tbuckley/cabot-search huggingface dataset:
Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes
Authors: Xiangling Deng, Wenquan Niu
Journal: JAMA Internal Medicine (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Symptom Assessment in Patients with BCR-ABL-Negative Myeloproliferative Neoplasms at an Academic Medical Institution
Authors: Kelly L. Schoenbeck, Miguel Carlos Cerejo, Patricia A. Cornett, Lloyd E. Damon, Karin L. Gaensler, Andrew D. Leavitt, Aaron C. Logan, Gabriel N. Mannis, Rebecca L. Olin, Giselle Salmasi, Peter H. Sayre, Neil P. Shah, Anand Dhruva, Chloe E. Atreya, Catherine C. Smith
Journal: Blood (2019)
Circulating DNA for Molecular Response Prediction, Characterization of Resistance Mechanisms and Quantification of CAR T-Cells during Axicabtagene Ciloleucel Therapy
Authors: Brian Sworder, David M. Kurtz, Charles Macaulay, Matthew J. Frank, Stefan Alig, Andrea Garofalo, Bita Sahaf, Mohammad Shahrokh Esfahani, Jay Y. Spiegel, Jean Oak, Sara Beygi, Michael C. Jin, Jacob J Chabon, Michael S. Khodadoust, Robbie G. Majzner, Crystal L. Mackall, Maximilian Diehn, David B Miklos, Ash A. Alizadeh
Journal: Blood (2019)
SHP2 inhibition reduces leukemogenesis in models of combined genetic and epigenetic mutations
Authors: Ruchi Pandey, Baskar Ramdas, Changlin Wan, George Sandusky, Morvarid Mohseni, Chi Zhang, Reuben Kapur
Journal: Journal of Clinical Investigation (2019)

In patients with acute myeloid leukemia (AML), 10% to 30% with the normal karyotype express mutations in regulators of DNA methylation, such as TET2 or DNMT3A, in conjunction with activating mutation in the receptor tyrosine kinase FLT3. These patients have a poor prognosis because they do not respond well to established therapies. Here, utilizing mouse models of AML that recapitulate cardinal features of the human disease and bear a combination of loss-of-function mutations in either Tet2 or Dnmt3a along with expression of Flt3ITD, we show that inhibition of the protein tyrosine phosphatase SHP2, which is essential for cytokine receptor signaling (including FLT3), by the small molecule allosteric inhibitor SHP099 impairs growth and induces differentiation of leukemic cells without impacting normal hematopoietic cells. We also show that SHP099 normalizes the gene expression program associated with increased cell proliferation and self-renewal in leukemic cells by downregulating the Myc signature. Our results provide a new and more effective target for treating a subset of patients with AML who bear a combination of genetic and epigenetic mutations.
Targeting the Plasma Cell Specific Purine Metabolic Enzyme, AMPD1, Induces Multiple Myeloma Cell Death Accompanying NAD Depletion
Authors: Yawara Kawano, Takayuki Sasano, Saki Kushima, Yuki Inada, Nao Nishimura, Hiroyuki Hata, Masao Matsuoka
Journal: Blood (2019)
ATIM-43. PLASMA EXTRACELLULAR VESICLE MIRNA SIGNATURES IN GBM PATIENTS RECEIVING AN EXPERIMENTAL IMMUNOTHERAPY
Authors: Luz Cumba-Garcia, Mrunal Dehankar, Asha Nair, Ian Parney
Journal: Neuro-Oncology (2019)

