Search PubMed⌕ Search

Biomedical subjects

B Chauvet

Publications and source records attributed to B Chauvet.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Predisposing factors for local recurrence after conservative treatment of breast cancer].

The factors predisposing to local relapse after conservative treatment of early stage breast cancer are controversial. To determine these factors, we analysed the results obtained in a series of 512 patients consecutively treated for invasive breast carcinomas by conservative surgery and radiotherapy. All patients were treated by tumorectomy and axillary dissection, radiation therapy of 45 Gy to the whole breast with a boost of 15 Gy to the tumor area, and adjuvant medical treatment for 168 out of 187 patients. The overall 5-year and 10-year survival rates were respectively 92.5% and 79.9%. The actuarial 5-year and 10-year local control rates were respectively 91.2% and 83.6%. Local relapses occurred in 35 patients. Local relapse occurred more frequently in premenopausal patients, in patients less than 50 years-old as compared to older patients, in patients with low body-mass index (BMI), and in patients with small breast size. Local control was not significantly affected by tumor size or node involvement. With multivariate analysis, the only factor influencing local control was the body-mass index: the actuarial risk of local relapse was increased by 5.7 in patients with a BMI less than or equal to 22 as compared to patients with a BMI greater than 22 (p less than 0.02). We concluded that although certain clinical factors such as age, menopausal status, breast size and body-mass index have an influence on local control, these factors are not sufficiently discriminant to question the indication of conservative treatment. There is a need to individualize factors that could allow a better discrimination of patients with a high probability of local relapse.

Adult↗
PubMed1990

[Epithelial cancer of the ovary in adults: prognostic and therapeutic study of 95 cases].

The authors report 95 cases of ovarian carcinoma treated between 1st January 1975 and December 1986 in the department of gynecology and radiotherapy of hospital Bretonneau in Tours. The overall actuarial 5-year survival was 37.5%, for stage I 100%, stage II 51%, stage III 36%, stage IV 5%, grade I 88%, grade II 51%, grade III 18%. The authors stress the prognostic importance of histologic grade and the bad prognosis of small cell ovarian carcinoma with hypercalcemia. The authors propose a therapeutic attitude based on the results and a review of the literature.

Actuarial Analysis↗
PubMed1990

[Pure primary retroperitoneal seminoma in a woman. Apropos of a case].

The authors report a case of a stage IV retroperitoneal seminoma in a patient of 43 years of age diagnosed after histological examination of a biopsy specimen from the left sub clavicular lymph mode showed metastatic seminomatosis. After complete assessment including and abdominal and pelvic ultrasound, a CT scan of the abdomen and pelvis, an intravenous urogram, a lymphogram and serial estimations of tumour markers (alpha feta protein and beta HCG) a laparotomy was carried out. This made it possible to take a retroperitoneal biopsy as well as to carry out a total hysterectomy without conservation of the ovaries. From all this we concluded that we were dealing with a straightforward very large retroperitoneal seminoma. The treatment was continued with large doses of chemotherapy using Vinblastin, Cisplatin and Bleomycin (V.C.B.). She received 5 treatments of this and then had radiotherapy. The authors report this first case described in the literature (because they found no other in women) and what made them decide on the therapy.

Adult↗
PubMed1990

[Radiotherapy of inoperable esophageal cancer. Retrospective analysis apropos of 108 cases].

Between 1976 and 1986, we treated with curative intent, 108 patients with inoperable esophageal cancer. Eighty-three patients (77%) were treated with radiation therapy alone with a mean total dose of 61 Gy and 25 (23%) patients were treated with induction chemotherapy followed by radiotherapy. Actuarial survival, site of failure, sequellae of treatment, and prognostic factors were analysed in this retrospective study. Survival rates at 2, 3 and 5 years were 23, 16 and 9%, respectively. Local failure occurred in more than 61% of documented failures. Patients with tumor located in the upper third of the esophagus, or with total tumor stenosis or poor performance status had low results, but the difference was not statistically significant. Patients treated according to CT scan plans had a 43% 3-year survival rate; this difference is statistically significant (P = 0.0001). Induction chemotherapy improved one year local control and survival rate (60%), but no long term survival benefit was observed. We conclude that inoperable esophageal cancer can be treated successfully by radiotherapy with a curative intent. We also discuss the role that CT scan planning can play in the effective treatment of these patients.

Actuarial Analysis↗
PubMed1989

Carcinoma of the uterine cervix stage IB and early stage II. Prognostic value of the histological tumor regression after initial brachytherapy.

