A performance measure for rating the ability of a person to perform usual activities, evaluating a patient's progress after a therapeutic procedure, and determining a patient's suitability for therapy. It is used most commonly in the prognosis of cancer therapy, usually after chemotherapy and customarily administered before and after therapy. It was named for Dr. David A. Karnofsky, an American specialist in cancer chemotherapy.
Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres, basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Primary and metastatic (secondary) tumors of the brain located above the tentorium cerebelli, a fold of dura mater separating the CEREBELLUM and BRAIN STEM from the cerebral hemispheres and DIENCEPHALON (i.e., THALAMUS and HYPOTHALAMUS and related structures). In adults, primary neoplasms tend to arise in the supratentorial compartment, whereas in children they occur more frequently in the infratentorial space. Clinical manifestations vary with the location of the lesion, but SEIZURES; APHASIA; HEMIANOPSIA; hemiparesis; and sensory deficits are relatively common features. Metastatic supratentorial neoplasms are frequently multiple at the time of presentation.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
An antineoplastic agent. It has significant activity against melanomas. (from Martindale, The Extra Pharmacopoeia, 31st ed, p564)
The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form.
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.
A radiological stereotactic technique developed for cutting or destroying tissue by high doses of radiation in place of surgical incisions. It was originally developed for neurosurgery on structures in the brain and its use gradually spread to radiation surgery on extracranial structures as well. The usual rigid needles or probes of stereotactic surgery are replaced with beams of ionizing radiation directed toward a target so as to achieve local tissue destruction.
Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.
Tumors or cancer of the LUNG.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Benign and malignant central nervous system neoplasms derived from glial cells (i.e., astrocytes, oligodendrocytes, and ependymocytes). Astrocytes may give rise to astrocytomas (ASTROCYTOMA) or glioblastoma multiforme (see GLIOBLASTOMA). Oligodendrocytes give rise to oligodendrogliomas (OLIGODENDROGLIOMA) and ependymocytes may undergo transformation to become EPENDYMOMA; CHOROID PLEXUS NEOPLASMS; or colloid cysts of the third ventricle. (From Escourolle et al., Manual of Basic Neuropathology, 2nd ed, p21)
Deoxycytidine is a nucleoside consisting of the pentose sugar deoxyribose linked to the nitrogenous base cytosine, which plays a crucial role in DNA replication and repair processes within cells.
Period after successful treatment in which there is no appearance of the symptoms or effects of the disease.
A class of drugs that differs from other alkylating agents used clinically in that they are monofunctional and thus unable to cross-link cellular macromolecules. Among their common properties are a requirement for metabolic activation to intermediates with antitumor efficacy and the presence in their chemical structures of N-methyl groups, that after metabolism, can covalently modify cellular DNA. The precise mechanisms by which each of these drugs acts to kill tumor cells are not completely understood. (From AMA, Drug Evaluations Annual, 1994, p2026)
Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)
The exposure of the head to roentgen rays or other forms of radioactivity for therapeutic or preventive purposes.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.
An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.
A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy.
Methods which attempt to express in replicable terms the extent of the neoplasm in the patient.
Substances that inhibit or prevent the proliferation of NEOPLASMS.
The total amount of radiation absorbed by tissues as a result of radiotherapy.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.
Antimetabolites that are useful in cancer chemotherapy.
The transfer of a neoplasm from one organ or part of the body to another remote from the primary site.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
The use of IONIZING RADIATION to treat malignant NEOPLASMS and some benign conditions.
New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
A pyrimidine analog that is an antineoplastic antimetabolite. It interferes with DNA synthesis by blocking the THYMIDYLATE SYNTHETASE conversion of deoxyuridylic acid to thymidylic acid.
Tumors or cancers of the KIDNEY.
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
A heterogeneous group of sporadic or hereditary carcinoma derived from cells of the KIDNEYS. There are several subtypes including the clear cells, the papillary, the chromophobe, the collecting duct, the spindle cells (sarcomatoid), or mixed cell-type carcinoma.
Elements of limited time intervals, contributing to particular results or situations.
A malignant epithelial tumor with a glandular organization.
Neoplasms of the brain and spinal cord derived from glial cells which vary from histologically benign forms to highly anaplastic and malignant tumors. Fibrillary astrocytomas are the most common type and may be classified in order of increasing malignancy (grades I through IV). In the first two decades of life, astrocytomas tend to originate in the cerebellar hemispheres; in adults, they most frequently arise in the cerebrum and frequently undergo malignant transformation. (From Devita et al., Cancer: Principles and Practice of Oncology, 5th ed, pp2013-7; Holland et al., Cancer Medicine, 3d ed, p1082)
Benign and malignant neoplastic processes that arise from or secondarily involve the brain, spinal cord, or meninges.
An organoplatinum compound that possesses antineoplastic activity.
Administration of the total dose of radiation (RADIATION DOSAGE) in parts, at timed intervals.
The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.
The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.
An antineoplastic agent used primarily in combination with mechlorethamine, vincristine, and prednisone (the MOPP protocol) in the treatment of Hodgkin's disease.
Antitumor alkaloid isolated from Vinca rosea. (Merck, 11th ed.)
A semisynthetic derivative of PODOPHYLLOTOXIN that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle.
A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases.
A relatively slow-growing glioma that is derived from oligodendrocytes and tends to occur in the cerebral hemispheres, thalamus, or lateral ventricle. They may present at any age, but are most frequent in the third to fifth decades, with an earlier incidence peak in the first decade. Histologically, these tumors are encapsulated, relatively avascular, and tend to form cysts and microcalcifications. Neoplastic cells tend to have small round nuclei surrounded by unstained nuclei. The tumors may vary from well-differentiated to highly anaplastic forms. (From DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2052; Adams et al., Principles of Neurology, 6th ed, p655)
A cell-cycle phase nonspecific alkylating antineoplastic agent. It is used in the treatment of brain tumors and various other malignant neoplasms. (From Martindale, The Extra Pharmacopoeia, 30th ed, p462) This substance may reasonably be anticipated to be a carcinogen according to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985). (From Merck Index, 11th ed)
Therapeutic act or process that initiates a response to a complete or partial remission level.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Methods which attempt to express in replicable terms the level of CELL DIFFERENTIATION in neoplasms as increasing ANAPLASIA correlates with the aggressiveness of the neoplasm.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of TETRAHYDROFOLATE DEHYDROGENASE and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA.
The coordination of a sensory or ideational (cognitive) process and a motor activity.
Enzymes that are part of the restriction-modification systems. They are responsible for producing a species-characteristic methylation pattern, on either adenine or cytosine residues, in a specific short base sequence in the host cell's own DNA. This methylated sequence will occur many times in the host-cell DNA and remain intact for the lifetime of the cell. Any DNA from another species which gains entry into a living cell and lacks the characteristic methylation pattern will be recognized by the restriction endonucleases of similar specificity and destroyed by cleavage. Most have been studied in bacterial systems, but a few have been found in eukaryotic organisms.
Surgery performed on the nervous system or its parts.
Any of a group of malignant tumors of lymphoid tissue that differ from HODGKIN DISEASE, being more heterogeneous with respect to malignant cell lineage, clinical course, prognosis, and therapy. The only common feature among these tumors is the absence of giant REED-STERNBERG CELLS, a characteristic of Hodgkin's disease.
The detailed examination of observable activity or behavior associated with the execution or completion of a required function or unit of work.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.
Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.
A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death.
State of the body in relation to the consumption and utilization of nutrients.
Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
The giving of drugs, chemicals, or other substances by mouth.
An anaplastic, highly malignant, and usually bronchogenic carcinoma composed of small ovoid cells with scanty neoplasm. It is characterized by a dominant, deeply basophilic nucleus, and absent or indistinct nucleoli. (From Stedman, 25th ed; Holland et al., Cancer Medicine, 3d ed, p1286-7)
The return of a sign, symptom, or disease after a remission.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.
A general term for various neoplastic diseases of the lymphoid tissue.
The relationship between the dose of an administered drug and the response of the organism to the drug.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
Molecular products metabolized and secreted by neoplastic tissue and characterized biochemically in cells or body fluids. They are indicators of tumor stage and grade as well as useful for monitoring responses to treatment and predicting recurrence. Many chemical groups are represented including hormones, antigens, amino and nucleic acids, enzymes, polyamines, and specific cell membrane proteins and lipids.
A group of diterpenoid CYCLODECANES named for the taxanes that were discovered in the TAXUS tree. The action on MICROTUBULES has made some of them useful as ANTINEOPLASTIC AGENTS.
An antitumor alkaloid isolated from VINCA ROSEA. (Merck, 11th ed.)
Antineoplastic antibiotic obtained from Streptomyces peucetius. It is a hydroxy derivative of DAUNORUBICIN.
The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.

Survival prediction of terminally ill cancer patients by clinical symptoms: development of a simple indicator. (1/318)

BACKGROUND: Although accurate prediction of survival is essential for palliative care, no clinical tools have been established. METHODS: Performance status and clinical symptoms were prospectively assessed on two independent series of terminally ill cancer patients (training set, n = 150; testing set, n = 95). On the training set, the cases were divided into two groups with or without a risk factor for shorter than 3 and 6 weeks survival, according to the way the classification achieved acceptable predictive value. The validity of this classification for survival prediction was examined on the test samples. RESULTS: The cases with performance status 10 or 20, dyspnea at rest or delirium were classified in the group with a predicted survival of shorter than 3 weeks. The cases with performance status 10 or 20, edema, dyspnea at rest or delirium were classified in the group with a predicted survival of shorter than 6 weeks. On the training set, this classification predicted 3 and 6 weeks survival with sensitivity 75 and 76% and specificity 84 and 78%, respectively. On the test populations, whether patients survived for 3 and 6 weeks or not was predicted with sensitivity 85 and 79% and specificity 84 and 72%, respectively. CONCLUSION: Whether or not patients live for 3 and 6 weeks can be acceptably predicted by this simple classification.  (+info)

Prognostic factors for supratentorial low grade astrocytomas in adults. (2/318)

The principal prognostic factors and effect on survival were retrospectively evaluated in 56 adult patients with supratentorial low grade astrocytomas treated between 1967 and 1993. Fifteen factors were evaluated with uni- and multivariate analysis to investigate their importance in predicting the length of survival. The median patient age at presentation was 42 years and the median survival was 5.0 years. The following characteristics were associated with improved patient survival by univariate analysis (p < 0.01): Age group, preoperative Karnofsky scale, and extent of surgery. Age group and Karnofsky scale were significant by multivariate analysis, but not the extent of surgery. Thus the usefulness of cytoreductive surgery in the management remains unclear, but the extent of surgery is determined by the characteristics of the tumor and the potential of the patient. Since 93% of our patients received postoperative radiotherapy, the effect of adjuvant irradiation could not be determined.  (+info)

Weight loss and low body cell mass in males with lung cancer: relationship with systemic inflammation, acute-phase response, resting energy expenditure, and catabolic and anabolic hormones. (3/318)

The aim of the present study was to investigate, in human lung cancer, the relationship between weight loss and the existence of a low body cell mass (BCM) on the one hand, and the putative presence of systemic inflammation, an increased acute-phase response, anorexia, hypermetabolism and changes in circulating levels of several anabolic and catabolic hormones on the other. In 20 male lung cancer patients, pre-stratified by weight loss of >/=10% (n=10) or of <10% (n=10), the following measurements were performed: BCM (by dual-energy X-ray absorptiometry/bromide dilution), circulating levels of sTNF-R55 and sTNF-R75 (soluble tumour necrosis factor receptors of molecular masses 55 and 75 kDa respectively), interleukin-6, lipopolysaccharide-binding protein, albumin, appetite (scale of 0-10), resting energy expenditure (by indirect calorimetry) and circulating levels of catabolic (cortisol) and anabolic [testosterone, insulin-like growth factor-I (IGF-I)] hormones. Compared with the patients with a weight loss of <10%, those with a weight loss of >/=10% were characterized by higher levels of sTNF-R55 (trend towards significance; P=0.06), and lower levels of albumin (27.4 compared with 34.4 mmol/l; P=0.02), testosterone (13.2 compared with 21.5 nmol/l; P=0.01) and IGF-I (119 compared with 184 ng/ml; P=0.004). In the patient group as a whole, the percentage weight loss was significantly correlated with sTNF-R55 (r=0.59, P=0.02), albumin (r=-0.63, P=0.006) and IGF-I (r=-0.50, P=0.02) levels. Height-adjusted BCM was significantly correlated with sTNF-R55 (r=-0.57, P=0.03), sTNF-R75 (r=-0.50, P=0. 04), lipopolysaccharide-binding protein (r=-0.50, P=0.04), albumin (r=0.56, P=0.02) and resting energy expenditure/BCM (r=-0.54, P=0. 03), and there was a trend towards a correlation with IGF-I concentration (r=0.44, P=0.06). We conclude that, in human lung cancer, weight loss and the presence of a low BCM are associated with systemic inflammation, an increased acute-phase response and decreased levels of IGF-I. In addition, a decreased BCM is associated with hypermetabolism.  (+info)

