Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39
Filtrar
1.
Braz. j. biol ; 842024.
Artículo en Inglés | LILACS-Express | LILACS, VETINDEX | ID: biblio-1469270

RESUMEN

Abstract Amphisbaenians are fossorial reptiles that have a cylindrical and elongated body covered with scales arranged in rings, and are all apodal, except for the three species of the genus Bipes. The amphisbaenian diet consists of a variety of invertebrates and small vertebrates. As these animals live underground, many aspects of their natural history are difficult to study. Most feeding studies of amphisbaenians have focused on the composition of the diet and feeding ecology, and the data available on feeding behavior are based on precursory observations. The present study describes the food capture behavior of Leposternon microcephalum Wagler, 1824 in captivity. In this experiment we used non-live bait (moist cat food), which was placed near a burrow opening, on the surface of the substrate. Three animals were monitored visually and filmed using cellphone cameras deployed at fixed points, to capture images from the dorsal and lateral perspectives of the study subjects. Two principal types of behavior were observed: the capture of food and defense mechanisms. The strategies used to capture the food were similar to those observed in other fossorial species. Although the backward movement has already been observed and described, we were able to record this movement being used as an escape strategy. These findings enrich our knowledge on different aspects of the natural history of the amphisbaenians.


Resumo Anfisbênas são répteis fossoriais caracterizadas por apresentarem corpo cilíndrico e alongado coberto por escamas dispostas exclusivamente em anéis e todas são ápodas, com exceção das três espécies do gênero Bipes. Sua dieta consiste em uma variedade de invertebrados e pequenos vertebrados. Por viverem no subsolo, muitos aspectos de sua história natural são difíceis de observar. A maioria dos estudos sobre alimentação em anfisbenas concentra-se na dieta e na ecologia alimentar, enquanto as informações sobre o comportamento alimentar se baseiam em observações preliminares. O objetivo deste artigo foi descrever o comportamento de captura de alimentos exibido por Leposternon microcephalum Wagler, 1824, fora da galeria, em cativeiro. Para o experimento foi utilizada uma isca não viva, ração úmida de gato, que foi oferecida e posicionada próxima a uma das aberturas da galeria, na superfície do solo. Um total de três animais foi analisadopor meio de observações visuais e registros de câmeras de telefones celulares posicionadas em um ponto fixo, captando imagens de suas vistas dorsal e lateral. Foram detectados dois tipos principais de comportamento: captura de recursos alimentares e mecanismo de defesa. As estratégias utilizadas para capturar o recurso alimentar foram semelhantes às observadas em outras espécies fossoriais. Embora o movimento de marcha-à-ré tenha sido observado e descrito, o registramos sendo usado como uma estratégia de fuga. Esses resultados contribuem para enriquecer o conhecimento sobre diferentes aspectos da história natural dos Amphisbaenia.

2.
Braz J Biol ; 84: e251255, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34909919

RESUMEN

Amphisbaenians are fossorial reptiles that have a cylindrical and elongated body covered with scales arranged in rings, and are all apodal, except for the three species of the genus Bipes. The amphisbaenian diet consists of a variety of invertebrates and small vertebrates. As these animals live underground, many aspects of their natural history are difficult to study. Most feeding studies of amphisbaenians have focused on the composition of the diet and feeding ecology, and the data available on feeding behavior are based on precursory observations. The present study describes the food capture behavior of Leposternon microcephalum Wagler, 1824 in captivity. In this experiment we used non-live bait (moist cat food), which was placed near a burrow opening, on the surface of the substrate. Three animals were monitored visually and filmed using cellphone cameras deployed at fixed points, to capture images from the dorsal and lateral perspectives of the study subjects. Two principal types of behavior were observed: the capture of food and defense mechanisms. The strategies used to capture the food were similar to those observed in other fossorial species. Although the backward movement has already been observed and described, we were able to record this movement being used as an escape strategy. These findings enrich our knowledge on different aspects of the natural history of the amphisbaenians.


