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F Pene

Publications and source records attributed to F Pene.

At least 19 recordsLinked to original sources
PubMed2000

Post-radiation severe xerostomia relieved by pilocarpine: a prospective French cooperative study.

BACKGROUND AND PURPOSE: The aim of the study was: (1) to confirm the action of pilocarpine hydrochloride (Salagen) against xerostomia: (2) to correlate the response to dose/volume radiotherapy parameters. MATERIALS AND METHODS: From June 1995 to February 1996, 156 patients with severe radiation induced xerostomia received pilocarpine hydrochloride orally. IS mg per day with a 5 mg optional increase at S weeks up to a daily dose of 25 mg beyond 9 weeks. RESULTS: One hundred and forty five patients are fully evaluable. Treatment compliance was 75%. Thirty eight patients (26%) stopped treatment before week 12 for acute intolerance (sweating, nausea, vomiting) or no response. No severe complication occurred. Ninety ses en patients (67%) reported a significant relief of symptoms of xerostomia at 12 weeks. Within 12 weeks, the size of the subgroup ith normal food intake almost doubled (13-24 patients) while the size of the subgroup with (nearly) impossible solid food ingestion decreased by 38% (47 vs. 29 patients). The impact on quality of life was considered important or very important by 77% of the responders. CONCLUSIONS: No difference was found according to dose/volume radiotherapy parameters suggesting that oral pilocarpine hydrochloride: (1) acts primarily by stimulating minor salivary glands: (2) can be of benefit to patients suffering of severe xerostomia regardless of radiotherapy dose/volume parameters: (3) all responders are identified at 12 weeks.

Administration, Oral↗
PubMed1999

[Small cell lung carcinoma].

Small cell lung carcinoma represents less than twenty five percent of all lung cancers. Nevertheless, a lot of studies permitted to better define this cancer and to propose specific therapeutic approaches. Clinical symptoms, results and roles of chemotherapy, radiation therapy and surgery are discussed in this review.

Antineoplastic Agents↗
PubMed1997

Age is not a limiting factor for radical radiotherapy in pelvic malignancies.

BACKGROUND AND PURPOSE: Pelvic radiotherapy (RT) toxicity in the elderly is poorly documented. We developed a study aiming to evaluate whether or not a limit of age could be identified beyond which toxicities in patients receiving pelvic RT were more frequent or more severe. MATERIAL AND METHODS: 1619 patients with pelvic cancers enrolled in nine EORTC trials, RT arms, were retrospectively studied. Patients were split into six age ranges from 50 years to 70 years and over. Survivals and late toxicity occurrence were calculated with the Kaplan-Meier method and comparison between age groups with the logrank test. A trend test was done to examine if chronological age had an impact on acute toxicity occurrence. RESULTS: Survival was comparable in each age group for prostate (P = 0.18), uterus (0.41), anal canal cancer (P = 0.6) and slightly better for the younger group of rectum cancer (P = 0.04). A total of 1722 acute and 514 late grade > or = 1 were recorded. Acute nausea/ vomiting, skin complications and performance status deterioration were significantly more frequent in younger patients. There was no trend toward more aged patients to experience diarrhea (P = 0.149) and after adjustment on RT dose, acute urinary complications were observed equally in each age range (P = 0.32). Eighty percent of patients were free of late complication at 5 years in each age range (P = 0.79). For the grade > 2 late side-effects, a plateau was observed after 1 year at near 9% without any difference (P = 0.06) nor trend (P = 0.13) between age-groups. CONCLUSION: Age per se is not a limiting factor for radical radiotherapy in pelvic malignancies.

Age Factors↗
PubMed1997

Radical surgery and postoperative radiotherapy as combined treatment in rectal cancer. Final results of a phase III study of the European Organization for Research and Treatment of Cancer.

