[A combination of non-Hodgkin lymphoma of the small bowel and primary sclerosing cholangitis with isolated lesion of small ducts].
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Biomedical subjects
Publications and source records attributed to I V Poddubnaia.
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Chemotherapy (taxotere + doxorubicin) was given to 46 patients with disseminated breast cancer: first line--27 (group A) and second line (including treatment after anthracycline-containing combinations and taxol--19) (group B). Average effectiveness in group A was 70.4% (10/27); group B--42.1% (8/19). The highest response was shown by metastases to the lung, liver, peripheral lymph nodes and primary tumors; least response--metastases to bones and soft tissues. Remission duration ranged 3-26 months. Median remission duration in group A was significantly longer than in group B (13.3 +/- 1.0 and 7.0 +/- 1.4 months, respectively) (p(0 < 05). Remission is still on in 11 patients (more than 26 months). Toxic poisoning was moderate: neutropenia stage III-IV was reported in 82/225 cycles (36.4%) lasting more than 7 days in 4/225 cycles (1.7%), febrile neutropenia stage 1-II--10/225 cycles (4.4%); stomatitis and diarrhea stage III-IV--1/225 cycles (0.44%). Treatment was suspended because of hypertension in one patient. No other side effects stage III-IV were registered.
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A study of the features of a course of lymphosarcoma made it possible to establish effective time-periods of dynamic examination of patients for timely detection of such manifestations of disease as G. I. tract involvement. The regularity of examination and diagnostic methods depended on a primary focus site and the nature of G. I. tract involvement.
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Comparative study of the efficacy of the different therapeutic measures for colonic lymphosarcoma indicates that in locally disseminated colonic lymphosarcoma (primary injury) radical surgery appears to be the most efficacious. Application of the drug therapy is helpful for disseminated primary colonic lymphosarcoma and metastatic injuries. The performance of the palliative surgery noticeably deteriorates the disease prognosis.
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Based on the use in 119 patients, the COP scheme can be regarded as an effective method of drug therapy of lymphosarcoma of the gastrointestinal tract: the total efficacy amounts to 65.4% and is practically identical in primary (61.8%) and metastatic (70%) involvement of the alimentary tube into the pathological process. However, the attainment of complete remissions was stated in an insignificant number of patients (16%). The five-year survival is equal to 60.2%.
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A case of the development of gastric adenocarcinoma in a woman of 47 who for the previous 9 years had been treated for lymphoplasmocytic lymphosarcoma is described. The patient periodically received courses of polychemotherapy and twice radiotherapy on the stomach area because of the affection of the stomach detected by roentgenological examination and endoscopy with gastrobiopsy. In the past two years the patient underwent multiple endoscopic examinations demonstrating over time the changes in the gastric mucosa which initially showed superficial adenomatous outgrowths of the proliferating epithelium in the presence of marked atrophy and intestinal metaplasia. Gradually the signs of dysplasia increased in them and finally adenocarcinoma was established. Resection of the stomach revealed a highly differentiated adenocarcinoma in the form of an exophytic node 2 x 2 x 1 cm in size growing into the submucous layer.
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