Updated Hodgkin's disease. C. Advanced disease and special problems. Comment: the non-Hodgkin's lymphomas.
Explore the source record for details and available documents.
Burkitt Lymphoma↗
SEARCH · PubMed Health
Results for “advance disease”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Bronchial carcinoma. II. Quantitative measurements of the quality of survival. A prospective randomized study of the result of therapy in inoperable patients with advanced disease.
Forty-eight bronchial carcinoma patients in clinicoanatomical stage 4 of the disease (advanced disease) were randomly assigned to groups for radiotherapy, chemotherapy (cyclophosphamide) and placebo treatment, respectively. The results were assessed by the survival time and quality of survival. The median survival time was 4.7 months for radiotherapy, 4.7 months for cyclophosphamide and 1.7 months for placebo. The median total sum of vitagram points was 28.1 for radiotherapy, 20.7 for cyclophosphamide and 6.8 for placebo. When calculated per month, the median sum of vitagram points was 5.9 for radiotherapy, 5.7 for cyclophosphamide and 4.8 for placebo. Statistically the results give no reason to believe that placebo is better than radiotherapy, but it cannot be excluded that radiotherapy patients could have a much longer survival. As for cyclophosphamide versus radiotherapy, the differences are to uncertain for any conclusion to be drawn.
Adult↗
LHRH analogues in combination with an anti-androgen in the treatment of advanced disease.
Treatment of advanced prostate cancer with a combination of luteinising hormone-releasing hormone analogues and anti-androgens is advisable for the initial 2 weeks, in patients with newly diagnosed, extensive disease. Advances in long-term combination treatment are questionable until results of phase III studies become available. Reference is made to poster presentations at the International Symposium on Endocrine Therapy.
Androgen Antagonists↗
Systemic therapy of breast cancer in early and advanced disease.
Despite substantial advances in breast cancer treatment, mortality from this disease remains high. While adjuvant chemo-hormonal therapy has significantly improved survival, breast cancer still claims the lives of more than 45,000 American women each year. This article is a brief review of various modalities used in the management of breast cancer, including adjuvant and neoadjuvant therapy, treatment for advanced disease, dose intensification, and autologous bone marrow transplantation.
Antineoplastic Combined Chemotherapy Protocols↗
Immunological profile of breast cancer patients in early or advanced disease.
Immune reactivity of patients with early or advanced breast cancer, compared with healthy controls, has been measured using in vivo and in vitro tests. The results of our study show that impairment of cellular responsiveness occurred in women with advanced disease.
Adult↗
Pleomorphic rhabdomyosarcoma, outcomes of patients with advanced disease treated with systemic agents: Retrospective study from the global pushing ultra-rare sarcomas towards hope (PUSH) consortium.
OBJECTIVES: To report the outcomes in adult patients with advanced pleomorphic rhabdomyosarcoma (P-RMS) treated with systemic therapy. METHODS: This global, multicenter, retrospective study conducted within the Pushing Ultra-Rare Sarcomas Towards Hope consortium (PUSH) included patients > 40 years with histologically confirmed advanced P-RMS, treated with at least one line of systemic therapy between 2013 and 2023. The primary endpoint was progression-free survival from first diagnosis of advanced disease, and from systemic treatment start (PFS-1 and PFS-2). Secondary endpoints included overall response rate (ORR), overall survival from first diagnosis of advanced disease and from treatment start (OS-1 and OS-2), and treatment-specific outcomes. RESULTS: Seventy-seven patients were included from 21 sarcoma reference centers. At a median follow-up of 44 months (IQR: 17.0-74.8), 49 (64%) patients had died and 48 (62%) had progressed. The median OS-1 and PFS-1 were 13.6 (95% confidence interval (CI): 9.4-22.5) and 5.4 (95% CI: 4.2-7.3) months, respectively. Two- and three-year OS-1 were 32.5% and 30.3%. Anthracycline-based regimens (n = 42) achieved a 50% ORR, with mPFS-2 and mOS-2 of 5.2 and 19.2 months; gemcitabine-based regimens (n = 15) a 42% ORR, with mPFS-2 and mOS-2 of 3.7 and 7.8 months; pazopanib (n = 6) a 33% ORR, with mPFS-2 and mOS-2 of 2.4 and 4.2 months; PD-1 inhibitors (n = 2) induced one response lasting 53 months. CONCLUSIONS: This series of advanced P-RMS treated with systemic agents, the largest available to date, showed meaningful activity of anthracycline- and gemcitabine-based regimens, and anecdotal responses to pazopanib and PD-1 inhibitors. Further prospective validation is planned.
