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[PMID]:29361628
[Au] Autor:Okamoto S; Tanaka M; Goto T; Nakashima M; Nagura E
[Ad] Endereço:Dept. of Hematology, Chutoen General Medical Center.
[Ti] Título:[Clinical Analysis of Combination Chemotherapy Using High Dose Methotrexate, Rituximab, and Vincristine with or without Procarbazine for Elderly Patients with Diffuse Large B-Cell Lymphoma of the Central Nervous System].
[So] Source:Gan To Kagaku Ryoho;44(13):2109-2112, 2017 Dec.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We studied the clinical effects of high-dose methotrexate(HD-MTX)combined with rituximab and vincristine in 5 elderly patients, aged 65-83 years, with diffuse large B-cell lymphoma of the central nervous system(DLBCL CNS). Patients aged 65- 71 years were given 3.0 g/m2 of HD-MTX, while patients aged 75-83 years were given 1.5 g/m2 of the drug. All patients showed responses; 1 CR and 1 PR in MTX 3.0 g/m2 group, and 2 CRs and 1 PR in MTX 1.5 g/m2 group.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias do Sistema Nervoso Central/tratamento farmacológico
Linfoma Difuso de Grandes Células B/tratamento farmacológico
Procarbazina/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Neoplasias do Sistema Nervoso Central/patologia
Feminino
Seres Humanos
Masculino
Metotrexato/administração & dosagem
Rituximab/administração & dosagem
Resultado do Tratamento
Vincristina/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
35S93Y190K (Procarbazine); 4F4X42SYQ6 (Rituximab); 5J49Q6B70F (Vincristine); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


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[PMID]:28888722
[Au] Autor:Krul IM; Opstal-van Winden AWJ; Aleman BMP; Janus CPM; van Eggermond AM; De Bruin ML; Hauptmann M; Krol ADG; Schaapveld M; Broeks A; Kooijman KR; Fase S; Lybeert ML; Zijlstra JM; van der Maazen RWM; Kesminiene A; Diallo I; de Vathaire F; Russell NS; van Leeuwen FE
[Ad] Endereço:Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
[Ti] Título:Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma: Influence of Gonadal Hormone Exposure.
[So] Source:Int J Radiat Oncol Biol Phys;99(4):843-853, 2017 Nov 15.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Young women treated with chest radiation therapy (RT) for Hodgkin lymphoma (HL) experience a strongly increased risk of breast cancer (BC). It is unknown whether endogenous and exogenous gonadal hormones affect RT-associated BC risk. METHODS: We conducted a nested case-control study among female 5-year HL survivors treated before age 41. Hormone exposure and HL treatment data were collected through medical records and questionnaires for 174 BC case patients and 466 control patients. Radiation dose to breast tumor location was estimated based on RT charts, simulation films, and mammography reports. RESULTS: We observed a linear radiation dose-response curve with an adjusted excess odds ratio (EOR) of 6.1%/Gy (95% confidence interval [CI]: 2.1%-15.4%). Women with menopause <30 years (caused by high-dose procarbazine or pelvic RT) had a lower BC risk (OR, 0.13; 95% CI, 0.03-0.51) than did women with menopause ≥50 years. BC risk increased by 6.4% per additional year of post-RT intact ovarian function (P<.001). Among women with early menopause (<45 years), hormone replacement therapy (HRT) use for ≥2 years did not increase BC risk (OR, 0.86; 95% CI, 0.32-2.32), whereas this risk was nonsignificantly increased among women without early menopause (OR, 3.69; 95% CI, 0.97-14.0; P for interaction: .06). Stratification by duration of post-RT intact ovarian function or HRT use did not statistically significantly modify the radiation dose-response curve. CONCLUSIONS: BC risk in female HL survivors increases linearly with radiation dose. HRT does not appear to increase BC risk for HL survivors with therapy-induced early menopause. There are no indications that endogenous and exogenous gonadal hormones affect the radiation dose-response relationship.
