Stage IA to IIB mediastinal Hodgkin's disease: three-dimensional volumetric assessment of response to treatment.

1988 ◽  
Vol 6 (5) ◽  
pp. 819-824 ◽  
Author(s):  
C G Willett ◽  
R M Linggood ◽  
J C Leong ◽  
L M Miketic ◽  
M A Stracher ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Three Dimensional ◽  
Volumetric Analysis ◽  
Response To Treatment ◽  
Initial Volume ◽  
Volumetric Assessment ◽  
Mediastinal Disease ◽  
Stage Ia ◽  
The Mean

From 1979 to 1986, the response to treatment of 53 patients with stage IA to IIB mediastinal Hodgkin's disease was evaluated by three-dimensional volumetric analysis using thoracic computed tomographic (CT) scans. The mean initial volume of mediastinal disease in 34 patients treated with mantle and para-aortic irradiation was 166 mL, whereas for 19 patients treated with two to six cycles of multiagent chemotherapy and mantle and para-aortic irradiation the mean initial volume was 446 mL. Preliminary data suggested that patients with mediastinal volumes of less than 200 mL had a lower mediastinal relapse rate (13%) than patients with volumes greater than 200 mL (32%). For 12 patients receiving six cycles of nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP), those with a greater than 85% reduction in volume 1 to 2 months after chemotherapy had a lower incidence of mediastinal relapse (zero of six, 0%) compared with patients having 85% or less reduction in volume (four of six, 67%). The primary value of this technique is that it provides a sensitive assessment of response to treatment and may aid in monitoring the effectiveness of a given treatment.

scholarly journals Results of treatment of stage IA and IIA Hodgkin's disease

Cancer ◽  
1987 ◽  
Vol 59 (6) ◽  
pp. 1107-1111 ◽  
Author(s):  
Christopher G. Willett ◽  
Rita M. Linggood ◽  
Jack Meyer ◽  
Erica Orlow ◽  
Karen Lindfors ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Results Of Treatment ◽  
Stage Ia

Efficacy and toxicity of multiagent chemotherapy and low-dose involved-field radiotherapy in children and adolescents with Hodgkin's disease.

1993 ◽  
Vol 11 (1) ◽  
pp. 100-108 ◽  
Author(s):  
M M Hudson ◽  
C Greenwald ◽  
E Thompson ◽  
J Wilimas ◽  
N Marina ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Low Dose ◽  
Hodgkin’S Disease ◽  
Pulmonary Function Tests ◽  
Rest Period ◽  
Late Toxicity ◽  
Symptomatic Patient ◽  
Asymptomatic Patients ◽  
Mediastinal Disease ◽  
Multiagent Chemotherapy

PURPOSE Between May 1980 and September 1990, 85 patients with Hodgkin's disease were treated with a regimen designed to increase cure rates while reducing late toxicity. PATIENTS AND METHODS Therapy consisted of five cycles of cyclophosphamide, Oncovin (vincristine; Eli Lilly and Co, Indianapolis, IN), and procarbazine (COP), alternated with four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and low-dose (20 Gy) regional radiotherapy. Vincristine and cyclophosphamide were administered as tolerated during irradiation and during the 2- to 4-week rest period between radiation volumes. The need for staging laparotomy was defined by clinical presentation. RESULTS The median age at diagnosis was 14 years (range, 4 to 20), and 56% of patients were male. The majority (67%) had stage III or IV disease and 68% (19 of 28) of stage II patients had bulky mediastinal disease. Nodular sclerosing histology predominated (67%). Ninety-three percent of patients were alive without disease with a median follow-up of 4.1 years. Abnormalities were detected on chest roentgenograms and/or pulmonary function tests in 58% and 25% of clinically asymptomatic patients who were tested at least 1 year after completion of therapy. The only symptomatic patient had pulmonary fibrosis after treatment with bleomycin (20 U/m2) and mantle (20 Gy)/lung (13 Gy) irradiation, and developed multiple spontaneous pneumothoraces that required cortical stripping. One patient had congestive heart failure 19 months post-treatment, and two had abnormalities on echocardiograms. Thyroid abnormalities occurred in 21 (27%) patients who were assessable for late toxicity. The majority of female patients have had regular menstrual cycles. Six developed ovarian failure, and 10 have had a total of 17 pregnancies. Other than one documented case of oligospermia, information was not available on male fertility. CONCLUSION The results demonstrate excellent disease control for the COP/ABVD regimen, with acceptable toxicity.

Two cycles of MOPP and radiotherapy for stage III1A and stage III1B Hodgkin's disease.

