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Biomedical subjects

F Reboul

Publications and source records attributed to F Reboul.

At least 55 records · Page 3Linked to original sources
PubMed1990

CT of malignant anal canal tumors.

Radiation therapy of malignant neoplasms of the anal canal has promising results in the majority of patients if the disease is limited at initial diagnosis. Computed tomography (CT), especially when performed with contrast material injected intravenously, is valuable in the pre- and posttreatment assessment of the anorectal musculature and perirectal nodes. The authors review the anatomy of the anorectal area and their experience with CT evaluation of anal canal cancer in a series of 26 patients. They also discuss their experience with treatment of this cancer in a series of 48 patients.

Anal Canal↗
PubMed1990

[Combination radiotherapy and chemotherapy in cancer of the pancreas. Review of the literature and prospects].

Overall prognosis of pancreatic adenocarcinoma is still very poor with median survival around 10 months after radical surgery in operable patients, or after full-dose radiation therapy in non-surgical candidates. In metastatic disease, multidrug chemotherapy regimens give a response rate of around 30% with median survival of 10 months. Random trials conducted by the GITSG in inoperable cases have shown improved results for chemoradiation with 5-FU for radiotherapy alone and a doubling of median survival with a 1-year survival of 40% vs 10%. Incorporation of Adriamycin in these combined modality protocols does not improve the results in terms of survival. Chemoradiation also shows improved results compared with chemotherapy alone. In patients amenable to radical surgery, adjuvant post-operative treatment with chemoradiation gave superior results over surgery alone with a doubling of median survival and a significant improvement of a two-year survival rate (42% versus 15%). Intra-operative radiation therapy leads to better local control but without a significant improvement in survival. With a better understanding of radio-chemotherapy interactions and mechanisms of radiosensitization through continuous infusion of fluorouracil and/or cisplatinum, these encouraging results should be confirmed within the next few years.

Adenocarcinoma↗
PubMed1986

[The value of breast lymphoscintigraphy in the definition of axillary staging in cancer of the breast].

Axillary lymphoscintigraphy (ALS) has been investigated in 51 patients with operable breast carcinoma between July 1982 and February 1984. Pre-operative intra-tumoral injection of 2.5 cm Ci of technetium 99 m antimony sulfide colloid has been performed before axillary dissection. We compared the scans produced by ALS with the results of pre-operative clinical examination of the axilla (UICC criterias) and to the histological status of the nodes surgically removed. We focused on the statistical methodology because, for us, most of the studies use inadequate tests. Axillary lymphoscintigraphy did not predict axillary metastase in breast cancer with precision. Its score was under clinical exam. Today, we are not allowed to abandon axillary dissection for pre-operative ALS. That simple and non traumatic examination appeared to be of no value in order to determine the axillary metastatic nodal status in breast cancer.

Axilla↗
PubMed1985

[Chemotherapy of embryonal carcinoma of the testis with lymph node invasion and/or pulmonary metastases. Results of a VBP type protocol].

Fourteen patients with histologically proven embryonal carcinoma of the testis with pulmonary metastasis (10 pts) or para-aortic nodal involvement (4 pts) were treated by a chemotherapy regimen including vinblastine, bleomycin and cisplatin. Extreme ages were 19 and 51 years with a median age of 32 years. Median duration of treatment was 6 months (6 cycles of chemotherapy) without maintenance treatment. After completion of chemotherapy, 6 patients in complete remission received para-aortic node irradiation (45 Grays in 25 fractions). One patient had a para-aortic node dissection, histologically negative. With a median follow-up of 47 months (maximum 92 months, minimum 12 months), eleven patients are in complete remission (78.6%). Three patients are dead from the disease, in spite of salvage chemotherapy. There were no toxic deaths. Disease-free actuarial survival is 74% at 4 years. Our results confirm the excellent therapeutic results of this chemotherapy regimen in embryonal carcinoma of the testis with pulmonary metastasis and/or para-aortic nodal involvement.

Adult↗
PubMed1983

[Transhepatic fine needle cholangiography. Retrospective study of 60 patients].

The purpose of this study was to present the retrospective results of 60 percutaneous transhepatic cholangiograms performed with a Chiba needle between 1978 and 1980 in a general radiology department. The puncture technique is now well established and the use of the Chiba needle considerably diminished the risk of local complications. The incidence of local complications is 5%. The complications are mainly due to the high pressure in the dilated bile ducts which can favorize infection and intraperitoneal bile effusion. When the right technique is used excellent imaging of the biliary system can be obtained. A correct diagnosis can be made in 95% of cases. The main indication of percutaneous transhepatic cholangiography is the obstruction of the main bile duct. The usual cases are: carcinoma of the head of the pancreas, carcinoma of the ampulla and other tumors of the main bile duct, neoplastic or inflamatory stenosis of the main bile duct, common duct stones and postoperatory complications of the biliary surgery. The errors of interpretation can be due to the difficulty to analyze the terminal portion of the bile duct or to false defects due to inhomogeneity of the contrast medium or a thick bile. The low complication rate and ist easy performance make the percutaneous transhepatic cholangiography competitive with the retrograde endoscopic opacification of the biliary system.

