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)

An analysis is made of the contribution of clinical examination to the diagnosis of primary bronchopulmonary cancer in a lot of 355 patients. As it is known bronchopulmonary cancer does not have a characteristic and patognomonic clinical symptomatology. In two thirds of the patients (236/66.4%) the disease' onset was marked by respiratory symptoms. In half of these patients (120/33.8% of the total number of cases) the respiratory syndromes for which the patient had requested medical help could have suggested the diagnosis, and were marked by a pseudo-pneumonia, or pneumopathy with long evolution, intensified coughing in a patient who had been coughing for a long time, or an onset marked by hemopthysis. In the other half of the patients in this group the onset symptoms had nothing characteristic. The onset marked by metastases was noted 69 of the patients (19.4%), and para-neoplastic syndromes were noted in 10 (2.8%). These certainly suggested the presence of pulmonary cancer. It appears that in over half of the patients 9195, or 54.1%) the clinical examination could suggest the existence of bronchopulmonary cancer, and this percentage increases if patients are included in those whose respiratory symptoms are not characteristic but in those which physical examination will evidence suggestive changes. Only in a very small number of patients (12, or 3.3%) the clinical examination did not provide any diagnostic element. These were the asymptomatic cases, accidentally identified in the course of a radiological examination. It should be stressed that the clinical suspicion of pulmonary cancer should always be confirmed by paraclinical investigations.
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PMID:[The contribution of the clinical examination to the diagnosis of bronchopulmonary cancer]. 629 7

From 1969 through 1979, 171 patients with localized but inoperable or unresectable non-oat-cell carcinoma (NOCC) of the lung completed high-dose definitive irradiation. One hundred fifteen received continuous course irradiation to 6000-6500 rad at 180-200 rad/day. Fifty-six received split-course irradiation to 5500 rad at 250-300 rad/day, which included a 2-week break. The two groups were similar with respect to all measured variables. There were no differences in the response rates, failure patterns, survival, or complication rates between the two regimens. The 5-year survival was 6%, with 25.8% dying with infield failure alone and 54.7% with metastases. The incidence of complications was 8.2%, predominantly acute radiation pneumonitis. A review of the most comparable literature reveals no significant improvement in the cure rate of definitively irradiated NOCC with increasing tumor dose, split-course irradiation, or other modifications of radiotherapeutic technique over the past 25 years. The problems of frequent local recurrences and distant metastases, and the poor response of NOCC to presently available systemic therapy, requires that more effective and broadly applicable local and systemic therapies be developed before substantial improvements in the cure rate of NOCC can be expected.
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PMID:A comparison of high-dose continuous and split-course irradiation in non-oat-cell carcinoma of the lung. 630 35

Primary lung cancer is divided into two types: peripheral type and hilar or central type. Peripheral lung cancer appears as a solitary mass or patchy shadow and is typically lobulated or irregular in shape. Any regular or scattered calcification within or around the lesion on routine radiographs indicates that it is benign. Hilar or central lung cancer may accompany hilar and mediastinal lymphadenopathy, lobar collapse and consolidation, and pneumonitis distal to a mass in a large bronchus. In addition, it is very important that the metastases of the hilar and mediastinal lymph nodes are detected preoperatively or prior to conservative therapy. On 44 cases of lung cancer pathologically proved, the diagnostic accuracy of the metastases of the hilar or mediastinal lymph nodes is 42.4% preoperatively on routine radiographs.
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PMID:[Radiographic diagnosis of lung cancer and lymph nodal metastasis of the mediastinum]. 630 91

Forty-two patients with histologically confirmed inoperable small (oat) cell lung cancer were treated with local tumor irradiation (approximately 4,000 cGy) combined with "one-time" irradiation of the upper and lower half of the body. Twenty-five patients (Group I) received the irradiation in lateral position first to the upper half-body, and six weeks later to the lower half-body, the midplane dose averaging 880 cGy (not corrected for lung tissue). In 17 patients, lethal pneumonitis occurred. The mean time of survival was 8.2 months for 22 patients having the disease limited to one thorax-side and 4.0 months for three patients having distant metastases, stated by conventional clinical and X ray investigations. Seventeen patients (Group II) received the two half-body irradiation treatments through anterior-posterior fields. The average dose had been reduced to 800 cGy (uncorrected) and was given on one day in two fractions (600 and 200 cGy, separated by an interval of 5 hours). Furthermore, the forearms and the lower legs had been left outside the fields. Only one patient showed pneumonitis. The mean time of survival was 14.3 months for 12 patients having the disease limited to one thorax-side and 6.6 months for five patients having distant metastases. In both groups, serious reactions of the bone marrow were not observed. In Group II, leucocytes and lymphocytes had reached their original values three months after the end of irradiation. For all 42 patients, X ray films showed complete regression of the primary tumor. In 12 out of 35 autopsy specimens, the primary tumor could not be detected histologically, but only five of these were free of metastases. Presently, additional irradiation of the two halves of the body with lower and fractionated doses are being tested in order to achieve the further reduction of tumor cell numbers.
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PMID:Preliminary report on "one-time" and high dose irradiation of the upper and lower half-body in patients with small cell lung cancer. 631 57