Acute effects of thirty minutes of light-intensity, intermittent exercise on patients with chronic fatigue syndrome. (4/318)

BACKGROUND AND PURPOSE: Currently, there is no consensus on exercise prescription for patients with chronic fatigue syndrome (CFS). This investigation examined whether light-intensity, intermittent physical activity exacerbated symptoms in patients with CFS immediately following exercise to 7 days following exercise. Subjects. Subjects were 9 women (mean age=44.2 years, SD=8.4, range=29-56; mean weight=74.2 kg, SD=18.8, range=56.36-110.91; and mean height=1.63 m, SD=0.8, range=1.55-1.78) and 1 man (age=48 years, weight=97.1 kg, and height= 1.98 m) who met the Centels for Disease Control and Prevention's criteria fi)r (FS. METHODS: Subjects performed 10 discontinuous 3-minute exercise bouts (separated by 3 minutes of recovery) at a self-selected, comfortable walking pace on a treadmill. Oxygen consumption, minute ventilation, respiratory exchange ratio, and heart rate were measured every minute during the exercise session. To assess degree of disability, general health status, activity level, symptoms, and mood, subjects completed various questionnaires before and after exercise. RESULTS: Results indicated that degree of disability, general health status, symptoms, and mood did not change immediately and up to 7 days following exercise. CONCLUSION AND DISCUSSION: Thirty minutes of intermittent walking did not exacerbate symptoms in subjects with CFS. The physiological data did not show any abnormal response to exercise. Although this study did not determine whether 30 minutes of continuous versus intermittent exercise would exacerbate symptoms, all 10 subjects felt that they could not exercise continuously for 30 minutes without experiencing symptom exacerbation. Despite this limitation, the results indicate that some individuals with CFS may be able to use low-level, intermittent exercise without exacerbating their symptoms.  (+info)

First year after head and neck cancer: quality of life. (5/318)

PURPOSE: Treatment regimens for head and neck cancer patients profoundly affect several quality-of-life domains. Rehabilitative needs have been identified through cross-sectional analyses; however, few studies have prospectively assessed quality of life, included assessment of psychosocial variables, and identified predictors of long-term follow-up. PARTICIPANTS AND METHODS: The present study addresses these limitations through a prospective assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity, pharynx, or larynx. Participants were enrolled onto a larger randomized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition. Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality-of-life instruments at 1 and 12 months after initial smoking cessation advice. RESULTS: Participants displayed improvements at 12 months in functional status (P = .006) and in the areas of eating, diet, and speech; however, the latter three represent areas of continued dysfunction, and the changes were not statistically significant. Despite these improvements, patients reported a decline in certain quality-of-life domains, including marital (P = .002) and sexual functioning (P = .017), as well as an increase in alcohol use (P < .001). Predictors of quality of life at 12 months included treatment type, the Vigor subscale of the Profile of Mood States instrument, and quality-of-life scores obtained 1 month after initial smoking cessation advice. CONCLUSION: Results reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up.  (+info)

Long-term survival in metastatic transitional-cell carcinoma and prognostic factors predicting outcome of therapy. (6/318)

PURPOSE: The variation in reported survival of patients with metastatic transitional-cell carcinoma (TCC) treated with systemic chemotherapy may be a consequence of pretreatment patient characteristics. We hypothesized that a prognostic factor-based model of survival among patients treated with methotrexate, vinblastine, doxorubicin, and cisplatin chemotherapy could account for such differences and help guide clinical trial design and interpretation. PATIENTS AND METHODS: A database of 203 patients with unresectable or metastatic TCC was retrospectively subjected to a multivariate regression analysis to determine which patient characteristics had independent prognostic significance for survival. Patients were assigned to three risk categories depending on the number of unfavorable characteristics. Patient selection in phase II studies was addressed by developing a table of expected median survival for patient cohorts that had varying proportions of patients from the three risk categories. RESULTS: Two factors had independent prognosis: Karnofsky performance status (KPS) less than 80% and visceral (lung, liver, or bone) metastasis. Median survival times for patients who had zero, one, or two risk factors were 33, 13.4, and 9.3 months, respectively (P =.0001). The median survival time of patient cohorts could vary from 9 to 26 months simply by altering the proportion of patients from different risk categories. CONCLUSION: The presence of baseline KPS less than 80% or visceral metastasis has an impact on survival. Reporting the proportion of patients with zero, one, and two risk factors will facilitate understanding of the relevance of the median survival in phase II trials. Phase III trials should stratify patients according to the number of risk factors to avoid imbalance in treatment arms.  (+info)

Procarbazine, lomustine, and vincristine (PCV) chemotherapy for anaplastic astrocytoma: A retrospective review of radiation therapy oncology group protocols comparing survival with carmustine or PCV adjuvant chemotherapy. (7/318)

PURPOSE: To determine any differences in outcome for patients with anaplastic astrocytoma (AA) treated with adjuvant carmustine (BCNU) versus procarbazine, lomustine, and vincristine (PCV) chemotherapy. MATERIALS AND METHODS: The Radiation Therapy Oncology Group (RTOG) database was reviewed for patients with newly diagnosed AA treated according to protocols that included either BCNU or PCV adjuvant chemotherapy. All patients were treated with radiation therapy. The outcome analysis included overall survival, taking into account patient age, extent of resection, Karnofsky performance status (KPS), and treatment group (BCNU v PCV). Stratified and nonstratified Cox proportional hazards models were used, as well as an analysis using matched cases between the groups. RESULTS: A total of 257 patients were treated with BCNU according to RTOG protocols 70-18, 83-02, and 90-06; 175 patients were treated with PCV according to RTOG protocol 94-04. All pretreatment characteristics except KPS were well balanced by treatment group; 61% of the BCNU group had a KPS of 90 to 100 compared with 73% of the PCV group (P =.0075). No statistically significant difference in survival was observed in any age group or by KPS or extent of surgery. The stratified analysis also showed no trends for improved survival by treatment group (P =. 40). The Cox model identified only age, KPS, and extent of surgery as important variables influencing survival, not treatment group. Matching cases between groups using age, KPS, and surgery resulted in 133 matched pairs. No difference in survival was observed (P =. 41). In a Cox model in which each matched pair is a strata, there was no difference between groups (P =.20). CONCLUSION: Using this retrospective analysis, there does not seem to be any survival benefit to PCV chemotherapy. Future phase III studies for patients with AA may need to consider whether BCNU or PCV is used in the control arm.  (+info)

Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. (8/318)

PURPOSE: To identify prognostic factors and a model predictive for survival in patients with metastatic renal-cell carcinoma (RCC). PATIENTS AND METHODS: The relationship between pretreatment clinical features and survival was studied in 670 patients with advanced RCC treated in 24 Memorial Sloan-Kettering Cancer Center clinical trials between 1975 and 1996. Clinical features were first examined univariately. A stepwise modeling approach based on Cox proportional hazards regression was then used to form a multivariate model. The predictive performance of the model was internally validated through a two-step nonparametric bootstrapping process. RESULTS: The median survival time was 10 months (95% confidence interval [CI], 9 to 11 months). Fifty-seven of 670 patients remain alive, and the median follow-up time for survivors was 33 months. Pretreatment features associated with a shorter survival in the multivariate analysis were low Karnofsky performance status (<80%), high serum lactate dehydrogenase (> 1.5 times upper limit of normal), low hemoglobin (< lower limit of normal), high "corrected" serum calcium (> 10 mg/dL), and absence of prior nephrectomy. These were used as risk factors to categorize patients into three different groups. The median time to death in the 25% of patients with zero risk factors (favorable-risk) was 20 months. Fifty-three percent of the patients had one or two risk factors (intermediate-risk), and the median survival time in this group was 10 months. Patients with three or more risk factors (poor-risk), who comprised 22% of the patients, had a median survival time of 4 months. CONCLUSIONS: Five prognostic factors for predicting survival were identified and used to categorize patients with metastatic RCC into three risk groups, for which the median survival times were separated by 6 months or more. These risk categories can be used in clinical trial design and interpretation and in patient management. The low long-term survival rate emphasizes the priority of clinical investigation to identify more effective therapy.  (+info)

The Karnofsky Performance Status (KPS) is a clinical tool used by healthcare professionals to assess the functional impairment and overall health of a patient with a chronic illness or malignancy. It was originally developed in 1948 by Dr. David A. Karnofsky and Dr. Joseph H. Burchenal to evaluate the ability of cancer patients to undergo specific treatments.

The KPS scale ranges from 0 to 100, with increments of 10, and it is based on the patient's ability to perform daily activities independently and their need for assistance or medical intervention. The following is a brief overview of the KPS scale:

* 100: Normal; no complaints; no evidence of disease
* 90: Able to carry on normal activity; minor symptoms of disease
* 80: Normal activity with effort; some symptoms of disease
* 70: Cares for self; unable to carry on normal activity or do active work
* 60: Requires occasional assistance but can take care of most needs
* 50: Requires considerable assistance and frequent medical care
* 40: Disabled; requires special care and assistance
* 30: Severely disabled; hospitalization is indicated although death not imminent
* 20: Very sick; hospitalization necessary; active supportive treatment required
* 10: Moribund; fatal processes progressing rapidly
* 0: Dead

The KPS score helps healthcare professionals determine the appropriate treatment plan, prognosis, and potential for recovery in patients with various medical conditions. It is widely used in oncology, palliative care, and clinical trials to assess the overall health status of patients and their ability to tolerate specific therapies.

Brain neoplasms, also known as brain tumors, are abnormal growths of cells within the brain. These growths can be benign (non-cancerous) or malignant (cancerous). Benign brain tumors typically grow slowly and do not spread to other parts of the body. However, they can still cause serious problems if they press on sensitive areas of the brain. Malignant brain tumors, on the other hand, are cancerous and can grow quickly, invading surrounding brain tissue and spreading to other parts of the brain or spinal cord.

Brain neoplasms can arise from various types of cells within the brain, including glial cells (which provide support and insulation for nerve cells), neurons (nerve cells that transmit signals in the brain), and meninges (the membranes that cover the brain and spinal cord). They can also result from the spread of cancer cells from other parts of the body, known as metastatic brain tumors.

Symptoms of brain neoplasms may vary depending on their size, location, and growth rate. Common symptoms include headaches, seizures, weakness or paralysis in the limbs, difficulty with balance and coordination, changes in speech or vision, confusion, memory loss, and changes in behavior or personality.

Treatment for brain neoplasms depends on several factors, including the type, size, location, and grade of the tumor, as well as the patient's age and overall health. Treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these approaches. Regular follow-up care is essential to monitor for recurrence and manage any long-term effects of treatment.

Survival analysis is a branch of statistics that deals with the analysis of time to event data. It is used to estimate the time it takes for a certain event of interest to occur, such as death, disease recurrence, or treatment failure. The event of interest is called the "failure" event, and survival analysis estimates the probability of not experiencing the failure event until a certain point in time, also known as the "survival" probability.

Survival analysis can provide important information about the effectiveness of treatments, the prognosis of patients, and the identification of risk factors associated with the event of interest. It can handle censored data, which is common in medical research where some participants may drop out or be lost to follow-up before the event of interest occurs.

Survival analysis typically involves estimating the survival function, which describes the probability of surviving beyond a certain time point, as well as hazard functions, which describe the instantaneous rate of failure at a given time point. Other important concepts in survival analysis include median survival times, restricted mean survival times, and various statistical tests to compare survival curves between groups.

Glioblastoma, also known as Glioblastoma multiforme (GBM), is a highly aggressive and malignant type of brain tumor that arises from the glial cells in the brain. These tumors are characterized by their rapid growth, invasion into surrounding brain tissue, and resistance to treatment.

Glioblastomas are composed of various cell types, including astrocytes and other glial cells, which make them highly heterogeneous and difficult to treat. They typically have a poor prognosis, with a median survival rate of 14-15 months from the time of diagnosis, even with aggressive treatment.

