Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 348 out of 349 patients with laryngeal cancer were treated over the period 1960-1970. Radiation therapy alone was used in 262 of them and surgical intervention with postoperative irradiation in 86. Results in the form of a five-year survival rate in the group treated solely by irradiation were superior by 12% in the case of glottic than in that of supraglottic carcinoma (48.8% and 36.8% respectively). In the group of patients operated upon and subsequently irradiated, relatively satisfactory results were obtained in the advanced, i. e. the III stage of supraglottic carcinoma (5-year survival in 61.4%). The overall 5-year survival rate in the patients operated upon and then irradiated proved to be better by 24.5% in supraglottic and by 4.1% in the glottic carcinoma, than in patients subjected solely to irradiation. Of 27 cases of relapses, 6 patients were successfully treated by laryngectomy. Post-irradiation complications involved most frequently minor cases of endolaryngeal edema; among the more serious ones were 2 cases of radiation myelitis. The discussion on the problem of radiation dosage in cancer of the larynx, the treatment of regional metastases and combined surgico-radiation therapy.
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PMID:Results of radiation therapy and a combination of radiation and surgery in the laryngeal cancer. 86 51

During the 30 year period from 1957 to 1986, 42 patients with primary tumors arising from the spinal cord or cauda equina received postoperative irradiation at the University of California, San Francisco. Twenty-one patients had ependymomas: 18 were localized to one site, and 3 diffusely involved the cord. There were 12 patients with low grade astrocytomas and 3 with highly anaplastic astrocytoma or glioblastoma multiforme. All astrocytomas were localized at presentation. In 6 cases tissue was insufficient to permit a histologic diagnosis. Thirty-nine patients (93%) received total radiation doses ranging between 45.0-54.7 Gy using standard fractionation. The 10-year actuarial disease-specific survival rate for patients with localized ependymoma was 93%; 33% of these tumors recurred locally. The corresponding rate for diffuse ependymomas was 50%; the spinal disease was controlled in all 3 patients, but one developed a cerebral metastasis despite prophylactic cranial irradiation. Low-grade astrocytoma patients had a 10-year actuarial disease-specific survival rate of 91%, with 33% of these tumors recurring locally. No patient with highly anaplastic astrocytoma or glioblastoma multiforme survived longer than 8 months; all of these tumors recurred locally, and two of the three also developed diffuse craniospinal axis metastases. Local recurrence for ependymoma was delayed as long as 12 years following treatment, while all but one astrocytoma failure occurred within 3 years of treatment. No significant dose-response relationship with respect to local control was noted for either localized ependymomas or low grade astrocytomas. One patient developed radiation myelitis after receiving 50.4 Gy with standard fractionation. These results indicate that patients who undergo postoperative irradiation for low grade spinal astrocytomas and localized spinal ependymomas achieve excellent survival. However, despite treatment with total radiation doses taken to the practical limit of spinal cord tolerance, local failure remains common.
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PMID:Postoperative radiotherapy of primary spinal cord tumors. 254 94

A clinical description and pathological findings are reported in a case of extrameningeal, angiogenic malignant meningioma of the vertebral canal (Th7-Th11) in a patient aged 17 years. Clinical picture was that of transverse myelitis at the Th9 level, with spastic paraparesis, funicular loss of all sensory functions and sphincter disturbances. The authors suppose that the used combined treatment (chemotherapy and radiotherapy, surgery) improved greatly the health state inhibiting the spread of metastases and prolonged survival to 3 years. Autopsy demonstrated recurrence of he tumour in the vertebral canal and numerous metastases to the brain, lungs, liver, bones and pancreas.
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PMID:[A case of malignant extrameningeal meningioma of the spinal canal with multiple metastases in a 17-year-old patient. Clinical and morphologic studies]. 324 15

