RESUMO
Rhabdomyosarcoma of the head and neck is a rare childhood neoplasm. Most occur in the orbit, which accounts for the scarcity of papers on modern techniques of treatment of soft palate rhabdomyosarcomas. Only 30 cases of soft palate rhabdomyosarcoma have been reported in recent years and none had long-term follow-up periods (greater than 10 yr). This study reports three cases of pediatric soft palate rhabdomyosarcomas treated with surgery, radiotherapy (two of three), and chemotherapy. The complications that occurred in one patient are discussed.
Assuntos
Neoplasias Palatinas/cirurgia , Rabdomiossarcoma/cirurgia , Criança , Pré-Escolar , Terapia Combinada , Seguimentos , Humanos , MasculinoRESUMO
Investigators of the Children's Cancer Study Group entered 73 children with previously untreated localized non-Hodgkin's lymphoma on a prospective randomized trial of systemic treatment with either a four-drug program (cyclophosphamide, vincristine, methotrexate, prednisone [COMP]) or a 10-drug (LSA2-L2 modified) program of 18 months duration. All patients received central nervous system prophylaxis with intrathecal methotrexate and most received local or regional radiation treatment. The three-year relapse-free survival rate for all patients (N = 73) was 84%; for COMP (N = 42) was 85%, and for LSA2-L2 (N = 31) was 84%. Of the 12 patients who suffered adverse events eight relapsed and four died of toxicity. Histopathology was reviewed centrally. Of 32 patients with nonlymphoblastic disease treated with COMP only one relapsed. Of 26 patients treated with LSA2-L2, four relapsed. Patients with localized lymphoblastic disease were uncommon. None of three patients treated with LSA2-L2 relapsed compared with three of nine treated with COMP. COMP is an excellent treatment for patients with localized disease of nonlymphoblastic type, but the relative value of the two regimens for patients with localized lymphoblastic disease is uncertain.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Daunorrubicina/administração & dosagem , Daunorrubicina/efeitos adversos , Feminino , Humanos , Lactente , Recém-Nascido , Linfoma/mortalidade , Linfoma/patologia , Linfoma/radioterapia , Masculino , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Vincristina/administração & dosagem , Vincristina/efeitos adversosRESUMO
Human leukocyte interferon was evaluated as a treatment for varicella in a randomized double-blind, placebo-controlled study carried out in two phases. A total of 44 children being treated for cancer were enrolled within 72 hours of the appearance of the exanthem. The mean number of days of new lesion formation was 3.8 +/- 1.89 (+/- S.D.) in the interferon recipients and 5.3 +/- 2.56 in the placebo recipients (P less than 0.05). Eighty-one per cent of the interferon recipients had had no new lesions for 24 hours by Day 7, as compared with 56 per cent of the placebo recipients (P less than 0.025). In the second, higher-dose phase of the study 92 per cent of the interferon recipients had had no new lesions for 24 hours by Day 6, as compared with 45 per cent of the placebo recipients (P less than 0.025). Three of 21 placebo recipients died of progressive varicella. Two of the 23 interferon recipients died two to three weeks after the onset of varicella; viral cultures were negative in one of these patients, and the second had recurrent viremia at the end of the treatment period. Among the survivors, treatment with interferon reduced the number of patients who had life-threatening dissemination (none of 21 vs. three of 18; P = 0.053). We conclude that interferon had an antiviral effect against varicella virus in immunocompromised patients.
Assuntos
Varicela/terapia , Interferons/uso terapêutico , Neoplasias/complicações , Varicela/mortalidade , Criança , Ensaios Clínicos como Assunto , Método Duplo-Cego , Humanos , Interferons/administração & dosagem , Leucemia/complicações , Distribuição AleatóriaRESUMO
We describe the previously unreported finding of ossification within a rhabdomyosarcoma of the extremity in the absence of bone destruction. Rhabdomyosarcoma is a highly malignant tumor but could not be radiographically differentiated from benign or other malignant causes of soft-tissue masses containing calcium. Definitive diagnosis and thus appropriate therapy requires prompt pathologic examination.
Assuntos
Ossificação Heterotópica/complicações , Rabdomiossarcoma/complicações , Neoplasias de Tecidos Moles/complicações , Feminino , Humanos , Lactente , Ossificação Heterotópica/diagnóstico por imagem , Radiografia , Rabdomiossarcoma/patologia , Neoplasias de Tecidos Moles/patologiaAssuntos
Neoplasias Renais/terapia , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/terapia , Tumor de Wilms/terapia , Criança , Dactinomicina/uso terapêutico , Humanos , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Metástase NeoplásicaAssuntos
Dactinomicina/uso terapêutico , Neoplasias Renais/terapia , Tumor de Wilms/terapia , Pré-Escolar , Estudos de Avaliação como Assunto , Humanos , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/radioterapia , Neoplasias Renais/cirurgia , Neoplasias Pulmonares/prevenção & controle , Metástase Neoplásica , Nefrectomia , Tumor de Wilms/tratamento farmacológico , Tumor de Wilms/radioterapia , Tumor de Wilms/cirurgiaAssuntos
Transtornos Plaquetários/genética , Surdez/genética , Nefrite/genética , Difosfato de Adenosina/análise , Trifosfato de Adenosina/análise , Adolescente , Adulto , Coagulação Sanguínea , Transtornos Plaquetários/complicações , Transtornos Plaquetários/patologia , Transtornos Plaquetários/fisiopatologia , Plaquetas/análise , Medula Óssea/patologia , Pré-Escolar , Colágeno , Surdez/complicações , Feminino , Humanos , Rim/patologia , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Nefrite/complicações , Nefrite/patologia , Linhagem , Adesividade Plaquetária , Trombocitopenia/genéticaAssuntos
Leucemia/diagnóstico , Pré-Escolar , Humanos , Leucemia/mortalidade , Leucemia/terapia , PrognósticoAssuntos
Emoções , Família , Leucemia , Adaptação Psicológica , Adolescente , Atitude , Criança , Pré-Escolar , Morte , Mecanismos de Defesa , Feminino , Pesar , Humanos , Relações Interpessoais , Entrevista Psicológica , Leucemia/diagnóstico , Masculino , Corpo Clínico Hospitalar , Transtornos Mentais/etiologia , Recursos Humanos de Enfermagem Hospitalar , Relações Pais-Filho , Encaminhamento e Consulta , Estudos Retrospectivos , Relações entre Irmãos , Serviço Social , Estresse PsicológicoAssuntos
Transplante de Rim , Tumor de Wilms/cirurgia , Cadáver , Pré-Escolar , Feminino , Humanos , Nefrectomia , Preservação de Tecido , Transplante HomólogoRESUMO
In order to find ways to decrease mortality from hemolytic disease of the newborn, a study was undertaken by physicians of the California Medical Association in cooperation with the California State Department of Public Health. Neonatal deaths during a two and a half year period were investigated and analyzed by review committees with the view of evaluating presumed deficiencies in management. The findings indicate that proper prenatal prediction and preparation by the physician for the management of HDN calls for earlier and more comprehensive use of warning signals, as well as a constant reappraisal of current technology. New advances in the management of HDN require increasingly close cooperation between patients, their physicians and consultants.