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C Parmentier

Publications and source records attributed to C Parmentier.

At least 145 records · Page 8Linked to original sources
PubMed1984

[Role of radiotherapy in the treatment of medullary cancer of the thyroid].

Medullary thyroid carcinoma (MTC) is a rare tumor for which the main treatment is surgery. However, external radiation therapy (RT) plays an important part in well-defined patients. Out of the 115 patients with MTC treated at the Institute Gustave Roussy: Thirty-five MTC patients with residual cervical disease and without distant metastases had their thyroid region irradiated (60Co, 45 to 50 Gy in 5 weeks). The overall survival of these patients is similar to that of patients with limited cervical extension (n = 57) treated by surgery alone. The results of this study show the effectiveness of cervico-mediastinal irradiation treatment for MTC with extensive local tumor after incomplete surgery. Eight MTCs with inoperable cervical tumor were treated only by external RT. Median survival was 44 months. In six of them, long-term local control was observed: three are alive at 52, 62 and 70 months and 3 died from distant metastases at 36, 36, and 117 months after treatment. Sixteen MTCs with distant metastases were treated with RT on bone metastases (n = 10) or compressive lymph node metastases (n = 6) with good palliative effect. This study shows the efficacy of post-operative external RT in MTCs with extensive cervical tumors, as a curative treatment in non-surgically eradicable cervical tumors and as a palliative treatment for metastatic localisations. The technique of cervico-mediastinal RT is discussed.

Bone Neoplasms↗
PubMed1984

Effect of alkylating agents on hematopoiesis in myelofibrosis. 4 case report.

Four patients presenting with myelofibrosis (2 primary myelofibrosis and 2 postpolycythemic myeloid metaplasia) were treated with alkylating agents. For three patients (one treated with busulfan and two treated with chlorambucil) the treatment was a success: the general condition improved, the splenomegaly decreased or disappeared, and the blood picture returned to normal. Moreover, for two cases, a trend towards polycythemia was observed under treatment. For the fourth patient, treated with chlorambucil, there was no improvement: a life-threatening, pancytopenic phase developed at the end of the treatment, but it disappeared after 2 months. For the three successfully treated cases, a redistribution of hematopoiesis from spleen to bone marrow was shown by ferrokinetics, 59Fe scans, and bone marrow biopsies. In addition, in the case treated with busulfan, a decrease in the bone marrow granulopoietic pool at the expense of the erythropoietic one was observed. No redistribution was seen in the patient for whom the treatment was a failure. In this case, the spleen remained the major site of active hematopoiesis. Studies on blood granulomonocytic-colony forming cells (GM-CFC's) helped to discriminate the successfully treated patients from the unsuccessfully treated one. In the successfully treated patients, the GM-CFC concentrations dropped to normal values and increased again within weeks following the treatment interruption; this increase involved mainly high density GM-CFC's (greater than 1.060). In the unsuccessfully treated patient, GM-CFC concentrations decreased only after 5 weeks of intensive treatment. The mean density of the GM-CFC's was 1.064 before treatment, shifted towards 1.060 during the neutropenic phase and returned to 1.064 during the recovery.

Alkylating Agents↗
PubMed1984

[Chemotherapy for medullary cancer of the thyroid. Phase II trials with adriamycin and cis-platinum administered as monochemotherapy].

Medullary thyroid carcinoma (MTC) is a rare tumor, and patients with distant metastases have a poor prognosis. Chemotherapy efficacity is not well established and we have conducted a phase II trial of monochemotherapy with Adriamycin (ADR) and Cis-platinum (CDDP) in 18 patients. Fourteen MTC have been treated by ADR, the dose was 60 mg/m2 every 4 weeks. The mean number of administration has been 5.3. The results have been: 1 complete response (6 months), 1 partial response (36 months), 1 minor response, 4 stabilisations and 6 failures. The overall responses rate has been 15 per cent and the toxicity has been low. Fourteen MTC have been treated by CDDP. Ten patients had been treated before with ADR. The dose of CDDP was 90 mg/m2 in two hours perfusion with hyperhydration administered every 4 weeks. The mean number of treatment has been 5. The results have been: 1 complete response (9 months), 2 partial responses (16 and 48 months), 4 stabilisations and 7 failures. The overall responses rate has been 21 per cent. In conclusion, ADR and CDDP have some, but limited, efficiency in treatment of metastatic MTC. The effect of their association must be evaluated.

Adolescent↗
PubMed1984

Redistribution of granulopoiesis from extramedullary territories to bone marrow in a case of spent polycythemia treated with alkylating agents.