[Mh] Termos MeSH primário: Neoplasias da Mama/etiologia
Mama/efeitos da radiação
Hormônios Esteroides Gonadais
Doença de Hodgkin/radioterapia
Neoplasias Induzidas por Radiação/etiologia
[Mh] Termos MeSH secundário: Adulto
Antineoplásicos/efeitos adversos
Antineoplásicos Alquilantes/efeitos adversos
Antineoplásicos Alquilantes/uso terapêutico
Mama/efeitos dos fármacos
Carcinoma Intraductal não Infiltrante/etiologia
Estudos de Casos e Controles
Intervalos de Confiança
Relação Dose-Resposta à Radiação
Feminino
Hormônios Esteroides Gonadais/farmacologia
Hormônios Esteroides Gonadais/fisiologia
Doença de Hodgkin/tratamento farmacológico
Terapia de Reposição Hormonal/efeitos adversos
Seres Humanos
Menopausa Precoce
Meia-Idade
Países Baixos
Ovário/fisiologia
Procarbazina/efeitos adversos
Dosagem Radioterapêutica
Fatores de Risco
Sobreviventes
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Antineoplastic Agents, Alkylating); 0 (Gonadal Steroid Hormones); 35S93Y190K (Procarbazine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170911
[St] Status:MEDLINE


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[PMID]:28632726
[Au] Autor:van Eggermond AM; Schaapveld M; Janus CP; de Boer JP; Krol AD; Zijlstra JM; van der Maazen RW; Kremer LC; van Leerdam ME; Louwman MW; Visser O; De Bruin ML; Aleman BM; van Leeuwen FE
[Ad] Endereço:Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066 CX, The Netherlands.
[Ti] Título:Infradiaphragmatic irradiation and high procarbazine doses increase colorectal cancer risk in Hodgkin lymphoma survivors.
[So] Source:Br J Cancer;117(3):306-314, 2017 Jul 25.
[Is] ISSN:1532-1827
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hodgkin lymphoma (HL) survivors are at increased risk of second malignancies, but few studies have assessed colorectal cancer (CRC) risk after HL treatment. We assessed long-term, subsite-specific CRC risk associated with specific radiation fields and chemotherapy regimens. METHODS: In a Dutch cohort of 3121 5-year HL survivors treated between 1965 and 1995, subsite-specific CRC incidence was compared with general population rates. Treatment effects were quantified by Cox regression analyses. RESULTS: After a median follow-up of 22.9 years, 55 patients developed CRC. The standardized incidence ratios (SIR) was 2.4-fold increased (95% confidence interval (95%CI) 1.8-3.2), leading to 5.7 excess cases per 10 000 patient-years. Risk was still increased 30 years after HL treatment (SIR: 2.8; 95%CI: 1.6-4.6). The highest (SIR: 6.5, 95%CI: 3.3-11.3) was seen for transverse colon cancer (15.0 (95%CI: 4.3-40.8) after inverted-Y irradiation). A prescribed cumulative procarbazine dose >4.2 g m was associated with a 3.3-fold higher CRC risk (95%CI: 1.8-6.1) compared to treatment without procarbazine. Patients receiving >4.2 g m procarbazine and infradiaphragmatic radiotherapy had a hazard ratio of 6.8 (95%CI: 3.0-15.6) compared with patients receiving neither treatment, which is significantly higher than an additive joint effect (P =0.004). CONCLUSIONS: Colorectal cancer surveillance should be considered for HL survivors who received Infradiaphragmatic radiotherapy and a high cumulative procarbazine dose.
[Mh] Termos MeSH primário: Antineoplásicos/administração & dosagem
Colo
Neoplasias Colorretais/epidemiologia
Doença de Hodgkin/tratamento farmacológico
Doença de Hodgkin/radioterapia
Neoplasias Induzidas por Radiação/epidemiologia
Segunda Neoplasia Primária/epidemiologia
Procarbazina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Bleomicina/uso terapêutico
Neoplasias Colorretais/etiologia
Diafragma
Doxorrubicina/uso terapêutico
Feminino
Seguimentos
Seres Humanos
Masculino
Mecloretamina/uso terapêutico
Meia-Idade
Neoplasias Induzidas por Radiação/etiologia
Segunda Neoplasia Primária/etiologia
Países Baixos/epidemiologia
Prednisona/uso terapêutico
Procarbazina/uso terapêutico
Reto
Fatores de Risco
Sobreviventes
Vimblastina/uso terapêutico
Vincristina/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 50D9XSG0VR (Mechlorethamine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 80168379AG (Doxorubicin); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1038/bjc.2017.177


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[PMID]:28601705
[Au] Autor:Fermé C; Thomas J; Brice P; Casasnovas O; Vranovsky A; Bologna S; Lugtenburg PJ; Bouabdallah R; Carde P; Sebban C; Eghbali H; Salles G; van Imhoff GW; Thyss A; Noordijk EM; Reman O; Lybeert MLM; Janvier M; Spina M; Audhuy B; Raemaekers JMM; Delarue R; Anglaret B; de Weerdt O; Marjanovic Z; Tersteeg RJHA; de Jong D; Brière J; Henry-Amar M; European Organisation for Research and Treatment of Cancer Lymphoma Group, and; Groupe d'Étude des Lymphomes de l'Adulte
[Ad] Endereço:Gustave Roussy, 114 Rue Édouard Vaillant, 94805 Villejuif Cedex, France.
[Ti] Título:ABVD or BEACOPP along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Étude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial.