Humans↗
Progressive T cell exhaustion and predominance of aging tissue associated macrophages with advancing disease stage in penile squamous cell carcinoma.
Penile squamous cell carcinoma (PSCC) is a rare malignancy with limited understanding of the tumor immune microenvironment (TIME). The interplay between PSCC and the immune system across disease progression and HPV infection status remains poorly characterized. This study aims to assess the TIME changes from localized to advanced disease and between HPV-positive versus negative tumors to identify potential immune evasion mechanisms in advanced PSCC. scRNA-seq was performed on ten PSCC tissue samples from penile, lymph node and distant metastatic sites with four matched penile and lymph node samples to understand the cellular heterogeneity within PSCC tumors. Analysis of immune cell populations and transcriptional hallmarks were performed stratified by localized (pT1-3, N0) versus advanced (N1-3, M0 or any N, M1) disease states and HPV infection status. We observed significant differences in immune cell infiltration between localized and advanced PSCC disease states and by HPV status. Advanced disease states demonstrated an exhausted immune phenotype, characterized by terminally exhausted CD8+ T cells, M2-like macrophages and hypoxic signature, while localized disease states demonstrated an active innate immune system characterized by increased DCs. HPV-negative tumors displayed low immune cell infiltration while HPV-positive tumors demonstrated an immune exhausted phenotype. These findings offer valuable insights into the evolving PSCC immune landscape, paving the way for the development of potential therapeutic approaches for advanced PSCC.
Humans↗
Advanced Coats' disease.
Advanced Coats' disease and retinoblastoma can both present with the triad of a retinal detachment, the appearance of a subretinal mass, and dilated retinal vessels. Thus, even the most experienced observer may not be able to differentiate these entities on ophthalmoscopic findings alone. Coats' disease is the most common reason for which eyes are enucleated with the misdiagnosis of retinoblastoma. Ultrasonography is the auxiliary diagnostic test most easily incorporated into the clinical examination, and can be utilized repeatedly without biologic tissue hazard. Ultrasonically identifiable features allowing differentiation between Coats' disease and retinoblastoma include the topography and character of retinal detachment and presence or absence of subretinal calcifications. Ultrasonography is of lesser use in poorly calcified retinoblastoma and in detecting optic nerve or extraocular extension in heavily calcified retinoblastoma. CT is perhaps the single most valuable test because of its ability to: (a) delineate intraocular morphology, (b) quantify subretinal densities, (c) identify vascularities within the subretinal space through the use of contrast enhancement, and (d) detected associated orbital or intracranial abnormalities. Optimal computed tomographic studies, however, require multiple thin slices both before and after contrast introduction and expose the child to low levels of radiation if studies are repeated periodically. MR imaging is valuable for its multiplanar imaging capabilities, its superior contrast resolution, and its ability to provide insights into the biochemical structure and composition of tissues. It is limited in its ability to detect calcium, which is the mainstay of ultrasonic and CT differentiation. Aqueous LDH and isoenzyme levels were not valuable in distinguishing between Coats' disease and retinoblastoma. The value of aqueous NSE levels in the differentiation of advanced Coats' disease and exophytic retinoblastoma deserves further study. Specimens from patients with intraocular hemorrhage should be viewed cautiously, since erythrocytes contain high levels of enolase. Analysis of subretinal aspirates is an extremely accurate method of confirming the diagnosis of Coats' disease. The key diagnostic findings are the presence of cholesterol crystals and pigment-laden macrophages and the absence of tumor cells on fresh preparations. The technique should be reserved for patients where retinoblastoma has been ruled out by all noninvasive means and massive subretinal drainage is anticipated. The natural progression in advanced Coats' disease is toward the development of a blind, painful eye. Spontaneous regression does rarely occur, and some eyes quietly progress to a phthisical state.(ABSTRACT TRUNCATED AT 400 WORDS)
Child↗
[Testicular cancer--clinical results of chemotherapy and surgery for advanced disease].
The CDDP-based chemotherapy improves prognosis of patients with advanced testicular cancer. Surgery is still effective in some patients who partly respond to induction chemotherapy. Thus, chemotherapy and surgery are now the standard treatment modality for advanced disease of this kind. More effective induction and salvage chemotherapy will be needed for poor prognosis-patients with far advanced metastasis. Chemotherapy which is less toxic but still effective may be more appropriate for those with a good prognosis who have a less extensive disease.
Antineoplastic Combined Chemotherapy Protocols↗
Non-Hodgkin's lymphoma of the stomach: a prospective pilot study of surgery plus chemotherapy in early and advanced disease.
