[Ethmoidal adenocarcinoma surgically treated in one stage by transfacial and subfrontal approach after inductive chemotherapy. Preliminary results of a new therapeutic approach].
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%.
Roux
F X
FX
Service de Neurochirurgie, Centre Hospitalier, Sainte-Anne, Paris.
Brasnu
D
D
Laccourreye
H
H
Fabre
A
A
Chodkiewicz
J P
JP
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
D005472:Fluorouracil
Les adénocarcinomes ethmoïdaux opérés en un temps par voie transfaciale et sous-frontale après chimiothérapie d'induction. Résultats préliminaires d'une nouvelle approche thérapeutique.