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Biomedical subjects

P Beutter

Publications and source records attributed to P Beutter.

At least 55 records · Page 3Linked to original sources

[Cancer of the tonsillar region. Role of irradiation in treatment].

In our center, carcinomas of the tonsillar region are usually treated by radiotherapy. This study presents the results of our treatment experience over ten years. Between 1976 and 1986, we treated 137 patients with carcinoma of the tonsillar area. The mean age was 54.3 years. The UICC TNM staging of 1979 was used: 63% of the patients had T3 and T4 tumours and 53% had lymph nodes at the first examination. All patients were treated by radiotherapy, alone for 121 patients and associated with brachytherapy for 16 patients. 61 patients received induction chemotherapy with Cisplatinum. Local control rate at the primary site was 56%, and was respectively 92%, 71%, 57% and 11% for T1, T2, T3 and T4 tumours. Local control rate in the neck was 72%. The 5-year actuarial survival rate was 34%. Distant metastasis occurred in 12 patients. 9 patients had a second primary tumor. Node status and stage were the main prognostic factors. Age, sex, histological subtype were not prognostic factors.

Carcinoma, Squamous Cell↗

[Radiotherapy of carcinoma of the oropharynx. Results of 10 years' experience at the University Hospital Center, Tours].

In our centre, the vast majority of patients with oropharyngeal tumours are treated by irradiation. Over a period of 10 years, between 1976 and 1986 we treated 305 patients with squamous carcinomas of the oropharynx. The mean age was 58.2 years. There were 24 women and 281 men. 59% of the patients had advanced tumours, classified as T3 or T4, 54% of the patients showed the presence of adenopathy at the first examination. All patients received radiation therapy. 69 patients had surgical treatment of the tumour or glands. 21 patients had implant therapy (most often combined with transcutaneous irradiation). 165 patients had induction chemotherapy. Local tumour control was obtained in 124 patients (41%), i.e. 82, 56, 31 and 4% for T1, T2, T3 and T4 respectively. The 5 years survival rate of the overall population was 28%. The principle causes of failure were local progression for T3 and T4 tumours and metastases and second cancers in patients with T1 or T2 tumours. The prognostic factors were gland involvement and general health. The site of the tumour, sex and histological type were not prognostic factors. Induction chemotherapy did not improve the results of treatment.

Carcinoma↗

[Carcinomas of the base of tongue: analysis of treatment results in 115 patients].

Between 1976 and 1986, we have treated 115 patients with base of the tongue carcinomas. The mean age was 53.8 years. Staging system used was the UICC TNM classification of 1979. 70% of the tumors were T3 or T4 and 42% had N2 or N3 lymph nodes. Loco-regional treatment was irradiation alone (98/115) or surgery and post-operative radiotherapy (17/115). 67 patients received an induction chemotherapy. 3 and 5 years actuarial survival was 25% and 23%, and 42, 48, 20 and 17% at 3 years for T1, T2, T3 and T4 lesions respectively. Local control rate at the primary sites was 55%, local control rate in the neck was 78%. Distant metastases occurred for 10% and 8% had a second primary. Nodal status was the only other prognostic factor. Local control rate obtained with irradiation alone was not good. For limited tumors T1 and T2, a better local control rate can be obtained with interstitial therapy or surgery.

Carcinoma, Squamous Cell↗

[Carcinoma of the soft palate and uvula. An analysis of the results and the reasons for failures. A study of 76 cases].

The treatment of carcinomas of the soft palate most often involves radiotherapy. In order to assess the value of irradiation, notably in the treatment of limited T1 or T2 tumours, a retrospective study was carried out of 76 case records suitable for analysis of patients treated in our hospital for this type of tumour between 1974 and 1987. There were 70 men and 6 women. The mean age was 54 years. Fifty-four patients had limited T1 or T2 tumours (including 40 without lymphadenopathy). Treatment methods varied but 48/76 were treated by radiotherapy only (transcutaneous irradiation and/or local interstitial implant). Local tumour control was obtained in 87% of patients with T1 tumours, in 77% with T2 and in 50% with T3 tumours. Lymph node control was obtained in 68% of patients. None of the patients initially classified NO showed any subsequent lymph node involvement. The actuarial five-year survival rate was 67% for T1, 38% for T2 and 22% for T3. Lymph node involvement was the only other prognostic factor. Fourteen patients developed distant metastases and 13% had at least one other tumour site. Radiotherapy as tumour treatment is thus felt to be the method most widely used apart from tumours strictly limited to the uvula, where surgery is preferred. Cervical lymph nodes are treated surgically when there is a palpable lymphadenopathy and by radiotherapy for N0 patients. Induction chemotherapy before radiotherapy is used in addition at stages T3 and T4.

