C. Guillemet

Centre Hospitalier Universitaire Rouen, Rouen, Upper Normandy, France

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Publications (7)7.69 Total impact

  • Cancer/Radiothérapie 09/2012; 16(s 5–6):522. · 1.48 Impact Factor
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    ABSTRACT: Leptomeningeal meningitis occurs in approximately 5% of metastatic breast cancers, and there is no standard treatment for this complication. We retrospectively analyzed the clinical data and cerebrospinal fluid of 24 patients treated with high-dose intrathecal methotrexate for breast cancer leptomeningeal meningitis (BLM). Cytologic response (CSF cytology without neoplastic cells after treatment) was observed in 11 patients (46%) and related to survival (P = 0.005). In addition, clinical symptoms improved in all 11 patients who had a cytologic response and in 7 patients (54%) without cytologic response (P = 0.02). The predictive value of cytologic response needs further confirmation. Cytologic response could be helpful in the management of intrathecal chemotherapy in patients with BLM.
    Journal of Neuro-Oncology 07/2009; 95(3):421-6. · 3.12 Impact Factor
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    ABSTRACT: We report two cases of pneumocystis pneumonia in patients receiving chemotherapy for breast cancer. These case series emphasize the frailty of the patients as the causative role for occurrence of this uncommon complication of chemotherapy in breast cancer. We remind the importance of screening for unusual adverse events in frail patients receiving chemotherapy.
    La Revue de Médecine Interne 05/2009; 31(4):e1-3. · 0.90 Impact Factor
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    ABSTRACT: CXC chemokine receptor 4 (CXCR4) has been reported to be involved in organ-specific homing of breast cancer-derived metastasis. We investigated CXCR4 expression by immunohistochemistry as a possible new prognostic factor for primary breast cancer. Two groups of women treated for breast cancer in 1991 at the Centre for the fight against cancer of Upper Normandy-France (Centre de Lutte contre le Cancer de Haute Normandie) were assessed retrospectively. CXCR4 expression was evaluated using standard immunohistochemistry. Usual prognostic factors were recorded in the computer database. Final date of follow-up was December 31, 2001. Tissues were available for 110 node-positive and 84 node-negative breast cancer patients treated in 1991. CXCR4 membrane staining was considered a strong prognostic factor for both 10-year metastasis-free- (p < 0.0001) and overall survival (p < 0.0001) in node-negative but not in node-positive breast cancer patients. CXCR4 cytoplasmic staining was not considered a significant prognostic factor. Our results suggest that CXCR4 membrane staining could be considered a new prognostic factor. Moreover, targeting CXCR4 in primary breast cancer patients may be a new therapeutic concept. However, these results warrant further investigation.
    The Breast Journal 01/2008; 14(3):268-74. · 1.83 Impact Factor
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    ABSTRACT: The diagnostic and therapeutic management of patients with soft-tissue tumors would be similar to the approach used for bone tumors if it were not for one crucial factor: the absolute necessity to recognize a sarcoma. The predominant features are the size of the tumor and its superficial or deep localization. If the tumor is small and superficial, biopsy can be associated with immediate resection without risk of dissemination to the deep tissues: this is the biopsy-resection approach. If the tumor is deep or superficial but large sized, search for locoregional spread with MRI is necessary before undertaking any surgical procedure. MRI can help guide the biopsy and plan resection if the tumor is a sarcoma. A first biopsy is necessary to establish the histological diagnosis and elaborate the therapeutic strategy. Samples should be sent immediately to the pathology lab which should examine sterile fresh tissue. Experience has demonstrated that proper rules for diagnosis and treatment are not necessarily applied initially in approximately one-fourth of all subjects with a malignant soft-tissue tumor. Besides the medical problems caused by this situation, the patient loses a chance for cure. When the tumor is a sarcoma, surgery is the basis of treatment. Complementary radiation therapy may be necessary, particularly for high-grade tumors or if the surgical margin was insufficient. Systemic or locoregional chemotherapy can also be used for high-grade or non-resectable tumors.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 12/2006; 92(7):637-50. · 0.37 Impact Factor