1988 ◽  
Vol 6 (8) ◽  
pp. 1293-1302 ◽  
Author(s):  
G C Henkelmann ◽  
F B Hagemeister ◽  
L M Fuller
Keyword(s):  
Hodgkin's Disease ◽  
Low Dose ◽  
Hodgkin’S Disease ◽  
Survival Rates ◽  
Histologic Subtype ◽  
Survival Difference ◽  
Abdominal Disease ◽  
Mediastinal Disease ◽  
Upper Abdomen

One hundred two adult patients with stage III1A (76 patients) and stage III1B (26 patients) Hodgkin's disease were treated with two cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) and radiotherapy (XRT) between 1970 and 1984. Sixty-four of the patients were treated between 1970 and 1978 with two cycles of MOPP and XRT to the mantle, upper abdomen, and pelvis. The remaining 38 patients were treated from 1978 to 1984 with a modification of the protocol in which pelvic XRT was omitted and low-dose whole-lung XRT was administered to patients with unfavorable mediastinal disease. The 10-year actuarial freedom-from-progression (FFP) and determinate survival rates at a mean follow-up of 93 months were 84% and 86% for stage III1 disease, 86% and 84% for stage III1A disease, and 78% and 91% for stage III1B disease. Three patients died of treatment-related toxicities without evidence of Hodgkin's disease, two died of complications of myelosuppression and one of acute nonlymphocytic leukemia (ANLL). Neither FFP nor determinate survival rates were significantly influenced by B symptoms, unfavorable mediastinal disease, histologic subtype, extent of abdominal disease, the omission of pelvic XRT, the use of whole-lung XRT, or the number of splenic nodules. Patients 40 years of age or older had a 73% determinate survival rate at 10 years compared with 88% for patients younger than 40 years (P = .01). This survival difference was due to treatment-related toxicity in the older group. This study indicates that two cycles of MOPP and XRT to the mantle and upper abdomen is as effective as more intensive treatment for all patients with stage III1 Hodgkin's disease. This treatment program can preserve fertility and has had only a 1% actuarial incidence of ANLL at 15 years.

scholarly journals Hodgkin’s Disease

Blood ◽  
1955 ◽  
Vol 10 (12) ◽  
pp. 1214-1227 ◽  
Author(s):  
MICHAEL B. SHIMKIN
Keyword(s):  
United States ◽  
Sex Ratio ◽  
Hodgkin's Disease ◽  
Death Rate ◽  
Hodgkin’S Disease ◽  
The United States ◽  
Age At Death ◽  
Male Predominance ◽  
Female Sex ◽  
The Mean

Abstract Mortality from Hodgkin’s disease in the United States during the period 1921 through 1951 was analyzed with respect to race, sex and age incidence and distribution. The findings were compared with those reported for leukemia. The recorded death rate from Hodgkin’s disease rose from 6.9 in 1921 to 17.0 per million in 1951. During this period, the death rate from leukemia rose from 14 to 61 per million. The death rate among males is higher than among females for both diseases; the male predominance is more marked in Hodgkin’s disease than in leukemia. The rate is higher among whites than non-whites for both diseases; the white predominance is more marked in leukemia than in Hodgkin’s disease. There is no peak in rate during childhood for Hodgkin’s disease as there is for leukemia, and the increase in rate with age is much less steep for Hodgkin’s disease than for leukemia. The mean age at death of adults dying from Hodgkin’s disease and from leukemia increased by 3.5 and 8.0 years, respectively, between 1925 and 1950. The male-female sex ratio for Hodgkin’s disease decreased slightly, and increased slightly for leukemia between 1925 and 1950.

scholarly journals Measuring Differential Volume Using the Subtraction Tool for Three-Dimensional Breast Volumetry: A Proof of Concept Study

2020 ◽  
pp. 155335062094556
Author(s):  
Faith Hyun Kyung Jeon ◽  
Michelle Griffin ◽  
Aurora Almadori ◽  
Jajini Varghese ◽  
Stephanie Bogan ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Computer Software ◽  
Patient Positioning ◽  
Volumetric Analysis ◽  
Volumetric Assessment ◽  
Alternative Approach ◽  
Significant Difference ◽  
Actual Volume ◽  
Novel Method ◽  
The Subject

