Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “multimodality”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMed1987

[Adult Wilms tumor: a case of prolonged survival achieved by multimodal treatment].

Wilms tumor is one of the most common malignant neoplasms in children. In the last 2 decades the survival rate of children with this disease has dramatically increased. However, in adults, the guideline for its management is less clear. We herein report the prolonged survival of a patient with advanced adult Wilms tumor after treatment with chemotherapy, irradiation and operations. Adult Wilms tumor should be treated aggressively with a well-timed combination of surgery, chemotherapy and radiotherapy (i.e., multimodal treatment), even if the stage of the disease was advanced. Thereby, we suspect that the prognosis of adult Wilms tumor would be markedly improved.

Adult↗
PubMed1987

Multimodality treatment with surgery in small-cell lung cancer.

The paper reviews the role of surgery in the local treatment of the primary tumour of small-cell bronchial carcinomas (SCLC) and the preliminary results of a multicentre cooperative prospective randomized trial with multimodality treatments of SCLC. This randomized cooperative trial was activated in 1979 comparing a new sequential intermittent polychemotherapy (sq CT) of three different drug combinations alternatingly given intermittently within one year after surgery, with a standard chemotherapy (CT) of one combination of four drugs given intermittently within three years after surgery. Observations on 25 patients at nine different cooperating surgical departments showed that sq CT was applicable and unexpected side-effects did not occur. Live table curves, calculated from 56 patients up to February 1986, indicate the improvement of the survival rate five years after surgery for the cure of 25 patients receiving sq CT after surgery in comparison with 31 patients receiving standard chemotherapy (36% : 22%). Following discussions of this and other results at the symposium "Adjuvant Therapy of Small-Cell Bronchial Carcinoma" at the 13th Congress of the International Society of Chemotherapy (ISC) 1983 in Vienna, a related new protocol was designed and activated by a further enlarged ISC-Study-Group in October 1984. This protocol for a two-armed randomized cooperative trial for patients operated for T1, 2N0M0SCLC is comparing a chemotherapy-combination 1 (CAV)--as also used in a trial of the North American Lung Cancer Study Group-0--with chemotherapy 2 (sq CT) as used in our forementioned previous study.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Multimodality treatment of adrenal ganglioneuroblastoma: a case report].

We present adult adrenal ganglioneuroblastoma with giant regional lymph node metastasis. The patient was a 21-year-old male, who had a left adrenal tumor diagnosed by ultrasonography incidentally. He was moderately developed and physical examination was almost normal. Blood pressure was within the normal range. Only the value of the vanilmandelic acid, which was 68.7 mg/day, in the urine was abnormal. Other laboratory data were almost normal. Neither chemical nor physical hormonal disorders were present. We carried out the radical surgical treatment by trans-thoracoabdominal approach under the diagnosis of left adrenal neuroblastoma. Pathological diagnosis was ganglioneuroblastoma. After the operation, the patient received both systemic chemotherapy of vincristine and cyclophosphamide and immunotherapy of OK-432 by subcutaneous administration. Furthermore, 40 Gy of the regional irradiation of 60Co to the operative space after the surgery was performed. At eight months after the operation, he is alive with no evidence of disease. Ganglioneuroblastoma is a neuroblastic tumor including neuroblastoma, which commonly occurs in childhood. The prognosis of the neuroblastic tumors which occur either in the adrenal gland of a young child or in an older child is poor. On the other hand, the biological activity of the adult neuroblastic tumors is different from that of the pediatric neuroblastic tumors. In the adult, the adrenal ganglioneuroblastoma does not always have a poor prognosis. The multimodality treatment which we performed is effective for the neuroblastic tumor. Ultrasonography is both effective and adequate for the screening of the retroperitoneal lesion such as in our case.

Adrenal Gland Neoplasms↗
PubMed1987

[Multimodal evoked potentials and heart rate variability in comatose patients--1: Method of measuring and normal values].

