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  • 1
    Electronic Resource
    Electronic Resource
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts, 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The 5-year survival of patients with advanced cervical cancer is poor. Major problems are the high frequency of pelvic recurrences and distant metastases. To prevent both, various efforts have been made to combine local radiotherapy with systemic chemotherapy. In this prospective study, 28 previously untreated patients with advanced cervical cancer (FIGO IIB-IVB) were treated with a newly designed therapy consisting of fractionated external beam irradiation (54 Gy) followed by two intracavitary cesium (Cs) applications (2 × 15 Gy), combined with carboplatin (70 mg m−2), 5-fluorouracil (5-FU) (400 mg m−2) and folinic acid (400 mg m−2). Cytotoxic agents were given intravenously on days 1, 8, 15, 22 and 29 as 1-day courses during external irradiation followed by three 3-day courses with carboplatin (100 mg m−2 i.v. daily), 5-FU (400 mg m−2 i.v. daily) and folinic acid (400 mg m−2 i.v. daily) after 8, 12 and 16 weeks of treatment.Acute toxicities ( 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:1048891X:IJG06010020:ges" location="ges.gif"/〉 WHO grade 2) were leucopenia (27 of 28 patients), diarrhea (23/28), abdominal pain (19/28), nausea (14/28) and skin desquamation (12/28). Clinically diagnosed pelvic response was achieved in 88.5% (23/26) with a complete response of 34.5% (9/26). As yet, 19 of 26 patients (73.1%) are alive and well (persistent complete/partial remission), two patients (7.7%) are alive with local progression, four (15.4%) have died from pelvic and/or distal recurrence and one (3.8%) died some weeks after the start of therapy. The combined modality treatment concept has to be considered for the therapy of advanced cervical cancer and a prospective and randomized trial with a greater number of patients is warranted.
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  • 2
    ISSN: 1569-8041
    Keywords: chemotherapy ; hematopoietic growth-factor support ; high-dose chemotherapy ; non-small-cell lung cancer ; peripheral blood stem cell transplantation ; treatment toxicity and mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We conducted a phase I/II trial to assess the feasibilityand activity of combination chemotherapy with etoposide, ifosfamide,cisplatin, and epirubicin in limited-stage (LS, stage I–IIIB) andextensive-stage (ES, stage IV) non-small-cell lung cancer (NSCLC). End-pointswere treatment-related morbidity and mortality, response rate, duration ofresponse, and survival. Patients and methods: Chemotherapy followed by granulocytecolony-stimulating factor was given at a dose of etoposide (500mg/m2), ifosfamide (4000 mg/m2), cisplatin (50mg/m2), and epirubicin (50 mg/m2) (VIP-E) to107 patients with NSCLC. Twenty-five patients with qualifying responsesproceeded to high-dose chemotherapy with autologous peripheral blood stem celltransplantation after etoposide (1500 mg/m2), ifosfamide(12,000 mg/m2), carboplatin (750 mg/m2) andepirubicin (150 mg/m2) (VIC-E) conditioning. Results of conventional-dose VIP-E: 35 of 102 (34%) evaluablepatients responded (2 CR's, 33 PR's), 33/102 patients (33%) showed nochange (NC); the remainder of patients progressed with therapy (PD). Objectiveresponse rate was 68% (4% CR, 64% PR) in LS-NSCLC and23% (1.4% CR, 21.4% PR) in ES-NSCLC. Median duration ofsurvival was 13 months in LS-NSCLC and 5.5 months in ES-NSCLC. Two-yearsurvival was 26% in LS and 2% in ES-NSCLC. Results of high-dose VIC-E: 23 of 24 evaluable patients improved ormaintained prior responses (92%), 1 patient showed NC. Treatmentmortality was 4%. Median duration of survival was 17 months in LS-NSCLCand 10 months in ES-NSCLC. Two-year survival was 30% in LS and8% in ES-NSCLC. Conclusion: Response-rates and survival after conventional-dose VIP-Echemotherapy are comparable to other published trials of combinationchemotherapy in NSCLC. Toxicity and mortality is acceptable in limited stage,but unacceptably high in extensive stage NSCLC. Although better response-rateswere achieved in the high-dose arm, they did not translate into improvedsurvival. Most stage IV NSCLC-patients will neither benefit from VIP-Econventional dose, nor from VIC-E high dose chemotherapy. Whether selectedLS-patients with partial or complete responses to VIP-E induction chemotherapycould benefit from dose intensification in an adjuvant or neo-adjuvant settingremains to be determined.
