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Pereira S, Deneuve S, Iacovelli NA, Duclos M, Cavallo A, Nokovitch L, Roux PE, Girodet D, Poupart M, Zrounba P, Claude L, Ferella L, Valdagni R, Foray N, Orlandi E, Rancati T. Predicting Acute Radio-Induced Toxicity for Head and Neck Cancer Patients: Combining Dosimetry with Biomarker Data, Disclosing a Synergistic Effect. Int J Radiat Oncol Biol Phys 2023; 117:e615. [PMID: 37785847 DOI: 10.1016/j.ijrobp.2023.06.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We aimed to establish the added value of combining dosimetry with a binary blood assay for radiosensitivity based on quantification of pATM protein (RADIODTECT©) to predict acute radiotherapy (RT) induced mucositis (MUC) and dysphagia (DYS) in head & neck cancer patients (pts). MATERIALS/METHODS We enrolled 101 pts prospectively scored for acute toxicity with CTCAE. We considered four endpoints: grade≥2 (G2+) and grade≥3 (G3+) MUC, G2+, and G3+ DYS. We dichotomized the pATM concentration to define radiosensitive (RS) vs. radioresistant (RR) pts using previously described cutoffs for G2+ (57.8 ng/mL) and G3+ toxicity (46 ng/mL). We did RADIODTECT© and toxicity scoring blindly. We considered two already published NTCP models, including (i) the Equivalent Uniform Dose to the oral cavity (n = 0.05, EUD_OC, Odds Ratio [OR] = 1.02) and the mean dose to the parotid glands (Dmean_PG, OR = 1.06) for MUC and (ii) EUD_OC (OR = 1.04), the glottic larynx EUD (n = 0.35, EUD_GL, OR = 1.02) and the volume of pharyngeal constrictor muscles receiving>50Gy (V50Gy_CM, OR = 1.02) for DYS. To account for the association of toxicity with the dose distribution in multiple organs at risk (OARs), we derived a "Weighted Dose Score" (WDS) as a linear combination of the dose factors, using their β-coefficients (= lnOR) as weights. WDS for MUC (WDS_OM) = 0.06*Dmean_PG + 0.02*EUD_OC WDS for DYS (WDS_DYS) = 0.02*V50Gy_CM + 0.02*EUD_GL + 0.04*EUD_OC We used WDS as a comprehensive dose feature to fit a dose response and allowed WDS50 (i.e., the WDS associated with 50% toxicity probability) to be different for RR (WDS50_RR) and RS pts (WDS50_RS). The dose-modifying factor (DMF) is the ratio of WDS50_RS/WDS50_RR. It measures the horizontal shift of the dose-response curve when comparing RS vs. RR pts. RESULTS We scored G2+ and G3+ MUC in 80 and 41 pts; G2+ and G3+ DYS in 73 and 35 pts. The average concentration of pATM was 57.4ng/mL (sd 22.3ng/mL): 53/101 pts were classified as RS for G2+ toxicity and 35/101 as RS for G3+. On the whole cohort, the RADIODTECT© did not significantly associate with the risk of toxicity. However, we found two different dose-response curves at low WDS. There, the intrinsic biological sensitivity significantly affects the toxicity probability: ORs for RADIODTECT© are 2.6/2.4 for G2+/G3+ DYS, 6.4/2.9 for G2+/G3+ MUC. Furthermore, the difference in the incidence of side effects in RR vs. RS pts decreases as the WDS increases, reaching a region where the doses of OARs play a significant role. When combined with WDS, the RADIODTECT© effectively predicted RS pts, with DMF ranging from 0.77 for G3+ DYS to 0.40 for G2+ MUC. CONCLUSION These findings support the hypothesis that dose and biomarkers act synergistically; biologically based radiosensitivity plays a significant role when OARs are exposed at lower doses, while high doses of OARs determine toxicity irrespective of the underlying single pt biological characterization.