[So] Source:Eur J Cancer;81:45-55, 2017 Aug.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: For early-stage Hodgkin lymphoma (HL), optimal chemotherapy regimen and the number of cycles to be delivered remain to settle down. The H9-U trial compared three modalities of chemotherapy followed by involved-field radiotherapy (IFRT) in patients with stage I-II HL and risk factors (NCT00005584). PATIENTS AND METHODS: Patients aged 15-70 years with untreated supradiaphragmatic HL with at least one risk factor (age ≥ 50, involvement of 4-5 nodal areas, mediastinum/thoracic ratio ≥ 0.35, erythrocyte sedimentation rate (ESR) ≥ 50 without B-symptoms or ESR ≥ 30 and B-symptoms) were eligible for the randomised, open label, multicentre, non-inferiority H9-U trial. The limit of non-inferiority was set at 10% for the difference between 5-year event-free survival (EFS) estimates. From October 1998 to September 2002, 808 patients were randomised to receive either the control arm 6-ABVD-IFRT (n = 276), or one of the two experimental arms: 4-ABVD-IFRT (n = 277) or 4-BEACOPP -IFRT (n = 255). RESULTS: Results in the 4-ABVD-IFRT (5-year EFS, 85.9%) and the 4-BEACOPP -IFRT (5-year EFS, 88.8%) were not inferior to 6-ABVD-IFRT (5-year EFS, 89.9%): difference of 4.0% (90%CI, -0.7%-8.8%) and of 1.1% (90%CI,-3.5%-5.6%) respectively. The 5-year overall survival estimates were 94%, 93%, and 93%, respectively. Patients treated with combined modality treatment chemotherapeutic regimen comprising doxorubicin (Adriamycin), bleomycin, vincristine (Oncovin), cyclophosphamide, procarbazine, etoposide and prednisone (BEACOPP) more often developed serious adverse events requiring supportive measures and hospitalisation compared with patients receiving the chemotherapeutic regimen comprising doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD). CONCLUSIONS: The trial demonstrates that 4-ABVD followed by IFRT yields high disease control in patients with early-stage HL and risk factors responding to chemotherapy. Although non-inferior in terms of efficacy, four cycles of BEACOPP were more toxic than four or six cycles of ABVD.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/tratamento farmacológico
Doença de Hodgkin/radioterapia
Radioterapia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Bleomicina/administração & dosagem
Terapia Combinada
Ciclofosfamida/administração & dosagem
Dacarbazina/administração & dosagem
Doxorrubicina/administração & dosagem
Etoposídeo/administração & dosagem
Feminino
Doença de Hodgkin/mortalidade
Seres Humanos
Masculino
Meia-Idade
Prednisona/administração & dosagem
Procarbazina/administração & dosagem
Fatores de Risco
Análise de Sobrevida
Vimblastina/administração & dosagem
Vincristina/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE


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[PMID]:28589704
[Au] Autor:Dann EJ; Bairey O; Bar-Shalom R; Mashiach T; Barzilai E; Kornberg A; Akria L; Tadmor T; Filanovsky K; Abadi U; Kagna O; Ruchlemer R; Abdah-Bortnyak R; Goldschmidt N; Epelbaum R; Horowitz NA; Lavie D; Ben-Yehuda D; Shpilberg O; Paltiel O
[Ad] Endereço:Rambam Health Care Campus, Haifa, Israel.
[Ti] Título:Modification of initial therapy in early and advanced Hodgkin lymphoma, based on interim PET/CT is beneficial: a prospective multicentre trial of 355 patients.