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  • 3
    ISSN: 1569-8041
    Keywords: chemotherapy ; hematopoietic growth-factor support ; high-dose chemotherapy ; peripheral blood stem cell transplantation ; small-cell lung cancer ; treatment toxicity and mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We conducted a phase I/II trial to assess the feasibilityand activity of VIP-E chemotherapy in small-cell lung cancer. End-points weretreatment-related morbidity and mortality, response to treatment, duration ofresponse, and survival. Patients and methods: Two cycles of combination chemotherapy followedby granulocyte colony-stimulating factor (G-CSF) were given at a dose ofetoposide (500 mg/m2), ifosfamide (4000mg/m2), cisplatin (50 mg/m2), and epirubicin(50 mg/m2) to 100 consecutive patients with SCLC. Thirtypatients (19 with LD, and 11 with ED SCLC) proceeded to VIC-E high-dosechemotherapy with autologous peripheral blood stem cell transplantation(PBSCT) at a cumulative dose of etoposide 1500 mg/m2,ifosfamide 12,000 mg/m2, carboplatin 750 mg/m2and epirubicin 150 mg/m2 (VIC-E). Surgical resection ofprimary tumor was attempted at the earliest feasible point. Thoracicirradiation was given after completion of chemotherapy. Results of conventional-dose VIP-E: 97 patients were evaluable forresponse. Objective response rate was 81% in LD-SCLC (33% CR,48% PR; excluding patients in surgical CR) and 77% in ED-SCLC(18% CR, 58% PR). Treatment mortality was 2%. Mediansurvival was 19 months in LD-SCLC and 6 months in ED-SCLC. Two-year survivalwas 36% in LD and 0% in ED SCLC. Results of high-dose VIC-E: All 30 patients improved on or maintainedprior responses. Four patients (13%) died of treatment-relatedcomplications. Median survival was 26 months in LD-SCLC and 8 months inED-SCLC. Two-year survival was 53% in LD and 9% in ED SCLC. Conclusion: VIP-E chemotherapy is an effective induction therapy forSCLC. Compared with traditional protocols such as ACO orcarboplatin/etoposide, response rates are slightly improved, while survivalis not different. In the LD SCLC subgroup, high-dose chemotherapy improvedresponse rates and survival, especially for patients in surgical CR prior tohigh-dose therapy. In ED SCLC, however, higher response-rates did nottranslate into improved survival. Selected LD-SCLC patients with good partialor complete remissions after prior therapy may benefit from HDC and PBSCT.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 5 (1999), S. 215-220 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Prognose des Pankreaskarzinoms ist auch heute trotz aller Fortschritte schlecht. Die hohe Neigung zu Lokal- rezidiven einerseits aber auch zu einer systemischen Aussaat andererseits verlangt neben der Operation den Einsatz weiterer therapeutischer Maßnahmen, wie dies im Rahmen multimodaler Therapiekonzepte möglich ist. Im Folgenden soll eine komprimierte Übersicht und Bewertung der derzeit praktizierten und künftig möglichen radioonkologischen Therapiestrategien beim Pankreaskarzinom wiedergegeben werden.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 6 (2000), S. 1061-1071 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Behandlung des Vulvakarzinoms hat in den letzten Jahren eine konsequente Hinwendung zu kombinierten, individuellen Therapiestrategien erfahren. Sofern es möglich ist, wird auf eine radikale Vulvektomie verzichtet und die organerhaltende Tumorexzision oder -reduktion durchgeführt. Die Strahlentherapie ist als lokal wirksame Behandlungsmethode fest in das adjuvante Therapiemanagement für Tumorbett und Lymphabstrom integriert. In den fortgeschrittenen Stadien wird die definitive Radiotherapie traditionell als kurative Behandlungsform genutzt. Technischer Fortschritt und moderne Bestrahlungsplanung ermöglichen die präzise Applikation der angestrebten Dosis ins Zielvolumen, ohne die Risikoorgane zu kompromittieren. Heute bestehen 5 Bestrahlungsindikationen: adjuvante Bestrahlung der Leisten nach “wide excision”, adjuvante Bestrahlung bei histologisch positivem Resektionsrand, adjuvante Bestrahlung nach Debulking-Tumorektomie, neoadjuvante Bestrahlung bei primär inoperablem Befund, kurative Salvage-Bestrahlung nach postoperativem Rezidiv.