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

The treatment results obtained in patients with both small and non small cell lung cancer have remained stagnant for years. Therefore, in order to select patients who will have a profit from radiotherapy the indication has to take into account prognostic factors such as tumor stage, extent of resection, patient's age, lymph node status, weight loss and the patient's performance status. Non small cell lung cancer: Postoperative radiotherapy seems to benefit only in patients with hilar or mediastinal lymph node involvement, where a five-year survival rate of up to 30% of cases can be achieved. Postoperative irradiation should not be applied following curative resection and negative lymph node status (R0 N0). In inoperable cases conventional fractionated radiotherapy may definitively have a favourable effect on the patient's survival time, even when the treatment was originally intended to be merely palliative. Only those patients will live five years, who received more than 50 Gy to the hilar and mediastinal nodes and at least 60 Gy to the primary lesion. The volume to be irradiated must include the primary tumor, the ipsilateral and contralateral hilum, the mediastinum, and both supraclavicular regions. If a Pancoast tumor is present, radiotherapy alone obtains a similar result as preoperative irradiation followed by resection. Small cell lung cancer: Radiation treatment of the primary tumor region and the lymph drainage area increases the remission rate by roughly 20% compared with chemotherapy alone, considerably reduces the incidence of local recurrences and exerts a beneficial effect on the survival of the patients. Recently, this has been confirmed by prospectively randomised protocols. Prophylactic brain irradiation has been found to decrease the risk of cerebral metastases to 4-6% in patients affected by limited disease and complete tumor remission under chemotherapy, and to improve the quality of life without, however, showing the benefit on survival time. Future efforts in radiotherapy should be aimed not only at increasing dose intensities but also at developing less toxic treatment modalities to the benefit of the quality of life.
 ...
PMID:[The role of radio-oncology in the treatment of bronchial cancer]. 215 88

The purpose of the study was to investigate the antitumour activity and toxicity of high dose (120 mg m-2) single agent epirubicin therapy in untreated extensive small cell lung cancer patients. Out of 80 patients entered, 71 were evaluable for both antitumour activity and toxicity, 4 only for toxicity and 5 were lost for follow-up. The drug possessed a high antitumour activity, the overall response rate was 47.9% (34/71) with 4 complete remissions (CR) and 30 partial remissions (PR). The median remission duration was 3.5 months. Particular drug activity was observed in the primary tumours, lymph nodes and pleural metastases. Toxicity (leukopenia, anaemia, vomiting, reversible rhythmic cardiac disorder, stomatitis) was mild, alopecia was registered less than in adriamycin medication. One fatal congestive heart failure occurred. The actual mean survival time calculated on the basis of the data gained from 64 patients was 7.0 months (range 2-22). The high antitumour activity and no increase in toxicity justify the incorporation of high dose epirubicin into combination therapy.
 ...
PMID:Phase II study of 4'-epi-doxorubicin in patients with untreated, extensive small cell lung cancer. South-East European Oncology Group (SEEOG). 216 33

The ability of computed tomography (CT) to detect mediastinal lymph node metastases from nonsmall cell bronchogenic lung cancer is highly controversial, as evidenced by reported accuracies ranging from 0.35 to 0.95 over the past eight years. We examined all studies on this matter published between January 1980 and April 1988, both to describe the overall experience and to identify characteristics (study design and methodology and CT scan techniques) that influenced reported accuracy. Of 79 relevant publications, 37 were excluded because they were review reports, assessed small cell lung cancer, or contained insufficient evidence to construct a contingency table (CT result versus node histology). The pooled, unweighted (weighted) results based on the remaining 42 studies were as follows: sensitivity, 0.79 (0.83); specificity, 0.78 (0.81); accuracy, 0.79 (0.81). Using a node size greater than 1.0 cm to define a "positive" CT result, as compared to a smaller diameter, was associated with significantly higher specificity, 0.89 versus 0.76, and accuracy, 0.86 versus 0.75 (p less than or equal to 0.005), but not sensitivity, 0.79 versus 0.75. The observed differences in accuracy between a fourth generation CT (0.83) and either a third or a second generation CT, (0.77 and 0.78, respectively) were not significant at p less than 0.05. No characteristics, either singly or in combination, resulted in accuracies exceeding 0.86. There exists random variation of individual study results around an overall mean accuracy of only 0.79, which is marginally improved by advances in CT technology and methods. Significant advances in the noninvasive detection of lymph node metastases must await an approach fundamentally different from CT-determined node size.
 ...
PMID:Computed tomography to stage lung cancer. Approaching a controversy using meta-analysis. 216 Feb 11

The prognosis for carcinoma of the lung is influenced by the stage of the disease at presentation and by the potential for resectability. The five-year survival rate following resection of stage I carcinoma is as high as 83% for T1N0 lesions and about 65% for T2N0 tumors. Some stage III tumors are also amenable to surgery in the absence of distant metastases. N2 disease tends to be refractory to cure, despite a localized presentation; however, 20% of patients with N2 disease have resectable tumors despite the presence of lymph node metastases, with a 5-year survival rate of 30% following surgery and postoperative external radiation therapy. Surgery is not beneficial for patients with small cell lung cancer. Proper case selection and careful preoperative and perioperative management are necessary to minimize complications.
 ...
PMID:Surgical treatment of lung cancer. 216 49

