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Biomedical subjects

F Flamant

Publications and source records attributed to F Flamant.

123 records · Page 7Linked to original sources

[Fertility and the progeny of children surviving cancer treatment (author's transl)].

Little is known about the late effects of damage to the gonads in children treated for cancer. This investigation requires a prolonged surveillance. Radiotherapy sterilizes the ovaries above a dose of about 500 rads in an adult. Therefore, to protect at least one ovary in partial irradiation of a child's abdomen in mandatory whenever possible, either by restriction of the irradiated volume, or transposition of the ovary. Combined chemotherapies do not seem to inhibit endocrine function but it is too early to appreciate the effects of different combinations of drugs on reproductive function in girls. In boys, alkylating drugs cause an oligo or azoospermia, either temporary or permanently. The genetic risks in the descendants of children treated for cancer are still unknown.

Adolescent↗

Wilms' tumor: natural history and prognostic factors: a retrospective study of 248 cases treated at the Institut Gustave-Roussy 1952-1967.

A statistical analysis of 248 histologically proven cases of Wilms' tumor treated at the Institut Gustave-Roussy, Villejuif, France, from 1952 to 1967, is presented. Two years recurrence-free survival and five years survival have been selected as prognostic criteria. Patients under two years of age have significantly fewer metastases and a better five-year survival rate than those over two. Stage is stronly correlated with recurrences and survival. Influence of tumor size, number of tumor nodules, tumor rupture, adhesions, regional lymph node involvement, and renal vein infiltration is shown. Detailed analysis of histopathologic features indicates that a favorable clinical course is significantly related to the number of different varieties of epithelial differentiation (tubular, glomerular, microcystic) found in any tumor, whatever the abundance of each of them. Presence of striated muscular cells, however abundant, does not influence survival or metastatic rates. Cases where irradiation given prior to surgery resulted in complete destruction of tumor cells, form a distinctive group of very unfavorable prognosis. Relapse of tumor occurs in 54% of cases, 10% presenting with metastases. Involved sites are listed. No correlation is found between date of metastases and other parameters. The three major prognostic factors of age, stage, histologic pattern, bear prognostic value separately. Stage and age are linked, as well as histology and age. Stage and histology are not linked. Age in itself therefore seems less important. It is concluded that these well-defining treatment for each individual case.

Age Factors↗

Importance of a post-therapeutic residue in the prognosis of head and neck rhabdomyosarcoma in children.

Enhanced contrast computed tomography (CT) was performed in 23 children treated for head and neck rhabdomyosarcoma (RMS). The CT studies were retrospectively reviewed by two senior radiologists. Analysis of these CT studies revealed to separate groups of patients. One group (12 patients) had a post-therapeutic residue defined as soft tissue thickening at the original site, which remained stable over a period of 3 months and caused no mass effect on adjacent structures. Of these 12, eight showed enhancement at the area of thickening. Nine of these 12 patients relapsed. The other group (11 patients) demonstrated no post-therapeutic residue; only three of these patients relapsed. In this study the presence of a post-therapeutic residue was significantly associated with a poor prognosis, using a Fischer's test (P = 0.04).

Adolescent↗

Pheochromocytoma and paraganglioma in children: a report of 24 cases of the French Society of Pediatric Oncology.

Pheochromocytoma and paraganglioma of childhood are rare neuroendocrine tumors. Urinary catecholamine measurements, metaiobenzylguanidine (MIBG) scanning, computed tomographic scanning, and magnetic resonance imaging have greatly facilitated diagnosis. Prognosis after surgical resection is excellent. In this retrospective series collected from French oncology centers, the risk of tumor progression was studied in order to assess prognostic factors and the optimal diagnostic and therapeutic management. Medical records of 24 children with paraganglioma were reviewed. This tumor occurred at a median age of 12.5 years and in most cases was revealed by arterial hypertension. The diagnosis was made by the demonstration of urinary excretion of catecholamines and their metabolites. Six patients had bilateral adrenal pheochromocytomas; two patients had extra-adrenal paragangliomas. In eight patients, the paraganglioma occurred as a familial disease. Surgical excision was the only therapeutic procedure. With a follow-up of 5.2 years, 14 of the patients are still in first complete remission and 6 have developed metastases or shown tumor progression. Despite a high long-term survival rate, the risk of malignancy and of multifocal involvement is of concern and is associated with a significant rate of late events. The outcome depends on adequacy of tumor resection and must be serially assessed.

Adolescent↗

[Actual treatment of rhabdomyosarcoma of the orbit in children (author's transl)].

Among malignant tumor of the orbit in children, rhabdomyosarcoma remains the most frequent; it should be suspected on any unilateral exophthalmia. Twenty cases have been treated in the "Institut Gustave Roussy" (1960--1975). It can be shown with polychimiotherapy and a better coordination in timing of the other therapies, the survival rate improved clearly. In addition, since 1972 more localized forms have been treated. In the future, the survival rate is supposed to improve yet, if the diagnosis is made earlier. In such conditions a recovery with few inconveniences may be expected. Exenteration is an important mutilation and do not supply a better protection. A secondary inucleation due to complications of radio-therapy is not an exception. However a prothesis will be possible later.

Child↗

[Embryonal rhabdomyosarcoma diagnosed antenatally].

A case of congenital embryonal rhabdomyosarcoma of the right shoulder is described. The patient was the first child born to a 24 year-old woman who had previously been treated for sterility. The diagnosis was made by echography during the 36th week of gestation. This full term white boy was born by cesarean section because of the tumor size. Surgical treatment was completed by chemotherapy. Despite 4 courses of VAC, local recurrence was noted that led to a second surgical excision followed by a new cyclic chemotherapy (IVA). The treatment was fairly well tolerated. The child is well 24 months later.

Antineoplastic Combined Chemotherapy Protocols↗

[Endocrine sequela of radiation treatment of extracranial head and neck tumors].

A study of the thyroid and hypothalamo-pituitary functions was undertaken in 14 children having been irradiated for tumors of the neck and head. The following anomalies were found: S.T.H. deficiency: 8 cases, A.C.T.H. deficiency: 2 cases, T.S.H. deficiency: 4 cases, primary thyroid insufficiency: 4 cases. Growth was severely impaired since the height of 10 out of 14 patients was less than or equal to 2 S.D. These results emphasize the frequency of endocrine lesions related to radiotherapy, as the lesions were essentially extracranial. They also show a repercussion on growth, which worsen the long-term prognosis of these diseases.

Adolescent↗

Multidrug resistance gene transcript level, and P-glycoprotein expression in paediatric malignant mesenchymal tumours.

Twenty-four malignant mesenchymal tumour specimens were analysed for human multidrug resistance (MDRI) gene transcript levels using Northern and slot blot techniques. The presence of P-glycoprotein was assessed in 12 of the 24 samples by immunohistochemistry using the monoclonal antibody (MAb) C219. Increased MDRI transcript levels were found in 2 (8.3%), while, using immunohistochemistry, 2 samples were positive and 3 faintly positive (41.6%). Overall, elevated P-glycoprotein or MDRI transcript levels were found in tumours of 6 patients, 3 of whom are dead. The relationship to MDRI expression and subsequent resistance to chemotherapy has to be established.

ATP Binding Cassette Transporter, Subfamily B, Mem↗