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 6 (2000), S. 1072-1082 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Das primär invasive Vaginalkarzinom gehört zu den seltenen gynäkologischen Malignomen, bietet aber viele Parallelen zum Zervixkarzinom. Standardtherapien existieren nicht, operative Lösungen sind aufgrund der engen Organbeziehungen im Becken schwierig. Die Therapiestrategie wird heute an spezifisch anatomischen Erfordernissen von Tumorstadium, -lokalisation und Lymphabfluss orientiert und interdisziplinär geplant. Die Radiotherapie hat traditionell einen hohen Stellenwert im interdisziplinären Behandlungskonzept, in fortgeschrittenen Stadien bleibt sie als effektive und erfolgreiche Behandlungsform “Therapie der Wahl”, zumeist als Kombination aus Teletherapie und moderner Brachytherapie. Die Fortschritte in der modernen Bestrahlungstechnik mit computergestützter Therapieplanung und differenzierten Afterloadingverfahren schaffen individuelle Behandlungsmöglichkeiten bei gutem Schutz der Nachbarorgane.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 4 (1998), S. 324-331 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Therapie der Wahl in der Behandlung des Magenkarzinoms stellt die Operation samt Lymphadenektomie dar. Leider erfordert die trotzdem auftretende hohe Rate an lokoregionären und hämatogenen Rezidiven jenseits des Stadiums Ia die Etablierung zusätzlicher Therapiemaßnahmen wie z. B. die Strahlenbehandlung des radiosensitiven Magenkarzinoms. Im Folgenden soll eine komprimierte Übersicht und Bewertung der derzeit praktizierten und künftig möglichen radioonkolo- gischen Therapiestrategien beim Magenkarzinom gegeben werden.
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  • 8
    ISSN: 1569-8041
    Keywords: hematopoietic growth-factors ; high-dose chemotherapy ; non-small-cell lung cancer ; peripheral blood stem-cell transplantation ; standard-dose chemotherapy ; treatment-related mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We conducted a phase I–II trial to assess the activity of standard-dose (SDC) and high-dose chemotherapy (HDC) with etoposide, ifosfamide, cis/carboplatin, and epirubicin (VIP-E, VIC-E) in 107 patients with limited-stage (LS, stage I–IIIB) and extensive stage (ES, stage IV) non-small-cell lung cancer (NSCLC). Patients and methods: Updated results of a previously published trial are presented. Results: Response rates and survival after VIP-E were comparable to those of other standard-dose combination chemotherapies in NSCLC. Treatment-related mortality (TRM) in SDC was 3% in LS-NSCLC, and 8% in ES-NSCLC. TRM was 4% in patients selected for HDC by response rate and performance score. Five-year survival in LS-NSCLC was 12% after SDC, and 18% after HDC; it was 0% for both treatment protocols in ES-NSCLC. Conclusions: The activity of VIP-E SDC and VIC-E HDC is not superior to that of established protocols in the treatment of NSCLC. In view of the toxicity and TRM associated with this protocol, less aggressive regimens should be preferred for most patients. Whether selected patients with chemosensitive disease could benefit from VIP-E SDC and/or VIC-E HDC in an adjuvant or neo-adjuvant setting could not be determined within the scope of this study.