Asunto(s)
Alimentación Animal , Conducta Animal , Lagartos , Animales , Serpientes , Especificidad de la Especie
3.
Acta Mater ; 97: 245-256, 2015 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-27099566

RESUMEN

Currently, there is significant interest in magnetocaloric materials for solid state refrigeration. In this work, polycrystalline Heusler alloys belonging to the Ni2+xMn1-xGa family, with x between 0.08 and 0.24, were evaluated for the purpose of finding composition(s) with an enhanced magnetocaloric effect (MCE) close to room temperature. Differential scanning calorimetry (DSC) was successfully used to screen alloy composition for simultaneous magnetic and structural phase transformations; this coupling needed for a giant MCE. The alloy with x = 0.16 showed an excellent match of transformation temperatures and exhibited the highest magnetic entropy change, ΔSM, in the as-annealed state. Furthermore, the MCE increased by up to 84 % with a 2 Tesla (T) field change when the samples were thermally cycled through the martensite to austenite transformation temperature while held under a constant mechanical load. The highest ΔSM measured for our x = 0.16 alloy for a 2 T magnetic field change was -18 J/kg-K. Texture measurements suggest that preferential orientation of martensite variants contributed to the enhanced MCE in the stress-assisted thermally cycled state.

4.
Rev Sci Instrum ; 83(5): 053901, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22667627

RESUMEN

A resistive furnace combined with a load frame was built that allows for in situ neutron diffraction studies of high temperature deformation, in particular, creep. A maximum force of 2700 N can be applied at temperatures up to 1000 °C. A load control mode permits studies of, e.g., creep or phase transformations under applied uni-axial stress. In position control, a range of high temperature deformation experiments can be achieved. The examined specimen can be rotated up to 80° around the vertical compression axis allowing texture measurements in the neutron time-of-flight diffractometer HIPPO (High Pressure - Preferred Orientation). We present results from the successful commissioning, deforming a Zr-2.5 wt.% Nb cylinder at 975 °C. The device is now available for the user program of the HIPPO diffractometer at the LANSCE (Los Alamos Neutron Science Center) user facility.

5.
Rev Sci Instrum ; 81(9): 093302, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20886975

RESUMEN

An automated sample changer with an Eulerian cradle for neutron texture measurements is described. This device has been measuring over 2300 texture and almost 400 powder samples at ambient conditions since it became operational in 2002 for use in the high pressure-preferred orientation diffractometer at the LANSCE neutron scattering facility. Operation for almost a decade resulted in sustained enhancements of mechanics, electronics, and software which significantly improved reliability and resiliency. We also describe in this paper our platform independent computer program POD2K which we use to create publication quality pole figure plots for texture samples.

6.
Neurology ; 62(4): 544-7, 2004 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-14981168

RESUMEN

OBJECTIVE: To evaluate the cognitive status and quality of life (QOL) in a cohort of 19 consecutive patients treated in a prospective European Organization for Research and Treatment of Cancer study (20962) for primary CNS lymphoma (PCNSL). All patients were in complete remission after combined modality treatment with IV and intrathecal high-dose methotrexate (MTX)-based chemotherapy followed by whole brain radiotherapy (WBRT). METHODS: An extensive neuropsychological assessment, including QOL measures, was conducted in 19 patients with PCNSL. The results were compared with matched control subjects with systemic hematologic malignancies treated with systemic chemotherapy or non-CNS radiotherapy. In addition, a neuroradiologic evaluation was carried out in 18 patients with PCNSL. RESULTS: Cognitive impairment was found in 12 patients with PCNSL (63%) despite a complete tumor response. Four patients (21%) showed severe cognitive deficits, and the percentage of impaired test indices correlated with age. In comparison, only two control subjects (11%) showed cognitive dysfunction (p = 0.002). Forty-two percent of the patients with PCNSL, in contrast to 81% of the control subjects, resumed work. White matter abnormalities were observed in 14 patients with PCNSL, and 14 had cortical atrophy. Cortical atrophy correlated with cognitive functioning, age, and Karnofsky performance score. Group differences in cognitive status and QOL could not be explained by anxiety, depression, or fatigue. CONCLUSIONS: Combined modality treatment for primary CNS lymphoma is associated with cognitive impairment even in patients aged <60 years.


