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U Rühl

Publications and source records attributed to U Rühl.

49 records · Page 3Linked to original sources
PubMed1979

[Cobalt teletherapy of the carcinoma of the urinary bladder (author's transl)].

A three-year survival rate of 40% of a group of 287 patients was achieved by a standardized Co-60 teletherapy. This survival rate and the radiogenic late effects observed over a ten-year period are compared with results communicated in literature. Important prognostic factors were the findings of a pretherapeutic urogram, the tumor localization, histologic findings, the stade and the surgical proceeding. In this connexion, the W.H.O. classification containing the stades of penetration and the degrees of malignity proved to be valuable. Taking into consideration the own results and those found in literature, the authors propose a therapy depending on the stade and based on modern diagnostic methods and a reliable histologic classification.

Adult↗
PubMed1977

[Total-body irradiation in non-Hodgkin's lymphomas as an alternative to chemotherapy].

On the bases of previous experiences and present results it can be stated that total-body irradiation is an effective therapeutical technique for treatment of lymphocytic non-Hodkin's lymphomas including chronic lymphatic leukemia; first results from prospectively randomized studies even revealed a slight superiority of this method as compared to the scheme of combined cytostatical therapy (CVP) mostly applied at present. Particular advantages of total-body irradiation are the easy applicability, the relatively short time needed for treatment, and the lack of subjective secondary effects. Thus, ambulatory therapy can be performed without any difficulty. The only complication which may occur arises from myelotoxicity reaching its maximum not earlier than after the end of treatment. Careful follow-up of the patients, therefore, is indispensable. The indication of total-body irradiation for the treatment of non-Hodgkin's lymphomas depends on the objective findings, the stage of disease, and mainly on the histological classification.

Antineoplastic Agents↗
PubMed1977

[Irradiation for prevention of gynecomastia prior to estrogen therapy in cases of carcinoma of the prostate (author's transl)].

The most frequent and most unpleasant side-effect of therapy with estrogen hormones in patients with carcinoma of the prostate is the painful gynecomastia. Since 1969, we have been performing the prophylactic irradiation of the mammary glands on 284 patients in order to prevent a hormone-induced gynecomastia. The majority (262 patients) was irradiated with 600 rad surface dose in fractions of 150 rad prior to the hormone therapy. One hundred and two patients, having been treated endocrinologically for 2-75 months, had a follow-up examination. After irradiation, only 19% of the patients did not develop a gynecomastia, and 60% had no mamillary hyperesthesias. Compared to other authors, the therapy was less efficient, the symptoms, however, were discrete. As a consequence, an increase of the radiation dose as well as an alteration of the fractionation must be used.

Aged↗
PubMedDate not supplied

Preliminary results of the multicenter trial GPOH-HD 95 for the treatment of Hodgkin's disease in children and adolescents: analysis and outlook.

BACKGROUND: In 5 consecutive pediatric and adolescent Hodgkin's disease trials DAL-HD since 1978 the invasive diagnostic procedures and the radiotherapy have gradually been reduced and chemotherapy modified to minimize toxicity and the risk of late effects. Since 1982 the overall survival increased up to 95%. In this trial the possibility of reducing local radiation doses to 20 Gy in patients with good response to chemotherapy and omitting radiotherapy totally for patients with complete remission after chemotherapy was tested. PATIENTS AND METHODS: Over a period of 6 years, from August 1995 to July 2001, 1018 children and adolescents with Hodgkin's disease from Germany, Austria,Switzerland, the Netherlands, Sweden, Norway and Denmark were enrolled in this trial. The chemotherapy was equivalent to previous trial DAL-HD 90. The treatment group (TG) 1 (stages I and IIA) received 2 cycles OPPA for girls and 2 cycles OEPA for boys, TG2 (stages IIEA, IIB, IIIA) and TG3 (stages IIEB, IIIEA, IIIB, IV) received additional 2 or 4 cycles COPP respectively. In contrast to trial DAL-HD 90 boys in stage IIIB and IIIEB received OPPA instead of OEPA. The initial staging as well as the restaging for evaluating tumor volume reduction after chemotherapy was reviewed by the study center. Radiotherapy was planned accordingly: patients with complete remission after chemotherapy were not irradiated (21.9%); all other patients received local radiotherapy to the initially involved sites, depending on the tu-mor response. Patients with a partial remission of> 75 tumor regression were irradiated with 20 Gy (50AX), partial remission of< 75% with 30 Gy (4.1 %), and residual masses of > 50 ml were boosted up to 35 Gy (20.2 %). RESULTS: 36 tumor progressions and 49 relapses occurred over a period of 7 1/2 years (median followup 3 years, data deadline 12/19/02). Kaplan-Meier-analysis after 5 years showed a probability for event-free survival (pEFS) for all patients of 0.88 and for overall survival (pOS) of 0.97. For the total group the pDFS (disease free survival) was lower in 222 non irradiated patients than in the 758 irradiated patients (0.88 vs. 0.92,p - 0.049). But there was a difference between the individual treatment groups. In TG 1 there was no difference between nonirradiated and irradiated patients (0.97 vs. 0.94) and the non-ir-radiated patients showed a better trend. In TG 2, and in TG 2 and TG 3 combined, the pDFS was significantly worse for non irradiated patients in comparison with the irradiated patients (TG2:0.78 vs. 0.92; TG 2 +3:0.79 vs. 0.91). Compared to former DAL-HD trials the pOS stayed stable despite therapy reduction. CONCLUSIONS: A reduction of radiotherapy to 20 Gy for patients in all stages with good response to chemotherapy is possible without deterioration of the results. The omission of radiotherapy for patients in complete remission after chemotherapy is recommended only for patients in early stages (TG1). In future trials the possibility of a wider selection for chemotherapy alone for this group needs to be evaluated. In intermediate (TG2) and advanced (TG3) stages omission of radiotherapy for patients incomplete remission results in a lower pEFS, but the pOS is not significantly reduced. Only with knowledge of the long term effects of today's therapy we can give a satisfactory answer to the question whether in future trials the primary aim should be pEFS as high as possible due to front-line-therapy or reduction of late effects.