BACKGROUND: There is controversy whether adjuvant radiotherapy should be given before or after surgery for locally advanced, resectable rectal cancer. Preoperative radiotherapy substantially reduces local recurrence rates but may increase postoperative complications. In addition, patients found to have early cancers are treated unnecessarily. This study is a randomized trial of postoperative radiotherapy in patients who had a potentially curative resection for locally advanced rectal carcinoma. METHODS: Following complete excision of a Dukes B or C rectal cancer, 172 patients were randomized to adjuvant radiotherapy (46 Gy 5 days per week in 30-38 days) (84 patients) or controls (88 patients). RESULTS: After a median follow-up of 85 months, no benefit from postoperative radiotherapy had been observed in disease-free survival (P = 0.81), overall survival (P = 0.52), local recurrence-free interval (P = 0.46) or in the number and sites of recurrence. Acute toxicity following radiotherapy included diarrhoea (20 per cent), cystitis (13 per cent), delayed wound healing (7 per cent), pneumonia (5 per cent) and seizures (1 per cent). Late complications included reoperation for small bowel obstruction (5 per cent), chronic diarrhoea (20 per cent), chronic cystitis (12 per cent) and persistent perineal sinus (9 per cent). In the group who had surgery alone, late morbidity was found in 11 per cent. CONCLUSION: This trial failed to demonstrate any improvement in overall survival or local control when postoperative irradiation was given following resection of locally advanced rectal carcinoma.

Adult↗
PubMed1996

[High-dose therapy and hematopoietic cell autotransplantation in the treatment of adult gynecologic tumors].

Autologous bone marrow transplantation for the treatment of gynecologic tumors in adults remains an uncommon therapeutic approach. The feasibility of such high-dose therapies is clearly proved, especially with the advent of hematopoietic growth factors and the rescue by the peripheral stem cells to reduce the duration of the chemotherapy-induced myeloid aplasia. The question is to exactly define the place of high-dose therapy in the land of solid tumors. In the treatment of poor prognosis breast cancer, high-dose therapy with autologous bone marrow transplantation or with peripheral stem cells support is able to convert some patients with partial response into complete responders. However, the consequences on overall survival and disease-free survival are not convincing. For metastatic breast cancer and for poor-prognosis tumors (inflammatory breast cancer, axillary metastatic nodes > or = 8), the interest of high-dose therapy has to be determined by randomized studies. These studies are ongoing in USA and in France. For the treatment of poor-prognosis ovarian cancer, the situation is more difficult to appraise. Randomized studies have to be done to precisely define the interest of high-dose therapy in terms of response and disease-free survival for the treatment of ovarian carcinomas.

Adult↗
PubMed1995

A modified 60C teletherapy unit for total body irradiation.

PURPOSE: A modified teletherapy unit to achieve total body irradiation with a vertical beam in a conventional treatment room. METHODS AND MATERIALS: A standard 60C teletherapy unit has been modified to achieve total body irradiation with a vertical beam in a conventional treatment room. Patients are treated in prone and supine positions. Removal of the adjustable collimator assembly of this standard machine provides a circular field of 196 cm in diameter at 167 cm from the source. Second, the machine has been elevated by about 50 cm on a metallic base to enlarge irradiation field to obtain 248 cm in diameter at 210 cm from the source, and to encompass tall patients under better conditions. A special lead conical beam flattening filter, 10-mm thick at the center, was designed to compensate the spatial inhomogeneity of the beam. An instantaneous dose rate of 6.10(-2) Gy/min is attained at the L4 level (midplane) in an average 20-cm thick patient with a source activity of 5099 RHM (air kerma rate of 44.8 Gy.h-1.m2). Between February 2, 1984 and December 27, 1990, 244 total body irradiations were performed either by single dose (n = 69, 10 Gy were given to midplane at L4 level in about 6 to 8 h, 8 Gy to the lungs), or by fractionated dose (n = 175, 12 Gy were given in 6 fractions over 3 consecutive days to midplane at L4 level, 9 Gy to the lungs). RESULTS: The dose distribution is similar than the ones obtained by a linear accelerator with patients lying on their sides. CONCLUSION: Patients were treated in a comfortable and highly reproductible position. Organ shielding was easily achievable. This could be a less expensive and reasonable alternative to linear accelerator.

