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Biomedical subjects

F Eschwege

Publications and source records attributed to F Eschwege.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Cancers of the upper face. The experience of the Gustave Roussy Institute. Apropos of 162 cases (1965-1980)].

Cancer of para-nasal cavities represented only a small group among cancers of upper aero-digestive tract; 3 to 4% of 1,200 admissions yearly with cancer of head and neck. These cancers may arise from bone or cartilage but originated mainly in the mucosal lining of nasal and sinus cavities. In the latter case these were carcinomas representing approximately 75% of nasosinusal cancers treated. Carcinomas are reviewed, with a distinction between epidermoid and glandular types due to their particular evolutive courses, this retrospective study involving 162 case-reports of patients over 16 years of age treated entirely in the Institut Gustave-Roussy between 1965 and 1980.

Adenocarcinoma↗
PubMed1987

Bone marrow biopsies in patients with undifferentiated carcinoma of the nasopharyngeal type.

Bone marrow involvement was found in 21 of 56 patients with undifferentiated carcinoma of the nasopharyngeal type UCNT whose nasopharyngeal and bone marrow biopsies were available. Radiotherapy and chemotherapy (cisplatin, 5-fluorouracil and bleomycin) were given because of distant metastases. The microscopic aspects of bone invasion were investigated and were classified into three subtypes osteolytic, osteosclerotic and mixed type. The UCNT patients population was 10 years younger than that studied previously. Both the extent of the primary tumor (T) and cervical lymph node status (N) exerted an influence on the probability of metastases developing. Chemotherapy given to patients must be improved because UCNT with bone metastases is a disease with a poor prognosis.

Adolescent↗
PubMed1987

Cervico-facial adenoid cystic carcinoma: study of 102 cases. Influence of radiation therapy.

One hundred two patients with cervico-facial adenoid cystic carcinoma were treated with surgery alone, radiotherapy alone or both from 1951 to 1980. All the cases have a 5-year minimum follow-up. The local control rate is 55.5% at 5 years and 37.7% at 10 years. The 5-year local control rate is 44% with surgery alone, 65.8% with radiotherapy alone and 77.8% with post-operative radiotherapy. The difference between surgery alone and radiosurgical association is significant (p less than 0.01). The bone involvement diminished local control rate (32.2%/k 68.8%). The 5-year survival rate of the patients who recurred and have been retreated is 70.5%. The 5-year survival rate of the patients after the appearance of a metastasis is 38.1% and 2 patients have survived more than 10 years. The NED 5-year survival rate is 48.8%. There is no significant difference in the NED 5-year survival rate according to sites or treatments. The crude 5-year survival rate is 70%, 51.4% at 10 years and 32.2% at 15 years. Our study shows that adenoid cystic carcinoma have a peculiar and slow evolution. Surgery with post-operative radiotherapy obtains the best local control. These results and the radiosensibility of these lesions allow us to propose an aggressive treatment for the recurrence and the primary tumor of the directly metastatic patients.

Actuarial Analysis↗
PubMed1987

[Cancer of the valleculal and laryngeal vestibule treated by supraglottic horizontal laryngectomy. Apropos of 173 surgically treated cases at the Institut Gustave-Roussy].

The authors make a report on a series of 173 supraglottal horizontal laryngectomies carried out from 1970 to 1984 at the Gustave-Roussy Institute of Villejuif. After recalling of operability conditions and tackling characteristics of this series are quoted variants required from tumours localisations diversity and importance of extension. Then are treated clinical and anatomo-pathological classification as briefly surgeries results. This work is specially concerning in survival by analysing different topographical clinical and histological criteria. Survival of 173 patients, having gone through an supra-glottal laryngectomy is 45.5% at 3 years and 31.3% at 5 years. At least, reasons of failure are analysed. This kind of partial surgery caring of voice, should be proposed to patients affected by vallecula or epiglottis carcinomas as regards of good functional and improved carcinological results.

