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Biomedical subjects

P Schlienger

Publications and source records attributed to P Schlienger.

At least 55 records · Page 3Linked to original sources
PubMed1987

Medullary breast carcinoma: the role of radiotherapy as primary treatment.

The results are reported of a selected series of 41 patients with medullary carcinoma of the breast, treated with primary radiotherapy with (24 patients) or without (17 patients) adjuvant chemotherapy. Complete responses to radiotherapy occurred with moderate doses (67% of the patients had a complete response after a dose of 55-60 Gy) and were increased by the addition of an irradiation boost. The 6-year actuarial free of local recurrence survival, metastase-free survival and survival rates were 86, 83, and 83%, respectively. The 6-year actuarial probability of living with breast preserved was 72%. Recurrences and survivals were not influenced by the tumor size or clinical axillary node status. Adjuvant chemotherapy had no effect on the rate of recurrence or survival.

Adult↗
PubMed1987

Treatment of bilateral retinoblastoma stage V at the Curie Foundation. 33 cases.

A retrospective study was undertaken on 33 patients with bilateral retinoblastoma in whom one eye at least was classified as stage IV or V (Reese-Ellsworth classification). In most cases the other eye had been enucleated elsewhere. Conservative therapy consisted of primary chemotherapy (vincristine, actinomycin, cyclophosphamide) followed by external beam irradiation, six courses of chemotherapy and, if necessary, by cobalt-60 plaques, xenon arc photocoagulation or secondary enucleation. Ten patients were lost to follow-up, eight patients died or are currently being treated for recurrence, 15 patients are alive and free from disease and 42% of eyes at stage IV or V were saved. These results indicate that primary chemotherapy does not improve the final outcome of stage IV or V retinoblastoma, as compared with primary irradiation.

Combined Modality Therapy↗
PubMed1987

[Paget's disease of the nipple without any associated mammary tumor clinically or radiologically detectable. Apropos of 51 cases treated at the Curie Institute].

Between 1960 and 1984, 51 patients with Paget's disease of the nipple, with no concomitant palpable or radiological breast tumour, were treated at the Institut Curie. The diagnosis was made in all cases through a simple biopsy of the nipple and/or the areola. All slides were reviewed for the present study. 20/51 patients were treated conservatively, with external radiotherapy alone (17/20 pts), or limited surgery and radiotherapy (3/20 pts). The mean age was 54 years (range 40 to 80). The median follow-up was 7.5 years. No patients died of breast disease. Three local recurrences occurred and were treated by mastectomy. All were located in the nipple or areola and were Paget's disease without intraduct or invasive carcinoma. The actuarial probability of living 4.5 years free of disease when the breast is preserved with a good cosmetic result is 81%. 31/51 patients underwent mastectomy; 30 a modified mastectomy, 1 a simple mastectomy. The mean age was 66 years (range 55 to 90). Associated intraduct carcinoma was found in 30/31 microscopic examinations. No axillary node invasion was found after dissection of the axilla. In the group treated by surgery, the median follow-up was 5 years. No patient died of breast disease. No chest wall recurrence occurred. The 5 years disease-free survival rate was 87%. This retrospective non randomized study of 51 patients treated for Paget's disease of the nipple suggests that radiotherapy is a valuable alternative to mastectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Conservative treatment of tumors of the retina at the Curie Institute. 5-year ophthalmologic results of 129 cases treated with the Stallard disc and electrons].

The authors report a retrospective study of 129 children with retino-blastoma treated from 1963 to 1977 at the Institute Curie by enucleation of the worst eye and conservative irradiation of the other eye; this irradiation was performed either with Stallard plaque (19 cases) or with electrons (110 cases). In 8 familial cases no enucleation was performed. T.E.M. was used from 1964 to 1973 and iterative photocoagulation has been performed since 1968. Five years absolute NED survival rate was 68% (88/129 children). In these 88 children, 94 eyes were irradiated. Ophthalmological results were as follows: 21 eyes were enucleate secondarily (20/21 were tumoral); the attempt of ocular conservation was succeeded in 78% of the cases: 73 of the 94 irradiated eyes were cured; among these 73 cured eyes, 4 had complications and 15 had sequelae; the others 54 eyes were normal; only 5 eyes escaped ophthalmological survey; for the other 68 eyes vision was evaluated: 2 eyes (3%) were functional but vision could not be measured; 10 (14%) had less than 1/10 of visual acuity; 14 (19%) had vision at least equal to 1/10 but less than 5/10; 42 (57%) had 5/10 or more. 62% of all irradiated eyes (58/94) and 79% of conservated eyes (58/73) had "useful vision". Results are discussed and compared with these published by other teams; the authors try to determine elements of visual prognosis.