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Affiliation(s)
- S Pereira
- Neolys Diagnostics, LYON CEDEX 08, France
| | | | - N A Iacovelli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Radiation Oncology, Milan, Italy
| | - M Duclos
- Neolys Diagnostics, Entzheim, France
| | - A Cavallo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Division of Medical Physics, Milan, Italy
| | | | - P E Roux
- Centre Léon Bérard, LYON, France
| | | | - M Poupart
- Centre Léon Bérard, Radiation Oncology Department, Lyon, France
| | | | - L Claude
- Centre Léon Bérard, Radiation Oncology Department, Lyon, France
| | | | | | | | - E Orlandi
- National Center for Oncological Hadrontherapy (CNAO), Radiation Oncology Clinical Department, Pavia, Italy
| | - T Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Data Science Unit, Milan, Italy
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Deneuve S, Mirjolet C, Bastogne T, duclos M, Retif P, Zrounba P, Roux P, Poupart M, Vogin G, Foray N, Pereira S. PO-1936 Performances of a binary blood assay for predicting radiosensitivity. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nokovitch L, Peyrachon B, Chaux-Bodard AG, Poupart M, Roux PE, Devauchelle B, Deneuve S. Reverse blood flow in cervicofacial veins after venous ligations: Potential implications in microsurgery. J Plast Reconstr Aesthet Surg 2020; 74:2042-2049. [PMID: 33455872 DOI: 10.1016/j.bjps.2020.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The consequences on the cervicofacial venous circulation of major cervicofacial vein ligations are poorly known. We aimed to highlight by using Doppler Ultrasound flow differences in the cervicofacial venous network in the case of unilateral or bilateral ligation of main venous collector trunks (external jugular vein [EJV] and internal jugular vein [IJV]) METHODS: A Doppler ultrasound was performed on 10 healthy volunteers, 8 patients with previous bilateral ligation of the EJV, 8 with a unilateral ligation of the EJV, and 8 with a unilateral ligation of the EJV and IJV, after modified radical neck dissection. The diameter, the flow direction and the peak systolic velocity (PSV) of the superficial temporal vein, the facial vein (FV) and the IJV were measured. RESULTS Healthy patients had a similar right and left PSV for all the veins studied, with always antegrade flows. Patients with previous ligations had some significant right/left differences and retrograde flows. CONCLUSION A redistribution of venous blood flow on the contralateral side of the face and neck seems to take place in the case of unilateral ligation of the EJV and/or IJV. Retrograde flows are sometimes observed in the case of previous ligation of the EJV and/or IJV and might compromise the success of venous microanastomoses.
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Affiliation(s)
- L Nokovitch
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France.
| | - B Peyrachon
- Vascular Medicine Department, Hôpital Privé Jean Mermoz, Lyon, France
| | | | - M Poupart
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France
| | - P-E Roux
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France
| | - B Devauchelle
- Maxillo-Facial Surgery Department, University Hospital of Amiens, Amiens, France
| | - S Deneuve
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France
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Deneuve S, Rancati T, Bastogne T, Duclos M, Bois P, Bachman P, Roux P, Girodet D, Poupart M, Zrounba P, Mallet C, Claude L, Ferella L, Orlandi E, Pereira S. Approach Combining Dosimetry and Biology to Predict Severe Toxicity of Radiotherapy for Head and Neck Squamous Cell Carcinomas. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pujo K, Philouze P, Scalabre A, Céruse P, Poupart M, Buiret G. Salvage surgery for recurrence of laryngeal and hypopharyngeal squamous cell carcinoma: A retrospective study from 2005 to 2013. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:111-117. [DOI: 10.1016/j.anorl.2017.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Letievant JC, Poupart M, Ambrun A, Colin C, Pignat JC. Single-center retrospective series of fourteen patients with mucosal melanoma of the nasal cavity and paranasal sinuses. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:387-391. [PMID: 27502822 DOI: 10.1016/j.anorl.2016.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Mucosal melanoma of the nasal cavity and paranasal sinuses is a rare and highly aggressive tumor. We report our experience over 20 years in management of this tumor. PATIENTS AND METHODS A retrospective study included 14 patients with primary sinonasal mucosal melanoma. RESULTS The series comprised 8 male and 6 female patients, with a median age at diagnosis of 67 years. Staging on the American Joint Committee on Cancer classification of sinus cancer was 14% T2, 22% T3, 75% T4a and 7% T4b. All patients underwent primary surgical treatment; 71% received adjuvant external radiotherapy. Median recurrence-free interval was 28.7 months. Two- and 5-year overall survival was 43% and 32%, respectively. Median follow-up was 43 months. CONCLUSIONS Mucosal melanomas of the nasal cavity and paranasal sinuses are very specific entities. Limited pathophysiological knowledge still precludes effective medium- and long-term management. Future treatment will probably be based on global adjuvant or neoadjuvant-targeted chemotherapy.
