Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the cases of 37 patients with carcinoma of the lung revealed by brain metastases. The most frequent clinical manifestation was focal neurological symptoms associated with headache and vomiting in 50% of the cases. X-ray films of the chest were abnormal in 34 patients. At the time of diagnosis 11 patients also presented with extra-cerebral metastases. The histological type of the primary lung tumor was obtained by examination of the thorax in 32 cases and in 5 cases from brain or lymph node metastases: 11 patients had small-cell lung carcinoma and 26 had non small-cell lung carcinoma. The overall actuarial median survival was 4.5 months, irrespective of the histological type. The group of 20 patients who underwent neurosurgery had a longer median survival (10 months versus 4.5, p < 0.05), and in the subgroup where brain and lung resections were combined the median survival was even longer (13 months). Cerebral relapses occurred in 12 patients: in 7 out of 15 patients with brain surgery but without adjuvant brain radiotherapy, and in 5 out of 16 patients with brain radiotherapy without neurosurgery. No cerebral relapse was observed in the group of 5 patients who had complete resection followed by radiotherapy of the brain. This demonstrated a clear benefit from postoperative radiotherapy. Conventional chemotherapy induced objective responses only in the small-cell carcinoma group and could be too toxic when combined with simultaneous radiotherapy, but it proved a useful adjuvant treatment in patients with radiotherapy of the brain.
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PMID:[Cerebral metastasis disclosing primary bronchogenic cancers]. 133 93

Fourteen patients with metastatic renal cell carcinoma (RCC) were treated by systemic administration of autologous lymphokine-activated killer (LAK) cells and interleukin-2 (IL-2). Pulmonary metastases alone were found in 9 cases, pulmonary and mediastinal nodal metastases in 3, and pulmonary and bone metastases in 2. LAK cells, generated by incubation in 2 units/ml of IL 2 for 3-4 days, were intravenously administered once or twice a week. In addition, beginning on the day of the first LAK cell infusion, 1000 units of IL 2 diluted in normal saline were intravenously infused once or twice a day with occasional supplementation of 1000 units of IL-2 on each day of LAK cell infusion. The total number of LAK cells and total amount of IL-2 administered per patient in this study ranged from 0.8 x 10(10) to 6.9 x 10(10) cells and from 3.3 x 10(4) to 21.4 x 10(4) units, respectively. As toxic effects caused by the infusion of LAK cells, headache, shaking chills, fever and leukocytosis were found in all 14 cases. Side effects possibly induced by IL-2 infusion were tolerable fever, fluid retention (body weight gain of 2-3 kg) and eosinophilia. No objective regression of mediastinal nodal or bone metastases was observed. In regard to lung metastases, however, partial and minor responses were observed in 3 and 2 cases, respectively. One of the 3 patients with a partial response was clinically free of disease after undergoing a thoracotomy for resection of residual lesions, but a brain metastasis was detected 10 months after the thoracotomy. The remaining 2 patients are being closely followed up at present. In 3 of 11 patients who showed a minor response, no change or progressive disease, brain metastases were observed during or after the immunotherapy. Furthermore, we examined the possibility of selection of suitable candidates for this therapy on the basis of the degree of in vitro LAK activity against autologous cultured tumor cells in 6 patients, but there was no significant correlation between in vitro autologous tumor cell lysis by LAK cells and the clinical response to immunotherapy. In conclusion, although a complete response could not be obtained, it can be said that this immunotherapy may be effective against RCC, in particular lung metastases, since a partial response was achieved in 3 of 14 patients. However, it should be taken into consideration that this immunotherapeutic approach may have a risk of increasing the frequency of brain metastases.
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PMID:[Usefulness and limitation of immunotherapy of metastatic renal cell carcinoma with autologous lymphokine-activated killer cells and interleukin 2]. 207 2

Brain metastases from renal cell carcinoma are uncommon. The present study was undertaken to determine the value of routine computerized tomographic (CT) scanning of the brain in patients with renal cell carcinoma. A review of 106 patients with renal cell carcinoma who had undergone CT scan of the brain revealed brain metastases in only 13.2 percent. Brain metastases were accompanied by central nervous system (CNS) symptoms in 78.6 percent of patients, with headaches constituting the most common presenting symptom (64.3%). Brain metastases were detected in only 3.3 percent of patients who had no CNS symptoms at the time of evaluation. It is concluded that CT scanning of the brain should be performed routinely only for those patients who report CNS symptoms at the time of evaluation.
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PMID:Low incidence of asymptomatic brain metastases in patients with renal cell carcinoma. 221 5

