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  1. Article: Treatment of pediatric Hodgkin disease avoiding radiotherapy: excellent outcome with the Rotterdam-HD-84-protocol.

    Hakvoort-Cammel, Friederike G A J / Buitendijk, Saskia / van den Heuvel-Eibrink, Marry / Hählen, Karel

    Pediatric blood & cancer

    2004  Volume 43, Issue 1, Page(s) 8–16

    Abstract: Background: To reduce radiotherapy (XRT) induced toxicity of treatment of children with Hodgkin disease (HD) while maintaining a high cure rate, we introduced a risk-adapted protocol consisting of chemotherapy (CT) alone in 1984.: Procedure: The ... ...

    Abstract Background: To reduce radiotherapy (XRT) induced toxicity of treatment of children with Hodgkin disease (HD) while maintaining a high cure rate, we introduced a risk-adapted protocol consisting of chemotherapy (CT) alone in 1984.
    Procedure: The outcome of 46 children treated for HD from 1984 until 2000 according to the Rotterdam-HD-84-protocol was determined. Children with stage I-IIA disease (n = 23), were treated with six courses of epirubicin, bleomycin, vinblastine, and dacarbazine (EBVD). Children with stage IIB-IV disease (n = 23), were treated with three to five alternating cycles of EBVD and mechlorethamine, vincristine, procarbazine, and prednisone (MOPP).
    Results: At a median follow-up time of 8.6 years (range 2.6-18.3 years), the 10-year overall survival (OS) is 95% and the event-free survival (EFS) 91%. In 5/46 patients XRT was administered because of residual mediastinal mass. Four children relapsed, two of them died. Up until now only one patient developed hypothyroidism; no symptomatic cardiac or pulmonary dysfunction, no second malignancy has been diagnosed.
    Conclusions: Risk-adapted treatment consisting of CT alone is highly efficacious for children with HD and toxicity is low. XRT was administered in only a small minority of children with HD. CT should be the first choice for HD in children and XRT should preferably be used for those with refractory or histologically proven residual disease or relapse.
    MeSH term(s) Adolescent ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bleomycin/adverse effects ; Bleomycin/therapeutic use ; Child ; Child, Preschool ; Dacarbazine/adverse effects ; Dacarbazine/therapeutic use ; Disease-Free Survival ; Drug Administration Schedule ; Epirubicin/adverse effects ; Epirubicin/therapeutic use ; Female ; Follow-Up Studies ; Hodgkin Disease/drug therapy ; Hodgkin Disease/mortality ; Hodgkin Disease/radiotherapy ; Humans ; Male ; Mechlorethamine/adverse effects ; Mechlorethamine/therapeutic use ; Netherlands/epidemiology ; Prednisone/adverse effects ; Prednisone/therapeutic use ; Procarbazine/adverse effects ; Procarbazine/therapeutic use ; Statistics, Nonparametric ; Survival Rate ; Vinblastine/adverse effects ; Vinblastine/therapeutic use ; Vincristine/adverse effects ; Vincristine/therapeutic use
    Chemical Substances Bleomycin (11056-06-7) ; Procarbazine (35S93Y190K) ; Epirubicin (3Z8479ZZ5X) ; Mechlorethamine (50D9XSG0VR) ; Vincristine (5J49Q6B70F) ; Vinblastine (5V9KLZ54CY) ; Dacarbazine (7GR28W0FJI) ; Prednisone (VB0R961HZT)
    Language English
    Publishing date 2004-07
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 2131448-2
    ISSN 1545-5017 ; 1545-5009
    ISSN (online) 1545-5017
    ISSN 1545-5009
    DOI 10.1002/pbc.20031
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  2. Article: The effect of preconception counselling on lifestyle and other behaviour before and during pregnancy.

    Elsinga, Joyce / de Jong-Potjer, Lieke C / van der Pal-de Bruin, Karin M / le Cessie, Saskia / Assendelft, Willem J J / Buitendijk, Simone E

    Women's health issues : official publication of the Jacobs Institute of Women's Health

    2008  Volume 18, Issue 6 Suppl, Page(s) S117–25

    Abstract: Background: Recent studies suggest that the basis for adverse pregnancy outcomes is often established early in pregnancy, during organogenesis. It is therefore important to take preventive action as early as possible, preferably before pregnancy. ... ...

