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)

For 105 patients with healthy lungs (76 breast carcinomas, 29 testicular tumors) irradiated from 1981 to 1983 with the linear accelerator Neptune 10p. the pulmonary effects of irradiation were monitored over several years. The true dose applied for breast carcinomas was 46 Gy (2 Gy per fraction), for testicular tumors 40 Gy were applied in the mediastinal field. 9% of the patients showed excessive infiltrations, 18% radiation pneumonitis of medium degree. In 35% of the patients slight infiltrations were found. The course of the pneumonitis was, according to its stage, regular. After a latency period 30 days post irradiation the early stadium occurs. Florid pneumonitis develops between the 45th and 90th day after irradiation. Extended radiographic effects occur up to 10 days earlier. Through a period of pneumonitis with pronounced shrinkage fibrosis develops. By CT-based individual radiation planning the pulmonary radiation reaction can be significantly reduced. The differential diagnostics of radiation effects and metastases is discussed.
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PMID:[Radiation pneumonitis in the x-ray picture following megavoltage irradiation using the Neptune 10 p. linear accelerator]. 251 42

Thirty patients with Stage III non-small cell lung cancer were entered on a trial to evaluate the feasibility of combined radiation and concomitant 5-fluorouracil infusion. Patients had received prior debulking surgery (nine), induction chemotherapy (16), or no therapy (five). Radiation employed standard fractionation (180-200 rad/day) administered to a median cumulative dose of 5500 rad (range, 4500-6200 rad). 5-Fluorouracil was infused 24 hours per day throughout the period of radiation at a dose of 300 mg/m2/day for a median of 42 days (range, 28-56 days). Radiation complications included pneumonitis three of 30 (10%) and esophagitis (27%). Chemotherapy complications included stomatitis, two of 27 (7%), and hand-foot syndrome, three of 30 (10%). Treatment interruptions were necessary in six of 30 (20%) and four of 30 required parenteral nutrition. At a median follow-up of 12 months 26/30 (87%) maintained local control and eight had distant metastases (three of whom presented with Stage IV disease). 5-Fluorouracil delivered continuously throughout standard fractionation radiation to high cumulative doses is feasible and practical. Comparative clinical trials of the various combined radiation and chemotherapy schedules employed are in order. One additional clinical observation was the identification of six of 30 (20%) with brain metastases at presentation or after 12 months, all of whom had adenocarcinoma histologic subtype.
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PMID:Concomitant 5-fluorouracil infusion and high-dose radiation for stage III non-small cell lung cancer. 254 5

A 53-year-old female smoker with small cell carcinoma of the lung with cerebral metastases was initially treated with whole brain radiation with favorable responses. She developed fulminant and fatal interstitial pneumonia following administration of 30 mg of doxorubicin and 6 mg of vindesine. Histopathology revealed that the interstitial pneumonia was compatible with a drug-induced pneumonia.
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PMID:Fatal acute interstitial pneumonia induced by low-dose doxorubicin and vindesine. 254 58

To establish whether bronchoplastic procedures designed to minimize loss of lung tissue are justifiable for the treatment of bronchial carcinoid tumours, data were analysed from 37 patients (17 men, 20 women, average age 51 [22-70] years) who had undergone surgery for typical (n = 30) or atypical (n = 7) bronchial carcinoids. Conventional tumour resections had been performed in 29 cases and bronchoplastic operations in eight. After an average observation period of 54 months one patient who had undergone lobectomy for a bronchial carcinoid had died of recurrent tumour, and one other patient who had been treated by pneumonectomy for an atypical carcinoid had developed distant metastases. All the other patients were free from tumour at that time. This indicates that patients treated by bronchoplastic procedures do not have any higher incidence of recurrences or any lower chance of survival than those treated by lobectomy or pneumonectomy. A bronchoplastic operation should therefore be the treatment of first choice, provided that the adjacent lung tissue has not been destroyed by retention pneumonia and that lymph node dissection does not reveal any involvement.
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PMID:[Bronchial carcinoid. A clinical study of 37 patients]. 255 82