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Affiliation(s)
- J-C Letievant
- CHU Croix-Rousse, Service d'ORL et de Chirurgie de la Face et du Cou, 69006 Lyon, France.
| | - M Poupart
- CHU Croix-Rousse, Service d'ORL et de Chirurgie de la Face et du Cou, 69006 Lyon, France
| | - A Ambrun
- CHU Croix-Rousse, Service d'ORL et de Chirurgie de la Face et du Cou, 69006 Lyon, France
| | - C Colin
- CHU Croix-Rousse, Service d'ORL et de Chirurgie de la Face et du Cou, 69006 Lyon, France
| | - J-C Pignat
- CHU Croix-Rousse, Service d'ORL et de Chirurgie de la Face et du Cou, 69006 Lyon, France
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Tassy L, Zrounba P, Girodet D, Ceruse P, Pivot X, Poupart M, Villanueva E, Pignat J, Reyt E, De Laroche G, Prades J, Fayette J, Cellier D, Lurkin A, Laure B, Ray-Coquard I. Impact of Clinical Practice Guideline'S on Medical Practice and Survival for Head and Neck Cancer Management in Fisrt Line Treatment (N = 1121 Patients). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Durbec M, Ambrun A, Barnoud R, Poupart M, Pignat JC, Merrot O. Localized nasopharyngeal amyloidosis. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:160-2. [PMID: 22475977 DOI: 10.1016/j.anorl.2011.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 08/29/2011] [Accepted: 10/26/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To illustrate, via a case report, how a differential diagnosis of amyloidosis is to be suspected in case of a nasopharyngeal mass. CASE REPORT A 59-year-old woman presented with bilateral nasal obstruction with associated episodic tubal dysfunction. Physical examination found a mass occupying the entire nasopharynx, initially suggestive of tumor. DISCUSSION Amyloidosis was diagnosed on histopathologic study of the biopsy and surgical specimens. Exploration for systemic disease proved negative. The localized amyloidosis was managed conservatively. At 9 months' follow-up, there was no recurrence. CONCLUSION Localized amyloidosis, however rare, should be considered as differential diagnosis in any case of nasal obstruction with tubal dysfunction, even if bilateral. ENT physicians need to recognize and understand this pathology for adapted diagnostic and treatment planning.
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Affiliation(s)
- M Durbec
- Département d'otorhinolaryngologie et de chirurgie cervico-faciale, université Claude-Bernard Lyon I, hôpital de la Croix-Rousse, 93, Grande-rue-de-la-Croix-Rousse, 69317 Lyon cedex 04, France.