Prognostic factors for survival were analyzed retrospectively in 214 patients with brain metastases of the solid tumour type. The most frequent neurological signs and symptoms at diagnosis of cerebral involvement were headache-nausea-vomiting and focal weakness. Similar numbers of patients were found to have solitary metastasis and multiple lesions. Non-small cell lung cancer, small cell lung cancer, breast cancer, melanoma, and renal cell cancer comprised the majority of the primaries. Most patients received high-dose corticosteroids, while in a third, anticonvulsant agents were administered. Of 157 patients treated with radiation alone, or surgery with or without radiation, 110 experienced alleviation of symptoms or stabilisation of the disease. In 38 patients with a solitary lesion, craniotomy was carried out, either with or without postoperative radiation; the latter group showed the longest survival with a median of 37 wk. The remaining group of 73 patients with one brain metastasis had a median survival of only 15 wk. The 69 patients with multiple lesions who had been irradiated had a median survival of 15 wk, while that for 34 untreated patients was 7 wk. A short median survival of 11 and 13 wk, respectively, was observed in patients with concurrent progressive extracerebral disease and in those with progressive neurological symptoms regardless of treatment. It is concluded that in patients with a solitary brain metastasis without progressive extracerebral disease surgery should be considered the treatment of first choice aiming at a long-term survival with a good quality of life.
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PMID:Palliative care for brain metastases of solid tumour types. 246 70

On the basis of epidemiologic and experimental evidence of an anticancer activity of vitamin A, a randomized clinical trial was activated in Milan with the aim of evaluating if retinol palmitate administration (per os, 300,000 I.U. daily) after complete resection of stage Ia non small-cell lung cancer could reduce the occurrence of cancer relapses (within 3 years) and/or the occurrence of new primary tumors (beyond 3 years). By September 1987, 181 patients had entered the trial: 87 in the treatment arm and 94 in the control arm. After a median follow-up of 14 months, the interim analysis was focused on the evaluation of toxicity, compliance, and early recurrences. Although the large majority of patients were affected by skin and mucous membrane desquamation and dryness during treatment, these symptoms were generally mild and well tolerated, and never induced the patient to stop the treatment. Other side effects like headache, hair loss, itching, or dyspepsia were detected at a much lower frequency. Only in 3 patients the treatment was interrupted, because of signs or symptoms potentially related to vitamin A administration. At the time of the analysis, a total of 42 (23%) patients had relapsed; 16 (18%) in the treated arm, and 26 (28%) in the control arm. The largest difference between treated patients and controls was observed for bone metastases (2 vs. 7) and brain metastases (3 vs. 6), and for squamous histology (6 vs. 11). Only 2 cases of new primary cancer were detected, both in the control arm. These results are promising both in terms of tolerance and efficacy of treatment, but given the short median follow-up they must be very cautiously interpreted. A longer follow-up is necessary to establish whether a significant proportion of early recurrences could be prevented, or only delayed, by vitamin A administration.
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PMID:Lung cancer chemoprevention with retinol palmitate. Preliminary data from a randomized trial on stage Ia non small-cell lung cancer. 285 45

Eight patients were treated with leukocyte interferon for a variety of neurological malignancies that had failed or recurred after conventional therapy. Three patients with malignant astrocytoma received intratumoral interferon in dosages up to 9 million units 3X/week, with total dosages of up to 160 million units. Interferon was administered intraventricularly in 4 patients with leptomeningeal metastases and one patient with multiple brain metastases. Dosages increased from 1 to 10 million units 3X/week, and total dosages of up to 113 million units were given intraventricularly. Acute side effects of fever, nausea, vomiting, and headache occurred almost exclusively with intraventricular injections, and these subsided after the initial injection. Fatigue, loss of appetite, weight loss, and hematologic toxicity developed a few weeks after onset of treatment, independent of the dose given. A modest tumor regression was seen on CT scans of one patient with a malignant astrocytoma, who was treated with interferon for 8 months. In all 4 patients with leptomeningeal metastases, the CSF became free of malignant cells for 6 to 10 weeks, while clinical improvement was less dramatic.
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PMID:Phase I clinical trial of intralesional or intraventricular leukocyte interferon for intracranial malignancies. 298 29

