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)

Sixty-two patients with pulmonary metastases from a variety of primary malignant neoplasms were treated with total-lung irradiation. The incidence of radiation pneumonitis was 21%(13/62) overall, rising to 23% (9/39) in those receiving a tumor dose of 1,500 rads or more. Nine patients with radiation pneumonitis were given chemotherapy (actinomycin D) together with irradiation, and in this group the incidence of radiation pneumonitis was 25%. Five survivors, including 4 treated for metastatic Wilms' tumor, were treated more than 13 months prior to analysis without evidence of disease thus far. Total-lung irradiation for primary malignant neoplasms other than Wilms' tumor does not presently appear to be indicated. A dose of 1,500 rads in 2 weeks in conjunction with actinomycin D is recommended for metastatic Wilms' tumor.
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PMID:Total-lung irradiation in the treatment of pulmonary metastases. 16 12

In an unselected series of 49 children with Wilms' tumour treated in 1969-74 the 5-year relapse-free survival and survival rates were 78% and 81%, respectively, whereas in the series of children treated in 1963-68 the corresponding rates were 49% and 70%. The significant improvement in the relapse-free survival rate was a result of adjuvant treatment with actinomycin D and vincristine (AMD + VCR), which, in some patients, eradicated occult metastatic disease. In the treatment of lung metastases the combination of whole-lung irradiation and maintained chemotherapy with AMD + VCR proved excessively toxic: in 5 of 11 patients acute diffuse pneumonitis developed, and it was fatal in 3. Adjuvant AMD + VCR therapy is advocated in all patients with Wilms' tumour except children less than 12 months old with a tumour of moderate size, limited to the kidney and completely resectable.
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PMID:Wilms' tumour: adjuvant treatment with actinomycin D and vincristine. 17 90

Whole-lung irradiation in Wilms' Tumor patients has been given prophylactically and for treatment of metastasis. Thirty-three children with Wilm's tumor who have survived for 4 to 20 years from the time of diagnosis were avaiable for study. Whole-lung irradiation was given in doses from 1163 to 1370 rads (orthovoltage). Eighteen patients (Group N) received no irradiation to the lungs. The remaining 15 patients were divided according to whether pulmonary irradiation was given for metastatic disease (Group M--10 patients) or for prophylactic treatment (Group P--five patients). All but five patients in Group N received at least one course of actinomycin D. A routine set of pulmonary function tests was done to assess possible abnormalities of lung volume and the mechanics of breathing. Group N was normal. The findings in Group M suggested moderately reduced lung volumes and may have also reflected obstruction of the large airways and/or a limited expiratory effort. Group P had essentially normal lung volumes but also appeared to have obstruction of the larger airways. Abnormalities were generally not severe; only two patients, in Group M, were symptomatic. Excess irradiation, presence of metastatsis, additional lung irradiation, and pneumonitis may have contributed to morbidity.
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PMID:Pulmonary function in survivors of Wilm's tumor. Patterns of impairment. 18 Nov 23

Whole lung irradiation has been effective in 10 of 17 patients irradiated solely electively (no demonstrable metastatic nodules) who are alive and well 2 to 5 years. Of an additional 17 patients with only one or two demonstrable pulmonary metastases (treated with resection or boost therapy plus whole lung irradiation), 6 are alive and well 5 to 8 years. Only one patient developed clinically significant postirradiation pneumonitis and this case proved to be fatal. Elective whole lung irradiation, especially in conjunction with modern adjuvant chemotherapy, shows promise in improving the survival of patients with tumors having a high propensity for metastasizing to the lungs.
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PMID:Elective whole lung irradiation. 18 85

1351 patients with lung resection were analyzed. Lethality during hospital treatment was 6.2%. 11 patients, who died during the 6 first weeks after the resection, had occult metastases. The causes of death among these 6.2% were pulmonary embolism (40.5%), insufficiency of the bronchial stump and following complications (17.9%), pneumonia (10.7%), cardiorespiratory failure (9.5%) and intraabdominal complications (8.3%). Improving these figures should begin with reducing the cases with pulmonary embolism.
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PMID:[Mortality rate after lung resection for bronchial carcinoma (author's transl)]. 19 45

We report the case of a 13-year-old boy who was known to have Fanconi's anemia for five years. For treatment of this condition he was given androgens and corticosteroids. Two months before his death, severe varicella developed complicated by pneumonia, jaundice, and prolonged fever; all of which resolved during a five-week hospitalization. Three weeks later he died of Clostridium septicum sepsis caused by necrotizing enterocolitis. At autopsy he was found to have multiple hepatocellular neoplasms. A striking feature of the neoplasms was cholestasis. The liver also showed peliosis hepatis. The association of the use of certain androgenic steroids with hepatic neoplasms histologically resembling hepatocarcinomas, but characterized by lack of metastases and apparent reversibility, suggests the desirability of a new nomenclature for these hepatocellular lesions.
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PMID:Multiple hepatic tumors and peliosis hepatis in Fanconi's anemia treated with androgens. 19 56