Symptoms of glioblastoma can vary depending on the location and size of the tumor but may include headaches, seizures, nausea, vomiting, memory loss, difficulty speaking or understanding speech, changes in personality or behavior, and weakness or paralysis on one side of the body.

Standard treatment for glioblastoma typically involves surgical resection of the tumor, followed by radiation therapy and chemotherapy with temozolomide. However, despite these treatments, glioblastomas often recur, leading to a poor overall prognosis.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Supratentorial neoplasms refer to tumors that originate in the region of the brain located above the tentorium cerebelli, which is a dual layer of dura mater (the protective outer covering of the brain) that separates the cerebrum from the cerebellum. This area includes the cerebral hemispheres, basal ganglia, thalamus, hypothalamus, and pineal gland. Supratentorial neoplasms can be benign or malignant and may arise from various cell types such as neurons, glial cells, meninges, or blood vessels. They can cause a variety of neurological symptoms depending on their size, location, and rate of growth.

Prognosis is a medical term that refers to the prediction of the likely outcome or course of a disease, including the chances of recovery or recurrence, based on the patient's symptoms, medical history, physical examination, and diagnostic tests. It is an important aspect of clinical decision-making and patient communication, as it helps doctors and patients make informed decisions about treatment options, set realistic expectations, and plan for future care.

Prognosis can be expressed in various ways, such as percentages, categories (e.g., good, fair, poor), or survival rates, depending on the nature of the disease and the available evidence. However, it is important to note that prognosis is not an exact science and may vary depending on individual factors, such as age, overall health status, and response to treatment. Therefore, it should be used as a guide rather than a definitive forecast.

Dacarbazine is a medical term that refers to a chemotherapeutic agent used in the treatment of various types of cancer. It is an alkylating agent, which means it works by modifying the DNA of cancer cells, preventing them from dividing and growing. Dacarbazine is often used to treat malignant melanoma, Hodgkin's lymphoma, and soft tissue sarcomas.

The drug is typically administered intravenously in a hospital or clinic setting, and the dosage and schedule may vary depending on the type and stage of cancer being treated, as well as the patient's overall health and response to treatment. Common side effects of dacarbazine include nausea, vomiting, loss of appetite, and weakness or fatigue. More serious side effects, such as low white blood cell counts, anemia, and liver damage, may also occur.

It is important for patients receiving dacarbazine to follow their doctor's instructions carefully and report any unusual symptoms or side effects promptly. Regular monitoring of blood counts and other laboratory tests may be necessary to ensure safe and effective treatment.

Antineoplastic combined chemotherapy protocols refer to a treatment plan for cancer that involves the use of more than one antineoplastic (chemotherapy) drug given in a specific sequence and schedule. The combination of drugs is used because they may work better together to destroy cancer cells compared to using a single agent alone. This approach can also help to reduce the likelihood of cancer cells becoming resistant to the treatment.

The choice of drugs, dose, duration, and frequency are determined by various factors such as the type and stage of cancer, patient's overall health, and potential side effects. Combination chemotherapy protocols can be used in various settings, including as a primary treatment, adjuvant therapy (given after surgery or radiation to kill any remaining cancer cells), neoadjuvant therapy (given before surgery or radiation to shrink the tumor), or palliative care (to alleviate symptoms and prolong survival).

It is important to note that while combined chemotherapy protocols can be effective in treating certain types of cancer, they can also cause significant side effects, including nausea, vomiting, hair loss, fatigue, and an increased risk of infection. Therefore, patients undergoing such treatment should be closely monitored and managed by a healthcare team experienced in administering chemotherapy.

Medical survival rate is a statistical measure used to determine the percentage of patients who are still alive for a specific period of time after their diagnosis or treatment for a certain condition or disease. It is often expressed as a five-year survival rate, which refers to the proportion of people who are alive five years after their diagnosis. Survival rates can be affected by many factors, including the stage of the disease at diagnosis, the patient's age and overall health, the effectiveness of treatment, and other health conditions that the patient may have. It is important to note that survival rates are statistical estimates and do not necessarily predict an individual patient's prognosis.

Combined modality therapy (CMT) is a medical treatment approach that utilizes more than one method or type of therapy simultaneously or in close succession, with the goal of enhancing the overall effectiveness of the treatment. In the context of cancer care, CMT often refers to the combination of two or more primary treatment modalities, such as surgery, radiation therapy, and systemic therapies (chemotherapy, immunotherapy, targeted therapy, etc.).

The rationale behind using combined modality therapy is that each treatment method can target cancer cells in different ways, potentially increasing the likelihood of eliminating all cancer cells and reducing the risk of recurrence. The specific combination and sequence of treatments will depend on various factors, including the type and stage of cancer, patient's overall health, and individual preferences.

For example, a common CMT approach for locally advanced rectal cancer may involve preoperative (neoadjuvant) chemoradiation therapy, followed by surgery to remove the tumor, and then postoperative (adjuvant) chemotherapy. This combined approach allows for the reduction of the tumor size before surgery, increases the likelihood of complete tumor removal, and targets any remaining microscopic cancer cells with systemic chemotherapy.

It is essential to consult with a multidisciplinary team of healthcare professionals to determine the most appropriate CMT plan for each individual patient, considering both the potential benefits and risks associated with each treatment method.

Radiosurgery is a non-invasive surgical procedure that uses precisely focused beams of radiation to treat various medical conditions, primarily in the field of neurosurgery and oncology. It allows for the destruction of targeted tissue while minimizing damage to surrounding healthy structures. Unlike traditional surgery, radiosurgery does not require any incisions, as it delivers radiation through the skin to reach the intended target.

The term "stereotactic" is often associated with radiosurgery, which refers to the use of a three-dimensional coordinate system to precisely locate and target the affected area. This technique enables high doses of radiation to be delivered accurately and efficiently, maximizing therapeutic effectiveness while minimizing side effects.

Radiosurgery can be used to treat various conditions such as brain tumors (both malignant and benign), arteriovenous malformations (AVMs), trigeminal neuralgia, acoustic neuromas, pituitary adenomas, and spinal cord tumors. Common radiosurgery platforms include the Gamma Knife, CyberKnife, and linear accelerator-based systems like Novalis Tx or TrueBeam.

It is essential to note that although it is called "surgery," radiosurgery does not involve any physical incisions or removal of tissue. Instead, it relies on the destructive effects of high-dose radiation to ablate or damage targeted cells over time, leading to their eventual death and resolution of symptoms or tumor control.

A "Drug Administration Schedule" refers to the plan for when and how a medication should be given to a patient. It includes details such as the dose, frequency (how often it should be taken), route (how it should be administered, such as orally, intravenously, etc.), and duration (how long it should be taken) of the medication. This schedule is often created and prescribed by healthcare professionals, such as doctors or pharmacists, to ensure that the medication is taken safely and effectively. It may also include instructions for missed doses or changes in the dosage.

Lung neoplasms refer to abnormal growths or tumors in the lung tissue. These tumors can be benign (non-cancerous) or malignant (cancerous). Malignant lung neoplasms are further classified into two main types: small cell lung carcinoma and non-small cell lung carcinoma. Lung neoplasms can cause symptoms such as cough, chest pain, shortness of breath, and weight loss. They are often caused by smoking or exposure to secondhand smoke, but can also occur due to genetic factors, radiation exposure, and other environmental carcinogens. Early detection and treatment of lung neoplasms is crucial for improving outcomes and survival rates.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

A glioma is a type of tumor that originates from the glial cells in the brain. Glial cells are non-neuronal cells that provide support and protection for nerve cells (neurons) within the central nervous system, including providing nutrients, maintaining homeostasis, and insulating neurons.

Gliomas can be classified into several types based on the specific type of glial cell from which they originate. The most common types include:

1. Astrocytoma: Arises from astrocytes, a type of star-shaped glial cells that provide structural support to neurons.
2. Oligodendroglioma: Develops from oligodendrocytes, which produce the myelin sheath that insulates nerve fibers.
3. Ependymoma: Originate from ependymal cells, which line the ventricles (fluid-filled spaces) in the brain and spinal cord.
4. Glioblastoma multiforme (GBM): A highly aggressive and malignant type of astrocytoma that tends to spread quickly within the brain.

Gliomas can be further classified based on their grade, which indicates how aggressive and fast-growing they are. Lower-grade gliomas tend to grow more slowly and may be less aggressive, while higher-grade gliomas are more likely to be aggressive and rapidly growing.

Symptoms of gliomas depend on the location and size of the tumor but can include headaches, seizures, cognitive changes, and neurological deficits such as weakness or paralysis in certain parts of the body. Treatment options for gliomas may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Deoxycytidine is a chemical compound that is a component of DNA, one of the nucleic acids in living organisms. It is a nucleoside, consisting of the sugar deoxyribose and the base cytosine. Deoxycytidine pairs with guanine via hydrogen bonds to form base pairs in the double helix structure of DNA.

In biochemistry, deoxycytidine can also exist as a free nucleoside, not bound to other molecules. It is involved in various cellular processes related to DNA metabolism and replication. Deoxycytidine can be phosphorylated to form deoxycytidine monophosphate (dCMP), which is an important intermediate in the synthesis of DNA.

It's worth noting that while deoxycytidine is a component of DNA, its counterpart in RNA is cytidine, which contains ribose instead of deoxyribose as the sugar component.

Disease-free survival (DFS) is a term used in medical research and clinical practice, particularly in the field of oncology. It refers to the length of time after primary treatment for a cancer during which no evidence of the disease can be found. This means that the patient shows no signs or symptoms of the cancer, and any imaging studies or other tests do not reveal any tumors or other indications of the disease.

DFS is often used as an important endpoint in clinical trials to evaluate the effectiveness of different treatments for cancer. By measuring the length of time until the cancer recurs or a new cancer develops, researchers can get a better sense of how well a particular treatment is working and whether it is improving patient outcomes.

It's important to note that DFS is not the same as overall survival (OS), which refers to the length of time from primary treatment until death from any cause. While DFS can provide valuable information about the effectiveness of cancer treatments, it does not necessarily reflect the impact of those treatments on patients' overall survival.

Antineoplastic agents, alkylating, are a class of chemotherapeutic drugs that work by alkylating (adding alkyl groups) to DNA, which can lead to the death or dysfunction of cancer cells. These agents can form cross-links between strands of DNA, preventing DNA replication and transcription, ultimately leading to cell cycle arrest and apoptosis (programmed cell death). Examples of alkylating agents include cyclophosphamide, melphalan, and cisplatin. While these drugs are designed to target rapidly dividing cancer cells, they can also affect normal cells that divide quickly, such as those in the bone marrow and digestive tract, leading to side effects like anemia, neutropenia, thrombocytopenia, and nausea/vomiting.

Palliative care is a type of medical care that focuses on relieving the pain, symptoms, and stress of serious illnesses. The goal is to improve quality of life for both the patient and their family. It is provided by a team of doctors, nurses, and other specialists who work together to address the physical, emotional, social, and spiritual needs of the patient. Palliative care can be provided at any stage of an illness, alongside curative treatments, and is not dependent on prognosis.

The World Health Organization (WHO) defines palliative care as: "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual."

Cranial irradiation is a medical treatment that involves the use of radiation therapy to target the brain. It is often used to treat various conditions affecting the brain, such as brain tumors, leukemia, and certain neurological disorders. The radiation is directed at the skull and can be focused on specific areas of the brain or delivered more broadly, depending on the nature and location of the condition being treated.

The goal of cranial irradiation may be to destroy cancer cells, reduce the size of tumors, prevent the spread of cancer, or provide symptomatic relief for patients with advanced disease. However, it is important to note that cranial irradiation can have side effects, including hair loss, fatigue, memory problems, and cognitive changes, among others. These side effects can vary in severity and duration depending on the individual patient and the specific treatment regimen.

The Kaplan-Meier estimate is a statistical method used to calculate the survival probability over time in a population. It is commonly used in medical research to analyze time-to-event data, such as the time until a patient experiences a specific event like disease progression or death. The Kaplan-Meier estimate takes into account censored data, which occurs when some individuals are lost to follow-up before experiencing the event of interest.

The method involves constructing a survival curve that shows the proportion of subjects still surviving at different time points. At each time point, the survival probability is calculated as the product of the conditional probabilities of surviving from one time point to the next. The Kaplan-Meier estimate provides an unbiased and consistent estimator of the survival function, even when censoring is present.

In summary, the Kaplan-Meier estimate is a crucial tool in medical research for analyzing time-to-event data and estimating survival probabilities over time while accounting for censored observations.