Adolescent↗
PubMedDate not supplied

[Multi-national therapy study for Hodgkin's disease in children and adolescents GPOH-DH 95. Interim report after 2 1/2 years].

Based on concepts of the successful German-Austrian pediatric Hodgkin studies DAL-HD 78 until-90, a new trial was initiated addressing the question whether radiotherapy can be further reduced or can be omitted in case of complete remission after initial chemotherapy, aiming at reduction of sequelae after radiotherapy, especially radiogenic second malignancies. In respect to CHEMOTHERAPY patients are stratified into 3 therapy groups (TG) according to stage and gender: 2 courses of OPPA (girls) or OEPA (boys) in TG1 (stage IA/B, IIA), and in addition 2 (TG2: stage IEA/B, IIEA, IIB, IIIA) or 4 (TG3: stage IIEB, IIIEA/B, IIIB, IVA/B) COPP courses. Boys with stage IIIB and IIIEB receive OPPA instead of OEPA. RADIOTHERAPY is administered according to response to chemotherapy independent of stage: patients with complete remission or minimal residues do not receive irradiation; patients with more than 75% tumor regression are irradiated to involved fields at a dose of 20 Gy. Doses of 30 or 35 Gy are given to regions with tumor regression below 75% or residual bulky tumor of > 50 ml, respectively. INTERIM RESULTS: From 8/95 till 1/98 we registered 385 patients under the age of 18 years from Germany, Austria, Switzerland, Sweden and the Netherlands. Therapy has been completed in 334 patients. Three patients with solitary nodular paragranuloma were treated with surgery only. Out of 331 patients 89 (26.9%) achieved a complete remission with chemotherapy. Tumor regression of more than 75% was seen in 193 (58.3%) patients and below 75% in 39 (11.8%) patients. Tumor progression during chemotherapy occurred in 1 (0.3%) patient. Response after chemotherapy was not evaluable for 9 (2.7%) patients. Radiotherapy was omitted in 91 (27.1%) patients: in TG1 50 of 142 (34%) patients, TG2 24 of 98 (24.5%) patients and TG3 18 of 94 (19.2%) patients. Initially involved regions were irradiated at a dose of 20 Gy in 164 of 334 (49.1%) patients. Doses up to 30 Gy or 35 Gy were given to 19 (5.7%) or 57 (17.1%) patients respectively. Events (tumor progression, relapse or death) occurred in 23 of 334 patients until now. The event-free survival rate is 0.91 at 2 1/2 years for all study patients and 0.89 for patients without radiotherapy. Six relapses occurred in 91 patients without radiotherapy. No relapse occurred in TG1 (n = 49), but in 5 of 24 TG2-patients, and in 1 of 18 TG3 patients without radiotherapy. As yet, the results are not significantly inferior compared with trial DAL-HD 82. Therefore this trial aiming at omitting radiation therapy in patients with complete remission after a short lasting chemotherapy will be continued. Longer follow up is necessary for final evaluations and conclusions.

Adolescent↗
PubMedDate not supplied

Lymphocyte function in patients with Hodgkin's disease.

Lymphocyte functions in vitro were tested in patients with Hodgkin's disease. The PHA-induced lymphocyte stimulation and the responding capacity in the one-way mixed lymphocyte culture reaction was found to be severely depressed. In contrast, the PHA-induced production of a human mononuclear leukocyte chemotactic factor was not significantly impaired.

Adolescent↗