Multimodal EPs and heart rate variability-measurements in comatose patients have been performed for few years at the university hospitals of Graz and Erlangen. The following data and parameters are analysed and discussed: brainstem auditory evoked potentials, mechanical evoked long-latency SEP, VEP recorded over the central and occipital region and heart rate variability (HRV). The method of data acquisition and processing is described and normative data are introduced. For the long-latency EP-components a signal-to-noise-ratio (SNR) is calculated. SNR is defined as ratio of the largest EP peak-to-peak amplitude and the mean amplitude (standard deviation) of a period prior to the stimulation. An unmeasurable or questionable EP is defined when SNR less than 2.6. For the vertex-SEP the following mean +/- standard deviation was obtained: SNR = 10.6 +/- 4.6; the vertex VEP was calculated with SNR = 7.0 +/- 3.0. The SNR of the bipolar recorded occipitally VEP was 3.9 +/- 2.0. Heart rate variability measurements in normal persons revealed the following mean +/- standard deviation at a heart rate of 67.8/min +/- 10.8/min: HRV = 7.8% +/- 2.5%.

Brain Death↗
PubMed1988

[Multimodal evoked potentials and heart rate variability in comatose patients. 2. Visual evoked potentials and computed tomographic findings].

Visual evoked potentials (VEPs) were examined as an integrated parameter in a multimodal EP study of brain bioelectrical activity in 33 comatose patients (Glasgow Coma Score 3-6) after craniocerebral trauma. Recordings were performed not only from the occipital (01-02) but also from the central (Cz-C3, Cz-A1, Cz-C4) and frontal (F3-F4) areas. The results show an attenuation of the vertex VEP (SNR 3.2 +/- 1.7) and an increase in the occipital VEP (SNR 4.8 +/- 2.3) as compared to the control group (SNR vertex 7.0 +/- 3.0/SNR occipital 3.9 +/- 2.0). In addition, 16 of the comatose patients showed a very considerable loss of the normally polyphasic character of the occipital VEP in favour of a potential that looked almost monophasic; this was either left or right dominant, and was recorded as a negative or positive potential, respectively, in bipolar recording (01-02). Comparison of the electrophysiological and computer tomography findings showed a laterally correlated change in the occipital VEP: contralateral to the injured hemisphere, the VEP was dominant, ipsilateral it was reduced or extinguished.

Adolescent↗
PubMed1988

Sequential administration of methotrexate, cisplatin, and 5-fluorouracil in multimodal therapy for locally advanced head and neck cancer.

Thirty-eight previously untreated patients with locally advanced head and neck cancer received three cycles of induction chemotherapy with methotrexate (120 mg/m2) followed by cisplatin (100 mg/m2) and a 5-day continuous infusion of 5-fluorouracil (1,000 mg/m2 per day). The response rate in 34 evaluable patients was 94%, with a complete response rate of 26%. Thirty-one patients underwent local therapy following induction chemotherapy, and 25 (81%) were rendered free of disease: 14 of 15 treated with surgery and radiotherapy and 11 of 16 treated with radiotherapy alone. At a median follow-up of 11 months, 8 patients have relapsed while the remaining 17 patients continue free of disease. The dose-limiting toxicity of chemotherapy was mucositis resulting in reduction of the 5-fluorouracil dose in 28 patients. This regimen is highly effective in inducing responses in patients with locally advanced head and neck cancer; 81% of the patients who complete local therapy are rendered free of disease with this multimodal approach. Due to short follow-up, the relapse rate, overall survival, and disease-free survival cannot yet be determined.

Adolescent↗
PubMed1987

Multimodal evoked potentials in multiple sclerosis: a contribution to diagnosis and classification.

The adoption of multimodal evoked potential procedures for the diagnosis and classification of multiple sclerosis is recommended as capable of revealing subclinical lesions of the central nervous system. The CSF test is also helpful, though in a different way. We present the results obtained by VEP, BAEP, SEP-median and SEP-tibial examinations and by CSF analysis (OB+) in a group of 189 MS patients, of whom 103 were diagnosed as definite. 58 as probable and 28 as suspected MS cases according to McDonald and Halliday, criteria. EPs frequently displayed clinically silent lesions, enabling us to reclassify 14 of the 37 potentially reclassifiable subjects (37.8%). The CSF test (OB+) allowed the reclassification of 31 out of the 58 reclassifiable cases (53.4%). In the present report we discuss the usefulness of the two methods.