[So] Source:Br J Haematol;178(5):709-718, 2017 Sep.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This multicentre study evaluated 5-year progression-free (PFS) and overall survival (OS) in early and advanced Hodgkin lymphoma (HL), where therapy was individualized based on initial prognostic factors and positron emission tomography-computed tomography performed after two cycles (PET-2). Between September 2006 and August 2013, 359 patients aged 18-60 years, were recruited in nine Israeli centres. Early-HL patients initially received ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) ×2. Depending on initial unfavourable prognostic features, PET-2-positive patients received additional ABVD followed by involved-site radiotherapy (ISRT). Patients with negative PET-2 and favourable disease received ISRT or ABVD ×2; those with unfavourable disease received ABVD ×2 with ISRT or, alternatively, ABVD ×4. Advanced-HL patients initially received ABVD ×2 or escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone; EB) ×2 based on their international prognostic score (≤2 or ≥3). PET-2-negative patients further received ABVD ×4; PET-2-positive patients received EB ×4 and ISRT to residual masses. With a median follow-up of 55 (13-119) months, 5-year PFS was 91% and 69% for PET-2-negative and positive early-HL, respectively; 5-year OS was 100% and 95%, respectively. For advanced-HL, the PFS was 81% and 68%, respectively (P = 0·08); 5-year OS was 98% and 91%, respectively. PET-2 positivity is associated with inferior prognosis in early-HL, even with additional ABVD and ISRT. Advanced-HL patients benefit from therapy escalation following positive PET-2. EB can be safely de-escalated to ABVD in PET-2-negative patients.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Bleomicina/administração & dosagem
Bleomicina/efeitos adversos
Ciclofosfamida/administração & dosagem
Ciclofosfamida/efeitos adversos
Dacarbazina/administração & dosagem
Dacarbazina/efeitos adversos
Doxorrubicina/administração & dosagem
Doxorrubicina/efeitos adversos
Esquema de Medicação
Monitoramento de Medicamentos/métodos
Etoposídeo/administração & dosagem
Etoposídeo/efeitos adversos
Feminino
Doença de Hodgkin/diagnóstico por imagem
Doença de Hodgkin/patologia
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Estadiamento de Neoplasias
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
Prednisona/administração & dosagem
Prednisona/efeitos adversos
Procarbazina/administração & dosagem
Procarbazina/efeitos adversos
Prognóstico
Estudos Prospectivos
Radioterapia Adjuvante
Vimblastina/administração & dosagem
Vimblastina/efeitos adversos
Vincristina/administração & dosagem
Vincristina/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.14734


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[PMID]:28541603
[Au] Autor:Skoetz N; Will A; Monsef I; Brillant C; Engert A; von Tresckow B
[Ad] Endereço:Cochrane Haematological Malignancies Group, Department I of Internal Medicine, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany, 50937.
[Ti] Título:Comparison of first-line chemotherapy including escalated BEACOPP versus chemotherapy including ABVD for people with early unfavourable or advanced stage Hodgkin lymphoma.
[So] Source:Cochrane Database Syst Rev;5:CD007941, 2017 05 25.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are two different international standards for the treatment of early unfavourable and advanced stage Hodgkin lymphoma (HL): chemotherapy with escalated BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone) regimen and chemotherapy with ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) regimen. OBJECTIVES: To determine the advantages and disadvantages of chemotherapy including escalated BEACOPP compared to chemotherapy including ABVD in the treatment of early unfavourable or advanced stage HL as first-line treatment. SEARCH METHODS: We searched for randomised controlled trials in MEDLINE, CENTRAL and conference proceedings (January 1985 to July 2013 and for the update to March 2017) and Embase (1985 to November 2008). Moreover we searched trial registries (March 2017; www.controlled-trials.com, www.clinicaltrialsregister.eu/ctr-search/search, clinicaltrials.gov, www.eortc.be, www.ghsg.org, www.ctc.usyd.edu.au, www.trialscentral.org/index.html) SELECTION CRITERIA: We included randomised controlled trials examining chemotherapy including at least two cycles of escalated BEACOPP regimens compared with chemotherapy including at least four cycles of ABVD regimens as first-line treatment for patients with early unfavourable stage or advanced stage HL. DATA COLLECTION AND ANALYSIS: The effect measures we used were hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS) and freedom from first progression.We used risk ratios (RRs) relative risks to analyse harms: treatment-related mortality, secondary malignancies (including myeloid dysplastic syndrome (MDS) or acute myeloid leukaemia (AML)), infertility and adverse events.Quality of life was not reported in any trial, therefore not analysed. Two review authors independently extracted data and assessed quality of trials. MAIN RESULTS: We screened 1796 records and identified five eligible trials in total i.e. one trial could be added on the previous