RESUMO
OBJECTIVES: The aim of this study is to assess the levels and diagnostic accuracy of a set of bone resorption biomarkers, including TRAP-5, RANKL, and OPG in symptomatic and asymptomatic apical lesions and controls. MATERIALS AND METHODS: Apical tissues from symptomatic and asymptomatic apical periodontitis patients and periodontal ligaments from healthy teeth extracted for orthodontic reasons were processed for tissue homogenization and the levels of TRAP-5, RANKL, and OPG were determined by multiplex assay. Marker levels were analyzed by Kruskal Wallis test, and diagnostic accuracy was analyzed with ROC curves. RESULTS: Higher levels of RANKL, OPG, and RANKL/OPG ratio were determined in both types of apical lesions compared to healthy periodontal ligament, whereas higher TRAP-5 levels were found only in symptomatic apical lesions (p < 0.05). OPG, RANKL, and RANKL/OPG ratio showed diagnostic potential to identify apical lesions versus healthy controls (AUC = 0.69, p < 0.05); while TRAP-5 showed a potential to discriminate symptomatic versus asymptomatic apical periodontitis (AUC = 0.71, p < 0.05) and healthy controls (AUC = 0.83, p < 0.05). CONCLUSIONS: Apical lesions showed higher RANKL and OPG levels than healthy tissues. TRAP-5 levels were the highest in symptomatic apical lesions, suggesting that these represent a progressive state, and showed diagnostic potential. CLINICAL RELEVANCE: Clinically symptomatic apical periodontitis might represent biologically progressive apical lesions based on TRAP5 levels. TRAP5 has diagnostic potential to identify these lesions, representing a candidate prognostic biomarker.
Assuntos
Reabsorção Óssea/patologia , Osteoprotegerina/análise , Periodontite Periapical/patologia , Ligamento Periodontal/patologia , Ligante RANK/análise , Fosfatase Ácida Resistente a Tartarato/análise , Adolescente , Biomarcadores/análise , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The aim of this study was to evaluate the effect of genetic variants on candidate genes corresponding to the sterol recognition element-binding protein-1 (SREBP-1) signaling pathway and stearoyl-CoA desaturases (SCD1 and SCD5) on muscle fatty acid (FA) composition of Brangus steers fattened on grass. FA profiles were measured on Longissimus lumborum muscle samples using a gas chromatography-flame ionization detection technique. A total of 43 tag single-nucleotide polymorphisms on the SCD1, SCD5, SREBP-1, SCAP, INSIG1, INSIG2, MBTPS1, MBTPS2, and SRPR genes were genotyped on 246 steers to perform a marker-trait association study. To evaluate the influence of the Indicine breed in the composite breed, additional groups of 48 Angus, 18 Hereford, 75 Hereford x Angus, and 36 Limousin x Hereford-Angus steers were also genotyped. To perform the association analysis, FA data were grouped according to the number of carbon atoms and/or number of double bonds (i.e. SFA, MUFA, PUFA, etc.). In addition, different indexes that reflect the activity of FA desaturase and elongase enzymes were calculated. SCD1 markers significantly affected C14:1/(C14:0 + C14:1) and C18:1/(C18:0 + C18:1) indexes, whereas one SNP in SCD5 was correlated with the C16:1/(C16:0 + C16:1) index. Polymorphisms in the signal recognition particle receptor (SRPR) gene were associated with all the estimated desaturase indexes. Because the evaluated markers showed no effect on total lipid content of beef, this work supports the potential utilization of these markers for the improvement of grass-fed beef without undesirable side effects.
