Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role and timing of physical therapy following axillary dissection for melanoma, or in conjunction with modified radical mastectomy has not been extensively studied. A prospective randomized clinical trial was carried out over an 18-month period in the Surgery Branch, National Cancer Institute (NCI) and Department of Rehabilitation Medicine, Clinical Center, in which patients were assigned to receive one of two postoperative physical therapy regimens. Patients were assigned to receive graduated increases in allowed range of motion (ROM), either beginning on postoperative day 1 (early) or day 7 (delayed). All patients were advanced to full pain-free ROM when the suction catheters were removed. A total of 36 patients with 40 axillary dissections (19 for melanoma, 21 for breast cancer) were included in this study. Patients randomized to receive early motion had more total wound drainage (805 +/- 516 cc vs. 420 +/- 301 cc, p < 0.01), more days of drainage (10.3 +/- 5.3 vs. 6.2 +/- 2.7, p < 0.01), and later postoperative day of discharge (12.8 +/- 5.1 days vs. 9.2 +/- 4.0 days, p < 0.02) than did patients who started motion on day 7. Wound complications including infection and small areas of skin breakdown occurred more frequently in the early group (seven patients vs. one patient, p < 0.02). No significant differences in the per cent of patients achieving functional ROM could be identified between these two groups at one, three or six months after operation. Transient serratus anterior palsy (12 patients) and latissimus dorsi palsy (2 patients) occurred in approximately 30% of all patients, regardless of group (breast vs. melanoma, early vs. delayed), but returned to normal in all patients. The early institution of flexion and abduction exercises following axillary dissection thus appears to have a deleterious effect on wound healing and drainage. Adequate functional ROM is attained in all patients with a minimum of complications when active motion exercises are delayed for up to 7 days after axillary dissection.
 ...
PMID:Early versus delayed shoulder motion following axillary dissection: a randomized prospective study. 701 Dec 21

The authors' previous surgical adjuvant trial in patients with malignant melanoma at high risk of recurrence has shown no difference in disease-free interval or survival between patients randomized to surgery + BCG or surgery alone. Reported here is a subsequent nonrandomized trial in 30 similar patients who received surgery + Corynebacterium parvum (CP) 4 mg I.V. daily x 5, followed by 4 mg S.C. weekly for up to three years. After I.V. C. parvum, chills, fever, headache, and hypertension were common. After S.C. C. parvum, varying degrees of local induration, erythema, and pain were experienced. Dose reduction was necessary for 14 patients during I.V. treatment and for six patients during S.C. treatment. A marked decrease in absolute lymphocyte count and a decreased proliferative response of lymphocytes to common antigens in vitro was observed after 2-3 days of I.V. C. parvum. Lymphocyte reactivity to mitogens decreased, particularly with Con A. Marked increase in nitroblue tetrazolium reduction by granulocytes was seen in 20 patients. Although changes in delayed cutaneous hypersensitivity reactions to recall antigens followed no consistent pattern, reactivity to DNCB increased in 18 patients. In addition, median time to recurrence was 33 weeks, significantly shorter than in the previous trial, but the survival distribution was no different from before. It can be concluded, therefore, that the administration of C. parvum in this dose and schedule had essentially no effect on the outcome of these patients.
 ...
PMID:Surgical adjuvant therapy of malignant melanoma with corynebacterium parvum. 701 2

Thirty patients with unresectable disseminated melanoma (Stage IV) were treated with Bacillus Calmette-Guerin (BCG) (Moreau strain--Rio de Janeiro) by mouth, with weekly doses ranging between 200 mg and 28,000 mg. Five patients died in the first two months of treatment. Of the remaining 25 patients, two (8%) showed complete regression, and one (4%) partial regression. Seven patients (28%) had stabilization of the disease for a six-month period, and 15 (60%) had progression of the disease. Complete and partial regressions were seen only in patients with extravisceral (subcutaneous) metastases, and were associated with a longer survival time. Regression of the subcutaneous metastatic nodules was always accompanied by the following local phenomena: increased temperature; local inflammation; softening, pain and pruritus at the nodule site; and a gradual decrease in size. At the site of the tumor mass, a hypochromic halo appeared. This halo remained permanently and was pathognomonic of the metastatic nodule rejection. When the halo was fully established, the inflammatory infiltrate was minimal and the malignant cells disappeared. If the area contained hairs, they underwent complete albinization. Serial biopsies of the nodules undergoing inflammatory changes and decreased consistency exhibited an intense cellular infiltration of lymphocytes, macrophages, and plasma cells around the malignant cells. This sometimes simulated lymphoid follicle formation involving the melanoma cells associated with necrosis in a centripetal way. Some patients with visceral metastases (particularly pulmonary) had an unexpectedly long survival, apparently associated with interruption of the growth rate of the masses. Eleven out of 20 deaths were due to cerebral metastases. When cerebral disease was diagnosed, BCG was discontinued and the administration of corticoids was usually associated with a disappearance of the inflammatory signs at the nodule sites, but with progression of the disease. Toxicity was minimal.
 ...
PMID:Treatment of disseminated malignant melanoma with high-dose oral BCG. 702 54

