Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Palliative treatment was applied to 131 cases of unresectable or palliatively resected colorectal carcinoma being monitored with serial CEA determinations. There were 84 instances of disease progression with 67 (80%) of them showing an increase in CEA above pretreatment levels or maintaining high levels, and 17 (20%) showing a fall when compared to pretreatment values or maintaining low initial values. There was a clear-cut regression of the disease in only 9 instances. In all 9, the CEA clearly dropped or maintained low valles throughout the period of regression. No patient in regression had a rise or maintained an elevated CEA level. These changes in CEA followed closely the clinical response of our patient to the use of a particular agent, although for the Nitrosourea compounds there may be a tendency to lower the CEA regardless of the patient's tumor response to the drug. This could be due to the fact that the Nitrosoureas produce a diffuse block of cellular activity, both at the nucleous and cytoplasm; while other compounds act as alkylating agents or by inhibition of enzymes involved in the metabolism of nucleic acids (i.e., 5-FU inhibiting thymidylate synthetase). In general, longer survival was found in those patients who had initially lower levels of CEA as compared to those with high initial levels. The patients with a favorable CEA response to the treatment (falling CEA or maintained low value), even in many who did not show a clinical response had a longer survival than the group with rising or stable high levels. The main value in CEA monitoring of patients resides in its correlation with the amount of disease present and then its ability to detect progression of tumor mass which is not clinically measurable.
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PMID:CEA monitoring of palliative treatment for colorectal carcinoma. 6 32

A total of 77 patients with cancer of the head and neck area were treated with five different drug combination regimens. Five of the 77 patients had lymphoepithelioma; four had adenocystic carcinoma, and 68 had squamous-cell carcinoma of the head and neck (16 from the skin). Of these 77 patients, 16 had no previous treatment, five had surgery, 11 had radiotherapy, and 45 had surgery and radiotherapy. The first regimen consisted of a four-day Bleomycin infusion followed after a 24-hour rest, by cyclophosphamide (Cytoxan), Vincristine (Oncovin), methotrexate and 5-Fluorouracil (5-FU) (B-COMF). The next three regimens consisted of a four-day Bleomycin course, followed by either Cytoxan and methotrexate (B-CM), Cytoxan and 5-FU (B-CF) or Methotrexate and 5-FU (B-MF). The fifth regimen consisted of Bleomycin concomitant with Cytoxan, Methotrexate, and 5-FU (B-CMF). Of the 49 patients receiving B-COMF and B-CMF, 12 showed a complete response and 12 a partial response. Among the 28 patients receiving Bleomycin, followed by any one of the two drug regimens, only six showed a partial response. The severity of the thrombocytopenia, number of drugs, lymphoepithelioma histology and performance status of the patient influenced the rate of response. Drug toxicity consisted mostly in myelosuppression. The B-CMF combination is highly effective and can be used as an adjuvant to surgery and/or radiotherapy.
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PMID:Combination chemotherapy of head and neck cancer. 8 14

In summary, of the 460 patients of primary carcinoma of the liver admitted to the University Surgical Unit at the Queen Mary Hospital over a period of 12 years, more than 40% could not be treated, and only 91 of the patients were candidates for curative resection. The cure rate is very small; a 1- to 2-year survival was obtained in 46% of 15 resections. From 1964 to 1969, out of 22 patients with resections, 3 are still alive more than 5 year after the operation. Lin30 reported a 19.1% 5-year survival. When the hepatoma has ruptured and bleeding takes place, surgical treatment is obligatory to control the hemorrhage. Ninety-eight patients underwent a clinical trial of 5 categories: hepatic dearterialization, hepatic arterial cannulation and infusion of 5-FU, hepatic arterial ligation and portal venous infusion of 5-FU, radiotherapy and no treatment. The results show that the advantage of each form of treatment when compared with no treatment is marginal. Thus a gloomy picture of primary hepatoma is held. Since the operative mortality of hepatic resection for a solitary secondary carcinoma of the liver is negligible, it should be done in each instance because a long-term survival may be possible. This is especially true with primary carcinoma of the colon.
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PMID:Techniques and therapies for primary and metastatic liver cancer. 8 19