Adult↗
PubMed1986

Synovial sarcoma of the head and neck: an account of four cases and review of the literature.

Four cases of Malignant Synovioma of the head and neck are reported. It is a rare tumour with only 76 published cases in the world literature. Study of these 76 cases allows identification of the clinical features of this tumour and also highlights the problems of histological diagnosis. The study shows that the most effective treatment is radical primary surgery in association with post-operative radiotherapy and chemotherapy.

Adolescent↗
PubMed1986

[Pelvic cancers: radioprotection of the small intestine by using a mammary prosthesis for postoperative irradiation. Apropos of 12 cases].

A preventive technique of radiation injuries to small intestines with intrapelvic mammary prosthesis is described. It has been used for twelve cases in which 9 concerned rectal adenocarcinomas (local recurrences 7 and fixated tumors 2). After this short experience, we can recommend this reliable technique without important local complication and describe the irradiation technique. The indications of this method are precised because it is finally an unfrequent therapeutic.

Adenocarcinoma↗
PubMed1986

Epidermoid cancers of the anus. Changes in therapeutic ideas.

Under this term, the authors discuss cancers of the anal canal. Cancers of the edge of the anus are skin cancers whose treatment will not be discussed here. Cancers of the anal canal are rare and are much more frequently found in women than in men. They are more or less differentiated epidermoid cancers. The therapeutic problems raised: cure a cancer with a loco-regional evolution beginning in the mucous lining of the anal canal and able to spread throughout the pelvic cavity; treatment should be total (on the tumor and ganglia) and conservative; treatment should avoid major complications such as necroses, fistulas, incontinence; it will often be carried out in elderly patients in poor general condition, poorly supporting lengthy treatments, hospitalization and anaesthesia. The therapeutic possibilities; two major therapeutic techniques possible, radiotherapy and surgery.

Anal Canal↗
PubMed1985

[Prevention of radiolesions of the small intestine by intrapelvic silicone breast prosthesis].

In a patient with non resectable pelvi-perineal recurrence of epidermoid carcinoma of the anus, a silicone breast prosthesis inserted into the lower pelvis made it possible to irradiate the malignant lesion without risk of radiation-induced damage to the small intestine displaced upward by the prosthesis. This unusual technique, indicated when epiplooplasty cannot be performed, has several advantages over other techniques of radioprotection of the small intestine.

Anus Neoplasms↗
PubMed1985

Reirradiation of head and neck cancers. Presentation of 35 cases treated at the Gustave Roussy Institute.

Thirty-five patients with head and neck carcinoma who were treated with a second course of radiotherapy for relapse or second malignancy at the Gustave Roussy Institute between 1973 and 1981 were studied. Immediate tolerance for total doses greater than 80 Gy was good but 37% of patients suffered from delayed necrosis or bleeding. Thirty-seven per cent of lesions were locally controlled at 3 months and 97% of patients showed a subjective improvement to reirradiation. Local control was obtained in 53% of patients aged between 40 and 60 as compared to 19% in other age groups, and was obtained in 55% of patients who were irradiated a second time with a dose greater than 60 Gy as compared to 8% for doses less than 60 Gy. Complications following treatment are related to failure to achieve local control and area of second treatment fields greater than 70 cm2. Survival was worse for those patients having an interval less than 12 months between the two courses of irradiation and those in whom local control was not achieved.

Adult↗
PubMed1985

Squamous cell carcinoma of the anal canal: treatment by external beam irradiation.

External beam radiation therapy alone or in combination with curietherapy is the recommended treatment for anal canal carcinoma in some countries. In others, surgery is the sole accepted treatment. The results for 64 patients treated by external radiotherapy alone show excellent survival for stage T1T2 tumors but results are poor for large tumors (stage T4). The overall 5 year crude survival rate is 46%. The 5-year results are better for stage T1T2 (72%) than for stage T3T4 (35%). The presence of inguinal node involvement at first examination is a very poor prognostic sign. Local recurrences and metastases are infrequent for stage T1T2, but are more common for stage T3 and T4. Complications follow radiotherapy more frequently in those with stage T3 and T4 tumors. The analysis of local recurrences, complications and survival shows that radiation therapy may be sufficient treatment for stage T1 and T2 and for some stage T3 tumors. The importance of anal sphincter involvement and the poor quality of life for patients who are cured but develop complications, shows the need for combined treatment with surgery and perhaps with chemotherapy. For small tumors the results obtained by external radiotherapy alone are comparable with those obtained by external radiotherapy and curietherapy in terms of survival and complications.

Adult↗
PubMed1985

[Surgical treatment of severe radiation injuries of the small intestine and colon-rectum. Apropos of 85 patients surgically-treated at the Gustave-Roussy Institute].

Radiation lesions of the small intestine, colon and rectum were treated surgically in 85 patients between 1970 and 1983. These were serious complications in all cases involving the short-term vital prognosis in patients lacking signs of recurrence of cancer for which they had received radiotherapy. Immediate operative mortality was 26%. Anastomotic digestive fistulae complicated 31% of resection-anastomosis and 29% of internal bypass operations. During the next 2 years the progression of the chronic radiation lesions themselves required repeat operations due to further complications in 19% of patients, with an operative mortality of 33%. Rather than comparing efficacy of resection-anastomosis with that of internal bypass procedures they should be considered as complementary, since they have different indications. Based on the analysis of results and acquired experience, a surgical strategy is proposed for treating complicated radiation lesions of the intestines.

Adolescent↗
PubMed1983

The value of combining radiotherapy with surgery in the treatment of hypopharyngeal and laryngeal cancers.

Two-hundred and six cases of hypopharyngeal and laryngeal squamous cell carcinoma treated at the Institut Gustave-Roussy were retrospectively analyzed. All of them were treated by surgery and they were divided into three therapeutic groups following the adjuvant radiotherapy: (A) Postoperative radiotherapy at doses equal to or greater than 4500 rad; (B) Postoperative radiotherapy at doses less than 4500 rad; and (C) Preoperative irradiation at doses less than 4500 rad. Group A included a greater proportion of patients with hypopharyngeal cancer and patients with advanced tumors (T3, T4; N1b, N2, N3). However, the local and regional control rate in this group is significantly higher than those of the other groups in spite of the poor prognostic factors. The survival rate is comparable in all the three groups, with distant metastases more frequently found in group A. The results showing a significant improvement in lymph node control with postoperative radiotherapy, this adjuvant therapy is used systematically in this center in patients being operated on for hypopharyngeal and laryngeal cancer with incomplete histologically defined resection and/or with lymph nodes histologically involved.

Carcinoma, Squamous Cell↗
PubMed1983

[Cancer of the cervical esophagus. 64 cases treated by radiotherapy. Evaluation and considerations].

Radiotherapy was applied in 64 of 88 cases of cervical esophagus cancer during the period 1968 to 1980. The lesions treated were 49 epitheliomas of the esophageal opening, excluding hypopharyngeal tumors extending into the esophagus, and 15 epitheliomas of the remaining cervical segment of the esophagus. Survival did not exceed 2 years in any patient, and the reasons for these poor results are investigated. These included the particular selection of patients, the choice of radiotherapy as basic treatment, and the dosage administered. A new therapeutic approach is proposed based on pathologic findings and the various therapeutic measures available. Preoperative chemotherapy is followed by a total laryngopharyngectomy, with a total esophagectomy without opening the thorax and under certain well defined conditions. Continuity is re-established by a gastropharyngostomy, and postoperative radiotherapy is given routinely. This very heavy therapeutic approach, is appropriate for selected patients only, other cases having, unfortunately, to make do with an association of radio and chemotherapy.

Carcinoma, Squamous Cell↗