review. These trials included only adults (16 to 65 years of age). We included all five trials with 3427 people in the meta-analyses: the HD9 and HD14 trials were co-ordinated in Germany, the HD2000 and GSM-HD trials were performed in Italy and the EORTC 20012 was conducted in Belgium. The overall risk of performance and detection bias was low for overall survival (OS), but was high for other outcomes, as therapy blinding was not feasible. The remaining 'Risk of bias' domains were low and unclear.All trials reported results for OS and progression-free survival (PFS). In contrast to the our first published review (2011) the addition of results from the EORTC 20012 BEACOPP escalated increases OS (3142 participants; HR 0.74 (95% confidence interval (CI) 0.57 to 0.97; high-quality evidence). This means that only 90 (70 to 117) patients will die after five years in the BEACOPP escalated arm compared to 120 in the ABVD arm. This survival advantage is also reflected in an increased PFS with BEACOPP escalated (3142 participants; HR 0.54 (95% CI 0.45 to 0.64); moderate-quality evidence), meaning that after five years only 144 (121 to 168) patients will experience a progress, relapse or death in the BEACOPP escalated arm compared to 250 in the ABVD arm.There is no evidence for a difference for treatment-related mortality (2700 participants, RR 2.15 (95% CI = 0.93 to 4.95), low-quality evidence).Although the occurrence of MDS or AML may increase with BEACOPP escalated (3332 participants, RR 3.90 (95% CI 1.36 to 11.21); low-quality evidence)), there is no evidence for a difference between both regimens for overall secondary malignancies (3332 participants, RR 1.00 (95% CI 0.68 to 1.48), low-quality evidence). However, the observation time of the studies included in the review is too short to be expected to demonstrate differences with respect to second solid tumours which would not be expected to show significance until around 15 years after treatment.We are very uncertain how many female patients will be infertile due to chemotherapy and which arm might be favoured (106 participants, RR 1.37 (95% CI 0.83 to 2.26), very low-quality evidence). This is a very small sample, and the age of the patients was not detailed. No analysis of male fertility was provided.Five trials reported adverse events and the analysis shows that the escalated BEACOPP regimens probably causes more haematological toxicities WHO grade III or IV ((anaemia: 2425 participants, RR 10.67 (95% CI 7.14 to 15.93); neutropenia: 519 participants, RR 1.80 (95% CI 1.52 to 2.13); thrombocytopenia: 2425 participants, RR 18.12 (95% CI 11.77 to 27.92); infections: 2425 participants, RR 3.73 (95% CI 2.58 to 5.38), all low-quality evidence).Only one trial (EORTC 20012) planned to assess quality of life, however, no results were reported. AUTHORS' CONCLUSIONS: This meta-analysis provides moderate- to high-quality evidence that adult patients between 16 and 60 years of age with early unfavourable and advanced stage HL benefit regarding OS and PFS from first-line chemotherapy including escalated BEACOPP. The proven benefit in OS for patients with advanced HL is a new finding of this updated review due to the inclusion of the results from the EORTC 20012 trial. Furthermore, there is only low-quality evidence of a difference in the total number of secondary malignancies, as the follow-up period might be too short to detect meaningful differences. Low-quality evidence also suggests that people treated with escalated BEACOPP may have a higher risk to develop secondary AML or MDS. Due to the availability of only very low-quality evidence available, we are unable to come to a conclusion in terms of infertility. This review does for the first time suggest a survival benefit. However, it is clear from this review that BEACOPP escalated may be more toxic that ABVD, and very important long-term side effects of second malignancies and infertility have not been sufficiently analysed yet.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Bleomicina/administração & dosagem
Bleomicina/efeitos adversos
Ciclofosfamida/administração & dosagem
Ciclofosfamida/efeitos adversos
Dacarbazina/administração & dosagem
Dacarbazina/efeitos adversos
Progressão da Doença
Doxorrubicina/administração & dosagem
Doxorrubicina/efeitos adversos
Etoposídeo/administração & dosagem
Etoposídeo/efeitos adversos
Doença de Hodgkin/mortalidade
Doença de Hodgkin/patologia
Seres Humanos
Meia-Idade
Prednisona/administração & dosagem
Prednisona/efeitos adversos
Procarbazina/administração & dosagem
Procarbazina/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Vimblastina/administração & dosagem
Vimblastina/efeitos adversos
Vincristina/administração & dosagem
Vincristina/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD007941.pub3


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[PMID]:28418763
[Au] Autor:Sasse S; Bröckelmann PJ; Goergen H; Plütschow A; Müller H; Kreissl S; Buerkle C; Borchmann S; Fuchs M; Borchmann P; Diehl V; Engert A
[Ad] Endereço:All authors: German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
[Ti] Título:Long-Term Follow-Up of Contemporary Treatment in Early-Stage Hodgkin Lymphoma: Updated Analyses of the German Hodgkin Study Group HD7, HD8, HD10, and HD11 Trials.