Assuntos
Bovinos/genética , Variação Genética , Carne/análise , Valor Nutritivo/genética , Transdução de Sinais/genética , Proteína de Ligação a Elemento Regulador de Esterol 1/genética , Animais , Argentina , Cromatografia Gasosa/veterinária , Ácidos Graxos/análise , Marcadores Genéticos , Genótipo , Modelos Lineares , Músculo Esquelético/química , Poaceae , Receptores Citoplasmáticos e Nucleares/genética , Receptores de Peptídeos/genética , Estearoil-CoA Dessaturase/genéticaRESUMO
Nearly 50-60% of cancer patients will undergo radiotherapy at some point in their treatment. Around 85% of the world's population live in developing countries served by approximately 30% of the world's radiotherapy facilities. It has been suggested that 1 megavoltage unit is required for every 500 new treatment courses per year, while others estimate that 1 megavoltage unit is needed for every 300 new treatments. However, these numbers do not necessarily take into account the development of new technologies and treatment modalities, which are more time- and resource-intensive. The International Commission on Radiological Protection has emphasised that 'purchasing new equipment without a concomitant effort on education and training and on a programme of quality assurance is dangerous', and 'the decision to implement a new technology for radiation therapy should be based on a thorough evaluation of the expected benefits, rather than being driven by the technology itself'. It is estimated that the rate of serious mistakes could be as high as 0.2%, which is several orders of magnitude higher than the rate reported for commercial aviation. So, how safe is safe? It can be stated that the development of a culture of safety is critical and requires efforts in education and training, which could prove difficult in overloaded departments.
Assuntos
Prevenção de Acidentes/normas , Países em Desenvolvimento , Segurança do Paciente/normas , Lesões por Radiação/prevenção & controle , Radioterapia (Especialidade)/normas , Humanos , Erros de Configuração em Radioterapia/efeitos adversos , Erros de Configuração em Radioterapia/prevenção & controleRESUMO
UNLABELLED: During pregnancy, the prolonged stress and worry felt by mothers can alter the development and function of the right brain hemisphere. For this reason, importance is given to prenatal stimulation programs for pregnant women. OBJECTIVES: To determine the perinatal results in the moment of childbirth in mothers who had participated in prenatal stimulation programs. MATERIAL: An experimental study was conducted in five health districts in the town of Cienfuegos (Cuba) with a view to identifying the perinatal results at the moment of childbirth in women that had participated in prenatal stimulation programs. METHODOLOGY: The study consisted of an intentional sampling of all of the subjects (n = 200 women who were 20-28 weeks pregnant). The variables studied were the following: duration of labor, baby's birth weight, Apgar score at birth, type of childbirth, and opinion of the subjects about the prenatal stimulation program. RESULTS: Of the population sample, 36% of the subjects gave birth in less than six hours; 67.5% had babies weighing 2,500-3,000 grams; and 96.5% had babies whose Apgar scores were between 8 and 9. Finally, 68.5% of the subjects had natural childbirths and 96% were satisfied with the prenatal stimulation program. CONCLUSIONS: The results obtained showed that these new prenatal stimulation programs were well received by the subjects in this study.
Assuntos
Cuidado Pré-Natal/métodos , Estimulação Acústica , Adulto , Afeto , Índice de Apgar , Peso ao Nascer/fisiologia , Cuba , Feminino , Humanos , Lactente , Recém-Nascido , Satisfação do Paciente , Estimulação Luminosa , Estimulação Física , Gravidez , Resultado da GravidezRESUMO
The somatotropic axis is a major regulatory pathway of energy metabolism during postnatal growth in mammals. Genes involved in this pathway influence many economically important traits. The association of selected SNPs in these genes with carcass traits was examined in grazing Brangus steers. These traits included final live weight, ultrasound backfat thickness (UBFT), rib-eye area, kidney fat weight, hot carcass weight, and intramuscular fat percentage (%IMF). Genomic DNA (N = 246) was genotyped for a panel of 15 tag SNPs located in the growth hormone receptor (GHR), insulin-like growth factor I, insulin-like growth factor-binding protein 6, pro-melanin-concentrating hormone, suppressor of cytokine signaling 2, and signal transducer and activator of transcription 6 (STAT6) genes. Allelic and haplotype frequencies were compared with those of a sample of European breeds (N = 177 steers). Two tag SNPs in the GHR affected %IMF; one of them (ss86273136) was also strongly associated with UBFT (P < 0.003). The frequency of the most favorable GHR haplotype for %IMF was lower in Brangus steers. Moreover, the haplotype carrying two unfavorable alleles was present at a frequency of 31% in this group. Four tag SNPs on STAT6 had a significant effect on UBFT. One of these, SNP ss115492467, was also associated with %IMF. The STAT6 haplotype, including all the alleles favoring UBFT, was the most abundant variant (34%) in the European cattle, while it had a frequency of 14% in the Brangus steers. The four less favorable variants (absent in the European cattle) were found at a frequency of 38% in the Brangus steers. These results support the association of GHR and STAT6 SNP with carcass traits in composite breeds, such as Brangus, under grazing conditions.
