BACKGROUND Survival after first‐line therapy is poor for patients with glioblastoma. The role of second‐line treatment for recurrent disease is controversial. The authors studied the outcome in a subset of patients with glioblastoma who were selected for an aggressive reintervention strategy at the time of progression. Their objectives were to improve patients' overall survival with sustained quality of life and to make comparisons with overall survival in unselected patients. METHODS Overall, 168 patients were eligible for retrospective analysis. Ninety patients received specific therapy for disease recurrence (reintervention group) by specific criteria. RESULTS In the reintervention group, promising median overall survival (mOS) results after diagnosis (61.5 weeks) and progression (33 weeks) were obtained. The progression‐free survival (PFS) rate at 12 months and the overall survival rate were superior in the reintervention group (71% at 12 months and 32% at 24 months) compared with the total cohort (45% and 20%, respectively) and the standard group (15% and 5%, respectively). A matched‐pair analysis (n = 46 in each group), with an mOS period of 65.5 versus 28.5 weeks, confirmed these data. Quality of life was stable or slightly improved during reinterventions in a subset of patients treated within clinical studies. CONCLUSIONS The majority of patients in the current series were treated with a reintervention strategy, which had an impact on PFS and mOS. A second resection, focal radiotherapy (in selected cases), and additional chemotherapeutic regimens should be considered for patients with recurrent glioblastoma. Cancer 2003;98:2678–86. © 2003 American Cancer Society.
Zusammenfassung: In diesem Aufsatz wird das mentale Lexikon als System beschrieben, in dem Lexeme aufgenommen, gespeichert und nach bestimmten Regeln geordnet und eingesetzt werden. Hierbei spielen Bedeutungsbeziehungen eine grundlegende Rolle. Die Mikrostruktur dieses Netzwerks bildet die Polysemie, die durch Bedeutungssterne (mit Kernbedeutung und Nebenbedeutungen einzelner Lexeme) dargestellt werden kann. Anhand von Musterübungen wird gezeigt, wie dieses Thema im muttersprachlichen Unterricht didaktisch umgesetzt werden kann. Stichwörter: Semantik, Lexem, Polysemie, Didaktik, Wortschatzarbeit.Resumo: O presente trabalho descreve o léxico mental enquanto sistema no qual os lexemas são assimilados e armazenados. As relações de significado têm uma importância fundamental para as regras que influenciam a organização e o uso dos lexemas. A microestrutura dessa rede é formada pela polissemia, que pode ser representada através de "estrelas" de significados (em que o significado prototípico do lexema ocupa a posição central e os significados secundários posições periféricas). São apresentados alguns exercícios-modelo para ilustrar como este tema pode ser abordado em sala de aula.Palavras-chaves: Semântica, lexema, polissemia, didática, exercícios de vocabulário.Abstract: This paper describes the mental lexicon as a system in which the lexemes are assimilated, memorized, organized and applied according to certain rules. The microstructure of this network is based on polysemy which can be represented by star graphs (showing the prototypical and the secondary meanings of a lexeme). Some sample exercises are presented in order to illustrate the practical application in schools.
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