Kooperativer Bibliotheksverbund

Berlin Brandenburg

and
and

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
Type of Medium
Language
Year
  • 1
    Language: English
    In: Radiology, February 2013, Vol.266(2), pp.649-56
    Description: To evaluate tumor response by means of volumetric assessment, survival, and changes in patient symptoms after the treatment of unresectable and/or recurrent pleural mesothelioma by using regional nonselective transarterial chemoperfusion as a palliative treatment option. This retrospective study was approved by the hospital ethical committee, and all patients signed an informed consent prior to treatment. Thirty-nine patients (mean age, 64.0 years; 10 women and 29 men) with unresectable pleural mesothelioma were treated with repetitive transarterial chemoperfusion between March 2007 and March 2010, with a mean of 2.9 sessions per patient at 4-week intervals. Transarterial chemoperfusion was performed by using mitomycin C, cisplatin, and gemcitabine. Computed tomography findings and patient symptoms were evaluated. Tumor response was evaluated by using Response Evaluation Criteria in Solid Tumors guidelines, and survival was assessed with the Kaplan-Meier method. The change in volume for the partial-response group was tested by using the Wilcoxon signed-rank test. In 36% of treated tumors (14 of 39), partial response was achieved, and tumor volume decreased from a mean value ± standard deviation of 839.6 mL ± 590.3 (range, 3.9-1972.2 mL) to 137 mL ± 399.8 (range, 0.88-1131.4; P = .00012). In 49% of tumors (19 of 39), stable disease was noted. In 15% of tumors (six of 39), progressive disease was seen. Mean specific growth rate of the tumor was 0.00158% per day. The mean survival time was 14.2 months (range, 2.1-33.1 months) from the start of treatment. For patients with tumors that responded to treatment, mean survival time was 15 months (range, 4.5-33.1 months). Mean time to disease progression was 2.6 months for all tumors, 1.5 months for stable disease, and 1.3 months for progressive disease. Transarterial chemoperfusion may have the potential to yield positive results and response in the treatment of recurrent and/or unresectable pleural mesothelioma. © RSNA, 2012.
    Keywords: Palliative Care ; Antineoplastic Combined Chemotherapy Protocols -- Therapeutic Use ; Mesothelioma -- Drug Therapy ; Pleural Neoplasms -- Drug Therapy
    ISSN: 00338419
    E-ISSN: 1527-1315
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Language: English
    In: American Journal of Obstetrics and Gynecology, December 2014, Vol.211(6), pp.662.e1-662.e9
    Description: The purpose of this study was to assess the impact of different positions on pelvic diameters by comparing pregnant and nonpregnant women who assumed a dorsal supine and kneeling squat position. In this cohort study from a tertiary referral center in Germany, we enrolled 50 pregnant women and 50 nonpregnant women. Pelvic measurements were obtained with obstetric magnetic resonance imaging pelvimetry with the use of a 1.5-T scanner. We compared measurements of the depth (anteroposterior (AP) and width (transverse diameters) of the pelvis between the 2 positions. The most striking finding was a significant 0.9-1.9 cm increase (7-15%) in the average transverse diameters in the kneeling squat position in both pregnant and nonpregnant groups. The average bispinous diameter in the pregnant group increased from 12.6 cm ± 0.65 cm in the supine dorsal to 14.5 cm ± 0.64 cm ( 〈 .0001) in the kneeling squat; in the nonpregnant group the increase was from 12 cm ± 0.76 cm to 13.9 cm ± 1.04 cm (  〈 .0001). The average bituberous diameter in the pregnant group increased from 13.6 cm ± 0.93 cm in the supine dorsal to 14.5 cm ± 0.83 cm ( 〈 .0001) in the kneeling squat position; in the nonpregnant women the increase was from 12.6 cm ± 0.92 cm to 13.5 cm ± 0.88 cm ( 〈 .0001). A kneeling squat position significantly increases the bony transverse and anteroposterior dimension in the mid pelvic plane and the pelvic outlet. Because this indicates that pelvic diameters change when women change positions, the potential for facilitation of delivery of the fetal head suggests further research that will compare maternal delivery positions is warranted.