Adolescent↗
PubMed1987

Multimodality evoked response testing in sarcoidosis.

Neurosarcoidosis is suspected on clinical grounds. The diagnosis is confirmed radiographically or by spinal fluid examination or biopsy. Evoked response testing in sarcoidosis has been studied by three groups of investigators. Visual, somatosensory, or brainstem auditory evoked potentials were abnormal in some sarcoidosis patients with, and in others without clinical evidence of neurological involvement. Multimodality evoked response testing may be useful in further defining neurosarcoidosis and in detecting subclinical disease.

Evoked Potentials↗
PubMedDate not supplied

Multimodal evoked potentials and CSF findings in the diagnosis of multiple sclerosis.

A group of 30 patients classified on clinical grounds as having definite (N = 16) or probable MS (N = 14) according to McAlpine's criteria, has been studied using multimodal recordings of evoked potentials (visual, auditory, and somatosensory) and examination of the cerebrospinal fluid (CSF) for oligoclonal bands and Link's Index. Evoked potentials examination proved extremely sensitive in discovering asymptomatic lesions of the central nervous system. CSF data, in particular the presence of oligoclonal bands, had a high sensitivity for MS. According to these electrophysiologic and immunologic results, we have reclassified our patients in conformity with the diagnostic criteria proposed by Bartel. The combination of electrophysiological and CSF data, together with common clinical criteria, led to greater diagnostic accuracy, making it possible to reclassify most patients previously considered to have probable MS as having definite MS.

Adult↗
PubMed1986

[Value of multimodal evoked potentials in the diagnosis of multiple sclerosis].

94 Patients diagnosed as having multiple sclerosis (MS) were examined by multimodal evoked potentials. According to the criteria of Bauer and Poser the patients were classified as possible, probable and certain forms of MS. Abnormalities were found in the VEP in 82.6% of cases (possible - 44.4%, probable - 87.5%, certain - 95.2%), in the BAEP in 51.3% of cases (possible - 27.3%, probable - 46.2%, certain - 68.8%) and in the SSEP in 71.1% of cases (possible - 35.3%, probable - 67.7%, certain - 88.1%). Subclinical lesions were detected by VEP in 37.0% of cases, by BAEP in 43.6% and by SSEP in 21.1%. Reclassification according to the results of the evoked potentials studies was required in 21.2% of cases. The value of evoked potentials in the diagnosis of MS is discussed with regard to the different forms of evoked potentials, as well as in comparison with other examination techniques.

Adolescent↗
PubMed1985

[Multimodality therapy of colorectal cancer].

Multimodality therapy for colorectal cancer is composed of surgery, chemotherapy and irradiation; and hyperthermia joins them recently. As patients with operable colorectal cancer are a good candidate for a chemotherapeutic approach, we began postoperative adjuvant chemotherapy since 1971. On the other hand, our treatment policy towards inoperable cases is various treatments combined with the four therapies described above. The most patients with hepatic metastasis are unamenable for surgery, and they have been mainly treated with intra-arterial chemotherapy. With conventional infusion treatment, however, the infusion drugs are eliminated rapidly from the drainage vein. Thus, we prepared biodegradable albumin microspheres containing MMC (mean diameter 45 +/- 8 micron); and in 6 patients with liver metastasis, we infused MMC microspheres into the proper hepatic artery, with marked tumor regression. Hyperthermia treatment has been performed with ThermaTech 2000 (International Institute for Medical Sciences, U.S.A.), which has a complete capacitive, 3-channel, "crossfire" heating system operating by RF at 13.56 MHz. Six patients with local recurrence and/or hepatic metastasis were treated by hyperthermia combined with chemotherapy or irradiation, with a fair success in tumor response and improvement of subjective symptoms.

Aged↗
PubMed1985

Results of multimodality therapy of resectable soft-tissue sarcomas of the retroperitoneum.

