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Biomedical subjects

H Pourquier

Publications and source records attributed to H Pourquier.

At least 37 records · Page 2Linked to original sources
PubMed1986

Cancer of the piriform sinus: treatment by radiation therapy alone and with surgery.

To ascertain the optimal treatment for carcinoma of the piriform sinus, the authors determined survival rates and local and regional tumor growth for two groups of patients: those treated by radiation therapy alone (n = 209) and those treated by radiation therapy combined with surgery (n = 154). The two groups were similar with respect to the characteristics of primary tumor stage and degree of nodal involvement. The overall 3-year and 5-year actuarial survival rates were 19.2% and 15.5%, respectively. For 5-year actuarial survival, there was no significant difference between patients with T1 and T2 tumors, but there was a significant difference between patients with T1 + T2 tumors versus those with T3 tumor. There was no significant difference in 3- and 5-year survival between patients with N0 and N1 nodal involvement and those with N1 and N2 involvement, but there was a significant difference between patients with N0 versus those with N3 involvement. The 5-year actuarial survival rate is significantly better for patients who underwent surgery followed by radiation therapy than for those who received only radiation therapy. However, for patients with early-stage (T1 and T2) tumors, radiation therapy alone controls local tumor growth as well as the combination of surgery and radiation therapy does. For each treatment group, the causes of death and patterns of failure were studied and compared with investigations to date.

Actuarial Analysis↗
PubMed1986

[Cancer of the prostate. Results and causes of failure after exclusive radiotherapy in 131 cases treated at in locoregional stage between 1972 and 1981].

A retrospective study was carried out to evaluate results of exclusively physical treatment by external radiotherapy of 131 cases of cancer of prostate treated between 1972 and 1981. Median follow up has been for 8 years in 19 cases (stage A), 61 cases (stage B) and 51 cases (stage C). Patients were treated exclusively by external irradiation after histopathologic diagnosis and assessment of possible extension of tumor. High energy photons were developed by a linear accelerator and irradiation carried out through four portals, two anteroposterior, two lateral, with precise guidance by rectal and bladder opacification. Irradiation delivered to a pelvic volume over 5 weeks was subsequently reduced to the prostate bed until a total dose of about 65 to 70 Gy has been given. Primary glandular chains received 60 to 65 Gy, and critical organs, bladder, rectum, small intestine a smaller dose of less than the tolerance levels for these organs. Clinical, biologic and scintiscan examinations were repeated every three months. Results are presented as actuarial survival, as survival without local recurrence and a detailed analysis of failure of treatment. The 8-year survival rate was 60% for stage A, 47% for stage B and 33% for stage C. Unsuccessful cases were evaluated in terms of isolated metastases, metastases associated with local recurrence and isolated local recurrence. The highest incidence of ineffectiveness of therapy was noted in patients with distant metastases (26%), the rate being higher (41%) in stage C cases than in stage B cases (19%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Radiotherapy of seminomas of the testis. Apropos of 41 cases].

Our study reports on 41 patients with testicular seminoma (21 stage I and 20 stage II). Stage I patients received 20 Gy and stage II 35 to 36 Gy on infradiaphragmatic nodes and 20 Gy preventive mediastino-supraclavicular irradiation. The survival rate at 5 years for stage I patients was 100%. The stage II 5-year survival rate was 70%: 83.3% for stage IIA and 50% for stage IIB. For stage I patients only one death occurred and this was the result of a second cancer (bronchial cancer) which was diagnosed during the 8th year postirradiation. Of the stage II patients who did not respond to treatment, 3 were misdiagnosed histologically, one was due to the evolution of a secondary site (bladder), the 5th was due to insufficient irradiation and the 6th (anaplastic seminoma) presented extension of the disease in both irradiated and non-irradiated zone. Excluding these latter cases our study substantiates the curability of testicular seminomas by radiotherapy when dealing with stage I and stage II tumors. This early forms represent three fourths of all seminoma patients.

Adult↗
PubMed1985

Results of radiotherapy alone in 581 patients with Stage II carcinoma of the uterine cervix.

From January 1976 to December 1978, 581 previously untreated patients with Stage II carcinoma of the uterine cervix were treated by radiotherapy alone in nine departments of radiotherapy in France. This retrospective analysis was undertaken in an attempt to evaluate the therapeutic results and prognostically significant factors. The initial clinical staging and the therapeutic guidelines were as outlined at the U.T. M. D. Anderson Hospital in Houston; all our patients were treated by standardized protocols combining external beam irradiation and intracavitary irradiation with cesium sources. The overall locoregional control rate was 83.2%, with total disease control of 74.5%. Uncorrected actuarial survival rates are 76% at 3 years and 68% at 5 years. The incidence of severe posttherapeutic complications is 7.2%. Clinical substaging, patient's age at the time of the diagnosis, lymphangiogram findings, and tolerance to external irradiation were all found to have prognostic significance. According to those findings, the possibilities of improving the results are discussed.

Actuarial Analysis↗
PubMed1985

[Cancer of the endometrium: analysis of the comparative results and causes of failure in radiosurgical treatment and physical agents alone. 215 cases treated between 1968 and 1978].