In a prospectively randomized study, the effect of adjuvant chemotherapy with 5-FU on survival and recurrence rates was analyzed in 299 evaluable patients with colorectal carcinoma who either underwent a curative or a palliative resection. In the treatment group, chemotherapy consisted of the intravenous administration of 12 mg/kg daily of 5-FU for 4 consecutive days, then 6 mg/kg on alternate days, to the point of toxicity, or to a maximum of five doses, followed by 12mg/kg weekly for 1 year. Some degree of drug toxicity was seen in the majority of patients, was rarely severe, and there have been no drug-related deaths. Analysis of the survival curves and disease-free interval curves reveal definite evidence of drug benefit in two unfavorable subgroups, namely patients with Dukes C tumors and in patients whose tumor was located in the rectum. In the chemotherapy groups, patients who were treated to toxicity (WBC less than 4000 mm3), the disease-free interval was significantly longer than the nonleukopenic patients. We conclude that the addition of 5-FU to the surgical treatment of colorectal carcinoma provides a small, but significant benefit in patients with colorectal cancer in certain unfavorable subgroups, namely patients with Dukes C lesions and patients with rectal carcinoma.
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PMID:Adjuvant chemotherapy in large-bowel cancer: demonstration of effectiveness of single agent chemotherapy in a prospectively controlled,, randomized trial. 8 53

Gastrointestinal cancer has proved exceedingly resistant to chemotherapy efforts. 5-Fluorouracil (5-FU) accepted as standard treatment, has provided only infrequent and incomplete antitumor effects. Other drugs as the nitrosoureas BCNU and CCNU or Mitomycin C do not match the effectiveness of 5-FU. Improvement in frequency of tumor regression have been recorded for gastric carcinoma with combinations of 5-FU and BCNU and 5-FU, adriamycin and Mitomycin C and for colorectal carcinoma with combination of 5-FU, methyl-CCNU and vincristine. There are also suggestions that such combination chemotherapy may produce increased survival when compared to untreated patients. The combination of 5-FU and streptozotocin in carcinoid tumors or adriamycin in primary hepatoma may be of some effectiveness.
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PMID:[Chemotherapy of gastrointestinal cancer (author's transl)]. 15 93

The fact that the national death rate from carcinoma of the colon and rectum has remained static over the past two decades is strong incentive for future investigation of measures to allow detection in its early and more favorable stage. Although no significant improvements in surgical techniques have afforded improvement in longevity, certain technical factors are known to inhibit tumor implantation during surgery. Data suggest that the extent of en bloc resection is the most crucial factor in avoiding recurrence. Extensive use of radiotherapy as the sole method of treatment or as preoperative or postoperative adjunctive therapy remains investigational, but it seems likely that this form of treatment will play an increasing role in the future. Preoperative radiotherapy seems to be useful in reducing the stage of the neoplasm and the incidence of extraserosal involvement; postoperative radiotherapy is beneficial for palliation. Chemotherapy, particularly with the fluorinated pyrimidines (5-FU and 5-FUDR), is being evaluated for its usefulness in lengthening survival time; response to 5-FU is occasionally dramatic. It remains for major investigational centers to clarify the role of combination chemotherapy in metastatic disease. Immunotherapy at present must be considered an unproven mode of treatment and of inconclusive benefit in any stage of colorectal carcinoma. Carcinoembryonic antigen assay is a useful prognostic and diagnostic tool in localizing primary tumor and in subsequent evaluation of response to treatment.
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PMID:Colorectal carcinoma: overview of management techniques. 15 80