Asunto(s)
Neoplasias del Sistema Nervioso Central/psicología , Trastornos del Conocimiento/etiología , Linfoma no Hodgkin/psicología , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Atrofia , Encéfalo/patología , Carmustina/administración & dosificación , Estudios de Casos y Controles , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/radioterapia , Estudios de Cohortes , Terapia Combinada , Irradiación Craneana/efectos adversos , Citarabina/administración & dosificación , Femenino , Humanos , Hidrocortisona/administración & dosificación , Inyecciones Espinales , Linfoma no Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/radioterapia , Masculino , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Metilprednisolona/administración & dosificación , Persona de Mediana Edad , Vaina de Mielina/patología , Pruebas Neuropsicológicas , Estudios Prospectivos , Calidad de Vida , Tenipósido/administración & dosificación
7.
J Neurol Sci ; 210(1-2): 23-30, 2003 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-12736083

RESUMEN

Positron emission tomography (PET) was used for the study of regional cerebral perfusion and metabolism in eight patients with severe post-hypoxic encephalopathy, caused by cardiac arrest and resulting in a coma lasting for at least 24 h. Using this method, we aimed to identify regional vulnerability, which was hypothesized to provide (i) insight in pathogenic mechanisms and (ii) early prognostic parameters. On day 1 post-resuscitation, 18-Fluor deoxyglucose ([F18]-FDG) indicated a marked decrease of cerebral metabolic activity. Gray matter glucose consumption was 54% of normal values, whereas white matter uptake was 70% of normal. Regional differences followed a pattern of neuronal density rather than specific patterns of functionally or biochemically defined regions or of vascular territories. In contrast to [F18]-FDG, the distribution of 15-oxygen labeled water ([O-15]-water) showed a better demarcation between gray and white matter, whereas focal deficit was not observed. In some patients, hyperperfusion relative to regional glucose consumption was observed in the occipital poles and basal ganglia. This suggests loss of vascular tone, i.e. vascular paralysis, in the basilar artery territory. CT and MRI scanning did not show any major change with respect to the hypoxic injury. In the small group studied, all patients had a poor outcome. The comparison between survivors and nonsurvivors did not reveal obvious differences in PET data, suggesting that this technique does not provide major prognostic clues adding to the prognostic information derived from serial neurological assessment in the restricted patient group characterized by prolonged coma.


Asunto(s)
Encéfalo/metabolismo , Hipoxia Encefálica/metabolismo , Resucitación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Encéfalo/anatomía & histología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Mapeo Encefálico , Quimioterapia del Cáncer por Perfusión Regional/métodos , Economía , Femenino , Fluorodesoxiglucosa F18/metabolismo , Glucosa/metabolismo , Paro Cardíaco/metabolismo , Humanos , Hipoxia Encefálica/diagnóstico por imagen , Hipoxia Encefálica/etiología , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Consumo de Oxígeno , Estudios Prospectivos , Distribución Tisular , Tomografía Computarizada de Emisión
9.
J Clin Oncol ; 18(19): 3400-8, 2000 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-11013281

RESUMEN

PURPOSE: Approximately 60% of patients with small-cell lung cancer (SCLC) develop brain metastases. Whole-brain radiotherapy (WBRT) gives symptomatic improvement in more than 50% of these patients. Because brain metastases are a sign of systemic progression, and chemotherapy was found to be effective as well, it becomes questionable whether WBRT is the only appropriate therapy in this situation. PATIENTS AND METHODS: In a phase III study, SCLC patients with brain metastases were randomized to receive teniposide with or without WBRT. Teniposide 120 mg/m(2) was given intravenously three times a week, every 3 weeks. WBRT (10 fractions of 3 Gy) had to start within 3 weeks from the start of chemotherapy. Response was measured clinically and by computed tomography of the brain. RESULTS: One hundred twenty eligible patients were randomized. A 57% response rate was seen in the combined-modality arm (95% confidence interval [CI], 43% to 69%), and a 22% response rate was seen in the teniposide-alone arm (95% CI, 12% to 34%) (P<.001). Time to progression in the brain was longer in the combined-modality group (P=.005). Clinical response and response outside the brain were not different. The median survival time was 3.5 months in the combined-modality arm and 3.2 months in the teniposide-alone arm. Overall survival in both groups was not different (P=.087). CONCLUSION: Adding WBRT to teniposide results in a much higher response rate of brain metastases and in a longer time to progression of brain metastases than teniposide alone. Survival was poor in both groups and not significantly different.


Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundario , Carcinoma de Células Pequeñas/radioterapia , Carcinoma de Células Pequeñas/secundario , Neoplasias Pulmonares/patología , Tenipósido/uso terapéutico , Adulto , Anciano , Análisis de Varianza , Antineoplásicos/efectos adversos , Neoplasias Encefálicas/tratamiento farmacológico , Carcinoma de Células Pequeñas/tratamiento farmacológico , Terapia Combinada , Irradiación Craneana , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/radioterapia , Masculino , Persona de Mediana Edad , Tenipósido/efectos adversos
10.
Acta Neurochir (Wien) ; 142(6): 627-31, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10949436

RESUMEN

BACKGROUND: In the preoperative diagnosis of malignant brain tumours there is often uncertainty regarding their metastatic or primary nature, requiring dissemination studies. Currently FDG-wbPET is being used for the efficient detection of systemic tumours. It therefore may become a substitute for the conventional dissemination studies if it allows an earlier diagnosis. METHOD: In this descriptive and preliminary study a population of 14 patients with suspected or proven metastatic lesions, [18F]-fluoro-2-deoxy-D-glucose whole body positron emission tomography (FDG-wbPET) was conducted and verified by additional conventional dissemination studies. FINDINGS AND THEIR INTERPRETATION: The entire series of dissemination studies required an average of 30 days with a range of 4-73 days. The FDG-wbPET was corroborated by the other dissemination studies in 10 of the 14 patients. In 7 of these 10 patients both PET and dissemination studies showed systemic abnormal findings, but in one case the presence of high pulmonary activity on the FDG-wbPET and the abnormal findings on the chest X-rays proved to be Aspergillus infection at autopsy. In the other 2 cases the negative PET findings corresponded to the absence of systemic dissemination. In 5 cases there was disagreement of the results of the FDG-wbPET with other evidence, among which there were 2 cases of glioblastoma in which systemic metastases were most unlikely, and the foci of activity on the FDG-wbPET had to be considered as false positives. In the remaining 3 cases the systemic presence of high activity on the FDG-wbPET indicated the systemic presence of tumour, whereas the other dissemination studies disclosed no tumour. CONCLUSION: The results warrant the use of FDG-wbPET as a screening method for the search of metastases, allowing other studies to be focussed on the lesion. But from the cost/benefit point of view this would make the method less suitable as a substitute for dissemination studies in general, although it may speed up the diagnostic process.


Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/secundario , Tomografía Computarizada de Emisión , Adulto , Anciano , Neoplasias Encefálicas/diagnóstico , Femenino , Fluorodesoxiglucosa F18 , Humanos , Masculino , Persona de Mediana Edad , Radiofármacos , Neoplasias de la Columna Vertebral/diagnóstico
11.
Transpl Infect Dis ; 2(1): 29-32, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11429007

RESUMEN

After solid organ transplantation, signs and symptoms of the central nervous system may present a diagnostic challenge. A 43-year-old patient developed a decrease in vision 15 months after bilateral lung transplantation. The initial diagnosis was a left posterior cataract, but left eye cataract extraction did not improve his vision. Seizures led to investigation of a broader differential diagnosis (cyclosporine intoxication, post-transplant lymphoproliferative disorder, infectious disease, chronic lymphatic leukemia). The clinical diagnosis of progressive multifocal leukoencephalopathy (PML) was confirmed by demonstration of JC virus in the cerebrospinal fluid and by autopsy findings. Modulation of the immunosuppressive regimen was unsuccessful. This case illustrates that decreased vision in immunocompromised patients may be the first manifestation of PML.