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Thariat J, Hamoir M, Garrel R, Cosmidis A, Dassonville O, Janot, Righini CA, Vedrine PO, Prades JM, Lacau-Saint-Guily J, Jegoux F, Malard O, De Mones E, Benlyazid A, Bensadoun RJ, Baujat B, Merol JC, Ferron C, Scavennec C, Salvan D, Mallet Y, Moriniere S, Vergez S, Choussy O, Dollivet G, Guevara N, Ceruse P, De Raucourt D, Lallemant B, Lawson G, Lindas P, Poupart M, Duflo S, Dufour X. Management of the Neck in the Setting of Definitive Chemoradiation: Is There a Consensus? A GETTEC Study. Ann Surg Oncol 2012; 19:2311-9. [DOI: 10.1245/s10434-012-2275-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Indexed: 11/18/2022]
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Perottino F, Barnoud R, Ambrun A, Poupart M, Pignat JC, Merrot O. Sclerosing polycystic adenosis of the parotid gland: diagnosis and management. Eur Ann Otorhinolaryngol Head Neck Dis 2010; 127:20-2. [PMID: 20822751 DOI: 10.1016/j.anorl.2010.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe diagnostic and therapeutic management of a rare parotid lesion: sclerosing polycystic adenosis. PATIENT AND METHOD We report a case of persistent right intraparotid tumefaction. RESULTS A 68-year-old man was referred with a right parotid nodule of 2 years' evolution. Cytology diagnosed pleomorphic adenoma, verified on MRI. Conservative subtotal parotidectomy diagnosed sclerosing polycystic adenosis. Over 1 year's regular follow-up, there were no signs of local recurrence. CONCLUSION Sclerosing polycystic adenosis of the parotid gland is a rare and recently described entity presenting several analogies to the much more frequent cystic mastitis. Although benign and well-delimited, it requires complete exeresis of the parotid, due to a non-negligible risk of recurrence.
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Merrot O, Bige V, Poupart M, Montbarbon X, Ardiet JM, Pignat JC. [Comparison between external radiotherapy and laser microsurgery for the treatment of TisT1N0 glottic carcinoma: Clinical modelling and cost-minimization study from the French national health insurance payer's point of view]. Rev Laryngol Otol Rhinol (Bord) 2010; 131:257-262. [PMID: 21866736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The excellent effectiveness of both treatment modalities (radiotherapy, endoscopic laser surgery) for early glottic carcinoma (Tis, TlaN0) is similar (carcinologic, functional and QoL results). This is part of an evidence-based medicine policy, which is to choose the cheapest of various treatment modalities known as equally effective and equally morbid. Is analytical economic approach useful and efficient to guide decision making? The aim of this study is to perform a costminimization analysis using an objective clinical modeling. MATERIAL AND METHODS For each modality, probabilities of various events were recorded from review of literature. Only local recurrences which constitute the major end-point affecting survival were considered. French national Health insurance's point of view (as the payer's point of view), with a 100% case-mix based payment system was used. Results of cost-minimization between laser endoscopic surgery and external radiation therapy are: Global Cost of laser endoscopic surgery is about 2613.01 euro. Without (90% of cases) and with recurrence it is about 1700.36 euro and 10826.87 euro respectively. Global Cost of external radiation therapy is about 4490.88 euro. Without (90% of cases) and with recurrence it is about 3578.23 euro and 12704.74 euro respectively. CONCLUSION Cordectomy by CO2 laser seems to be an efficient cost-effective alternative to radiotherapy for early glottic carcinoma management from the French national Health insurance perspective.
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Affiliation(s)
- O Merrot
- CHU La Croix-Rousse, Département d'ORL et de CCF, Université Claude Bernard Lyon, Lyon, France.