Assuntos
Composição Corporal/genética , Bovinos/anatomia & histologia , Estudos de Associação Genética , Marcadores Genéticos , Aumento de Peso/genética , Tecido Adiposo/química , Alelos , Animais , Argentina , Pesos e Medidas Corporais , Cruzamento , Bovinos/genética , Genótipo , Haplótipos , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/genética , Fator de Crescimento Insulin-Like I/genética , Carne , Músculo Esquelético/química , Fenótipo , Polimorfismo de Nucleotídeo Único , Receptores da Somatotropina/genética , Fator de Transcrição STAT6/genéticaRESUMO
In the yeast Xanthophyllomyces dendrorhous the genes idi, crtE, crtYB, crtl and ast are involved in the biosynthesis of astaxanthin from isopentenyl pyrophosphate. The carotenoid production and the kinetics of mRNA expression of structural genes controlling the carotenogenesis in a wild-type ATCC 24230 and in carotenoid overproducer deregulated atxS2 strains were studied. The biosynthesis of carotenoid was induced at the late exponential growth phase in both strains. However, the cellular carotenoid concentration was four times higher in atxS2 than in the wild-type strain in the exponential growth phase, suggesting that carotenogenesis was deregulated in atxS2 at the beginning of growth. In addition, the maximum expression of the carotenogenesis genes at the mRNA level was observed during the induction period of carotenoid biosynthesis in the wild-type strain. The mRNA level of the crtYB, crtl, ast genes and to a lesser extent the idi gene, decayed at the end of the exponential growth phase. The mRNA levels of the crtE gene remained high along the whole growth curve of the yeast. In the atxS2 strain the mRNA levels of crtE gene were about two times higher than the wild-type strain in the early phase of the growth cycle.
Assuntos
Basidiomycota/genética , Carotenoides/genética , Regulação Fúngica da Expressão Gênica , Basidiomycota/metabolismo , Carotenoides/biossíntese , Meios de Cultura , RNA Fúngico/genética , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , XantofilasRESUMO
In the yeast Xanthophyllomyces dendrorhous the genes idi, crtE, crtYB, crtl and ast are involved in the biosynthesis of astaxanthin from isopentenyl pyrophosphate. The carotenoid production and the kinetics of mRNA expression of structural genes controlling the carotenogenesis in a wild-type ATCC 24230 and in carotenoid overproducer deregulated atxS2 strains were studied. The biosynthesis of carotenoid was induced at the late exponential growth phase in both strains. However, the cellular carotenoid concentration was four times higher in atxS2 than in the wild-type strain in the exponential growth phase, suggesting that carotenogenesis was deregulated in atxS2 at the beginning of growth. In addition, the maximum expression of the carotenogenesis genes at the mRNA level was observed during the induction period of carotenoid biosynthesis in the wild-type strain. The mRNA level of the crtYB, crtl, ast genes and to a lesser extent the idi gene, decayed at the end of the exponential growth phase. The mRNA levels of the crtE gene remained high along the whole growth curve of the yeast. In the atxS2 strain the mRNA levels of crtE gene were about two times higher than the wild-type strain in the early phase of the growth cycle.