Asunto(s)
Virus JC/aislamiento & purificación , Leucoencefalopatía Multifocal Progresiva/diagnóstico , Trasplante de Pulmón , Complicaciones Posoperatorias , Trastornos de la Visión/etiología , Adulto , Autopsia , Encéfalo/patología , Cerebelo/patología , Resultado Fatal , Humanos , Leucoencefalopatía Multifocal Progresiva/líquido cefalorraquídeo , Imagen por Resonancia Magnética , Masculino , Agudeza Visual
12.
Eur Neurol ; 41(4): 187-93, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10343148

RESUMEN

In order to test the hypothesis whether the pathogenesis of cerebral systemic lupus erythematosus (SLE) may include an immune-mediated deficit in specific vulnerable brain regions, the regional cerebral metabolism in 9 patients with diffuse as well as focal cerebral symptoms was compared with that of 10 age-matched control subjects. The cerebral distribution of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) uptake was measured by means of positron emission tomography. Subsequently performed statistical parametric mapping showed (i) a relative increase in metabolism in the striatum and (ii) regional decreases in the premotor cortex as a common feature in the patient group. Region of interest measurements of absolute FDG uptake confirmed these findings. The increased striatal activity may support the presence of a direct immune response against neuronal tissue in SLE, similar to the cross-reaction against inhibitory components in striatal tissue provoked by streptococcal antigens.


Asunto(s)
Encéfalo , Lupus Eritematoso Sistémico/diagnóstico por imagen , Lupus Eritematoso Sistémico/metabolismo , Tomografía Computarizada de Emisión , Adolescente , Adulto , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Femenino , Fluorodesoxiglucosa F18 , Humanos , Masculino , Persona de Mediana Edad , Flujo Sanguíneo Regional
13.
Radiother Oncol ; 46(1): 29-32, 1998 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9488124

RESUMEN

BACKGROUND AND PURPOSE: To evaluate the efficacy of WBRT as a single treatment modality in patients with brain metastases of small cell lung cancer. PATIENTS AND METHODS: The patients had brain metastases of small cell lung cancer without any sign of tumour outside the brain and were treated with 10 x 3.0 Gy WBRT. Response and neurological functions were evaluated after 6, 18 and 36 weeks. RESULTS: Twenty of 22 eligible patients were evaluable for response. In six patients a complete response was seen and in five patients a partial response was seen giving a response rate of 50% (95% CI 28-72%). Response duration was 5.4 months (range 63-260 days) and median survival was 4.7 months (range 14-743 days). In the majority of patients the first site of progression after WBRT was in the central nervous system. Twelve of the patients had stabilization or improvement of the neurological function. CONCLUSION: WBRT for brain metastases of small cell lung cancer gives a 50% response rate with stabilization or improvement of neurological function. Response duration and survival are short.


Asunto(s)
Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundario , Carcinoma de Células Pequeñas/radioterapia , Carcinoma de Células Pequeñas/secundario , Neoplasias Pulmonares/patología , Adulto , Anciano , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de la radiación , Neoplasias Encefálicas/diagnóstico por imagen , Carcinoma de Células Pequeñas/diagnóstico por imagen , Progresión de la Enfermedad , Relación Dosis-Respuesta en la Radiación , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/radioterapia , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
14.
Br J Haematol ; 100(2): 273-82, 1998 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9488613

RESUMEN

Sixty-six consecutive adult patients with acute lymphoblastic leukaemia (ALL) were treated with intensified chemotherapy which included a 'pre-induction' course of cytarabine (AraC) and etoposide (VP16) when the white blood cell count (WBC) was > or = 30 x 10(9)/l (18 patients), and maintenance chemotherapy with regular intensifications for a total treatment duration of 3 years. Patients with a mediastinal mass (17) received consolidation courses with intermediate-dose AraC and VP16 followed by mediastinal irradiation. 11 patients underwent allogeneic bone marrow transplantation in first complete remission (CR). 58 patients (87.9%, CI 77.5-94.6) attained CR; with a median follow-up of 7 years, 35 of them (60.3%, CI 46.6-73.0) remain in CR. Toxicity was mild, although three patients died during remission induction, including two who were over 70 years of age. 23 patients (39.7%, CI 27.1-53.4) relapsed, seven of them primarily in the central nervous system (CNS), necessitating intensification of CNS-directed therapy. Only one of 13 patients with WBC 30-100 x 10(9)/l, but eight of nine with WBC > 100 x 10(9)/l, relapsed. The survival of older patients in CR did not differ from younger patients. The outcome of ALL in adult patients could thus be improved by slight intensification of treatment whilst keeping the toxicity within acceptable limits. 'Pre-induction' with AraC and VP16 might improve the prognosis, especially in patients with WBC < 100 x 10(9)/l. Patients with WBC > 100 x 10(9)/l, however, almost always relapse, and the intensified chemotherapy might not be tolerated well by patients over 70 years of age.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Adolescente , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Inducción de Remisión , Análisis de Supervivencia , Resultado del Tratamiento
16.
J Clin Oncol ; 13(3): 660-5, 1995 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-7884426