A Phase I trial of intravenous bromodeoxyuridine (BUdR) and conventional fractionated radiation therapy was performed in 14 patients with glioblastoma multiforme and 7 patients with other poorly radioresponsive tumors. The BUdR was given as a constant intravenous infusion for 12 hr/day for up to 14 days. Thirteen patients received a second 14 day infusion following a 10 to 14 day interruption for bone marrow recovery. Local toxicity (within the radiation field) was minor, with 7 of the 21 patients requiring a brief treatment break for moist skin desquamation. There was no significant CNS toxicity noted clinically nor by autopsy examination. Additionally, no significant enhancement of radiation injury was noted to bowel or liver. However, one patient treated for multiple pulmonary metastases experienced a clinical and radiographic pattern consistent with radiation pneumonitis. Dose-dependent systemic toxicity occurred in bone marrow and skin. Moderate myelosuppression, especially thrombocytopenia, was found following a 14 day cycle of BUdR at and above 650 mg/m2/12 hr infusion. Approximately one-third of patients developed a maculo-papular erythematous rash to the scalp, neck and upper chest. In two patients, the rash became generalized with evidence of epidermolysis on skin biopsy. Pharmacology studies revealed steady-state arterial plasma levels of 2 X 10(-6) M/1 during the 12 hr infusion of 650 to 700 mg/m2. Radiosensitization was measured by a change in the D0 of radiation survival curves of human bone marrow CFUc prior to and following the 14 day infusion in 4 patients. A trend of increasing radiosensitization was noted in most patients as the infusion rate of BUdR was increased from 500 to 870 mg/m2/12 hr. We conclude that the maximum tolerable dose of BUdR is 650 to 700 mg/m2/12 hrs when given as a 2 week intermittent intravenous infusion. Local toxicity is acceptable. The major systemic toxicities are myelosuppression and a maculopapular skin rash.
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PMID:A Phase I study of intermittent intravenous bromodeoxyuridine (BUdR) with conventional fractionated irradiation. 632 12

From 1976 to 1981, 28 episodes of group B streptococcus (GBS) septicemia were identified in our hospital (CHUV, University Hospital Lausanne), 18 in 17 adults and 10 in newborns. The latter had acute respiratory distress syndrome (8 cases) or meningitis (2 cases). In adults the skin was the main source of infection (6 diabetic foot, 4 acute cellulitis complicating chronic skin diseases, 2 infections secondary to diagnostic procedures (capillary and ascitic taps) and 1 meningitis secondary to neurosurgery). The other sources of infection were 1 pharyngitis, 1 pneumonia and 1 pyelonephritis. Eleven patients had an underlying disease (7 diabetes and 4 malignancies). Four patients developed septic osteoarticular metastases, one after a 3 weeks' course of antibiotic. In the latter case, as well as in the two adult patients who died, the strains of GBS were found to be tolerant to penicillin. Thus, GBS septicemia are not rare in adults and occur often in compromised hosts such as diabetics. The portal of entry is frequently the skin and the course may be severe with distant complications.
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PMID:[Streptococcus group B septicemia. Analysis of 18 cases in adults and 10 in newborn infants]. 633 80

Chemotherapy-related pneumonitis developed in eight patients during treatment for breast cancer. Six were receiving adjuvant therapy and two were being treated for metastatic disease. Fever, chills, dyspnea, and dry cough were the initial symptoms. Observations from chest roentgenograms varied from normal to bilateral interstitial-alveolar infiltrates. Results of pulmonary function tests were markedly abnormal, with a decreased diffusing capacity being the most characteristic abnormality. The pneumonitis developed in six patients while receiving 20 mg or less per day of prednisone and appeared temporarily related to tapering of steroid therapy in four patients. All patients recovered clinically, although prednisone therapy of 60 mg/day or its equivalent was required in three cases. Mild pulmonary function abnormalities persisted. Drug-induced pneumonitis should be considered in the differential diagnoses of patients with breast cancer in whom unexplained fever, dyspnea, or infiltrates develop during multidrug chemotherapy.
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PMID:Chemotherapy-associated pulmonary toxic reactions during treatment for breast cancer. 660 32

It is essential to recognize radiation pneumonitis after whole lung irradiation, or nodular changes in response to chemotherapy, so that such conditions are not mistaken for tumor metastases, causing grave error in patient management and the possibility of further lung damage.
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PMID:Lung nodules after whole lung radiation. 662 11

Distant metastases were detected in 52 (30.7%) of 169 patients with advanced head and neck cancer observed from 1968 until 1982. Both clinical and autopsy findings are included in the assessment. The occurrence of distant metastases was related to primary disease site, stage of disease at presentation, and development of infectious complications during the course of the disease. The duration of survival was unrelated to the development of metastases. The incidence of distant spread was low for patients with floor-of-mouth lesions (11.8%) and high for patients with advanced disease arising in some regions of the larynx (58.6%). Patients who experienced wound infection, pneumonia, or bacteremia had infrequent development of metastatic disease.
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PMID:Distant metastases from head and neck cancer. 669 16

Twelve cases of interstitial pneumonitis were seen in 50 patients (24%) treated with cyclophosphamide, methotrexate, and etoposide (VP-16-213) for small cell anaplastic lung cancer. The clinical course and pathologic characteristics were consistent with drug-induced pneumonitis in all 12 cases. One additional patient had concurrent histologic evidence of interstitial pneumonitis, pneumocystis infection, and perivascular metastases. Patients presented with severe dyspnea, hypoxemia, cough, fever, and bilateral interstitial infiltrates on chest films. The onset was rapid and unpredictable, following as little as one month or as much as five months of therapy. Nine patients recovered but there were three deaths in the acute period directly attributable to the drug-induced pneumonitis. Although the use of twice weekly oral methotrexate may have been a causative factor, a previously unsuspected drug interaction with etoposide may be the etiologic factor resulting in this unusually high incidence of pulmonary toxicity. The difficulty in establishing a diagnosis of interstitial pneumonitis in this group of patients with chronic lung disease and lung cancer is well known. The extent of morbidity and mortality seen in this study and the commercial availability of etoposide make earlier clinical recognition of this complication imperative.
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PMID:Chemotherapy-induced interstitial pneumonitis during treatment of small cell anaplastic lung cancer. 672 94


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