We report a case of splenectomized spent polycythemia, where under the influence of alkylating agents (busulfan or chlorambucil), a true redistribution of granulopoiesis appeared. Before treatment, granulopoiesis was confined to the liver (within the portal spaces and the sinusoids), whereas bone marrow was depleted of any hematopoiesis, being the site of a mutilating fibrosis; the blood concentration of granulomonocytic colony-forming cells (GM-CFCs) was high. After a year of discontinuous treatment an intense granulopoiesis was present in bone marrow, comprising more than 90% of the hematopoietic cells, whereas circulating colony-forming cells were low to nil. This phenomenon was long-lasting, since after another year of treatment, a third bone marrow biopsy revealed the persistence of an active granulopoiesis. During the last year of treatment, the treatment was continuous with chlorambucil. After 6 months a decrease in polymorph and platelet values appeared and treatment had to be interrupted. Death supervened one month after treatment interruption. Histological examination revealed the lack of any intrahepatic hematopoiesis whereas bone marrow granulopoiesis was active but presented gross maturation abnormalities. The results obtained in this case permit discussion of some aspects of the physiopathology of myelofibrosis, and particularly the genesis of extramedullary hematopoiesis in this clonal disease.

Biopsy↗
PubMed1983

The values of calcitonin and carcinoembryonic antigen in the treatment and management of nonfamilial medullary thyroid carcinoma.

Thirty-one patients were studied to evaluate the prognostic value of both calcitonin (CT) and CEA levels determined after the initial treatment in medullary thyroid carcinoma (MTC). Twenty-seven patients were evaluated three to nine months after initial treatment and four others afterwards. The CT and CEA levels were significantly higher and the survival rate lower in the eight patients with residual clinical disease as compared to the 19 patients in complete clinical remission. In patients in complete clinical remission, 11 had elevated CT level after treatment, and all had initial lymph node involvement. Five of these 11 relapsed and one died. None of the eight patients with normal CT levels after treatment relapsed. CEA levels were always abnormally high when patients relapsed. Fourteen patients in complete remission with high CT levels were followed for more than four years. Six had normal CEA levels and no relapse was observed. Eight of the 14 had pathological CEA levels and six of eight relapsed: five of these six patients presented CEA elevation from six to 36 months before the clinical relapse. In two of these six patients, a venous catheterization sampling method demonstrated infra clinical local recurrence. In two patients with liver metastases, the time course changes of CT and CEA levels were different and CEA appeared to be a more sensitive tumor marker than CT. These data are consistent with previous data concerning the values and limits of CT level for the management of MTC. Furthermore, this study demonstrates the prognostic significance of CEA determination in MTC. CEA appears to be a sensitive selective tumor marker capable of defining a high-risk subgroup.

Adult↗
PubMed1983

Physical requirements of a 59Fe bone marrow distribution digital scanning study.

A method is described to provide whole-body scannings of 59Fe bone marrow distribution using a tungsten-alloy collimator. The physical requirements of this method were determined by means of dedicated phantoms. As we were only interested in bounded 59Fe regions (sacral bone, liver and spleen), it was necessary to subtract the 59Fe activity in the blood. An estimate of this activity was obtained by means of 99mTc-labelled erythrocyte whole-body scanning to which a correction factor K was applied. The independence versus depth was performed by computing geometrical means of prone and supine images. The results of these experiments indicate the possible feasibility of a scanning method for a ferrokinetic study in place of the usual external counting.

Bone Marrow↗
PubMed1983

Feasibility of a 59Fe ferrokinetic study based on bone-marrow scans.

The purpose of this study was to evaluate the feasibility of a method that would use 59Fe quantitative sequential scintigrams together with a few blood samples in place of conventional ferrokinetic studies. To quantitate the efficiency of erythropoiesis or iron deposition sites, the radio-iron blood activity was subtracted by means of a whole body scanning with 99mTc-labelled erythrocytes. The study was performed on 31 patients (36 examinations) and regions of interest were drawn by three physicians on the sacral bone, the liver, the spleen and the femoral bone. To assess the physical feasibility of the scintigraphic method, correlation coefficients were computed between the number of counts of the 59Fe and 99mTc images and the corresponding 99mTc and 59Fe activities. To assess the clinical feasibility, the consistency of the data resulting from the drawing of the ROIs was verified and those of conventional ferrokinetics were introduced and their consistency verified. These assessments suggest that the scintigraphic method can be used in place of the conventional external counting method.

Bone Marrow↗
PubMed1983

Medullary thyroid carcinoma: prognostic factors and treatment.

