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J Lumbroso

Publications and source records attributed to J Lumbroso.

At least 19 recordsLinked to original sources
PubMed1992

Malignant pheochromocytoma: clinical, biological, histologic and therapeutic data in a series of 20 patients with distant metastases.

Twenty patients, 16 males and 4 females, aged 11-76 yr, were treated for a metastatic pheochromocytoma at our institution between 1985 and 1990. A neurofibromatosis was associated in 4. Thirteen patients had a unilateral adrenal tumor, 3 had an extraadrenal retroperitoneal tumor, 2 had a bilateral adrenal pheochromocytoma, one had a unilateral tumor with a contralateral medullary hyperplasia and one an adrenal and an extraadrenal pheochromocytoma. Metastases occurred in all patients, at presentation in 11, 10 to 30 months later in 7, and 9 and 28 yr later, respectively in two. Histology did not afford conclusive evidence for malignancy. Catecholamine hyperproduction was present in all, predominantly affecting norepinephrine. Neuron Specific Enolase level was elevated in 11, Neuro-Peptide Y level in 9 and procalcitonin level in 11/18. High dopamine, methoxytyramine and homovanillic acid excretion levels seemed to correlate with large tumors or terminal stage. MIBG uptake was found in 16 after a diagnostic dose and in 1 only after a therapeutic dose. Surgery was performed on primary tumor in 18 and on distant metastase in 10. Iodine-131 MIBG therapy was performed in 11, among whom 9 were evaluable. Cumulative activity ranged from 100 to 711 mCi, in 1 to 6 courses. Symptomatic improvement occurred in 5 patients, stabilization was observed in 3 and tumor partial response in two, which lasted for 28 and 9 months, respectively terminating in a rapidly progressing disease with bone marrow involvement. Moderate myelosuppression occurred in 4 patients. Chemotherapy gave no response in 7 evaluable patients. Fourteen patients died with a median survival of 16 months from diagnosis of metastases (range 3-60). Response to therapy was poor and warrants further cooperative trials.

3-Iodobenzylguanidine↗
PubMed1992

[How can metastatic bone involvement be assessed?].

The first intention imaging modality for detecting bone metastases of non small cell (NSC) bronchogenic carcinoma is bone scintigraphy using technetium-99m pyrophosphate or diphosphonates. This test has a high sensitivity but equivocal images may lead to complementary tests including magnetic resonance imaging (MRI) or bone biopsy. Based on bone metastases prevalence, scintigraphy is recommended for patients entering a therapeutic trial, having bone pain, having a non characteristic bone abnormality on radiography or CT, having a non epidermoid histology or having associated pathologies increasing the risk of surgery. The utility of bone scan is questionable for patients having a Stage I or II epidermoid cancer, having already evidence of bone metastases or for whom the result of the bone scan will not change the therapeutic management. After a negative bone scan, there will be probably an indication for MRI at search of small infra-scintigraphic osteo-medullary metastases.

Bone Neoplasms↗
PubMed1991

A new immunoradiometric assay (IRMA) system for thyroglobulin measurement in the follow-up of thyroid cancer patients.

A new commercially available kit for thyroglobulin (Tg) measurement [immunoradiometric assay (IRMA) system based on monoclonal antibodies] was used in 479 patients with thyroid carcinoma. The effective working range was 1 ng/ml, and results were strongly correlated with our homemade radioimmunoassay (RIA). This IRMA method is less susceptible to interferences of auto-antibodies than our RIA. During thyroxine (T4) treatment, the Tg level was undetectable in 98% of patients after total thyroid ablation, in 91% after total thyroidectomy and in 42% after lobectomy only. In this situation, Tg was found in all patients with large metastases and in 88% of those with small metastases. Following T4 withdrawal, Tg was detectable in all patients with neoplastic disease and in 13% of those in complete remission after total thyroid ablation. In conclusion, Tg measured with this IRMA method appears to be a reliable marker of differentiated thyroid carcinoma.

Follow-Up Studies↗
PubMed1991

Prognostic factors in patients with liver metastases from colorectal carcinoma treated with discontinuous intra-arterial hepatic chemotherapy.

48 patients with colorectal cancer metastatic to the liver were implanted with a subcutaneous access system allowing hepatic intra-arterial perfusion. Regional chemotherapy used 5-fluorouracil, while 17 patients also received low-dose mitomycin at the beginning of the study. Responses to the treatment occurred in 29 patients (60%) and median survival was 14.4 months. Toxicity included gastroduodenal erosions in 12.5% of the patients, leucopenia in 20.8%, catheter thrombosis in 42% and arterial thrombosis in 50%. 2 patients died of digestive haemorrhage probably related to treatment. When individually analysed, four factors were found to significantly affect survival: presence of hepatomegaly (defined as palpable liver edge exceeding the right costal margin by more than 5 cm) (P = 0.006), percentage of hepatic replacement superior to 50% (P = 0.003), more than four metastases (P = 0.025) and hypovascularised metastases at radionuclide liver scan with 99m technetium-labelled macroaggregate albumin (MAA) (P = 0.04). The effect of the four variables on the observed survival time was analysed using a Cox regression model. Two variables were found to have simultaneously influenced survival. Presence of hepatomegaly emerged as the more significant (P = 0.0001), the other being hypovascularised metastases at 99mTc-MAA.