Abstract Patients with glioblastoma (GBM) have a median survival of 15 months despite aggressive treatment. Immunotherapies such as dendritic cell (DC) vaccines have modest clinical efficacy in small clinical trials. Treatment-related pseudo-progression confounds outcome assessment by MRI, particularly in patients receiving immunotherapy. Thus, there is a need for additional non-invasive methods to monitor treatment response. Extracellular vesicles (EVs), especially plasma exosomes, contain tumor-specific microRNA (miRNA) cargo that could serve as a liquid biopsy to distinguish true progression from treatment-related pseudo-progression. Plasma exosomes were isolated by serial density gradient ultracentrifugation from 20 newly diagnosed GBM patients enrolled in a clinical trial of allogeneic tumor lysate-pulsed autologous DC vaccination. Short non-coding RNA sequencing and bioinformatics analysis was performed for each patient at three time points (TP): pre-vaccine (TP1), post-initial vaccine (TP2), and at end of treatment (TP3). miRNA expression analysis revealed a total of 14 upregulated and 12 downregulated miRNAs across time points (p-value &lt; 0.05, |logFC| &gt;1), few of which have been previously reported to be differentially expressed in GBM. Interestingly, patients’ miRNA profile expression differed more at the beginning of treatment (e.g. TP1-vs-TP2) and at subsequent time points (e.g. TP2-vs-TP3). Ingenuity Pathway Analysis is in progress to identify pathways associated with immunotherapy treatment response in malignant gliomas. In conclusion, miRNA sequencing from GBM patients’ plasma exosomes enrolled in our DC clinical trial shows marked differential miRNA expression between time points. These results suggest that as patients progress through treatment, consistent differences in plasma exosomal miRNA expression profile can be identified that could be utilized as predictors of treatment response. Thus, plasma EVs may serve as a robust platform to monitor treatment outcome.
Farmer's Lung
Authors: J. Pepys
Journal: BMJ (1965)

12-20 minutes per visit (including travelling).Few thoughtful patients or conscientious doctors would deny that this is totally inadequate, even as an average, for the prac- tice of good medicine.Dr. Fry and his colleagues have sampled the existing system -the very " soup kitchen service " which I criticized at Swansea.For the sake of our patients and our own standards, may God forbid that future planning is based on this "five-minute medicine."-Iam, etc., East Preston, Sussex.ALAN BuSsEY.SIR,-Without discussion of the value of the idea of payment at the time of consultation by the patient we are dismayed by the introduction of this suggestion into the family-doctor Charter at this time.The National Conference of Local Medical Com- mittees and the Special Representative Meet- ing of the British Medical Association both in June 1965 decided to continue to negoti- ate the Charter, to get it priced, and then to decide whether resignation was necessary to achieve just and reasonable terms and conditions of service.We feel this new move can only complicate and delay matters.We wish to express our full support for
David Oliver: Sepsis—what’s behind the “hype”?
Authors: David Oliver
Journal: BMJ (2019)

A letter was published in the Lancet last week, entitled “Sepsis hysteria: excess hype and unrealistic expectations.”1 It triggered lively Twitter exchanges under the hashtag #sepsishysteria.2 The ensuing discussion starkly exemplified some issues doctors now face when discussing contested, emotionally charged topics on social media.

