Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A report is given about radiation late damage on the thoracic marrow, basing on the case histories of 100 patients irradiated in the mediastinal region with telegamma from a 60 Cobalt or 137 Caesium source between 1959, January 1st and 1972, december 31st. 77 patients were followed up during 18 months after the radiotherapy was ended; in 3 of them (equal to 4 p.c.) a radiation-induced myelopathy was found. These 3 cases were suffering from Hodgkin's disease, whereas in none of the patients with bronchial carcinoma--in spite of markedly higher radiation doses--any late damage was observed. Therefore, in irradiation of the mediastinal region, the exposure of the spinal marrow should be reduced, although the dose alone is not decisive for the development of a radiation myelopathy.
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PMID:[Radiation late damage of the thoracic marrow after irradiation in the thoracic region (author's transl)]. 112 51

Twelve consecutive cases of non-Hodgkin's lymphomas with initial testicular involvement have been considered in this retrospective evaluation. In 801 cases with referred for treatment to the Istituto Nazionale Tumori of Milan from 1962 to 1974 evidence of initial testicular involvement was observed in 1,4% of cases. Of the whole group of testicular tumors treated in our Institute only 3% were classified as non-Hodgkin's lymphomas. Six out of 12 patients with stage I (2 cases) and II (4 cases) diseases were treated with Cobalt therapy to the retroperitoneal nodes. Only one patient remained free of disease after radiotherapy. Three patients relapsed after primary irradiation and six patients classified as stage IV were treated with chemotherapy. Patients receiving combination chemotherapy had in general a better quality of response and a larger, but not significantly different, survival, compared to patients given simple agent sequential chemotherapy. Since the differential diagnosis between testicular lymphomas and seminomas may cause some difficulties and therapeutic implications are different, clinicians should be alert to this problem: in our case series testicular non-Hodgkin's lymphomas was the most frequent non-germinal tumor of the testicle.
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PMID:[Study of 12 cases of non-Hodgkin's lymphoma of the testicle (author's transl)]. 122 97

Between 1956 and 1990, 775 women were treated for Hodgkin's disease at The University of Texas M.D. Anderson Cancer Center. Of these, 25 (3.2%) were pregnant at diagnosis. Seven of these women were in the first trimester, 10 in the second, and eight in the third. Prior to treatment, three women in the third trimester had normal deliveries, and six patients in the first trimester had abortions. Sixteen patients received radiotherapy for supradiaphragmatic presentations during their pregnancies. All these patients had nodular sclerosing Hodgkin's disease: Two had clinical stage IA presentations and 14 had clinical stage IIA. In two patients radiotherapy (35 Gy) was limited to the neck, three patients were treated definitively to the neck and mediastinum (40 Gy), and 11 patients received mantle irradiation (40 Gy). Four to five half-value layers of lead were used to shield the uterus during radiotherapy. The dose to the fetus was estimated individually in nine patients, using a combination of an Alderson-Rando and a water phantom. The estimated total dose to the mid-fetus ranged from 1.4 to 5.5 cGy for treatment with 6 MV photons, and from 10 to 13.6 cGy for Cobalt 60. All 16 patients subsequently delivered full-term, normal infants. Following delivery, all of the patients had further staging procedures; eight received additional treatment. Subsequently, the disease relapsed in four patients; two eventually died of Hodgkin's disease. The 10-year determinant and overall survival rates were 83% and 71%, respectively. Currently, all offspring are physically and mentally normal, and none has developed a malignancy. Radiotherapy is an appropriate initial treatment for supradiaphragmatic presentations of Hodgkin's disease during the second and third trimesters of pregnancy, provided special attention is paid to treatment and shielding techniques. The outcome for women treated with irradiation for clinical stage I and II Hodgkin's disease during pregnancy has not been shown to be adversely affected by pregnancy, and after the first 8 weeks of gestation, the risk to the fetus appears to be minimal.
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PMID:Radiotherapy during pregnancy for clinical stages IA-IIA Hodgkin's disease. 158 64

Experience with the use of external beam conventional radiation over a period of several decades has shown that in every instance where there has been a major advance in the physical delivery of radiation to the tumor (beam energy and characteristics and precise tumor dose delivery) there has been a corresponding major improvement in the treatment results. The advent of megavoltage sources following the invention and use of Cobalt 60 and medical linear accelerator units during the late 1940's and early 1950's and their major impact on tumor control and patient survival in solid tumors such as carcinoma of the prostate, Hodgkin's Disease, head and neck tumors and cancer of the cervix are being discussed. Most recently, the use of computerized tomography and computer systems for treatment planning is likely to show a further improvement in the therapeutic results.
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PMID:Does improved depth dose characteristics and treatment planning correlate with a gain in therapeutic results? Evidence from past clinical experience using conventional radiation sources. 174 Mar 90