Assuntos
Basidiomycota/genética , Carotenoides/genética , Regulação Fúngica da Expressão Gênica , Basidiomycota/metabolismo , Meios de Cultura , Carotenoides/biossíntese , Reação em Cadeia da Polimerase Via Transcriptase Reversa , RNA Fúngico/genética , RNA Mensageiro/genética , XantofilasAssuntos
Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/secundário , Irradiação Craniana , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/prevenção & controle , Relação Dose-Resposta à Radiação , Humanos , Neoplasias Pulmonares/prevenção & controle , Qualidade de Vida , Lesões por Radiação , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de RiscoRESUMO
Desde 1997, INCOSUR ha propuesto incorporar a las actividades de control, los programas que realicen los diversos países para intervenir la transmisión transplacentaria del Trypanosoma cruzi. El presente estudio tuvo como propósito conocer, diagnosticar y tratar los casos de enfermedad de Chagas congénita en la II Región de Chile, para lo que se estudiaron los 1.987 partos producidos en un año cronológico en uno de sus hospitales más importantes. De los 1.987, 45 casos resultaron positivos (2,4 por cento) para la infección por el T. cruzi y la transmisión transplacentaria se produjo en 5 niños (11 por cento). Todos los niños fueron asintomáticos al nacer, se trataron médicamente con Nifurtimox y al cabo de un año todos presentaron cura serológica y parasitológica la cual fué corroborada durante 2 años de seguimiento. El estudio epidemiológico de los casos índices permitió detectar otros 8 niños infectados, los cuales también fueron tratados, obteniéndose una cura serológica y parasitológica en 50 por cento de los casos a los dos años de control. De acuerdo a los resultados se recomienda la implementación de un programa de intervención de la infección transplacentaria por Trypanosoma cruzi en las áreas de endemia chagásica de Chile.
Assuntos
Humanos , Trypanosoma cruzi , Nifurtimox , Doença de Chagas , Doenças Placentárias/patologia , Doenças Placentárias/tratamento farmacológicoRESUMO
Microcin E492 is a low-molecular-weight, channel-forming bacteriocin produced and excreted by Klebsiella pneumoniae RYC492. A 13 kb chromosomal DNA fragment from K. pneumoniae RYC492 was sequenced, and it was demonstrated by random Tn5 mutagenesis that most of this segment, which has at least 10 cistrons, is needed for the production of active microcin and its immunity protein. Genes mceG and mceH correspond to an ABC exporter and its accessory protein, respectively, and they are closely related to the colicin V ABC export system. The microcin E492 system also requires the product of gene mceF as an additional factor for export. Despite the fact that this bacteriocin lacks post-translational modifications, genes mceC, mceI and mceJ are needed for the production of active microcin. Genes mceC and mceI are homologous to a glycosyl transferase and acyltransferase, respectively, whereas mceJ has no known homologue. Mutants in these three genes secrete an inactive form of microcin, able to form ion channels in a phospholipidic bilayer, indicating that the mutation of these microcin genes does not alter the process of membrane insertion. On the other hand, microcin isolated from mutants in genes mceC and mceJ has a lethal effect when incubated with spheroplasts of sensitive cells, indicating that the microcin defects in these mutants are likely to alter receptor recognition at the outer membrane. A model for synthesis and export is proposed as well as a novel maturation pathway that would involve conformational changes to explain the production of active microcin E492.
