High-dose folinic acid, 5-fluorouracil bolus and continuous infusion in poor-prognosis patients with advanced measurable gastric cancer.

Twenty-five patients with advanced measurable gastric cancer were treated with high-dose folinic acid (200 mg/m2), 5-fluorouracil bolus (400 mg/m2) and continuous infusion (600 mg/m2) for two consecutive days every two weeks. Fourteen patients over 65 yr old and/or with a poor general status received first-line treatment, and eleven younger patients second-line. The response rate was 43.5% in 23 evaluable patients. There were 2 complete responses (8.7%) and 8 partial responses (34.8%). Median survival was 6 months in first-line and 8 months, calculated from start of folinic acid-5FU, in second-line. Toxicity was mild without WHO Grade greater than 2 events. This combination is effective for advanced gastric cancer in poor-prognosis patients and requires further studies.

High-dose folinic acid and 5-fluorouracil bolus and continuous infusion in advanced colorectal cancer.

An enhanced antineoplastic effect of 5-fluorouracil in patients with advanced colorectal cancer has been produced either by combination with folinic acid or administration by continuous infusion. Thirty-seven patients with advanced measurable colorectal cancer received high-dose folinic acid (LV 200 mg/m2) followed by 5-fluorouracil i.v. bolus (300 mg/m2) and continuous infusion (300 mg/m2) on days 1 and 2 then 14 and 15 every 4 weeks. In the absence of toxicity, 5-FU was increased to 400 mg/m2 i.v. bolus and continuous infusion at course 2 and to 500 mg/m2 at course 3 and from course 4 maintained at 500 mg/m2. Responses were: complete responses: 1 (2.7%), partial responses: 19 (51.4%), no change: 8 (21.6%) and progressive disease: 9 (24.3%). CEA decrease was correlated with response. Median duration of response was 11 months. Median survival was 18 months, 21% of the patients were alive at 2 years. Toxicity was low, with diarrhea in 17% and nausea in 11.5% of the patients. LV-5-FU bolus and continuous infusion is safe and has definite activity in metastatic colorectal cancer.

[Total duodenopancreatectomy for non-secreting pancreatic nesidioblastoma]. / Duodéno-pancréatectomie totale pour nésidioblastome pancréatique non sécrétant.

Non-secreting tumors of pancreatic islets of Langerhans are now rarely encountered as a result of the increasing performance of techniques for detecting the different hormones of insular origin or their precursors. Histologically, these tumors, that can be termed nesidioblastomas of the pancreas, have a poorly defined potential course, but there is a definite risk of malignancy. A case is reported of a pancreatic nesidioblastoma located in two regions, treatment being by total duodenopancreatectomy with a good result at 4-year follow up review. A bibliographic list of 13 published reports in the international literature is provided.

[Idiopathic congenital dilatation of the common bile duct and pregnancy. Report of one case, reflexions and comments (author's transl)]. / Dilatation idiopathique congénitale de la voie biliaire principale et grossesse. A propos d'une observation, réflexions et commentaires.

Congenital idiopathic dilatation of the common bile duct, called commonly and incorrectly congenital cyst of the common bile duct, is sometimes diagnosed during pregnancy. The latter may be the source of severe complications. The disease should thus be treated rapidly, even if the pregnancy is at a late stage. In a case of this type we carried out surgical treatment in two stages: firstly simple external drainage of the common bile duct and of the gall bladder and only after labour has been brought to term by Caesarian section, for breech presentation, was a cystojejunostomy carried out on a Y shaped jejunal loop.