Quality of Life (QOL) is a broad, multidimensional concept that usually includes an individual's physical health, psychological state, level of independence, social relationships, personal beliefs, and their relationship to salient features of their environment. It reflects the impact of disease and treatment on a patient's overall well-being and ability to function in daily life.

The World Health Organization (WHO) defines QOL as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns." It is a subjective concept, meaning it can vary greatly from person to person.

In healthcare, QOL is often used as an outcome measure in clinical trials and other research studies to assess the impact of interventions or treatments on overall patient well-being.

Cisplatin is a chemotherapeutic agent used to treat various types of cancers, including testicular, ovarian, bladder, head and neck, lung, and cervical cancers. It is an inorganic platinum compound that contains a central platinum atom surrounded by two chloride atoms and two ammonia molecules in a cis configuration.

Cisplatin works by forming crosslinks between DNA strands, which disrupts the structure of DNA and prevents cancer cells from replicating. This ultimately leads to cell death and slows down or stops the growth of tumors. However, cisplatin can also cause damage to normal cells, leading to side effects such as nausea, vomiting, hearing loss, and kidney damage. Therefore, it is essential to monitor patients closely during treatment and manage any adverse effects promptly.

Carcinoma, non-small-cell lung (NSCLC) is a type of lung cancer that includes several subtypes of malignant tumors arising from the epithelial cells of the lung. These subtypes are classified based on the appearance of the cancer cells under a microscope and include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. NSCLC accounts for about 85% of all lung cancers and tends to grow and spread more slowly than small-cell lung cancer (SCLC).

NSCLC is often asymptomatic in its early stages, but as the tumor grows, symptoms such as coughing, chest pain, shortness of breath, hoarseness, and weight loss may develop. Treatment options for NSCLC depend on the stage and location of the cancer, as well as the patient's overall health and lung function. Common treatments include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these approaches.

Neoplasm staging is a systematic process used in medicine to describe the extent of spread of a cancer, including the size and location of the original (primary) tumor and whether it has metastasized (spread) to other parts of the body. The most widely accepted system for this purpose is the TNM classification system developed by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC).

In this system, T stands for tumor, and it describes the size and extent of the primary tumor. N stands for nodes, and it indicates whether the cancer has spread to nearby lymph nodes. M stands for metastasis, and it shows whether the cancer has spread to distant parts of the body.

Each letter is followed by a number that provides more details about the extent of the disease. For example, a T1N0M0 cancer means that the primary tumor is small and has not spread to nearby lymph nodes or distant sites. The higher the numbers, the more advanced the cancer.

Staging helps doctors determine the most appropriate treatment for each patient and estimate the patient's prognosis. It is an essential tool for communication among members of the healthcare team and for comparing outcomes of treatments in clinical trials.

Antineoplastic agents are a class of drugs used to treat malignant neoplasms or cancer. These agents work by inhibiting the growth and proliferation of cancer cells, either by killing them or preventing their division and replication. Antineoplastic agents can be classified based on their mechanism of action, such as alkylating agents, antimetabolites, topoisomerase inhibitors, mitotic inhibitors, and targeted therapy agents.

Alkylating agents work by adding alkyl groups to DNA, which can cause cross-linking of DNA strands and ultimately lead to cell death. Antimetabolites interfere with the metabolic processes necessary for DNA synthesis and replication, while topoisomerase inhibitors prevent the relaxation of supercoiled DNA during replication. Mitotic inhibitors disrupt the normal functioning of the mitotic spindle, which is essential for cell division. Targeted therapy agents are designed to target specific molecular abnormalities in cancer cells, such as mutated oncogenes or dysregulated signaling pathways.

It's important to note that antineoplastic agents can also affect normal cells and tissues, leading to various side effects such as nausea, vomiting, hair loss, and myelosuppression (suppression of bone marrow function). Therefore, the use of these drugs requires careful monitoring and management of their potential adverse effects.

Radiotherapy dosage refers to the total amount of radiation energy that is absorbed by tissues or organs, typically measured in units of Gray (Gy), during a course of radiotherapy treatment. It is the product of the dose rate (the amount of radiation delivered per unit time) and the duration of treatment. The prescribed dosage for cancer treatments can range from a few Gray to more than 70 Gy, depending on the type and location of the tumor, the patient's overall health, and other factors. The goal of radiotherapy is to deliver a sufficient dosage to destroy the cancer cells while minimizing damage to surrounding healthy tissues.

Multivariate analysis is a statistical method used to examine the relationship between multiple independent variables and a dependent variable. It allows for the simultaneous examination of the effects of two or more independent variables on an outcome, while controlling for the effects of other variables in the model. This technique can be used to identify patterns, associations, and interactions among multiple variables, and is commonly used in medical research to understand complex health outcomes and disease processes. Examples of multivariate analysis methods include multiple regression, factor analysis, cluster analysis, and discriminant analysis.

Local neoplasm recurrence is the return or regrowth of a tumor in the same location where it was originally removed or treated. This means that cancer cells have survived the initial treatment and started to grow again in the same area. It's essential to monitor and detect any local recurrence as early as possible, as it can affect the prognosis and may require additional treatment.

Proportional hazards models are a type of statistical analysis used in medical research to investigate the relationship between covariates (predictor variables) and survival times. The most common application of proportional hazards models is in the Cox regression model, which is named after its developer, Sir David Cox.

In a proportional hazards model, the hazard rate or risk of an event occurring at a given time is assumed to be proportional to the hazard rate of a reference group, after adjusting for the covariates. This means that the ratio of the hazard rates between any two individuals remains constant over time, regardless of their survival times.

Mathematically, the hazard function h(t) at time t for an individual with a set of covariates X can be expressed as:

h(t|X) = h0(t) \* exp(β1X1 + β2X2 + ... + βpXp)

where h0(t) is the baseline hazard function, X1, X2, ..., Xp are the covariates, and β1, β2, ..., βp are the regression coefficients that represent the effect of each covariate on the hazard rate.

The assumption of proportionality is crucial in the interpretation of the results from a Cox regression model. If the assumption is violated, then the estimated regression coefficients may be biased and misleading. Therefore, it is important to test for the proportional hazards assumption before interpreting the results of a Cox regression analysis.

Antimetabolites are a class of antineoplastic (chemotherapy) drugs that interfere with the metabolism of cancer cells and inhibit their growth and proliferation. These agents are structurally similar to naturally occurring metabolites, such as amino acids, nucleotides, and folic acid, which are essential for cellular replication and growth. Antimetabolites act as false analogs and get incorporated into the growing cells' DNA or RNA, causing disruption of the normal synthesis process, leading to cell cycle arrest and apoptosis (programmed cell death).

Examples of antimetabolite drugs include:

1. Folate antagonists: Methotrexate, Pemetrexed
2. Purine analogs: Mercaptopurine, Thioguanine, Fludarabine, Cladribine
3. Pyrimidine analogs: 5-Fluorouracil (5-FU), Capecitabine, Cytarabine, Gemcitabine

These drugs are used to treat various types of cancers, such as leukemias, lymphomas, breast, ovarian, and gastrointestinal cancers. Due to their mechanism of action, antimetabolites can also affect normal, rapidly dividing cells in the body, leading to side effects like myelosuppression (decreased production of blood cells), mucositis (inflammation and ulceration of the gastrointestinal tract), and alopecia (hair loss).

Neoplasm metastasis is the spread of cancer cells from the primary site (where the original or primary tumor formed) to other places in the body. This happens when cancer cells break away from the original (primary) tumor and enter the bloodstream or lymphatic system. The cancer cells can then travel to other parts of the body and form new tumors, called secondary tumors or metastases.

Metastasis is a key feature of malignant neoplasms (cancers), and it is one of the main ways that cancer can cause harm in the body. The metastatic tumors may continue to grow and may cause damage to the organs and tissues where they are located. They can also release additional cancer cells into the bloodstream or lymphatic system, leading to further spread of the cancer.

The metastatic tumors are named based on the location where they are found, as well as the type of primary cancer. For example, if a patient has a primary lung cancer that has metastasized to the liver, the metastatic tumor would be called a liver metastasis from lung cancer.

It is important to note that the presence of metastases can significantly affect a person's prognosis and treatment options. In general, metastatic cancer is more difficult to treat than cancer that has not spread beyond its original site. However, there are many factors that can influence a person's prognosis and response to treatment, so it is important for each individual to discuss their specific situation with their healthcare team.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Radiotherapy, also known as radiation therapy, is a medical treatment that uses ionizing radiation to kill cancer cells, shrink tumors, and prevent the growth and spread of cancer. The radiation can be delivered externally using machines or internally via radioactive substances placed in or near the tumor. Radiotherapy works by damaging the DNA of cancer cells, which prevents them from dividing and growing. Normal cells are also affected by radiation, but they have a greater ability to repair themselves compared to cancer cells. The goal of radiotherapy is to destroy as many cancer cells as possible while minimizing damage to healthy tissue.

Neoplasms are abnormal growths of cells or tissues in the body that serve no physiological function. They can be benign (non-cancerous) or malignant (cancerous). Benign neoplasms are typically slow growing and do not spread to other parts of the body, while malignant neoplasms are aggressive, invasive, and can metastasize to distant sites.

Neoplasms occur when there is a dysregulation in the normal process of cell division and differentiation, leading to uncontrolled growth and accumulation of cells. This can result from genetic mutations or other factors such as viral infections, environmental exposures, or hormonal imbalances.

Neoplasms can develop in any organ or tissue of the body and can cause various symptoms depending on their size, location, and type. Treatment options for neoplasms include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy, among others.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Fluorouracil is a antineoplastic medication, which means it is used to treat cancer. It is a type of chemotherapy drug known as an antimetabolite. Fluorouracil works by interfering with the growth of cancer cells and ultimately killing them. It is often used to treat colon, esophageal, stomach, and breast cancers, as well as skin conditions such as actinic keratosis and superficial basal cell carcinoma. Fluorouracil may be given by injection or applied directly to the skin in the form of a cream.

It is important to note that fluorouracil can have serious side effects, including suppression of bone marrow function, mouth sores, stomach and intestinal ulcers, and nerve damage. It should only be used under the close supervision of a healthcare professional.

Kidney neoplasms refer to abnormal growths or tumors in the kidney tissues that can be benign (non-cancerous) or malignant (cancerous). These growths can originate from various types of kidney cells, including the renal tubules, glomeruli, and the renal pelvis.

Malignant kidney neoplasms are also known as kidney cancers, with renal cell carcinoma being the most common type. Benign kidney neoplasms include renal adenomas, oncocytomas, and angiomyolipomas. While benign neoplasms are generally not life-threatening, they can still cause problems if they grow large enough to compromise kidney function or if they undergo malignant transformation.

Early detection and appropriate management of kidney neoplasms are crucial for improving patient outcomes and overall prognosis. Regular medical check-ups, imaging studies, and urinalysis can help in the early identification of these growths, allowing for timely intervention and treatment.

Adjuvant radiotherapy is a type of cancer treatment that uses radiation therapy as an adjunct to a primary surgical procedure. The goal of adjuvant radiotherapy is to eliminate any remaining microscopic cancer cells that may be present in the surrounding tissues after surgery, thereby reducing the risk of local recurrence and improving the chances of cure.

Radiotherapy involves the use of high-energy radiation to destroy cancer cells and shrink tumors. In adjuvant radiotherapy, the radiation is usually delivered to the tumor bed and regional lymph nodes in order to target any potential sites of residual disease. The timing and dosing of adjuvant radiotherapy may vary depending on the type and stage of cancer being treated, as well as other factors such as patient age and overall health status.

Adjuvant radiotherapy is commonly used in the treatment of various types of cancer, including breast, colorectal, lung, head and neck, and gynecologic cancers. Its use has been shown to improve survival rates and reduce the risk of recurrence in many cases, making it an important component of comprehensive cancer care.

Carcinoma, renal cell (also known as renal cell carcinoma or RCC) is a type of cancer that originates in the lining of the tubules of the kidney. These tubules are small structures within the kidney that help filter waste and fluids from the blood to form urine.

Renal cell carcinoma is the most common type of kidney cancer in adults, accounting for about 80-85% of all cases. It can affect people of any age, but it is more commonly diagnosed in those over the age of 50.

There are several subtypes of renal cell carcinoma, including clear cell, papillary, chromophobe, and collecting duct carcinomas, among others. Each subtype has a different appearance under the microscope and may have a different prognosis and response to treatment.