Cobalt Radioisotopes↗
PubMed1995

Conservative versus nonconservative treatment of epidermoid carcinoma of the anal canal for tumors longer than or equal to 5 centimeters. A retrospective comparison.

BACKGROUND: The role of radiotherapy alone in the sterilization of anal canal epidermoid carcinomas of 5 cm or more remains to be assessed. Thus, the outcomes of patients treated with radiotherapy alone (RT) versus those treated with preoperative radiotherapy and surgery (RS) were compared retrospectively. METHODS: Between 1972 and 1990, 185 patients were treated with curative intent either with RT alone (n = 147) or with RS (n = 38). The Mean tumor length was 6.18 +/- 1.14 cm and was significantly longer in the RS group (6.55 +/- 1.29 cm) than in the RT group (6.08 +/- 1.08 cm) (P = 0.02). The median follow-up was 77 +/- 57 months and 93 +/- 60 months (P = 0.23) for the RT and RS groups, respectively. For the RT group, the first course of radiotherapy was 40 to 45 Gy in the pelvis for 4 to 5 weeks; after a rest of 4 to 6 weeks, radiotherapy was boosted an additional 15 to 20 Gy for 2 weeks. The RS patients received 40 to 45 Gy in the pelvis for 4 to 5 weeks, then received surgery after a median period of 54 days. RESULTS: The overall 10-year cancer specific survival rates were 58% in the RT group and 66% in the RS group (P = 0.48). The T-stage 10-year cancer specific survival rates were 68% in the RT group and 67% in the RS group for T2 tumors (P = 0.96); 57% in the RT group and 53% in the RS group for T3 tumors (P = 0.85); and 42% in the RT group and 40% in the RS group for T4 tumors (P = 0.05). In the RS group, the local control rate was 75% (3/4) for T2 tumors; 74% (17/23) for T3 tumors; and 82% (9/11) for T4 tumors. In the RT group, the local control rate was 77% (34/44) for T2 tumors; 70% (58/82) for T3 tumors; and 60% (12/20) for T4 tumors. In the RT group, the anal conservation rate was 61% (27/44) for T2 tumors, 59% (48/82) for T3 tumors, and 55% (11/20) for T4 tumors. Local tumoral control and a functioning anus were present in 72 out of 147 (49%) patients [52% (23/44) for T2 patients, 52% (43/82) for T3 tumors, and 30% (6/20) for T4 patients]. In the RS group, the grade 3 complication rate was 9% (13/146) and in the RS group, 5% (2/38). CONCLUSION: For patients with T4 tumors, preoperative radiotherapy and surgery seemed to be better in terms of survival and local tumor control rate, but the difference was not significant probably because the number of patients in the RS group was small. For these large tumors, the treatment should probably be more aggressive, combining chemotherapy and radiation therapy, but the increase of local control in relation with the addition of cytotoxic chemotherapy to irradiation is not proved.

Adult↗
PubMed1995

Fractionated or single-dose total body irradiation in 171 acute myeloblastic leukemias in first complete remission: is there a best choice? SFGM. Société Française de Greffe de Moelle.