Age Factors↗
PubMed1985

Cytogenetic forms of retinoblastoma: their incidence in a survey of 66 patients.

Sixty-six retinoblastoma patients were investigated using high resolution banding techniques, sister chromatid exchange (SCE) studies, and esterase-D phenotype determination and dosage. Seven patients (in six families) were found to be carriers of a rearrangement of band 13q14 due to de novo deletions, apparently balanced de novo translocations, or parental insertions. The possible role of submicroscopic parental insertions is suggested to explain transmission of nonchromosomal forms through unaffected carriers.

Child↗
PubMed1985

[Bone sarcoma and malignant tumors of the retina].

Secondary bone sarcomas are frequent among children who have been treated previously for a retinoblastoma. The main point is that these bone sarcoma occur almost always after a bilateral retinoblastoma and more often in the irradiated area; from these, the classical concept of "radiocancer" was generally admitted. However, since many authors reported bone sarcomas occurring in a different location from the irradiated area, radiotherapy cannot be by itself the causative factor of these secondary bone sarcomas. Therefore the genetical factor is probably one of the predisposing factor. The authors report 6 cases of bone sarcomas with a review of the literature of bone sarcomas occurring in the irradiated field or not, for children "cured" of retinoblastoma.

Bone Neoplasms↗
PubMed1985

[Conservative treatment of tumors of the retina at the Curie Institute. Long-term results of 129 cases treated with Stallard's disk and electrons].

The authors report a retrospective study of 129 children with retinoblastoma treated from 1963 to 1977 at the Institut Curie by enucleation of the worst eye and conservative irradiation of the other eye; this irradiation was performed either with Stallard plaque (19 cases) or with electrons (110 cases). In 8 familial cases, no enucleation has been performed. T.E.M. was used from 1964 to 1973 and iterative photocoagulation since 1968. With a 5 years follow up, 88 children (68%) are living NED, 6 are lost. There was 34 treatment failures (26%) and 1 death from second malignant tumor. At 10 and 15 years, the results are stable despite the occurrence of two other second primary tumors. Irradiation preserved 73/94 (78%) of the irradiated eyes. The technical aspects of the radiotherapy with electrons and both ocular and vital prognostic factors are discussed.

Brachytherapy↗
PubMed1984

Incidence of anterior pituitary deficiency after radiotherapy at an early age: study in retinoblastoma.

Thirty-one patients treated for retinoblastoma in the first few years (3 months to 3 years and 6 months) of life were studied 2 to 15 years later. Radiotherapy delivered 1 300 to 6 500 rads to the hypothalamo-pituitary area. Growth deficiency was documented in 30% of all cases. Other pituitary deficiencies were the exception. The critical dose for GH insufficiency is between 2 000 and 3 000 rads, as in older children or adults. Our study does not support the hypothesis that the hypothalamo-pituitary area is more sensitive to radiation at an early age. Furthermore, conservative therapy of retinoblastoma leads to double lateral irradiation and will increase the number of GH deficient children after retinoblastoma.

Adolescent↗
PubMed1983

[Epithelioma of the lacrimal sac. Review of the literature and analysis of 8 cases].

Eight patients with lacrimal sac epitheliomas are reported and the published literature reviewed. Clinical signs of these very particular type of tumor are described, as well as their method of extension to the upper facial region which has now been perfectly documented by computed tomography images. Papillomatous forms are relatively frequent, progression of the tumors is slow, and the prognosis for recurrences is fairly good if extensive surgery has been applied.

Adult↗
PubMed1982

[Malignant melanoma of the conjunctiva and eyelids: analysis of prognosis in 56 cases (author's transl)].

Long-term prognosis was analyzed by a retrospective study of 56 patients with malignant melanoma of the conjunctiva and the eyelids. Survival rate at 5 years was 85 p. cent, at 10 years 68 p. cent, and at 15 or 20 years 55 p. cent; neither the localization of the tumor nor the type of initial treatment had a significant influence on these rates. Local or nodal recurrences occurred in 80 p. cent of cases, and were frequent following conservative surgery; prognosis is bad after radiotherapy.

