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Biomedical subjects

M Delapierre

Publications and source records attributed to M Delapierre.

6 recordsLinked to original sources

[Brachytherapy in cervix cancers: development of techniques and concepts].

Brachytherapy plays an important role in the treatment of patients with cervical carcinoma. Technical modalities have evolved during the last years and have benefited from imaging modalities development, specially MRI. Imaging modalities contribute to a better knowledge of tumoral extension and critical organs. Ultrasound during brachytherapy has led to the almost complete eradication of uterine perforation. In the future, a more systematic use of systems allowing optimization may induce a better dose distribution in the tumor as well as in the critical organs. Recent data provided information in favor of a better analysis in the relative role of dose-rate, total dose and treated volume and their influence on the local control and complication incidence. Concomitant radiochemotherapy represents a standard in the treatment of patients with tumoral size exceeding 4 cm. Some questions still remain: is concomitant chemotherapy of benefit during brachytherapy? Is there any place for complementary surgery, specially in patients with complete response after external irradiation with concomitant chemotherapy and brachytherapy? In order to answer the former question, a phase III randomized trial is going to start, with the Fédération Nationale des Centres de Lutte Contre le Cancer as a promoter.

Antineoplastic Agents↗

Feasibility of measuring oxygen tension in uterine cervix carcinoma.

Cellular hypoxia is a cause of radioresistance. The oxygen tension (pO2) in normal tissues and in tumours can be measured by polarography. In this feasibility study we have measured the tissue pO2 of 10 patients suffering from uterine cervix carcinoma, using the Eppendorf histograph. The measurements were performed at the time of the brachytherapy after external radiotherapy. The machine was found to be reliable and no adverse effect was noted. The mean pO2 values in tumours were lower than those of normal tissues.

Adult↗

Prospective comparison of ultrasound and computed tomography in the evaluation of the size of the uterus: can these methods be used for intracavitary treatment planning of carcinoma of the uterus?

A prospective evaluation of computed tomography and ultrasound was performed on 34 patients with Stage I and II endometrial carcinoma. All patients underwent immediate surgery following intracavitary treatment directed to vaginal mucosa. Pathologic measurements of the uterus were compared to those obtained by imaging technologies. The results of the study suggest that all but height measurements were rather accurately determined by both ultrasound and CT scan. However ultrasound was significantly better in determining the size of the cervix. Therefore ultrasound measurements could be used routinely for intracavitary treatment planning in endocervical carcinoma and endometrial carcinoma.

Brachytherapy↗

[X-ray computed tomography of cancers of the uterine body (stages I and II). Anatomopathologic correlations. Apropos of 25 cases].

Twenty-five patients with endometrial cancer of body of uterus were examined by CT before and after intravenous administration of contrast medium. Hypodensity was noted before injection and was accentuated after injection in 4 cases, was observed after injection only in 9 and was totally absent in 12 cases. Comparison of findings with results of examination of frozen specimens indicated lack of correlation between size of tumor and depth to which myometrium was invaded, and results of CT imaging.

Adenocarcinoma↗

Endoluminal high-dose-rate brachytherapy with a palliative aim in esophageal cancer: preliminary results at the Institut Gustave Roussy.

Ten patients with advanced esophageal carcinoma were treated with endoluminal high-dose-rate brachytherapy at the Institut Gustave Roussy. Eight of them had recurrences after external beam radiotherapy. They were treated with a high-dose rate iridium-192 source. Five patients received 6 sessions of 4 Gy, 4 patients 3 sessions of 4 Gy, and 1 patient received 3 sessions of 8 Gy. The interval time between each session was 1 week. Seventy percent of patients improved their dysphagia, with 80% endoscopic tumor response. The Karnofsky index was improved in most of the patients. The mean survival was 4 months, and dysphagia-free survival was 2.5 months. Two patients had treatment toxicity but only a transitory WHO G1 esophagitis. Endoesophageal high-dose-rate curietherapy seems an effective technique in palliative treatments. We found low toxicity and an excellent tolerance to treatment in previously irradiated patients. The efficacy of the treatment is highly dependent on a precise tumor volume evaluation.

Aged↗