Thirty-seven patients with resectable retroperitoneal sarcomas were studied prospectively to determine the efficacy of aggressive multimodality treatments. No patients was lost to follow-up, which ranged from 11 to 85 months (median 29 months). All patients received radiotherapy and some received postoperative chemotherapy (doxorubicin, cyclophosphamide, and high-dose methotrexate). A subset of 15 patients were entered into a prospective, randomized study testing the efficacy of adjuvant chemotherapy (eight received chemotherapy; seven did not). Two-year actuarial survival rates were inferior in the chemotherapy arm (100% versus 47%; p = 0.06), but the small number of patients precluded drawing definitive conclusions from this randomized study alone. Among the entire 37 patients (21 received chemotherapy; 16 did not) the actuarial 3-year survival rate was 43% and appeared unaffected by chemotherapy. Two patients suffered doxorubicin infiltration, three sustained cardiac toxicity, two developed cyclophosphamide-induced cystitis, and three withstood transient, severe bone marrow suppression. Eight patients suffered severe radiation enteritis, and one patient died after bowel resection for this problem. Thus the chemotherapy regimen we administered did not appear to improve survival but was associated with major morbidity. Radiotherapy was also associated with major complications, and since all patients received radiotherapy, it remains to be established if this modality is beneficial in improving survival.

Actuarial Analysis↗
PubMed1985

[Significance of multimodality evoked potentials (MEPs) in severe head injuries].

Clinical significance of multimodality evoked potentials (MEPs) consisting of auditory evoked brainstem response (ABR), cortical somatosensory evoked potential (SEP) and visual evoked potential (VEP) was studied in 14 cases with severe head injuries. The cases in this series associated with cerebral contusion and/or intracranial mass lesions such as acute subdural, intracerebral and acute epidural hematomas and Glasgow Coma Scale (GCS) score was less than 8 in all instances. MEPs were recorded for 14 days after injury and evaluated by MEP grade modified from Greenberg, et al. Intracranial pressure (ICP) was monitored from the extradural space on main lesion side in all cases for 3 to 5 days. Transtentorial herniation on CT scan was also graded according to the status of subarachnoid cisterns around the tentorium. The outcome was assessed by Glasgow Outcome Scale at 3 months after injury and was classified into good, poor and dead. MEPs on admission showed mild to severe abnormalities determined by single or all modalities in all cases and they were fairly well correlated with GCS score on admission and initial ICP. In the cases with good outcome, initial MEPs showed mild to moderate abnormalities determined by single modality and improved within 3 days after injury. They returned to normal or remained at mild abnormality at 7 days. But abnormality on initial MEPs was more severe in the cases with poor outcome and they were deteriorated within 3 to 7 days when elevation of ICP above 25 mmHg was observed. MEPs remained at moderate abnormality even at 14 days after injury in these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Aggressive multimodality therapy based on a multicompartmental model of glioblastoma.

Glioblastoma multiforme is composed of multiple cellular compartments with different morphologic, kinetic, metabolic, vascular, and genetic properties. Optimal therapy may consist of a variety of therapeutic strategies designed for individual compartments, administered in close temporal relation. These concepts may turn out to be valid for other solid tumors as well. Microwave-induced hyperthermia can be used to treat metabolically quiescent, relatively hypoxic, nondividing cells (Go) otherwise resistant to radiation and chemotherapy. Similarly, polychemotherapy can treat a broad spectrum of cell types if the blood-brain barrier can be circumvented. Radical surgery, repetitively applied, can be safely used to "set up" experimental agents if the operation microscope and laser are employed. A consecutive series of 74 adult patients with malignant astrocytoma were treated with primary resection, radiation therapy, and 1,3,-bis(2 chloroethyl) 1 nitrosourea chemotherapy. At recurrence, all patients were offered reoperation with the microscope and the laser prior to administration of phase-I agents--hyperthermia via an implantable miniature microwave antenna (6 cases); aziridinylbenzoquinone chemotherapy (13 cases); and blood-brain barrier reversal with dimethyl sulfoxide (DMSO) and polychemotherapy (9 cases). It was concluded that temperatures of 45 degrees C could be safely achieved and human tumors could not efficiently dissipate heat; that DMSO plus drug therapy could be tolerated but blood-brain barrier reversal demonstrated by us in animals could not be shown in humans; and that aggressive multimodality therapy and reoperation could produce a 40% 2-year survival rate for patients younger than 40 years.