[So] Source:J Clin Oncol;35(18):1999-2007, 2017 Jun 20.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose Combined-modality treatment is widely considered the standard of care in early-stage Hodgkin lymphoma (HL), and treatment intensity has been reduced over the last years. Long-term follow-up is important to judge both efficacy and safety of the different therapies used. Patients and Methods We analyzed updated follow-up data on 4,276 patients treated within the German Hodgkin Study Group trials HD7 and HD10 for early-stage favorable HL and HD8 and HD11 for early-stage unfavorable HL between 1993 and 2003. Results In HD7 (N = 627; median follow-up, 120 months), combined-modality treatment was superior to extended-field radiotherapy (RT), with 15-year progression-free survival (PFS) of 73% versus 52% (hazard ratio [HR], 0.5; 95% CI, 0.3 to 0.6; P < .001), without differences in overall survival (OS). In HD10 (N = 1,190; median follow-up, 98 months), noninferiority of two cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) plus 20 Gy involved-field (IF)-RT to more intensive four cycles of ABVD plus 30 Gy IF-RT was confirmed with 10-year PFS of 87% each (HR, 1.0; 95%, 0.6 to 1.5) and OS of 94% each (HR, 0.9; 95% CI, 0.5 to 1.6), respectively. In both trials, no differences in second neoplasias were observed. In HD8 (N = 1,064; median follow-up, 153 months), noninferiority of involved-field RT to extended-field RT regarding PFS was confirmed (HR, 1.0; 95% CI, 0.8 to 1.2). In HD11 (N = 1,395; median follow-up, 106 months), superiority of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone at baseline over ABVD was not observed. After BEACOPP , 20 Gy IF-RT was noninferior to 30 Gy (10-year PFS, 84% v 84%; HR, 1.0; 95% CI, 0.7 to 1.5). In contrast, PFS was inferior in ABVD-treated patients receiving 20 Gy instead of 30 Gy IF-RT (10-year PFS, 76% v 84%; HR, 1.5; 95% CI, 1.0 to 2.1). No differences in OS or second neoplasias were observed in in both trials. Conclusion Long-term follow-up data of the four randomized trials largely support the current risk-adapted therapeutic strategies in early-stage HL. Nevertheless, continued follow-up is necessary to assess the long-term safety of currently applied therapeutic strategies.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/terapia
Segunda Neoplasia Primária/etiologia
Radioterapia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bleomicina/administração & dosagem
Bleomicina/uso terapêutico
Terapia Combinada
Ciclofosfamida/administração & dosagem
Dacarbazina/uso terapêutico
Intervalo Livre de Doença
Doxorrubicina/administração & dosagem
Doxorrubicina/uso terapêutico
Etoposídeo/administração & dosagem
Feminino
Seguimentos
Alemanha
Doença de Hodgkin/patologia
Seres Humanos
Masculino
Meia-Idade
Estadiamento de Neoplasias
Prednisona/administração & dosagem
Procarbazina/administração & dosagem
Dosagem Radioterapêutica
Taxa de Sobrevida
Fatores de Tempo
Vimblastina/uso terapêutico
Vincristina/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2016.70.9410


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[PMID]:28291393
[Au] Autor:André MPE; Girinsky T; Federico M; Reman O; Fortpied C; Gotti M; Casasnovas O; Brice P; van der Maazen R; Re A; Edeline V; Fermé C; van Imhoff G; Merli F; Bouabdallah R; Sebban C; Specht L; Stamatoullas A; Delarue R; Fiaccadori V; Bellei M; Raveloarivahy T; Versari A; Hutchings M; Meignan M; Raemaekers J
[Ad] Endereço:Marc P.E. André, Université Catholique de Louvain, Yvoir; Catherine Fortpied, Valeria Fiaccadori, and Tiana Raveloarivahy, European Organisation for Research and Treatment of Cancer, Brussels, Belgium; Théodore Girinsky and Christophe Fermé, Institut Gustave Roussy, Villejuif; Oumédaly Reman, Instit
[Ti] Título:Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial.
[So] Source:J Clin Oncol;35(16):1786-1794, 2017 Jun 01.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose Patients who receive combined modality treatment for stage I and II Hodgkin lymphoma (HL) have an excellent outcome. Early response evaluation with positron emission tomography (PET) scan may improve selection of patients who need reduced or more intensive treatments. Methods We performed a randomized trial to evaluate treatment adaptation on the basis of early PET (ePET) after two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in previously untreated-according to European Organisation for Research and Treatment of Cancer criteria favorable (F) and unfavorable (U)-stage I and II HL. The standard arm consisted of ABVD followed by involved-node radiotherapy (INRT), regardless of ePET result. In the experimental arm, ePET-negative patients received ABVD only (noninferiority design), whereas ePET-positive patients switched to two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc) and INRT (superiority design). Primary end point was progression-free survival (PFS). Results Of 1,950 randomly assigned patients, 1,925 received an ePET-361 patients (18.8%) were positive. In ePET-positive patients, 5-year PFS improved from 