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Biomedical subjects

E Touboul

Publications and source records attributed to E Touboul.

At least 127 records · Page 7Linked to original sources
PubMed1987

[Half-body irradiation and drug-resistant non-Hodgkin's lymphomas. Apropos of 9 cases].

Nine patients, aged 19 to 57 years (mean: 37 years) with non hodgkin lymphoma (NHL) secondarily resistant to chemotherapy (8 stages CS IV involving the bone marrow and 1 stage III) were studied. Histologic forms according to the Lennert classification were as follow: 1 nodular centrocytic which developed into a diffuse centroblastic, 3 diffuse immunoblastic, 4 diffuse centrocytic-centroblastic, and 1 T cell lymphoblastic. The nine patients were managed by external irradiation of the lower half of the body (LHBI), followed six weeks later by irradiation of the upper half of the body (UHBI). A single dose of 8.00 Gy in 7 cases and 6.00 Gy in 2 cases was delivered. Three patients developed severe medullary aplasia. Each of these patients had received 8.00 Gy and been given a course of chemotherapy between the two radiation sessions. The aplasia was fatal in two patients. Overall apparent clinical remission rate was 5/9, with one iatrogenic death at 3.5 months; one lost to follow-up after 8 months; for three other cases, the duration of apparent complete remission was 15, 22 and 36 months. One patient was alive in partial remission 30 months after irradiation. Three patients who failed to respond to treatment, were died between 4 and 11 months.

Adult↗
PubMed1984

[Radiotherapy of primary malignant tumors of the trachea. Apropos of 31 cases].

We report 31 cases of primary malignant tumours of the trachea, treated with radiotherapy at the Tumour Centre, Pitié-Salpêtrière, from June 1968 to January 1982. Three patients received complementary post-operative irradiation: one had an epidermoid carcinoma, operated by incomplete resection and anastomosis, and survived 12 months after irradiation with 60,00 grays in 6 weeks (local recurrence of tumour and mediastinal extension); the other two had cylindromas of the trachea with complete resection and anastomosis: the first remains alive 6 years after an irradiation of 65,00 grays over 6 weeks, the second is alive 5 years after post-operative irradiation of 60,00 grays in 6 weeks. These two latter tumours evolved slowly and local recurrence may occur after five years and sometimes longer, after local treatment. 28 other cases presenting with an epidermoid carcinoma of the trachea received radiotherapy exclusively, when a surgical cure was impossible. Irradiation was interrupted in two patients: one after a dose of 12,00 grays for sudden massive haemoptysis, the other after a dose of 22,00 grays for an oesophago-tracheal fistula. An apparent complete remission was obtained in 80% of cases, judged by a tracheo-bronchial endoscopic examination carried out in the six weeks following the treatment. Two deaths were seen from intercurrent disease: one at two months from a granulocytosis caused iatrogenically from medication and the other at five months from bilateral bronchopneumonia. One patient was alive at 9 months in apparent complete local remission, but lost to follow up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1983

[Epiduritis disclosing non-Hodgkin's lymphoma. Apropos of 11 cases].

We report eleven cases of non-Hodgkin lymphoma (NHL) revealed by epidural involvement treated at the Pitié Salpêtrière Tumor Center over ten years. This condition is uncommon. The tumor can be excised after laminectomy, thus establishing diagnosis. Rather than on histological type, prognosis is dependent on the presence or absence of associated vertebral involvement. Four patients presented with apparently primary, localized, epidural involvement without vertebral lesions; they are still alive 2, 3, 6 and 11 years after onset. Prognosis is guarded in the seven other patients as they have vertebral involvement; other localizations are frequently found and survival does not exceed 8 to 36 months. Only 3 patients are still alive, 8 months, 10 months and 3 years after onset. We advocate preoperative irradiation of the tumor delivering 45.00 Grays, followed by systematic combination chemotherapy. Chemotherapy can be given both before and after radiotherapy in patients with vertebral bone involvement.

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↗
PubMed1983

[Bifractionated radiotherapy and oropharyngeal carcinoma].

