Search PubMed⌕ Search

Biomedical subjects

J Lumbroso

Publications and source records attributed to J Lumbroso.

At least 73 records · Page 4Linked to original sources
PubMed1988

Follow-up of patients with differentiated thyroid carcinoma. Experience at Institut Gustave-Roussy, Villejuif.

The recent introduction of sTSH assays allows for a definite control of the inhibition of TSH secretion. Clinical examination and serum thyroid hormone measurements are necessary to obviate hyperthyroidism. Relapses may occur after decades of apparent complete remission. Follow-up should be pursued throughout the patient's lifetime. Two specific means allow the detection of relapses at a stage when X-rays are still normal: measurement of serum thyroglobulin and 131I total body scan. Their combined use is recommended.

Follow-Up Studies↗
PubMed1988

[Experience with protocol T10 in the pediatric service at the Gustave-Roussy Institute].

Between April and September 1986, 60 patients with osteosarcoma have been treated according to the T10 protocol in the Pediatrics Department of the Gustave Roussy Institute in Villejuif, France. Limb sparing could be achieved in 49 patients and amputation was necessary in 11. The necrosis of the primary tumor was total or subtotal in 33 cases and incomplete in the 27 others. With a median follow-up of 28 months, the actuarial survival is 85% at 48 months and the actuarial disease-free survival is 58%; the disease-free survival of "good responders" is 75% and 32% for "bad responders".

Adolescent↗
PubMed1988

[Treatment of malignant pheochromocytoma by 131-I-metaiodobenzylguanidine].

Twelve patients (2 with only bone metastases, 3 with only soft tissues metastases and 7 with bone and soft tissues metastases) were treated with 131-I-MIBG (specific activity: 20 mCi/mg), 100 to 200 mCi every 3-6 months. A dosimetric study was carried out before each administration. The follow-up ranged from 6 to 24 months and the number of doses ranged from 1 to 8, with 1.85-9 GBq per administration and a cumulative activity of 1.85-62. 2 GBq according to patients. The cumulative absorbed activity ranged from 850 to 9700 cGy. The following side effects were observed: a bone marrow hypoplasia (1 patient) and a transient increase in catecholamines (3 patients). The treatment was successful in 7 patients (3 with soft tissue metastases, 3 with bone and soft tissue metastases and one with bone metastases). This success consisted in clinical improvement and a decrease greater than 50% of hormonal values in the 7 patients and a decrease greater than 50% of tumoral masses in only 3 patients. No complete remission was obtained at this stage of the study. The disease recurred in 1 patient after a year of partial remission. There was no clear-cut relation between the number of doses and the results. This study shows that 131-I-MIBG can give encouraging though limited results.

3-Iodobenzylguanidine↗
PubMed1988

[Sensitivity and specificity of meta-iodobenzylguanidine (mIBG) scintigraphy in the evaluation of neuroblastoma: analysis of 115 cases].

Seventy children (3.7 +/- 3.3 y) with definitely confirmed diagnosis of neuroblastoma had 115 whole body scans carried out 24 h after injection of 3.7 MBq/kg of I-123 mIBG (83 scans) or 0.7 MBq/kg of I-131 mIBG (17 scans) or 0.9 to 4.5 GBq of I-131 mIBG (15 post-therapeutic scans). The scans were interpreted as positive in the presence of any non-physiological uptake area or of any bone uptake of the tracer, even at the level of the metaphyseal complex. For the primary tumour, the sensitivity of mIBG scans was 73%. Ten false negative patients had an overlap of the tumour with the bladder or heart images (4 cases) or with positive metastatic images (6 cases: liver, spine). Three false negative patients had neuroblastomas which did not secrete catecholamines. The specificity of mIBG was 94%. In our opinion, mIBG scans have a complementary role to assess the activity of post-therapeutic remnants. For the detection of hepatic and lymph node metastases, the sensitivity was about 50% and the specificity was 100%. The standard used for the detection of bone marrow metastases was the cytological and histological examination of 10 bone marrow aspirations and one or more biopsies (CHBMS). The sensitivity of mIBG scans was 90% and the specificity 68%. However, reviewing the data from the 16 false positive scans, we found 11 definitely proven bone metastases, 3 biological relapses and 2 cases of delayed abnormal CHBMS supporting the positivity of the mIBG scans, raising the specificity to 100%. Tc-99m diphosphonate bone scans had a sensitivity of 78% and a specificity of 51%. We suggest that positive mIBG scans may save other procedures since our data do not support false positive detection of bone or bone marrow metastases. In contrast, patients with negative mIBG findings should be further explored.