    Keywords: Birth ; Magnetic Resonance Imaging (Mri) ; Maternal Position ; Pelvimetry ; Pregnancy ; Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 3
    In: International Journal of Cancer, 01 March 2014, Vol.134(5), pp.1225-1231
    Description: The aims of the study were to evaluate therapeutic efficacy and to determine the prognostic factors for treatment success in patients with liver metastases from colorectal cancer (CRC) treated with transarterial chemoembolization (TACE). A total of 564 patients (mean age, 60.3 years) with liver metastases of CRC were repeatedly treated with TACE. In total, 3,384 TACE procedures were performed (mean, six sessions per patient). The local chemotherapy protocol consisted of mitomycin C alone (43.1%), mitomycin C with gemcitabine (27.1%), mitomycin C with irinotecan (15.6%) or mitomycin C with irinotecan and cisplatin (15.6%). Embolization was performed with lipiodol and starch microspheres. Tumor response was evaluated using magnetic resonance imaging or computed tomography. The change in tumor size was calculated and the response was evaluated according to the RECIST‐Criteria. Survival rates were calculated according to the Kaplan–Meier method. Prognostic factors for patient's survival were evaluated using log‐rank test. Evaluation of local tumor control showed partial response in 16.7%, stable disease in 48.2% and progressive disease in 16.7%. The 1‐year survival rate after chemoembolization was 62%, the 2‐year survival rate was 28% and the 3‐year survival rate was 7%. Median survival from the start of chemoembolization treatment was 14.3 months. The indication ( = 0.001) and initial tumor response ( = 0.015) were statistically significant factors for patient's survival. TACE is a minimally invasive therapy option for controlling local metastases and improving survival time in patients with hepatic metastases from CRC. TN stage, extrahepatic metastases, number of lesions, tumor location within the liver and choice of chemotherapy protocol of TACE are none significant factors for patient's survival. What's new? About two‐thirds of colorectal cancer patients develop life‐threatening liver metastases, for which the only potentially curative therapy is resection. But only a small proportion of patients are candidates for resection, and those who undergo resection may suffer from intrahepatic recurrence. Here, transarterial chemoembolization (TACE), a minimally invasive procedure, was explored for colorectal cancer liver metastases. TACE was performed repeatedly for each of more than 560 patients. Following treatment, 48.2 percent of patients had stable disease, and the 1‐year survival rate was 62 percent. Initial tumor response was a significant prognostic factor for patient survival after TACE.
    Keywords: Chemoembolization ; Liver Metastases ; Colorectal Cancer
    ISSN: 0020-7136
    E-ISSN: 1097-0215
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 4
    Language: English
    In: Skeletal Radiology, 2014, Vol.43(4), pp.493-498
    Description: Our goal was to assess the technical results in patients who underwent long-axis sacroplasty for the treatment of sacral insufficiency fractures (SIF) by radiofrequency-induced high-viscosity bone cement augmentation. Twelve patients with bilateral sacral fractures were treated by augmentation with radiofrequency-activated, high-viscosity polymethylmethacrylate (PMMA) bone cement under local anesthesia. CT-guided sacroplasty was performed by using a long-axis approach through a single entry point. Thirty-six vertebrae were treated in 12 sessions under a combination of CT and fluoroscopic guidance using a bilateral access and a cavity-creating osteotome prior to remote-controlled, hydraulically driven cement injection. The visual analogue scale (VAS) score before sacroplasty and at 1 and 3 months after the treatment was obtained. PMMA leaks were evaluated retrospectively using the post-interventional CT. The mean amount of high-viscosity PMMA injected per patient was 7.8 ml. No major adverse events were observed. In the first 4 days after the procedure, the mean VAS score decreased from 8.1 ± 1.9 to mean 3.1 ± 1.2 and was followed by a gradual but continuous decrease throughout the rest of the follow-up period at 24 weeks (mean 2.2 ± 1.1) and 48 weeks (mean 2.1 ± 1.4). CT fluoroscopy-guided sacral augmentation was safe and effective in all 12 patients with osteoporotic SIF.