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Elgandli D, Perottino F, Bouchene M, Poupart M, Pignat JC, Merrot O. Endostenting par prothèse en Y sur hématome après chirurgie de l’aorte thoracique. ACTA ACUST UNITED AC 2009; 126:221-5. [DOI: 10.1016/j.aorl.2009.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Accepted: 04/10/2009] [Indexed: 12/20/2022]
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Perottino F, Bouchene M, Poupart M, Pignat JC, Merrot O. [Bilateral hypopharyngocele]. Ann Otolaryngol Chir Cervicofac 2009; 126:11-13. [PMID: 19232568 DOI: 10.1016/j.aorl.2008.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 12/01/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Describe the management of bilateral hypopharyngocele in a trumpet player. MATERIAL AND METHOD Case report of a professional trumpet player suffering from bilateral hypopharyngocele. RESULTS A professional trumpet player was referred for an ORL consultation after he noticed that a bad sound was produced while he was playing associated with cervical pain. A CT scan demonstrated an asymmetric bilateral hypopharyngocele with no other abnormality. Because of the mild symptoms and the professional context, a successful conservative approach was used with antireflux medications. He was advised to seek professional instruction in order to improve his technique. On follow-up examination 6 months later, he had had no further problems since adopting the corrected techniques. CONCLUSION Pharyngoceles are rare and easily misdiagnosed. Because of the mild symptoms and the professional context, a conservative medical approach should be proposed (antireflux medications) combined with specific orthophonic and physical therapy to modify breathing and trumpet playing techniques.
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Affiliation(s)
- F Perottino
- Centre hospitalier des Escartons, 05100 Briançon, France
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Abstract
PURPOSE OF STUDY To discuss the authors' experience with thyroglossal duct (TD) carcinoma and expose the interest of the thyroidectomy in the management of this entity. PATIENTS AND METHODS A retrospective review of all patients with the diagnosis of TD operated on from 1985 to 2002 was performed. RESULTS Four cases of papillary TD carcinoma were identified. Two patients were treated by a Sistrunk procedure associated with total thyroidectomy. One patient needed a thyroidectomy fifteen years after the initial management of the papillary thyroglossal duct carcinoma. The last patient had a medical treatment, with no evidence of complication after eleven years of follow up. CONCLUSION A microscopic focus of papillary carcinoma, without cyst wall invasion, can be managed by a Sistrunk procedure, with the need for long-term follow up. Treatment of all other thyroglossal duct papillary carcinomas should include thyroidectomy followed by radioactive iodine treatment.
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Affiliation(s)
- Al Belnoue
- Hôpital de la Croix-Rousse, rue Henon, 6900 Lyon, France.
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Sève P, Poupart M, Bui-Xuanl C, Charhon A, Broussolle C. Arthrite cricoaryténoïdienne et maladie de Gougerot-Sjögren. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80471-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pommier P, Ginestet C, Sunyach M, Zrounba P, Poupart M, Céruse P, Ciupea C, Carrie C, Montbarbon X. Conformal radiotherapy for paranasal sinus and nasal cavity tumors: three-dimensional treatment planning and preliminary results in 40 patients. Int J Radiat Oncol Biol Phys 2000; 48:485-93. [PMID: 10974466 DOI: 10.1016/s0360-3016(00)00616-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the possibility to deliver a high and homogeneous irradiation with respect to maximal tolerated dose to the visual pathways for paranasal sinus and nasal cavity tumors. METHODS AND MATERIALS Forty patients with advanced stage malignant tumors were treated with postoperative (30) or primary (10 patients) conformal radiotherapy (CRT). Five patients were previously irradiated. Six to 15 individually shaped isocentric noncoplanar field arrangements, using a multileaf collimator were designed. Dose-volume histograms (DVH) for the planning target volumes (PTV) and the optic pathways were analyzed in 31 cases. RESULTS Median and maximal delivered doses to the PTV were 60 (+/-3) and 66 (+/-4) Gy. Dose distributions for critical organs are detailed. Median follow-up was 19 months (3 to 48). Local, nodal, and metastatic recurrences occurred in 8, 2, and 7 cases, respectively. Major prognostic factor for local recurrences was central nervous system (CNS) involvement. One patient died of meningitis. Two patients developed cataract, and 1 patient ipsilateral blindness due to vascular glaucoma. CONCLUSION CRT for locally advanced paranasal sinus and nasal cavity tumors enables the delivery of high homogeneous doses to the PTV with respect to critical organs, with a low toxicity and a high local control.
