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1.
Front Vet Sci ; 8: 704796, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34660754

RESUMO

This study evaluated the effect of an algoclay-based mycotoxin decontaminant on the levels of ZEN, DON, and their derivatives in the colostrum, milk, and serum of sows, as well as in the serum of weaned piglets after maternal mycotoxin exposure during the last week of gestation and during lactation of sows (26 days). For this, sows (n = 5) were fed diets artificially contaminated with 100 (LoZEN) or 300 (HiZEN) ppb ZEN, with or without an algoclay-based mycotoxin decontaminant in the highly contaminated diet. All diets contained 250 ppb deoxynivalenol (DON). Dietary treatments did not affect the performance of the sows and piglets. Only α-ZEL was significantly increased in the colostrum of sows fed the HiZEN diet, and this increase was even higher in the colostrum of the sows fed the HiZEN diet supplemented with the test decontaminant. However, no differences in milk mycotoxin levels were observed at weaning. The highest levels of ZEN, α-ZEL, and ß-ZEL were observed in the serum of sows fed the HiZEN diet. When the HiZEN diet was supplemented with the tested algoclay-based mycotoxin decontaminant the levels of ZEN and its metabolites were significantly decreased in the serum of sows. Although all sows were fed the same levels of DON, the serum level of de-epoxy-DON was increased only in the serum of piglets from the sows fed a diet with the non-supplemented HiZEN diet. In conclusion, the tested algoclay-based mycotoxin decontaminant can decrease the levels of ZEN and its metabolites in the serum of sows and the level of de-DON in the serum of piglets.

2.
Blood Adv ; 5(14): 2799-2806, 2021 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-34264268

RESUMO

The Endothelial Activation and Stress Index (EASIX) score, defined as [(creatinine × lactate dehydrogenase [LDH])/platelets], is a marker of endothelial activation that has been validated in the allogeneic hematopoietic stem cell transplant setting. Endothelial activation is one of the mechanisms driving immune-mediated toxicities in patients treated with chimeric antigen receptor-T (CAR-T)-cell therapy. This study's objective was to evaluate the association between EASIX and other laboratory parameters collected before lymphodepletion and the subsequent onset of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) those patients. Toxicity data were collected prospectively on 171 patients treated with axicabtagene ciloleucel (axi-cel) for large B-cell lymphoma (LBCL). CRS grades 2 to 4 were diagnosed in 81 (47%) patients and ICANS grades 2 to 4 in 84 (49%). EASIX combined with ferritin (EASIX-F) identified 3 risk groups with CRS grades 2 to 4 cumulative incidence of 74% (hazards ratio [HR], 4.8; 95% confidence interval [CI], 2.1-11; P < .001), 49% (HR, 2.3; 95% CI, 1.02-5; P = .04), and 23% (reference), respectively. EASIX combined with CRP and ferritin (EASIX-FC) identified 3 risk groups with an ICANS grade 2 to 4 cumulative incidence of 74% (HR, 3.6; 95% CI, 1.9-6.9; P < .001), 51% (HR, 2.1; 95% CI, 1.1-3.9; P = .025), and 29% (reference). Our results indicate that common laboratory parameters before lymphodepletion correlate with CAR-T-related toxicities and can help support clinical decisions, such as preemptive toxicity management, hospitalization length, and proper setting for CAR-T administration.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma Difuso de Grandes Células B , Receptores de Antígenos Quiméricos , Síndrome da Liberação de Citocina , Ferritinas , Humanos
3.
Arch Oral Biol ; 125: 105103, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33721694

