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N Daly

Publications and source records attributed to N Daly.

At least 37 records · Page 2Linked to original sources

Fracture-dislocation of the talus in the pediatric patient. An unusual injury.

Subtalar fracture-dislocations in children are unusual, perhaps because of the greater elasticity of bone in children. The authors have presented a case of medial subtalar dislocation in a 13-year-old boy, accompanied by a rare fracture of the entire posterior process of the talus. This particular fracture has not been previously reported in association with a subtalar joint dislocation, nor has it been reported in a child. The patient was treated successfully by closed reduction of both the dislocation and the fractures.

Adolescent↗

[Laitinen's stereo-adapter: application to the fractionated cerebral irradiation under stereotaxic conditions].

Radiosurgery is a technique which provides a single high dose of radiation very precisely to an intracranial lesion. The volume of tissue treated is small enough to avoid undue biological damage. This treatment requires very sophisticated apparatus and often considerable modifications in the treatment apparatus. The authors have closen to elaborate a system which makes it possible to deliver conventional fractionated irradiation, using a non-invasive stereotactic head frame called "Laitinen stereo-adapter". By fractionating the dose, most benign or low-grade malignant brain tumours can be treated, whatever their volume. The stereo-adapter and the target localization process are described. It can be used with C.T. scanning, angiography or M.R.I. The treatment apparatus is a linear accelerator delivering a 10 M.V. photon beam and treatment is made in the precise positioning of the target localization. The geometrical accuracy of the repeated mountings was studied in a preliminary study, showing a mean discrepancy of less than 1 mm in the three space planes. The geometrical accuracy of the radiation treatment was also studied on a phantom and the precision evaluated at less than 1 mm. The addition of extra collimators with a precollimation system decreased the lateral penumbra to 2-3 mm. Careful dosimetry was performed for each collimator. The use of non-coplanar arcs makes it possible to obtain a steep dose fall off outside the target volume. The dose planning calculations were compared to photodensitometry and thermoluminescent measurements, showing a good correlation. Each technical point will be discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗

Radiation therapy of carcinomas of the skin of nose and nasal vestibule: a report of 1676 cases by the Groupe Europeen de Curiethérapie.

A retrospective multicentric analysis of the results of irradiation of 1676 carcinomas of the skin of the nose and nasal vestibule was performed by the Groupe Européen de Curiethérapie (Tunis, May 1986). Overall local control was 93% with a minimum follow-up of 2 years. Local control is dependent on the tumor size (diameter less than 2 cm: 96%, 2-3.9 cm: 88%, greater than or equal to 4 cm: 81%), and tumor site (external surface of the nose: 94%, vestibule: 75%). Local control was independent of histology for smaller tumors, but for those larger than 4 cm, basal cell carcinomas were more frequently controlled than squamous cell carcinomas. Recurrent tumors are less frequently controlled than those being treated for the first time (88 vs. 95%). There were few complications and cosmetic results were generally satisfactory. The results of implantation, orthovoltage and megavoltage irradiation are compared with respect to local control, complication rate and cosmesis. Implantation is usually the treatment of choice for vestibular tumors but for those of the external surface the choice depends on the tumor diameter. Implantation and orthovoltage irradiation are equivalent for tumors less than 2 cm. For those from 2 to 3.9 cm, the results of orthovoltage irradiation may be satisfactory in a selected population but implantation is usually more suitable for tumors with rapidly changing contour.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Radiotherapy alone in carcinoma of the intact uterine cervix according to G. H. Fletcher guidelines: a French cooperative study of 1383 cases.

A French Cooperative study of 1383 cases with invasive carcinoma of the intact uterine cervix treated with radiation therapy alone, using the guidelines provided by G. H. Fletcher led to the following conclusions: The techniques of treatment were easily reproducible in 9 French centers, working in a prospective cooperative study; Results similar to those of the original study were achieved in Stages I and IIA (MDAH substaging) with a locoregional failure rate of 7%; In Stage IIB, the locoregional failure rate of 16% is also comparable in both studies; Locoregional failures in Stage III are slightly lower than those reported in Houston, probably reflecting differences in patient's prognostic factors in France and Texas; The 5-year survival rate obtained in advanced Stages (UICC FIGO staging) are among the highest in the literature (76% in Stage IIb, 62% in Stage IIIa and 50% in Stage IIIb); The rate of severe complications remains acceptable and decreased throughout the study thanks to a better use of computer dosimetry.

