Therapie der Non-Hodgkin-Lymphome (NHL) von hohem Malignitaetsgrad des Erwachsenenalters Schlussbericht

With the aim to improve the induction polychemotherapy in stage II-IV (Ann Arbor classification) high grade malignant non-Hodgkin lymphoma, the sequential application of two regimens was evaluated (COP-BLAM/IMVP-16 protocol). According to the results of an early restaging evaluation, the switch to the second regimen was performed response-adapted after 3 (in case of partial remission) or 5 (in case of complete remission) cycles of COP-BLAM/IMVP-16. After completion of chemotherapy, patients in complete remission were randomized to receive additional radiotherapy or remain without further treatment. 593 patients were recruited in a multicenter trial, median observation time 55 months. The rate of complete remissions was 60% and the relapse-free and overall survival 57% and 52% after 4 years. There was no prognostic difference between patients randomized to radiotherapy and those followed without. Instead, detailed analyses of prognostic risk revealed that the long-term prognosis was predominantly influenced by the presence of crucial initial parameters. In younger patients with lymphoblastic lymphoma a multiphase regimen was evaluated and a 4-years survival of 44% was achieved. (orig.)SIGLEAvailable from TIB Hannover: F94B0422 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman

Kontrollierbarkeit, Bewaeltigungsverhalten und Krankheitsbewaeltigung bei Patienten mit Non-Hodgkin Lymphomen (NHL) Abschlussbericht

Assuming that processes which help tumor patients overcome their diseases may shift the switches for the long-time success of rehabilitation during the primary treatment stage, the spontaneous recovery efforts made by non-Hodgkin lymphoma patients during first in-patient treatments were observed and investigated. Knowing that various concrete, disease-specific problems and situations must be coped with and solved to successfully overcome cancerous diseases, a prospective sectional study was made where the test persons were interviewed repeatedly over a period of 12 months about the stress situations they perceived and about their reactions while struggling with and evaluating such situations. Emphasis was placed on investigations into problems which patients must cope with when adapting to clinico-therapeutic measures. In addition, the significance of individual personality differences and of objective initial medical features in the struggle to overcome the disease was investigated. The project compares patients suffering from highly malignant lymphomas to patients suffering from less malignant lymphomas while considering differing dispositions to managing the specific requirements and reactions. Efficient ways of coping with the disease were identified by assessing the relative effectiveness of problem- versus emotion-centered recovery strategies as a function of situative moments. For that purpose medical, social and psychological variables which may serve as long-time rehabilitation indicators were collected one year after therapy started at the earliest. The 'naive' behavior in the struggle to overcome the disease during early tumor treatment was investigated for its predictive value as regards the result of rehabilitation. The findings could provide a basis for the development of specific methods of intervention for early application during primary treatment. (orig.)SIGLEAvailable from TIB Hannover: F94B1136+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman

Vergleich einer operativen mit einer konservativen Behandlungsstrategie bei asymptomatischer Stenose der A. carotis interna Abschlussbericht

SIGLEAvailable from TIB Hannover: RR 2802(5)+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman

Wissenschaftler helfen Tschernobyl-Kindern Bericht der Phase I und Anhang zum Bericht der Phase I: 1.4.1993 - 31.3.1996

The bilateral project of Belarus and Germany was commissioned on 1.04.1993 and is placed under the scientific guidance of the Gemeinschaftsausschuss Strahlenforschung. In the framework of the project part devoted to ''therapy and medical training'', covering the period from 1.04.1993 until 31.03.1996, all in all 99 children from Belarus suffering from advanced-stage tumors of the thyroid received a special radio-iodine therapy in Germany. In about 60% of the children complete removal of the tumor was achieved. Another task of the project was to train over the reporting period 41 doctors and physicists from Belarus in the fields of nuclear medical diagnostic evaluation and therapy of thyroid tumors. The project part ''biological dosimetry'' was to investigate the role of micronuclei in peripheral lymphocytes, and whether their presence in the lymphocytes permits to derive information on the radiation dose received even several years after the reactor accident. The scientists also exmained the role of the micronuclei in follow-up examinations of the radio-iodine therapy. Further studies used the relatively large number of tumors in the children, as compared to the literature available until the accident, to examine whether there are specific mutation patterns to be found in tumot suppressor genes (p-53) in thyroid tumors which might be used as indicators revealing radiation-induced onset of tumor growth. The project part ''retrospective dosimetry and risk analysis'' was in charge of detecting information answering the question of whether the release of I-131, suspected to be critical nuclide, really was the cause of enhanced incidence of thyroid tumors in the children. The project part ''coordination and examination center at Minsk'' was to establish and hold available the support required by the GAST project participants. (orig./CB)Am 01.04.1993 wurde ein bilateral weissrussisch-deutsches Projekt begonnen, das unter der wissenschaftlichen Begleitung des Gemeinschaftsausschusses Strahlenforschung stand. Im Rahmen des Teilprojekts 'Therapie und Ausbildung' wurden in der Zeit vom 01.04.1993-31.03.1996 insgesamt 99 Kinder aus Weissrussland mit besonders fortgeschrittenen Formen des Schilddruesenkrebses in Deutschland einer Spezialbehandlung mit Radioiod unterzogen. Bei rund 60% dieser Kinder konnte bisher eine komplette Beseitigung des Schilddruesenkrebses erreicht werden. Im Berichtzeitraum wurden ausserdem insgesamt 41 weissrussische Aerzte und Physiker auf dem Gebiete der nuklearmedizinischen Diagnostik und Therapie des Schilddruesenkarzinoms ausgebildet. Das Teilprojekt 'Biologische Dosimetrie' befasst sich einerseits mit der Frage, ob die Bestimmung von Mikronuklei in peripheren Lymphozyten auch noch mehrere Jahre nach der Reaktorkatastrophe eine Aussage zur Strahlenexposition erlaubt. Ausserdem wurde geprueft, ob Mikronuklei geeignet sind, den Verlauf der Radioiodtherapie im Rahmen der Behandlung von Schilddruesentumoren zu verfolgen. Weiterhin wurde an einer im Vergleich zur vorliegenden Literatur grossen Zahl von kindlichen Tumoren geprueft, ob es spezifische Mutationsmuster in Tumor-Suppressorgenen (p-53) in Schilddruesentumoren gibt, die zum Nachweis der Strahleninduktion dieser Tumoren geeignet sich. Das Teilprojekt 'Retrospektive Dosimetrie und Risikoanalyse' befasste sich vor allem mit der Frage, ob die Vermutung zutrifft, dass die Freisetzung von I-131 bei der Reaktorkatastrophe zur erhoehten Inzidenz von Schilddruesenkarzinomen bei Kindern gefuehrt hat. Das Teilprojekt 'Koordinations- und Untersuchungsstelle Minsk' setzte die Aufgaben einer Dienstleistungsstelle vor Ort fuer alle am GAST-Projekt beteiligten Aktivitaeten um. (orig./MG)SIGLEAvailable from TIB Hannover: RO 2674(1997,29) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekVereinigung Deutscher Elektrizitaetswerke e.V. (VDEW), Frankfurt am Main (Germany)DEGerman