1.
Early prediction of therapy outcome in patients with high-risk soft tissue sarcoma using positron emission tomography.
Kasper, B, Dietrich, S, Dimitrakopoulou-Strauss, A, Strauss, LG, Haberkorn, U, Ho, AD, Egerer, G
Onkologie. 2008;(3):107-12
Abstract
BACKGROUND We used 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) positron emission tomography (PET) to evaluate the FDG uptake in patients with soft tissue sarcoma (STS). Treatment effect was assessed with regard to prediction of therapy outcome. PATIENTS AND METHODS The ongoing evaluation includes 27 patients with high-risk STS receiving chemotherapy consisting of doxorubicin and ifosfamide (AI-G regimen), or etoposide, ifosfamide and doxorubicin (EIA regimen). Patients were examined using PET prior to onset of therapy, and after completion of the first cycle of AI-G and after 2 cycles of EIA chemotherapy, respectively. Restaging according to RECIST was performed after 6 cycles of AI-G or 4 cycles of EIA chemotherapy and served as reference. RESULTS Clinical outcome of 27 evaluable patients was as follows: 2 patients with no evidence of disease, 7 with partial remission, 14 with stable disease, and 4 patients with progressive disease. A significant difference of the progression-free survival for patients with a decrease in the standardised uptake value (SUV; responders) in comparison to patients with an increase or stable SUV (non-responders) could be demonstrated (p = 0.0187). CONCLUSION On the basis of these data, prediction of chemo-sensitivity of the tumour and moreover of the therapy outcome might be possible.
2.
The impact of prior multidisciplinary predialysis care on mineral metabolic control among chronic hemodialysis patients.
Friedman, O, Wald, R, Goldstein, MB
Nephron. Clinical practice. 2008;(4):c229-34
Abstract
BACKGROUND/AIMS: Disordered mineral metabolism is independently associated with mortality among chronic dialysis patients. We hypothesized that, upon dialysis start, biochemical markers of mineral metabolism would be better controlled among patients who had received multidisciplinary predialysis care (MDC). METHODS We conducted a retrospective cohort study of incident hemodialysis patients between 2002 and 2005. Corrected calcium (Ca), phosphate (P), calcium-phosphate product (CaxP), and intact parathyroid hormone (iPTH) at the time of dialysis initiation and over the first year thereafter were compared based on prior MDC receipt. Furthermore, we examined the relationship between the duration of MDC and mineral metabolic parameters. RESULTS 67 patients received MDC and 84 patients received conventional or no nephrologist-based care. Patients who received MDC had a higher iPTH (p = 0.03) both at dialysis initiation and over the subsequent year while Ca, P, and CaxP were not significantly impacted. Among patients who received MDC, mineral metabolic values at dialysis initiation did not differ by duration of predialysis care. CONCLUSIONS The receipt of MDC had a limited effect on mineral metabolic profiles at the time of and over the first year following chronic hemodialysis initiation. The survival benefits associated with the receipt of MDC may be mediated by mechanisms other than improved mineral metabolic control.
3.
A clinical risk score to predict the time to first appropriate device therapy in recipients of implantable cardioverter defibrillators.
Hreybe, H, Saba, S
Pacing and clinical electrophysiology : PACE. 2007;(3):385-9
Abstract
BACKGROUND To develop a risk score to predict the occurrence of appropriate defibrillator [implantable cardioverter-defibrillator (ICD)] therapies. A simple clinical score predicting the risk of appropriate ICD therapy is lacking. METHODS A Cox regression model was developed from a database of ICD patients at a single tertiary center to predict the time to appropriate ICD therapy defined as shock or antitachycardia pacing. A risk score was derived from this model using half of the database and was validated using the other half. RESULTS A total of 399 patients were entered into the database between July 2001 and February 2004. There were no statistically significant differences between the derivation (n = 200) and validation (n = 199) groups in any of the demographic or clinical variables recorded. The risk score included three independent variables: indication for ICD implantation (P = 0.03), serum creatinine level (P = 0.015), and QRS width (P = 0.028). The observed risk scores were highly predictive of time to ICD therapy in the validation group (P = 0.02). CONCLUSION We describe a new clinical risk score that predicts the time to appropriate device therapy in ICD recipients of a single tertiary center hospital. The performance of this risk score needs to be investigated prospectively in a larger patient population.