Adult↗

[Advanced carcinoma of the oropharynx: the value of induction chemotherapy before locoregional treatment. A retrospective study of 138 cases].

Induction chemotherapy in oropharynx carcinomas had demonstrated overall response rates of 80%, but no overall survival benefit have been reported. In order to determine the value of induction chemotherapy for these patients, we conducted a retrospective study: 86 patients were treated with chemotherapy (CT) and RT (group 1) and 52 patients were treated by radiotherapy (RT) alone (group 2). All patients had T3 or T4 tumors. CT used was cisplatinum based associated with bleomycin and vincristine or vindesine and actually with 5 fluoro-uracil. Objective response to the CT was observed for 34% patients. Five years actuarial survival rate was 18% for group 1 and 17% for group 2. Patterns of failure were identical in the 2 groups. A difference was observed only for patients with N3 nodes (24% 5 years survival rate in group 1 versus 6% in group 2) (P = 0.05). According to the histologic differentiation, the tumor site or the type of CT, no difference was observed. We concluded that this study failed to demonstrate an advantage for induction chemotherapy in advanced oropharynx carcinoma excepted for patients with N3 nodes.

Actuarial Analysis↗

[Surgical correction of saddle nose. Apropos of 23 cases].

Choice of graft for repair of a saddle nose in 23 patients, usually late sequelae of nasal fracture, varied with degree of concavity : moderate anomalies usually by cartilaginous graft, major lesions by iliac bone graft. Postoperative course was always simple. The Rethi approach was used when a bone graft was necessary, with a minimum esthetic ransom, and a skin flap of V-Y advancement at the expense of the white labrum when there was insufficiency of columellar height. Although results were assessed as satisfactory by the patients, the difficulties in obtaining excellent results in this type of rhinoplasty are emphasized, imperfections being frequent : filling of nasofrontal angle, asymmetry of naries orifices and fixed nose appearance.

Adolescent↗

[Study by auditory evoked potentials of the efficacy of transcutaneous electric stimulation in the treatment of tinnitus].

Thirty patients complaining about tinnitus were treated by transcutaneous tragal electrical stimulation. The effect of this treatment has been evaluated by BASR recordings before and after treatment. Taking into account the subjective results three groups are described. The first one (10 patients) is relieved of tinnitus. In second and third group the symptoms still exist, whatever the electrode's position (anode or cathode in tragal position). When BASR are studied before the electrical stimulation no inter-subjects difference can be found. After stimulation, the left delta I-V latency is significatively lengthened, and the wave I latency is shortened in the first group. The study of the two other groups do not reveal any difference between the pre- and the post- stimulation evaluation. So the BASR appears to be a good predictive tool for tinnitus suppression by electrical stimulation.

Adolescent↗

[Effects of nicotine on precocious evoked auditory potentials of the rat in the presence or absence of endogenous serotonin].

In the rat, nicotine bitartrate (100 micrograms/kg) by intraperitoneal route provokes modifications of the brain stem auditory evoked potentials. These changes are complex: a) decrease of the amplitude of waves IV and V, probably by fixation on nicotinic type receptors, neuronal serotonin stores being normal; b) increase of the amplitude of waves I, I' and II, more important when endogenous stores are depleted; c) increase in the latency of these waves when serotonin stores are normal.

Animals↗

[Use of coral implants in maxillofacial and otorhinolaryngologic surgery].

The coral, as bio-compatible implant, has been used in several indications: in Otology: for ossicular chain and external auditory canal reconstruction. In Maxillo-facial surgery: for orbital floor, maxillary sinus and jawbone reconstruction. The first results of this study are favorable but coral resorption might be prevent by a careful sealing of the implant deep under the surface layer.