Symptoms of renal cell carcinoma can vary but may include blood in the urine, flank pain, a lump or mass in the abdomen, unexplained weight loss, fatigue, and fever. Treatment options for renal cell carcinoma depend on the stage and grade of the cancer, as well as the patient's overall health and preferences. Treatment may include surgery, radiation therapy, chemotherapy, immunotherapy, or targeted therapy.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Adenocarcinoma is a type of cancer that arises from glandular epithelial cells. These cells line the inside of many internal organs, including the breasts, prostate, colon, and lungs. Adenocarcinomas can occur in any of these organs, as well as in other locations where glands are present.

The term "adenocarcinoma" is used to describe a cancer that has features of glandular tissue, such as mucus-secreting cells or cells that produce hormones. These cancers often form glandular structures within the tumor mass and may produce mucus or other substances.

Adenocarcinomas are typically slow-growing and tend to spread (metastasize) to other parts of the body through the lymphatic system or bloodstream. They can be treated with surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. The prognosis for adenocarcinoma depends on several factors, including the location and stage of the cancer, as well as the patient's overall health and age.

Astrocytoma is a type of brain tumor that arises from astrocytes, which are star-shaped glial cells in the brain. These tumors can occur in various parts of the brain and can have different grades of malignancy, ranging from low-grade (I or II) to high-grade (III or IV). Low-grade astrocytomas tend to grow slowly and may not cause any symptoms for a long time, while high-grade astrocytomas are more aggressive and can grow quickly, causing neurological problems.

Symptoms of astrocytoma depend on the location and size of the tumor but may include headaches, seizures, weakness or numbness in the limbs, difficulty speaking or swallowing, changes in vision or behavior, and memory loss. Treatment options for astrocytomas include surgery, radiation therapy, chemotherapy, or a combination of these approaches. The prognosis for astrocytoma varies widely depending on the grade and location of the tumor, as well as the age and overall health of the patient.

Central nervous system (CNS) neoplasms refer to a group of abnormal growths or tumors that develop within the brain or spinal cord. These tumors can be benign or malignant, and their growth can compress or disrupt the normal functioning of surrounding brain or spinal cord tissue.

Benign CNS neoplasms are slow-growing and rarely spread to other parts of the body. However, they can still cause significant problems if they grow large enough to put pressure on vital structures within the brain or spinal cord. Malignant CNS neoplasms, on the other hand, are aggressive tumors that can invade and destroy surrounding tissue. They may also spread to other parts of the CNS or, rarely, to other organs in the body.

CNS neoplasms can arise from various types of cells within the brain or spinal cord, including nerve cells, glial cells (which provide support and insulation for nerve cells), and supportive tissues such as blood vessels. The specific type of CNS neoplasm is often used to help guide treatment decisions and determine prognosis.

Symptoms of CNS neoplasms can vary widely depending on the location and size of the tumor, but may include headaches, seizures, weakness or paralysis, vision or hearing changes, balance problems, memory loss, and changes in behavior or personality. Treatment options for CNS neoplasms may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Carboplatin is a chemotherapeutic agent used to treat various types of cancers, including ovarian, lung, and head and neck cancer. It is a platinum-containing compound that works by forming crosslinks in DNA, which leads to the death of rapidly dividing cells, such as cancer cells. Carboplatin is often used in combination with other chemotherapy drugs and is administered intravenously.

The medical definition of Carboplatin is:

"A platinum-containing antineoplastic agent that forms crosslinks with DNA, inducing cell cycle arrest and apoptosis. It is used to treat a variety of cancers, including ovarian, lung, and head and neck cancer."

Dose fractionation is a medical term that refers to the practice of dividing the total dose of radiation therapy or chemotherapy into smaller doses, which are given over a longer period. This approach allows for the delivery of a higher total dose of treatment while minimizing damage to healthy tissues and reducing side effects.

In radiation therapy, fractionation is used to target cancer cells while sparing surrounding normal tissues. By delivering smaller doses of radiation over several treatments, healthy tissue has time to recover between treatments, reducing the risk of complications. The number and size of fractions can vary depending on the type and location of the tumor, as well as other factors such as the patient's overall health.

Similarly, in chemotherapy, dose fractionation is used to maximize the effectiveness of the treatment while minimizing toxicity. By administering smaller doses of chemotherapy over time, the body has a chance to recover between treatments, reducing side effects and allowing for higher total doses to be given. The schedule and duration of chemotherapy fractionation may vary depending on the type of drug used, the type and stage of cancer, and other factors.

Overall, dose fractionation is an important technique in both radiation therapy and chemotherapy that allows for more effective treatment while minimizing harm to healthy tissues.

Intravenous (IV) infusion is a medical procedure in which liquids, such as medications, nutrients, or fluids, are delivered directly into a patient's vein through a needle or a catheter. This route of administration allows for rapid absorption and distribution of the infused substance throughout the body. IV infusions can be used for various purposes, including resuscitation, hydration, nutrition support, medication delivery, and blood product transfusion. The rate and volume of the infusion are carefully controlled to ensure patient safety and efficacy of treatment.

Disease progression is the worsening or advancement of a medical condition over time. It refers to the natural course of a disease, including its development, the severity of symptoms and complications, and the impact on the patient's overall health and quality of life. Understanding disease progression is important for developing appropriate treatment plans, monitoring response to therapy, and predicting outcomes.

The rate of disease progression can vary widely depending on the type of medical condition, individual patient factors, and the effectiveness of treatment. Some diseases may progress rapidly over a short period of time, while others may progress more slowly over many years. In some cases, disease progression may be slowed or even halted with appropriate medical interventions, while in other cases, the progression may be inevitable and irreversible.

In clinical practice, healthcare providers closely monitor disease progression through regular assessments, imaging studies, and laboratory tests. This information is used to guide treatment decisions and adjust care plans as needed to optimize patient outcomes and improve quality of life.

Procarbazine is an antineoplastic agent, specifically an alkylating agent, used in the treatment of certain types of cancer such as Hodgkin's lymphoma and brain tumors. It works by interfering with the DNA of cancer cells, preventing them from dividing and growing. Procarbazine is often used in combination with other chemotherapy drugs to increase its effectiveness.

It is important to note that procarbazine can have significant side effects, including nausea, vomiting, loss of appetite, and weakness. It can also suppress the immune system, increasing the risk of infection. Additionally, it can cause damage to cells outside of the cancerous tissue, which can result in side effects such as hair loss and mouth sores.

Procarbazine is a prescription medication that should only be used under the supervision of a healthcare professional. It is important for patients to follow their doctor's instructions carefully when taking this medication and to report any side effects or concerns promptly.

Vinblastine is an alkaloid derived from the Madagascar periwinkle plant (Catharanthus roseus) and is primarily used in cancer chemotherapy. It is classified as a vinca alkaloid, along with vincristine, vinorelbine, and others.

Medically, vinblastine is an antimicrotubule agent that binds to tubulin, a protein involved in the formation of microtubules during cell division. By binding to tubulin, vinblastine prevents the assembly of microtubules, which are essential for mitosis (cell division). This leads to the inhibition of cell division and ultimately results in the death of rapidly dividing cells, such as cancer cells.

Vinblastine is used to treat various types of cancers, including Hodgkin's lymphoma, non-Hodgkin's lymphoma, testicular cancer, breast cancer, and others. It is often administered intravenously in a healthcare setting and may be given as part of a combination chemotherapy regimen with other anticancer drugs.

As with any medication, vinblastine can have side effects, including bone marrow suppression (leading to an increased risk of infection, anemia, and bleeding), neurotoxicity (resulting in peripheral neuropathy, constipation, and jaw pain), nausea, vomiting, hair loss, and mouth sores. Regular monitoring by a healthcare professional is necessary during vinblastine treatment to manage side effects and ensure the safe and effective use of this medication.

Etoposide is a chemotherapy medication used to treat various types of cancer, including lung cancer, testicular cancer, and certain types of leukemia. It works by inhibiting the activity of an enzyme called topoisomerase II, which is involved in DNA replication and transcription. By doing so, etoposide can interfere with the growth and multiplication of cancer cells.

Etoposide is often administered intravenously in a hospital or clinic setting, although it may also be given orally in some cases. The medication can cause a range of side effects, including nausea, vomiting, hair loss, and an increased risk of infection. It can also have more serious side effects, such as bone marrow suppression, which can lead to anemia, bleeding, and a weakened immune system.

Like all chemotherapy drugs, etoposide is not without risks and should only be used under the close supervision of a qualified healthcare provider. It is important for patients to discuss the potential benefits and risks of this medication with their doctor before starting treatment.

Salvage therapy, in the context of medical oncology, refers to the use of treatments that are typically considered less desirable or more aggressive, often due to greater side effects or lower efficacy, when standard treatment options have failed. These therapies are used to attempt to salvage a response or delay disease progression in patients with refractory or relapsed cancers.

In other words, salvage therapy is a last-resort treatment approach for patients who have not responded to first-line or subsequent lines of therapy. It may involve the use of different drug combinations, higher doses of chemotherapy, immunotherapy, targeted therapy, or radiation therapy. The goal of salvage therapy is to extend survival, improve quality of life, or achieve disease stabilization in patients with limited treatment options.

Oligodendroglioma is a type of brain tumor that originates from the glial cells, specifically the oligodendrocytes, which normally provide support and protection for the nerve cells (neurons) within the brain. This type of tumor is typically slow-growing and located in the cerebrum, particularly in the frontal or temporal lobes.

Oligodendrogliomas are characterized by their distinct appearance under a microscope, where the tumor cells have a round nucleus with a clear halo around it, resembling a "fried egg." They often contain calcifications and have a tendency to infiltrate the brain tissue, making them difficult to completely remove through surgery.

Oligodendrogliomas are classified based on their genetic profile, which includes the presence or absence of certain chromosomal abnormalities like 1p/19q co-deletion. This genetic information can help predict the tumor's behavior and response to specific treatments. Overall, oligodendrogliomas tend to have a better prognosis compared to other types of brain tumors, but their treatment and management depend on various factors, including the patient's age, overall health, and the extent of the tumor.

Carmustine is a chemotherapy drug used to treat various types of cancer, including brain tumors, multiple myeloma, and Hodgkin's lymphoma. It belongs to a class of drugs called alkylating agents, which work by damaging the DNA in cancer cells, preventing them from dividing and growing.

Carmustine is available as an injectable solution that is administered intravenously (into a vein) or as implantable wafers that are placed directly into the brain during surgery. The drug can cause side effects such as nausea, vomiting, hair loss, and low blood cell counts, among others. It may also increase the risk of certain infections and bleeding complications.

As with all chemotherapy drugs, carmustine can have serious and potentially life-threatening side effects, and it should only be administered under the close supervision of a qualified healthcare professional. Patients receiving carmustine treatment should be closely monitored for signs of toxicity and other adverse reactions.

Remission induction is a treatment approach in medicine, particularly in the field of oncology and hematology. It refers to the initial phase of therapy aimed at reducing or eliminating the signs and symptoms of active disease, such as cancer or autoimmune disorders. The primary goal of remission induction is to achieve a complete response (disappearance of all detectable signs of the disease) or a partial response (a decrease in the measurable extent of the disease). This phase of treatment is often intensive and may involve the use of multiple drugs or therapies, including chemotherapy, immunotherapy, or targeted therapy. After remission induction, patients may receive additional treatments to maintain the remission and prevent relapse, known as consolidation or maintenance therapy.

"Age factors" refer to the effects, changes, or differences that age can have on various aspects of health, disease, and medical care. These factors can encompass a wide range of issues, including:

1. Physiological changes: As people age, their bodies undergo numerous physical changes that can affect how they respond to medications, illnesses, and medical procedures. For example, older adults may be more sensitive to certain drugs or have weaker immune systems, making them more susceptible to infections.
2. Chronic conditions: Age is a significant risk factor for many chronic diseases, such as heart disease, diabetes, cancer, and arthritis. As a result, age-related medical issues are common and can impact treatment decisions and outcomes.
3. Cognitive decline: Aging can also lead to cognitive changes, including memory loss and decreased decision-making abilities. These changes can affect a person's ability to understand and comply with medical instructions, leading to potential complications in their care.
4. Functional limitations: Older adults may experience physical limitations that impact their mobility, strength, and balance, increasing the risk of falls and other injuries. These limitations can also make it more challenging for them to perform daily activities, such as bathing, dressing, or cooking.
5. Social determinants: Age-related factors, such as social isolation, poverty, and lack of access to transportation, can impact a person's ability to obtain necessary medical care and affect their overall health outcomes.