Background. Three-dimensional (3D) photography provides a promising means of breast volumetry. Sources of error using a single-captured surface to calculate breast volume include inaccurate designation of breast boundaries and prediction of the invisible chest wall generated by computer software. An alternative approach is to measure differential volume using subtraction of 2 captured surfaces. Objectives. To explore 3D breast volumetry using the subtraction of superimposed images to calculate differential volume. To assess optimal patient positioning for accurate volumetric assessment. Methods. Known volumes of breast enhancers simulated volumetric changes to the breast (n = 12). 3D photographs were taken (3dMDtorso) with the subject positioned upright at 90° and posteriorly inclined at 30°. Patient position, breathing, distance and camera calibration were standardised. Volumetric analysis was performed using 3dMDvultus software. Results. A statistically significant difference was found between actual volume and measured volumes with subjects positioned at 90° ( P < .05). No statistical difference was found at 30° ( P = .078), but subsequent Bland–Altman analysis showed evidence of proportional bias ( P < .05). There was good correlation between measured and actual volumes in both positions (r = .77 and r = .85, respectively). Univariate analyses showed breast enhancer volumes of 195 mL and 295 mL to incur bias. The coefficient of variation was 5.76% for single observer analysis. Conclusion. Positioning the subject at a 30° posterior incline provides more accurate results from better exposure of the inferior breast. The subtraction tool is a novel method of measuring differential volume. Future studies should explore methodology for application into the clinical setting.

The prognostic significance of mediastinal bulk in patients with stage IA-IVB Hodgkin's disease: A report from the Manchester Lymphoma Group

1985 ◽  
Vol 36 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Heather Anderson ◽  
Jeremy P.R. Jenkins ◽  
David J. Brigg ◽  
David P. Deakin ◽  
Michael K. Palmer ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Prognostic Significance ◽  
Stage Ia

Bleomycin Pulmonary Toxicity Does Impact on Hodgkin’s Disease Outcome.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1318-1318
Author(s):  
William G. Martin ◽  
Kay M. Ristow ◽  
Joseph P. Colgan ◽  
Thomas M. Habermann ◽  
Stephen M. Ansell
Keyword(s):  
Hodgkin's Disease ◽  
Pulmonary Toxicity ◽  
Hodgkin’S Disease ◽  
Progression Free Survival ◽  
Corticosteroid Treatment ◽  
Free Survival ◽  
Appropriate Treatment ◽  
The Mean ◽  
Infectious Etiology ◽  
Nodular Sclerosing

Abstract Background: Bleomycin-containing chemotherapy regimens have become the mainstay of treatment in Hodgkin’s Disease (HD). The risk of bleomycin pulmonary toxicity (BPT) ranges from 0–46% and mortality rates range from 0–27%. Although there is no excepted standard treatment for BPT, corticosteroid treatment, withholding bleomycin from subsequent chemotherapy, and proceeding with a non-bleomycin containing regimen is the most common approach. We reviewed our experience to better delineate outcome and appropriate treatment in these patients. Methods: We reviewed all patients managed for HD at Mayo Clinic, Rochester, from January 1986 to February 2003. BPT was defined by the presence of pulmonary symptoms, bilateral interstitial infiltrates, and no evidence for an infectious etiology. Results: A retrospective review identified 141 patients with HD treated with a bleomycin-containing regimen. The mean age of patients at diagnosis was 34 years. Fifty four percent were males. The histology was nodular sclerosing in 85%. The Hasenclever index was 0 in 15%, 1 in 35%, 2 in 24%, 3 in 16%, 4 in 9%, and &gt;5 in 1%. Frontline chemotherapy included ABVD in 57%, MOPP-ABV(D) in 33%, COPP-ABV in 8%, BEACOPP in 3%, and Stanford V in 2%. Forty one percent of patients received radiation. The 5-year overall survival (OS) and progression free survival (PFS) for all patients were 87% and 79% respectively. BPT was observed in 18% of patients (25/141). There was a significant decrease in OS, 63% in patients with BPT versus 90% in non-BPT patients at 5 years (p=0.0013). The mortality from BPT was 4.2% (6/141) in all patients and 24% (6/25) in patients who developed the pulmonary syndrome. These 6 patients all died within 9 months of their HD diagnosis from BPT. The Hasenclever index was 3 or less in 5 of these 6 patients. CR rates were equal at 91% and 93% in BPT and non-BPT patients respectively (p=0.299). Twenty two percent (31/141) of patients, either symptomatic or asymptomatic, had bleomycin omitted at any time from their regimen with no difference in OS or PFS, 83% versus 88% (p=0.369) and 82% versus 78% (p=0.853) respectively. The mean bleomycin dose was 84 mg/m2 (range of 20–180 mg/m2). Bleomycin dose had no impact on OS or PFS. In BPT patients subsequent non-bleomycin therapy included AVD 44%, MOPP-AV 31%, or no further chemotherapy 25%. The five-year OS was equal between the AVD and MOPP-AV groups at 91%. However in patients who received no further chemotherapy 5-year OS was 30% (p=0.0001). Conclusion: Bleomycin pulmonary toxicity (BPT) results in a significant decrease in OS survival at 5 years in patients being treated for Hodgkin’s Disease. In patients who do not die acutely from pulmonary toxicity both OS and PFS appear equal despite the omission of bleomycin.

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