Two groups of patients (215 cases) with endometrial cancer were treated between 1968 and 1978 either by a combination of radiotherapy and surgery or by radiotherapy alone. In the first group (99 cases) with a mean age of 59 years, results were very favorable for stage T1 and T2 (49/60, 82%) which confirm other results in the literature. The combination of radiotherapy and surgery comprising external irradiation and intracavitary irradiation prior to total hysterectomy did not appear to increase the number of complications to the urinary or digestive tracts. The second group (116 cases) comprised patients treated exclusively by radiotherapy due to the presence of metastatic disease (74 cases) or excessive local-regional extension (37 cases). The cure rate at 5 years appeared satisfactory for stage T1 (35/54, 65%). The differing results between combined radiotherapy and surgery with methods using radiotherapy alone should be partially corrected to take into account the older average age of the second group (69 years). Failures due to the appearance of metastases were approximately similar in both groups (near 6%); on the other hand, local-regional recurrences were more frequent when radiotherapy alone was used, which accounts for the differing results between the two groups. In the second period (1972 to 1978), the group treated exclusively with radiotherapy benefited from a technique used with cervical cancer: external irradiation followed by intracavitary irradiation with a Fletcher-Suit applicator with results similar to those treated in the first period with intracavitary irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometrium↗
PubMed1985

[Epithelial tumors of the ovary. Therapeutic results apropos of 165 cases of stage II and III tumors].

A report on the treatment of 165 epithelial tumours of the ovary (60 of which were stage II and 105 were stage III) by medical means after surgery. The results are far better in stage II cases for the length of survival without disease and the 5 year survival rate when surgical excision was complete (40 months and 43%) as compared with the disease-free interval and survival when surgical excision was incomplete (14 months and 27%) (p less than 0.05). There was a significant difference (p less than 0.05) in favour of pelvic and total abdominal irradiation as compared with other added therapeutic measures: 41 months as a median of disease-free interval and 60% survival at 5 years for patients who had pelvic and total abdominal irradiation combined with chemotherapy as against 26 months and 38% survival for patients who had only pelvic irradiation with chemotherapy. In the 105 stage III cases the median interval of disease-free survival and the survival at 5 years are quite different (p less than 0.01) for the 57 cases who had complete surgical excision (30 months and 17.5%) as compared with those who only had incomplete surgical treatment (1.4 months and 2%). There was no significant difference in the disease-free interval and the 5 year survival rate according to the different post-surgical therapeutic measures, whether these were chemotherapy alone or pelvic irradiation or pelvic and abdominal irradiation. These results are compared with those of other treatments following surgery of tumours of the ovary (a historical comparison and random trials).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Analysis of the results of irradiation in the treatment of tonsillar region carcinomas.

Five year follow-up data are presented for 215 patients with carcinomas of the tonsillar region, all of whom were treated by radiation therapy alone. Data are analyzed retrospectively to determine the factors associated with prognosis. As in many reports in the literature, prognostic factors regarding survival of the patients were: the initial tumor site (tumor extension to the base of the tongue was considered to be a bad prognosis factor); the initial tumor size and lymph node involvement (9.4% 5 year survival for T3N3 vs 73.7% 5 year survival for T1N0 cases); and histological type of differentiation (better prognosis for well differentiated carcinomas than for poorly differentiated tumors). Studies on the biological and volumetric data (the NSD value and target volume were calculated for each case) allowed a statistical and critical correlation between therapeutic results and physical characteristics of the radiation treatment.

Adult↗
PubMed1982

Cancer of the uterine cervix: dosimetric guidelines for prevention of late rectal and rectosigmoid complications as a result of radiotherapeutic treatment.

This paper is the report of a dosimetric study of 41 rectal and rectosigmoid complications after radiotherapeutic treatment (1974-1978) of 287 cervical uterine tumors. Treatment consisted of external irradiation (25 MeV linear accelerator) and intracavitary irradiation (Fletcher-Suit applicator) at different doses depending on tumor stage. Dosimetric measurements were expressed as the maximum rectal dose and mean rectal dose on the anterior surface of the rectum, as proposed by the Groupe Européen de Curiethérapie. Rectal doses were also studied as a function of intracavitary irradiation and intracavitary + external irradiation (maximum rectal and mean cumulative doses for each). The results show a significant difference in the state of the patients with and without complications, based on the dose reaching the rectum. The maximum and the mean cumulative rectal doses serve as one of the primary indicators for predicting complications. These values should therefore be determined before placement of intracavitary sources or, at the latest, before the second intracavitary application. We have shown that there is no fixed threshold dose, but that it varies from one region to another, depending on level of external irradiation. Our results argue in favor of adapting individual patient therapy based on simple precautions, which are adjustable to all treatment modalities. This method could lead to complete elimination of late rectal and rectosigmoid complications arising from radiotherapeutic treatment of cervical uterine cancer.

Brachytherapy↗
PubMed1981

[Therapeutic failures in early stages of Hodgkin's disease : causes and prevention (author's transl)].

