Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malignant intra-abdominal neuroendocrine tumors are rare; consequently, a standard chemotherapeutic protocol for patients with unresectable disease has not been established. This prompted a review of our experience with dimethyltriazeno imidazole carboxamide (dacarbazine) (DTIC) treatment for these tumors. From 1976 to 1986, 14 patients were treated with DTIC for metastatic neuroendocrine tumors. There were seven men and seven women whose ages ranged from 19 to 76 years. Diagnoses included eight nonfunctioning islet-cell carcinomas, three retroperitoneal neuroendocrine tumors, two glucagonomas, and one ileal carcinoid. Before DTIC chemotherapy, four patients were treated with streptozotocin and 5-FU, and one was treated with cytoxan and methotrexate without response. Two patients who were initially treated with DTIC with no response were subsequently treated with streptozotocin and 5-FU without benefit. Standard treatment with DTIC consisted of monthly cycles of 250 mg/m2/day administered intravenously for 5 days. Seven patients had an objective response to DTIC with both improvement in quality of life and a decrease of more than 50% in tumor size on computerized tomography (CT) or liver scanning. Response duration ranged from 1 to 10 years. One patient with a glucagonoma was treated for two years and had no evidence of disease at laparotomy 7 years later. Four patients with nonfunctioning islet cell carcinoma had a positive response to DTIC, but three of these patients had tumor recurrence 3 to 6 years after treatment. Two patients with retroperitoneal neuroendocrine tumors had a positive response to DTIC treatment. One patient with a glucagonoma and one with a nonfunctioning islet-cell tumor had equivocal responses with transient clinical improvement but no objective changes in tumor size. Five patients did not respond; two were given DTIC therapy as a last resort and died 1 and 12 days later. Of the other three patients, two died 6 months and one 2 years after treatment. DTIC chemotherapy was effective in 50% of patients with intra-abdominal neuroendocrine tumors. Although DTIC therapy was associated with nausea, no major gastrointestinal, hematologic, or renal complications were noted. This favorable experience with DTIC chemotherapy for nonresectable intra-abdominal neuroendocrine tumors indicates that further clinical evaluation and use are warranted.
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PMID:DTIC therapy in patients with malignant intra-abdominal neuroendocrine tumors. 282 70

A case of a primary ovarian carcinoid arising in the right ovary of a 17-year-old female is reported. The microscopic picture was very heterogeneous and there was heavily metastatic involvement of the liver but no symptoms of the carcinoid syndrome. No response to DTIC as part of combination chemotherapy was achieved.
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PMID:Primary malignant ovarian carcinoid. 371 Feb 72

We treated 5 cases of invasive thymomas with single agent and combination chemotherapy. A carcinoid tumor of the thymus had a 13-month objective response to monthly courses of a combination of DTIC, adriamycin, cytoxan, and vincristine. A second case of carcinoid achieved stabilization of disease with a combination of adriamycin, cyclophosphamide, and DTIC for 9 months and subsequently 10 months, with fluorouracil and methotrexate. A case of thymoma had stabilization of disease for 14 months with oral cytoxan and prednisone.
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PMID:Chemotherapy in invasive thymomas: five case reports. 376 67

Twelve autopsy cases of carcinomatosis of the bone marrow were examined clinicopathologically. Among them, 7 were gastric adenocarcinoma, and the other 5 were a rectal carcinoid and carcinomas of the lung, prostate, maxilla and kidney, respectively. The gastric cancers were almost all poorly differentiated adenocarcinoma with mucin production and presented poorer prognoses than the other cancers. Leukoerythroblastic anemia, microangiopathic hemolytic anemia and DIC were found more frequently in the gastric cancers than in the others. It is concluded that the evolution of these critical hematologic disorders may be dependent on differences of histologic type, original focus and cancer-host interactions as well as wide-spread skeletal metastases of cancer cells.
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PMID:[Clinicopathological examination of 12 autopsy cases of carcinomatosis of the bone marrow]. 398 85