3-Iodobenzylguanidine↗
PubMed1987

Therapeutic use of 131I-metaiodobenzylguanidine (MIBG) in neuroblastoma: a phase II study in nine patients.

Effects of high activities of I 131 meta-iodobenzylguanidine (mIBG) were evaluated in nine children with advanced neuroblastoma. All patients had been previously heavily treated and had either primarily refractory disease or resistant relapse. Twenty-two doses of mIBG labeled with 1.3 to 4 GBq (35-108 mCi) of iodine 131 were administered. Three subjective effects, especially relief of pain, and two objective effects were observed. Transient blood pressure increase was observed once and did not recur after prolongation of the infusion time to 6 hours. A major side effect was bone marrow toxicity, essentially marked by thrombopenia, particularly severe in previously bone-marrow-transplanted patients.

3-Iodobenzylguanidine↗
PubMed1987

[Locoregional chemotherapy of hepatic metastases of colorectal cancer].

Locoregional, intra-arterial chemotherapy of liver metastases secondary to colo-rectal cancers is the least damaging among non-surgical treatments. In our experience of 58 cases treated during three years either with intermittent perfusions of 5 FU, or with continuous perfusion of FUDR (by pump), we observed 52% and 53% of objective responses with a survival rate at one year, of 73% and 90% respectively. However, this technique is limited because of locoregional complications and less effective, due to the development of extra-hepatic metastases. The proof of its effectiveness, in terms of survival, is currently being studied in the scope of a prospective and randomized trial with control group.

Adenocarcinoma↗
PubMed1987

[Value of DTPA scintigraphy following furosemide injection in the diagnosis of obstruction in renal transplantation].

Following development of dilatation on ultrasonography and/or intravenous pyelography in the course of follow-up after renal transplantation, a dilatation due to obstruction must be distinguished from dilatation without obstruction. DTPA scintigraphy is frequently used for the diagnosis of hydronephrosis caused by an anomaly of the pyeloureteric junction. In renal transplantation, this examination is used less frequently. The authors report a prospective study of Lasilix scintigraphy in the diagnosis of obstruction in 30 renal transplant. The results presenting with stasis of their transplant. The results were classified into 4 groups according to O'Reilly's classification and were compared with the course of the stasis. Lasilix scintigraphy demonstrated a specificity of 93% and a sensitivity of 63%. The role of stasis in the deterioration of the renal function of a transplant is difficult to evaluate. In cases of stasis with altered renal function, the authors propose the addition of study of the renal parenchyma by renal biopsy, which excludes rejection and Cyclosporin nephrotoxicity. When the renal biopsy is normal, the kidney should be drained by percutaneous nephrostomy which evaluates the capacity of recovery of renal function and determines the indication for antegrade dilatation or surgical repair.

Adult↗
PubMed1987

Early adjuvant intraportal chemotherapy after curative hepatectomy for colorectal liver metastases--a pilot study.

A preliminary study was conducted with early and continuous intraportal adjuvant chemotherapy (IPAC) after a curative hepatectomy for colorectal metastases. The IPAC consisted of 14 days of 5-FU infusion at the rate of 600 mg/m2/d. The ultimate aim of this study was to reduce the frequency of recurrences in the remaining liver after curative hepatectomy. Twelve patients were included. IPAC was initiated in nine of them, while three technical failures occurred. The 14-day course with continuous 5-FU was given five times. The treatment had to be ceased prematurely because one medical and three mechanical complications occurred during the infusion. Pains and vomiting were frequent, but were usually the result of mechanical complications. No important hepatotoxicity or haematological toxicity was observed. This study shows that a full course of chemotherapy could be administered in only 40% of the patients. Further pilot studies with the aim of improving feasibility should be undertaken. If the mechanical problems are improved and IPAC duration is reduced, then feasibility should be dramatically increased. Subsequently, only a prospective randomized study would confirm the efficiency of the method in minimizing liver recurrence.