Understanding age factors is critical for healthcare providers to deliver high-quality, patient-centered care that addresses the unique needs and challenges of older adults. By taking these factors into account, healthcare providers can develop personalized treatment plans that consider a person's age, physical condition, cognitive abilities, and social circumstances.

Neoplasm grading is a system used by pathologists to classify the degree of abnormality in cells that make up a tumor (neoplasm). It provides an assessment of how quickly the tumor is likely to grow and spread. The grade helps doctors predict the prognosis and determine the best treatment options.

Neoplasm grading typically involves evaluating certain cellular features under a microscope, such as:

1. Differentiation or degree of maturity: This refers to how closely the tumor cells resemble their normal counterparts in terms of size, shape, and organization. Well-differentiated tumors have cells that look more like normal cells and are usually slower growing. Poorly differentiated tumors have cells that appear very abnormal and tend to grow and spread more aggressively.

2. Mitotic count: This is the number of times the tumor cells divide (mitosis) within a given area. A higher mitotic count indicates a faster-growing tumor.

3. Necrosis: This refers to areas of dead tissue within the tumor. A significant amount of necrosis may suggest a more aggressive tumor.

Based on these and other factors, pathologists assign a grade to the tumor using a standardized system, such as the Bloom-Richardson or Scarff-Bloom-Richardson grading systems for breast cancer or the Fuhrman grading system for kidney cancer. The grade usually consists of a number or a range (e.g., G1, G2, G3, or G4) or a combination of grades (e.g., low grade, intermediate grade, and high grade).

In general, higher-grade tumors have a worse prognosis than lower-grade tumors because they are more likely to grow quickly, invade surrounding tissues, and metastasize (spread) to other parts of the body. However, neoplasm grading is just one aspect of cancer diagnosis and treatment planning. Other factors, such as the stage of the disease, location of the tumor, patient's overall health, and specific molecular markers, are also considered when making treatment decisions.

Analysis of Variance (ANOVA) is a statistical technique used to compare the means of two or more groups and determine whether there are any significant differences between them. It is a way to analyze the variance in a dataset to determine whether the variability between groups is greater than the variability within groups, which can indicate that the groups are significantly different from one another.

ANOVA is based on the concept of partitioning the total variance in a dataset into two components: variance due to differences between group means (also known as "between-group variance") and variance due to differences within each group (also known as "within-group variance"). By comparing these two sources of variance, ANOVA can help researchers determine whether any observed differences between groups are statistically significant, or whether they could have occurred by chance.

ANOVA is a widely used technique in many areas of research, including biology, psychology, engineering, and business. It is often used to compare the means of two or more experimental groups, such as a treatment group and a control group, to determine whether the treatment had a significant effect. ANOVA can also be used to compare the means of different populations or subgroups within a population, to identify any differences that may exist between them.

Methotrexate is a medication used in the treatment of certain types of cancer and autoimmune diseases. It is an antimetabolite that inhibits the enzyme dihydrofolate reductase, which is necessary for the synthesis of purines and pyrimidines, essential components of DNA and RNA. By blocking this enzyme, methotrexate interferes with cell division and growth, making it effective in treating rapidly dividing cells such as cancer cells.

In addition to its use in cancer treatment, methotrexate is also used to manage autoimmune diseases such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease. In these conditions, methotrexate modulates the immune system and reduces inflammation.

It's important to note that methotrexate can have significant side effects and should be used under the close supervision of a healthcare provider. Regular monitoring of blood counts, liver function, and kidney function is necessary during treatment with methotrexate.

Psychomotor performance refers to the integration and coordination of mental processes (cognitive functions) with physical movements. It involves the ability to perform complex tasks that require both cognitive skills, such as thinking, remembering, and perceiving, and motor skills, such as gross and fine motor movements. Examples of psychomotor performances include driving a car, playing a musical instrument, or performing surgical procedures.

In a medical context, psychomotor performance is often used to assess an individual's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), such as bathing, dressing, cooking, cleaning, and managing medications. Deficits in psychomotor performance can be a sign of neurological or psychiatric disorders, such as dementia, Parkinson's disease, or depression.

Assessment of psychomotor performance may involve tests that measure reaction time, coordination, speed, precision, and accuracy of movements, as well as cognitive functions such as attention, memory, and problem-solving skills. These assessments can help healthcare professionals develop appropriate treatment plans and monitor the progression of diseases or the effectiveness of interventions.

DNA modification methylases are a type of enzyme that catalyze the transfer of methyl groups (-CH3) to specific nucleotides in DNA, usually cytosine or adenine residues. This process is known as DNA methylation and is an important epigenetic mechanism that regulates gene expression, genome stability, and other cellular processes.

There are several types of DNA modification methylases, including:

1. Cytosine-5 methyltransferases (CNMTs or DNMTs): These enzymes catalyze the transfer of a methyl group to the fifth carbon atom of cytosine residues in DNA, forming 5-methylcytosine (5mC). This is the most common type of DNA methylation and plays a crucial role in gene silencing, X-chromosome inactivation, and genomic imprinting.
2. N6-adenine methyltransferases (MTases): These enzymes catalyze the transfer of a methyl group to the sixth nitrogen atom of adenine residues in DNA, forming N6-methyladenine (6mA). This type of DNA methylation is less common than 5mC but has been found to be involved in various cellular processes, such as transcriptional regulation and DNA repair.
3. GpC methyltransferases: These enzymes catalyze the transfer of a methyl group to the second carbon atom of guanine residues in DNA, forming N4-methylcytosine (4mC). This type of DNA methylation is relatively rare and has been found mainly in prokaryotic genomes.

Dysregulation of DNA modification methylases has been implicated in various diseases, including cancer, neurological disorders, and immunological diseases. Therefore, understanding the function and regulation of these enzymes is essential for developing novel therapeutic strategies to treat these conditions.

Neurosurgical procedures are operations that are performed on the brain, spinal cord, and peripheral nerves. These procedures are typically carried out by neurosurgeons, who are medical doctors with specialized training in the diagnosis and treatment of disorders of the nervous system. Neurosurgical procedures can be used to treat a wide range of conditions, including traumatic injuries, tumors, aneurysms, vascular malformations, infections, degenerative diseases, and congenital abnormalities.

Some common types of neurosurgical procedures include:

* Craniotomy: A procedure in which a bone flap is temporarily removed from the skull to gain access to the brain. This type of procedure may be performed to remove a tumor, repair a blood vessel, or relieve pressure on the brain.
* Spinal fusion: A procedure in which two or more vertebrae in the spine are fused together using bone grafts and metal hardware. This is often done to stabilize the spine and alleviate pain caused by degenerative conditions or spinal deformities.
* Microvascular decompression: A procedure in which a blood vessel that is causing pressure on a nerve is repositioned or removed. This type of procedure is often used to treat trigeminal neuralgia, a condition that causes severe facial pain.
* Deep brain stimulation: A procedure in which electrodes are implanted in specific areas of the brain and connected to a battery-operated device called a neurostimulator. The neurostimulator sends electrical impulses to the brain to help alleviate symptoms of movement disorders such as Parkinson's disease or dystonia.
* Stereotactic radiosurgery: A non-invasive procedure that uses focused beams of radiation to treat tumors, vascular malformations, and other abnormalities in the brain or spine. This type of procedure is often used for patients who are not good candidates for traditional surgery due to age, health status, or location of the lesion.

Neurosurgical procedures can be complex and require a high degree of skill and expertise. Patients considering neurosurgical treatment should consult with a qualified neurosurgeon to discuss their options and determine the best course of action for their individual situation.

Non-Hodgkin lymphoma (NHL) is a type of cancer that originates in the lymphatic system, which is part of the immune system. It involves the abnormal growth and proliferation of malignant lymphocytes (a type of white blood cell), leading to the formation of tumors in lymph nodes, spleen, bone marrow, or other organs. NHL can be further classified into various subtypes based on the specific type of lymphocyte involved and its characteristics.

The symptoms of Non-Hodgkin lymphoma may include:

* Painless swelling of lymph nodes in the neck, armpits, or groin
* Persistent fatigue
* Unexplained weight loss
* Fever
* Night sweats
* Itchy skin

The exact cause of Non-Hodgkin lymphoma is not well understood, but it has been associated with certain risk factors such as age (most common in people over 60), exposure to certain chemicals, immune system deficiencies, and infection with viruses like Epstein-Barr virus or HIV.

Treatment for Non-Hodgkin lymphoma depends on the stage and subtype of the disease, as well as the patient's overall health. Treatment options may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, stem cell transplantation, or a combination of these approaches. Regular follow-up care is essential to monitor the progression of the disease and manage any potential long-term side effects of treatment.

'Task Performance and Analysis' is not a commonly used medical term, but it can be found in the field of rehabilitation medicine and ergonomics. It refers to the process of evaluating and understanding how a specific task is performed, in order to identify any physical or cognitive demands placed on an individual during the performance of that task. This information can then be used to inform the design of interventions, such as workplace modifications or rehabilitation programs, aimed at improving task performance or reducing the risk of injury.

In a medical context, task performance and analysis may be used in the assessment and treatment of individuals with disabilities or injuries, to help them return to work or other activities of daily living. The analysis involves breaking down the task into its component parts, observing and measuring the physical and cognitive demands of each part, and evaluating the individual's ability to perform those demands. Based on this analysis, recommendations may be made for modifications to the task or the environment, training or education, or assistive devices that can help the individual perform the task more safely and efficiently.

Overall, task performance and analysis is a valuable tool in promoting safe and effective task performance, reducing the risk of injury, and improving functional outcomes for individuals with disabilities or injuries.

The Predictive Value of Tests, specifically the Positive Predictive Value (PPV) and Negative Predictive Value (NPV), are measures used in diagnostic tests to determine the probability that a positive or negative test result is correct.

Positive Predictive Value (PPV) is the proportion of patients with a positive test result who actually have the disease. It is calculated as the number of true positives divided by the total number of positive results (true positives + false positives). A higher PPV indicates that a positive test result is more likely to be a true positive, and therefore the disease is more likely to be present.

Negative Predictive Value (NPV) is the proportion of patients with a negative test result who do not have the disease. It is calculated as the number of true negatives divided by the total number of negative results (true negatives + false negatives). A higher NPV indicates that a negative test result is more likely to be a true negative, and therefore the disease is less likely to be present.

The predictive value of tests depends on the prevalence of the disease in the population being tested, as well as the sensitivity and specificity of the test. A test with high sensitivity and specificity will generally have higher predictive values than a test with low sensitivity and specificity. However, even a highly sensitive and specific test can have low predictive values if the prevalence of the disease is low in the population being tested.

Health status is a term used to describe the overall condition of an individual's health, including physical, mental, and social well-being. It is often assessed through various measures such as medical history, physical examination, laboratory tests, and self-reported health assessments. Health status can be used to identify health disparities, track changes in population health over time, and evaluate the effectiveness of healthcare interventions.

Pancreatic neoplasms refer to abnormal growths in the pancreas that can be benign or malignant. The pancreas is a gland located behind the stomach that produces hormones and digestive enzymes. Pancreatic neoplasms can interfere with the normal functioning of the pancreas, leading to various health complications.

Benign pancreatic neoplasms are non-cancerous growths that do not spread to other parts of the body. They are usually removed through surgery to prevent any potential complications, such as blocking the bile duct or causing pain.

Malignant pancreatic neoplasms, also known as pancreatic cancer, are cancerous growths that can invade and destroy surrounding tissues and organs. They can also spread (metastasize) to other parts of the body, such as the liver, lungs, or bones. Pancreatic cancer is often aggressive and difficult to treat, with a poor prognosis.

There are several types of pancreatic neoplasms, including adenocarcinomas, neuroendocrine tumors, solid pseudopapillary neoplasms, and cystic neoplasms. The specific type of neoplasm is determined through various diagnostic tests, such as imaging studies, biopsies, and blood tests. Treatment options depend on the type, stage, and location of the neoplasm, as well as the patient's overall health and preferences.

Medical Definition:

"Risk factors" are any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. They can be divided into modifiable and non-modifiable risk factors. Modifiable risk factors are those that can be changed through lifestyle choices or medical treatment, while non-modifiable risk factors are inherent traits such as age, gender, or genetic predisposition. Examples of modifiable risk factors include smoking, alcohol consumption, physical inactivity, and unhealthy diet, while non-modifiable risk factors include age, sex, and family history. It is important to note that having a risk factor does not guarantee that a person will develop the disease, but rather indicates an increased susceptibility.