What made the Lancet letter especially interesting was that the authors were recognised experts in sepsis deterioration and scores for identifying physiological decline. Mervyn Singer has been a key player in international consensus definitions of sepsis and an advocate for improving care3; Matt Inada-Kim is a national clinical adviser on sepsis and deterioration4; and Manu Shankar-Hari is a recognised sepsis researcher.5 This made their pause for critical thought all the more noteworthy and added to …
A Multicentre, Retrospective Observational Study to Evaluate the Clinical Outcomes of Patients with Chronic Lymphocytic Leukaemia (CLL) Treated with Idelalisib and Rituximab in the UK (RETRO-idel) - a Cohort of 110 Patients
Authors: Toby A. Eyre, Gavin Preston, Huseini Hatimbhai Kagdi, Amin Islam, Toby Nicholson, Christopher Fegan, Harry W Smith, Adam P Cursley, Heribert Ramroth, Nishan Rajakumaraswamy
Journal: Blood (2019)
Studying the Determinant of Sickle Cell Disease Vasculopathy in Sub-Saharan Africa : The Biocadre Study
Authors: Brigitte Ranque, Abdoul Karim Dembele, Mor Diaw, Claudine Lapoumeroulie, Lucile Offredo, Dapa Aly Diallo, Diop Saliou, Yves Colin Aronovicz, Olivier Blanc Brude, Philippe Connes, Pierre-Louis Tharaux, Marc Romana, Xavier Jouven, Caroline Le Van Kim
Journal: Blood (2019)
Adoptive Immunotherapy with Regulatory and Conventional T Cells in Haploidentical Transplantation Primes Dendritic Cells to Promote T Cell Alloreactivity in the Bone Marrow and Tolerance in the Periphery
Authors: Mauro Di Ianni, Raffaella Giancola, Stefano Baldoni, Francesca Ulbar, Beatrice Del Papa, Stella Santarone, Annalisa Natale, Paola Olioso, Paolo Di Bartolomeo, Tiziana Bonfini, Patrizia Accorsi, Paolo Sportoletti, Alessandra Carotti, Antonio Pierini, Loredana Ruggeri, Franca Falzetti, Massimo Fabrizio Martelli, Andrea Velardi
Journal: Blood (2019)
Latent Tuberculosis in Hematopoietic Stem Cell Transplantation: Diagnostic and Therapeutic Strategies to Prevent Disease Activation in an Endemic Population
Authors: Christianne Bourlon, Oscar Manuel Fierro-Angulo, Jesus A Garcia-Ramos, Rocio Camacho-Hernandez, Roberta Demichelis, Aldo A Acosta-Medina
Journal: Blood (2019)
Prediction of Survival Among Patients Receiving Transarterial Chemoembolization for Hepatocellular Carcinoma: A Response‐Based Approach
Authors: Guohong Han, Sarah Berhane, Hidenori Toyoda, Dominik Bettinger, Omar Elshaarawy, Anthony W. H. Chan, Martha Kirstein, Cristina Mosconi, Florian Hucke, Daniel Palmer, David J. Pinato, Rohini Sharma, Diego Ottaviani, Jeong W. Jang, Tim A. Labeur, Otto M. van Delden, Mario Pirisi, Nick Stern, Bruno Sangro, Tim Meyer, Waleed Fateen, Marta García‐Fiñana, Asmaa Gomaa, Imam Waked, Eman Rewisha, Guru P. Aithal, Simon Travis, Masatoshi Kudo, Alessandro Cucchetti, Markus Peck‐Radosavljevic, R.B. Takkenberg, Stephen L. Chan, Arndt Vogel, Philip J. Johnson
Journal: Hepatology (2019)

The heterogeneity of intermediate-stage hepatocellular carcinoma (HCC) and the widespread use of transarterial chemoembolization (TACE) outside recommended guidelines have encouraged the development of scoring systems that predict patient survival. The aim of this study was to build and validate statistical models that offer individualized patient survival prediction using response to TACE as a variable.Clinically relevant baseline parameters were collected for 4,621 patients with HCC treated with TACE at 19 centers in 11 countries. In some of the centers, radiological responses (as assessed by modified Response Evaluation Criteria in Solid Tumors [mRECIST]) were also accrued. The data set was divided into a training set, an internal validation set, and two external validation sets. A pre-TACE model ("Pre-TACE-Predict") and a post-TACE model ("Post-TACE-Predict") that included response were built. The performance of the models in predicting overall survival (OS) was compared with existing ones. The median OS was 19.9 months. The factors influencing survival were tumor number and size, alpha-fetoprotein, albumin, bilirubin, vascular invasion, cause, and response as assessed by mRECIST. The proposed models showed superior predictive accuracy compared with existing models (the hepatoma arterial embolization prognostic score and its various modifications) and allowed for patient stratification into four distinct risk categories whose median OS ranged from 7 months to more than 4 years.A TACE-specific and extensively validated model based on routinely available clinical features and response after first TACE permitted patient-level prognostication.
Higher Numbers of Circulating Dendritic Cells and T-Cells Predict Response to Extracorporeal Photopheresis in Patients with Chronic Graft-Versus-Host Disease
Authors: Cynthia R. Giver, Mojtaba Akhtari, Amelia A. Langston, H. Jean Khoury, Christopher R. Flowers, Jonathan L. Kaufman, Sagar Lonial, Mary J. Lechowicz, Charise L. Gleason, M. Louette Vaughn, Edmund K. Waller
Journal: Blood (2008)
Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) in Patients with Therapy-Related Myeloid Neoplasm: A Study from the Chronic Malignancies Working Party of the EBMT
Authors: Marie Robin, Junfeng Wang, Linda Koster, Dietrich W. Beelen, Martin Bornhäuser, Nicolaus Kroeger, Uwe Platzbecker, Jürgen Finke, Arnold Ganser, Didier Blaise, Fabio Ciceri, Johan Maertens, Helene Labussiere-Wallet, Patrice Chevallier, Jakob R. Passweg, Jan J Cornelissen, Noel Milpied, Amandine Charbonnier, Francesca Bonifazi, Liesbeth C. de Wreede, Patrick Hayden, Christoph Scheid, Ibrahim Yakoub-Agha
Journal: Blood (2019)
Is Transcultural Psychiatry Possible?
Authors: Daniel Guinart, John M. Kane, Christoph U. Correll
Journal: JAMA (2019)

