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Biomedical subjects

F Mornex

Publications and source records attributed to F Mornex.

At least 109 records · Page 6Linked to original sources
PubMed1993

Limited disease small cell lung cancer: alternating combination of doxorubicin, etoposide, ifosfamide and hyperfractionated radiotherapy. Final results of a multicentric pilot study for the Groupe Lyonnias d'Oncologie Thoracique (GLOT).

In order to evaluate the effect on prolonging survival of alternating chemotherapy and radiotherapy schedules in patients with limited disease small cell lung cancer, 89 patients were included in a multi-institutional pilot study between January 1986 and May 1989. Treatment consisted of induction chemotherapy using the combination of doxorubicin, etoposide and ifosfamide (AVI) for four consecutive courses, followed by two cycles of the VI chemotherapy alternating with three hyperfractionated radiotherapy courses and then followed by two additional courses of AVI. Objective response to the four cycles of AVI combination was observed in 65 patients (75%). Thirteen out of 30 patients (44%) who were in partial response (PR) after induction chemotherapy were converted into complete response (CR) after the three alternating courses of chemotherapy and radiotherapy. The principal side effect related to combined modality treatment was acute radiation pneumonitis (21.5% cases) reversible except one which resulted in toxic death, and a second with chronic lung fibrosis with permanent WHO Grade 2 dyspnea (14%). Local relapse was observed in 47% of the patients who were considered in CR at the end of the treatment program and cerebral metastases were the first site of detectable relapse in 25% cases. The 3-year actuarial disease-free survival of the 89 patients is 5%, and the median actuarial survival is 14 months. This study shows that the promising survival rates seen in our previously published interim analysis were not maintained. Reasons for this might include the choice of a non cisplatinum containing induction chemotherapy, the late introduction of thoracic irradiation and/or to the use of non-restrictive criteria for selecting patients.

Adult↗
PubMed1990

Hyperfractionated radiotherapy alternating with multidrug chemotherapy in the treatment of limited small cell lung cancer (SCLC). Groupe Lyonnais d'Oncologie Thoracique.

From January 1986 through December 1988, 227 patients were included in a multi-institutional pilot study for small cell lung cancer (SCLC). Out of the 211 patients who fully completed the staging procedures, 77 (35%) appeared to have SCLC limited to the thorax. All patients received combination therapy consisting of AVI (Adriamycin, VP-16 and Ifosfamide), except during radiotherapy when the Adriamycin was omitted, plus twice daily fractionated 18 MV radiotherapy. Treatment protocol consisted of 4 initial courses of AVI, followed by 3 courses of radiotherapy alternating with modified chemotherapy (VP-16 and Ifosfamide), completed by 2 courses of initial chemotherapy (AVI). Radiotherapy consisted of 1.5 Gy/fraction, 2 fractions/day, 5 days/week in the first course, and 1.8 Gy/fraction, 2 fractions/day, 5 days/week, in the second and third courses, for a total tumor dose of 51 Gy, felt to be equivalent to 60 Gy at normal fractionation. CT treatment planning was employed to design a treatment consisting of multiport radiotherapy, using AP-PA and laterals or obliques beams. During the first course, the homolateral hemithorax received 9 Gy total dose on days 1, 3, 5. During the third course, 360 degrees arctherapy was generally used to boost the reduced tumor volume to a 51 Gy. Besides chest X ray and CT scan, staging and restaging procedures included fiberoptic bronchoscopy. Response rate after irradiation is 61%, with 46% complete responders and 51% local control. The median survival is 14 months, and disease-free survival 42% at 1 year. Complications consisted of cardiac toxicity in 2 patients, 1 death of acute pulmonary toxicity, and 4 instances of moderate chronic radiation pneumonitis. Thus, high doses of radiation can be delivered combined with chemotherapy using this protocol, with an acceptable toxicity and encouraging results in response rate and local control. A longer follow-up is needed to evaluate the impact of these results on survival.

Adult↗
PubMed1990

[Conservative treatment of breast cancer (the Lyon experience during 1963-1983)].

Over a 20-year period (1969-1983), 570 infiltrating primary breast carcinomas were conservatively treated in Lyons. Two different protocols were used: a first group of 162 patients with T1 T2 less than 3 cm NO lesions was treated, between 1963 and 1973, by lumpectomy and external beam irradiation with 60cobalt. The 5 and 10 year overall survival rates are 86% and 66% respectively. Local and regional failure rates are 10% and 2.5%. Cosmetic result was good or excellent in 70% of patients with only 5% poor results; a second group of 408 patients with T1 T2 less than 3 cm lesions was treated between 1973 and 1983 by tumorectomy and axillary dissection, followed by cobalt irradiation and 192iridium boost. The 5-year overall survival rate was 90% and, at 5 years, the probability of failure is 5% in the breast and 2% in the axilla. Cosmetic results are comparable in the 2 groups. Comparison of these 2 groups indicates an improvement in local control with Iridium boost. No obvious change in axillary recurrence rate and overall survival rate was observed. Boost modalities are discussed, with regard to cosmetic results. A prospective randomized study was initiated in 1986, in order to assess the value of the boost in the conservative treatment of breast cancer.

