4) Because of the advantages of ADT, it may be desirable to try patients on this form of therapy who have been on daily corticoids for long periods of time (eg, patients with rheumatoid arthritis). Since these patients may already have a suppressed HPA axis, establishing them on ADT may be difficult and not always successful. However, it is recommended that regular attempts be made to change them over. It may be helpful to triple or even quadruple the daily maintenance dose and administer this every other day rather than just doubling the daily dose if difficulty is encountered. Once the patient is again controlled, an attempt should be made to reduce this dose to a minimum.
As previously indicated, it is imperative for the head and neck surgeon to properly identify the type of scar as a wound contracture, hypertrophic scar, or keloid as this information will dictate the most effective form of treatment. A scar contracture can be identified by its restrictive nature as well as its confinement to the area of trauma and its lack of fibrous tissue outgrowths. Keloids and HTSs, on the otherhand, all have some degree of fibrous outgrowth. HTSs remain with the confines of the wound and typically decrease in size over time as op-posed to keloids, which may have phases of quiescence followed by reactivation and enlargement.
Stanford V is a more rigorously administered form of chemotherapy, with treatments roughly twice as fast as those of other Hodgkin's lymphoma treatments. However, in a randomized controlled study, Stanford V was inferior to ABVD.  This study has been criticized for not adhering to the proper Stanford V protocol. Specifically, the radiation therapy component following chemotherapy was not properly administered in the Italian study. A retrospective study from the Memorial Sloan-Kettering Cancer Center displayed results similar to the Stanford Cancer Center's own experience. The study concluded that, "Stanford V with appropriate radiotherapy is a highly effective regimen for locally extensive and advanced HL."