RESUMO

OBJECTIVE: To determine nickel levels and their impact on protein carbonylation in gum samples from patients with gingival overgrowth by orthodontic treatment. DESIGN: A retrospective observational study with 33 patients divided into three groups. Group 1 patients with gingival overgrowth by orthodontic appliances; group 2 patients without gingival overgrowth but with a history of orthodontic treatment; group 3 patients without overgrowth and history of orthodontic appliances. Nickel level in gingiva samples was measured by atomic absorption while protein carbonylation was determined by Western Blot. Furthermore, three proteins were identified in carbonylated protein bands by mass spectrometry. RESULTS: Statistically significant differences (p < 0,05) in tissue nickel levels among groups were established (nickel levels group 1: 1.33 ± 1.52; group 2: 0.33 ± 0.44; group 3: 0.20 ± 0.22 µg Ni/g tissue). Protein carbonylation was higher in patients with gingival enlargement (group 1) and history of appliance use (group 2) than controls (group 3). It was observed that band A of the Western blots presented the highest intensity (Rf 0.23) with an average intensity of 4.133.830 ± 1.958.569 for group 1; 4.420.146 ± 1.594.679 for group 2 and 2.110. 727 ± 1.640.721 for group 3. Also, the proteins Teneurin-4, Bromodomain adjacent to zinc finger domain protein 2B, Lysine-specific demethylase 5B, and Serum albumin, were identified from oxidized bands. CONCLUSIONS: The gum of patients with gingival overgrowth by orthodontic appliances contains higher nickel residues and carbonylation of its proteins.


Assuntos
Crescimento Excessivo da Gengiva , Níquel , Gengiva , Humanos , Aparelhos Ortodônticos , Carbonilação Proteica
4.
World J Surg ; 45(5): 1297-1305, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33611661

RESUMO

BACKGROUND: Since the declaration of the pandemic, humanitarian medicine has been discontinued. Until now, there have been no general recommendations on how humanitarian surgical missions should be organized. METHODS: Based on our experience in the field of humanitarian surgical missions to Sub-Saharan Africa, a panel of recommendations in times of COVID-19 was developed. The fields under study were as follows: (1) Planning of a multidisciplinary project; (2) Organization of the infrastructure; (3) Screening, management and treatment of SARS-COV-2; (4) Diagnostic tests for SARS-COV-2; (5) Surgical priorization and (6) Context of patients during health-care assistance. We applied a risk bias measurement to obtain a consensus among humanitarian health-care providers with experience in this field. RESULTS: A total of 94.36% of agreement were reached for the approval of the recommendations. Emergency surgery must be a priority, and elective surgery adapted. For emergency surgery, we established a priority level 1a (< 24 h) and 1b (< 72 h). For an elective procedure, according our American College of Surgeon adaptation score, process with more than 60 points should be reconsidered. Due to the low life expectancy in many African countries, we consider 45-50 years as age of risk. In case of SARS-COV-2 active infection or high clinical suspicion, the screening, management and treatment should be following the international guidelines adapted to duration of the stay, available infrastructure, size of the cooperation team and medical resources. CONCLUSIONS: Humanitarian surgical mission in times of COVID-19 is a challenge that must extrapolate the established recommendations to the local cooperation environment.


Assuntos
COVID-19 , Missões Médicas , Procedimentos Cirúrgicos Operatórios , África ao Sul do Saara , Humanos , Pandemias
5.
Blood ; 137(23): 3272-3276, 2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-33534891

RESUMO

Corticosteroids are commonly used for the management of severe toxicities associated with chimeric antigen receptor (CAR) T-cell therapy. However, it remains unclear whether their dose, duration, and timing may affect clinical efficacy. Here, we determined the impact of corticosteroids on clinical outcomes in patients with relapsed or refractory large B-cell lymphoma treated with standard of care anti-CD19 CAR T-cell therapy. Among 100 patients evaluated, 60 (60%) received corticosteroids for management of CAR T-cell therapy-associated toxicities. The median cumulative dexamethasone-equivalent dose was 186 mg (range, 8-1803) and the median duration of corticosteroid treatment was 9 days (range, 1-30). Corticosteroid treatment was started between days 0 and 7 in 45 (75%) patients and beyond day 7 in 15 (25%). After a median follow-up of 10 months (95% confidence interval, 8-12 months), use of higher cumulative dose of corticosteroids was associated with significantly shorter progression-free survival. More importantly, higher cumulative dose of corticosteroids, and prolonged and early use after CAR T-cell infusion were associated with significantly shorter overall survival. These results suggest that corticosteroids should be used at the lowest dose and for the shortest duration and their initiation should be delayed whenever clinically feasible while managing CAR T-cell therapy-associated toxicities.