Ten patients with squamous cancer of the esophagus were treated with an outpatient regimen combining cis-diamminedichloroplatinum (II), methotrexate and bleomycin. Nine of these had metastatic disease or recurrence after radiotherapy. Objective responses were noted in 50%, regardless of performance status or metastatic site. None of three patients with prior radiation therapy responded, however. Median duration of response was six months. Responders survived a median of eight months versus five months for nonresponders. Three patients had severe hematologic toxicity. A single patient with massive disease confined to the esophagus had an excellent response to six weeks of chemotherapy before radical irradiation. He is disease-free after two years but is paraplegic from radiation myelitis. This chemotherapy program is an effective palliative therapy for metastatic esophageal cancer. Its safety and efficacy as part of the initial treatment of local disease should be further investigated.
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PMID:Effective chemotherapy for esophageal cancer with methotrexate, bleomycin, and cis-diamminedichloroplatinum II. 617 34

A case of suspected radiation myelitis based on clinical history, previous irradiation, neurologic deficit in the irradiated volume, and normal myelogram is reported. At autopsy, intramedullary metastatic disease was found, but not radiation damage. All radiation details must be considered before making the diagnosis of radiation myelitis with confidence. It is important not to exclude other potentially helpful treatment, such as surgery or chemotherapy, by the presumptive diagnosis of radiation myelitis.
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PMID:Intramedullary tumor metastasis simulating radiation myelitis: report of a case. 728 68

Radiation therapy is the elective treatment of inoperable non small cell lung cancer, but is potentially curative only for a few of them: failures result from distant metastases and/or from progressive local disease. During the last years, following the progress in chemotherapy, combining radiation and drugs is becoming a more common approach. Nevertheless, one of the main concerns remains the potential interference between both modalities leading to an increased toxicity, which may outweigh all potential benefit. Several organs can be a target for acute or late toxicity: lung (pneumonitis and fibrosis), esophagus (acute esophagitis, stenosis), heart (pericarditis, impaired ventricular functions, heart failure, coronary stenosis), spinal cord (transient myelopathy, radiation myelitis), skin (moist desquamation, fibrosis, telangiectasia). The current published trials combining drug and radiation appear to be a rather safe approach especially when avoiding concomitant treatment. However, several points remain unsolved: the optimal combination scheme, the real risk of late damage observation including the second cancer occurrence risk. This risk is uneasy to evaluate due to the long latency period. The way of describing the late damage is crucial, seeking for a more precise system of evaluating, recording and reporting late effects, taking into account objective damage as well as the patient's symptoms. Therefore, combining drug and radiation should preferentially be performed within prospective studies, with precise evaluation procedures.
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PMID:[Non small-cell bronchial cancers: toxicity of the association radiotherapy-chemotherapy. Review of the literature]. 794 85

Clinicopathological and immunohistochemical studies were performed in a patient with paraneoplastic limbic encephalitis, myelitis, sensory neuropathy and cerebellar degeneration secondary to small cell lung cancer. A 67-year-old male smoker developed orthostatic dizziness 6 months prior to admission. Over the following months, his wife noticed that he became forgetful and confused. Over the next three weeks, he became unable to sit or stand unaided and admitted to our service. On admission, he was lethargic and disoriented in time and place. Neurological examination revealed marked limb weakness with distal dominant muscle atrophy. A chest radiograph demonstrated a mass in the right middle lobe and a bronchial biopsy revealed a small cell carcinoma. CT scan and MRI of the brain revealed abnormalities in the bilateral medial temporal lobes and putamen. He was treated with anti-cancer chemotherapy, but died of respiratory failure after 13 months illness. Postmortem examination showed a mass in the right middle lobe of the lung. No tumor metastases were noted in the nervous tissue. Microscopical examinations of the nervous system revealed neuronal loss, astrogliosis and perivascular and parenchymatous lymphocytic infiltration in the hippocampus, subiculum, amygdala, putamen, medulla oblongata, spinal cord and dorsal root ganglia. Loss of Purkinje cells was also seen in the cerebellum without lymphocytic infiltration. Immunohistochemical analysis of the patient's serum and CSF by the use of adult rat brain revealed immunoreactivity at the hippocampal pyramidal neurons CA3 and CA4. At the higher dilution, neuronal nuclei were specifically stained.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A clinicopathological study of a patient with paraneoplastic limbic encephalitis, myelitis, sensory neuropathy and cerebellar degeneration, associated with a unique antineuronal antibody]. 839 16