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  • 9
    ISSN: 1569-8041
    Keywords: chemotherapy ; hematopoietic growth-factor support ; high-dose chemotherapy ; peripheral blood stem-cell transplantation ; small-cell lung cancer ; treatment toxicity and mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We conducted a phase I–II trial to assess the feasibility and activity of a combination chemotherapy regimen with etoposide, ifosfamide, cisplatin or carboplatin, and epirubicin in limited-disease (LD, stages I–IIIB) and extensive-stage (ED, stage IV) small-cell lung cancer (SCLC). Patients and methods: Standard-dose chemotherapy (SDC) consisting of etoposide (500 mg/m2), ifosfamide (4000 mg/m2), cisplatin (50 mg/m2) and epirubicin (50 mg/m2) (VIP-E), followed by granulocyte colony-stimulating factor (G-CSF), was given to 100 patients with SCLC. Thirty patients with qualifying responses to VIP-E proceeded to high-dose chemotherapy (HDC) with autologous peripheral blood stem-cell transplantation (PBSCT) after etoposide (1,500 mg/m2), ifosfamide (12,000 mg/m2), carboplatin (750 mg/m2) and epirubicin (150 mg/m2) (VIC-E) conditioning. Results of standard-dose VIP-E: Ninety-seven patients were evaluable for response. The objective response rate was 81% in LD SCLC (33% CR, 48% PR; excluding patients in surgical CR) and 77% in ED SCLC (18% CR, 58% PR). The treatment-related mortality (TRM) of SDC was 2%. Two additional patients in CR from their SCLC developed secondary non-small-cell lung cancers (NSCLC), and both were cured by surgery. The median survival was 19 months in LD SCLC and 6 months in ED SCLC. The five-year survivals were 36% in LD and 0% in ED SCLC. Results of high-dose VIC-E: HDC was feasible in 16% of ED-, and 58% of LD-patients. All HDC patients (n = 30) improved or maintained prior responses. Four patients died of early treatment-related complications (TRM 13%). Two additional patients in CR from their SCLC developed secondary malignancies (esophageal cancer, secondary chronic myelogenous leukemia). The median survivals were 26 months in LD SCLC, and 8 months in ED SCLC. The five-year survival was 50% in LD and 0% in ED SCLC. Conclusions: Despite high response rates, survival after VIP-E SDC and VIC-E HDC in patients with ED SCLC is not superior to that achieved with less toxic traditional regimens. The high five-year survival rates achieved with these protocols in LD SCLC probably reflect both patient selection (high proportion of patients with prior surgical resection) and the high activity of our chemotherapy regimen in combination with radiotherapy. A study comparing protocols using simultaneous radiation therapy and chemotherapy, and other dose-escalated forms of SDC with HDC is needed to further define the role of this treatment modality in SCLC. Given the high rate of secondary malignancies observed in patients in CR 〉2 years in our study, close follow-up and early treatment of these neoplasms may contribute to maintaining overall survival in patients with SCLC.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 334 (1973), S. 984-984 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Mit photographischem Filmmaterial (Agfacontour der Agfa-Gevaert) sind vergleichende densitometrische Messungen von Rö.-Vorlagen möglich. Verschiedene Aquidensiten sind nach chromogener Anfärbung aus dem Summationsbild sofort ablesbar. Durch Mitabbildung eines stand. Vergleichskeiles sind quantitative Aussagen über den knöchernen Mineralgehalt erreichbar. Der qualitative Rö.-Befund wird durch Differenzierung ineinanderfließender Grautöne verbessert. Es werden primäre und sekundäre Knochenheilung, knorpligknöcherne Ausrisse (Lux. pat. lat.), Einbau von Knochenplastiken, Osteoporosen, Osteonekrosen, M. Sudeck, Lockerung und Zeitpunkt der Implantatentfernung u.a. ausführlich mit farblich und plastisch wirkenden Bildern demonstriert.
    Notes: Summary Comparative densitometric measurement of X-ray pictures are possible with the aid of a new and simple photographic method (Agfacontour, Agfa-Gevaert). Different and elective chromogen-stained equidensities show the density distribution directly. Comparison against a standard bone staircase allows quantitative identification of the mineral distribution. The differentiation of vaguely grey X-ray pictures may constitute an essential improvement in roentgen diagnosis, though interpretation is still rather difficult. Examples of primary and secondary bone are shown, healing and also dislocation of the patella, with verification of bone and chondric fragments, monitoring of bone grafting, fracture consolidation after stabilization by internal fixation (AO), disintegration and time of removal of bone implants, M. Sudeck, osteoporosis, etc.
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