Seventy-five patients with medullary thyroid carcinoma (MTC) have been treated at Institut Gustave-Roussy from 1932 to 1979. Of these, 13 patients had distant metastases and received palliative treatment, their median survival was 3 years. Sixty-two patients with MTC limited to the neck received curative treatment; 6 had exclusive external radiotherapy for inoperable disease and 56 were surgically treated: 23 by total thyroidectomy and 33 by partial thyroidectomy. After surgery 29 patients received external radiotherapy for cervical lymph node involvement (25/29) and/or incomplete surgical resection (12/27). The survival rate was 69% at 5 years and 48% at 10 years. It was lower in patients with distant metastases at presentation (p less than 10(-5)), with tumoral infiltration of the posterior tissue planes (p less than 0.025) and in patients in whom surgical excision had not been satisfactory (p less than 0.01). It was not correlated with cervical lymph node involvement probably because those patients with lymph node involvement had been irradiated. The 29 patients who received post-operative cervical radiotherapy had initially more extensive local disease (p less than 0.05) than the 27 patients treated by surgery alone, nevertheless their survival was slightly higher. No difference in survival rate was observed between patients treated by total thyroidectomy or partial thyroidectomy, among whom only 4 local recurrences occurred. Three of the 6 patients treated with external radiotherapy alone experienced long survival (4, 7 and 10 years) and a fourth is still in clinical remission 4 years after treatment. The effectiveness of chemotherapy in patients with metastases was poor, only one patient out of 6 had a partial remission following a treatment by adriamycin. In the familial form and multiple endocrine neoplasia type II, total thyroidectomy appears to be indicated. In the sporadic cases, partial thyroidectomy is usually sufficient. External radiotherapy is effective in MTC and seems to be able to eradicate small foci of residual tumor; it is indicated when surgical excision is impossible or incomplete.

Adolescent↗
PubMed1983

Late effects on human bone marrow after extended field radiotherapy.

Thirty-two patients with lymphoma were treated with extended radiotherapy (RT) at a dose of Gy and were studied by ferrokinetic studies and surface counting at various times following irradiation. Loss of hematopoietic activity in the irradiated areas is compensated by increased activity in the non-irradiated areas. Despite the return of peripheral blood counts to normal, the hyperactivity of the non-irradiated bone marrow persists over up to 13 years after RT, while the hematopoietic activity of the irradiated areas remains depressed and is only slightly higher than immediately after RT. The hypoactivity persisted even when the hemopoietic tissues had been subjected to the intense stimulation provoked by an aplasia caused by chemotherapy. However, a recovery was observed for dose of 20 Gy or lower. The hemopoietic activity of the irradiated bone marrow appears to be related to the volume of the marrow irradiated and is higher after a mantle + inverted Y field than after a mantle field. Both marrow scintigraphies with 59Fe in 7 out of 9 patients studied revealed an extension of hematopoiesis into a normally dormant area of the marrow, such as the femora. In 2 patients an erythropoietic activity was observed in spleens which had received a dose of 40 Gy, and extra medullary erythropoiesis was found in approximately two-thirds of the patients.

Adaptation, Physiological↗
PubMed1983

Relationship between thyrotropin stimulation and radioiodine uptake in lung metastases of differentiated thyroid carcinoma.

To examine whether the injection of bovine TSH (bTSH) produces maximal radioactive iodine uptake (RAIU) in lung metastases in patients with differentiated thyroid cancer, 10 patients were studied 12 times. In 10 of these studies, an initial RAIU measurement was performed immediately after 3 injections of 10 IU bTSH given immediately after T3 withdrawal. Another RAIU measurement was performed 7-19 days after T3 withdrawal. Uptake increased in all patients even when it was clearly detectable immediately after bTSH stimulation. Thus, 3 days of bTSH stimulation in these patients did not lead to maximal 131I uptake, and it could only be reached after prolonged endogenous TSH stimulation. bTSH was not injected in the 2 other patients, in whom 6 RAIU measurements were carried out. Radioiodine uptake increased with time in both patients. It appears that both the level of endogenous TSH and the length of stimulation play a determining role in RAIU. This might explain why 3 days of bTSH stimulation are insufficient to elicit maximal 131I uptake.

Adolescent↗
PubMed1983

[Use of tomographic scintigraphy with radio-labelled monoclonal antibodies for detecting human digestive cancers and medullary cancers of the thyroid].

Two 131-Iodine radiolabelled monoclonal antibodies were used to perform tomoscintigraphy in 42 patients: 11 patients bearing medullary thyroid cancers and 19 patients bearing gastrointestinal cancers received an antibody directed against carcino-embryonic antigen; 12 patients bearing gastro-intestinal cancers received an antibody directed against a non circulating antigen expressed by human colorectal cancers cell lines. Tomoscintigraphy is particularly useful for analysing the complex biodistribution of radiolabelled antibodies and the low contrast images encountered in immunoscintigraphy; the problems related to the true positive rate and to the clinical specificity of the method are discussed.

Antibodies, Monoclonal↗
PubMed1982

Tomoscintigraphy for detecting gastrointestinal and medullary thyroid cancers: first clinical results using radiolabelled monoclonal antibodies against carcinoembryonic antigen.

Transaxial tomoscintigraphy (or single-photon emission computerised tomography) was used to detect secondary deposits of carcinoma in 17 patients who had been injected with iodine-131-labelled monoclonal antibodies against carcinoembryonic antigen. Of 17 tumor sites studied by tomoscintigraphy 16 were detected (sensitivity 94%); five sites had a volume smaller than 10 cm3. Tomoscintigraphy also detected three unknown tumour deposits later confirmed by surgery or radiology. In contrast, when 21 tumour sites in the same patients were studied by rectilinear scintigraphy, only nine tumour sites were detected (sensitivity 43%), of which eight had a volume larger than 50 cm3.

Antibodies, Monoclonal↗