As part of two sequential protocols using intensive combined modality treatment in pediatric and adolescent sarcomas, 31 consecutive patients with primary chest wall tumors were treated between November 1977 and March 1986. This group included 13 patients with peripheral neuroepithelioma (Askin's tumor), 11 patients with Ewing's sarcoma, 3 patients with rhabdomyosarcoma, and 4 patients with undifferentiated sarcomas. Following complete work-up, 17 patients presented with localized disease and 14 patients presented with metastases. Patients received intensive combined modality treatment with combination chemotherapy (vincristine, cyclophosphamide, Adriamycin, +/- actinomycin-D and DTIC) and high-dose conventionally fractionated radiation therapy to the primary (55-60 Gy) and non-pulmonary metastases (45-50 Gy). Radiation techniques used for the primary chest wall tumor varied with the clinical presentation. Patients achieving a complete response received either low-dose fractionated TBI (1.5 Gy/0.15 Gy fx/5 weeks) or high-dose TBI (8 Gy/4 Gy fx/2 days) and an intensive cycle of chemotherapy followed by autologous bone marrow transplantation. Twenty-five of 31 patients were judged to have a complete response (including 1 patient with complete resection). With minimum follow-up of 6 months and median follow-up of 36 months from completion of treatment, 14 patients remain disease-free with 2 additional patients alive in second remission after relapse. Patients with localized disease at presentation have improved disease-free survival and overall survival compared to patients with metastases at presentation. All 17 localized patients achieved a CR and 11 are NED compared to 8 of 14 metastatic patients achieving a CR and only 3 are NED. There have been 5 loco-regional recurrences with 3 "in-field" failures and 2 failures in the regional pleura. There were no treatment-related deaths and no clinically significant cases of pneumonitis. To date, 2 patients have significant treatment related morbidity, including 1 patient with scoliosis requiring surgery and 1 patient with acute leukemia developing 42 months after the start of therapy (presently in remission). We conclude that this intensive combined modality therapy results in a high CR rate and good local control with acceptable morbidity. Patients with metastatic disease at presentation remain a therapeutic challenge.
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PMID:Treatment of sarcomas of the chest wall using intensive combined modality therapy. 264 97

1. Widespread visceral and intestinal wall metastases are present in women dying with ovarian cancer. Intestinal wall invasion is commonly found at autopsy and is associated with bowel obstruction. Liver parenchymal replacement by metastases in more extensive than that in the lung, where most metastases have a subpleural location. Multifocality characterizes metastases in both of these organs. 2. Neoplastic lymphatic invasion is common. Lymphatic and blood vascular invasion are associated with an increased incidence of metastases in lymph nodes, small bowel wall, pancreas, lungs, ureter, and liver. 3. The mean survival time from diagnosis to death is less than 2 years. Both increasing neoplastic histological grade and clinical stage at diagnosis are associated with decreased survival time. 4. The most common causes of death are carcinomatosis, infection, or a combination of these processes. Sepsis, pneumonia, or both of these account for most of the fatal infections. 5. Bowel and ureteral obstruction constitute the most common forms of tumor-induced morbidity. The former process tends to be multifocal, involving the small and large intestines, and it is found during the disease course as well as at autopsy. Ureteral involvement is usually associated with hydronephrosis and is bilateral in approximately one fourth of the cases.
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PMID:The pathology and biologic behavior of ovarian cancer. An autopsy review. 265 34

Between April 1986 and April 1989, each of 108 patients received an ileum neobladder, 94 patients for total bladder substitution after radical cysto-prostatectomy and 14 for augmentation of a fibrotic and contracted bladder following tuberculosis, interstitial cystitis or radiotherapy of the pelvis. The operative technique is standardized, relatively simple and safe, and it prevents upper urinary tract deterioration and reflux. Continence is preserved in more than 80% of all patients by the function of the external urethral sphincter and by the high capacity and the low internal pressure of the intestinal reservoir. Follow-up of more than 3 months postoperatively was possible in 96 patients, the evaluation including micturition behavior at home and a urodynamic investigation. Stress incontinence requiring correction by an artificial sphincter was found in 3 and nocturnal incontinence necessitating some external device in 6 patients. There was no perioperative mortality. Local tumor recurrence and/or metastases occurred in 14 patients; 7 patients died postoperatively, 5 owing to tumor progression, 1 of pneumonia and serve metabolic acidosis, and 1 owing to septicemia of unknown cause. Re-operation was necessary in 13 patients, in 6 because of mechanical ileus or intra-abdominal abscess, in 3 because of stenosis of the uretero-ileal anastomosis, in 1 because of tumor progression, in 1 because of vesico-vaginal fistula, in 1 patient because of incisional hernia, and in 1 because of wound dehiscence. Urethrotomy or dilatation of urethral strictures was necessary in 8 patients. All other early and late complications were rare and could be managed by conservative means.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[3 years' experience with the ileum neobladder--the first 108 patients]. 276 96

