Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastrointestinal metastases secondary to bronchogenic carcinoma are relatively uncommon and most are found incidentally at autopsy examination in patients with advanced or widely disseminated lung cancer. Occasionally gastrointestinal metastases occurr relatively early in the course of the disease and give rise to a variety of clinical symptoms and radiological abnormalities. Recognition of these abnormalities is important in order that appropriate palliative therapy may be undertaken. The clinical. radiological and pathological findings in 12 patients with symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma were reviewed. Clinical symptoms varied according to the site of metastatic involvement and included dysphagia, epigastric pain, nausea, vomiting, gastrointestinal bleeding, anaemia and signs of intestinal obstruction or perforation. The sites of metastatic involvement were: oesphagogastric junction (2 cases); stomach (2 cases); duodenum (1 case): jejunum (3 cases); ileum (2 cases), colon (2 cases). The radiological findings are discussed and illustrated.
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PMID:Symptomatic gastrointestinal metastases secondary to bronchogenic carcinoma. 63 63

Thirty-two patients with esophageal involvement by lung cancer were managed by endoscopic intubation. In 22 patients with extrinsic esophageal strictures, the success rate of intubation was 91%, and 82% were discharged with their dysphagia relieved and esophageal patency restored. The mean survival rate was 4.4 months. In 10 patients with esophago-bronchial fistulas, 3 had the fistulous tract obliterated and lived a mean of 5 months. This low success rate of closing fistulas is due to failure to seal off the space between the stent and the fistula because of absence of tumor-associated stenosis. The overall morbidity rate was 28.1% (18.8% perforation, 6.3% hemorrhage, and 3.1% tracheal obstruction). The overall mortality rate was 18.8%. Although complications were more frequent than in primary esophageal tumors, endoscopic intubation was the only way to palliate this desperate condition and provided 66.6% of patients with relief of symptoms, nutritional improvement, and a mean survival time of 4.5 months.
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PMID:Endoscopic palliative intubation of the esophagus invaded by lung cancer. 169 87

Two policies of palliative thoracic radiotherapy for non-small-cell lung cancer have been compared in a randomised multicentre controlled trial. A total of 369 patients with inoperable, histologically or cytologically confirmed disease, too advanced for radical 'curative' radiotherapy, and with their main symptoms related to the primary intrathoracic tumour even if metastases were present, were studied. They were allocated at random either to a regimen of 17 Gy given in two fractions of 8.5 Gy 1 week apart (F2 regimen), or to a conventional multifractionated regimen of either 30 Gy in ten fractions or 27 Gy in six fractions (a biologically equivalent dose), given daily except at weekends (FM regimen). On admission, 93% of the patients had cough, 47% haemoptysis, 57% chest pain, 58% anorexia, and 11% dysphagia. As assessed by the clinicians, palliation of the main symptoms was achieved in high proportions of patients ranging in the F2 group from 65% for cough to 81% for haemoptysis and in the FM group from 56% for cough to 86% for haemoptysis. Haemoptysis, chest pain, and anorexia disappeared for a time in well over half the patients with these symptoms, and cough in 37%. For all the main symptoms, the median duration of palliation was 50% or more of survival. Performance status improved in approximately half of the patients with a poor status on admission. All these results were similar in the two treatment groups. As assessed daily by the patients using a diary card, the quality of life deteriorated slightly during treatment but then improved steadily during the next 5 weeks. The proportion of patients with dysphagia increased considerably during treatment, but fell to the pretreatment level during the next 2 weeks. The results were similar in the two groups. Radiation myelopathy was suspected in one (F2) patient. There was no difference in survival between the two groups (log-rank test), the median survival time from the date of allocation being 179 days in the F2 and 177 days in the FM group. In the light of all the findings, the regimen of two fractions of 8.5 Gy given 1 week apart is recommended.
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PMID:Inoperable non-small-cell lung cancer (NSCLC): a Medical Research Council randomised trial of palliative radiotherapy with two fractions or ten fractions. Report to the Medical Research Council by its Lung Cancer Working Party. 170 40

An 80-year-old man was admitted to our hospital with a complaint of insidious hearing loss and facial palsy. Chest X-ray film showed an abnormal shadow in the right lower lobe. Adenocarcinoma of the lung was diagnosed by transbronchial brushing cytology. During admission, headache and dysphagia appeared, although no abnormality was detected in the brain CT and MRI. Lumbar puncture yielded adenocarcinoma cells in the cerebrospinal fluid. A diagnosis of leptomeningeal metastasis from the adenocarcinoma of the lung was considered and intrathecal administration of methotrexate was performed. The patient's condition deteriorated gradually and he died of respiratory failure. Autopsy revealed massive invasion of tumor cells in the leptomeninges of the brain and spinal cord. This case illustrates that facial nerve palsy with insidious hearing impairment may appear as the initial symptoms in meningeal carcinomatosis resulting from lung cancer metastasis.
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PMID:[Insidious hearing loss and facial palsy as the presenting symptoms of meningeal carcinomatosis resulting from adenocarcinoma of the lung]. 175 49