The relatively poor results of therapy for epidermoid oropharyngeal carcinoma stages T3 and T4 suggested the need for new treatment regimens. A study involving 24 patients included bifractionated radiation on a daily basis, as used by J. C. Horiot and A. Nabib and then by the E.O.R.T.C. group. The more encouraging results reported by A. Nabib were not obtained. The 5-year survival rate will possibly be no better than after conventional external radiation. Post-radiotherapy complications were observed.

Aged↗
PubMedDate not supplied

[The point of view of the radiotherapist].

During the last decade, stereotactic radiotherapy has widely improved in France. Thus one should study the present situation and its future trend. QUANTITATIVE NEED: Considering single dose radiotherapy, there are about 900 to 1,000 cases treated per year. However, the trend towards more fractionated treatment will disturb this temporary equilibrium; thus more machine time will be necessary. QUALITATIVE NEED: Stereotactic radiotherapy is practiced by multi-disciplinary teams including physicians, physicists and scientific specialists. Radiotherapists and physicist are responsible for treatment planning and evaluation as well as for clinical and methodological research. Accordingly, they should possess computers, treatment planning systems, etc. Such teams are necessary to carry out complex irradiations. GENERAL EVOLUTION: Fractionation of irradiation nowadays seems mandatory for most intracranial tumors except metastases and small regular arteriovenous malformations. Heterogeneity of lesion dose is related to the geometry and the physics of convergent fixed or mobile beams. It can be improved and the healthy tissue irradiation can be diminished using the multi-isocentric planning for complex lesion or with micro multi leaf collimators. MODALITIES OF STEREOTACTIC RADIOTHERAPY ACCORDING TO LESION TYPE: For neurinomas of the acoustic nerve, fractionated stereotactic radiotherapy yields few of the complications published after single dose stereotactic radiotherapy. The same can be said for meningiomas although some series reported very few complications after single dose stereotactic radiotherapy. Solitary metastases without systemic evolution, not situated on the mid-line, are favorable candidates for palliative single dose stereotactic radiotherapy. The conjunction with total brain irradiation seems to be useful. Small arteriovenous malformations will be treated with single dose stereotactic radiotherapy, whereas voluminous and/or geometrically complex nidus could benefit from protons or photon beams modulated by micro multi leaf collimators and a few fractions. EXTRA-CRANIAL STEREOTACTIC RADIOTHERAPY: Single dose stereotactic radiotherapy and fractionated stereotactic radiotherapy will be used as boost in various situations such as massif facial and in all sorts of tumors in the body specially when lesions are close to critical organs.

Brain Neoplasms↗
PubMedDate not supplied

[Locoregional recurrence of adenocarcinomas of the rectum treated with irradiation combined with or without excision surgery].

PURPOSE: Retrospective study to analyze the results of external beam radiation treatment with or without surgery for loco-regional recurrence of adenocarcinoma of the rectum following previous surgery without pre- or post-operative radiotherapy. PATIENTS AND METHODS: Between March 1973 and November 1991, 211 patients with loco-regional recurrence of rectum cancer were treated with external beam radiation treatment. Radical surgery was the only initial treatment modality. Surgical resection of local recurrence was done in 36 patients and only 17 patients could undergo complete resection. Forty-seven patients underwent radiotherapy (RT) combined with surgery and 164 received external beam radiation treatment alone to a mean total dose of 46 Gy. RESULTS: Among the 151 patients whose recurrence was revealed by pain, 64 (42%) were considered to have a complete symptomatic response after loco-regional treatment with radiosurgery or RT alone. The mean duration of response was 12 months. The 3-year overall survival rate was 16%. Five prognostic factors decreased the overall survival rate in multivariate analysis: high age, sex (male), concomitant distant metastasis, no tumor resection, and low total radiation dose with external beam radiation treatment alone. The 3-year overall survival rate for patients with completely resected recurrences was 39%. CONCLUSION: External beam RT treatment can only be considered a palliative symptomatic treatment. New techniques of early detection of local recurrence and new combined modalities approaches (radiation sensitizers or intra-operative radiotherapy) with surgical resection in some favorable cases should be studied.

Adenocarcinoma↗