Female↗

[Rectal cancer].

Explore the source record for details and available documents.

Humans↗

[Long-term results of the treatment with physical agents exclusively in a series of cancers of the uterine cervix. Cooperative study of 1,383 cases].

The authors present a study of 1,383 cases of invasive carcinoma of the cervix treated exclusively by radiotherapy between 1970 and 1981. Combination external radiotherapy followed by intra-cavitary applications was carried out. The study was carried out in 9 different radiotherapy centres in France using the same protocol and the same recording systems. The therapeutic results which have been recorded at every stage are among the best obtained until now, with 90% success for stage I after 5 years, 80% success for stage II, 52% for stage III growths. Only 2.1% failures occurred in the cervico-vaginal region. Pelvic recurrences were 7% in stage I and IIA, 14% in stage IIB and 24% in stage III. These recurrence rates are lower than have generally been recorded. Complication rates are also low and became less as the study continued, thanks to better use of dose distribution in individual cases which took note of doses received by neighbouring organs. The prognostic value of lymphography was analysed.

Cesium Radioisotopes↗

[Curietherapy of palpebral epithelioma with iridium-192. Method and results apropos of 192 cases treated at the Claudius-Regaud Center].

Authors report a series of 192 eyelid epithelial tumors (187 patients) treated by curietherapy (192 iridium) at the Centre Claudius-Regaud, from January 1977 to December 1982. Curietherapy is an interstitial radiotherapy technique which inserts radio-active lines directly in the epithelial area. The first part of treatment consisted in using disposable vascular catheters as after loading procedure. In 90% of the cases, lesions were either on the lower lid or on the inner canthus. Tumors were mainly of basal cell type (77%). One thousand forty one tumors occurred in untreated patients: treatment was made for local recurrences in 51 cases. The control rate was 97% (186/192). Six recurrences were all observed in basal cell carcinoma. Four of them were cured by a second curietherapy, the two others needed a large surgical enucleation followed in one case by external radiotherapy. Late side effects essentially were functional and ocular. Functional side effects (19% of the series) consisted in eyelid hole reduction (5%), epiphora stenosis (6%), ectropion (4%) and loss of substance (4%). Ocular complications (3% of the series), were ulcerated cornea (one case) hypertrophic conjunctivitis (one case), iatrogenic cataract (two cases) and enucleation for recurrence (two cases). Iridium 192 curietherapy allowed a high local control rate. The best results were seen in untreated patients. Iatrogenic cataract eventually would be avoided by the use of lead contact lenses (recent utilisation not included in this series).

Adult↗

[Carcinoma of the nasopharynx. Clinical signs and therapeutic problems].

Most of the carcinoma of the nasopharynx diagnosed in our country, are loco-regionally advanced disease. Thus 31/54 (57%) of our patients referred to the Centre Claudius Regaud between 1970 and 1980 were T2 N3, T3 N3, T4 N0 or N1 N2 N3. In spite of this poor initial presentation external radiotherapy can achieve a quite good rate of tumoral control inside the treated volume. In our series there were 17/47 (36%) tumoral and/or nodal recurrences and 7/47 (15%) metastases without local or regional failure. Improvement of initial évaluation of the tumoral volume is now obtained by the systematic use of C.A.T. and this procedure should reduce local failure rate. In the other hand, the association of chemotherapy and radiotherapy should be useful in treating advanced disease or poorly differentiated carcinomas with high metastatic risk.

Adolescent↗

[Thyroid trabecular carcinoma. A clinicopathological entity of poor prognosis? (author's transl)].

The records of 32 patients with trabecular carcinomas of the thyroid gland were critically reviewed from a previously published serie of 138 thyroid cancers referred to the Centre Claudius Regaud, between 1952 and 1973. On the basis of clinico-pathological considerations, it seems possible to divide trabecular carcinomas into two groups. Pure trabecular carcinomas (moderately differenciated follicular carcinomas--WOH) which have a poor prognosis (5 years actuarial survival: 13%) related to high rate of local recurrences, fast metastatic spread to the lung, bad response to suppressive hormonotherapy and lack of 131 iode uptake by malignant tissue. Mixed trabeculo-vesicular carcinomas which have in comparison a fairly good prognosis (5 years actuarial survival: 63%) in keeping with a lower tendency to local recurrences and a useful concentration of radioactive iodine by metastases (most of them located in the skeleton) although dependent on the pourcentage of vesicles in the tumor process. Among differentiated thyroid carcinomas, distinction between pure trabecular and mixed trabeculo-vesicular carcinomas with quantitative determination of vesicules seems of great interest in relation to the therapeutic approach.

Adenocarcinoma↗

[Cervical lymph nodes metastasis from an unknown primary: diagnosis, treatment and prognosis. A retrospective study of 127 cases observed from 1959 to 1973 (author's transl)].

Authors present clinical records of 127 patients bearing metastatic cervical lymph nodes of unknown origin and referred to the Cl. Regaud Cancer Center between 1959 and 1973. According the prognosis, it is possible to distinguish patients into three groups. In group I, patients (10%) have a lower neck involvement by an adenocarcinoma. The survival is dramatically bad. Group II includes also 10% of patients who have a fairly better prognosis, they are younger people bearing poorly differenciated squamous metastatic lymphonode(s) in the upper neck. Group III. The remaining eighty per cent of patients are heavy drinkers and smokers. Their upper neck is hurt by lymphatic metastases from a well or moderately differenciated squamous cell carcinoma. They have much about the same prognosis than people bearing a known primary carcinoma of the upper aerodigestive tract. After having excluded the first group of patients who is at high risk of having a widely disseminated illness, we can remark that about one half of relapses occurred in the cervical area. A well planned combination of neck dissection and whole cervical lymphatic areas irradiation may further reduce such recurrences and so may enhance the present results: 23% survival 3 years after completion of treatment.

Adenocarcinoma↗

[Influence of inaccuracy of certain parameters on dose distribution in telecobalt therapy (author's transl)].

Progress in dosimetry and in radiobiology together with the evolution of radiation generators led to adopt very elaborated radiotherapy protocols. However, the therapist should have confidence in these protocols on condition that irradiation parameters are strictly respected. For obvious reasons, this is impossible despite the meticulous rules. In this, paper, we therefore intend to study the role of the angle of incidence on the actual distribution of doses; we also study the inaccuracy of certain parameters recorded during preparation for the therapy or shown during successive irradiation courses. In this paper we retain only errors which can be easily quantified. These are errors concerning the irradiation apparatus (source to skin distance, angle of the rays, field dimension) and those due to factors related to the patient treated: contour measurement, entrance point of rays and positional changes of the patient. The different errors can be associated in various ways for a given therapy protocol. For the same reason, an isodose of a given nominal value will have several curves. All these tracings are lined by two curves which we call "superior and inferior envelops": these border the "incertitude area". It can be said that at the end of the treatment, the given isodose lies in this area; it is however impossible to define its form or exact position. A few examples in the text illustrate these results and show the possible practical angles of incidence. If we assume that errors during successive irradiations are distributed at random, a certain compensation is noted and the "areas of incertitude" decrease. But if the errors are constantly on the same side, as is sometimes the case, the dose distribution can be very different from that predicted in the dosimetric protocol.

Breast Neoplasms↗

[Fifty cases of penile tumors treated at the Claudius-Regaud center from 1958 to 1973].

From the study of this series of 50 patients suffering from cancer of the penis, and in particular from the comparison of two successive groups, several facts stand out which determine our present attitude: -subjects suffering from cancer of the penis, at least in our area, are aged, fragile people, whose cause of death, in more than half of the cases, was not the penile cancer. Proposable therapeutic methods must take this specific background into account; -tumoral and glandular indications must be looked at separately, as there does not seem to be any strict correlation between the size of the tumor and glandular invasion; -inguinal glandular invasion must as far as possible, be proved histologically, whatever the appearance of adenopathy on palpation; -No and N-patients should not be treated in the inguinal folds, but carefully followed-up; in this connection, very strict follow-up, at least for the first three years, seems to be indispensable; -N+ patients must evidently undergo bilateral removal and subsequent irradiation. This therapeutic attitude, leads to bilateral edema of the lower limbs in a high percentage of cases, against which no therapy is at present active; -tumors of the penis, classified T1, T2, or T3 are best benefitted by the technique of interstitial curietherapy using irridium 192, the only conservative technique offering a high level of local sterilization, without major after-effects; it permits possible reparatory surgery; -on the other hand, T4 tumors cannot be marked, the target-volume being too large, and they justify radical surgery.

Humans↗