[Stereotaxic radiosurgery:methods and indications in the treatment of cerebral arteriovenous malformations]. / La radiochirurgie stéréotaxique:méthode et indications dans le traitement des malformations artério-veineuses cérébrales.

After Leksell and Steiner's pioneering experience with the use of the gamma units, another technically different system has been developed, using a linear accelerator. It's a very precise stereotactic radiosurgical approach which allows to deliver the necessary dose of radiation to the target volume while sparing the surrounding structures from potentially dangerous levels of radiation. This hyperselective irradiation is a new and complementary method of treatment of arteriovenous malformations located in central or functionally critical areas of the brain. The aim is to obtain a progressive and total obliteration of the lesion. The place of radiosurgery is obviously reserved for the patients who do not seem able to profit from the benefits of open surgery and/or embolization techniques.

Initial chemotherapy and low-dose radiation in limited fields in childhood Hodgkin's disease: results of a joint cooperative study by the French Society of Pediatric Oncology (SFOP) and Hôpital Saint-Louis, Paris.

To minimize the drawbacks of treatment we had shown in a previous study that it was possible after chemotherapy to limit the radiation fields to the involved areas only. Pursuing our policy of deescalation, we started in January 1982 a study in 29 French pediatric and hematologic centers, with two aims: (1) To compare the efficacy of 4 cycles of two different chemotherapeutic regimens (4 ABVD vs 2 MOPP + ABVD) in early stages (CSIA and II A) while other stages would receive 6 cycles of the same regimen (3 MOPP + 3 ABVD); (2) To evaluate the efficacy of irradiation given at a low dose (20 Gy) in the patients who had a minimum 70% reduction of the size of their nodes (good responders). From January 1982 to March 1987, 174 patients were entered in this study, of whom 157 completed their treatment program at the time of analysis. On completion of chemotherapy, 94% were considered as good responders and were irradiated to 20 Gy. Only 6 patients received a mediastinal boost (up to 40 Gy). Of the 6% (10/157) poor responders a complete remission was obtained in 6 after 40 Gy. Among the good responders, 5 patients relapsed, with only 3 within an area irradiated to 20 Gy. So that 4 nodal relapses occurred among 364 involved lymph areas. The actuarial survival at 42 months (median 30 months) is 95% (IA + IIA = 100%, IB + IIB + III = 94% and IV = 80%) and the disease-free survival 88% (respectively 94, 93 and 54). Until now there is no statistically significant difference between the 2 randomized arms. This study shows that it is possible to achieve a durable remission in most children treated with a less toxic protocol eliminating or reducing Nitrogen Mustard and reducing the dose of irradiation. Less late complications and sequelae are expected with a longer follow-up.

Ten-year results of randomized trial comparing radiotherapy and concomitant bleomycin to radiotherapy alone in epidermoid carcinomas of the oropharynx: experience of the European Organization for Research and Treatment of Cancer.

This trial of treatment for head and neck carcinoma was initiated in 1973 by the European Organization for Research and Treatment of Cancer. Its purpose was to investigate the value of single-agent chemotherapy with bleomycin (BLM) given during the course of a conventional treatment by external radiotherapy (RT) compared to treatment by external RT alone. In this randomized study, we compared treatment results in 2 groups of patients with squamous cell carcinoma of the oropharynx (T2, T3, and T4; International Union Against Cancer classification). One group of 92 patients was treated by RT at the prescribed dose of 70 Gy. The other group of 107 patients received radiation according to the same protocol and simultaneously received im injection of BLM at a dose of 15 mg twice a week, 2 hours prior to the session of RT, for a total dose of 150 mg in 5 weeks. The occurrence of local toxic effects (i.e., mucositis and epidermatitis) was significantly greater in the RT-BLM group (RT-BLM, 72%, vs. RT, 21%). Primary tumor response 6 weeks after completion of RT was the same in both arms of the study (RT, 68%, vs. RT-BLM, 67%). The 6-year survival rate was 24% (RT-BLM) versus 22% (RT). Long-term analysis (10 yr) is given.

[Results of primary surgery in the treatment of oropharyngeal cancer]. / Les résultats de la chirurgie première dans le traitement des cancers de l'oropharynx.

A homogeneous series of 106 cases of malignant tumor of tonsillar region was treated by first intention surgery. Treatment proposed for these patients with ulcerated or infiltration tumors often extending to pillars or to tongue was transmandibular buccopharyngectomy with curettage of glands and postoperative radiotherapy. Unadjusted survival rate at 3 years was 62% (T2 and T3) and at 5 years 35%. Clinical glandular enlargement, detected in 50% of cases, resulted in poorer prognosis, which decreased from 48% at 5 years to 25% in patients with histologic metastasis in lymph nodes.

[Indications and results of surgery in the treatment of cancer of the tonsillar region. Apropos of 106 transmandibular bucco-pharyngectomies]. / Indications et résultats de la chirurgie dans le traitement des cancers de la région amygdalienne. A propos de 106 bucco-pharyngectomies trans-mandibulaires.

From 1970 through 1982, 106 patients with carcinoma of the tonsillar region were treated by trans-mandibular bucco-pharyngectomy (composite resection) in the ENT department of Prof. Piquet at Lille University. After a brief reminder of the surgical process, the authors study the group of the operated patients (localization and classification of the UICC 1979), present the oncological results (crude 3-year survival of 58% and 5 years as 35%) and analyse them. According to several other series, they specify their therapeutic attitudes.

[Nasopharyngeal epitheliomas: experience of the Regional Cancer Control Center in Lille (79 cases 1970-1982)]. / Les épitheliomas nasopharyngés: expérience du Centre Régional de Lutte contre le Cancer de Lille (79 cas de 1970 à 1982).

From 1970 to 1982, 79 cases of nasopharyngeal carcinomas were treated at the Regional Cancer Center of Lille (France). At the term of the study, it appears that patients of Central Europe origin have a rather high risk of NPC (17% of cases, that ethnic population representing about 8% of all superior aerodigestive tract carcinomas). The classical differences between well and undifferentiated tumors are founded, the first presenting local spread the other general involvement.

[Surgical treatment of intestinal radio-lesions. 53 patients operated, out of 171 radio-lesions among 7301 irradiated (author's transl)]. / Traitement chirurgical des radio-lésions intestinales. 53 opérés sur 171 radio-lésions parmi 7301 irradiés.

Results of a complete and homogenous series by the Medical Team of the Centre Anti-Cancéreux.--2,45% of abdomino-pelvic irradiations among 6516 cases,--but only 0.78 are serious and need surgery (i.e. 1/3 of the radio-lesions). The study concerned 65 cases;--during the same period, medical treatment alone controlled 51 cases of rectitis and 51 stenoses. The interval after irradiation is variable: 33 times, it was shorter than 1 year, in 32 cases, it was longer, up to 13 years. The plan for therapy is to continue the medical treatment as well as possible and to operate only in case of absolute need, but before obstruction;--to prefer immediate resection to internal derivation. The 27 resections resulted in 18 recoveries and 9 cases of peritonitis. In spite of the serious nature of the initial irradiated lesion, followed by this complicated radio-lesion, we observed: 28% of 5-year survivals, and over 10 years in 9 cases.