    Keywords: Sacroplasty ; Radiofrequency ; Osteoporosis
    ISSN: 0364-2348
    E-ISSN: 1432-2161
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 5
    Language: English
    In: European Journal of Radiology, December 2013, Vol.82(12), pp.e816-e822
    Description: Evaluation of the efficacy and tolerability of transarterial chemoembolization with gemcitabine in patients with inoperable liver metastases of breast cancer. Open-label, prospective non-randomized single-center study design; patients had previous chemotherapy including anthracyclines and/or taxanes in the metastatic setting, adequate bone marrow reserve, sufficient liver/renal function, no centralnervous system metastases, Karnovsky-performance-status 〉70%, and life expectancy 〉12 weeks. Forty-three patients were enrolled (median 58 years, range 48–71). A suspension of gemcitabine 1.200 mg/m , 2–10 ml/m of Lipiodol, and 5 ml of a degradable starch microsphere (Embocept) suspension, were administered intra-arterially up to 3 times with a 4-weaks-interval. Dose-limiting toxicit is defined as grade 4 thrombocytopenia, neutropenia, or nonhematologic toxicity 〉 grade 3. Tumor response was evaluated by magnetic resonance (MRI) and computed tomography (CT) imaging. All patients tolerated the treatment well; with no dose limiting toxicities. Imaging follow-up according to the RECIST-criteria (Response Evaluation Criteria in Solid Tumors) revealed a partial response in 3 patients, stable disease in 16 patients and progression in 22 patients. The progression free survival was 3.3 months. A significant correlation exists only with the factor vascularization: strongly vascularized tumors show a significantly lowered response. Patients with complete or partial response and the main fraction of the stable disease group showed in the MRI and angiography only a moderate vascularization. The resulting estimate of the total survival rate amounts to a median of 10.2 months. Transarterial chemoembolization with gemcitabine is well tolerated and provides an alternative treatment method for patients with liver metastases of breast cancer.
    Keywords: Transarterial Chemoembolization ; Liver Metastases ; Breast Cancer ; Medicine
    ISSN: 0720-048X
    E-ISSN: 1872-7727
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 6
    Language: English
    In: European radiology, March 2013, Vol.23(3), pp.797-804
    Description: The liver is involved in about half of patients with metastatic breast cancer. Unfortunately systemic chemotherapy as the treatment of choice is limited. Due to multifocality and/or insufficient remnant liver volume, the majority of liver metastases are also unresectable. Currently, thermal ablations are used in these patients with acceptable impact. We reviewed studies on radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MWA) regarding local tumour response, progression and survival indexes in patients with breast cancer liver metastases (BCLM). The reviewed literature showed positive response rates of 63 % to 97 % in RF-ablated lesions, 98.2 % in LITT-treated lesions and 34.5-62.5 % in MW-ablated lesions. Median survival was 10.9-60 months using RFA, 51-54 months after LITT and 41.8 months using MWA. Five-year survival rates were 27-30 %, 35 % and 29 %, respectively. Local tumour progression ranged from 13.5 % to 58 % using RFA, 2.9 % with LITT and 9.6 % with MWA. The reviewed literature demonstrated that ablation therapies either as single therapy or combined with other locoregional therapies are a good alternative as an adjunction to resection in patients with resectable lesions or with positive response using chemotherapy. However, multicentre randomised studies should be conducted to obtain further evidence of the benefits of these treatments in patients with BCLM.
    Keywords: Ablation Techniques -- Mortality ; Breast Neoplasms -- Surgery ; Hyperthermia, Induced -- Mortality ; Liver Neoplasms -- Secondary
    ISSN: 09387994
    E-ISSN: 1432-1084
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 7
  • 8
    Language: English
    In: Visceral Medicine, October 2012, Vol.28(5), pp.317-323
    Description: Hintergrund: Lange Wartezeiten vor einer Lebertransplantation führen bei Patienten mit hepatozellulärem Karzinom (HCC) aufgrund eines Tumorprogresses zunehmend zu einem Ausschluss von der Transplantationsliste und damit auch zu einem reduzierten Langzeitüberleben. Methode und Ergebnisse: Aus diesem Grund werden heute verschiedene lokale Therapien wie die transarterielle Chemoembolisation (TACE) und verschiedene lokal ablative Verfahren einschließlich der perkutanen Alkoholinjektion (PEI), der Radiofrequenzablation (RFA), der MR-gesteuerten Laserablation (LITT) und der Mikrowellenablation (MWA) zum Bridging vor einer Lebertransplantation eingesetzt. Die Auswahl der geeigneten Verfahren ist hierbei abhängig von der Anwendbarkeit, den Limitationen und den spezifischen Risiken der verschiedenen Techniken. Insbesondere das Management von HCC-Patienten mit Leberzirrhose ist komplex, sodass die Auswahl der therapeutischen Maßnahmen interdisziplinär abgestimmt werden sollte. Schlussfolgerung: Auch wenn für die Bridging-Therapien derzeit keine evidenzbasierten Daten vorliegen, zeigen sich die verschiedenen interventionellen Therapien als vielversprechende therapeutische Optionen zum Bridging vor einer Lebertransplantation.