    Abstract Background: Recent studies suggest that the basis for adverse pregnancy outcomes is often established early in pregnancy, during organogenesis. It is therefore important to take preventive action as early as possible, preferably before pregnancy. Because most adverse pregnancy outcomes occur in women who are unaware of being at risk, we conducted a randomized controlled trial, "Parents to Be." With this study, we sought to assess the extent to which women who have participated in preconception counseling (PCC) increase their knowledge on pregnancy-related risk factors and preventive measures and change their behavior before and during pregnancy and to provide an overview of adverse pregnancy outcomes among such women.
    Methods: Knowledge: Women aged 18-40 who attended PCC and women who received standard care were matched on previous pregnancy, time since last pregnancy, age, country of birth, and educational achievement. They were sent a questionnaire on knowledge about pregnancy-related risk factors and preventive measures. Behavior: Data on pregnancies and outcomes were collected. Two months after pregnancy, a questionnaire was sent regarding behavior before and during pregnancy.
    Results: Knowledge of women who received PCC (81.5%; n=211) exceeded that of women who did not (76.9%; n=422). Levels of knowledge in women who were not yet pregnant after PCC were comparable to those in women who became pregnant after PCC, indicating that, even before pregnancy, PCC increased knowledge in women contemplating pregnancy. After PCC, significantly more women started using folic acid before pregnancy (adjusted odds ratio [OR], 4.93; 95% confidence interval [CI], 2.81-8.66) and reduced alcohol use during the first 3 months of pregnancy (adjusted OR, 1.79; 95% CI, 1.08-2.97). Among the group receiving standard care, about 20% of all pregnancies ended in an adverse outcome; in the group with PCC this was 16% (OR, 0.77; 95% CI, 0.48-1.22).
    Conclusion: After PCC, women have more knowledge about essential items. Importantly, they gained this greater knowledge before pregnancy and more women changed their behavior to reduce adverse pregnancy outcomes.
    MeSH term(s) Adult ; Counseling/methods ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Life Style ; Maternal Behavior ; Odds Ratio ; Preconception Care/methods ; Pregnancy ; Pregnancy Complications/prevention & control ; Pregnancy Outcome ; Prenatal Care/methods ; Self Care/methods ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2008-11
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1085396-0
    ISSN 1878-4321 ; 1049-3867
    ISSN (online) 1878-4321
    ISSN 1049-3867
    DOI 10.1016/j.whi.2008.09.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Pediatric aggressive fibromatosis: a retrospective analysis of 13 patients and review of literature.

    Buitendijk, Saskia / van de Ven, Cees P / Dumans, Ton G / den Hollander, Jan C / Nowak, Peter J / Tissing, Wim J / Pieters, Rob / van den Heuvel-Eibrink, Marry M

    Cancer

    2005  Volume 104, Issue 5, Page(s) 1090–1099

    Abstract: Background: Aggressive fibromatosis (AF) is a soft tissue tumor and is rare in childhood, with high potential for local invasiveness and recurrence. General recommendations for the clinical management of pediatric patients with AF remain undetermined.!## ...

    Abstract Background: Aggressive fibromatosis (AF) is a soft tissue tumor and is rare in childhood, with high potential for local invasiveness and recurrence. General recommendations for the clinical management of pediatric patients with AF remain undetermined.
    Methods: The authors retrospectively analyzed 13 children with AF who were diagnosed from 1987 until 2004 in the Erasmus MC-Sophia Children's Hospital, and a review of the pediatric literature was conducted.
    Results: Two patients received preoperative chemotherapy with combined vincristine, actinomycin-D, and cyclophosphamide (VAC). All 13 patients underwent surgery. Three of six patients who underwent incomplete resection received adjuvant treatment, two patients received radiotherapy, and one patient received chemotherapy (VAC). The median follow-up was 3.9 years (range, 0.6-14.0 years). Three patients developed recurrent AF, including two recurrences after patients underwent incomplete resection without adjuvant treatment. Secondary resection was performed, which was incomplete in one patient who subsequently received chemotherapy (VAC). At the time of the current report, all 13 patients were in complete remission. Ten pediatric AF studies, including the current study, with a total of 187 patients were reviewed. Incomplete resection was the most important determinant for disease recurrence; in the authors' opinion, the role of adjuvant therapy needs to be studied further.
    Conclusions: Primary surgery with negative surgical margins was found to be the most successful primary treatment modality for children with AF. Positive margins after surgery indicated a high risk for disease recurrence. Multicenter, prospective (randomized) trials will be necessary to clarify the role of adjuvant treatment for patients with pediatric AF.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Child ; Child, Preschool ; Female ; Fibromatosis, Aggressive/surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Retrospective Studies ; Soft Tissue Neoplasms/surgery
    Language English
    Publishing date 2005-09-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.21275
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