Hyperthermia appears to be an important adjunct to present day cancer therapies. A literary review indicates that at least 60 of the patients studied showed improvement-primarily relief of pain. Radiographically, approximately 50% of the patients demonstrated a remission or decrease in the size of the tumor (4-7, 9, 10). Although further research in hyperthermia continues, amputation of a limb because of osteogenic sarcoma or malignant melanoma may no longer be the primary treatment of choice.
 ...
PMID:hyperthermia for lower extremity neoplasms: a review of the literature. 703 35

9,10-Anthracenedicarboxaldehyde bis[(4,5-dihydro-1H-imidazol-2-yl)hydrazone] dihydrochloride (bisantrene) is a new anthracene bishydrazone derivative which was entered into a Phase I clinical trial (one dose weekly for 3 weeks) because it showed significant antitumor activity in a number of animal tumor models and in vitro in the human tumor stem cell assay. When possible, patients were entered into the phase I study if their tumors showed in vitro sensitivity to bisantrene and resistance to standard agents, using a human tumor stem cell assay. Thirty-one patients were treated with bisantrene over a 10-month period, starting at a dose of 70 mg/sq m/week. The appearance of leukopenia determined the dose-limiting toxicity of bisantrene. The maximally tolerated dose appeared to be 200 mg/sq m in that three of five patients tolerated these weekly-for-3-weeks doses while experiencing only mild or moderate leukopenia. In contrast, the 220-mg/sq m dose caused moderate to life-threatening leukopenia after just two weekly doses in four of five patients. Local bisantrene toxicity included mild to severe arm swelling, phlebitis, pain, urticaria, and erythema in 68% of the patients. In general, these toxicities were well tolerated and rapidly reversible, but two patients had severe local swelling for up to 6 months. In this Phase I trial, bisantrene showed clinical antitumor activity against both hematological cancer (i.e., lymphoma and myeloma) and solid tumors (i.e., bladder, lung, and renal cancer and melanoma). Of importance, four of the six responses occurred in patients whose therapy was selected on the basis of in vitro sensitivity to bisantrene using the human tumor stem cell assay. One patient with disseminated melanoma had complete disappearance of an axillary node metastasis (for more than 6 months) while developing a brain metastasis, suggesting that bisantrene does not concentrate in the central nervous system.
 ...
PMID:Phase I clinical investigation of 9,10-anthracenedicarboxaldehyde bis[(4,5-dihydro-1H-imidazol-2-yl)hydrazone] dihydrochloride with correlative in vitro human tumor clonogenic assay. 703 74

A phase I study of intracarotid cis-diamminedichloroplatinum was performed in 11 patients with intracerebral tumors (five glioblastoma, four melanoma, one meningeal sarcoma, and one lung carcinoma) progressing after radiation +/- chemotherapy. The internal carotid artery was temporarily cannulated by a percutaneous transfemoral approach. All patients received i.v. heparin, mannitol, and fluids; seven received dexamethasone, 50 mg i.v., twice the day before and the day of treatment. Intracarotid cis-diamminedichloroplatinum, 60 to 100 mg/sq m in 175 to 250 ml 0.45% NaCl solution with 1000 units heparin, was infused over 1 hr. Six patients received two or more courses (maximum of 6) at 2- to 8-week intervals. Gastrointestinal toxicity was mild to moderate. Ototoxicity was minor. Central nervous system (CNS) toxicity was focal, severe, permanent, and possibly due to embolus in one patient at 75 mg/sq m; focal and reversible in one patient at 100 mg/sq m; and generalized but reversible in one patient at 75 mg/sq m. Possible CNS toxicity was noted in two additional patients. Two patients with CNS toxicity developed permanent ipsilateral retinal toxicity, and one patients without CNS toxicity developed bilateral decreased visual and auditory acuity 2 weeks after his sixth treatment. Renal and hematological toxicity and orbital pain were mild. Response status included: early death, one; probable responses, six (2+ 4+, 6, 6+, 8, and 8+ months); stabilization, two (3+ and 4 months); and failure, two. We recommend cis-diamminedichloroplatinum (60 mg/sq m) every 2 to 4 weeks for Phase II studies. Severe CNS and retinal toxicity are possible.
 ...
PMID:A phase I study of intracarotid artery infusion of cis-Diamminedichloroplatinum(II) in patients with recurrent malignant intracerebral tumors. 719 71