Assuntos
Bacteriocinas/genética , Genes Bacterianos , Klebsiella pneumoniae/genética , Sequência de Aminoácidos , Antibacterianos/metabolismo , Bacteriocinas/química , Bacteriocinas/metabolismo , Transporte Biológico , Eletrofisiologia , Canais Iônicos/metabolismo , Klebsiella pneumoniae/metabolismo , Dados de Sequência Molecular , Família Multigênica , Mutagênese , Fases de Leitura Aberta/genética , Peptídeos , Alinhamento de SequênciaRESUMO
PURPOSE: To analyze the efficacy and toxicity of adjuvant whole abdomen irradiation (WAI) and concomitant chemotherapy in the treatment of completely resected, high-risk gastric cancer. METHODS AND MATERIALS: Between October 1990 and September 1997, 52 patients with completely resected gastric cancer, with lymph node and/or serosal involvement, were treated. Ages were 16-78 (median, 53.5) years. Treatment was either total- or sub-total gastrectomy, followed by WAI, 2100 cGy/21 fractions plus a 2400 cGy/16 fractions boost to the tumor bed. Chemotherapy consisted of either 5-fluorouracil (5-FU) 450-500 mg/m(2) i.v. for 5 days first and 5th week or 200-300 mg/m(2) continuous infusion during irradiation. No further chemotherapy was given. RESULTS: With a minimum follow-up of 30 months and a median follow-up of 43.5 months, 25 of the 52 patients have died. Overall 5-year survival rate is 54%. Three patients sustained Grade 3-5 complications. Two patients with Grade 5 complications (malabsorption syndrome) died 31 and 56 months after the beginning of the treatment, respectively, with no evidence of recurrent tumor. For patients with involvement of the lymph nodes alone (n = 19) the 5-year survival was 69%, which was significantly better than the 36% 5-year survival observed for those patients with both serosal and lymph node involvement (n = 26, p = 0.004). CONCLUSION: Adjuvant radiochemotherapy, WAI, and concomitant 5-FU, is a feasible and a fairly well-tolerated treatment for patients with locally advanced (involvement of the lymph nodes or serosa) gastric carcinoma who undergo complete resection. The 54% overall 5-year survival compares favorably with the survival reported after surgery alone for those patients.
Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Fluoruracila/uso terapêutico , Neoplasias Gástricas/radioterapia , Adulto , Idoso , Antimetabólitos Antineoplásicos/efeitos adversos , Quimioterapia Adjuvante/efeitos adversos , Fracionamento da Dose de Radiação , Feminino , Fluoruracila/efeitos adversos , Gastrectomia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Radioterapia Adjuvante/efeitos adversos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Taxa de SobrevidaRESUMO
BACKGROUND: Since the widespread use of mammography, the incidence of ductal carcinoma in situ of the breast has increased. Until few years ago the standard treatment was mastectomy, however, from the analysis of conservative treatment trials for invasive carcinoma, it was evident that ductal carcinoma in situ could also be treated conservatively. This was confirmed later by randomized trials. AIM: To analyze the experience of our Institution with conservative treatment of ductal carcinoma in situ of the breast. PATIENTS AND METHODS: A search through the data base of our Institution found 69 patients treated with lumpectomy and radiotherapy between the years 1976 and 1997. RESULTS: Twenty three of 69 patients (33%) were diagnosed because of a palpable mass. Eleven of twelve were diagnosed prior to 1990 and 12 of 57 after 1990. With a median follow-up of 48 months local control and overall survival is 97%. None of the patients underwent mastectomy. CONCLUSIONS: Conservative treatment of ductal carcinoma in situ of the breast is a reasonable alternative, mainly if we realize that with increasing frequency--the diagnosis is made through mammography and with non-palpable lesions. The results reported in this study are similar to those reported by other centers.
Assuntos
Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/cirurgia , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/radioterapia , Carcinoma Intraductal não Infiltrante/diagnóstico , Carcinoma Intraductal não Infiltrante/radioterapia , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Mamografia , Mastectomia Segmentar , Pessoa de Meia-Idade , Radioterapia AdjuvanteAssuntos
Humanos , Feminino , Neoplasias Urogenitais/diagnóstico , Neoplasias Urogenitais/tratamento farmacológico , Neoplasias Urogenitais/cirurgia , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/cirurgia , Neoplasias Pélvicas/tratamento farmacológico , Neoplasias Pélvicas/cirurgia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/cirurgia , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/cirurgia , Neoplasias Ureterais/tratamento farmacológico , Neoplasias Ureterais/cirurgia , Procedimentos Cirúrgicos UrológicosRESUMO
The efficiency of organic matter degradation in attached biomass reactors depends on the suitable selection of artificial support for the retention of bacterial communities. We have studied the growth on glass and clay beads of methylaminotrophic, acetotrophic and hydrogenotrophic methanogenic bacterial communities isolated from anaerobic reactors. Bacterial counts were performed by the standard MPN technique. Experiments were performed in 50 ml vials for 12 days at 35 degrees C. Increase in the counts of methylaminotrophic and hydrogenotrophic methanogens occurred on both glass and clay beads. The latter support material also stimulated the growth rate of methylaminotrophic methanogens.