Adenocarcinoma↗
PubMed1991

Use of m-[131I]iodobenzylguanidine in the treatment of malignant pheochromocytoma.

The efficacy and safety of m-[131I]iodobenzylguanidine ([131I]MIBG) were assessed in 15 patients with malignant pheochromocytomas in a nonrandomized, single arm trial, in which patients were treated with [131I]MIBG (SA, 740 megabequerel/mg) every 3 months. Seven of these patients had bone and soft tissue metastases, 4 had only soft metastases, and 4 had only bone metastases. The follow-up period ranged from 6-54 months; the number of doses ranged from 2-11, with 2.9 (78.4 mCi) to 9.25 gigabequerel (GBq) (250 mCi)/administration and a cumulative activity from 11.1-85.90 GBq (300-2322 mCi). The absorbed cumulative dose in tumors ranged from 12-155 Gy. A beneficial effect of the treatment was observed in 9 patients (60%). No complete remission of the disease was observed. Seven patients died during the study, among whom 4 never responded to the treatment. Seven had hormonal responses (4 complete and 3 partial), with a duration ranging from 5-48 months. Among these patients, 4 relapsed, and 3 died within 3 months. Five patients had partial tumoral responses mainly located in soft tissues and for a duration ranging from 29-54 months. All patients with a hormonal response had objective improvement in clinical status and blood pressure. There was no clear-cut relationship between the cumulative dose and the responses. The main side-effect observed in 1 patient with widespread bone metastases after three doses (12.9 GBq) was a pancytopenia, which resolved after treatment was discontinued. This study suggests that repeated [131I]MIBG treatment could be effective in patients with advanced malignant pheochromocytoma.

3-Iodobenzylguanidine↗
PubMed1988

[Experience with protocol T10 in the pediatric service at the Gustave-Roussy Institute].

Between April and September 1986, 60 patients with osteosarcoma have been treated according to the T10 protocol in the Pediatrics Department of the Gustave Roussy Institute in Villejuif, France. Limb sparing could be achieved in 49 patients and amputation was necessary in 11. The necrosis of the primary tumor was total or subtotal in 33 cases and incomplete in the 27 others. With a median follow-up of 28 months, the actuarial survival is 85% at 48 months and the actuarial disease-free survival is 58%; the disease-free survival of "good responders" is 75% and 32% for "bad responders".

Adolescent↗
PubMed1976

[Gamma-myelography in neurosurgery].

The gamma-myelography is rapid and riskless investigation whose practice is very easy to perform while doing CSF study. The choice of radioactive tracer in liquid or gaseous phase depends on suspected abnormality. In case of medullar compression, it enables to affirm the diagnosis of block and define its level. It does not enable to know the intra or extradural localization of a lesion. For this reason we often use in the same time a 99mTc stannous pyrophosphates scintigraphy of rachis. Association of these two technics is particularly interesting in case of pressure myelitis due to vertebral metastatic localization. In traumatic pathology, gamma-myelography can be realized in cases of emergency, because of its inocuity and rapidity of its realization (10 min. with use of 133 Xenon).

Brain Diseases↗
PubMedDate not supplied

Therapeutic use of [131I]metaiodobenzylguanidine in neuroblastoma: a phase II study in 26 patients. "Société Française d'Oncologie Pédiatrique" and Nuclear Medicine Co-investigators.

Seven French Medical Centers were involved in a cooperative study evaluating [131I]Metaidobenzylguanidine (131I-MIBG) therapy in advanced neuroblastoma. Children (median age 4 years) had initially a stage III (4 patients) or stage IV (22 patients) neuroblastoma. Before MIBG treatment, 14 patients had a primarily refractory disease, 10 patients were relapsing; in 8 cases, autologous bone marrow transplantation had been performed. Tumour sites were in 24 patients: 13/24 local disease, 8/24 bone metastases, and 7 bone marrow involvement. Catecholamines were elevated in 7/24 patients. The median activity of 131I-MIBG per injection ranged from 30 to 108 mCi; the number of injections varied from 1 to 5. We observed 5/10 pain palliations and 10/24 stabilizations of the disease course for 1 to 7 months with no objective volume tumour response. Haematologic toxicity caused a platelet count less than 150,000/microL in 4 patients, less than 100,000 in 1 patient and less than 50,000 in 7 patients.

3-Iodobenzylguanidine↗