A prospective pilot study of 23 patients with non-Hodgkin's lymphoma involving the stomach was undertaken to assess the efficacy of surgical resection followed by chemotherapy with adjuvant cyclical cyclophosphamide, vincristine, and prednisolone (CVP) in early stage disease, and cyclical cyclophosphamide, vincristine, prednisolone, and doxorubicin (CHOP) in advanced disease. One of 18 evaluable patients died postoperatively; 17 of 18 completed therapy and are alive and disease-free at a median follow-up of 41 months after surgery (range, 5 to 111 months), including four patients with stage IV disease who remain in complete remission 19 to 47 months after surgery. There was one postoperative death, giving an actuarial survival rate of 94% in the study group. Three of five inoperable patients were treated with CHOP, with two achieving complete remission. Two untreated patients died. Overall actuarial disease-free survival was 82.6%. Surgical resection plus chemotherapy is capable of producing long-term remission and cure in both localized and advanced non-Hodgkin's lymphoma of the stomach. Intensive supportive care plus chemotherapy may salvage a proportion of patients with inoperable tumors.
Actuarial Analysis↗
Chemotherapy followed by lung resection in inoperable non-small cell lung carcinomas due to locally far-advanced disease.
From 1977, 29 patients with inoperable non-small cell lung carcinoma due to locally far-advanced disease underwent lung resection after receiving two to eight courses of chemotherapy. After the surgery was performed, three additional courses of chemotherapy were given. The overall median survival from onset of the chemotherapy was 30.5 months; postoperatively, it was 24.5 months (five patients survived greater than 5 years). Postoperative mortality was 10.3%. The overall survival results compare favorably with those obtained with radiation therapy.
Adult↗
[Primitive digestive localizations of malignant non-Hodgkin's lymphoma. Prognostic factors of locally advanced disease: stage II. Report of 67 cases].
Sixty-seven patients with non-Hodgkin's lymphoma of the digestive tract with locally advanced disease (stage II) were analyzed to determine the main factors influencing survival. There were 19 patients with stage II E1 and 48 with stage II E2 disease (Musshoff classification). According to the Kiel classification, 46 percent were low grade, 46 percent were high grade, and 8 percent were unclassified. The principal sites involved included the stomach: 11 cases, small intestine: 21 cases, colon: 12 cases, and mesentery: 11 cases. Lymphoma was unique in 45 cases (67 percent). Treatment consisted of laparotomy in 61 of 67 cases: partial resection was achieved in 21 cases, complete resection in 27 cases, and exploration only in 13 cases. Chemotherapy, according to histopathological subtypes, was employed in 90 percent of cases. Radiation therapy was applied in 25 patients (37 percent), essentially when there was residual disease after surgery (17 patients). Therapeutic indications were dependent on histological subtype, extension, and the therapy regimen in use at the time of treatment. Five patients were treated by surgery only, 2 by surgery and radiation therapy, 37 by surgery followed by chemotherapy, and 23 by all three treatment modalities. Overall survival was 62 percent at 5 years. Univariate analysis showed that 5-year survival rates were not influenced by sex, age, histopathological subtype (low grade: 69 percent; high grade: 59 percent; NS) or local extension (stage II E1: 76 percent vs stage II E2: 59 percent; NS). In contrast, complete surgical excision (p = 0.06) and radiation therapy in case of local residual disease (p = 0.02) seemed to improve survival. The main prognostic factor was the achievement of a complete therapeutic response (CR) (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Luteinising hormone-releasing hormone analogues alone in the treatment of advanced disease.
In the treatment of advanced prostate cancer, luteinising hormone-releasing hormone analogue monotherapy is a valuable alternative to standard treatment such as oestrogen therapy or surgical castration. The basis for this is discussed and reference is made to posters presented at the International Symposium on Endocrine Therapy.
Buserelin↗
A controlled release form of madopar in parkinsonian patients with advanced disease and marked fluctuations in motor performance.
Flucuations in motor performance is a major problem in long-term levodopa treatment of Parkinsonian patients. A slow release preparation of levodopa with benserazide, Madopar HBS, has been developed in an attempt to decrease this problem. Eleven of 22 Parkinsonian patients with advanced disease and marked fluctuations experienced long-lasting benefit with reduction of their fluctuations in motor performance on treatment with Madopar HBS; 11 dropped out within the first 5 months of the trial. This was probably due to lack of experience with the effect of this new slow-release formulation. Nine patients (82%) required an additional dose of standard Madopar, especially in the morning. Significant improvements were found for akinetic phenomenon and dystonic cramps, and with the global evaluation of motor fluctuations. The occurrence of peak dose dyskinesia remained unchanged. No abnormalities in laboratory values were found.