Synchronous double carcinoma of the lung and the esophagus is extremely rare disease. In Japan, 13 cases have reported by Abo and only 10 clinical cases have been documented so far. We describe two cases of synchronous double carcinoma of the lung and the esophagus. Case 1. A 74-year-old man was admitted to our hospital because of the abnormal shadow of the chest X-ray film. Left upper lobectomy was carried out for the lung carcinoma. Because of dysphagia after surgery, upper GI series and endoscopic biopsy were performed, and midesophageal carcinoma was revealed. Radical operation of the esophageal carcinoma was performed 2 months after the first operation. Pathological diagnosis of the lung tumor and the esophageal tumor were well differentiated adenocarcinoma and moderately differentiated squamous cell carcinoma respectively and both of them were early cancer. After 22 months of the second operation, he is doing well. Case 2. a 66-year-old man was operated on because of the esophageal carcinoma in other hospital. Abnormal shadow appeared in his X-ray film 10 months after operation. Although he received chemotherapy as metastatic lung cancer, bronchoscopic examination revealed it adenocarcinoma. We performed segmental lobectomy to him 17 months after the first operation. Pathological diagnosis was large cell carcinoma of the lung. He is also doing well 18 months after the second operation.
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PMID:[Two surgical cases of synchronous double carcinoma of the lung and esophagus and review of 10 documented cases in Japan]. 185 97

A case report is presented of a patient with lung cancer treated with chemotherapy followed by radiotherapy due to increasing dysphagia. A few months after radioterapy an esophago-tracheal fistula developed, which was diagnosed by a radiological contrast study and esophagofiberoscopy. Post mortem examination did not reveal malignant invasion of the fistula and surrounding tissues. It seems that the fistula was a late complication of radiotherapy.
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PMID:[Esophagotracheal fistula as a complication of radiotherapy of lung cancer]. 232 28

Precise 5-FU intra-arterial infusion and simultaneous irradiation are considered to reduce most tumors, with no functional disturbance occurring as a rule. We performed this therapy in 2 patients. One patient had lower esophageal cancer (T2N0M0) and the other had metastatic cancer of both lungs. We inserted a catheter into the lower periphery of the aortic arch via the left superficial temporal artery in the former patient, and into the upper thoracic aorta via the thyrocervical trunk in the latter patient, before infusing 5-FU together with simultaneous irradiation. Dysphagia disappeared and there was significant improvement of the esophagram, X-ray appearance, and endoscopic appearance in the former patient, who remains under observation. The latter patient showed remarkable regression of the tumor but died after a recurrence. Good efficacy is observed with the use of radiotherapy for the treatment of esophageal cancer at first. However, recurrences occur which carry a bad prognosis. The temporary favorable effect of radiotherapy suggests a promising future for this new therapy, since 5-FU is a strong radiosensitizer. We have a favorable impression of this mode of therapy in comparison with radiotherapy alone, though we have experience with only one patient. There was also a better response than expected when we used it for the treatment of metastatic lung cancer.
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PMID:[5-FU intra-arterial infusion and simultaneous irradiation in the treatment of esophageal cancer and metastatic lung cancer]. 278 81

This report describes our experience with six patients with dysphagia as the sole manifestation of radiographic, inconspicuous primary lung cancer and well-defined esophageal lesion by barium swallow. Esophagograms suggested leiomyoma, benign esophageal stricture, duplication cyst, achalasia, and primary carcinoma of the esophagus. Careful evaluation of the chest radiographs in all patients presenting with dysphagia is emphasized. The majority of esophageal findings are subcarinal and bronchoscopy should be considered essential in the workup of these patients.
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PMID:Bronchogenic carcinoma masquerading as primary esophageal disease. 628 56

A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen.
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PMID:A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. 750 4

The coplanar polycentric multiple 180 degrees single arc and narrow beams technique (PMA) allows high radiation doses to be delivered to the target, with similar dose distribution to that of brachytherapy. Since 1990, more than 100 patients have been treated: 80 had NSCLC, 12 had epidermoid head and neck (oral cavity and oropharynx) cancers, 8 brain tumors, 4 esophageal cancers and, sporadically, other patients had many other kinds of tumors, e.g., Hodgkin's and non-Hodgkin's lymphomas and sarcomas. X photons of a 12-MV Linac have always been used. NSCLC patients are assessable for local control, toxicity and survival, while the other patients only for local control and/or toxicity. As for 31 stage I-II lung cancer patients, CR has been observed in 82.8% of them and PR in 13.8%; the response was always assessed with chest radiography, CT, FBS, cytology and/or histology. The overall actuarial survival rate is 71% at 40 months, the disease-free survival rate is 75% and the local progression-free survival rate is 94%. As for 49 stage-III patients, CR has been observed in 40% of them and PR in 56%. The overall disease-free survival is 10% at 28 months (median survival: 14.37 +/- 0.6 months). The disease-free survival rate is 23%. The local progression-free survival rate is similar to the overall survival rate, which seems to prove the very high metastatic spread of this disease in advanced stages. Twelve head and neck cancer patients have been treated, 5 of them in stage II and 7 in stage IV. CR has been observed in all the patients in lower stages (100%), in 4/7 patients in stage IV (57%) and in 4/5 patients (80%) in the T4N0 subgroup. The response of brain tumors treated with the PMA technique is difficult to assess because radiographic, CT and MR images are difficult to correlate with patients clinical status. The patients in our series are still alive, with a medium follow-up of 7 months (range: 2-16 months). A longer follow-up is necessary before any other considerations on the effectiveness of this method can be made. This technique was used on the patients who were not eligible for the other techniques with high doses delivered to the tumor, because of its volume and/or shape. Four esophageal cancers were treated with palliative intent, because of absolute dysphagia, in alternative to HDR brachytherapy. All these patients have obtained symptom remission.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The polycentric multiple arc complanar technic, or telebrachytherapy. A 4-year experience (an innovative way for the local control of solid neoplasms)]. 756 75


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