77.4% for standard ABVD + INRT to 90.6% for intensification to BEACOPPesc + INRT (hazard ratio [HR], 0.42; 95% CI, 0.23 to 0.74; P = .002). In ePET-negative patients, 5-year PFS rates in the F group were 99.0% versus 87.1% (HR, 15.8; 95% CI, 3.8 to 66.1) in favor of ABVD + INRT; the U group, 92.1% versus 89.6% (HR, 1.45; 95% CI, 0.8 to 2.5) in favor of ABVD + INRT. For both F and U groups, noninferiority of ABVD only compared with combined modality treatment could not be demonstrated. Conclusion In stage I and II HL, PET response after two cycles of ABVD allows for early treatment adaptation. When ePET is positive after two cycles of ABVD, switching to BEACOPPesc + INRT significantly improved 5-year PFS. In ePET-negative patients, noninferiority of ABVD only could not be demonstrated: risk of relapse is increased when INRT is omitted, especially in patients in the F group.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/diagnóstico por imagem
Doença de Hodgkin/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Bleomicina/administração & dosagem
Quimiorradioterapia
Ciclofosfamida/administração & dosagem
Dacarbazina/administração & dosagem
Intervalo Livre de Doença
Doxorrubicina/administração & dosagem
Etoposídeo/administração & dosagem
Feminino
Doença de Hodgkin/patologia
Doença de Hodgkin/radioterapia
Seres Humanos
Masculino
Meia-Idade
Estadiamento de Neoplasias
Tomografia por Emissão de Pósitrons/métodos
Prednisona/administração & dosagem
Procarbazina/administração & dosagem
Taxa de Sobrevida
Vimblastina/administração & dosagem
Vincristina/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2016.68.6394


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[PMID]:28236583
[Au] Autor:Borchmann P; Haverkamp H; Lohri A; Mey U; Kreissl S; Greil R; Markova J; Feuring-Buske M; Meissner J; Dührsen U; Ostermann H; Keller U; Maschmeyer G; Kuhnert G; Dietlein M; Kobe C; Eich H; Baues C; Stein H; Fuchs M; Diehl V; Engert A
[Ad] Endereço:Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany. Electronic address: peter.borchmann@uni-koeln.de.
[Ti] Título:Progression-free survival of early interim PET-positive patients with advanced stage Hodgkin's lymphoma treated with BEACOPP alone or in combination with rituximab (HD18): an open-label, international, randomised phase 3 study by the German Hodgkin Study Group.
[So] Source:Lancet Oncol;18(4):454-463, 2017 Apr.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Advanced stage Hodgkin's lymphoma represents a heterogeneous group of patients with different risk profiles. Data suggests that interim PET assessment during chemotherapy is superior to baseline international prognostic scoring in terms of predicting long-term treatment outcome in patients with Hodgkin's lymphoma. We therefore hypothesised that early interim PET-imaging after two courses of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) might be suitable for guiding treatment in patients with advanced stage Hodgkin's lymphoma. We aimed to assess whether intensifying standard chemotherapy (BEACOPP ) by adding rituximab would improve progression-free survival in patients with positive PET after two courses of chemotherapy. METHODS: In this open-label, international, randomised, phase 3 study, we recruited patients aged 18-60 years with newly diagnosed, advanced stage Hodgkin's lymphoma from 160 hospitals and 77 private practices in Germany, Switzerland, Austria, the Netherlands, and the Czech Republic. Interim PET-imaging was done after two cycles of BEACOPP and centrally assessed by an expert panel. Patients with a positive PET after 2 cycles of BEACOPP chemotherapy (PET-2) were randomly assigned (1:1) to receive six additional courses of either BEACOPP (BEACOPP group) or BEACOPP plus rituximab (R-BEACOPP group). PET-2 was assessed using a 5-point scale with FDG uptake higher than the mediastinal blood pool (corresponding to Deauville scale 3) defined as positive. BEACOPP was given as previously described; rituximab was given intravenously at a dose of 375 mg/m (maximum total dose 700 mg), the first administration starting 24 h before starting the fourth cycle of BEACOPP (day 0 and day 3 in cycle 4, day 1 in cycles 5-8). Randomisation was done centrally and used the minimisation method including a random component, stratified according to centre, age, stage, international prognostic score, and sex. The primary efficacy endpoint was 5 year progression-free survival, analysed in the intention-to-treat population. We are reporting this second planned interim analysis as the final report of the trial. The trial is registered with ClinicalTrials.gov, number NCT00515554. FINDINGS: Between May 14, 2008, and May 31, 2011, we enrolled 1100 patients. 