Benserazide↗
The effect of plaque control and surgical pocket elimination on the establishment and maintenance of periodontal health. A longitudinal study of periodontal therapy in cases of advanced disease.
The present clinical study was initiated in 1969 to test the hypothesis that microbial plaque is the cause of periodontal disease and that hence even advanced cases of periodontitis can be cured in patients willing to exercise optimal plaque control. The material consisted of 75 patients with severe destruction of the periodontal tissues. The patients were selected for the study because of their ability to maintain plaque-free dentition. Following an initial examination, a preliminary treatment plan was presented to the patients. This plan included detailed instructions in plaque control measures, scaling, root planning and emergency dental care, including endodontic therapy and extractions. Three to six months after the termination of the so-called presurgical treatment, surgical elimination of pathologically deepened pockets was performed. The patients were recalled every 3 to 6 months after the end of the treatment. At these reexaminations the following parameters were assessed: Plaque Index, Gingival Index, Pocket Depths, Marginal alveolar bone topography and height. The results demonstrate that it is possible to treat periodontal disease successfully, even in advanced stages, in patients willing to maintain plaque-free dentition.
Adult↗
High serum interleukin-2 receptor levels are related to advanced disease and a poor outcome in childhood non-Hodgkin's lymphoma.
The clinical usefulness of serum interleukin-2 receptor (IL2R) measurements was determined in 59 children with non-Hodgkin's lymphoma (NHL) and six with B cell acute lymphoblastic leukemia (B-ALL). Levels of the receptor showed a clear relationship to disease stage, as follows: B-ALL greater than stage III or IV diffuse small noncleaved-cell NHL greater than stage III or IV lymphoblastic NHL greater than stage I or II NHL. Soluble IL2R levels were also closely correlated with serum lactic dehydrogenase levels (r = 0.7, P = .0001), a recognized indicator of tumor cell burden. Children with higher soluble IL2R levels (greater than 1,000 U/mL) were significantly more likely to fail treatment (P = .001), even when the analysis was limited to those with more advanced disease: stages III and IV NHL and B-ALL (P = .02). In a multivariate analysis, soluble IL2R level was found to have greater predictive strength than either serum lactic dehydrogenase level or disease stage. Thus, the measurement of soluble IL2R in children with NHL could be expected to improve existing methods of risk assignment in this disease.
Acute Disease↗
Hodgkin's disease in adults in Saudi Arabia. Clinical features, prognostic factors and an analysis of therapy. Outcome of combination chemotherapy only, for both localized and advanced disease.
Fifty evaluable, previously untreated, adult patients with clinically staged (CS) early and advanced Hodgkin's disease were treated with chemotherapy alone, using various regimens. Their mean age was 31.9 years. Fifteen patients (30%) had CS I or II and 35 (70%) had CS III or IV. Eighty-eight per cent of patients had one or more of the B symptoms and 64% had an unfavorable histology. Complete remission (CR) was achieved in 43 out of 50 patients (86% with 95% confidence interval of 76% to 96%), partial remission in 3 (6%) and treatment failure in 4. Adjusted analysis, using all possible subset regression, showed that unfavorable histology, bulky disease and receiving a total dose-intensity (TDI) less than or equal to 0.80 were negatively associated with the likelihood of achieving CR. At a median follow-up of 36 months (range, 6-90), 84% of patients were alive and 82% were disease-free. The overall median survival has not been reached, but the projected 5-year survival probability was 79%. Time-to-relapse was also estimated for those who achieved initial CR. The estimated 5-year relapse-free survival was 87%. The Cox proportional hazards model predicted that unfavorable histology, bulky disease and TDI less than or equal to 0.80 had an independent, adverse influence on survival. We conclude that the results of chemotherapy alone are encouraging and the rationale is practical and acceptable in those countries where the availability of radiotherapy units is limited.
Adult↗
Palliation in the management of laryngeal cancer. Comments on the radiotherapeutic approach to advanced disease.
The number of patients in the category of advanced cancer of the larynx and other sites will increase as the population increases, as longevity increases, and as increasingly effective treatment prolongs the life of the uncured cancer patient. Such patients expect no lesser effort on their behalf than is offered to patients with clinically curable cancer and an informed public may not be satisfied with the implications of palliation. Any planned improvement in the patient's status, any useful time gained, is successful treatment. The only true failure is the complication that results from plundering of tolerance which might be preserved and used to good effect by careful treatment planning.
Head and Neck Neoplasms↗