Eight patients with primary malignant pineal tumors have been seen at this institution over the past 6 years; six of them underwent definitive surgical exploration. Complete gross microsurgical excision of well encapsulated tumors was possible in four of these patients. In two cases of pineal germinomas, a biopsy and a subtotal resection were carried out because of the known radiosensitivity of this tumor. These six surgical patients all received postoperative craniospinal radiation and continue to do well up to 6 years postoperatively. Two nonoperative patients were initially treated at other institutions by ventriculoperitoneal shunt and radiation and were the only ones to develop metastatic disease. One patient had metastasis of her pineoblastoma to her unirradiated spinal canal and the other patient had metastasis of his germinoma to the peritoneum. The former patient was quadriplegic on admission, although her pineal tumor was no longer visible on computerized tomography (CT), and she died of pneumonia. The latter patient's tumor secreted the beta chain of human chorionic gonadotropin (HCG). This patient's massive metastatic tumor burden completely regressed as determined by body CT scan and HCG levels after four courses of chemotherapy with bleomycin, vinblastine, and cis-platinum. In 20 patients with lesions of the pineal region, craniotomy was associated with only one death (a patient with metastatic adenocarcinoma). Thus, microsurgery for pineal tumors provides either a reasonably safe potential for complete tumor extirpation and possible cure, or a tissue diagnosis which is necessary for appropriate therapeutic planning for radiotherapy and/or chemotherapy. The traditional therapeutic approach of empiric radiotherapy without a tissue diagnosis for pineal lesions may no longer be warranted.
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PMID:Malignant pineal region tumors. A clinico-pathological study. 50 98

Diagnosis, treatment and follow-up of 8 patients from 1955 to 1975 with extratesticular seminoma are presented. In 5 patients, the neoplasm developed in the mediastinum and in 3 in the retroperitoneum. All the patients were treated by radiation therapy after resection or biopsy. In the entire group, no tumor was diagnosed in the testes. Two patients expired with disease, one after 2 months due to pneumonia, and the other 5 years after diagnosis (10 months after treatment) due to cerebral metastases. Two patients died 12 and 16 years after diagnosis and treatment. At death, they were free of seminoma and the cause of death was a second malignancy. Four patients are alive and healthy, free of disease, 5, 10, 13, and 17 years after diagnosis and treatment. In essence, of the 8 patients, only one actually died of disease, and he was not adequately treated. We feel that this is an entity with an excellent prognosis if adequately and appropriately treated with radiation. We recommend not to perform an orchiectomy when the testes are clinically normal, and to follow the patient closely after treatment.
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PMID:The management of extratesticular seminoma without gonadal involvement. 50 87

Despite the radiocurability of stage I and II squamous cell carcinoma (SCC) of the cervix, palliation of patients with pulmonary metastases has been disappointing. Four patients with pulmonary metastases (three from cervical and one from endometrial carcinoma) were treated with total lung irradiation, followed two to three weeks after termination of radiotherapy with combination chemotherapy consisting of vincristine 1.4 mg/m(2) IV+ adriamycin 50 mg/m(2) IV + cyclophosphamide 500 mg/m(2) IV repeated at four-week intervals. Radiotherapy was delivered through a Co(60) teletherapy unit in a daily dosage of 100 rads in anterior and posterior opposing fields. After completion of irradiation in one lung, the other lung was similarly treated if involved with gross disease. Two out of four patients (both with cervix SCC) obtained complete tumor regression, whereas the other two patients had stabilization of their pulmonary lesions. The survival of the two responders was 216+ and 621 days from the start of irradiation. The two nonresponders survived 56 and 109 days. Except for one patient who died of pulmonary metastases, the remaining three patients died of metastases elsewhere. While only one patient developed radiation pneumonitis, all four had alopecia and leukopenia <4000/mm(3) from chemotherapy. Total lung irradiation and combination chemotherapy appear to have activity in the treatment of pulmonary metastases from SCC of the cervix and warrant further exploration.
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PMID:Total lung irradiation and chemotherapy in pulmonary metastases from carcinoma of the uterine cervix and endometrium. 52 4

Among 400 observations by the authors, 2 per cent were admitted without and another 22 per cent with slight neurological disturbances. An incomplete transverse lesion of the cord with paraplegia was found in 61.7 per cent, a complete paralysis in 14.3 per cent of the cases. Meningiomas and neurinomas were found in 60 per cent of the patients. The average age of the tumour patients was 43,8 years. Meningiomas and metastases show a tendency to occur in older age groups. The "Glioma Age" was around 25 years. The majority of the tumours were located at the level of the thoracic cord. When breaking down according to the kinds of tumours, a different picture is obtained: neurinomas are chiefly located in the region of the cervical medulla and the thoracolumbar region; gliomas are mainly found in the cervical part of the medulla up to the central thoracic cord. A dissociation of the cerebrospinal fluid was found in 90 per cent of the examinations; in 50 per cent of the patients it was above 200 mg%. Within a period of four weeks after the operation, the following results were obtained: 5 per cent free from complaints, improvement in 39 per cent, aggravation in 10 per cent and 46 per cent still uninfluenced. Meningiomas and neurinomas showed the highest degree of improvement. 24 per cent of the patients suffered from transitory rectovesical disturbances, 15 per cent from urinary tract infections, 12 per cent from decubitus, 9 per cent from wound healing disturbances and another 9 per cent from pneumonia. Meningitis was found in 2 per cent. Within four weeks post operationem, the death rate was 10.5 per cent, but this was in the phase before the introduction of microsurgery. On the accuracy of the diagnoses: in 18 per cent the neurological findings were in agreement with the diagnosis and in 49 per cent they showed differences of 1 to 3 segments; in 11 per cent no definite diagnosis could be made. In 46 per cent the native X-ray picture showed pathological changes. Myelography with positive contrast media showed positive findings in 97 per cent and 98 per cent of positive findings were obtained with myeloscintigraphy.
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PMID:[400 intraspinal space-narrowing processes--a clinical study]. 74 32


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