Oral malignant melanoma is uncommon, comprising less than 1% of all malignant melanomas. Consequently, few cases have been reported from any one institution. We report 10 cases of malignant melanoma of the oral cavity seen at the Mayo Clinic between 1905 and 1979. The site of the primary tumor was the hard palate in 4 patients, the soft palate in 2 patients, the lower alveolus in 2 patients, and the upper alveolus and the retromolar trigone in 1 patient each. Eight of these tumors occurred in men, and 8 patients were older than 60 years of age. Presenting symptoms were a pigmented mass in 9 patients, pain in 5 patients, and bleeding in 3 patients. In 4 patients, the tumor occurred in an area of preexisting hyperpigmentation. The treatment of choice in this disease is surgery; it is the only form of therapy with curative potential. Radiation therapy produced tumor regression in one patient in whom the tumor was considered inoperable, although there was no effect on eventual survival. Chemotherapy was ineffective in producing tumor regression. The prognosis of patients who have malignant melanoma of the oral cavity is dismal; the median survival time in this series was 16 months after diagnosis. Early diagnosis of pigmented lesions in the mouth and adequate tumor resection may improve the prognosis in this disease; however, once the tumor recurs, there is essentially no possibility of prolonged survival.
 ...
PMID:Malignant melanoma of the oral cavity: review of 10 cases. 740 34

Sinonasal melanoma is a rare malignancy. We present the clinicopathologic review of 18 cases seen at the British Columbia Cancer Agency between 1976 and 1992: 13 men and five women, mean age 66 years (range 32-88). Patients presented with nasal obstruction and bleeding (n = 8), obstruction alone (n = 4), bleeding alone (n = 5) or pain (n = 1). Those with bleeding presented with a shorter duration of symptoms than those with obstruction alone. All patients with obstruction alone died of their disease, while all patients with bleeding alone are alive or have died of an unrelated cause; four out of eight patients with both obstruction and bleeding are alive. There was no significant relationship between treatment modality and outcome. Histologic subtypes included epithelioid (n = 10), spindle-cell (n = 4), small-cell (n = 3) and pleomorphic (n = 1). Eight out of 11 cases from whom samples of paraffin-embedded tissue were available showed more prominent staining for HMB-45 than for S-100. In two cases, only rare (< 0.1%) cells stained for S-100. Cell type, mitotic rate and P53 expression were unrelated to disease outcome. Six out of seven patients with < or = 10% of cells showing intense staining for PCNA were alive or had died of an unrelated cause, while three out of four with > 10% staining died of their disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Melanoma Res 1995 Aug
PMID:Sinonasal malignant melanoma--a clinicopathologic analysis of 18 cases. 749 62

B16 F1C29 melanoma cells, which are thought to contain and release catecholamines, were implanted in mouse and rat spinal subarachnoid space. B16 F1C29 cell implants augmented the antinociceptive effect of morphine in tail-flick test, and this interaction was blocked by either the alpha 2-adrenergic antagonist idazoxan or the opioid antagonist naloxone. B16 F1C29 cell implants also augmented the antinociceptive effect of the catecholamine re-uptake blocker desipramine. Substance P-induced biting and scratching behaviors were inhibited in mice receiving B16 F1C29 cell implants, and this effect of B16 F1C29 cell implants was blocked by the alpha 2-adrenergic antagonist idazoxan. Mice receiving B16 F1C29 cell implants showed tolerance to intrathecal administration of the alpha 2-adrenergic agonist UK 14304. These results suggest that B16 cell implant-induced antinociception was mediated by catecholamines secreted from the cell implants and acting at spinal alpha 2-adrenergic receptors. Spinal implantation of catecholamine-releasing cells may provide an alternative approach for the therapy of chronic intractable pain and a useful model to study alpha 2-adrenergic receptor tolerance.
Pain 1994 Feb
PMID:Antinociception following implantation of mouse B16 melanoma cells in mouse and rat spinal cord. 751 33

Management of non-resectable pelvic tumours by intra-arterial local chemotherapy was shown to be beneficial but systemic toxicity limits its use. To overcome this problem isolated pelvic perfusion (IPP) was introduced as an alternative. This study summarizes our preliminary experience with IPP in the treatment of 18 non-resectable pelvic tumours [recurrent rectal adenocarcinoma (six), soft tissue sarcoma (STS) (five), bone tumour (three), epidermoid carcinoma (two), prostatic adenocarcinoma (one), malignant melanoma (one)]. Results of IPP were regarded as complete remission (CR), partial remission (PR), stable disease (SD) and disease progression (DP) according to the changes in three parameters including; scoring in pain, tumour marker and tumour size measurements. Complete and partial remission were established in five (27%) and seven (39%) patients respectively indicating a benefit ratio of 66%. Objective pain relief was encountered in 53% of the cases. All patients with STS had undergone further surgical treatment after IPP with successful curative resections in four. No residual tumour was found at the laparotomy of the fifth patient. Presenting symptom of the prostatic adenocarcinoma patient was symptomatic hypoglycaemia which resolved completely after IPP. To our knowledge, this represents the first case reported in the English literature in whom tumour related hypoglycaemia was successfully managed by IPP. In conclusion; management of non-resectable pelvic tumours by IPP seems to offer serious palliation and increase in the quality of life without any systemic toxicity. Our preliminary experience suggests even resectability may be achieved in a number of patients especially in those with STS.
 ...
PMID:Treatment of non-resectable pelvic malignancies by isolated pelvic perfusion. A preliminary study. 758 1


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>