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Biomedical subjects

R A Guerin

Publications and source records attributed to R A Guerin.

At least 19 recordsLinked to original sources
PubMed1992

Multidisciplinary treatment approach to locally advanced non-inflammatory breast cancer using chemotherapy and radiotherapy with or without surgery.

Between April 1982 and December 1987, 82 locally advanced non-metastatic and non-inflammatory breast cancers were treated (42 stage IIIA, 40 stage IIIB). The median follow-up is 70 months from the beginning of the treatment. The initial treatment consisted of 4 courses of chemotherapy (doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil) followed by irradiation (45 Gy to the breast and nodal area). A fifth course of chemotherapy was given after radiation therapy. Three different locoregional approaches were proposed depending on the tumoral response. In 32 patients (39%) with residual tumor larger than 3 cm in diameter or located behind the nipple or with multifocal tumors, mastectomy and axillary dissection were performed. Fifty other patients (61%) benefited from conservative treatment: 32 patients (39%) achieved complete remission and received a boost to the initial tumor bed; 18 patients (22%) who had a residual mass less than or equal to 3 cm in diameter were treated by tumorectomy and axillary dissection followed by a boost to the tumorectomy site. After completion of local therapy, all patients received a sixth course of chemotherapy. A maintenance adjuvant chemotherapy regimen without anthracycline was prescribed (12 monthly cycles). Three- and 5-year disease-free survival rates were 81.7% and 72% respectively. Five-year locoregional relapse rate (with or without other sites of failure) was 8.8%. In a multivariate analysis, disease-free survival was significantly influenced by the N-stage (p < 0.0001), initial tumor size (p = 0.01), and tumor response after initial chemotherapy (p = 0.02). Five-year breast conservation probability was 58.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Breast cancers, apparently non-metastatic, treated by prior chemotherapy and radiotherapy, combined with or without excision surgery. Preliminary results].

Combined treatment modality was applied in 51 consecutive patients with locally advanced breast carcinoma between December 1982 and December 1984. The treatment was started with 4 cycles of chemotherapy with combination of adriamycin, vincristine, 5-fluorouracil and cyclophosphamide. This was followed by high-energy radiotherapy (45 Gy to the breast and lymphatic areas), with or without surgery. After radiotherapy, the response rate was 76%: 39/51 (complete response 39%: 20/51). Twenty-nine patients (57%) were treated conservatively (20 treated by radiotherapy alone and 9 treated by tumorectomy with axillary dissection followed by interstitial implantation). For 22 patients (43%), the mastectomy with axillary dissection was necessary. The three year overall survival rate and disease free survival rate were 88, and 86%. Local recurrences occurred in one patient (2%). The toxicity with this combined treatment regime was low. The cosmetic results were acceptable when a conservative treatment was proposed.

Adult↗
PubMed1988

[Stage I and II Hodgkin's disease with enlarged mediastinum in adults. Apropos of 24 cases].

We have reported a retrospective study on 24 cases of supra-diaphragmatic Hodgkin's disease Stage I and II, with massive mediastinal invasion, followed from January 1981 to October 1986 and treated first with chemotherapy and then supra-diaphragmatic mantle type radiotherapy up to a dose of 40 Gy in 20 sessions and over 26 days; inverted irradiation was given to the aorto-lumbar region and the spleen up to a dose of 30 Gy in 15 sessions over 19 days. Supplementary irradiation to the superior mediastinum on average 10 Gy in five sessions over five days was given in two cases and five Gy in three sessions over three days in four cases. After initial chemotherapy there appeared to be a complete remission in 29% (7 out of 24), there was a partial remission in 71% (17 out of 24), of which one gave a 25% response, two a 50% response and 14 gave a response of greater than 80%. After radiotherapy the remission rate appeared complete in 96% (23 out of 24). The overall survival was 90% (19 out of 21) with a mean follow up of 45 months (range 8-78 months) with a complete remission level of 85.5% (18 out of 21). For the 13 cases followed for five years the overall survival level and the level of survival in complete remission was 84.5% (11 out of 13) and 77% (10 out of 13) respectively. We have seen symptomatic post radiotherapy pneumonia. The association of chemo and radiotherapy in this limited series of patients has enabled us to obtain a satisfying duration of remission.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Assessment of the quality of life of cancer patients. The preliminary applications to advanced bronchial cancers].

So far there is no good evidence that chemotherapy improves survival in non small cell lung cancer. Reports of randomized trials testing chemotherapy versus supportive treatment alone are very few. In recent years, more and more emphasis has been put on the quality of life for cancer patients. Subjective tests such as Anamnestic comparative self Assessment (A.C.S.A. test, Dr. Bernheim) were designed as well as objective ones, using different types of self evaluation. However very few studies have been focused on this aspect in patients with non small cell lung cancer. Therefore the G.E.T.C.B. (Groupe d'Etude et de Traitement des Cancers Bronchiques) decided to initiate a cooperative randomized trial (02 CB 84) in metastatic epidermoid and large cell bronchus carcinoma, in order to test the potential benefit from chemotherapy in these tumors and how it affects the quality of live. In this trial, C.O.P.A.C. combination (Cyclophosphamide, Vincristine, Cis-Platinum, Adriamycin and CCNU) is randomized versus no chemotherapy. The quality of life is assessed monthly on the one hand by a modified A.C.S.A. test performed by a physician and on the other hand by a question list given to the patient. This question list attempts to evaluate the impact of disease as a reference point. Finally protocol 02 CB 84 (activated in 05/84) may give information about the effect of chemotherapy on both survival and quality of life.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Invasive carcinoma of the thymus. A multicenter retrospective review of 56 cases.

This multicenter retrospective study included 56 cases of histologically reviewed invasive epithelial thymic tumors. All these patients underwent surgical treatment or exploration and were referred for complementary radiotherapy. The majority received a dose higher than 4000 rad. Twenty-three out of 50 patients (46%) with incomplete resection received some chemotherapy. The local recurrence rate at 2 yr was 34%. The overall 5-yr actuarial survival was 46%. There was no evidence of any relationship between radiation dose and local control. No difference in survival was observed with or without chemotherapy, nor according to histological type or lymphocytic infiltration, except cases with very undifferentiated carcinomas which presented a worse prognosis. Nor was any difference in survival observed between patients benefiting from incomplete resection and those only having undergone exploratory thoracotomy and biopsy. Radiotherapy seems to decrease the rate of local recurrence in invasive carcinoma of the thymus. The role of chemotherapy is still debatable, but it could have a role in decreasing tumor volume before radiotherapy. This study has shown the necessity of histological review by a panel of histopathologists in an attempt to better define terminology and diagnosis. A prospective study is necessary in order to solve the problems of concepts and management in epithelial thymic tumors.

Adolescent↗
PubMed1983

[Primary lymphoma of the central nervous system. Apropos of 8 cases].

Eight cases of intracranial primary lymphoma are reported. This condition accounts for 1.6% of all lymphomas. Although diagnosis is only confirmed by cerebral biopsy or surgical excision, it may be suggested by CT scan in multifocal forms. No localizations were demonstrated outside the CNS upon thorough clinical and radiological investigations or postmortem examination. Prognosis is poor: 5 patients died within four months. Tumor size and meningeal invasion are of more prognostic significance than the histological type. The authors advocate conventional radiotherapy delivering 45 000 grays over 5 weeks. Chemotherapy must be added in huge tumors or when meningeal invasion is present.

Adult↗