This Viewpoint reviews the importance of culture to expressions of mental health symptoms, definitions of disease, and response to treatment, and argues for integration of transcultural contexts to future disease taxonomies (eg, DSM-6 and ICD-12) to optomize global care of mental illness.
Increased Platelet Force Is Associated with Decreased Bleeding Severity in Pediatric Immune Thrombocytopenia
Authors: Oluwamayokun T. Oshinowo, Renee Copeland, Christina Caruso, Meredith E. Fay, Traci Leong, Carolyn M. Bennett, Wilbur A. Lam, David R. Myers
Journal: Blood (2019)
PDTM-03. CHICKEN EMBRYO CHORIOALLANTOIC MEMBRANE (CAM) ASSAY AS A XENOGRAFT MODEL FOR TREATMENT OF DIFFUSE INTRINSIC PONTINE GLIOMAS
Authors: Erica Power, Liang Zhang, Fabrice Lucien-Matteoni, David Daniels
Journal: Neuro-Oncology (2019)

Abstract BACKGROUND Diffuse intrinsic pontine gliomas (DIPG), known today as diffuse midline gliomas with the H3K27M mutation, are inoperable and aggressive brain tumors found predominantly in children. Despite extensive research no treatment or cure has been elucidated. Studies in 2012 showed that the majority of DIPG tumors have the H3K27M mutation, but the development of novel therapeutics has been hindered by lack of good laboratory models. Although patient derived cell lines with the H3K27M mutation have increased, the development of good murine xenografts are lagging, requiring extensive time and money. Previous studies have shown that the chicken embryo Chorioallantoic Membrane (CAM) model is an affordable and time-efficient method of studying tumor biology and response to treatment. We sought to develop this in H3K27M tumors to bridge the gap between in vitro—in vivo studies. METHODS Three patient-derived H3K27M cell lines were cultured and implanted on the chick embryo CAM on day 9 post-fertilization. Tumors underwent multiple drug treatment with 0.5uM or 2.0uM Alisertib (days 11, 13, 15) or a single targeted radiation treatment at 2 Grey (day 13). Tumor volume was assessed via ultrasound on day 16. The tumor specimens were harvested and analyzed by immunohistochemistry. RESULTS Patient-derived DIPG cells implanted on the CAM maintain their molecular characteristics and form tumors on the surface of the CAM as evidenced by H&amp;E and H3K27M status. Statistically significant differences in volume were found in three H3K27M DIPG lines in Alisertib treated tumors compared to the control (p&lt; 0.001, p&lt; 0.001, p= 0.005). Statistically significant differences in tumor volume were found when treating two DIPG lines with targeted radiation therapy compared to controls (p= 0.01, p= 0.02). CONCLUSIONS These results validated the CAM assay as a reliable xenograft model for studying DIPG tumor biology and determining efficacy of drug and radiation treatment.
High Serum VEGF Level in Erdheim-Chester Disease: Correlation with Cardiovascular Involvement and Response to Treatment
Authors: Anaïs Roeser, Marine Bravetti, Levi-Dan Azoulay, Makoto Miyara, Jean-François Emile, Jean Donadieu, Zahir Amoura, Fleur Cohen-Aubart, Julien Haroche
Journal: Blood (2019)
Calculation of the Colour Index
Authors: R. Elsdon-Dew
Journal: BMJ (1947)