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    ABSTRACT: The diagnostic and therapeutic management of patients with soft-tissue tumors would be similar to the approach used for bone tumors if it were not for one crucial factor: the absolute necessity to recognize a sarcoma. The predominant features are the size of the tumor and its superficial or deep localization. If the tumor is small and superficial, biopsy can be associated with immediate resection without risk of dissemination to the deep tissues: this is the biopsy-resection approach. If the tumor is deep or superficial but large sized, search for locoregional spread with MRI is necessary before undertaking any surgical procedure. MRI can help guide the biopsy and plan resection if the tumor is a sarcoma. A first biopsy is necessary to establish the histological diagnosis and elaborate the therapeutic strategy. Samples should be sent immediately to the pathology lab which should examine sterile fresh tissue. Experience has demonstrated that proper rules for diagnosis and treatment are not necessarily applied initially in approximately one-fourth of all subjects with a malignant soft-tissue tumor. Besides the medical problems caused by this situation, the patient loses a chance for cure. When the tumor is a sarcoma, surgery is the basis of treatment. Complementary radiation therapy may be necessary, particularly for high-grade tumors or if the surgical margin was insufficient. Systemic or locoregional chemotherapy can also be used for high-grade or non-resectable tumors.
    Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur - REV CHIR ORTHOP REPARAT APP. 01/2006; 92(7):637-650.
  • O. Rigal, C. Guillemet
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    ABSTRACT: L’augmentation du nombre de malades âgés atteints de cancer et la prise en compte de leur qualité de vie ont conduit au développement, en parallèle des soins oncologiques, des soins de support, parfaitement complémentaires avec les objectifs de l’oncogériatrie. Les soins de support définissent l’ensemble des pratiques de soins et de soutiens destinées à la personne atteinte de cancer, prenant en compte à la fois les répercussions d’ordres physique, psychologique ou social de la maladie ainsi que les complications des traitements oncologiques spécifiques entrepris. Ils sont proposés tout au long de la maladie, depuis l’annonce du diagnostic de cancer: pendant la phase où sont réalisés les traitements carcinologiques spécifiques et en fonction de l’évolution, durant les phases de « rémission » ou de « guérison », comme en phase palliative lorsque celle-ci est engagée. Ils sont complémentaires de la prise en charge gériatrique, proposés notamment à l’issue d’une évaluation gériatrique standardisée (EGS). Les soins de support apportent une aide supplémentaire pour gérer le risque supérieur de complications liées à la maladie et aux traitements. Les soins oncologiques de support nécessitent une coordination multidisciplinaire des soins et des soutiens destinés aux malades et à leurs proches. Les développements futurs devront tenir compte d’un nombre de plus en plus important de malades âgés « survivants » à leur cancer. La nécessité de bénéficier d’un suivi et d’un accompagnement adaptés à distance des traitements tels que le prévoient les orientations stratégiques du second Plan cancer (2009–2013) figure aussi dans cette approche qualitative des soins en oncologie. Les soins oncologiques de support connaissent aussi un développement vers des soins et des médecines dits « complémentaires » qui ambitionnent, en association aux traitements « classiques » carcinologiques, l’amélioration durable de la qualité de vie des malades. The increase in the number of elderly patients affected by cancer and the consideration of their quality of life led to the development, in parallel to oncology care, to that of the perfectly complementary supportive care with the objectives of geriatric oncology. Supportive care in oncology defines a set of care and support intended for the person affected by cancer, taking into account at the same time, the physical, psychological and social repercussions of the disease and the possible complications of the undertaken specific cancer treatments. It is offered throughout the disease, from the announcement of the cancer diagnosis, to the phase where specific cancer treatments are realized. According to the evolution of cancer, they are necessary during the phases of “remission” or “cure”, until the palliative phase when this one is engaged. It is complementary to geriatric care, offered in particular at the conclusion of a standardized geriatric evaluation. Supportive care in oncology provides additional help to manage the higher risk of complications bound to the disease and its treatments. Supportive care in oncology requires a multidisciplinary coordination of care and support intended for the patients and their close relations. Future developments will have to take into account the increasing number of older patients who are “survivors” of cancer. The necessity of benefiting of a follow-up and caring adapted at a distance of treatments such as the strategic orientations of the cancer plan (2009–2013) it also appears in this qualitative approach of care in oncology. The supportive care in oncology also knows a development towards care and said “complementary” medicines, which aspire in association with the “classic” cancer treatments to the sustainable improvement of the quality of life of the patients. Mots clésCancer–Oncogériatrie–Soins de support–Personne âgée KeywordsCancer–Oncogeriatrics–Supportive care–Elderly
    Les cahiers de l année gérontologique 3(1):33-39.