    Keywords: Hauptthema · Main Topic
    ISBN: 9783318021004
    ISBN: 3318021008
    ISSN: 2297-4725
    ISSN: 16626664
    E-ISSN: 2297-475X
    E-ISSN: 16626672
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 9
    Language: English
    In: Visceral Medicine, April 2016, Vol.32(2), pp.116-120
    Description: Background: Hepatocellular carcinoma (HCC) is a frequent complication of liver cirrhosis. Worldwide, HCC is one of the most common cancers, with a rising incidence. Methods: A selective literature search was conducted, taking into account current studies, reviews, meta-analyses, and guidelines. Results: The diagnosis is established either non-invasively by dynamic imaging, showing a typical contrast enhancement and wash-out, or histopathologically. Pathological diagnosis of HCC is recommended for all atypical nodules in patients with cirrhosis and for those in non-cirrhotic patients. Tumor therapy as well as treatment of the underlying chronic liver disease and/or preservation of liver function are important for the management of patients with HCC. Standard stage-adapted treatments are based on the widely applied Barcelona Clinic Liver Cancer staging system including liver resection and transplantation, interventional treatments such as thermal ablation and transarterial therapies, and systemic treatment with the tyrosine kinase inhibitor sorafenib. After failure of sorafenib, anti-angiogenic drugs, MET inhibitors, and immunotherapeutics are currently under advanced clinical investigation. Conclusion: Treatment of HCC is multidisciplinary and therefore requires a close cooperation between various disciplines such as hepatology, visceral surgery, radiology, and oncology to achieve the best outcome depending on the tumor stage and degree of liver function impairment.
    Keywords: Review Article ; Hepatocellular Carcinoma ; Liver Cirrhosis ; Resection ; Transplantation ; Interventional Treatment ; Systemic Therapy
    ISBN: 9783318058079
    ISBN: 3318058076
    ISSN: 2297-4725
    E-ISSN: 2297-475X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 10
    Language: English
    In: Radiology, June 2011, Vol.259(3), pp.903-10
    Description: To examine the feasibility and safety of magnetic resonance (MR)-guided biopsy by using a transgluteal approach in patients with suspicious prostate lesions by using an MR-compatible robotic system and a 1.5-T MR system. The study was approved by the institutional review board of University Frankfurt, and informed consent was obtained from each patient. A total of 20 patients (age range, 57.8-71.9 years; mean age, 65.1 years) underwent biopsy in a closed-bore high-field-strength MR system. Biopsy was performed with an MR-compatible pneumatically driven robotic system. T1-weighted gradient-echo fast low-angle shot and T2-weighted true fast imaging with steady-state precession sequences were used to plan and guide the intervention with a transgluteal access on the external planning computer of the assistance system. The system calculated the trajectory and then moved the guiding arm to the insertion point. The cannula was advanced manually, and biopsies were performed with the coaxial technique by using a 15-gauge pencil tip needle. Intervention time, complications, and biopsy findings were documented. The MR-compatible robotic system did not interfere with image quality, nor did MR imaging cause dysfunction of the robot. In one patient, the interventionist caused a fail-safe system shutdown. This was due to inadvertent displacement of the guiding arm during cannula insertion. This problem was solved by increasing the displacement threshold. Accurate coaxial cannula biopsy could be performed in all subsequent patients. Sufficient histopathologic assessment was performed in 19 patients. Insufficient material was retrieved in the patient who experienced fail-safe system shutdown. The median intervention time was 39 minutes (23-65 minutes). No procedure-related complications were observed. Preliminary results indicate that MR-guided robot-assisted biopsy is feasible and can be performed safely with highly accurate cannula placement.
    Keywords: Biopsy, Needle -- Instrumentation ; Magnetic Resonance Imaging, Interventional -- Instrumentation ; Prostatic Neoplasms -- Diagnosis ; Robotics -- Instrumentation
    ISSN: 00338419
    E-ISSN: 1527-1315
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages