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P F Combes

Publications and source records attributed to P F Combes.

At least 19 recordsLinked to original sources
PubMed1979

[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↗
PubMed1979

[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↗
PubMed1979

[Radiation therapy for stage IV carcinoma of the cervix (author's transl)].

Fifty four cases of stage IVa carcinoma of the cervix and treated with radiotherapy were collected between 1971 and 1977. Overall actuarial survival was 16 per cent at 3 years and almost all the deaths occurred before that time. Amongst the factors studied, the initial size of the pelvis tumour and lumbo-aortic lymphography findings were the determing factors in the prognosis. To a lesser extent, the age of the patient, tumour differentiation and the amount of irradiation modified the prognosis. It was thus possible to define, within the stage IVa category, several prognostic groups, the determination of which has therapeutic consequences.

Female↗
PubMed1977

[Kinetics of I-131 fibrinogen in cancer patients: pharmacological approach].

The results obtained in a previous study using 131I fibrinogen in cancerous patients suggested a local intravascular clotting precess. In order to elucidate the mechanism of fibrinogen kinetic abnormalities different drugs, including heparin, prednisone, ticlopidin, aspirin and indomethacin were administered in 68 patients and their effects evaluated by change in the 311I fibrinogen disappearance rate. The results suggest that these drugs may counteract with the early stages of coagulation (kinin-forming system, factor XII) and that abnormal 131I fibrinogen kinetic in cancer would be a non specific phenomenon.

Aspirin↗
PubMed1977

[Thyroid carcinomas. Critical study about 138 observations. Therapeutic deductions (author's transl)].

Between 1952 and 1973, 138 patients with thyroïd carcinoma have been recorded. From the critical study of these cases, the pathological, etiological and clinical features have been studied. Different therapeutic modalities are evaluated from these cases. Surgery was always used when possible. A hemithyroïdectomy was realised most often. We stress that sterilisation was obtained by 131I treatment in plurifocal metastasis, particularly in pulmonary metastasis, only when the iodine uptake was sufficient. Survival has been evaluated according to the pathology: papillary and vesicular carcinomas have a good prognosis (the papillary and vesicular survival rate at 10 years reaches respectively: 65% and 64%). Anaplastic carcinomas have a bad prognosis (the survival rate at 5 years is 18%, at 10 years, 0%. These results are similar to those published by differents authors. At the opposite, trabecular carcinomas have a very short survival (8% at 5 years, 7% at 10 years) which is very unusual in well differentiated thyroïd carcinomas. It has to be isolated from the others.

Age Factors↗
PubMed1977

[Evaluation of the results of radiotherapy in 14 cases of malignant thymoma. Therapeutic prospects].

The authors present a critical review of 14 cases of malignant thymomas. They point out that the development of the tumours is similar to Hodgkin disease's (13 relapses in contiguous areas), that surgery is never sufficient for cure and that radiosensitivity is high (in 8 patients radiotherapy alone results in a total and early regression of the tumour). Therefore the authors propose a complementary post-operative treatment by limited irradiation and MOPP type polychemotherapy. This temporary choice of treatment can be reevaluated after further case studies. To facilitate this they wish that a cooperative project could gather the rare and dispersed observations of different centers.

Adult↗
PubMed1977

[Influence of the diagnosis of Hodgkin's disease on the quality of life of cured patients].

Authors present results of an inquiry dealing with familial and socio-professional reinsertion of 130 patients who have been treated for Hodgkin disease. On a family point of view, after treatment, the rate of single people is higher than in general population. Even though one can observe marriages, and feminine sterility is rare, the number of children by married couple remains low. There is no change in rate of house moving. Most of cured patients return to work. This fact is related to duration of treatment, but variations depend essentially of familial situation, kind to work and quality of previous social insurance. For two groups of people risk of unemployement is higher: agricultural labourers who are often dismissed and contractual civil servants who meet with difficulties to be established. Definitive invalidity is rarely conceded by wearied social organisms. Finally cured patients appear most of the time comparable with healthy population. However they meet with important difficulties to get a loan or to contract a life insurance. Premiums are frequently raised and policies restricted. Difficulties are not related to organic sequelae. Cured patients still remain suspicious for their entourage and employer, that bring them about to hide the pathologic episode.

Adolescent↗
PubMed1976

[The half-life of iodine 131-labelled fibrinogen in cancer patients. Effects of heparin].

Sixty nine patients suffering from malignant tumours at different stages of their development underwent a kinetic study of fibrinogen 131I with external counting over the tumour and a study of haemostasis including P.D.F. The 1/2 T of fibrinogen 131I is shortened: 2.52 +/- 0.09 days (normal: 3.89 +/- 0.11 days.) The abnormality is proportional to serum P.D.F. levels (r=0.99). External counting demonstrated the uptake of labelled fibrinogen in the tumour. Heparine (15000 U/24h) restores the 1/2 T of fibrinogen to normal in 95 p. cent of cases. The results suggest the existence of a localised compensated intravascular coagulation process inside the tumour. Possible consequences of that phenomenon are discussed.

Blood Coagulation↗
PubMed1976

[Contribution to the scintigraphic diagnosis of malignant endothoracic tumors by 57Co labeled Bleomycin (author's transl)].

The authors report the results of the exploration by 57Co Bleomycin scinitigraphy in 97 thoracic tumors. The Bleo-57Co scintigraphy detects primary and secondary malignant tumors underevaluated by classical tests. In the thorax, the radioactive focus are easily detected on account of the light physiological fixation of the Bleo-57Co. It is particularly interesting in the mediastinal tumors where the picture is not covered by cardiovascular interference. Mediastinal, pleural and costal tumors have been explored. Pulmonary tumors give the best results, they fixe in 93% of the case. All the mediastinal tumors have capted the bleomycin but the authors insist on the fact that the fixation was very light even when the tumor was a large one. The exploration of pleural and costal tumors was less interesting. In conclusion, the Bleo-57Co scintigraphy, gives indications about the volume of the tumor and its spread in the organism. By this method, we can diagnose malignancy in tumor. It can be used to survey cancer patients which have been treated. Nevertheless the long half-life (270 days) and the lack of specificity of the Bleo-57Co for the malignant tumors, justify discussion about indications and the results of such an exploration.

Bleomycin↗
PubMed1975

[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↗
PubMed1975

[Late progressive radiation myelopathies. A study of 27 cases].

Several conclusions seem evident from this study : firstly radiation myelopathies exist without any doubt; secondly clinical observation, even very attentive, during irradiation is perfectly blind regarding this subject; lastly, one can only, at this time, attempt to anticipate medullary accidents caused by irradiation. Radiation myelopathies exist incontestably. We report 27 new cases which are added to the more than 500 cases already analysed in the world litterature. The improvement of results of cancerology and in particular of radiotherapy make and will continue to make the number of observations published increase. However, if there is no doubt as to existence of these myelopathies, discussions persist concerning their nature : purely vascular, cytotoxic, probably mixed, perhaps maintained and prolonged by a superimposed immunologic phenomenon. Prevention is the sole method at our disposal to be effective. It must be applied as much to the patient as to the technique of irradiation. With regard to the patient treated in a medullary volume, several factors are probably favorable to the development of myelopathy and must cause one to modify eventually the technique of radiation proposed : the existence of anterior vertebral medullary pathology, whatever its nature; two ages demonstrate increased incidences : the young which have relative immaturity of tissue (we report 4 cases patients less than 25 years old), and the old, whose chances of accumulating associated pathologies are great, especially as systemic hypertension and arteriosclerosis are likely to have played a favorable role; the patients for whom restraint is difficult or who present disrupted regions anatomy are qually much more fragile. With regard to the technical plan, several factors incontestably favor the appearance of radiation myelopathy : large medullary volumes irradiated, especially when they encompass the zones of vascular medullary junction; the overlap of fields involving the spinal cord; the reduction of fields too close to the spinal cord not allowing at least 1 cm margin of relative security; the association of physical agents in the measure to which the global dosimetry is uncertain, i.e. in particular the use of high energy electrons for boost dosage, the intensity of which must be chosen with the greatest prudence; finally and most importantly, it seems desirable to us not to surpass at the level of the spinal cord, treating 5 times per week, a dose of 5 000 rads with fractions of 200 rads of 4 500 rads with fractions of 250 rads, and of 4 000 rads with fractions of 300 rads. Can one reasonable pretend always to foresee all radiation myelopathies? No, for on the one hand there exist authentic cases which have occured after doses which were below the limits of tolerance which we have indicated above, in accordance with others authors, and on the other hand, the necessity of sterilising certain inoperable tumors obliges one sometimes to deliver to region of the spinal cord aggressive doses.

Adult↗