Assuntos
Técnicas Bacteriológicas/instrumentação , Euryarchaeota/crescimento & desenvolvimento , Silicatos de Alumínio , Anaerobiose , Biomassa , Argila , Euryarchaeota/classificação , Euryarchaeota/metabolismo , Vidro , Metano/metabolismo , Microesferas , Especificidade da Espécie , TemperaturaRESUMO
UNLABELLED: The timing of adjuvant radiotherapy is subject of debate at clinical and administrative levels and of concern for the treating physician and also the patient. There is a lack of prospective randomized studies dealing with this point and it is highly unlikely that they could be carried on. However there is evidence coming from the laboratory and retrospective clinical studies which could be of help. Data from the laboratory tell us that the Tpot (potential doubling time) of a solid tumor is brief, which means that a tumor can grow easily while the patient waits for treatment. This means that will be an increase in the risk of local and distant relapse. Clinical evidence coming from studies of head and neck cancer, breast cancer and small cell lung cancer suggest that delay should be limited only to a few weeks. IN CONCLUSION: radiotherapy should be started as soon as possible.
Assuntos
Neoplasias da Mama/radioterapia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias Pulmonares/radioterapia , Humanos , Radioterapia Adjuvante , Fatores de TempoRESUMO
The results of curative radiotherapy in 59 patients with non-small-cell carcinoma of the lung treated from 1977 to 1988 are reported. Squamous cell carcinoma without evidence of metastatic disease was present in 28 patients. Radiotherapy alone was used in 43 patients; 13 patients received either pre or post operative radiotherapy. Complications developed in 6 patients, only 1 had esophageal stenosis deemed important. The first site of failure was extrathoracic in 76% of patients, the brain being the most frequently involved site (41%). Brain failure rate was greater for squamous cell carcinoma than for other tumors. The 5 year survival rate was 20% with a minimum follow up period of 24 months (median 57). Better results were obtained in patients receiving high dose continuous radiotherapy and in those with associated surgery. Thus, radiotherapy is an alternative therapy for patients with lung carcinoma, with a reasonable survival rate and few complications.
Assuntos
Carcinoma Broncogênico/radioterapia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Análise Atuarial , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Broncogênico/epidemiologia , Carcinoma Broncogênico/secundário , Carcinoma Broncogênico/cirurgia , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/secundário , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Chile/epidemiologia , Terapia Combinada , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Dosagem Radioterapêutica , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Postoperative radiotherapy was performed in 58 patients with pituitary adenomas from 1977 to 1987. There were 21 non functioning adenomas and 22 growth hormone producing tumors. Extrasellar extension was found in 59% of patients. Radiotherapy was performed electively in 38 patients and due to tumor recurrence in 20. Megavoltage radiation was used in all patients. A dose of 5000 cGy in 5 weeks was attained in 54 of 58 patients. The recurrence free survival was 81% after a median follow-up of 6.8 years. Hypopituitarism developed in 13 of 58 patients. These findings confirm that external radiotherapy offers a real curative alternative for patients with macroadenomas of the pituitary gland.
Assuntos
Adenoma/radioterapia , Neoplasias Hipofisárias/radioterapia , Adenoma/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/cirurgia , Período Pós-Operatório , Radioterapia de Alta Energia , Análise de SobrevidaRESUMO
From November 1976 until September 1987, 59 patients with Hodgkin's disease have been admitted and treated with radiotherapy alone or radiotherapy plus elective chemotherapy after been staged according to Stanford's guidelines and following the Ann Arbor's classification. 33 patients were staged I or II, and 26 as stage III or IV. Patients in earlier stages received preferentially radiotherapy alone and those in more advanced stages received radio and chemotherapy. After a median follow-up of 39 months, 100% of patients in stage I, 81.5% of patients in stages II and III A and 45% of patients in stages III B and IV were alive and well. The relapse free survival for patients in stages II and III A was 48.4%, rising to 81.5% after rescue. The use of elective chemotherapy made no difference in survival for stages II B and III A.