Ca'lculatin of the C lour Indexmade provision for a variable erythrocyte standard, but this is Calculatio of the Coour Indexunnecessary and confuses the issue.A modified form of this Freedman (1946) describes a nomogram for the calculation of rule (see diagram) has been in use in this laboratory for many the colour index.Such nomograms are not new, having been years.To use the rule, the value of the erythrocyte count is described by Warburg (1927).Haden (1940), and others.Nomo-set against the haemoglobia value, and the arrow then points grams of this type suffer from one particular disadvantage in to the colour index.It is only a matter of arithmetic to make up a complete series of tables g iv i ng th e MAENI~& IN 2103.
Final Analysis of GOYA: A Randomized, Open-Label, Phase III Study of Obinutuzumab or Rituximab Plus CHOP in Patients with Previously Untreated Diffuse Large B-Cell Lymphoma
Authors: Laurie H Sehn, Maurizio Martelli, Marek Trněný, Wenxin Liu, Christopher R Bolen, Andrea Knapp, Deniz Sahin, Gila Sellam, Umberto Vitolo
Journal: Blood (2019)
Developmental Plasticity of Acute Myeloid Leukemia Mediates Resistance to Venetoclax-Based Therapy
Authors: Shanshan Pei, Daniel A Pollyea, Annika Gustafson, Mohammad Minhajuddin, Brett M. Stevens, Haobin Ye, Anagha Inguva, Maria L Amaya, Anna Krug, Courtney L Jones, Biniam Adane, Amanda Winters, Nabilah Khan, Jessica Ponder, Jeffrey Schowinsky, Andrew Hammes, Diana Abbott, Jason R Myers, John M Ashton, Jonathan A Gutman, Enkhtsetseg Purev, Haley E. Ramsey, Michael R. Savona, Stephen W. Fesik, Clayton Smith, Craig T Jordan
Journal: Blood (2019)
Evaluation, Management, and Outcomes of Patients Poorly Responsive to Cardiac Resynchronization Device Therapy
Authors: Niraj Varma, John Boehmer, Kartikeya Bhargava, Dale Yoo, Fabio Leonelli, Mariarosa Costanzo, Anil Saxena, Lixian Sun, Michael R Gold, Jagmeet Singh, John Gill, Angelo Auricchio
Journal: Journal of the American College of Cardiology (2019)
First Line Chemo-Free Therapy with the BRAF Inhibitor Vemurafenib Combined with Obinutuzumab Is Effective in Patients with Hcl
Authors: Jae H. Park, Madhulika Shukla, Jose M Salcedo, Shreya Vemuri, Julie C Kinoshita, Marissa D Smith, Eric S. Winer, Omar Abdel-Wahab, Martin S. Tallman
Journal: Blood (2019)
ONC201 IN COMBINATION WITH RADIATION EXHIBITS SYNERGISTIC EFFICACY IN HIGH GRADE GLIOMAS AND OTHER ADVANCED CANCERS
Authors: R Tarapore, S Jhawar, M Stein, B Haffty, A Zloza, S Mueller, J Zhang, F Amoroso, I Mills, W Oster, J Allen
Journal: Neuro-Oncology (2018)
Comparison of αLEPRA and αLELY Co-Inheritance with a SPTA1 Whole Gene Deletion, a Family Study
Authors: Molly S. Hein, Lea Coon, Tavanna R. Porter, Rong He, Michelle E. Savedra, Laura J. Train, Linnea M. Baudhuin, Andre M. Oliveira, Phuong L. Nguyen, James D. Hoyer, Aruna Rangan, Jennifer L. Oliveira
Journal: Blood (2019)
Effect of belimumab treatment on antiphospholipid antibody levels: post-hoc analysis based on two randomised placebo-controlled trials in systemic lupus erythematosus
Authors: Katerina Chatzidionysiou, Evangelia Samoli, Petros P Sfikakis, Maria G Tektonidou
Journal: Annals of the Rheumatic Diseases (2019)

