摘要:

AbstractForty‐two children, 6 months to 17 years of age with newly diagnosed soft‐tissue sarcomas (gross residual or metastatic), were treated according to either of two pilot protocols that included intensive chemotherapy before irradiation. Vincristine, actinomycin D, cyclophosphamide, and doxorubicin were used in various combinations with cisplatin alone (regimen 35) or with cisplatin plus etoposide (regimen 36) in a 20‐week induction treatment; irradiation (4,000 cGy) was delayed until week 6. Fourteen (82%) of the 17 patients on regimen 35 and 15 (60%) of the 25 on regimen 36 had a complete response. Although severe leukopenia was frequent in both groups (88% and 84% of patients), there were only two fatal infections and no early deaths. Other potentially serious toxicity included a>10% weight loss in 52% of the patients and hypomagnesemia in 74%. An average of 75‐100% of the prescribed drug doses were administered during the induction phase of therapy. We conclude that this intensified treatment is toxic but feasible to deliver. The higher overall response rate compared to that in the preceding Intergroup Rhabdomyosarcoma Study (69% vs 53%) suggests improved therapeutic efficacy that warrants further evaluation of both r

ISSN:0098-1532    

DOI:10.1002/mpo.2950150202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractLymphohistiocytic erythrophagocytosis (LE) is a usually fatal disease characterized by fever, organomegaly, hyperlipidemia, central nervous system involvement, and cellular immunodeficiency. Treatment with corticosteroids, cytotoxic chemotherapy, and blood exchange is unsuccessful. We have treated two children with the epipodophyllotoxin VP‐16 and with intrathecal chemotherapy. Each patient had an initial complete response, and one remains in remission 36 months after therapy began. Aziridinylbenzoquinone (AZQ) therapy induced a complete response in a patient who relapsed during VP‐16 therapy. A combination of VP‐16 and intrathecal chemotherapy appears to be the most effective therapy for LE, and further evaluation of the role of AZQ is indi

ISSN:0098-1532    

DOI:10.1002/mpo.2950150203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractThe psychosocial care of children with cancer has received increasing and welcome emphasis in the medical literature. However, the current and future status of siblings of such patients has been an underestimated area of concern. We examine the general importance of sibling relationships and present the literature regarding siblings of paediatric oncology patients. Donors and recipients of bone marrow transplants are considered specifically. Preliminary results of original research, supported by available published studies, suggest important disturbances in the mental health of siblings. Implications for paediatricians and other health professionals as well as prevention and intervention strategies are indicated.

ISSN:0098-1532    

DOI:10.1002/mpo.2950150204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractMethotrexate (MTX) has demonstrated significant activity against relapsed and metastatic osteosarcoma. However, there is little published data to indicate the appropriate dose for MTX when given as a component of a multidrug regimen for the treatment of osteosarcoma. Therefore, the investigators at the Childrens Cancer Study Group undertook a randomized clinical trial that compared Adriamycin and vincristine given with either highdose methotrexate or moderate‐dose methotrexate as postoperation chemotherapy in the treatment of childhood osteosarcoma. We report here the results for 166 patients with completely resected nonmetastatic disease of an extremity.The two therapies demonstrated equivalent disease‐free survival (DFS). Further, no therapy prejudices survival after relapse. Approximately 38% of patients remain disease free 4 years after diganosis. Two relapses occurred in patients free of disease at least 36 months after initiation of treatment. Some factors found by other investigators to be prognostic of poorer DFS, namely, male sex, primary tumor in the humerus or femur, and larger primary tumors, demonstrated similar though not statistically significant trends. The presence of spontaneous necrosis in the tumor sample from the definitive surgery was associated with poor prognosis for DFS. We postulate that this feature represents rapidly growing tumors with increased potential for metasta

ISSN:0098-1532    

DOI:10.1002/mpo.2950150205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractPrognosis in Ewing's sarcoma is inversely related to the extent of the disease at the time of presentation. The most common sites of metastases are the lungs and skeleton. Bone marrow metastases may be present but clinically silent. We report the use of Technetium (Tc)‐99m bone marrow scintigraphy to detect sites of marrow involvement by metastatic Ewing's sarcoma. This method of evaluation allowed identification of sites of involvement by Ewing's sarcoma that were not available by any other method of evaluation. In several instances, information provided by this method was pivotal in the management of these patients. Based on this small series of patients, bone marrow scintigraphy appears to be a sensitive modality in the detection of metastatic disease in patients with Ewing's sarcoma. Better understanding of the role of bone marrow scanning and its correlation with other diagnostic procedures in Ewing's sarcoma will require further stud

ISSN:0098-1532    

DOI:10.1002/mpo.2950150206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractEight cases of sarcoidosis diagnosed after a preceding malignant solid tumor are presented. An analysis of these eight cases along with four previously reported cases was unable to answer the question whether in some cases the development of sarcoidosis may be triggered or modified by a preceding treatment of a malignant tumor. However, in the reverse situation—sarcoidosis preceding cancer—an analysis of 23 such cases from the literature suggests 1) that sarcoidosis preceding cancer appears to be of the chronic active variety and 2) that lung and breast cancer may occur more often than expected after sarcoidosis. Thus, it is conceivable that the immunologic abnormalities associated with sarcoidosis may somehow promote the development of certain malignant tumors.True sarcoidosis may be confused with local sarcoid reactions in cancer patients. One such case is reported in which the finding of a regional sarcoid reaction to a solitary lung metastasis from a uterine adenocarcinoma led to insufficient treatment in the belief that the patient had systemic sarcoido

ISSN:0098-1532    

DOI:10.1002/mpo.2950150207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractRadiation myelopathy is a serious potential complication associated with radiation therapy to the spinal cord. Its exact cause is unknown. It represents a spectrum of syndromes, the most common of which are acute transient radiation myelopathy and chronic progressive radiation myelitis. A review of the literature indicates that cord damage is related to a number of controllable factors including dose fraction size, treatment time, total dose, length of cord irradiated, technical and clerical errors. Other less well understood factors that appear to contribute to the risk such as combined chemoradiotherapy effects and hyperthermia should also be recognized. A better awareness and understanding of these factors should ultimately lead to safer and more effective treatments.

ISSN:0098-1532    

DOI:10.1002/mpo.2950150208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

ISSN:0098-1532    

DOI:10.1002/mpo.2950150209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractTwo infants with malignant histiocytosis, as diagnosed by morphological and cytochemical examinations of malignant cells infiltrating pleural effusion, skin, and bone marrow, are described. Surface marker analysis of the malignant cells with monoclonal antibodies showed these cells to express markers of Tlymphocytes and HLA‐DR antigen, but not those of B‐lymphocytes, granulocytes, or monocytes. These immunological findings demonstrated that the neoplastic cells in malignant histiocytosis of infancy may be of Tcell origin, rather than histiocytic or monocytic ori

ISSN:0098-1532    

DOI:10.1002/mpo.2950150210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY

摘要:

AbstractA patient is described who developed Hodgkin's disease 16 years after treatment of Wilms' tumor with radiation and actinomycin D. The issues relating to Hodgkin's disease as a second malignancy are reviewed. The need for long‐term surveillance of patients with malignant disease for late effects of the cancer and its treatment is emphasize

ISSN:0098-1532    

DOI:10.1002/mpo.2950150211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1987

数据来源: WILEY