%. Eight patients died of progressive disease. One patient who presented with stage I disease was alive and free of disease at 24 months from diagnosis and, interestingly, one with stage III disease was alive at 111 months. No severe treatment-related complications were observed. CONCLUSIONS: As in carcinoma of the head of the pancreas, adjuvant radiotherapy should be considered as an adjuvant treatment of resected adenocarcinoma of the body and tail of the pancreas. Further evaluation is necessary to assess the role of intraoperative radiotherapy.

Adenocarcinoma↗
PubMedDate not supplied

Tolerance of intraperitoneal chemohyperthermia with mitomycin C: in vivo study in dogs.

Tolerance of intraperitoneal chemohyperthermia (IPCH) with mitomycin C (2 mg/kg) by irrigation of the peritoneal cavity via a closed circuit system was evaluated in Beagle dogs for possible use in the management of human peritoneal carcinomatosis. Of dogs, 24 underwent three digestive anastomoses each. They were randomized into three groups: control (n = 6), intraperitoneal hyperthermia (n = 8) and IPCH (n = 10). Peritoneal temperatures were maintained between 41-43 degrees C for 60 min. Tolerance was evaluated through clinical follow-up, biological samples (serum electrolytes, blood counts and serum enzymes), histological examinations and post-mortem macro- and microscopic controls of anastomosis. Mortality and morbidity rates were not different in the three groups. No anastomotic leakage occurred. Evidence of biological toxicity was minimal. Histological examinations showed no definitive tissue damage. IPCH appears to be a safe and reliable device in dogs. Plans to combine IPCH with MMC in surgical resection of patients with peritoneal carcinomatosis are underway.

Animals↗
PubMedDate not supplied

Intraperitoneal chemo-hyperthermia with mitomycin C for gastric cancer patients with peritoneal carcinomatosis.

OBJECTIVE: This study evaluates the tolerance and efficacy of Intraperitoneal Chemo-hyperthermia (IPCH) with Mitomycin C (MMC) associated with surgery, in peritoneal carcinomatosis of gastric origin. BACKGROUND: Most patients with peritoneal carcinomatosis of gastric origin die within 6 months, and IPCH associated with surgery has been reported as a possible new therapeutic approach. METHODS: A prospective non randomized trial was carried out on 42 patients with gastric cancers and peritoneal carcinomatosis. Fourty-three IPCH with MMC were used as complementary treatment after surgery (peritoneal perfusate with a 10 mg/l dose of MMC, inflow temperature 46 to 49 degrees C, use of a closed circuit, duration 90 minutes). Fourteen primary tumors were unresectable ones and 12 patients had large malignant preoperative ascites. RESULTS: Mortality and morbidity rates were 2/42 and 4/42 respectively. For resectable gastric cancers with stage 1 and 2 carcinomatosis (malignant granulations less than 5 mm in diameter), one, two and three year survival rates were 80, 61 and 41% respectively. For unresectable primary tumors and for stage 3 and 4 carcinomatosis (granulations larger than 5 mm in diameter), six and twelve month survival rates were 50% and 10% respectively. CONCLUSIONS: IPCH appears as a safe new therapeutic approach in gastric cancers with peritoneal carcinomatosis with small malignant granulations (stage 1 and 2) and randomized trials are now needed to clearly evaluate its efficacy.

Aged↗
PubMedDate not supplied

Peritonectomy combined with intraperitoneal chemohyperthermia in abdominal cancer with peritoneal carcinomatosis: phase I-II study.

OBJECTIVE: To evaluate the feasibility and the tolerance of Peritonectomy Procedure (PP) combined with Intraperitoneal Chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis, a phase I-II study has been realised from January 1997 to September 1998. METHODS: Eighteen patients were included for peritoneal carcinomatosis from colorectal cancer (13), ovarian cancer (2), gallbladder cancer (1), gastric cancer (1) and peritoneal mesothelioma (1). Peritoneal carcinomatosis were mainly advanced disease (16 stage 3 and 4, 2 stage 2). All the patients underwent surgical resection of their primary tumor with PP as described by Sugarbaker and IPCH (with Mitomycin C, Cisplatinum or both). IPCH used in this study was a "closed sterile circuit" device with inflow temperatures ranging from 46 to 48 degrees C. IPCH was performed on the same day as PP (8118) or delayed (10/18). RESULTS: Significant down-staging of peritoneal carcinomatosis was achieved for 16 patients. One patient died postoperatively, while the morbidity rate was 6/18 (long postoperative ileus, grade 3 leucopenia and anastomotic leakage). CONCLUSIONS: Combination of PP and IPCH could achieve significant tumoral volume reduction in peritoneal carcinomatosis. This aggressive treatment must be employed selectively because of its morbidity. Larger phase III studies are now needed.

Abdominal Neoplasms↗
PubMedDate not supplied

Liver cystadenocarcinoma originating in cystadenoma without mesenchymal stroma. Therapeutic strategy in case of atypical radiological criteria. A case report.

Optimal treatment of cystadenoma if diagnosed consists of complete resection of the tumor. In case of atypical radiological criteria, therapeutic strategy is not well defined. The attitude we adopt is to regularly monitor the lesion. Surgical removal of the tumor is of course indicated facing any significant change on sonography or tomodensiometry.

Aged↗