Although advanced gastrointestinal cancer is the most commonplace problem encountered by the medical oncologist, this group of diseases has proved exceedingly resistant to past chemotherapy efforts. 5-Fluorouracil (5-FU), accepted by some as standard treatment, had provided only infrequent, incomplete, and fleeting antitumor effects, which are probably more than counterbalanced by its gastrointestinal, mucocutaneous, and hematologic antihost effects. There is no evidence that any manipulation of route or schedule of administration provides any improvement in the therapeutic ratio of 5-FU. There is no evidence that this drug contributes to patient survival when used at any stage of any type of gastrointestinal carcinoma. The search for alternative single drugs to 5-FU has been disappointing. The nitrosoureas and Mitomycin C produce occasional regressions, but they do not match the meager effectiveness of 5-FU; and they, in addition, present the difficult problem of cumulative bone marrow suppression. Recent trials with combination regimens have given some indication that the long stalemate in chemotherapy of gastrointestinal cancer may be breaking. Substantial improvements in frequency of tumor regression have been recorded for gastric carcinoma with combinations of 5-FU and BCNU, 5-FU and methyl CCNU, and 5-FU, Mitomycin C, and cytosine arabinoside; for colorectal carcinoma, with the combination of 5-FU, methyl CCNU, and vincristine; and for carcinoid tumors and islet cell carcinomas, with the combination of 5-FU and Streptozotocin. There are also suggestion that such combination chemotherapy with response rates in the 30 to 50% range may produce increased survival when compared to the untreated patient and patients treated with single-drug regimens. While the accomplishments of chemotherapy for the gastrointestinal cancer patient remain less than spectacular there is nevertheless realistic hope that a respectable contribution can now be made to multidisciplinary efforts applied at a stage of disease with minimal tumor burden.
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PMID:Clinical management of advanced gastrointestinal cancer. 16 61

Thirty-seven patients with advanced or recurrent lung cancer were randomized to cytoxan (CTX) alone, COMF (CTX, oncovin, methotrecate and 5-FU) or AMCOF (adriamycin, methotrexate, CTX, oncovin and 5-FU) after receiving radiation therapy to primary and bulky tumor sites. Median survival was 3 months for CTX, 6 months for COMF and 14 months for AMCOF. Analysis of those with cell (small cell) carcinoma showed median survival of 8.5 months. Oat cell cases treated with CTX survived 5 months (8 patients) with COMF 7.5 months (15 patients) and with AMCOF 13 months (14 patients). The median survival of those with adenocarcinoma or epidermoid carcinoma treated with CTX survived 3 months, with COMF 6 months and with AMCOF 15.5 months. Toxicity was moderate though no life-theatening toxicity developed in spite of the protocol design of escalation to achieve some degree of hematologic toxicity in all patients.
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PMID:Combination modality therapy in lung cancer: a survival study showing beneficial results of AMCOF (adriamycin, methotrexate, cyclophosphamide, oncovin and 5-fluorouracil). 20 81

The outline of a cooperative study for adjuvant Chemo-Immunotherapy on radically operated Colon-Rectum-Carcinoma, is presented. One group of patients receiving Placebo, has to be randomized against another group who postoperatively received Chemo-Immunotherapy consisting of 5-Fluorouracil and CCNU and Corynebacterium parvum, which was administered intermittently, throughout one year. Patients with Rectum-Carcinoma additionally receive radio-therapy with 1500 rad HD before surgery and 4500--5000 rad HD postoperatively with Cobalt-60. The central documentation, and randomization, is provided at the Institute for Cancer Research of the University of Vienna.
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PMID:[Initial experiences with a nation-wide Austrian study of adjuvant chemo- and immunotherapy of colorectal cancer following radical surgery]. 29 21

The therapeutic results of 5-FU given by oral application (15 mg/kg body weight x 10 days) in 11 patients with hepatic metastases (after colorectal and mammary carcinoma) are reported: objective response in 2 patients and subjective improvement in 4 patients contrasts to 3 patients without response and 2 patients with indefinite response to adjuvant chemotherapy. However, a long lasting complete remission in a female patient with important metastatic hepatic involvement following breast cancer must be emphasized.
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PMID:[Oral 5-fluorouracil therapy in liver metastasis]. 29 22


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