Biomedical subjects

Andrea Bezjak

Publications and source records attributed to Andrea Bezjak.

39 records · Page 3Linked to original sources

PubMed2002

Prognostic significance of thymomas in patients with myasthenia gravis.

BACKGROUND: The presence of thymoma may be a negative prognostic factor with respect to the outcome of myasthenia gravis (MG). METHODS: Of 122 consecutive patients with MG undergoing thymectomy between August 1994 and September 2000, 37 had a thymoma. Postoperative radiation was administered to all patients with stage II thymoma and higher. To determine differences in presentation and outcome, thymoma patients were compared with patients with atrophic (n = 49) or hyperplastic (n = 36) thymus gland on final pathology. RESULTS: Thymoma patients were significantly older (52 +/- 14 vs 36 +/- 15 years, p < 0.0001) and included a significantly higher proportion of males (54% vs 28%, p = 0.006) than patients without thymoma. However, the preoperative Osserman grade and the duration of symptoms before surgery were not significantly different between groups. Mean follow-up after thymectomy was not significantly different between patients with or without thymoma (32 +/- 23 vs 37 +/- 19 months, respectively, p = 0.3). At last follow-up, the proportion of asymptomatic patients (63% vs 70%, respectively, p = 0.5) and the mean Osserman grade (0.6 +/- 0.9 vs 0.5 +/- 0.9, respectively, p = 0.6) were similar in both groups. In addition, the rate of complete remission reached 36% at 5 years in patients with or without thymoma (p = 0.8). CONCLUSIONS: Although myasthenic patients with thymoma are significantly older and include a greater proportion of males, the overall outcome, including the rate of complete remission, was similar between patients with or without thymoma. Therefore, the presence of a thymoma should not necessarily be viewed as a negative prognostic factor regarding recovery from myasthenia gravis.

Adult↗

PubMed2002

Primary treatment endpoint following palliative radiotherapy for painful bone metastases: need for a consensus definition?

OBJECTIVES: To compare and contrast the definitions of primary treatment endpoints in randomized studies of dose-fractionation schedules for treating bone metastases and to identify basic characteristics of treatment endpoint that may require consensus among investigators. METHODS: Randomized controlled trials (RCTs) of various dose-fractionation schedules for painful bone metastases, published between 1980 and 1999, and on-going trials whose protocols were available, were systematically reviewed based on the following features of the primary treatment endpoint: (i) degree of pain relief; (ii) timing of the pain response assessment; (iii) effect of co-interventions on pain relief; (iv) the reduction of analgesic as a treatment response; and (v) quantification of response duration. RESULTS: Ten published RCTs (each sampled over 100 patients), plus two current trial protocols were reviewed. Five of the 12 studies defined any reduction in pain score as the primary endpoint. Three trials defined response at pre-determined time points, whereas eight studies attributed pain improvement at any time during follow-up to the effect of radiotherapy. No trial incorporated effect of systemic treatments on response. Only two trials incorporated analgesic scores into the primary endpoint criteria, although several trials reported results of combined pain and analgesic relief. Eight trials reported duration of response. Three provided some estimation of duration with respect to survival: two of them employing actuarial time to pain progression, and one calculated the ratio of pain response to median survival duration (percent net relief). Quality of life was measured in four of 12 studies, as secondary endpoint. CONCLUSION: Although available data suggest similarity in pain relief among various dose-fractionation schedules, accurate and consistent description of the degree of benefit from radiotherapy is lacking. While pain relief is a consistent primary treatment goal among randomized trials, a consensus on several important features of treatment endpoint is needed in order to establish common grounds for future trials in palliative radiotherapy.

Bone Neoplasms↗

PubMedDate not supplied

Travelling for radiation cancer treatment: patient perspectives.

Radiation treatment for cancer requires patients to receive frequent administrations and attend the treatment facility on a daily basis for several weeks. Travelling for radiation treatment has the potential to add to the distress an individual may be feeling. This study utilized in-depth interviews to capture 118 patients' perspectives about travelling for cancer treatment. Four themes emerged during the analysis of the data: (1) waiting was the most difficult part of the experience; (2) the idea of travelling for treatment was distressing; (3) travelling for treatment was tiring and posed difficulties for patients; and (4) being away from home had both benefits and drawbacks. Given the inevitability of travelling for radiation treatment, and the issues that arises for patients, supportive strategies need to be designed and implemented.

Adult↗