PURPOSE: To evaluate the importance of fractionating total body irradiation (TBI) in patients receiving an allogenic bone marrow transplant (BMT) for an acute myeloblastic leukemia (AML) in first complete remission (CR1). METHODS AND MATERIALS: Between 1983 and 1990, 171 consecutive patients received either single dose TBI (STBI) (n = 65) or fractionated TBI (FTBI) (n = 106) after being conditioned with cyclophosphamide and before receiving a non-T-depleted Human Leucocyte Antigen (HLA)-identical marrow. Both groups were comparable except for date of BMT and diagnosis-to-BMT interval (D-BMT). RESULTS: After 63 months median follow-up, transplant-related mortality (TRM), probability of relapse, and 5-year disease-free survival (DFS) were 0.38 and 0.27 (p = 0.04), 0.29 and 0.26 (p = 0.22), 0.43 and 0.56 (p = 0.06), respectively, for STBI and FTBI. The supposed influence of the schedule of TBI disappeared in the multivariate analysis: TRM was enhanced by severe acute graft vs. host disease (p = 0.0002), early years of transplant (before January 1, 1987) (p = 0.0003), and longer D-BMT intervals (p = 0.038). Relapse was linked to early years of transplant (p < 0.00001), and the absence of chronic GVHD (p = 0.007). Longer DFSs were observed for later years of transplant (after January 1, 1987 and later) (p = 0.001), milder acute GVHD (p = 0.005), and shorter D-BMT intervals (p = 0.045). Important improvements of the results were made during the 7-year observation period: TRM, probability of relapse, and DFS were, respectively, 0.36, 0.28, and 0.46 for patients transplanted before January 1, 1987 vs. 0.21, 0.15, and 0.67 after that date. CONCLUSION: Our data strongly suggest that allogenic BMT is the best postremission treatment for AML in CR1, and the results are better when BMT shortly follows the achievement of remission. The schedule of TBI was of little importance compared with the improvements made in the management of patients undergoing BMT during the 1980s, and, therefore, reports concerning data prior to 1985 should be interpreted cautiously.

Adult↗
PubMed1995

Early breast cancer: influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy.

Between December 1981 and December 1988, 329 consecutive patients with stage I and II breast cancers who underwent wide excision (n = 261) or quadrantectomy (n = 68) with (n = 303) or without (n = 26) axillary dissection were referred to radiotherapy. Final margins of resection were microscopically free from tumor involvement in all cases. Radiotherapy consisted in 40-45 Gy over 4-4.5 weeks to the breast, with (n = 168) or without (n = 161) regional nodal irradiation of 45-50 Gy over 4.5-5 weeks. A mean booster dose of 15 Gy was delivered to the primary site by iridium-192 implant in 169 patients (group 1) or by electrons in 160 patients (group 2). Twenty-seven percent (n = 88) of patients received tamoxifen for > or = 2 years. Adjuvant chemotherapy was administered in 22% (n = 71) of patients. Groups 1 and 2 were not strictly comparable. Group 1 patients were significantly younger, had smaller tumors, were treated with cobalt at 5 x 2 Gy per week and axillary dissection was more frequently performed. Group 2 patients were more frequently bifocal and more frequently treated by quadrantectomy and tamoxifen, and irradiation used accelerator photons at 4 x 2.50 Gy per week. No difference in terms of follow-up and survival rates was observed between the two groups. For all patients the 5- and 10-year local breast relapse rates were 6.7% and 11%, respectively. No difference was observed regarding local control either by the electron or the iridium-192 implant boosts. Axillary dissection and age had an impact on the breast cosmetic outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Therapeutic intensification and hematopoietic stem cell autotransplantation in the treatment of solid tumors in adults: principles, realization and application to the treatment of germ cell, trophoblastic, breast, ovarian and small-cell bronchial tumors. 1].

