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  • 1
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-one patients with head and neck carcinomas relapsing after radiotherapy were treated with a combination of cis-platinum, bleomycin, and methotrexate. Four patients (19%) achieved a partial response. Toxicity was significant in selected cases; three patients developed WBC counts less than 1,000/mm3 and one of these patients died with sepsis. Severe mucositis was present in three of the twenty-one patients. Considering the toxicity of this combination and the limited therapeutic activity with the dose and schedule used in this study, this regimen is not recommended for the treatment of squamous head and neck carcinomas relapsing after radiotherapy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: circulating DNA ; plasma DNA alterations ; prognostic factor ; SCLC ; tumor DNA alterations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Small-cell lung cancer (SCLC), one of the major types of lung cancer, is associated with many different somatic molecular genetic changes. These alterations, observed in tumor DNA, have also been identified in the plasma DNA of patients. We undertook the present study to make a prospective investigation into the correlation between abnormal plasma DNA and patient survival. Patients and methods:Thirty-five patients with SCLC were selected after histological diagnosis. Polymorphic markers (ACTBP2, UT762 and AR) were chosen for their reported high rate of alterations in SCLC and analyzed in tumor tissue, normal blood cells and plasma DNA. Furthermore, we looked for mutations of the TP53 gene in tumor and plasma DNA. Results:In 25 patients (71%) at least one molecular change precisely matching that of the primary tumor was detected in the plasma DNA. No difference in survival was observed between patients with aberrant plasma DNA and patients without plasma DNA alterations. However, patients with microsatellite modifications and TP53 mutations concomitantly, showed a significant difference (P = 0.02) in survival compared with patients bearing only one of these molecular changes. In 15 cases it was possible to find a correlation either between tumor response and disappearance of abnormal plasma DNA, or tumor progression and persistence of plasma DNA alterations. Conclusions:Free plasma DNA with molecular alterations is present to a high degree in plasma DNA of SCLC patients and may have a role as a prognostic factor.
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  • 3
    ISSN: 1569-8041
    Keywords: Hodgkin's disease ; longitudinal study ; mortality ; survival analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Although Hodgkin's disease can be treated successfully, its long-term survival rate has yet to be definitely established. We compared the long-term mortality rate of patients diagnosed as having Hodgkin's disease with that of the general population. Patients and methods: We studied a retrospective cohort of 477 patients who received pathology-confirmed diagnoses of Hodgkin's disease between 1967 and 1993 and were treated with combined chemotherapy or radiotherapy with follow-up from the day of diagnosis. Standardised mortality ratios were computed with reference rates taken from the Spanish population. Results: The follow-up was complete for 427 (89.5%) of the patients. The median follow-up time was 8 years, 133 patients (28%) died and the median survival time was 21 years. The overall survival rates were 80% at 5 years, 70% at 10 years, and 64% at 15 years after diagnosis. The standardised mortality ratios were 10.8 (95% confidence interval: 9.0–12.8, P 〈 0.0001) overall, 5.5 in patients in favourable stages (IA, IIA), and 15.2 in those with unfavourable stages (IB, IIB, III, IV). There was a decreasing trend in mortality by calendar period (standardised mortality ratios for 1967–1975, 1976–1974 and 1985–1993: 16.8, 10.3 and 5.1, respectively). Higher mortality was observed in all periods of follow-up after diagnosis, even after 20 years. Conclusions: Despite the improvements in treatment, mortality in Hodgkin's disease remains higher than in the general population in all disease stages, even 20 years after diagnosis.
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  • 4
    ISSN: 1569-8041
    Keywords: autopsy ; causes of death ; Hodgkin's disease ; mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:The causes of mortality in Hodgkin's disease patients areinsufficiently known. Autopsy study is the fundamental procedure in theinvestigation of these causes. The present study analyzes the autopsiesperformed in a series of patients diagnosed as having Hodgkin's disease,determining the cause of death in each case and comparing the premortemclinical data and the postmortem findings. Patients and methods:A total of 486 patients diagnosed as havingHodgkin's disease between 1967 and 1996 were assessed. Autopsy was performedin 40 of the 144 deceased patients (28%). We reviewed the pathologicalfindings, effects of treatment, discordance between the clinical diagnosis andthe outcome of autopsy, and cause of death in each case. Results:The most common clinical causes of death in thosepatients with autopsy study were tumor progression (37%) and infections(43%) in those patients with autopsy study. The rate of discordancebetween the clinical and autopsy diagnoses in this study was 43%. Themost frequent location of residual Hodgkin's disease was in the lymph nodes. Conclusions:Autopsy study in Hodgkin's disease confirms a highrate of discrepancy between final clinical diagnosis and postmortem lesionsdespite advances in diagnostic methods. Autopsy revealed causes of deathdirectly related to the treatment, as well as some lesions directly relatedto patient death and secondary to treatment. Infectious processes are likelyto remain undetected and their symptoms can mimic tumor progression.
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  • 5
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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