Biliary Tract Diseases↗
PubMed1982

[A study on 333 patients with adenocarcinoma of the endometrium treated by combined surgery and radiation therapy (author's transl)].

Three hundred and thirty-three consecutive patients with adenocarcinoma of the endometrium treated from 1958 to 1978 by combined surgery and radiation therapy or radiation therapy alone were reviewed. According to the FIGO staging system, there were 204 stage I, 40 stage II, 24 stage III and 20 stage IV. 40 cases of recurrences were also included in this study. The main parameters influencing survival were clinical staging, depth of myometrial invasion, histologic differentiation as well as the possibilities of radical surgery in these patients. Analysis of therapeutic results shows the superiority of pre-operative intra-cavitary irradiation followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy with an 80% actuarial survival at five years in stage I. Primary surgery followed by radiation therapy gives inferior results, particularly in stage II. Treatment by radiation therapy alone should be reserved for inoperable patients after careful evaluation and gives a 35% actuarial survival at five years. The incidence of serious therapeutic complications was 3,6 %. The early diagnosis of endometrial carcinoma by means of systematic endo-uterine explorations in post-menopausal bleeding and the elaboration of combined multi-modality protocol prior to any treatment should lead to a better cure rate for this cancer of increasing incidence.

Adenocarcinoma↗
PubMed1978

Herpes zoster and varicella infections in children with Hodgkin's disease: an analysis of contributing factors.

181 children with Hodgkin's disease were analyzed with respect to the occurrence of herpes zoster and varicella (HZ-V) infections, possible contributing factors, and prognostic significance. The overall frequency of HZ-V was 34.8%. The occurrence in stage I was significantly lower than in other stages. Previous splenectomy was not found to increase significantly the risk of infection. High-risk patients were those receiving extensive radiotherapy plus combination chemotherapy; 56% developed HZ-V infections in this group. The frequency with extensive field radiotherapy alone was 23.8%. 80% of infections occurred during the first year after completion of treatment. Their occurrence was not a poor prognostic sign in terms of relapse or fatality, even when occurring late. The high frequency of disseminated infection (27%) with its subsequent morbidity should lead toward a better understanding of the immunologic deficiencies in these patients and the possible role of prophylactic measures, in patients undergoing extensive radiotherapy in combination with multiagent chemotherapy.

Adolescent↗
PubMedDate not supplied

[Conservative treatment of anal canal carcinoma with external radiotherapy and interstitial brachytherapy, with or without chemotherapy: long-term results].

PURPOSE: A retrospective analysis of conservative treatment of anal canal cancers with external radiation therapy and interstitial brachytherapy with or without chemotherapy. PATIENTS AND METHODS: From 1986 to 1996, 69 patients were treated with external radiotherapy (40 Gy/20 fractions) and interstitial brachytherapy (20 Gy) after a mean interval of six weeks for a localized epidermoid carcinoma of the anal canal. Patients who did not complete the whole therapeutic sequence were not included. Forty-five patients received additional 5-fluorouracil- and/or mitomycin C-based chemotherapy regimen. RESULTS: Acute toxicity was acceptable. Complete response rate was 81%. Actuarial local control rate was at two and five years, 65% and 59% respectively (median follow-up: eight years). At two, five and ten years, actuarial colostomy rate was 26%, 33% and 33% respectively, and colostomy-free survival rates 61%, 47% and 37%. Overall survival at two, five and ten years was 81%, 65% and 53% respectively. Distant metastases occurred in 11 patients (16%). Prognostic factors for overall survival were performance status (PS) (79% survival at five years for patients with PS 0 versus 50% for patients with PS 1-3, P = 0.04) and tumor stage (80% at five years for T1-T2 versus 53% for T3-T4, P = 0.03). Overall treatment time less than 12 weeks and time interval between external radiotherapy and brachytherapy inferior than six weeks were associated with a better local control (P = 0.05). In multivariate analysis, these prognostic factors were not significant. CONCLUSION: These results confirm the efficacy of external radiotherapy and brachytherapy in the treatment of small anal canal cancers, and point out the need for improving treatment outcome of larger tumors.

Adult↗