Adult↗
PubMed1990

[Time factor and curietherapy: the example of epidermoid carcinoma of the mobile tongue].

Experimental evidence exists of a dose-rate effect relationship in low dose continuous irradiation of cell population. In 1952, Paterson drew from his clinical experience on radium 226 implant, a dose-time iso-effect curve. Several authors, reviewing series of squamous cell carcinomas of the mobile tongue, implanted by radium 226 or iridium 192, did not confirm Paterson's hypothesis. Recently, a retrospective analysis of T1 and T2 squamous cell carcinomas, all treated exclusively by iridium 192 at the Henri-Mondor Hospital (Créteil, France), suggested a possible dose-rate effect relationship below 1 Gy/h. However, the role of dose-rate remains unclear. Further experience is needed before definitive conclusions can be drawn.

Brachytherapy↗
PubMed1990

[Predictive tests of radiocurability: towards a custom-made radiotherapy?].

Up to now, radiation oncologists had at their disposal only a number of well-known histological and clinical factors in order to define the optimal dose which should be delivered to a given tumor. Recently, radibiological studies have suggested additional parameters which may play a major role in tumor radiocurability. These parameters are: the number of clonogenic cells, intrinsic radiosensitivity, hypoxia and proliferation kinetics. "Predictive" tests are being developed and evaluated for each of these parameters. The more advanced studies deal with intrinsic radiosensitivity; preliminary data show impressive variations in radiosensitivity within groups of clinically "homogeneous" tumors. Should these tests prove to be reliably predictive of radiocurability, it will be possible, in the near future, to propose to any given patient a "custom-made radiotherapy" adapted to the precise features of his or her tumor.

Animals↗
PubMed1989

[Percutaneous vertebroplasty in the treatment of metastases. Technic and results].

The authors studied 20 patients with vertebral metastases. They injected in these metastases orthopaedic cement by a percutaneous technique under local anesthesis. The results are good for 16 patients, nul for 2 patients and we observed 2 complications. The authors conclude that the best indication is the painy somatic lysis of a vertebra without peri-radicular tumor.

Adult↗
PubMed1988

[Radiotherapy of cerebral metastases. 196 cases treated from 1973 to 1981].

One hundred and ninety six patients underwent brain irradiation for metastases between 1973 and 1981. Complete follow-up was possible in 180 cases. CT appeared to be the best diagnostic tool. Whatever the type of the tumor, irradiation improved symptoms and signs in 65.3 p. 100 of cases and neurological status in 37 p. 100 of cases. The median survival was 4.2 months, the mean survival 6.6 months, the percent survival at 1 year 11 p. 100. It is necessary to irradiate the whole brain with doses of 40-45 Gy in 4.5 weeks. Shorter periods of irradiation allows a short inhospital stay but implies anti-oedematous treatment. Chemotherapy did not improve the results. Excision surgery had limited indications: isolated metastases, accessible site in zones with no functional importance, good performance status, local control obtained for primary tumor, no extra-cerebral metastases. Surgery must be followed by whole brain irradiation. Derivation is necessary when increased intracranial pressure and treatment resistance are present. Irradiation indications are large. The results were palliative but valuable: irradiation was always indicated except when disorders of consciousness were present. Tolerance was usually good.

Adult↗
PubMed1987

Tissue distribution and stability of metalloporphyrin MRI contrast agents.

Mn(III), Fe(III), and Gd(III) complexes of tetrakis(4-sulfonatophenyl)porphyrin (TPPS) and several other porphyrins were evaluated as potential MRI contrast agents. Based on consideration of relaxivity and stability properties in solution, MnTPPS was found to be the compound of choice. At pH 7 the Gd and Mn complexes significantly enhanced the water proton relaxation rate, while the relaxivity of FeTPPS exhibited a significant loss of relaxivity above pH 6 due to oxy-dimer formation. Although GdTPPS exhibited the highest relaxivity in solution, this property was rapidly lost due to dissociation of the metal ion. By contrast MnTPPS remained stable in human plasma after incubation for 9 days. Upon intravenous injection into athymic mice bearing subcutaneous human colon carcinoma xenografts, MnTPPS provided enhanced relaxation of the tissue water in several excised mouse tissues, notably kidney, liver, and tumor. The results at a fixed field (0.25 T) and relaxation dispersion studies showed decreases in water relaxation rates with time for kidney and liver, but an increase for the tumor, with a maximum near 4 days at the highest dose used.

