The optimum treatment of primary CNS lymphoma (PCNSL) is not yet determined. The objective of this study was to assess the safety and efficacy of initial methotrexate-based chemotherapy followed by high-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) in patients with newly diagnosed PCNSL. Twenty-five patients received two courses of initial chemotherapy combining methotrexate, etoposide, carmustine and methylprednisolone, and one course of ifosfamide-cytarabine followed by peripheral stem cell collection. Seventeen responsive patients then received HDT using carmustine, etoposide, cytarabine and melphalan with autologous stem cell rescue. After ASCT for responding patients or after salvage therapy for non-responders, whole brain radiation therapy at a dose of 30 Gy was delivered. The objective response rate to the induction chemotherapy was 84%. Four of the 21 responding patients did not have ASCT because of toxicity or refusal. With a median follow-up time of 34 months, the projected event free survival rate is 46% at 4 years. Projected overall survival is 64% at 4 years. Sixteen patients are actually in continuous complete response. No evidence of late treatment-related toxicity was observed. This treatment approach appears feasible in newly diagnosed PCNSL with encouraging results.
Although preoperative assessment of the length of the intestine may be of interest to avoid postoperative consequences of large intestinal resection, measurements of the intestine are quite rare and results variable in the literature. This anatomical study aimed to assess the length of the different intestinal segments, their variation and their correlation with sex, age, weight and height. Two hundred non-fixed adult cadavers (100 men, 100 women) who willingly gave their bodies for scientific purposes were studied. The post mortem average length of the whole intestine was 795.5+/-129 cm and was significantly longer in men and in young subjects. It was correlated with the subject's weight but not height. Multivariate analysis demonstrated that the factor showing the strongest correlation with intestinal length was body weight. This latter parameter may be useful in the preoperative assessment of intestinal length.
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