A questionnaire in the medical context is a standardized, systematic, and structured tool used to gather information from individuals regarding their symptoms, medical history, lifestyle, or other health-related factors. It typically consists of a series of written questions that can be either self-administered or administered by an interviewer. Questionnaires are widely used in various areas of healthcare, including clinical research, epidemiological studies, patient care, and health services evaluation to collect data that can inform diagnosis, treatment planning, and population health management. They provide a consistent and organized method for obtaining information from large groups or individual patients, helping to ensure accurate and comprehensive data collection while minimizing bias and variability in the information gathered.

Paclitaxel is a chemotherapeutic agent derived from the bark of the Pacific yew tree (Taxus brevifolia). It is an antimicrotubule agent that promotes the assembly and stabilization of microtubules, thereby interfering with the normal dynamic reorganization of the microtubule network that is essential for cell division.

Paclitaxel is used in the treatment of various types of cancer including ovarian, breast, lung, and pancreatic cancers. It works by inhibiting the disassembly of microtubules, which prevents the separation of chromosomes during mitosis, leading to cell cycle arrest and apoptosis (programmed cell death).

Common side effects of paclitaxel include neutropenia (low white blood cell count), anemia (low red blood cell count), alopecia (hair loss), peripheral neuropathy (nerve damage causing numbness or tingling in the hands and feet), myalgias (muscle pain), arthralgias (joint pain), and hypersensitivity reactions.

Nutritional status is a concept that refers to the condition of an individual in relation to their nutrient intake, absorption, metabolism, and excretion. It encompasses various aspects such as body weight, muscle mass, fat distribution, presence of any deficiencies or excesses of specific nutrients, and overall health status.

A comprehensive assessment of nutritional status typically includes a review of dietary intake, anthropometric measurements (such as height, weight, waist circumference, blood pressure), laboratory tests (such as serum albumin, total protein, cholesterol levels, vitamin and mineral levels), and clinical evaluation for signs of malnutrition or overnutrition.

Malnutrition can result from inadequate intake or absorption of nutrients, increased nutrient requirements due to illness or injury, or excessive loss of nutrients due to medical conditions. On the other hand, overnutrition can lead to obesity and related health problems such as diabetes, cardiovascular disease, and certain types of cancer.

Therefore, maintaining a good nutritional status is essential for overall health and well-being, and it is an important consideration in the prevention, diagnosis, and treatment of various medical conditions.

Adjuvant chemotherapy is a medical treatment that is given in addition to the primary therapy, such as surgery or radiation, to increase the chances of a cure or to reduce the risk of recurrence in patients with cancer. It involves the use of chemicals (chemotherapeutic agents) to destroy any remaining cancer cells that may not have been removed by the primary treatment. This type of chemotherapy is typically given after the main treatment has been completed, and its goal is to kill any residual cancer cells that may be present in the body and reduce the risk of the cancer coming back. The specific drugs used and the duration of treatment will depend on the type and stage of cancer being treated.

A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.

Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.

It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.

Oral administration is a route of giving medications or other substances by mouth. This can be in the form of tablets, capsules, liquids, pastes, or other forms that can be swallowed. Once ingested, the substance is absorbed through the gastrointestinal tract and enters the bloodstream to reach its intended target site in the body. Oral administration is a common and convenient route of medication delivery, but it may not be appropriate for all substances or in certain situations, such as when rapid onset of action is required or when the patient has difficulty swallowing.

Carcinoma, small cell is a type of lung cancer that typically starts in the bronchi (the airways that lead to the lungs). It is called "small cell" because the cancer cells are small and appear round or oval in shape. This type of lung cancer is also sometimes referred to as "oat cell carcinoma" due to the distinctive appearance of the cells, which can resemble oats when viewed under a microscope.

Small cell carcinoma is a particularly aggressive form of lung cancer that tends to spread quickly to other parts of the body. It is strongly associated with smoking and is less common than non-small cell lung cancer (NSCLC), which accounts for about 85% of all lung cancers.

Like other types of lung cancer, small cell carcinoma may not cause any symptoms in its early stages. However, as the tumor grows and spreads, it can cause a variety of symptoms, including coughing, chest pain, shortness of breath, hoarseness, and weight loss. Treatment for small cell carcinoma typically involves a combination of chemotherapy, radiation therapy, and sometimes surgery.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

Regression analysis is a statistical technique used in medicine, as well as in other fields, to examine the relationship between one or more independent variables (predictors) and a dependent variable (outcome). It allows for the estimation of the average change in the outcome variable associated with a one-unit change in an independent variable, while controlling for the effects of other independent variables. This technique is often used to identify risk factors for diseases or to evaluate the effectiveness of medical interventions. In medical research, regression analysis can be used to adjust for potential confounding variables and to quantify the relationship between exposures and health outcomes. It can also be used in predictive modeling to estimate the probability of a particular outcome based on multiple predictors.

A cohort study is a type of observational study in which a group of individuals who share a common characteristic or exposure are followed up over time to determine the incidence of a specific outcome or outcomes. The cohort, or group, is defined based on the exposure status (e.g., exposed vs. unexposed) and then monitored prospectively to assess for the development of new health events or conditions.

Cohort studies can be either prospective or retrospective in design. In a prospective cohort study, participants are enrolled and followed forward in time from the beginning of the study. In contrast, in a retrospective cohort study, researchers identify a cohort that has already been assembled through medical records, insurance claims, or other sources and then look back in time to assess exposure status and health outcomes.

Cohort studies are useful for establishing causality between an exposure and an outcome because they allow researchers to observe the temporal relationship between the two. They can also provide information on the incidence of a disease or condition in different populations, which can be used to inform public health policy and interventions. However, cohort studies can be expensive and time-consuming to conduct, and they may be subject to bias if participants are not representative of the population or if there is loss to follow-up.

Medical Definition:

Magnetic Resonance Imaging (MRI) is a non-invasive diagnostic imaging technique that uses a strong magnetic field and radio waves to create detailed cross-sectional or three-dimensional images of the internal structures of the body. The patient lies within a large, cylindrical magnet, and the scanner detects changes in the direction of the magnetic field caused by protons in the body. These changes are then converted into detailed images that help medical professionals to diagnose and monitor various medical conditions, such as tumors, injuries, or diseases affecting the brain, spinal cord, heart, blood vessels, joints, and other internal organs. MRI does not use radiation like computed tomography (CT) scans.

Lymphoma is a type of cancer that originates from the white blood cells called lymphocytes, which are part of the immune system. These cells are found in various parts of the body such as the lymph nodes, spleen, bone marrow, and other organs. Lymphoma can be classified into two main types: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).

HL is characterized by the presence of a specific type of abnormal lymphocyte called Reed-Sternberg cells, while NHL includes a diverse group of lymphomas that lack these cells. The symptoms of lymphoma may include swollen lymph nodes, fever, night sweats, weight loss, and fatigue.

The exact cause of lymphoma is not known, but it is believed to result from genetic mutations in the lymphocytes that lead to uncontrolled cell growth and division. Exposure to certain viruses, chemicals, and radiation may increase the risk of developing lymphoma. Treatment options for lymphoma depend on various factors such as the type and stage of the disease, age, and overall health of the patient. Common treatments include chemotherapy, radiation therapy, immunotherapy, and stem cell transplantation.

A dose-response relationship in the context of drugs refers to the changes in the effects or symptoms that occur as the dose of a drug is increased or decreased. Generally, as the dose of a drug is increased, the severity or intensity of its effects also increases. Conversely, as the dose is decreased, the effects of the drug become less severe or may disappear altogether.

The dose-response relationship is an important concept in pharmacology and toxicology because it helps to establish the safe and effective dosage range for a drug. By understanding how changes in the dose of a drug affect its therapeutic and adverse effects, healthcare providers can optimize treatment plans for their patients while minimizing the risk of harm.

The dose-response relationship is typically depicted as a curve that shows the relationship between the dose of a drug and its effect. The shape of the curve may vary depending on the drug and the specific effect being measured. Some drugs may have a steep dose-response curve, meaning that small changes in the dose can result in large differences in the effect. Other drugs may have a more gradual dose-response curve, where larger changes in the dose are needed to produce significant effects.

In addition to helping establish safe and effective dosages, the dose-response relationship is also used to evaluate the potential therapeutic benefits and risks of new drugs during clinical trials. By systematically testing different doses of a drug in controlled studies, researchers can identify the optimal dosage range for the drug and assess its safety and efficacy.

Risk assessment in the medical context refers to the process of identifying, evaluating, and prioritizing risks to patients, healthcare workers, or the community related to healthcare delivery. It involves determining the likelihood and potential impact of adverse events or hazards, such as infectious diseases, medication errors, or medical devices failures, and implementing measures to mitigate or manage those risks. The goal of risk assessment is to promote safe and high-quality care by identifying areas for improvement and taking action to minimize harm.

Tumor markers are substances that can be found in the body and their presence can indicate the presence of certain types of cancer or other conditions. Biological tumor markers refer to those substances that are produced by cancer cells or by other cells in response to cancer or certain benign (non-cancerous) conditions. These markers can be found in various bodily fluids such as blood, urine, or tissue samples.

Examples of biological tumor markers include:

1. Proteins: Some tumor markers are proteins that are produced by cancer cells or by other cells in response to the presence of cancer. For example, prostate-specific antigen (PSA) is a protein produced by normal prostate cells and in higher amounts by prostate cancer cells.
2. Genetic material: Tumor markers can also include genetic material such as DNA, RNA, or microRNA that are shed by cancer cells into bodily fluids. For example, circulating tumor DNA (ctDNA) is genetic material from cancer cells that can be found in the bloodstream.
3. Metabolites: Tumor markers can also include metabolic products produced by cancer cells or by other cells in response to cancer. For example, lactate dehydrogenase (LDH) is an enzyme that is released into the bloodstream when cancer cells break down glucose for energy.

It's important to note that tumor markers are not specific to cancer and can be elevated in non-cancerous conditions as well. Therefore, they should not be used alone to diagnose cancer but rather as a tool in conjunction with other diagnostic tests and clinical evaluations.

Taxoids are a class of naturally occurring compounds that are derived from the bark of the Pacific yew tree (Taxus brevifolia) and other species of the genus Taxus. They are known for their antineoplastic (cancer-fighting) properties and have been used in chemotherapy to treat various types of cancer, including ovarian, breast, and lung cancer.

The most well-known taxoid is paclitaxel (also known by the brand name Taxol), which was first discovered in the 1960s and has since become a widely used cancer drug. Paclitaxel works by stabilizing microtubules, which are important components of the cell's skeleton, and preventing them from disassembling. This disrupts the normal function of the cell's mitotic spindle, leading to cell cycle arrest and ultimately apoptosis (programmed cell death).

Other taxoids that have been developed for clinical use include docetaxel (Taxotere), which is a semi-synthetic analogue of paclitaxel, and cabazitaxel (Jevtana), which is a second-generation taxoid. These drugs have similar mechanisms of action to paclitaxel but may have different pharmacokinetic properties or be effective against cancer cells that have developed resistance to other taxoids.

While taxoids have been successful in treating certain types of cancer, they can also cause significant side effects, including neutropenia (low white blood cell count), anemia (low red blood cell count), and peripheral neuropathy (nerve damage). As with all chemotherapy drugs, the use of taxoids must be carefully balanced against their potential benefits and risks.

Vincristine is an antineoplastic agent, specifically a vinca alkaloid. It is derived from the Madagascar periwinkle plant (Catharanthus roseus). Vincristine binds to tubulin, a protein found in microtubules, and inhibits their polymerization, which results in disruption of mitotic spindles leading to cell cycle arrest and apoptosis (programmed cell death). It is used in the treatment of various types of cancer including leukemias, lymphomas, and solid tumors. Common side effects include peripheral neuropathy, constipation, and alopecia.

Doxorubicin is a type of chemotherapy medication known as an anthracycline. It works by interfering with the DNA in cancer cells, which prevents them from growing and multiplying. Doxorubicin is used to treat a wide variety of cancers, including leukemia, lymphoma, breast cancer, lung cancer, ovarian cancer, and many others. It may be given alone or in combination with other chemotherapy drugs.

Doxorubicin is usually administered through a vein (intravenously) and can cause side effects such as nausea, vomiting, hair loss, mouth sores, and increased risk of infection. It can also cause damage to the heart muscle, which can lead to heart failure in some cases. For this reason, doctors may monitor patients' heart function closely while they are receiving doxorubicin treatment.