RESUMEN

PURPOSE: Here we report the results of a phase II study of teniposide, one of the most active drugs against small-cell lung cancer (SCLC), in patients with brain metastases. PATIENTS AND METHODS: Patients with SCLC who presented with brain metastases at diagnosis (n = 11) or during follow-up evaluation after treatment (n = 69) were treated with teniposide at a dose of 150 mg/m2 intravenously on days 1, 3, and 5 at 3-week intervals in an outpatient setting. Response in the brain was evaluated by brain computed tomography (CT) after two, six, and 12 courses. RESULTS: In 26 of 80 assessable patients, an intracranial response was seen, with a response rate of 33% (95% confidence interval, 22% to 44%). The median response duration was 5.4 months for patients with a complete response (CR) and 4.2 months for patients with a partial response (PR). Patients who required corticosteroids for peritumoral edema had a significantly lower response rate than patients who did not receive corticosteroids. Neurologic function at the start of treatment had a significant influence (neurologic function 1 better than 2, respectively, better than 3 and 4; P < .001), as did the number of cycles of previous chemotherapy (0 better than 1 to 5 cycles, respectively, better than > 5 cycles; P = .043). Grade 3/4 leukocytopenia and thrombocytopenia were seen in 3% and 39%, respectively, of 80 patients. Toxicity-related death was seen in eight patients, seven of whom were previously treated with chemotherapy. CONCLUSION: Teniposide is active against brain metastases of SCLC. It is a suitable drug for palliation, especially of patients without extensive pretreatment and with a good neurologic function and performance status. Patients previously treated with cranial radiotherapy are also candidates for this therapy. If systemic chemotherapy is considered for tumor progression outside the brain, radiotherapy of brain metastases might be omitted or delayed pending the effect of chemotherapy. The use of corticosteroids in patients with brain metastases treated with chemotherapy might influence the efficacy of the chemotherapy.


Asunto(s)
Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/secundario , Carcinoma de Células Pequeñas/tratamiento farmacológico , Carcinoma de Células Pequeñas/secundario , Neoplasias Pulmonares/patología , Tenipósido/uso terapéutico , Adulto , Anciano , Neoplasias Encefálicas/diagnóstico por imagen , Carcinoma de Células Pequeñas/diagnóstico por imagen , Irradiación Craneana , Europa (Continente) , Femenino , Humanos , Leucopenia/inducido químicamente , Masculino , Persona de Mediana Edad , Análisis Multivariante , Modelos de Riesgos Proporcionales , Inducción de Remisión , Tenipósido/efectos adversos , Trombocitopenia/inducido químicamente , Tomografía Computarizada por Rayos X
17.
Int J Radiat Oncol Biol Phys ; 29(4): 711-7, 1994 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-8040016

RESUMEN

PURPOSE: To determine if in patients with single brain metastasis the addition of neurosurgery to radiotherapy leads to lengthening of survival or to better quality of life. METHODS AND MATERIALS: From 1985 to 1990, 66 patients with single brain metastasis from a solid tumor were entered in a randomized trial of neurosurgery plus radiotherapy vs. radiotherapy alone. Patients were stratified for lung cancer vs. other sites of cancer and for progressive vs. stable systemic cancer. Radiotherapy was given to the whole brain by a novel scheme of two fractions of 2 Gy per day for a total dose of 40 Gy in 2 weeks, to obtain a relatively high total dose and short overall time, with minimal risk of late damage to normal tissue in long-term survivors. RESULTS: In the whole group of 63 evaluable patients, both with lung cancer as with other tumors, the combined treatment led to a better duration of survival (median 10 vs. 6 months; p = 0.04). The largest difference between both treatment arms was observed in patients with inactive extracranial disease (median 12 vs. 7 months; p = 0.02). Patients with active extracranial disease had an equal median survival of only 5 months, irrespective of given treatment. Age proved to be a strong and independent prognostic factor: patients older than 60 years had a hazard ratio of dying of 2.74 (p = 0.003) compared with younger patients. Following treatment, most patients remained functionally independent until a few weeks before death. In the majority of patients the cause of death was systemic tumor progression. CONCLUSION: Patients with single brain metastasis and with controlled or absent extracranial tumor activity should be treated with surgery and radiotherapy, especially when they are younger than 60 years. For patients with progressive extracranial disease, radiotherapy alone seems to be sufficient. The accelerated radiotherapy scheme of 40 Gy in 2 weeks to the whole brain is tolerated well and should also be considered for patients in a good performance status with surgically unaccessible single metastasis or even with multiple brain metastases.