440 patients had a positive PET-2 and were randomly assigned to either the BEACOPP group (n=220) or the R-BEACOPP group (n=220). With a median follow-up of 33 months (IQR 25-42) for progression-free survival, estimated 3 year progression-free survival was 91·4% (95% CI 87·0-95·7) for patients in the BEACOPP group and 93·0% (89·4-96·6) for those in the R-BEACOPP group (difference 1·6%, 95% CI -4·0 to 7·3; log rank p=0·99). Common grade 3-4 adverse events were leucopenia (207 [95%] of 218 patients in the BEACOPP group vs 211 [96%] of 220 patients in the R-BEACOPP group), and severe infections (51 [23%] vs 43 [20%] patients). Based on a futility analysis, the independent data monitoring committee recommended publication of this second planned interim analysis as the final result. Six (3%) of 219 patients in the BEACOPP group and ten (5%) of 220 in the R-BEACOPP group died; fatal treatment-related toxic effects occurred in one (<1%) patient in the BEACOPP group and three (1%) in the R-BEACOPP group, all of them due to infection. INTERPRETATION: The addition of rituximab to BEACOPP did not improve the progression-free survival of PET-2 positive patients with advanced stage Hodgkin's lymphoma. However, progression-free survival for PET-2 positive patients was much better than expected, exceeding even the outcome of PET-2-unselected patients in the previous HD15 trial. Thus, PET-2 cannot identify patients at high-risk for treatment failure in the context of the very effective German Hodgkin Study Group standard treatment for advanced stage Hodgkin's lymphoma. FUNDING: Deutsche Krebshilfe; Swiss State Secretariat for Education, Research and Innovation (SERI); and Roche Pharma.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/mortalidade
Recidiva Local de Neoplasia/mortalidade
Tomografia por Emissão de Pósitrons/métodos
[Mh] Termos MeSH secundário: Adulto
Bleomicina/administração & dosagem
Ciclofosfamida/administração & dosagem
Doxorrubicina/administração & dosagem
Etoposídeo/administração & dosagem
Feminino
Seguimentos
Doença de Hodgkin/diagnóstico por imagem
Doença de Hodgkin/tratamento farmacológico
Doença de Hodgkin/patologia
Seres Humanos
Agências Internacionais
Masculino
Meia-Idade
Recidiva Local de Neoplasia/diagnóstico por imagem
Recidiva Local de Neoplasia/tratamento farmacológico
Recidiva Local de Neoplasia/patologia
Estadiamento de Neoplasias
Prednisona/administração & dosagem
Procarbazina/administração & dosagem
Prognóstico
Rituximab/administração & dosagem
Taxa de Sobrevida
Vincristina/administração & dosagem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 4F4X42SYQ6 (Rituximab); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170608
[Lr] Data última revisão:
170608
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170226
[St] Status:MEDLINE


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[PMID]:28236527
[Au] Autor:Fourati N; Kanoun Belajouza S; Regaieg H; Khlif A; Bouaouina N
[Ad] Endereço:Département de radiothérapie oncologique, CHU Farhat-Hached, Sousse Medina, 4002 Sousse, Tunisie. Electronic address: nejla_fourati@yahoo.fr.
[Ti] Título:[Primary osseous Hodgkin's lymphoma of the sacrum: A diagnostic and therapeutic challenge].
[Ti] Título:Lymphome de Hodgkin primitif osseux de la région sacrée : un défi diagnostique et thérapeutique..
[So] Source:Cancer Radiother;21(1):51-54, 2017 Feb.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Primary osseous Hodgkin's lymphoma is a very rare entity. Cases reported in the literature are limited with often insufficient initial exploration. We report a new case of a 24 years old patient with a diagnosis of primary osseous Hodgkin lymphoma of the lumbosacral region with extension to the soft tissues, without simultaneous lymph node involvement confirmed both by conventional and metabolic imaging. The patient received a combination chemotherapy (two courses BEACOPP and four courses ABVD) followed by radiotherapy of the lombosacral region at the dose of 40Gy in 20 fractions. Fifteen months after the end of treatment, the patient was in complete remission.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Doença de Hodgkin/diagnóstico por imagem
Radioterapia Conformacional/métodos
Sacro/diagnóstico por imagem
Neoplasias da Coluna Vertebral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Biópsia
Bleomicina/administração & dosagem
Terapia Combinada
Ciclofosfamida/administração & dosagem
Dacarbazina/administração & dosagem
Diagnóstico Diferencial
Doxorrubicina/administração & dosagem
Etoposídeo/administração & dosagem
Reações Falso-Negativas
Feminino
Doença de Hodgkin/tratamento farmacológico
Doença de Hodgkin/radioterapia
Seres Humanos
Infertilidade Feminina/prevenção & controle
Dor Lombar/etiologia
Imagem por Ressonância Magnética
Tratamentos com Preservação do Órgão
Osteomielite/diagnóstico
Ovário/cirurgia
Tomografia por Emissão de Pósitrons
Prednisona/administração & dosagem
Procarbazina/administração & dosagem
Indução de Remissão
Neoplasias da Coluna Vertebral/tratamento farmacológico
Neoplasias da Coluna Vertebral/radioterapia
Vimblastina/administração & dosagem
Vincristina/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
11056-06-7 (Bleomycin); 35S93Y190K (Procarbazine); 5J49Q6B70F (Vincristine); 5V9KLZ54CY (Vinblastine); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170226
[St] Status:MEDLINE



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