6.
Patient Educ Couns ; 104(7): 1781-1788, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33516592

RESUMO

OBJECTIVE: To establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence. METHODS: This investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach's α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's ρ correlation coefficients. RESULTS: Cronbach's α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability. CONCLUSION: The SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension. PRACTICE IMPLICATIONS: This SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension.


Assuntos
Hipertensão , Autoeficácia , Adulto , Análise Fatorial , Humanos , Hipertensão/tratamento farmacológico , Adesão à Medicação , Reprodutibilidade dos Testes , Inquéritos e Questionários
7.
Toxins (Basel) ; 13(1)2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33419041

RESUMO

Sows were fed naturally contaminated diets containing: (i) 100 ppb zearalenone (ZEN) one week before farrowing and during the lactation period (at 26 days), (ii) 100 ppb ZEN one week before farrowing and 300 ppb ZEN during the lactation period, or (iii) 300 ppb ZEN one week before farrowing and during the lactation period. All diets contained 250 ppb deoxynivalenol (DON). The highest levels of ZEN, α-ZEL, or ß-ZEL were observed in the serum of sows fed 300 ppb ZEN before farrowing and during lactation. However, only α-ZEL was significantly increased in the colostrum and milk of these sows. Sows fed the 300 ppb ZEN during the complete trial presented a significant decrease in backfat thickness before farrowing. This effect was accompanied by a decrease in serum leptin levels. These sows also presented a decrease in estradiol levels and this effect was observed in their piglets exposed during lactation, which presented increased glucagon-like peptide 1, but no changes in serum levels of ZEN, α-ZEL, or ß-ZEL. Although all sows were fed the same levels of DON, the serum levels of DON and de-epoxy-DON were increased only in the serum of piglets from the sows fed a diet with the highest ZEN levels during the whole experimental period. Moreover, these piglets presented gut inflammation, as indicated by significantly increased calprotectin levels in their serum.


Assuntos
Ração Animal/análise , Resíduos de Drogas/análise , Leite/química , Suínos/metabolismo , Tricotecenos/metabolismo , Zearalenona/metabolismo , Animais , Dieta/veterinária , Resíduos de Drogas/metabolismo , Feminino , Contaminação de Alimentos , Lactação , Tricotecenos/química , Zearalenona/química
9.
Acta Obstet Gynecol Scand ; 100(1): 84-90, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970823

RESUMO

INTRODUCTION: This study aimed to evaluate the quality of the brain volumes acquired following an evidence-based guideline for the acquisition of brain volumes. MATERIAL AND METHODS: This was a prospective multicenter study. Five centers recruited five cases each, acquiring two volumes per case, at different gestational age ranges. From the collected volumes, 10 operators performed an advanced neurosonography of each case. The evaluable anatomic structures were counted in each volume and expressed as a percentage. The results were compared with those obtained in a previous study where no recommendations had been made for the acquisition of the volumes. RESULTS: Five hundred evaluations were included in the study. In the axial plane, 91.5% of the structures were satisfactorily evaluated, 81.8% in the coronal plane and 89.9% in the sagittal plane. These results were significantly better than those obtained in a previous study where the volumes had been acquired without any guidelines and the percentage of evaluable structures were 80% (P < .001), 67.1% (P < .001) and 55.1% (P < .001) in the axial, coronal and sagittal planes, respectively. CONCLUSIONS: The application of an evidence-based guideline for the acquisition of brain volumes improves the quality of these by increasing the number of evaluable structures in the volume.