In our center limited centro pelvic invasive carcinomas of the uterine cervix (less than 4 cm) are treated with brachytherapy and surgery. With these therapeutic modalities no residual carcinoma was observed for 80% of the patients. The purpose of this study was to evaluate our results with this treatment, and to evaluate the prognostic value of the pathological status of the cervix. From 1976 to 1987 we have treated 115 patients with these modalities. Staging system used was the FIGO classification modified for Stage II (divided in early Stage II and late Stage II). Patients were Stage IB (70 cases) and early Stage II (45 cases); 60 Gy were delivered with utero vaginal brachytherapy before any treatment. Six weeks later a radical hysterectomy with pelvic lymphadenectomy was performed. Twenty-one patients with positive nodes received a pelvic radiotherapy (45 to 55 Gy). Local control rate was 97% (100% for Stage IB and 93% for early Stage II). Uncorrected 10-year actuarial survival rate was 96% for Stage IB and 80% for early Stage II patients. No treatment failure was observed for Stage IB patients. Ninety-two patients (80%) had no residual carcinoma in the cervix (group 1) and 23 patients (20%) had a residual tumor (group 2). The sterilization rate of the cervix was 87% for Stage IB tumors versus 69% for early Stage II, and was 82% for N- patients versus 68% for N+ patients. Ten year actuarial survival rate was 92% for group 1 and 78% for group 2 (p = 0, 1). Grade 3 complications rate was 6%. We conclude that brachytherapy + surgery is a safe treatment for limited centro pelvic carcinomas of the uterine cervix (especially Stage IB) and that pathological status of the cervix after brachytherapy is not a prognostic factor.

Adenocarcinoma↗
PubMed1989

[Cancer of the tonsillar region. Role of irradiation in treatment].

In our center, carcinomas of the tonsillar region are usually treated by radiotherapy. This study presents the results of our treatment experience over ten years. Between 1976 and 1986, we treated 137 patients with carcinoma of the tonsillar area. The mean age was 54.3 years. The UICC TNM staging of 1979 was used: 63% of the patients had T3 and T4 tumours and 53% had lymph nodes at the first examination. All patients were treated by radiotherapy, alone for 121 patients and associated with brachytherapy for 16 patients. 61 patients received induction chemotherapy with Cisplatinum. Local control rate at the primary site was 56%, and was respectively 92%, 71%, 57% and 11% for T1, T2, T3 and T4 tumours. Local control rate in the neck was 72%. The 5-year actuarial survival rate was 34%. Distant metastasis occurred in 12 patients. 9 patients had a second primary tumor. Node status and stage were the main prognostic factors. Age, sex, histological subtype were not prognostic factors.

Carcinoma, Squamous Cell↗
PubMed1989

[Carcinoma of the cervical stump. Retrospective analysis of 43 cases].

Seven to eight percent of cervix carcinomas are carcinomas of the cervical stump. The prognosis for these tumors has sometimes been considered more unfavourable than that for carcinomas on intact uterus. From 1976 to 1986 we treated 43 patients with carcinoma of the cervical stump. The mean age was 63.6 years. Staging system used was FIGO classification modified according to the criteria of Institut Gustave Roussy in Villejuif. There were 12 stage IB, 12 early stage II, 5 late stage II and 14 stage III. Twenty-four centropelvic tumors (IB and early stage II) were treated with radiotherapy and surgery, 2 with surgery alone and one with radiotherapy alone. Late stage II and stage III tumors were treated with radiotherapy alone (+ hysterectomy for two patients). Local control rate was 83% for centropelvic tumors and 53% for late stage II and stage III. Seven patients developed distant metastases. Uncorrected 5-year actuarial survival rate was 78% for centro-pelvic tumors and 46% for late stage II and stage III. Three patients developed severe complications (grade 3). Prognostic factors were: stage, nodal status and pathological status of the cervix after radiotherapy. For the same stage the results were similar to those observed for carcinomas on intact uterus treated at our institution during the same time period.

Adult↗
PubMed1989

[Radiotherapy after chemotherapy and second-look laparotomy in the treatment of advanced ovarian cancers].

In order to better assess the place of abdominopelvic irradiation after chemotherapy in the treatment of advanced ovarian carcinoma, the survival times in 25 patients treated from 1976 to 1986 were examined. 2 stage IIc, 18 stage III and 4 stage IV were treated. Treatment included chemotherapy (with cisplatin in 16/25 cases) and a second-look laparotomy. 12 patients had only microscopic residual tumor, 5 had macroscopic tumor less than 2 cm, and 8 patients had no detectable residual tumor. A whole abdomen irradiation of 22.50 Gy with a pelvic boost to 45 Gy was also performed. Actuarial 3-year survival was 58% for the entire population. 10 loco-regional relapses were observed. The 3-year-actuarial survival was 71% for stage III patients. Haematologic tolerance of irradiation was poor with only 17 patients (68%) receiving the complete dose of irradiation. One late grade 3 intestinal complication was observed. These results and others previously published, suggest that abdominal irradiation is valuable in the treatment of advanced ovarian carcinoma for stage IIc or III patients without macroscopic residual disease after chemotherapy and second-look laparotomy.