Re-irradiation of previously treated areas may become necessary for recurrent cancer, new primary tumours (common in head and neck cancer patients), or nodal and metastatic disease. Factors that should be taken into account in the decision to re-treat include: 1) previously treated volume (how much overlap is there with new treatment fields) and dose fractionation schedule; 2) which critical tissues or organs are at risk; 3) how much time has elapsed since first treatment; 4) whether there are any practical alternatives to re-irradiation? Rapidly proliferating tissues generally recover well from the initial radiotherapy and will tolerate re-irradiation to almost full doses. Some slowly proliferating tissues are also capable of partial proliferative and functional recovery, although this takes several months and some residual damage remains. Preclinical data demonstrate that re-irradiation with reduced doses is possible in lung and spinal cord after intervals of 3-6 months. Other slowly proliferating organs, e.g. the kidneys, do not appear to be capable of recovery, even after low, subtolerance doses. The largest clinical experience of re-irradiation is for head and neck cancers. A review of this literature reveals that the most frequent normal tissue complication seen is trismus (lockjaw), which occurs in 16 to 30% of re-treated cases, with lower incidences of soft tissue or bone necrosis and fibrosis. Myelitis is rarely reported, even in the re-treatment situation. In general the highest incidence of local control for the lowest incidence of serious complications is achieved for combinations of external beam and brachytherapy, and for small, well-differentiated, new primary tumours rather than recurrent disease. Re-treatment with total doses < 55 Gy gives very poor local control rates. Re-treatment schedules with curative intent require a high re-treatment dose, which is accompanied by an increased risk of normal tissue damage. To minimize serious complications, re-irradiation schedules require the best possible treatment planning (conformal therapy where possible). Hyperfractionation or a combination of external beam and brachytherapy could also be beneficial.
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PMID:Re-treatment after full-course radiotherapy: is it a viable option? 1060 15

The majority of spinal cord lesions observed in prostate cancer are related to extradural compression. Intradural (extramedullary or intramedullary) metastases are very rare. The authors report a case of probable carcinomatous myelitis secondary to prostate cancer in a 50-year-old man, 9 months after the initial diagnosis of advanced metastatic prostate cancer. Despite endocrine therapy initiated immediately after diagnosis, the patient rapidly developed leg pain due to vertebral osteolysis. He developed flaccid paraplegia despite radiotherapy of the lumbar spine combined with corticosteroid therapy and chemotherapy. Spinal cord magnetic resonance imaging (MRI) showed typical features of very probable carcinomatous myelitis in the cervicothoracic zone. The patient died shortly after without histological confirmation. Regardless of the primary cancer, intramedullary spinal cord metastases have a very poor prognosis. Based on a literature search, this case appears to be the first case related to prostatic cancer reported in the medical literature.
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PMID:[Spinal cord metastasis from prostate cancer]. 1577 12

Magnetic resonance imaging is the current imaging modality of choice in the evaluation of patients presenting with myelopathic symptoms in the search for spinal cord lesions. It is important for the radiologist to recognize and differentiate nonneoplastic from the neoplastic process of the spinal cord as the differentiation of the 2 entities is extremely crucial to the neurosurgeon. This article presents a broad spectrum of benign intramedullary spinal abnormalities including syrinx, contusion, abscess, infarction, myelitis, multiple sclerosis, sarcoid, cavernoma, and arteriovenous malformation. Rare intramedullary neoplasms including dermoid tumor, astrocytoma, ependymoma, hemangioblastoma, lymphoma, ganglioneuroblastoma, and metastases are also illustrated. The clinical presentation and magnetic resonance signal characteristics as well as the differential diagnosis of the intramedullary lesions are discussed. The potential pitfalls in the differentiation of tumors from nonneoplastic disease of the spinal cord are also elucidated.
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PMID:Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review. 2051 Jul 54


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