title: [Ethmoidal adenocarcinoma surgically treated in one stage by transfacial and subfrontal approach after inductive chemotherapy. Preliminary results of a new therapeutic approach].
abstract: The authors present a new therapeutic protocol for ethmo++idal adenocarcinomas. It includes a pre-operative chemotherapy based on a four days continued infusion of cis-platinum and 5 F.U. (three cures with 3 weeks-intervals); it is followed by a carcinologic removal realized through a combined transfacial and intra-cranial approach. They discuss the interest of combined surgery which should allow a limitation of intra-cranial recurrencies. The intra-cranial extension must not be a limit to the removal even in case of dural, or even sub-dural extension. The reconstruction of the anterior basis of the skull has been simplified as much as possible: it has been performed either with a bone graft removed from the frontal flap inner table, or with a precut madreporic coral graft. In all cases, the dura has been doubled with a large shred of galea. They emphasize the efficiency of pre-operative chemotherapy. Eleven patients underwent such a protocol; two were operated in a recurrence, 9 in first hand. The preliminary results seem to be promising: the one year and two years actuarial survival rates are 84%.
authors.affiliation: Service de Neurochirurgie, Centre Hospitalier, Sainte-Anne, Paris.
authors.forename: F X
authors.initials: FX
authors.lastname: Roux
authors.forename: D
authors.initials: D
authors.lastname: Brasnu
authors.forename: H
authors.initials: H
authors.lastname: Laccourreye
authors.forename: A
authors.initials: A
authors.lastname: Fabre
authors.forename: J P
authors.initials: JP
authors.lastname: Chodkiewicz
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016025:Bone Transplantation; D005005:Ethmoid Sinus; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy / Q000601:surgery*; D013524:Surgical Flaps
chemical_list: D005472:Fluorouracil
vernacular_title: Les adénocarcinomes ethmoïdaux opérés en un temps par voie transfaciale et sous-frontale après chimiothérapie d'induction. Résultats préliminaires d'une nouvelle approche thérapeutique.