Adenocarcinoma↗
PubMed1986

[Isolated hepatic metastases. Treatment by intra-arterial chemotherapy using a subcutaneous access chamber].

Twenty eight patients with isolated liver metastases of colorectal origin have been treated with discontinuous intra-arterial chemotherapy. This treatment was performed weekly with a surgically implanted subcutaneous access chamber. In all the patients the metastases were non-resectable and involved less than 75% of the liver. The first six patients were investigated in a phase I study which demonstrated that the method was well tolerated and provided a normal life at a lower price than the totally implanted pump. A subsequent phase II study included 22 patients. After implantation, they received an 8-hour infusion of 5 Fu 1 g/m2 each day for 8 consecutive days and after discharge, a weekly 8-hour infusion of 5 Fu 1 g/m2 and mitomycin C 1.5 mg/m2 as out-patients. Twenty-one patients have now been followed up for more than 3 months and are assessable in terms of response: we observed 4/21 complete responses, 6/21 partial responses, 3/21 minor responses, 7/21 stable disease and 1/21 progression. The objective response rate was 48%. The complication rate was low (2 leukopenias and 2 duodenal ulcerations) and comfort excellent with normal life between courses. In conclusion, with discontinuous intra-arterial chemotherapy we obtained the same response rate as with the totally implanted pump, with good tolerance and quality of life and perhaps a lower rate of complication. The two methods should now be compared in a randomized trial.

Ambulatory Care↗
PubMed1986

Long-term results of treatment of 283 patients with lung and bone metastases from differentiated thyroid carcinoma.

We assessed the results of treatment in 283 patients with lung or bone metastases from differentiated thyroid carcinoma who were followed for up to 40 yr (median, 44 months) after the discovery of the metastases. The survival rates from the time of discovery of the metastases were 53% at 5 yr, 38% at 10 yr, and 30% at 15 yr; 156 patients died. Multivariate analysis revealed that only 4 variables had an independent prognostic significance for survival. They were extensive metastases, older age at discovery of the metastases, absence of radioiodine uptake by the metastases, and moderately differentiated follicular cell type. The site of metastases (lung or bone) was not a prognostic factor for survival after treatment of metastatic disease. Remission was achieved in 79 patients after metastases were found. The only predictive factor for 5-yr disease-free survival after treatment of metastases was the initial extent of disease. Our results suggest that the aim of management should be to detect and treat metastases in patients with thyroid cancer as early as possible.

Adult↗
PubMed1985

[Cancer of the prostate: value of bone scintigraphy. Point of view].

Radionuclide bone scanning carried out with technetium radiopharmaceutics detects almost all prostatic carcinoma osseous metastases. It is easy to recognize focal areas of increased tracer uptake or a diffuse increased uptake, and the test provides a synthetic view of the entire skeleton. Complementary bone radiographs are necessary if the diagnosis remains doubtful, if mechanical complications are searched and if there is a post-radiotherapeutic decrease of the tracer uptake. A bone scan is necessary before the radical treatment of the primary tumour, in order to rule out the possibility of bone metastases. The initial bone scan has also a pronostic value. However, in the follow-up of initially non-metastatic patients, serial bone scans should not be realized when clinical symptoms or biological abnormalities lack. Bone scintigraphy is also useful to monitor the course of bone metastases under treatment, especially when the value of new therapeutic agents is investigated.

Bone Neoplasms↗
PubMed1984

Pulmonary evaluation of patients with osteosarcoma: roles of standard radiography, tomography, CT, scintigraphy, and tomoscintigraphy.

Sixty-one radiologic evaluations were performed on 32 patients with possible pulmonary metastases from osteosarcoma. CT scanning was performed 61 times; standard chest radiography, 58; tomography, 36; scintigraphy, 40; and tomoscintigraphy, 33. Using CT as a reference (positive or negative results only), the sensitivities of the other examinations were 57% (32% of total metastases) for standard radiography, 88% (48%) for tomography, 21% (5%) for scintigraphy, and 41% (8%) for tomoscintigraphy. Of the 193 metastases, 98 were subpleural and 95 were parenchymatous. Five patients had surgery and the others had follow-up. One false-positive CT scan was thus detected. The authors' current evaluation of patients with metastases from osteosarcoma includes chest radiography and CT; the other three examinations are performed only before surgery.