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Affiliation(s)
- P Pommier
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
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Bolot G, Poupart M, Zrounba P, Herlemont F, Pignat JC. [Reconstructive subtotal laryngectomy: a personal technique in a series of 100 patients operated on between 1990 and 1997]. Rev Laryngol Otol Rhinol (Bord) 1999; 120:93-6. [PMID: 10444981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Described by Majer and Rieder, modified by Piquet, subtotal laryngectomy with cricohyoidoepiglottopexy (CHEP) allowed to treat intralaryngeal carcinoma with preservation of speech and swallowing. Some modifications were proposed to the procedure to simplify it and to improve functional results. Most important one is the one proposed by Guerrier. In the refined procedure we describe, we didn't do any -pexy to conserved as near as possible from normality morphology and physiology of pharyngolaryngeal unit. Dynamics is preserved by keeping jointly the laryngotracheal tract. In addition, we avoid doing a tracheotomy. We present the functional outcome of 100 patients treated between 1990 and 1997: oral feeding was initiated at the 6th day postoperative, delay to achieve proper swallowing was 11.5 days and median hospitalization duration was 18 days (14 days for non tracheotomized group). The comfort of patients without tracheotomy was greatly increased with a low risk of pneumonia. Such a procedure could be applied every time a laryngeal reconstruction had to be done (partial laryngectomy, laryngeal trauma).
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Affiliation(s)
- G Bolot
- Hôpital de la Croix-Rousse, Service d'ORL et de Chirurgie Cervico-Faciale, Lyon, France
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Baulieux J, Adham M, de la Roche E, Meziat-Burdin A, Poupart M, Ducerf C. Carcinoma of the oesophagus. Anastomotic leaks after manual sutures--incidence and treatment. Int Surg 1998; 83:277-9. [PMID: 10096740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Progress in the development of suture materials results in a lower rate of fistulas. Modern techniques for the diagnosis of leakage (contrast study, CT-scan) allow for an early diagnosis and adequate therapy: if possible conservative therapy with drainage of the abscess, adapted antibiotic therapy and parenteral and enteral nutrition are the best methods. In the case of necrosis of the transplant, reoperation permits enables extra time for reconstruction. All the technical possibilities of reconstruction must be known. It is necessary to apply prophylactic precautions to avoid leakage of the anastomosis on the oesophagus.
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Affiliation(s)
- J Baulieux
- Department of Gastrointestinal Surgery and Liver Transplantation, Hôpital de la Croix-Rousse, Lyon, France
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Bolot G, Poupart M, Pignat JC, Bertocchi M, Wiesendanger T, Thevenet F, Gamondes JP, Mornex JF. Self-expanding metal stents for the management of bronchial stenosis and bronchomalacia after lung transplantation. Laryngoscope 1998; 108:1230-3. [PMID: 9707249 DOI: 10.1097/00005537-199808000-00024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Airway stenosis or malacia after lung transplantation, usually as a result of anastomotic ischemia, remains a major problem. METHODS The authors report their experience with the Gianturco expandable stent for the management of 23 bronchial stenoses in 18 patients following lung transplantation. Stent placement occurred an average of 5.6 months after transplantation. RESULTS Stents were well tolerated and produced immediate symptomatic and functional improvement. The mean follow-up after implantation was 21 months (range, 4 to 48 mo). The authors removed five stents by endoscopy and replaced them, and removed one stent entirely. Laser resection was used to control granulomas or partial fibrosis stenosis that occurred in four stents (14.3%) after an average of 4 months. One stent broke but was still in place and effective 32 months later. One patient died of hemorrhage 4 months after stenting. CONCLUSION Although it can still be improved, this expandable metal stent is suitable for the treatment of posttransplantation proximal bronchial stenosis.