It is important for patients to discuss the potential risks and benefits of doxorubicin therapy with their healthcare provider before starting treatment.

Fatigue is a state of feeling very tired, weary, or exhausted, which can be physical, mental, or both. It is a common symptom that can be caused by various factors, including lack of sleep, poor nutrition, stress, medical conditions (such as anemia, diabetes, heart disease, or cancer), medications, and substance abuse. Fatigue can also be a symptom of depression or other mental health disorders. In medical terms, fatigue is often described as a subjective feeling of tiredness that is not proportional to recent activity levels and interferes with usual functioning. It is important to consult a healthcare professional if experiencing persistent or severe fatigue to determine the underlying cause and develop an appropriate treatment plan.

Karnofsky performance status less than 60. Extensive stage disease. Cerny, T; Blair V; Anderson H; et al. (1987). "Pretreatment ...
Karnofsky performance status ≥70) fare best; older patients with a Karnofsky performance status below 70 do poorly. Effective ... although symptomatic therapy alone may be chosen for those with poor performance status. Corticosteroids are crucial to the ... Symptoms of brain metastases from breast cancer are: new-onset headache changes in mental status, cognition and behavior ataxia ... Metastatic breast cancer cells frequently differ from the preceding primary breast cancer in properties such as receptor status ...
... described the Karnofsky Performance Status Scale. The primary purpose of the development of the scale was to allow physicians ... Practitioners occasionally assign performance scores in between standard intervals of 10. When Karnofsky died of lung cancer in ... Obituary: David A. Karnofsky. Cancer Res. 1970:30:549-550. Karnofsky DA and Burchenal JH. The clinical evaluation of ... "David A. Karnofsky". Scientificspine.com. Retrieved 2015-12-27. "David A. Karnofsky". Cancerres.aacrjournals.org. 2015-12-15. ...
2 equals Karnofsky 50-60 Zubrod 3 equals Karnofsky 30-40 Zubrod 4 equals Karnofsky 10-20 Zubrod 5 equals Karnofsky 0 Karnofsky ... Buccheri G, Ferrigno D, Tamburini M. Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal ... A table Archived 2008-12-02 at the Wayback Machine with the Karnofsky Performance Status. (Articles using infobox templates ... The Karnofsky Performance Score (KPS) ranking runs from 100 to 0, where 100 is "perfect" health and 0 is death. Practitioners ...
... factors which may present a poor prognosis include a low Karnofsky performance-status score (a standard way of measuring ... "The current status of tailor-made medicine with molecular biomarkers for patients with clear cell renal cell carcinoma". ... current status and future perspectives". Expert Review of Anticancer Therapy. 13 (6): 697-709. doi:10.1586/era.13.52. PMID ...
... karnofsky performance status MeSH E05.318.308.250.475.730 - sickness impact profile MeSH E05.318.308.250.580 - mass screening ... health status indicators MeSH E05.318.308.250.475.365 - apache MeSH E05.318.308.250.475.547 - severity of illness index MeSH ...
Engineering Karnofsky performance status, in medicine Keratic precipitate, a disease Kilometres per second; see metre per ...
Karnofsky performance status), it was not possible to come up with definitive conclusions about therapeutic efficacy. However, ... August 2012). "Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer". ... December 2011). "The status of Tsukuba BNCT trial: BPA-based boron neutron capture therapy combined with X-ray irradiation". ... 2016). "Present status of Accelerator-Based BNCT". Reports of Practical Oncology and Radiotherapy. 21 (2): 95-101. doi:10.1016/ ...
Karnofsky Performance Status - keloid - keratan sulfate - keratinocyte growth factor - keratoacanthoma - ketoconazole - ...
A good initial Karnofsky performance score (KPS) and MGMT methylation are associated with longer survival. A DNA test can be ... More prognostic power can be obtained by combining the mutational status of IDH1 and the methylation status of MGMT into a two- ... Fulci G, Chiocca EA (February 2007). "The status of gene therapy for brain tumors". Expert Opinion on Biological Therapy. 7 (2 ... September 2014). "The combination of IDH1 mutations and MGMT methylation status predicts survival in glioblastoma better than ...
Because brain metastasis can originate from various different primary cancers, the Karnofsky performance score is used for a ... a life expectancy of at least 3 months and a good performance status might be expected. Chemotherapy is rarely used for the ... functional status, or cognitive effects. Brain metastases are often managed surgically if they are accessible. Surgical ... as there is a risk of status epilepticus and death. Newer generation anticonvulsants including Lamotrigine and Topiramate are ...
Holden Karnofsky (January 16, 2013). "In memory of Aaron Swartz". Archived from the original on August 27, 2014. Retrieved July ... Brian Knappenberger alleges this was due to Oracle Corporation's financial interest in maintaining the status quo. The Fair ... we saw a performance hit on the live site, which I have only seen about 3 or 4 times in my 5 years here. The pattern used was ... enough to slow the site's performance. This prompted a block of the IP address. In the morning, another IP address, also from ...
Karnofsky (A.M. 1936, M.D. 1940), medical oncologist known for the Karnofsky score Henry Kendall (postdoc), Nobel Prize winner ... CS1 maint: bot: original URL status unknown, CS1 maint: DOI inactive as of August 2023, CS1: Julian-Gregorian uncertainty, ... performance artist and writer Carlos Fonseca Suárez (B.A. Comparative Literature), novelist Allegra Goodman (Ph.D. English ... Retrieved October 9, 2016.{{cite web}}: CS1 maint: bot: original URL status unknown (link) "Former dean of Stanford Graduate ...
... Last reviewed dd mmm yyyy. Last edited dd mmm yyyy ...
"Karnofsky Performance Status" by people in UAMS Profiles by year, and whether "Karnofsky Performance Status" was a major or ... "Karnofsky Performance Status" is a descriptor in the National Library of Medicines controlled vocabulary thesaurus, MeSH ( ... Below are the most recent publications written about "Karnofsky Performance Status" by people in Profiles over the past ten ... Karnofsky Performance Status*Karnofsky Performance Status. *Performance Status, Karnofsky. *Status, Karnofsky Performance ...
Mappings for the mcode-karnofsky-performance-status resource profile.. Mappings for Workflow Pattern (http://hl7.org/fhir/ ... status. status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of revise. ...
... the Karnofsky performance status, (4) the EuroQol visual analog scale, and (5) the Nottingham health profile. This pilot study ...
Karnofsky performance status less than 60. Extensive stage disease. Cerny, T; Blair V; Anderson H; et al. (1987). "Pretreatment ...
Karnofsky Performance Status. Systemic Disease. Median Survival, mo. Age 65 y or younger ... Systemic treatment of brain metastases in HER2-positive breast cancer: current status and future directions. Future Oncol. 2012 ...
Demographic information including age, Karnofsky Performance Status (KPS), gender, and primary cancer sites were collected. ...
Karnofsky Performance Status. Systemic Disease. Median Survival, mo. Age 65 y or younger ... Systemic treatment of brain metastases in HER2-positive breast cancer: current status and future directions. Future Oncol. 2012 ... Causes global CNS depression, presumably through agonist actions of GABA receptors; Indicated for treatment of status ... Indicated for status epilepticus as complication of disease ...
Karnofsky performance status ≥60; absence of active central nervous system lesions, and no changes to their antihypertensive ... Verify pregnancy status in females of reproductive potential prior to initiating AZEDRA [see Use in Specific Populations (8.1)] ... Verify pregnancy status in females of reproductive potential prior to initiating AZEDRA [see Dosage and Administration (2.1)]. ... Verify pregnancy status in females of reproductive potential prior to initiating AZEDRA [see Use in Specific Populations (8.1 ...
Karnofsky performance status < 80%. *Neutrophil count > ULN. *Platelet count > ULN. *No radiographic evidence of cavitating ... Performance status: Eastern Cooperative Oncology Group (ECOG) 0-2. *Archival tissue must be available for submission, though it ... Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation ...
Eastern Cooperative Oncology Group (ECOG) score of 0 or 1; or Karnofsky Performance Status (KPS) of ≥ 70%. ...
Performance status: Karnofsky >/= 60% for 12 to >/= 60% for 1 to < 12 years of age.. - Adequate hematologic function.. - ... Dementia, altered mental status, or any other medical condition or disorder that. would prohibit the understanding or rendering ...
A Karnofsky performance status of less than 70. Other HIV-related illness is present, for example, neurological disease or ... Immune system (I): The status of the immune system, which is measured by the number of a specific type of white blood cell, ... Aggressive lymphomas are also evaluated based on the International Prognostic Index and functional status. Learn more about ...
Karnofsky performance status was assessed at each follow-up, and clinical symptoms and signs of tumor progression were closely ... patients Karnofsky performance status greater than 70%; 4) previous chemotherapy limited to nonplatinum agents; 5) no prior ... During therapy, follow-up imaging was performed every 2 to 3 months depending on the clinical status of the patient. The ... In our study, the perfusion data corresponded much better with the actual clinical status of the patient than did conventional ...
2. Decreased performance status as measured by the Karnofsky Performance Status (KPS) scale, of ≤ 50.. 3. Documentation of the ... 2. Documentation certifying terminal status must contain enough information to confirm terminal status upon review. ... Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, ed. Evaluation of ... sufficient documentation of the patients condition that justifies terminal status, in the absence of meeting the above ...
5. Karnofsky Performance Status score ≥ 70. 6. Age > 19 years-old. 7. Capable of giving informed consent. 8. Must be willing to ...
Karnofsky or Lansky performance status (PS): performance status of >= 50 assessed within two weeks prior to registration; ... will be considered ambulatory for the purpose of assessing the performance score ...
... a Karnofsky performance status score of ≥60, and acceptable hematologic, liver, and renal function. The latter required an ... and median Karnofsky performance status score of 80 (range, 60-100). Twenty-six patients had glioblastomas, five had anaplastic ... and determination of Karnofsky performance status was done every other cycle. Complete blood counts, including differential and ... Stable disease was defined by a clinical status and radiographic tumor measurements that did not meet the criteria for CR, PR, ...
Poor performance status - Eastern Cooperative Oncology Group (ECOG) score ≥3 or Karnofsky Performance Status (KPS) score ≤50 ... Indicators of a potential benefit are ECOG/WHO performance score 0-2, a low level of systemic inflammation (normal levels of ... Managing symptoms, distress, and functional status (eg, pain, dyspnea, fatigue, sleep disturbance, mood, nausea, constipation) ... especially with changes in disease status (ie, remission, recurrence, or disease progression). ...
Karnofsky performance status ≥ 60% performed within a 14-day window prior to. randomization. ... Karnofsky performance status ≥ 70% performed within a 14-day window prior to. randomization. ...
Karnofsky performance status score is ≥70 (ie, patient is up and about most of the time and able to take care of him- or ... Karnofsky performance status score is ≥70 (ie, patient is up and about most of the time and able to take care of him- or ... 4] (with subsequent modifications). The ACTG system uses three variables: tumor extent (T), immune status (I), and systemic ... while tumor status was most predictive of death in the 4-24 month period. [5] ...
Lansky/Karnofsky performance status ≥ 60 Organ and marrow function as defined below: ...
Karnofsky performance status score (KPS score)≥70; normal function of heart, liver, kidney, and other important organs and ... The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 2003;56:1129-35. ...
Karnofsky performance status ≥50. For infants and children less than 12 years of age, the Lansky play scale ≥50% will be used. ... The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU ... Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, ...
Karnofsky Performance Status Score Assesses patient for functional impairment. Kawasaki Disease Diagnostic Criteria Diagnostic ...
The relationship between two performance scales: New York Heart Association Classification and Karnofsky Performance Status ... antioxidant status, glycoproteins and bone collagen on adjuvant-induced arthritis in rats. Fundam. Clin. Pharmacol. 2007, 21, ... ameliorating the functional status (higher Karnofski Scale Index) and the symptoms (lower WOMAC (Western Ontario and McMaster ... extracellular matrix degrading enzymes and antioxidant status. Eur. J. Nutr. 2013, 52, 1787-1799. [Google Scholar] [CrossRef] [ ...
... comprising Karnofsky performance status , 80% vs ≥ 80% and the presence of visceral metastases [0 vs 1 vs 2 or liver metastases ... Randomization was stratified by PD-L1 immune cell expression status of , 1% vs ≥ 1% and , 5% vs ≥ 5%, Bajorin risk factor score ...
... discriminant validity using the Karnofsky Performance Status scale; and feasibility, with response ratio and required time. ...

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