Carcinoma↗
PubMed1989

[Irradiation in the treatment of adenocarcinoma of the ovary. Retrospective study of 44 cases].

In order to better assess the place of radiotherapy in the treatment of ovarian carcinoma, the length of survival in 44 patients treated with irradiation has been examined. 44 patients, with nil or minimal (less than 2 cm) residual disease, were found among 92 patients with invasive ovarian carcinoma treated consecutively in our center from 1976 to 1986. Treatment included laparotomy for 42 patients. Debulking surgery was complete in 9 stage I and 10 stage II patients. Those patients also received abdominopelvic (16 cases) or pelvic (3 cases) irradiation. Residual tumour was left in the 25 remaining patients (2 with stage IIc, 18 with stage III, and 5 with stage IV) who further underwent various regimes of polychemotherapy (9 without and 16 with cisplatin) followed by second-look laparotomy. 25 patients had no (8 patients) or minimal (17 patients) residual disease after this second laparotomy and they underwent abdominopelvic irradiation. Overall 3-year survival was 68%, 3-year survival was 80% for stage I and II patients treated by radiotherapy after initial complete debulking surgery, and 58% for advanced stages treated by radiotherapy after chemotherapy and second-look laparotomy, 3-year survival was 71% for 18 patients with stage III. Tolerance for irradiation was significantly decreased after chemotherapy and this prevented a complete dose being delivered to 32% of the patients. A late severe complication was noted in only one case. For stage I or II our results are close to those already published by others.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1988

[Carcinoma of the soft palate and uvula. An analysis of the results and the reasons for failures. A study of 76 cases].

The treatment of carcinomas of the soft palate most often involves radiotherapy. In order to assess the value of irradiation, notably in the treatment of limited T1 or T2 tumours, a retrospective study was carried out of 76 case records suitable for analysis of patients treated in our hospital for this type of tumour between 1974 and 1987. There were 70 men and 6 women. The mean age was 54 years. Fifty-four patients had limited T1 or T2 tumours (including 40 without lymphadenopathy). Treatment methods varied but 48/76 were treated by radiotherapy only (transcutaneous irradiation and/or local interstitial implant). Local tumour control was obtained in 87% of patients with T1 tumours, in 77% with T2 and in 50% with T3 tumours. Lymph node control was obtained in 68% of patients. None of the patients initially classified NO showed any subsequent lymph node involvement. The actuarial five-year survival rate was 67% for T1, 38% for T2 and 22% for T3. Lymph node involvement was the only other prognostic factor. Fourteen patients developed distant metastases and 13% had at least one other tumour site. Radiotherapy as tumour treatment is thus felt to be the method most widely used apart from tumours strictly limited to the uvula, where surgery is preferred. Cervical lymph nodes are treated surgically when there is a palpable lymphadenopathy and by radiotherapy for N0 patients. Induction chemotherapy before radiotherapy is used in addition at stages T3 and T4.

Adult↗
PubMedDate not supplied

[Conformal radiotherapy of prostatic cancer: a general review].

Recent progress in radiotherapeutic management of localized prostate cancer is reviewed. Clinical aspects--including dose-effect beyond 70 Gy, relative role of conformal radiation therapy techniques and of early hormonal treatment--are discussed as well as technical components--including patient immobilization, organ motion, prostate contouring, beam arrangement, 3-D treatment planning and portal imaging. The local control and biological relapse-free survival rates appear to be improved by high dose conformal radiotherapy from 20 to 30% for patients with intermediate and high risk of relapse. A benefit of overall survival is expected but not yet demonstrated. Late reactions, especially the rectal toxicity, remain moderate despite the dose escalation. However, conformal radiotherapy demands a high precision at all steps of the procedure.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

[Conservative treatment of anal canal carcinoma with external radiotherapy and interstitial brachytherapy, with or without chemotherapy: long-term results].