A study of the mantle technique for Hodgkins disease patients was embarked upon using thermoluminescent dosimetry (TLD) and a RANDO phantom. There was concern that the technique using Co-60 and turning the patient over for the posterior field may not be optimal as it was felt that the axillary areas of these patients were being under-dosed. A variety of treatment set-ups were performed on a 60-Cobalt unit at extended SSD. The phantom was planned for treatment lying supine for the anterior field and prone for the posterior field. Measurements were made in the neck, hilum and axillae using various combinations of compensators and lead filters. The combination of full field compensators and a lead filter gave the best results in the phantom but did not give satisfactory axillary readings in the patient situation. This was attributed to the difference in shape and AP separation of the patient when lying prone. RANDO, being solid, retains its shape. Treatment was then planned for a 6 MV linear accelerator using a vertical couch extender which enables the patient to remain supine throughout the treatment by increasing the table height to allow the posterior portal to be treated through the couch. Full field compensation was found to give an adequate dose to all the measured areas. This technique has since been performed on 28 patients being treated for Hodgkins disease at the Hillbrow Hospital, and the average axillary dose recorded in these patients is 88.6% of the prescribed dose.
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PMID:A study of the mantle technique for Hodgkins disease using thermoluminescent dosimetry. 344 8

Improving the quality and accessibility of radiation care in the United States has been the primary objective of the Patterns of Care Study (PCS) since its inception. While patient care has two components, technical and interpersonal, the PCS has only studied the quality of technical care. Such assessments of technical quality of radiation oncology, which are representative of the United States as a whole, virtually do not exist outside those of the PCS. The methodology used by the PCS to assess quality in radiation oncology is based on an examination of structure, process, and outcome. Structural elements identified by the PCS to be associated with inferior quality include the use of a Cobalt 60 unit with surface-to-skin distance (SSD) </=80 cm, definitive treatment without the use of a simulator, and facilities with a part-time radiation oncology practitioner (usually a general radiologist) as chief. Process and outcome surveys conducted by the PCS have resulted in major findings related to quality of acre in prostate cancer, cervical cancer, Hodgkin's disease, and seminoma, which findings are reviewed elsewhere in this issue. The results of the PCS process and outcome findings related to quality of care for larynx, tonsil, anterior two thirds of the tongue and the floor to mouth, breast, endometrium, rectum, and palliation of bone and brain metastases and locally advanced lung cancer are reviewed here. The PCS has provided useful information on quality that has aided in standards development and in radiation oncology practice accreditation. Currently, the PCS is examining the patterns of care of minorities and the penetration of the results of clinical trials into national practice and is collaborating with the American College of Surgeons in studying the treatment of early-stage breast cancer. It is crucial that the PCS, rather than the government or health maintenance organizations (HMOs), be a leader in the evaluation of quality as the PCS represents a well-organized, experienced effort to provide professional guidelines for radiation oncology based on well-established methodology and unencumbered by political or shareholder concerns.
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PMID:Quality Assessment in the USA: How the Patterns of Care Study Has Made a Difference. 1071 9

We performed a retrospective study to evaluate the clinical outcome of patients with early stage testicular seminoma who received adjuvant radiation therapy after orchiectomy over the past 15 years. During the 15 year period, 61 patients were treated with adjuvant radiation therapy for stages I, IIA, and IIB testicular seminoma. Patients received from 2,000 to 4,000 cGy delivered by a Cobalt machine and later by a linear accelerator. Our standard treatment protocol was modified in 13 patients: 7 secondary to abnormal lymphangiography (LAG) parameters and 6 due to abnormal computed tomography findings. We analyzed each patient's outcome for survival, recurrence, and complications. We then compared outcomes, looking for differing trends based on evolving evaluation or treatment techniques. The average follow-up is 75 months, with an overall survival rate of 93%. The cause specific survival is 100%. Four patients died from intercurrent diseases; at time of autopsy, one of these patients was noted to have a small focus of seminoma in a lateral inguinal node. He died from widely disseminated Hodgkin's disease. Three patients, including the aforementioned one, had recurrent disease outside of the radiation field, yielding a recurrence rate of 5%. No significant long term treatment complications were reported, although 24% of patients had one or more complications from LAG. Regardless the various changes in patient evaluation and radiation treatment techniques over the past 15 years, adjuvant radiation therapy remains effective in patients with early stage testicular seminoma.
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PMID:Adjuvant radiation therapy for low stage testicular seminoma: Diagnosis and therapy in evolution. 2122 67

Hodgkin's lymphoma (HL) is a malignant disease of the lymphatic system. The therapy has been improved during the last decades but there are still patients who cannot be cured, and the therapy is associated with several adverse late effects. Therefore, we asked which genes might be involved in the chemotherapy resistance of HL cells. We observed that HL cells became more resistant against cisplatin after treatment with cobalt chloride. Therefore, we analyzed which genes were differentially expressed between cells incubated in medium with or without cobalt chloride. We found several genes which were up- or downregulated in the presence of cobalt chloride and might be involved in the modulation of chemotherapy resistance. Cobalt chloride is a hypoxia-mimetic agent. Therefore, we tested chemo-resistance and gene expression of HL cells under hypoxic conditions and confirmed the results from the cobalt chloride experiments. Taken together, activation of the hypoxia pathway led to altered gene expression and drug resistance of HL cells. Differentially expressed genes might be interesting targets for the development of future treatment strategies against drug-resistant HL.
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PMID:Stimulation of the hypoxia pathway modulates chemotherapy resistance in Hodgkin's lymphoma cells. 2671 11