PubMed Health⌕ Search

Biomedical subjects

G Delepine

Publications and source records attributed to G Delepine.

At least 37 records · Page 2Linked to original sources
PubMed1989

Methotrexate diffusion from acrylic cement. Local chemotherapy for bone tumours.

We investigated the possible use of acrylic cement containing chemotherapeutic drugs in the treatment of malignant lesions in bone. The diffusion of methotrexate (MTX) from methylpolymethacrylate implants was studied in vitro: polymerisation of the cement did not destroy the drug; liberation began immediately and about 10% was released by 18 hours. Some release continued for as long as six months. In vivo experiments on rats with induced osteosarcoma showed that MTX in cement had both local and general effects which were dependent on the dosage. A series of 17 large dogs with spontaneous osteosarcoma were then treated by local resection and cement containing MTX. General chemotherapeutic effects were detectable from 2 hours to 5 days, survival was increased and local recurrence was reduced, but there were four cases of delayed wound healing. Preliminary studies in human patients confirm the possibility that this method of local chemotherapy could be a useful addition to the treatment of malignant tumours of bone.

Animals↗
PubMed1989

[Value of a new induction protocol in Ewing's sarcoma. Apropos of 35 cases].

The use of a protocol of induction in Ewing's sarcoma based on the sequential association of Cyclophosphamide (150 mg/m2 for 7 days) and Adriamycin (35 mg/m2 on day 8) has shown that: 1. The clinical and radiological response (scan + MRI) even when complete is not predictive of the quality of the histological response. 2. For the histological response to be predictive, it must be evaluated on a complete monobloc resection. 3. A sustained, complete remission is more frequent after systematic extratumoral monobloc surgery and appropriate postoperative chemotherapy. When these conditions are respected, a complete remission rate of 88% at 30 months can be expected.

Adolescent↗
PubMed1989

[Comparative study of 3 successive treatment protocols of osteogenic osteosarcoma in children, adolescents and young adults. Apropos of 100 cases].

Three therapeutic protocols were used successively for the treatment of osteogenic osteosarcoma since 1978. The first protocol associated initial surgery and 12 months of chemotherapy and was applied to 41 patients with good results in adults but poor results in children. A protocol introducing adjuvant chemotherapy based on the association of adriamycin-cisplatinum gave very disappointing results first in children and then in adults. The protocol based on HD MTX gave much more encouraging results: the long version (3 months preoperative chemotherapy) was effective in good responders but did not influence the course of poor responders. The shortened version of this protocol, derived from the T 10 Rosen protocol (1 month preoperative chemotherapy conservative surgery and appropriate peri- and postoperative chemotherapy) seems to transform the prognosis of osteosarcoma. Our current results indicate a complete primary remission rate of 89% at one year, and 83% at 33 months.

Adolescent↗
PubMed1988

Importance of age and methotrexate dosage: prognosis in children and young adults with high-grade osteosarcomas.

The disease-free survival (DFS) in 87 patients with high-grade non-metastatic osteosarcoma of the limbs treated in 3 consecutive pilot studies was compared. From 1978-1982 (Group 1), 41 patients were treated after surgery by adjuvant chemotherapy alternating 2 non-cross resistant cyclic combinations each month for 1 year and early prophylactic lung irradiation. From 1982-1984 (Group 2), preoperative chemotherapy 2-drug combination: adriamycin-cisplatinum (ADR-CDDP) was tested in 20 patients. Surgery was followed by 3 treatment periods of the same combination. From 1984-1987 (Group 3), 26 patients were treated according to modified T-10 protocol with high-dose methotrexate (HDMTX) adapted to age and individual pharmacokinetics. In Group 1, the overall 5 yr DFS was 63% (average follow-up 60.6 months). The worst prognostic factor was low age: 5 yr, DFS under 15 yr was 30%; greater than 15.5 yr, DFS was 85%. The second negative prognostic factor was failure to give sufficient MTX in patients greater than 15 yr. In Group 2, the actuarial 3 yr DFS was only 35% and a low age was still a negative prognostic factor. In Group 3, the 2 yr DFS was 90%, confirming Rosen's results. With HDMTX adapted to age and individual pharmacokinetics, age was no longer a negative prognostic factor. We concluded that HDMTX has a positive effect in the treatment of osteosarcomas in young people; furthermore, in very high doses, as determined by individual pharmacokinetics. In adults, postoperative chemotherapy eventually including moderate doses of MTX, can be effective and may be better tolerated.