Autologous bone marrow transplantation for the treatment of solid tumors in adults remains an uncommon therapeutic approach. The feasibility of such high-dose therapies is clearly proved, especially with the advent of hematopoietic growth factors and the rescue by the peripheral stem cells to reduce the duration of the chemotherapy-induced myeloid aplasia. The question is to exactly define the place of high-dose therapy in the land of solid tumors. For the treatment of primary chemoresistant gonadal germ-cell tumors, the possibility to cure the patients and the interest of high-dose therapy with autologous bone marrow transplantation are clearly demonstrated. As consolidation for the treatment of poor prognosis tumors, the place of high-dose therapies remains moot. For the treatment of chemoresistant extragonadal germ-cell tumors, especially for primary mediastinal tumors, the level of resistance to cisplatin-based chemotherapy regimens is generally too high to be overcome by intensive therapies given as single course or as tandem courses. However in association with debulking surgery, this therapeutic approach has to be considered for some patients. In the treatment of poor prognosis breast cancer, high-dose therapy with autologous bone marrow transplantation or with peripheral stem cells support is able to convert some patients with partial response into complete responders. However, the consequences on overall survival and on disease-free survival are not evident. For metastatic breast cancer and for poor-prognosis tumors (inflammatory breast cancer, axillary metastatic nodes > or = 8), the interest of high-dose therapy has to be determined by randomized studies. These studies are ongoing in USA and in Europe. For the treatment of poor-prognosis ovarian cancer, the situation is more difficult to appraise. Once again, randomized studies have to be done to precisely define the place of high-dose therapy. In the land of small-cell lung carcinomas, high-dose therapy is actually forsaken by most of authors, even for limited diseases. The results of previous studies are disappointing. Moreover, occult medullary micrometastases involvement is frequent, once again even in limited diseases. However new therapeutic associations, as the ICE regimen (IFM, Carboplatin, VP-16) delivered as single or tandem therapy, have to be studied, especially as early consolidation therapy for the treatment of limited small-cell lung carcinomas.

Adult↗
PubMed1995

Radiation therapy with or without surgery in the management of low-grade brain astrocytomas. A retrospective study of 120 patients.

From 1977 to 1988, 120 consecutive patients with a diagnosis of low-grade astrocytoma were referred to our department for radiotherapy. Fourty-one patients (group 1) underwent surgery and post operative external radiation therapy (2 gross total resections and 39 subtotal resections). Sixty-nine patients underwent exclusive external radiotherapy (group 2). In ten patients, the irradiation was delivered by stereotactic implantation of iridium-192 wires into the tumor with or without external irradiation (group 3). Ten had pilocytic astrocytomas (mean age, 24 years) and twenty had microcystic astrocytomas (mean age, 35.4 years). The 5- and 10-year survival rates were 55.6% and 44.4%, respectively and 55% and 48%. Ninety astrocytomas were classified as "ordinary" astrocytoma (mean age, 36.8 years). The 5- and 10-year overall survival rates were 51% and 20.5%, respectively. The same probabilities at 5 and 10 years were 65% and 37% respectively, for group 1, 38.8% and 12.7% for group 2 and, 78.8 and 22.5% for group 3. In multivariate analysis, two prognostic factors had a significant impact on overall survival: IK score (IK < 90 vs IK > or = 90, p = 0.0001), surgical resection (surgical resection and post operative radiotherapy vs radiation therapy alone, p = 0.012). However, the patients who underwent surgical resection were those in the best condition, having tumors that were easily accessible and less invasive.

Adolescent↗
PubMed1994

Total-body irradiation and cataract incidence: a randomized comparison of two instantaneous dose rates.