Adolescent↗
PubMed1980

[Carcinoma of the breast: diagnosis of sub-clinical bone metastases. Predictive value of isotope bone scan (author's transl)].

The possibility of drawing a distinction between two groups with or without bone metastases is of fundamental importance in the determintion of management. With this in mind, isotope bone scan using Tc 99 was performed routinely in 99 cases of locally advanced non-metastatic carcinoma of the breast. Amongst 121 "operable" (T1, T2, T3, N0, N1a) carcinomas, 4 (3%) had a positive scan. Of these 4 cases, 3 showed evidence of bone metastases within one year, in 3 of which the site was not the same as that predicted by the scan. Amongst 53 "inoperable" (T4, N0, N1, T., N2, N3) cases, 5 (10%) had a positive scan and 5 a doubtful scan. Amongst the 5 positive cases, within one year metastases were seen at the predicted site. In agreement with a large number of authors, it would thus appear that routine isotope bone scan has no role to play in the pretherapeutic assessment of so-called "operative" breast carcinomas.

Bone Neoplasms↗
PubMed1978

Conservative management of operable breast cancer: ten years experience at the Foundation Curie.

514 patients were treated for a surgically operable (T1, T2, T3, N0, N1a, N1b) infiltrating breast carcinoma at the Foundation Curie, Paris, France, from 1960 to 1970 inclusive. Patients with tumors 3 cm or less and without axillary adenopathy had lumpectomy followed by radiotherapy. Patients with larger tumors and all patients with clinically significant lymph nodes (N1b) had exclusive radiotherapy (without lumpectomy). 120 had lumpectomy and 394 had exclusive radiotherapy. The five and ten years absolute survivals, free of disease (N.E.D.), for the lumpectomy are 85% and 75%, respectively. 12% had secondary surgery for local recurrence. The cosmetic results were satisfactory in 98%, with no severe radiation sequelae. The five and ten years, N.E.D., of the exclusive radiotherapy group are 68% and 43%. 55% had secondary surgery for persistent or recurrent disease. The cosmetic results were satisfactory in 85%. There were only three patients with severe radiation sequelae. The overall survival for 514 patients at five and ten years are 72% and 51%. Two-thirds of patients, alive at five years, had a preserved breast. Our conservative treatment resulted in survival at five and ten years comparable to those of radical surgery.

Adult↗
PubMed1977

[Prognostic factors in epitheliomas of the breast].

Prognostic factors in breast carcinoma were studied on material which consisted of 733 patients with a follow-up of over 5 years and on 361 with a follow-up of over 10 years. In the first part of the study the prognostic factors are related to the physical characteristics of the primary tumour such as its situation and size and its relationship to skin and deep tissues. Clinical examination of the axilla, studied in detail, has proved a reliable guide to prognosis. The second part deals with such factors as age, hormonal status, age at first pregnancy and parity. A critical analysis of the T.N.M. classification ends the study, with special reference to the prognostic factors which relate to the primary tumour.

Adult↗
PubMed1977

[Isotopic bone examination in operable breast cancer].

In the pre-treatment work-up in breast carcinoma cases the bone scan findings could be of major interest. If the presence of occult metastases is discovered management may be modified accordingly. In a group involving 78 cases of breast carcinoma, classified as primary, operable, in three cases only scintigraphy revealed bone metastases before they produced clinical and radiological signs. In two of them there was agreement, in one disagreement over the findings. Moreover, in 5 cases a bone metastasis was revealed and immediately confirmed on a complete bone assessment.

Bone Neoplasms↗
PubMed1977

[The place and limitations of therapeutic regimens in the management of breast epitheliomas. 10 year results].

Between 1960 and 1966, 258 carcinomas of the breast with a follow up of 10 years or more formed a group which had been treated conservatively. Two conservative approaches were used, either lumpectomy followed by irradiation, or irradiation, alone, surgery being reserved for failures. At 10 years the survival rate of 51 p. 100 with no sign of recurrence is comparable with the results of radical or modified mastectomy. Among those living with no sign of recurrence 61 p. 100 had retained their breast almost always with a satisfactory aesthetic result. The place of lumpectomy followed by irradiation is reserved for single lumps of small volume and unaccompanied by axillary lymph node enlargement.

Aged↗