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Affiliation(s)
- G Bolot
- Division of Otorhinolaryngology-Head and Neck Surgery, Hôpital de la Croix-Rousse, Lyon, France
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Pomrnier P, Bolot G, Malet C, Poupart M, Montbarbon X. 55 Intra-operative interstitial afterloading plastic tubes implantation with early low dose rate postoperative brachytherapy for posterior pharyngeal wall carcinoma. Radiother Oncol 1998. [DOI: 10.1016/s0167-8140(98)80060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pommier P, Zroumba P, Montbarbon X, Poupart M, Lafay F, Pignat J. 18 Intraoperative afterloading plastic tubes implantation for early postoperative low dose rate brachytherapy for head and neck cancers. Results in 16 patients with a 12 months minimal follow-up. Radiother Oncol 1998. [DOI: 10.1016/s0167-8140(98)80023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pommier P, Bolot G, Martel I, Montbarbon X, Ardiet JM, Coquart R, Poupart M, Leval J, Ramade A, Dubreuilh C, Pignat JC, Carrie C. Salvage brachytherapy of posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area. Int J Radiat Oncol Biol Phys 1997; 38:53-8. [PMID: 9212004 DOI: 10.1016/s0360-3016(97)00219-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Brachytherapy performed in patients with posterior pharyngeal wall carcinoma in a previously irradiated area is evaluated in terms of local control, survival, and complications. METHODS AND MATERIALS Between January 1982 and July 1993, 14 patients were treated with interstitial low dose rate brachytherapy alone for posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area (local recurrences in five cases and second tumors in nine cases). Tumor size ranged from 1 to 4 cm. No patient had a macroscopic nodal involvement or metastase at the time of diagnosis. Median dose delivered was 55 Gy (39 to 60 Gy). RESULTS Thirteen patients were assessed for local control. Twelve of them achieved complete macroscopic response within 2 months after brachytherapy. Local relapse occurred in five patients, from 5 to 29 months after brachytherapy. One patient developed distant metastatis without loco-regional relapse. Disease free survival was 69, 59, and 37% at 1, 2, and 5 years, respectively; overall survival was 78, 50, and 21% at 1, 2, and 5 years, respectively. Three patients were still alive without recurrence (8, 8, and 10 years after treatment). We did not observe any severe acute or delayed toxicity. CONCLUSION Based on these results, interstitial brachytherapy should be considered as a potentially curative treatment for selected patients with posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area. There are no reports in the literature on this subject.
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Affiliation(s)
- P Pommier
- Department of Radiotherapy, Centre Léon Bérard, Lyon, France
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Devouassoux-Shishe Boran M, Thivolet-Béjui F, Bolot G, Decaussin M, Poupart M, Patricot LM. [Glomangioma: an unusual ethmoid-nasal tumor]. Ann Pathol 1996; 16:460-2. [PMID: 9090939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Glomus tumors are benign vascular tumors usually located in the fingertip dermis. Extracutaneous glomus tumors are extremely rare. A new case of sino-nasal glomangioma is reported and both clinical and histological features and biological behavior of glomus tumors in this exceptional site are described.
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Pommier P, Martel I, Bolot G, Montbarbon X, Ardiet J, Leval J, Poupart M, Dubreuil C, Carrie C. 625Salvage brachytherapy of posterior pharyngeal wall squamous cell carcinoma in a previously irradiated field. Radiother Oncol 1996. [DOI: 10.1016/s0167-8140(96)80634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Poupart M, Damiano J, Bolot G, Biron P, Caldentey L, Ardiet JM, Pignat JC. [Contribution of chemotherapy in the treatment of cancer of the cavum (UCNT): apropos of 47 cases]. Bull Cancer 1994; 81:366-70. [PMID: 7538361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The authors present, from a 47 patients retrospective study, the place of BAC chemotherapy in the treatment of undifferenciated nasopharyngeal carcinoma. Twenty three patients treated with exclusive radiation therapy are compared with 24 patients treated with three courses of BAC chemotherapy prior to and after radiation therapy. The procedure using associated chemotherapy permits to increase the 5 years survival rate up to 20% more and to obtain a 100% primary response of the tumor. This encouraging results should be confirmed by a prospective randomized study about a great number of patients.
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Affiliation(s)
- M Poupart
- Service ORL, hôpital de la Croix-Rousse, Lyon, France
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