A retrospective study of 65 patients with Hodgkin's disease (clinical stage I: 11 cases; stage II: 54 cases) included an analysis of the causes of therapy failure. Twenty-five of the 65 patients had been treated by regional irradiation (thoracic mantle or inverted Y field) restricted to only one side of the diaphragm; 27 patients had received the same irradiation followed by chemotherapy (MOPP). The subjects were irradiated on both sides of the diaphragm; 3 of these had received the same radiotherapy followed by chemotherapy (MOPP). Relapses in the irradiated fields were rare. Relapses in the areas bordering the irradiated fields were definitely the result of faulty delivery. Better evaluation of the precise extent of the disease, particularly by laparotomy, would lead to improved initial treatment (radio- or chemotherapy). The availability of improved irradiation techniques and a better choice of indications, particularly concerning the timing for chemotherapy, should result in maximal reduction of therapeutic failures in the early stages of Hodgkin's disease.

Antineoplastic Agents↗
PubMed1979

[Treatment of inoperable lung carcinoma by means of concentrated radiotherapy: results from 361 cases (author's transl)].

In the present work the results of a radiotherapy protocol for the treatment of inoperable lung cancer are examined. The study was carried out on two groups of patients treated successively; the first of 140 patients by means of cobalt therapy at the normal rate, up to a dose of 4,500 to 5,000 rads in 5 weeks; the second of 221 cases by means of concentrated radiotherapy in two series of 2,000 rads in five sessions, separated by 3 weeks of rest. The results show a more rapid regression of the symptomatology in the second group of patients and a clear superiority in respect to the survival rate. The patients treated at the normal rate showed after 6 months a survival rate of 40 percent as against 60.5 percent in the second group. This difference became more evident when comparing the histologic types: 9 and 57 percent respectively for anaplastic carcinomas. The survival rate after 1 year shows a difference between the two groups which is statistically significant (16 and 21 percent respectively) (p less than 0.05). In no case did we find complications of the type of esophagitis, pericarditis or transverse myelitis. The treatment in two sessions was better tolerated both from the physical and the psychic point of view by all the patients because of the 3 weeks of rest. The superiority in regard to survival, the rapid disappearance of the symptomatology, as well as the reduction in the therapy time, justify the use of concentrated radiotherapy in the treatment of this type of tumors even in the more advanced stages of the disease.

Cobalt Radioisotopes↗
PubMed1979

[Carcinoma of the nasal sub-septum (author's transl)].

On the basis of 13 cases, the authors describe the anatomical characteristics and course of primary carcinomas of the nasal sub-septum. This is a transitional form between nasal carcinomas and those of the nasal fossa. The cases described were treated either by conventional radiotherapy (200 Kv) or by electron therapy. The successful results obtained (12/13) confirmed the value of irradiation in this special site, without the risk of radionecrosis. The technique should conform with precise rule, as in all tumours of the face or nasal pyramid and the quality of the results obtained is compared favourable with those of all other methods.

Aged↗
PubMed1979

[Carcinoma of the cervix. Stages I and 2 proximal. Treatment by radiotherapy alone (author's transl)].

Carcinoma of the cervix stages 1 and 2 (1b and 2a) can be treated either with physical agents exclusively, or by surgery or by combining the two methods. No randomized trial has been performed until now, and to assess the different techniques, the different results found in literature must be used. We analyse here the results of the C.R.L.C. of Montpellier. The improvement of the results over last years' survey, can be judged after the use of external radiotherapy, which started in 1967. The doses must be given according to the size as well as the stage of the lesion. A thourough study of relevant literature confirms the fact that results are as good when only physical agents are used than with other techniques. Local recurrence are exceptional at stage T1, and no more than 4 to 5 per cent at stage T2 (proximal parametrium included. Whem comparing the side-effects and complications to those in other methods (but which are very rare after radio-therapy, at an early stage), the quality of the results may be seen. Actually, side-effects which occur at more advanced stages should not have an influence on the choice of the therapy in the early stages. We can conclude that there is a link between the course of the carcinoma and the chosen therapy starting from early forms to more advanced stages, and that physical agents can in every circumstance be used with benefit.

Female↗
PubMed1977

[Epitheliomas of the retro-molar trigone and of the inside surface of the cheeks (author's transl)].

The authors have made a study of 53 cases of tumours of the retro-molar trigone and of the internal surface of the cheeks which were treated between 1959 and 1972; these were malphigian epitheliomas except for one case of cylindroma. The research is concerned with the choice of methods and the therapeutic indications. Retro-molar trigones call for combined telecobaltherapy-electrontherapy;--curie-therapy is too difficult in this area. Electrontherapy may be used on alternate days with telecobaltherapy or as a booster dose after external irradiation by cobaltherapy. In cases of epitheliomas of the cheek, curietherapy or electrontherapy may be used after external irradiation or in isolation for tumours which are small in size. Therapeutic results are satisfactory in lesions at the outset (7/8 and 7/9), for T1-T2. For advanced lesions T3 of the trigone (6/16) and especially for those of the internal surface of the cheeks (2/9), the success rate is considerably lower; in lesions of the T4 type, a palliative effect was obtained but without any definite improvement.

Adult↗