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ANFINSEN CB 《The Journal of biological chemistry》1950,185(2):827-831
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Although chemotherapy with procarbazine, lomustine and vincristine (PCV) is considered to be well tolerated, side effects
frequently lead to dose reduction or even discontinuation of treatment of oligodendroglial brain tumors. The primary objective
of the analysis was to retrospectively compare progression-free survival (PFS) after PCV vs. PC chemotherapy (without vincristine
to avoid side effects). Patients were retrospectively identified from a database containing our patients between 1990 and
2003. For the selected cases, all histopathology reports were re-evaluated by a local neuropathologist. Based on the updated
histology data, patients were included in the study if they had at least one histological diagnosis of an oligodendroglial
tumor. PFS after start of PCV (n = 61) and PC (n = 84) chemotherapy identical (median 30 months). Multivariate analysis adjusting
for prognostic imbalances favouring the PC group showed a minor, statistically non-significant benefit for PCV (hazard ratio
0.81, 95% confidence interval 0.53–1.25; p = 0.346). Younger age (< 50 y) was a statistically significant predictor of longer
PFS. Significant advantages in terms of overall survival after first diagnosis of oligodendroglial tumor (OS, n = 315) were
found for patients < 50 y (p < 0.001), oligodendrogliomas versus oligoastrocytomas (p = 0.002), and WHO°II vs. °III (p < 0.001).
Three risk groups regarding OS were identified. Findings support the hypothesis that PC may be as effective as PCV chemotherapy,
while avoiding the additonal risks of vincristine. Younger age, lower tumor grade and histology of an oligodendroglioma were
identified to be favorable prognostic factors. 相似文献
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