The presence of antiphospholipid antibodies (aPL) in patients with systemic lupus erythematosus (SLE) has been associated with increased risk of thrombotic and/or obstetric manifestations.1 The mechanism of action of belimumab is inhibition of the binding of soluble circulating B lymphocyte stimulator to its target receptors on B cells. Belimumab use was associated with autoantibody reduction, such as antidouble-stranded DNA, anti-Sm and anticardiolipin (aCL) antibodies in some previous reports.2 The objective of this study was to assess the effect of belimumab 10 mg/kg versus placebo on aPL titres using pooled data from two large randomised SLE-controlled trials (BLISS-76 (NCT00410384) and BLISS-52 trial (NCT00424476)).

Levels of three isotypes of aCL antibodies (IgG, IgM and IgA) were assessed at baseline and at each visit. There we no available data on antiβ2GPI antibodies and lupus anticoagulant. The median (IQR) aCL titre, and the titre change from baseline (Δ titre) at 3, 6 and 12 months was compared between treatment arms by Mann-Whitney U test. At a second step, we undertook a random intercept mixed-effects model with the change of aCL titres from baseline as the dependent variable and treatment arm as a fixed effect. Time was added in the model, while the interaction of treatment and time was also assessed. The models were further adjusted for potential confounders (age, sex, concomitant immunosuppressive therapy, concomitant antimalarials, baseline prednisolone dose). Due to a potential effect of antimalarials on aCL titres, stratified analyses were also performed. We also assessed the …
RTHP-02. INTRACRANIAL BASAL GANGLIA/THALAMUS GERM CELL TUMOURS: CLINICAL CHARACTERISTICS, TREATMENT OUTCOMES, AND QUALITY OF LIFE OF 211 PATIENTS FROM A SINGLE CENTRE
Authors: Bo Li, Jiayi Wang, Youqi Li, Xiaoguang Qiu
Journal: Neuro-Oncology (2019)

Abstract PURPOSE Intracranial germ cell tumours (iGCTs) originating from the basal ganglia/thalamus (BG/T) region are rare. We report the findings from a large single-centre series to explore the clinical features of this disease. PATIENTS AND METHODS Patients diagnosed as having BG/T iGCTs from January 2000 to December 2017 at our hospital were screened. Newly diagnosed patients who had histology-proven/tumour marker-elevated disease and received at least radiotherapy were eligible for analysis. RESULTS Of the 401 patients screened, 211 were eligible. The median age was 12 years (range, 5–41 years). The median duration of follow-up for surviving patients was 68 months (range, 12–189 months). In germinoma patients (n = 112), the 5-year disease-free survival (DFS) and overall survival (OS) were 94.9% and 98.2%, respectively. Multivariate analysis showed that the dose of radiotherapy could predict the DFS (hazard ratio [HR] 0.991, 95% confidence interval [CI] 0.983–0.998, p = 0.015). In non-germinomatous GCT (NGGCT) patients (n = 99), the 5-year DFS and OS were 83.8% and 88.6%, respectively. Multivariate analysis showed that irradiation field (whole-brain radiotherapy vs. local radiotherapy, HR = 0.163, 95% CI 0.031–0.897, p = 0.037; cranial spinal radiotherapy vs. local radiotherapy, HR = 0.095, 95% CI 0.009–1.031, p = 0.053) and chemotherapy cycle (&gt;3 vs. ≤3) (HR 0.234, 95% CI 0.055–0.996, p = 0.049) were independent factors for DFS. The median Z-score for height and body mass index (BMI) in patients ≤19 years of age (n = 69) at the last follow-up were -0.45 (range, -2.67 to 3.41) and 0.59 (range, -4.73 to 3.1), respectively. CONCLUSION BG/T GCTs had unique characteristics. Radiation dose was an independent factor influencing the DFS in cases of germinoma. In NGGCTs, extended field radiation and more chemotherapy cycles yielded better disease control. Physical development after treatment was within the normal range for most patients.