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Biomedical subjects

L Specht

Publications and source records attributed to L Specht.

50 records · Page 3Linked to original sources
PubMed1988

Prognostic factors in Hodgkin's disease stage III with special reference to tumour burden.

143 patients with Hodgkin's disease stage III (65 PS III, 78 CS III) were treated with radiotherapy alone (33 patients), combination chemotherapy alone (56 patients), or radiotherapy plus combination chemotherapy (54 patients). They were followed till death or from 7 to 191 months. Prognostic factors including treatment, peripheral + intrathoracic tumour burden (assessed by combining tumour size in each involved region with number of involved regions), intraabdominal tumour burden (assessed by combining size of lymphographically involved lymph nodes in each region with number of lymphographically involved regions), histologic subtype, B-symptoms, number of involved regions, mediastinal involvement, pretreatment ESR, sex, age, laparotomy, and substage were examined in multivariate analysis. With regard to disease-free survival, total tumour burden (intraabdominal and peripheral + intrathoracic) emerged as the only pre-treatment factor of independent prognostic significance. With regard to overall survival the only factor of independent significance apart from age turned out to be intraabdominal tumour burden. The results of the present study thus support recently published findings regarding early stage disease to the effect that tumour burden is the single most important prognostic factor in Hodgkin's disease.

Abdominal Neoplasms↗
PubMed1987

Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy.

391 patients treated intensively for Hodgkin's disease were followed for up to 15 years to evaluate the risk of therapy-related acute non-lymphocytic leukaemia (t-ANLL) and preleukaemia. Only two independent factors, patient age and cumulative dose of alkylating agents, were related to the risk of t-ANLL. The hazard rate of t-ANLL was roughly proportional to the square of patient age and to the total cumulative dose of alkylating agents. In 320 patients treated with alkylating agents the cumulative risk of t-ANLL increased steadily from 1 year after the start of treatment and reached 13.0% (SE 3.0) at 10 years after which time there were no further cases. Calculated from cessation of therapy with alkylating agents, however, the cumulative risk curve increased steeply during the first 1-2 years then gradually levelled out and no new cases were observed beyond 7 years. With a 15-year follow-up the general risk of solid tumours was not increased.

Adult↗
PubMed1987

Tumour burden in early stage Hodgkin's disease: the single most important prognostic factor for outcome after radiotherapy.

One hundred and forty-two patients with Hodgkin's disease PS I or II were treated with total or subtotal nodal irradiation as part of a prospective randomized trial in the Danish National Hodgkin Study during the period 1971-83. They were followed till death or--at the time of this analysis--from 15 to 146 months after initiation of therapy. The initial tumour burden of each patient was assessed, combining tumour size of each involved region and number of regions involved. Tumour burden thus assessed proved to be the single most important prognostic factor with regard to disease free survival. Other known prognostic factors such as number of involved regions, mediastinal size, pathological stage, systemic symptoms, and ESR were related to tumour burden and lost their prognostic significance in a multivariate analysis. The only other factors of independent significance were histologic subtype and, to a lesser extent, sex. Combining tumour burden and histologic subtype made it possible to single out a group of patients with a very poor disease free survival. These patients also had a poorer survival from Hodgkin's disease and thus clearly candidates for additional initial treatment.

Adult↗
PubMed1986

Prognostic significance of tumour burden in Hodgkin's disease PS I and II.

94 patients with Hodgkin's disease PS I or II, treated during the period 1969-78 and followed until death, or from 33 to 136 months after initiation of therapy, were analysed. 47 patients had been treated with radiotherapy alone (mantle field irradiation and, in all but 12 cases, irradiation of infradiaphragmatic lymph nodes), while the other 47 had been treated with mantle field irradiation plus 6 cycles of combination chemotherapy (MOPP or an equivalent regimen). Of the patients treated with radiotherapy alone, 13 relapsed whereas only 1 of the patients treated with radiotherapy plus combination chemotherapy relapsed. The initial tumour burden of each patient was estimated, combining tumour size of each involved area and number of sites involved. For patients treated with radiotherapy alone, a large tumour burden singled out the patients destined to relapse more accurately than other prognostic factors including pathological stage, B-symptoms, mediastinal involvement, bulky mediastinal involvement, and number of sites involved.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Therapeutic implications of mediastinal involvement in advanced Hodgkin's disease.