Brain Neoplasms↗
PubMed1978

L2C guinea pig leukemia. A potential model for structuring multimodality therapy.

L2C guinea pig leukemia is a lymphoblastic neoplasm that arose spontaneously in a nonirradiated female strain 2 guinea pig over 20 years ago. Mutation of the original tumor probably accounts for the discordant results which have been reported. The LE-L2C subline was used to develop a multimodality therapy model of acute leukemia. Syngeneic strain 2 animals challenged with 3 x 10(5) LE-L2C cells developed overt leukemia in 14 +/- 3 (SD) days. When treated with cytoreductive chemotherapy, they relapsed with either systemic or central nervous system (CNS) disease. However, CNS relapse was prevented by craniospinal irradiation, yielding a uniform pattern of relapse. Preliminary studies suggest that active immunotherapy with nonspecific agents, such as BCG, or immunoreconstitution with thymosin may prolong the duration of remission and increase the percentage of long-term survivors. L2C leukemia may represent a useful animal model for structuring the principles that govern the interrelationship between chemotherapy and immunomudulation.

Animals↗
PubMed1984

A multimodal assessment of behavioral and cognitive deficits in abused and neglected preschoolers.

42 preschool children who had a previous history of physical abuse, serious neglect, or no prior history of child maltreatment participated in a multimodal assessment of cognitive and behavioral functioning. In addition to standardized tests of cognitive ability and behavioral observations in the classrooms, both the parents and teachers rated the children on several measures. Results show that the abused and neglected children had lower scores on all the measures of cognitive functioning when compared to the matched comparison children. The behavioral observation data from the classrooms, however, were more complex. That is, differences among groups depended on the type of behavior observed. Neglected children engaged in the least number of interactions with other children, and the abused children demonstrated the most aggression. Both parents and teachers rated the maltreated children as more aggressive, less mature, and less ready to learn. In summary, differences between abused, neglected, and comparison children were present on a number of measures, indicating that maltreated children display significant cognitive and social deficits.

Aggression↗
PubMed1983

[Inpatient behavior therapy of depression--a multimodal approach in clinical practice].

Using a reinforcement-oriented model of depression, we applied a multimodal approach of behavior therapy in clinical setting. We modified the self-control-group-therapy of psychoreactive depression, developed by Fuchs und Rehm (1977) in order to reach applicability for inpatients of psychiatric hospital. Operant techniques, social skills training, self-control-techniques, and the cognitive techniques developed by Beck (1979) were used. In contrast to Becks cognitive therapy we emphasized both the motivational aspect of depression and the aspect of self-regulation and self-modification too. There was not only the therapist trying to change behavior, thinking, and feeling of the patient by cognitive techniques. The patient himself tried to develop cognitive and behavior coping strategies. The treatment of patients with severe depression in an early stage was controlled by the therapist, later on they learned to control themselves. A central point of the concept of self-modification is teaching well founded knowledge of behavior analyses to the patient. Self-modification is not very efficient without, and the patient's motivation to work on his own therapy is elevated significantly. In some cases we continue this form of therapy after the patient's leaving the hospital up to three months.

Adult↗
PubMed1981

Multimodal therapy in metastatic Ewing's sarcoma: an Intergroup Study.

Multimodal therapy consisting of radiation therapy to all areas of gross disease and intensive combination chemotherapy was administered to 44 patients with Ewing's sarcoma. Seven of these patients had regional disease and the others had clinical evidence of distant metastases. The median duration of time on study for all patients was 75 weeks. A complete response occurred in 31 of the patients and 17 are currently free of disease. Four deaths resulted from complications of therapy; 2 were due to infection and 2 due to adriamycin-related cardiomyopathy.

Bone Neoplasms↗