Asunto(s)
Envejecimiento/fisiología , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/terapia , Neoplasias/fisiopatología , Adulto , Anciano , Neoplasias Encefálicas/radioterapia , Neoplasias de la Mama/patología , Neoplasias de la Mama/fisiopatología , Terapia Combinada , Femenino , Humanos , Neoplasias Renales/patología , Neoplasias Renales/fisiopatología , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/fisiopatología , Masculino , Persona de Mediana Edad , Neoplasias/patología , Complicaciones Posoperatorias , Pronóstico
18.
Lung Cancer ; 10(3-4): 247-9, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8075970
19.
Ann Neurol ; 33(6): 583-90, 1993 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-8498838

RESUMEN

Most patients treated for single or multiple brain metastases die from progression of extracranial tumor activity. This makes it uncertain whether the combination of neurosurgery and radiotherapy for treatment of single brain metastasis will lead to better results than less invasive treatment with radiotherapy alone. The effect of neurosurgical excision plus radiotherapy was compared with radiotherapy alone in a prospectively randomized trial with 63 evaluable patients with systemic cancer and a radiological diagnosis of single brain metastasis. Radiotherapy was given to the whole brain by a novel scheme of 2 fractions per day of each 2 Gy for a total of 40 Gy. Before randomization, patients were stratified by site (lung cancer vs nonlung cancer) and status of extracranial disease (progressive vs stable). Survival as such and functionally independent survival (FIS; defined as World Health Organization performance status < or = 1 and neurological function < or = 1) were compared between both treatment arms. The combined treatment compared with radiotherapy alone led to a longer survival (p = 0.04) and a longer FIS (p = 0.06). This was most pronounced in patients with stable extracranial disease (median survival, 12 vs 7 mo; median FIS, 9 vs 4 mo). Patients with progressive extracranial cancer had a median overall survival of 5 months and a FIS of 2.5 months irrespective of given treatment. Improvement in functional status occurred more rapidly and for longer periods of time after neurosurgical excision and radiotherapy than after radiotherapy alone.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Neoplasias Encefálicas/secundario , Adulto , Factores de Edad , Anciano , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirugía , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Análisis de Supervivencia , Factores de Tiempo
20.
Eur J Cancer ; 29A(12): 1696-9, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-7691116

RESUMEN

Patients with brain metastases from small cell lung cancer (SCLC) have a poor prognosis. Although most patients die from metastatic disease outside the central nervous system, this disabling metastatic site often needs treatment to mitigate the signs and symptoms of intracranial disease. The effect of carboplatin (400 mg/m2 every 4 weeks) as second line treatment for recurrent or progressive brain metastases was studied in 20 SCLC patients. 19 patients could be evaluated: 16 by contrast enhanced brain computer tomography (CT) scan (2 patients had complete response, 6 partial response, 4 stable disease and 4 progressive disease) and 3 patients clinically, who had progressive disease. The objective response rate in the brain was 40% (95% CI:22-61%). The median response duration was 8 weeks (range 2-29). The median survival was 15 weeks (range 1-44). Previous cranial irradiation appeared to be beneficial for survival. There was only mild haematological and gastrointestinal toxicity. Carboplatin has activity against brain metastases and gives palliation in responding patients.


Asunto(s)
Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/secundario , Carboplatino/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Encefálicas/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Estudios Prospectivos , Factores de Tiempo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...