PURPOSE: A retrospective analysis of conservative treatment of anal canal cancers with external radiation therapy and interstitial brachytherapy with or without chemotherapy. PATIENTS AND METHODS: From 1986 to 1996, 69 patients were treated with external radiotherapy (40 Gy/20 fractions) and interstitial brachytherapy (20 Gy) after a mean interval of six weeks for a localized epidermoid carcinoma of the anal canal. Patients who did not complete the whole therapeutic sequence were not included. Forty-five patients received additional 5-fluorouracil- and/or mitomycin C-based chemotherapy regimen. RESULTS: Acute toxicity was acceptable. Complete response rate was 81%. Actuarial local control rate was at two and five years, 65% and 59% respectively (median follow-up: eight years). At two, five and ten years, actuarial colostomy rate was 26%, 33% and 33% respectively, and colostomy-free survival rates 61%, 47% and 37%. Overall survival at two, five and ten years was 81%, 65% and 53% respectively. Distant metastases occurred in 11 patients (16%). Prognostic factors for overall survival were performance status (PS) (79% survival at five years for patients with PS 0 versus 50% for patients with PS 1-3, P = 0.04) and tumor stage (80% at five years for T1-T2 versus 53% for T3-T4, P = 0.03). Overall treatment time less than 12 weeks and time interval between external radiotherapy and brachytherapy inferior than six weeks were associated with a better local control (P = 0.05). In multivariate analysis, these prognostic factors were not significant. CONCLUSION: These results confirm the efficacy of external radiotherapy and brachytherapy in the treatment of small anal canal cancers, and point out the need for improving treatment outcome of larger tumors.

Adult↗
PubMedDate not supplied

[Dosimetric evaluation of conformal radiotherapy: conformity factor].

The aim of three-dimensional conformal therapy (3DCRT) is to treat the Planning Target Volume (PTV) to the prescribed dose while reducing doses to normal tissues and critical structures, in order to increase local control and reduce toxicity. The evaluation tools used for optimizing treatment techniques are three-dimensional visualization of dose distributions, dose-volume histograms, tumor control probabilities (TCP) and normal tissue complication probabilities (NTCP). These tools, however, do not fully quantify the conformity of dose distributions to the PTV. Specific tools were introduced to measure this conformity for a given dose level. We have extended those definitions to different dose levels, using a conformity index (CI). CI is based on the relative volumes of PTV and outside the PTV receiving more than a given dose. This parameter has been evaluated by a clinical study including 82 patients treated for lung cancer and 82 patients treated for prostate cancer. The CI was low for lung dosimetric studies (0.35 at the prescribed dose 66 Gy) due to build-up around the GTV and to spinal cord sparing. For prostate dosimetric studies, the CI was higher (0.57 at the prescribed dose 70 Gy). The CI has been used to compare treatment plans for lung 3DCRT (2 vs 3 beams) and prostate 3DCRT (4 vs 7 beams). The variation of CI with dose can be used to optimize dose prescription.

Bronchial Neoplasms↗
PubMedDate not supplied

[Preoperative concurrent radiochemotherapy for cancer of the rectum].

PURPOSE: To evaluate retrospectively treatment-related morbidity of concurrent radiotherapy and chemotherapy for rectal cancer. PATIENTS AND METHODS: Between 1992 and 1995, 38 patients (median age: 60) were treated for locally advanced resectable rectal cancer. Median dose of radiotherapy was 45 Gy/25 fractions/5 weeks. Chemotherapy consisted of two courses of 5-fluorouracil and leucovorin administered during the first and the fifth weeks of radiotherapy. Median dose of 5-fluorouracil was 350 mg/m2/day, and median dose of leucovorin was 20 mg/m2/day, day 1 to day 5. Surgery was performed 5 weeks after completion of radiotherapy. RESULTS: Before surgery, one patient died of febrile neutropenia and sepsis after two cycles of chemotherapy and 45 Gy. Main pre-operative grade 3-4 toxicities were respectively: neutropenia: 3%; nausea/vomiting: 3%; diarrhea: 3%; proctitis: 5%; radiation dermatitis: 8%. Twenty-six patients underwent a low anterior resection and 11 an abdomino-perineal resection. A temporary colostomy was performed in 12 patients. Pathologic complete response rate was 27%. There was one post-operative death due to thromboembolic disease. Major post-operative grade 3-4 complications were: pelvic infection: 14%; abdominal infection: 5%; perineal sepsis: 8%; anastomotic dehiscence: 8%; cardiac failure: 5%. Delayed perineal wound healing was observed in six patients. No significant prognosic factor of post-operative complications has been observed. Median duration of hospitalization was 22 days. With a median follow-up of 24 months, 2-year overall and disease-free survival rates were 82 and 64%. CONCLUSION: Tolerance of preoperative concurrent chemoradiotherapy was acceptable. Ongoing controlled studies will assess the impact of this combined treatment on survival.

Adenocarcinoma↗