Biocompatible Materials↗

[Limits of auditory evoked potentials of the brain stem in the diagnosis of deafness in children].

117 children were examined in Gatien of Clocheville during 13 months. In the same session behavioural audiometry and brainstem auditory evoked response audiometry were performed. With the click technique: BSAER do not identify tonal notchs. The BSAER threshold is higher than the behavioural threshold because low frequencies are not explored in profound deafness. It is difficult to differentiate conductive and perceptive deafness when wawe I is missing. Within these limits BSAER is powerful test in babies and children with behavioural disorders.

Adolescent↗

[Comparative study of 2 chemotherapy induction protocols. Cisplatinum-methotrexate-bleomycin and oncovin-methotrexate-bleomycin].

A prospective randomized study was conducted in 77 patients with stages III and IV epidermoid carcinomas of the buccal cavity, oropharynx, and pharyngolaryngeal regions to compare effects of two induction chemotherapy regimens: cisplatinum, methotrexate, bleomycin, and oncovin, methotrexate, bleomycin. Tumoral response and complications were analyzed as a function of the regimen, the tumoral site, and the stage. Chemotherapy including cisplatinum provided a tumoral response in 58.8 p.cent of stage III pharyngolaryngeal epitheliomas as against 38.4 p.cent with oncovin, methotrexate, bleomycin, but with a higher frequency of complications.

Antineoplastic Combined Chemotherapy Protocols↗

[Value of computed tomography in tumors of the pharyngolarynx].

A study was conducted of 27 case-reports to assess the value of computed tomography for investigation of pharyngolaryngeal cancer spread. Analysis was by comparison of clinical, endoscopic, conventional radiologic, computed tomography, and definitive operative specimen histologic findings. Certain laryngeal structures were studied more particularly: the anterior commissure, the pre-epiglottic spaces, the subglottic region, and the thyroid cartilage. Findings demonstrated that the CT Scan is of no value for the study of the anterior commissure and the pre-epiglottic spaces, but is of major interest for detection of subclinical lesions of the subglottic region and thyroid cartilage.

Carcinoma, Squamous Cell↗

[Caustic digestive stenosis involving the hypopharynx. Esophagopharyngoplasty using a right ileocolic graft].

The authors describe an oesophago-laryngoplastic technique using a retrosternal ileocolic graft and involving anterior pharyngotomy above the hyoid bone. The technique was applied to five cases of major destructive lesions of the hypopharynx with fibrotic stenosis, due to severe burns of the upper digestive tract by ingestion of caustic substances. Continuity between the oral cavity and the digestive tract was re-established in all cases.

Adult↗

[Esophagopharyngoplasty by transplantation of a right ileocolic graft in the treatment of sequelae of esophageal and hypopharyngeal caustic stenosis].

Esophagopharyngoplasty was employed to treat 7 cases of severe stenosis from scarring due to caustic burns. Emphasis is placed on the advantages of retrosternally applied right ileocolic transplants using the supraphyoidal anterior pharyngeal approach. Results were considered as satisfactory in 4 cases, exclusively oral alimentation being possible, though bougierage, sometimes repeated, was necessary. The 3 unsuccessful cases were due to loss of oropharyngeal muscle peristaltism in one case, progression of scar retraction in the second patient, and the psychological behavior and lack of essential active cooperation in the third case.

Adult↗

[Preliminary results of a preoperative polychemotherapy protocol in carcinomas of the pharyngo-larynx. Oncovin, methotrexate and bleomycin (author's transl)].

213 squamous carcinomas of the pharyngo-larynx (piriform fossa, pharyngo-laryngeal junction and larynx) received preoperative chemotherapy in the form of oncovin, methotrexate and bleomycin (OMB). All the patients then underwent total or partial laryngectomy, associated with lymph node excision of some sort, followed by radiotherapy. A symptomatic improvement after OMB was seen in 21.2% of cases. Overall tumour response regardless of the site was 32%. Tumour response was all the better when lymph nodes were histologically free of disease (38.7% tumour response in N- as against 26.7% in N+). There was no significant difference in 1 year survival rates between those patients in whom there was a tumour response and those in whom tumour size remained the same.

Aged↗