A phase I study of the intracarotid administration of PCNU was conducted in patients with intracerebral tumors recurring after cranial radiation. Seventeen patients were treated including 16 with recurrent gliomas or glioblastomas and 1 with recurrent brain metastases from adenocarcinoma of the lung. An additional patient received a vertebral artery infusion of PCNU for a recurrent glioblastoma. Seven of 17 patients receiving intracarotid PCNU responded for a response rate of 41%. If only evaluable patients with gliomas are considered, the response rate was 44%. Tumor grade at time of initial diagnosis, exposure to prior chemotherapy, and dose of PCNU did not appear to have a major impact on response rate. Zubrod performance status 3 patients had a lower response rate (25%) than did patients with performance status 1 or 2 (response rate 63%). Thrombocytopenia and reversible central nervous system toxicity were dose limiting at a PCNU dose of 110 mg/m2. Two patients had possible permanent central nervous system toxicity. Three patients had permanent ipsilateral visual impairment, including one at the lowest dose used into the carotid artery (60 mg/m2). Orbital pain appeared to be substantially less than that seen with intracarotid BCNU but headaches may have been somewhat more common. The single patient receiving a vertebral artery infusion developed marked headaches and restlessness after receiving 25 mg/m2 of a planned 75 mg/m2 treatment into the vertebral artery and the treatment had to be discontinued. Symptoms were rapidly reversible upon stopping the medication. Our overall impression is that intracarotid PCNU causes less ocular pain but more transient central nervous system toxicity than does intracarotid BCNU.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase I study of intracarotid PCNU. 368 87

Two patients with parenchymal brain metastases from adenocarcinoma of the prostate (CaP) are presented. Both patients had the diagnosis made antemortem by biopsy, and tumor immunoreactivity for prostatic phosphatase and prostate specific antigen confirmed prostatic origin. Brain metastases from prostatic adenocarcinoma are unusual, occurring in only 0.2 per cent of all patients with CaP. Patients present with symptoms of motor dysfunction, headache, and seizures. The mean age at presentation of brain metastases from CaP is fifty-nine years old, which is younger than most patients with CaP. The majority of patients die within weeks after diagnosis. Craniotomy with tumor debulking, radiation therapy, and androgen deprivation may be useful in prolonging survival. All reported cases of CaP metastatic to brain have been histologically moderately differentiated or poorly differentiated. The periprostatic venous plexus is considered the most likely route of tumor spread to the brain.
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PMID:Parenchymal brain metastases from adenocarcinoma of prostate. 376 36

The pseudotumor cerebri, a neurological syndrome clinically characterized by headaches, vomiting and bilateral papilledema, occurred in two patients, previously subjected to total thyroidectomy for differentiated thyroid carcinoma, after initiation of levothyroxine replacement therapy. In patients with thyroid cancer, subjected to thyroidectomy and then thyroid hormone replacement therapy, the possible development of pseudotumor cerebri syndrome should be considered and differentiated from CNS symptoms due to brain metastases.
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PMID:Pseudotumor cerebri and thyroid-replacement therapy in patients affected by differentiated thyroid carcinoma. 406 7

Clinical investigations and computed brain scanning were done in 305 patients with primary extracerebral malignant tumours. One third of the patients had cerebral metastases. In most patients with brain metastases extracerebral secondary tumours were known already. Silent brain metastases were present in only 0.6% of all investigated tumour patients. All other patients had either objective neurologic-psychiatric defects or a least symptoms (headache, vomiting). Use of cranial computed tomography in all tumour patients as a pure screening method is thus not justified. The indication for the investigation is dependent on the clinical symptomatology. However, not only objective neurologic-psychiatric defects must be taken into account, but also occurrence of new symptoms.
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PMID:[Computed tomographic brain scanning in the diagnosis of metastatic neoplasms (author's transl)]. 627 97


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