PURPOSE: To assess the influence of instantaneous total-body irradiation dose rate in hematological malignancies, we randomized 157 patients according to different instantaneous dose rates. METHODS AND MATERIALS: Between December 10, 1986 and December 31, 1989 157 patients have undergone a total-body irradiation before bone-marrow transplantation according to two different techniques: either in one fraction (1000 cGy given to the midplane at the level of L4, and 800 cGy to the lungs) or in six fractions (1200 cGy over 3 consecutive days to the midplane at the level of L4, and 900 cGy to the lungs). Patients were randomized according to two instantaneous dose rates, called LOW and HIGH, in single-dose (6 vs. 15 cGy/min) and fractionated (3 vs. 6 cGy/min) TBI groups; there were 77 cases for the LOW and 80 for the HIGH groups, with 57 patients receiving single-dose (28 LOW, 29 HIGH) and 100 patients receiving fractionated total-body irradiation (49 LOW, 51 HIGH). RESULTS: As of July 1992, 16 (10%) of 157 patients developed cataracts after 17 to 46 months, with an estimated incidence of 23% at 5 years. Four (5%) of 77 patients in the LOW group, 12 (15%) of 80 patients in the HIGH group developed cataracts, with 5-year estimated incidences of 12% and 34%, respectively (p = 0.03). Ten (18%) of 57 patients in the single-dose group, and 6 (6%) of 100 patients in the fractionated group developed cataracts, with 5-year estimated incidences of 39% and 13%, respectively (p = 0.02). When the subgroups were considered, in the single-dose group, 3 (11%) of 28 LOW patients, and 7 (24%) of 29 HIGH patients developed cataracts, with 5-year estimated incidences of 24% and 53%, respectively; in the fractionated group, 1 (2%) of 49 LOW patients, and 5 (10%) of 51 HIGH patients developed cataracts, with 5-year estimated incidences of 4% and 22%, respectively (single-dose LOW vs. single-dose HIGH vs. fractionated LOW vs. fractionated HIGH, p = 0.006). There was no statistically significant difference in terms of 5-year estimated cataract incidence between the patients receiving steroids and those not (30% vs. 25%, p = 0.22). Multivariate analyses revealed that the instantaneous dose rate was the only independent factor influencing the cataractogenesis (p = 0.04). CONCLUSION: We conclude that the total-body irradiation regimen (instantaneous dose rate and/or fractionation) may have an influence on the development of cataracts following bone-marrow transplantation.

Adolescent↗
PubMed1994

Morbidity After Total Body Irradiation.

High-dose chemotherapy and total body irradiation with either allogeneic or autologous bone-marrow rescue has been used successfully in the treatment of various hematologic malignancies. Total body irradiation, despite its acute and late side effects, combined with cyclophosphamide remains one of the best conditioning regimens before bone marrow transplantation. Interstitial pneumonitis and veno-occlusive disease are major and lethal complications following bone marrow transplantation. In this article, morbidity after total body irradiation will be discussed.

Journal Article↗
PubMed1994

Aspartate aminotransferase macroenzyme complex in serum identified and characterized.

Macromolecular aspartate aminotransferase was found in the serum of an apparently healthy patient. This complex was composed of aspartate aminotransferase (AST; EC 2.6.1.1) and immunoglobulin. Electrophoresis of the patient's serum showed an abnormal band migrating between mitochondrial (m) and cytosolic (s) AST. The macromolecular complex was purified by gel filtration on Sephacryl S300. The molecular mass of the complex was estimated to be 250 kDa, suggesting that the complex probably consists of one immunoglobulin molecule associated with one AST molecule. By immunoelectrophoresis, the immunoglobulin was found to be an IgG with kappa-lambda type light chain. When we used polyclonal antibodies against human mAST or sAST, the sAST antibodies strongly inhibited the AST activity of the macrocomplex, whereas the mAST antibodies had no effect. Thus the AST molecule of the macrocomplex is an sAST type.

Aged↗
PubMed1992

[Review of results and clinical analysis of conservative partial surgery associated with postoperative radiotherapy in operable breast cancers stages I amd II].

Over the last 25 years, conservative forms of treatment have been used for the locoregional treatment of early breast cancer, stages I and II (< 3 cm in diameter). At present, the same carcinological results are obtained with conservative surgery and radiation therapy as with radical surgery, and the aesthetic and functional results have improved. Several parameters should be taken into account, ie tumour volume, breast volume, multifocal nature and histologic type. A number of questions still remain unanswered namely: what is the most appropriate conservative surgery (quadrantectomy, tumourectomy or local excision)? What is the most appropriate total irradiation dose (50 Gy over 5 weeks: or 45 Gy over 4.5 weeks)? What is the value of radiation boost in patients with negative resection margins? What is the value of radiation boost in patients with a high local risk of recurrence? What is the most appropriate radiation technique for boost in the primary tumour bed (electrons or iridium implants)? Does the external irradiation of regional lymph nodes improve survival rate? Is it possible to extend conservative treatment to a 4-cm diameter tumour? What is the impact of adjuvant systemic chemotherapy and/or hormonotherapy on the risk of isolated breast cancer recurrence?

Adult↗