Adolescent↗
PubMed1987

[Value of computed medical imaging in the surveillance of neo-adjuvant chemotherapy of osteogenic osteosarcoma in children and adolescents. 51 patients seen from 1984 to 1986].

The value of quantitative bone scintigraphy, digitised angiography, CT scanning and magnetic resonance imaging in the follow-up of neo-adjuvant chemotherapy for osteogenic osteosarcoma was assessed in 51 patients between 1984 and 1986. Bone scintigraphy was a very sensitive method of detecting bone metastases but of limited value in assessing the response to preoperative chemotherapy. CT scanning was very useful in small and medium sized tumours with predominantly non-calcific involvement of the soft tissue. At present, digitised angiography seems to be the best investigation for following up these patients as shown by the close histo-angiographical correlations. However, magnetic resonance imaging is a very promising method and may in future replace the more invasive aforementioned techniques in this indication.

Adolescent↗
PubMed1986

[Biopsy in sarcoma of the limbs. 135 cases].

Between 1979 and 1984, 135 patients with primary bone and soft tissue sarcoma of the limbs and girdles were treated conservatively, using a variety of methods. In 54 patients the biopsy was adapted to the requirements of one-block extratumoral resection; all remained with a functional limb and only suffered minima complications, viz. skin necrosis in 3 cases, resolved infection in 1 case and local recurrence in 2 cases, one of which was cured by a second conservative excision. Fifty-one patients were biopsied with a technique that was not adapted to a conservative anticancer treatment. In these patients the biopsy was most probably responsible for 4 therapeutic failures, 4 immediate amputations, 5 local recurrences, 6 out of 7 cases of skin necrosis and 2 out of 3 cases of deep infection consecutive to conservative surgery. The biopsy technique therefore is a determinant factor of local prognosis, more important than the size or location of the tumour or the presence of a fracture. Used routinely, without prior CT examination and disregarding precise rules, it is fraught with serious consequences and responsibilities.

Adolescent↗
PubMed1986

[Pre and postoperative chemotherapy of osteosarcoma with an adriamycin-cisplatin combination. Risks of a neoadjuvant chemotherapy which is not sufficiently effective].

The authors evaluated a new protocol of neoadjuvant chemotherapy for osteosarcoma, easier to manage and different from T10. The good results obtained with the postoperative ADR-CDDP association led us to undertake a pilot study between 1982 and 1984, using ADR-CDDP as preoperative chemotherapy. The records of sixteen patients were available for follow-up. The average age of the patients was 19.9 years. Patients received two or three preoperative courses, and a total of six identical courses. Tolerance was good. Pain usually disappeared but this was often misleading because associated with radiological and/or clinical tumor progression, low histological necrosis or poor outcome. The continuous disease-free survival actuarial rate was less than 57 and 40% at 18 months and two years respectively. The actuarial survival rate was 87% at one year and 65% at two years respectively. Disappointing results of this preoperative protocol, compared to results with the SO4 78 or T10 protocols for example, led to publish these data early in order to underline their potential dangers. As a result, we stopped our study. The charter of pilot studies justifies this publication. As well, these data point out the necessity of very close follow-up of neoadjuvant chemotherapy by sophisticated medical imaging. Neoadjuvant chemotherapy, if ineffective, must be stopped early, and should lead to surgery, followed by adequate postoperative chemotherapy.

Adolescent↗