Animals↗
PubMed1987

Radioimmunotherapy of athymic mice bearing human colon carcinomas with monoclonal antibody B72.3: histological and autoradiographic study of effects on tumors and normal organs.

Monoclonal antibody (MAb) B72.3 has been linked successfully to several radionuclides forming stable complexes and analyzed in vitro and in vivo without significant loss of its immunoreactivity. Previous studies have demonstrated that radioiodinated B72.3 can selectively bind to human colorectal carcinomas grown in athymic mice. The same successful localization has been obtained more recently in clinical trials in patients with metastatic colorectal carcinomas. The high degree of selective binding of this MAb has led us to investigate its potential as a radioimmunotherapeutic agent. Athymic mice bearing human colon carcinoma xenografts were injected with either 300 or 500 microCi of 131I-B72.3 IgG to assess the effect o the radiolabeled MAb on the tumor growth as well as potential toxic side effects in vital organs. In mice treated with the 131I-B72.3 IgG, a marked inhibition of the growth of the human colon carcinoma xenografts was noticed in comparison with control mice injected with PBS or control mice that received unlabeled B72.3 IgG. The tumors from these control mice weighed 2.7 to 3.7 times more than the tumors from the treated mice at 17 days post-inoculation of the radiolabeled MAb. Autoradiographic studies demonstrated a heterogeneous distribution of radioactivity throughout the tumor mass at 11 days post-administration of MAb. With time, the periphery of the tumor contained significantly less radioactivity than the medial areas composed of predominantly nonviable tissue; these findings suggest that the more biologically active peripheral tumor zones, with higher mitotic rates, could have partially escaped the radiation effect of the single dose administered. The tumor cells could have continued dividing when the levels of circulating radiolabeled monoclonal antibody had decreased. Toxicity was readily evident in the mice injected with the high-dose regimen (500 microCi), with confirmed bone marrow aplasia that proved lethal for 2 of 10 animals. The lower dose (300 microCi) resulted in a bone marrow suppression of approx. 50% of the cells, which proved to be non-lethal. The tumors in the treated mice showed extensive necrosis caused by the lethal dose of 131I-B72.3 that irreversibly damaged the cells. Radiation-induced terminal differentiation of cells was also found as manifested by the drastically decreased mitotic count (0-2 vs. 12-14 per 10 high power fields seen in control tumors) in treated animals.

Adenocarcinoma, Mucinous↗
PubMed1986

Radioimmunodetection of human colon carcinoma xenografts in visceral organs of congenitally athymic mice.

The LS-174T human colon carcinoma line and A375 human melanoma line were used to establish primary tumor xenografts at three sites (subcutaneous, spleen, and kidney) in congenitally athymic mice. A monoclonal antibody (MAb) reactive with the LS-174T line, B72.3 IgG, was labeled with iodine 125, and an isotype-identical control antibody MOPC-21, was labeled with iodine 131. Labeled antibodies were injected intravenously in tumor-bearing mice, and animals were killed at varying intervals. Tumor-to-blood and tumor-to-organ ratios of MAb 72.3 indicated no significant difference at any of the three primary tumor sites in LS-174T tumor-bearing mice. The percent injected dose per gram was higher at visceral sites on day 3, but was similar on days 5 and 7 at all sites. Localization indices on all days ranged from 4 to 1 to greater than 16 to 1, confirming the specificity of the B72.3 reactivity at all sites. Athymic mice bearing tumor xenografts were scanned on day 7, and the LS-174T spleen and kidney tumors were imaged, with efficacy similar to that of the subcutaneous site. The visceral tumor model is more representative of the human disease, and may therefore be a better model for evaluation of monoclonal antibodies for radioimmunodetection and therapy for cancer in intra-abdominal organs.

Animals↗
PubMed1984

Radiotherapy of high bile duct carcinoma using intra-catheter iridium 192 wire.

The authors developed an original procedure of endo-curietherapy of high bile duct carcinoma. An iridium 192 wire is inserted into either a percutaneous transhepatic catheter or a surgically implanted external diversion catheter. The delivered dose varies between 10 and 60 Gy at 1 cm from the wire. Four of the seven patients analyzed also received external irradiation. There were no systemic or local complications. All patients experienced symptomatic relief and four are alive with no evidence of disease. This well-tolerated procedure permits symptomatic palliation without excessive side effects for the patient. In some cases, a curative effect can be expected.

Adenocarcinoma↗