A pregnant woman in the 29th, week of gestation was admitted to the hospital with mediastinal pressure symptoms. A tentative diagnosis of lymphoma was made and the patient was given chemotherapy (vincristine, ciclophosphamide and adriamycin) plus radiotherapy, but no objective response was obtained. During the postoperative period (cesarean section) the patient developed clinical symptoms of muscular paralysis of unknown etiopathogenesis. Biopsy of a cervical lymph node showed histological pattern of tumor of the APUD system (chemodectoma). Multiple metastases appeared in the lungs, bones, brain, heart and ovaries in spite of treatment with various chemotherapeutic agents (vincristine, actinomycin D, CCNU and DTIC). Necropsy revealed the existence of a large tumor of the thymus gland, which histopathologic structure resembles to that of carcinoid. Ultrastructural examination showed abundant granules of neurosecretion confirming an APUD tumor. Cushing-like appearance of the patient was attributed "a posterior" to ACTH released by the tumor. A review ofthe clinical features, endocrine function and anatomical localizations of carcinoid tumors is included.
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PMID:[Carcinoid tumor of the thymus gland with multiple metastases. Report of a case (author's transl)]. 625 95

Eleven patients with malignant APUD tumors, five islet cell carcinomas, five carcinoid tumors and one medullary carcinoma of the thyroid were treated with DTIC. Nine of 11 patients benefitted from treatment. A literature review revealed that other APUD tumors responded when treated with DTIC. DTIC is a useful agent for treatment of malignant APUDomas, and may be the drug of choice for islet cell carcinoma of the pancreas.
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PMID:Therapy of malignant APUD cell tumors. Effectiveness of DTIC. 629 14

We studied the effect of two single drugs on patients with metastatic carcinoid tumors. All patients had symptomatic and measurable disease and all had elevations of urinary 5-hydroxy indole acetic acid excretion. Seventeen patients were treated with dactinomycin at a dose of 12-15 micrograms/kg/day for 5 days repeated every 4-5 weeks. One partial response was achieved. Fifteen patients were treated with dacarbazine (DTIC) at a dose of 250 mg/m2/day for 5 days every 4-5 weeks. Two partial responses were achieved. The median times to tumor progression were 10 weeks with dactinomycin and 18 weeks with DTIC. Median survival times were 28 and 47 weeks, respectively. Dactinomycin given by this schedule appears to have only limited activity as a single-agent treatment in malignant carcinoid tumor. DTIC, although showing only a slightly better response rate, perhaps warrants further investigation in view of our more favorable interval to tumor progression and survival experience and in view of this drug's more established activity in the closely related islet cell carcinoma.
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PMID:Treatment of metastatic carcinoid tumor with dactinomycin or dacarbazine. 686 Nov 65

Chemotherapy of neuroendocrine tumors must be improved. The most widely used regimen, which combines streptozotocin with fluorouracil, commonly obtains poor results. The best response rate that has been reported for carcinoid tumors is 33%. From July 1991 through September 1994, 18 patients who had advanced neuroendocrine tumors-including nine carcinoid tumors, seven neuroendocrine tumors of unknown primary site, one insulinoma, and one paraganglioma-were treated with a regimen of dacarbazine, 400 mg/m2/day, plus fluorouracil, 1 g/m2/day, with leucovorin, 200 mg/m2/day, for 2 days every 21 days (DTIC-LVFU2 protocol). The results were assessed according to the World Health Organization criteria of toxicity and response. Toxicity was moderate. The most severe side effects were grade 3 vomiting in two patients, grade 3 leukopenia in three patients, and grade 3 mucositis in one patient. The overall response rate was 27%, with only one partial response for carcinoid tumors but one complete and three partial responses for the other tumor types. Efficacy was insufficient in patients who had carcinoid tumors but the combination of dacarbazine with fluorouracil and leucovorin could be an effective regimen for the treatment of neuroendocrine tumors of unknown primary site.
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PMID:Dacarbazine, fluorouracil, and leucovorin in patients with advanced neuroendocrine tumors: a phase II trial. 962 88