Adolescent↗
PubMed1984

[Monoclonal antibodies directed against the beta hCG subunit and against a synthetic peptide analog of the carboxyl-terminal end. Clinical use in vivo and in vitro].

In order to detect specifically the beta-hCG, we have produced monoclonal antibodies (Mabs), using as immunogens hCG, beta hCG or a totally synthetic molecule (109-145 peptide) analogous to the beta-subunit carboxyl terminus. 34 fusion experiments were performed and led to 8 Mabs which presented a high reactivity to 125I beta hCG in the screening test. Mab D1E8 was directed to the 1-115 region of beta hCG and was cross reactive with hLH (greater than 60%). Mabs 702, 1032, and 1211 were directed against three different epitopes located in the 109-145 region and were specific for the beta hCG. The in vivo localization of tumors containing beta hCG ty tomoscintigraphy (SPECT) was evaluated in 5 patients by injecting 131I-Mab D1E8, selected for imaging because of its high affinity to beta hCG (Ka = 1.9 X 10(9)). SPECT was performed 48 h and 96 h after injection: 2 patients with proven tumor sites had positive "immunoscintigraphy" results. One patient, simultaneously injected with 125I non-specific IgG, had a tumor resection: the count ratio between normal and tumoral tissues revealed a low specific uptake. Two and three-site immunoradiometric assays (IRMA) were performed with monoclonal antibodies purified from nude mice ascitic fluids. IRMA were based upon two or three Mabs, with D1E8 on a solid phase and 125I Mab 702 or a mixing of 125I-702 and 125I-1032 as tracer. The specificity of IRMA was demonstrated by the absence of binding with increasing amount of hLH, hFSH and hTSH up to 5000 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗
PubMed1984

[Immunoscintigraphy with emission tomography in cancers of the thyroid].

Immunoscintigraphy (IS) consists of in vivo body structure imaging using a specific labelled antibody to an antigen concentrated in the structure under study. Technically, the image contrast is better when IS is performed with a computerized emission tomography system. High concentrations of carcinoembryonic antigen (CEA) have been reported in medullary thyroid carcinoma and thyroglobulin (Tg) is a marker for differentiated thyroid carcinoma. We used injections of 131-I labelled monoclonal antibodies to CEA and Tg to detect thyroid tumours. A feasibility trial using anti-CEA antibodies gave very encouraging results. However, only tumours larger than 10 cm3 could be detected. Contradictory results were obtained using anti-Tg antibodies but this data must be considered as preliminary. Various means of improving the method and the concept of accessibility of the antigen to the antibody in vivo are discussed. This study shows IS to be a promising experimental technique. Further studies are required to define its clinical indications before it can be advocated for routine use.

Animals↗
PubMed1984

Immunoscintigraphy in human squamous lung cancer using monoclonal antibodies.

We describe immunoscintigraphy using a radiolabelled anti-tumor monoclonal antibody 181-23 in 6 patients with squamous lung cancer. Double-label method using simultaneous injections of 131I MAB and 125I control immunoglobulin was performed to evaluate the specificity of MAB localization in the tumor. Immunohistological localization of MAB in resected specimen was obtained by immunoperoxidase technique. All our data are negative but correlated.

Aged↗
PubMed1984

[Detection of recurrence in patients with differentiated epithelioma of the thyroid].

Two complementary methods are available for detection of tumour recurrence in patients with treated differentiated thyroid carcinoma: plasma thyroglobulin (Tg) measurement and I 131 total body scans (TBS). Tg is measured during T4 treatment: in patients with no thyroid tissue, detectable Tg levels indicated relapse requiring localisation by TBS. False negative results are rare but have been reported and therefore, it is useful to repeat Tg measurement after TSH stimulation in patients with undetectable Tg levels during T4 treatment. Patients with residual thyroid tissues and an elevated Tg level probably have tumour recurrence, but in most cases, Tg is within normal limits and no conclusions can be drawn. TBS in patients with no thyroid tissue is performed 2 weeks after withdrawal of T3. Patients with residual thyroid tissue have TBS performed after 3 injections of bTSH. Doses of 1 to 5 mCi of I 131 are given and TBS is carried out 3 days later? In conclusion, we can say that these two methods are complementary: Tg levels indicate the need for TBS.

Carcinoma↗