47 patients with advanced Hodgkin's disease (stage IIIB or IV) and mediastinal involvement, treated during the period 1969-78 and followed till death or from 36 to 126 months after initiation of therapy, were analysed. All 47 patients had received combination chemotherapy (MOPP or equivalent regimens). 20 had also received additional radiotherapy to mediastinum (and in some cases to other involved areas as well). The 2 treatment groups did not differ significantly with regard to the more important prognostic factors. Both in the case of stages IV and IIIB patients in the group treated with combination chemotherapy alone, remissions were significantly more often only partial, the frequency of relapse and of treatment failure was significantly higher, and relapse-free survival was significantly poorer than in the group treated with additional radiotherapy. Furthermore, survival from Hodgkin's disease and crude survival including all causes of death were significantly better for patients treated with combination chemotherapy plus mediastinal irradiation. Consequently, for patients with advanced Hodgkin's disease and mediastinal involvement a combined approach including radiotherapy as well as combination chemotherapy would seem advisable.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Testicular function in young men in long-term remission after treatment for the early stages of Hodgkin's disease.

16 young men in long-term remission after standard treatment for the early stages of Hodgkin's disease were examined for testicular function 48 to 125 months after termination of therapy. The patients had received mantle field irradiation, plus either irradiation of infradiaphragmatic lymph nodes (7 patients) or 6 cycles of MOPP (9 patients). 5 patients had almost normal semen quality judged by seminal fluid analysis. 11 patients had reduced semen quality (8 severely reduced) and often elevated FSH values. Semen samples of poor quality were significantly more common in patients treated with MOPP (7/9) than in those treated with infradiaphragmatic irradiation (1/7). One patient showed signs of regeneration of spermatogenesis. None had experienced reduction in libido and sexual performance after therapy; correspondingly, none had below normal testosterone values or elevated LH values. Patients should be informed about the risk of infertility before treatment. If in a given case several treatment options with equal prospective antineoplastic effect are weighed against one another, the patient's possible desire to retain fertility should favour the use of radiotherapy as opposed to chemotherapy, especially including alkylating agents.

Adult↗
PubMed1984

Ovarian function in young women in long-term remission after treatment for Hodgkin's disease stage I or II.

16 young women in long-term remission after first-line treatment for the early stages of Hodgkin's disease were examined for ovarian function 48 to 125 months after termination of therapy. The patients had received mantle field irradiation, plus either irradiation of infradiaphragmatic lymph nodes or 6 cycles of MOPP. 4 patients showed signs of ovarian failure judged by menopausal symptoms, menstrual pattern and/or hormone values. 12 patients had functioning ovaries; 8 of these had become pregnant after treatment, 2 had had an induced abortion, and 7 had given birth to a total of 9 healthy babies after treatment. The patients with signs of ovarian failure were older than the others, but the difference was not statistically significant. No difference between the patients who had received different treatments was established, nor does the study confirm the proposed protective effect of oral contraceptives. For women under 35 years of age, the long-term chances of preserving ovarian function after standard treatment for the lower stages of Hodgkin's disease seem to be much better than hitherto assumed.

Adolescent↗
PubMedDate not supplied

Combined anterior and posterior spine fusion in cerebral palsy.

Two-staged anterior and posterior spine fusion with instrumentation was evaluated in 17 cerebral palsy patients, ages 11 to 30 years. Functional benefits included improved sitting balance and, in ambulators, no loss of independence. Curve correction averaged 60%. The pseudarthrosis rate of 18% was lower than previously reported for patients with anterior or posterior fusions alone. Instrumentation complications occurred in 50% of patients with athetosis. The combined anterior and posterior fusion for thoracolumbar and lumbar curves appeared to give the best correction, highest rate of fusion, and fewest complications in this complex patient group.

Adolescent↗
PubMedDate not supplied

Comparison of 99Tcm lymphoscintigraphy and lymphangiography in patients with malignant lymphomas.

Comparison of abdominal lymphoscintigraphy with 99Tcm microcolloid and conventional lymphangiography in 38 patients with malignant lymphomas showed 62 per cent agreement when the results were classified as normal, doubtful and abnormal. The present scintigraphic method seems to be sufficiently safe and accurate as a screening test, without significant side effects and associated with little patient discomfort.

Adult↗
PubMedDate not supplied

Orthopedic deformities in Emery-Dreifuss muscular dystrophy.

Orthopedic deformities in Emery-Dreifuss muscular dystrophy are discussed based on a study of four patients and an extensive literature review. The condition is characterized by slowly progressive humeroperoneal muscle weakness; ankle equinus, elbow flexion, and neck extensor muscle contractures; paravertebral muscle tightness; and cardiac abnormalities involving bradycardia and atrioventricular conduction defects. Tendo Achilles lengthening is warranted, since patients remain ambulatory for several decades. Scoliosis occurred in three patients but stabilized in the absence of treatment. Recognition of the condition is important to allow for heart pacemaker insertion because the usually asymptomatic cardiac abnormalities are associated with a high incidence of sudden death in mid-adult life.

Adult↗