CA-125 is known as a marker of ovarian carcinoma; it is useful in monitoring response to treatment and it is even said to be a means of detecting ovarian carcinomas. We have studied the serum levels of CA-125 in 260 patients with advanced carcinomas (excluding ovarian cancer) and in 120 patients with non-malignant diseases (excluding gynaecological diseases). Our cut-off value was 20 IU/ml. Sensitivity was 0.53 and Specificity only 0.38; sensitivity was high in lung cancer (0.56), in breast cancer (0.46) and in cancer of the stomach (0.91). Five percent of the cancer patients had values higher than 233.5 IU/ml. Sensitivity was correlated with the presence of a metastatic disease (p less than 0.001). A second assay was obtained in 163 cases; a concordance between the variation of the serum level and the clinical evolution was found in 65% cases. A high rate of false positive values was found in cases of acute pneumonia (0.74) and of gastro-intestinal diseases (0.41). In view of these results, the optimal threshold value was set at 65 IU/ml. CA-125 appears to be a useful marker in the monitoring of advanced non-ovarian carcinomas.
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PMID:Analysis of CA-125 levels in the sera of patients with non-ovarian carcinomas and non-malignant diseases. 276 5

Twenty-six stage II/III malignant melanoma patients with 321 measurable metastatic lesions were imaged using Fab fragments of an IgG murine monoclonal antibody labeled specifically with 10-30 mCi Tc-99m with a bi-functional chelating method (NeoRx, Seattle, WA). There were no side effects or adverse reactions. Immunoscintigraphy demonstrated 66.6% of lesions larger than 1 cm and 92.5% of lesions larger than 3 cm. Most frequently detected metastases were in lymph nodes, subcutaneous areas, and bone. Of lesions less than 1 cm, 23.6% were detected if superficial cutaneous lesions were excluded. The smallest detectable lesion was 4 mm. Twenty-one additional clinically unsuspected sites were visualized in 12 of the 26 patients studied. Of these, 56% were confirmed as metastasis by other tests. There were apparent nonspecific localizations owing to other causes, including fracture, varicosities, skin abscess and pneumonitis. Increased experience in image analysis facilitates correct interpretation of these localizations. This study demonstrates that imaging with Tc-99m labeled antibody fragments detects melanoma lesions in organs routinely surveyed and in other areas not routinely assessed by other imaging techniques. The procedure is readily performed and safe. The principal advantage of the test is its ability to survey the entire body and all organs with a single test. Its principal limitation, in common with other diagnostic imaging procedures, is its poor sensitivity for detecting lesions less than 1 cm.
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PMID:Technetium-99m labeled monoclonal antibodies in the detection of metastatic melanoma. 280 39

Interleukin-1 (IL-1) release by alveolar macrophages (AMs) from 29 patients with primary bronchogenic carcinoma, lung metastases, acute pneumonitis, and chronic infection was evaluated in response to a standard stimulus, lipopolysaccharide (LPS). The results were compared to those of AMs from normal smokers or nonsmokers (volunteers). AMs derived from healthy smokers secreted significantly more IL-1 than AMs from nonsmokers. In contrast, AMs from smokers affected with primary lung cancer have lost their capacity of secreting high levels of IL-1, whereas IL-1 secretion was high in nonsmokers with hematogenous metastases. AMs release high IL-1 levels in patients with acute bacterial infections. A significant correlation exists between numbers of AMs and IL-1 levels in normal individuals, a relationship which disappears in patients. These observations suggest that AMs in inflammatory lung disease, even discrete, have an increased capacity to secrete IL-1 on stimulation with LPS. They also suggest that an intrinsic dysfunction of AMs may accompany primary bronchogenic carcinoma. The influence of tobacco in modifying the functions of AMs is stressed.
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PMID:Interleukin-1 secretion by lipopolysaccharide-stimulated alveolar macrophages. Relationships to cell numbers--influence of smoking habits. 281 73


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