Assuntos
Encéfalo/diagnóstico por imagem , Imageamento Tridimensional/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Medicina Baseada em Evidências , Feminino , Idade Gestacional , Fidelidade a Diretrizes , Humanos , Interpretação de Imagem Assistida por Computador , Tamanho do Órgão , Gravidez , Estudos Prospectivos
10.
Arch Oral Biol ; 120: 104943, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33147550

RESUMO

OBJECTIVE: To evaluate the antimicrobial activity of a silver nanoparticles/carboxymethyl-cellulose (AgNPs/CMC) composite on in vitro and dentine disc heterogeneous biofilms. DESIGN: AgNPs/CMC composite effect on normal human gingival fibroblast cells (HGF) viability was determined by the MTT reduction assay. In addition, we evaluated the antimicrobial effect of AgNPs/CMC composite on Candida albicans, Enterococcus faecalis, and Fusobacterium nucleatum growth in vitro and heterogeneous biofilms, as well as dentine disc biofilms. RESULTS: Quasi-spherical AgNPs/CMC composites, with a mean 22.3 nm particle-size were synthesized. They were not toxic to HGF cells at concentrations tested that were antimicrobial, however they caused significant cytotoxicity (89 %, p <  0.05) at concentrations > 15 µg/mL. In vitro, they inhibited up to 67 %, 66 %, and 96 % C. albicans, E. faecalis, and F. nucleatum growth at concentrations ranging from 1.2 µg/mL to 9.6 µg/mL, as compared with untreated control. We also demonstrated significant (p <  0.05) 58 % biofilm reduction by 4.8 µg/mL AgNPs/CMC composite on human dentine discs. CONCLUSION: AgNPs/CMC composite showed anti biofilm activity on monocultures, heterogenous cultures, and dentine discs, resulting a potentially effective alternative to prevent and eliminate infections after endodontic treatment.


Assuntos
Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Dentina/microbiologia , Nanopartículas Metálicas , Prata/farmacologia , Carboximetilcelulose Sódica/química , Células Cultivadas , Fibroblastos/efeitos dos fármacos , Gengiva/citologia , Humanos , Testes de Sensibilidade Microbiana
11.
Kidney Int Rep ; 5(9): 1486-1494, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32954072

RESUMO

Introduction: Outcomes in acute decompensated heart failure (ADHF) have remained poor. Worsening renal function (WRF) is common among patients with ADHF. However, the impact of WRF on the prognosis is controversial. We hypothesized that in patients with ADHF, the achievement of concomitant decongestion would diminish the signal for harm associated with WRF. Methods: We performed a systematic search of PubMed, EMBASE, and the Cochrane Library up to December 2019 for studies that assessed signs of decongestion in patients with WRF during ADHF admission. The primary outcome was all-cause mortality and heart transplantation. Results: Thirteen studies were selected with a pooled population of 8138 patients. During the follow-up period of 60-450 days, 19.2% of patients died. Unstratified, patients with WRF versus no WRF had a higher risk for mortality (odds ratio [OR], 1.71 [95% confidence interval {CI}, 1.45-2.01]; P < 0.0001). However, patients who achieved decongestion had a similar prognosis (OR, 1.15 [95% CI, 0.89-1.49]; P = 0.30). Moreover, patients with WRF who achieved decongestion had a better prognosis compared with those without WRF or decongestion (OR, 0.63 [95% CI, 0.46-0.86]; P = 0.004). This tendency persisted for the sensitivity analyses. Conclusions: Decongestion is a powerful effect modifier that attenuates harmful associations of WRF with mortality. Future studies should not assess WRF as an endpoint without concomitant assessment of achieved volume status.

12.
Blood Adv ; 4(16): 3943-3951, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32822484

RESUMO

Neurotoxicity or immune effector cell-associated neurotoxicity syndrome (ICANS) is the second most common acute toxicity after chimeric antigen receptor (CAR) T-cell therapy. However, there are limited data on the clinical and radiologic correlates of ICANS. We conducted a cohort analysis of 100 consecutive patients with relapsed or refractory large B-cell lymphoma (LBCL) treated with standard of care axicabtagene ciloleucel (axi-cel). ICANS was graded according to an objective grading system. Neuroimaging studies and electroencephalograms (EEGs) were reviewed by an expert neuroradiologist and neurologist. Of 100 patients included in the study, 68 (68%) developed ICANS of any grade and 41 (41%) had grade ≥3. Median time to ICANS onset was 5 days, and median duration was 6 days. ICANS grade ≥3 was associated with high peak ferritin (P = .03) and C-reactive protein (P = .001) levels and a low peak monocyte count (P = .001) within the 30 days after axi-cel infusion. Magnetic resonance imaging was performed in 38 patients with ICANS and revealed 4 imaging patterns with features of encephalitis (n = 7), stroke (n = 3), leptomeningeal disease (n = 2), and posterior reversible encephalopathy syndrome (n = 2). Abnormalities noted on EEG included diffuse slowing (n = 49), epileptiform discharges (n = 6), and nonconvulsive status epilepticus (n = 8). Although reversible, grade ≥3 ICANS was associated with significantly shorter progression-free (P = .02) and overall survival (progression being the most common cause of death; P = .001). Our results suggest that imaging and EEG abnormalities are common in patients with ICANS, and high-grade ICANS is associated with worse outcome after CAR T-cell therapy in LBCL patients.


Assuntos
Síndromes Neurotóxicas , Síndrome da Leucoencefalopatia Posterior , Antígenos CD19/uso terapêutico , Humanos , Imunoterapia Adotiva , Síndromes Neurotóxicas/diagnóstico por imagem , Síndromes Neurotóxicas/etiologia
15.
Int J Antimicrob Agents ; 56(2): 106037, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32479893

RESUMO

Ivermectin (IVM) is a robust antiparasitic drug with an excellent tolerance and safety profile. Historically it has been the drug of choice for onchocerciasis and lymphatic filariasis global elimination programs. IVM is an oral insecticide and is a standard treatment against intestinal helminths and ectoparasites. The current humanitarian crisis in Venezuela is a regional public health threat that requires immediate action. The public health system in Venezuela has crumbled because of a 70% shortage of medicines in public hospitals, low vaccination campaigns, and the mass exodus of medical personnel. Herein we discuss the repurposing of IVM to attenuate the burden imposed by the most prevalent neglected tropical diseases (NTDs) in Venezuela, including soil-transmitted helminths, ectoparasites and, possibly, vector-borne diseases, such as malaria. In addition, novel experimental evidence has shown that IVM is active and efficacious in vitro against Chagas disease, Leishmaniases, arboviruses, and SARS-CoV-2. In crisis-hit Venezuela, all these infectious diseases are public health emergencies that have long been ignored and require immediate attention. The versatility of IVM could serve as a powerful tool to tackle the multiple overlapping endemic and emergent diseases that currently affect Venezuela. The repurposing of this multipurpose drug would be a timely therapeutic approach to help mitigate the tremendous burden of NTDs nationwide.


Assuntos
Antiparasitários/uso terapêutico , Reposicionamento de Medicamentos , Ivermectina/uso terapêutico , Doenças Parasitárias/tratamento farmacológico , Humanos , Venezuela
16.
Rev. enferm. neurol ; 19(1): 32-37, 20200430.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1253409

RESUMO

Introdución: cada vez son más los hombres que deciden ejercer la profesión de enfermería, lo cual supone cambios en la visión que tienen los propios enfermeros sobre su desempeño. Objetivo: describir las experiencias de los enfermeros en el desempeño de su profesión. Material y metodos: se empleó un diseño de investigación cualitativa, de corte fenomenológico descriptivo. Se realizó una entrevista semiestructurada a ocho profesionales de enfermería de sexo masculino que se desempeñan en algún rol de la profesión de enfermería. Resultados: la mayoría de los enfermeros entrevistados manifestaron: es un reto estar en enfermería en el contexto social actual, debido a las opiniones desfavorables respecto a su desempeño. Sin embargo, también coinciden en sentirse identificados con la carrera, cuidado y quehacer de la enfermería Conclusión: los profesionales de enfermería varones se enfrentan aún con varios retos en el camino de un reconocimiento cabal de su quehacer profesional.


Assuntos
Humanos , Enfermeiros , Percepção , Papel Profissional , Aprendizagem
17.
Leuk Lymphoma ; 61(6): 1380-1387, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31971032

RESUMO

In 2 randomized phase 3 trials BR resulted in longer progression-free survival (PFS) than frontline R-CHOP in patients with indolent and mantle cell lymphoma. However, in subset analyses of follicular lymphoma (FL), the results were incongruent. We conducted a retrospective matched-pair analysis to compare the outcome of patients with advanced stage FL, receiving frontline BR (N = 73) or R-CHOP (N = 73), matched by age, gender, stage, and FL International Prognostic Index score. On multivariable analysis, baseline maximum standardized uptake value (SUVmax) >13 was associated with use of R-CHOP (p = .001). After a median follow-up of 69 months for the BR arm and 126 months for the R-CHOP arm, 5-year PFS was 80% and 70%, respectively (p = .07). After adjusting for SUVmax >13, the trend for better PFS in BR was not maintained. Prospective studies are needed to validate the role of pretreatment SUVmax as a stratification factor in future randomized therapeutic trials in FL.


Assuntos
Linfoma Folicular , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Linfoma Folicular/tratamento farmacológico , Prednisona/uso terapêutico , Estudos Prospectivos , Estudos Retrospectivos , Rituximab/uso terapêutico , Vincristina/efeitos adversos
18.
Blood Adv ; 3(9): 1356-1367, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31036721

RESUMO

Radiation fields for limited-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) have shrunk over time; involved-site radiation therapy (ISRT) has replaced extended-field radiation therapy (EFRT) and involved-field radiation therapy (IFRT), but this has not been validated. The role of systemic therapy is unclear. We reviewed 71 stage I/II NLPHL patients and assessed progression-free survival (PFS), overall survival (OS), locoregional disease-free survival, and distant disease-free survival (DDFS). Median patient age was 39 years, and 61% had stage II disease. Thirty-six (51%) received radiation therapy (RT) only, 6 (8%) received systemic therapy only, and 29 (41%) received both. More patients receiving combined therapy had B symptoms (P = .035) and stage II disease (P = .001). In the RT-only group, 9 (25%) received EFRT, 13 (36%) received IFRT, and 14 (39%) received ISRT; in the combined-modality group, 3 (10%) received EFRT, 7 (24%) received IFRT, and 19 (66%) received ISRT. After a median follow-up of 6.2 years, 15 patients relapsed (13 distant, 2 locoregional). Five-year PFS and OS rates were 86% and 96% and did not differ by treatment. In the RT-only group, follow-up was shorter in the ISRT cohort (2.6 years vs 17.9 years [EFRT] and 8.5 years [IFRT], P < .01), but 5-year PFS did not differ by field size (P = .20). Locoregional control rates were 100% for the RT-only and combined groups, and corresponding 5-year DDFS rates were 93% and 95% (P = .95). Eight patients (11%) experienced a second malignancy (1 within RT field). Six patients died (1 from lymphoma). Use of limited ISRT fields does not appear to increase the risk of locoregional relapse, even when RT is given as single-modality therapy.


Assuntos
Doença de Hodgkin/terapia , Linfócitos/metabolismo , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada/métodos , Intervalo Livre de Doença , Feminino , Doença de Hodgkin/mortalidade , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Linfócitos/citologia , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
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