Small cell lung cancer (SCLC) is a fatal malignancy due to its propensity to metastasize widely and to reoccur after chemotherapy in a drug-resistant form. While most SCLC cell lines are anchorage independent for growth, laminin induced the attachment of five of six SCLC cell lines tested (NCI-N417, NCI-H345, NCI-H146, NCI-H187, NCI-H510, and NCI-H209). NCI-N417 SCLC cells adopted a flattened morphology on laminin, and a classic SCLC cell line (NCI-H345) demonstrated a neuron-like appearance while the other SCLC cell lines except NCI-H187 cells, attached but did not spread. Adhesion to laminin was associated with increased resistance to several cytotoxic drugs. Matrigel, an extract of basement membrane proteins, greatly accelerated tumor growth when coinjected with SCLC cells in athymic mice. A synthetic peptide from the B1 chain of laminin, cyclic-YIGSR (Tyr-Ile-Gly-Ser-Arg), inhibited laminin-induced SCLC cell adhesion and migration in vitro and reduced the size of the tumors they formed when coinjected with matrigel and YIGSR. These results suggest that the interaction of SCLC cells with laminin and possibly with other basement membrane proteins can enhance their tumorigenicity and drug resistance.
 ...
PMID:Reconstituted basement membrane (matrigel) and laminin can enhance the tumorigenicity and the drug resistance of small cell lung cancer cell lines. 216 54

Small cell lung cancer is an aggressive neoplasm; metastases are detected in two-thirds of patients at diagnosis with use of conventional staging, which includes bilateral bone marrow biopsy, bone scintigraphy, and computed tomography (CT) of the head and abdomen. In 25 patients, small cell lung cancer was staged prospectively with both conventional staging and a magnetic resonance (MR) imaging protocol that included 1.5-T MR imaging of the pelvis, abdomen, spine, and brain. According to conventional staging, 14 patients had extensive disease and 11 patients had limited disease; according to staging with MR, 19 patients had extensive disease and six had limited disease. All metastatic disease sites seen with conventional staging were identified on MR images. MR images showed additional metastatic involvement in bone (four patients) and liver (three patients) not detected at conventional staging. A low-attenuation hepatic lesion on a CT scan was identified as a hemangioma on MR images. These preliminary data suggest that small cell lung cancer may be accurately staged with use of a single MR imaging study.
 ...
PMID:Small cell lung cancer: staging with MR imaging. 217 44

One-hundred seventy-three patients with limited small cell lung cancer were included in three consecutive protocols alternating radiotherapy and chemotherapy. The alternating schedule consisted of six courses of chemotherapy (doxorubicin, VP16213, cyclophosphamide, and methotrexate in the first protocol; methotrexate being replaced by cisplatinum in the other two protocols) and three series of thoracic radiotherapy delivering a total dose of 45, 55, and 65 Gy in each consecutive protocol. Radiotherapy was started after the second course of chemotherapy. A 1-week gap was respected between each course of chemotherapy and each series of radiotherapy. Seventy percent of patients were in complete remission at the end of the induction treatment. The actuarial 5-year local control was 60% and the 5-year overall survival was 18%. Sixty percent of patients developed distant metastases. The death rate unrelated to cancer was 10%. These results show that alternating radiotherapy and chemotherapy schedules are reproducible, and provide a consistent long-term local control and a long-term survival rate exceeding 15% in limited disease.
 ...
PMID:Alternating radiotherapy and chemotherapy in 173 consecutive patients with limited small cell lung carcinoma. GROP and the French Cancer Center's Lung Group. 217 42

Thirty-nine of 225 patients with small cell lung cancer developed brain metastases after the initiation of chemotherapy. Treatment with high-dose dexamethasone in all 39 patients and cranial irradiation in 32 patients resulted in a complete neurological recovery in only eight of 39 patients (20%). Twenty-one of 39 patients (53%) failed to derive lasting benefit from their palliative treatment. Thirteen of 24 patients with limited disease with cranial relapse had no clinical evidence of other distant metastases prior to death and in these patients the CNS disease was an important cause of morbidity. On the basis of this study, it appears that palliative treatment of overt cranial metastases is relatively unsuccessful and that patients with limited disease represent a group with much to gain from effective prophylactic cranial irradiation.
 ...
PMID:Morbidity of cranial relapse in small cell lung cancer and the impact of radiation therapy. 242 35

Of 129 patients with small cell lung cancer (SCLC) who underwent bone marrow examination for staging, 39 (30%) had bone marrow involvement. Only three of 129 patients (2.3%) had bone marrow involvement as the only site of metastatic disease. When patients with bone marrow metastasis were compared with patients whose bone marrow was normal, there were significant differences in serum levels of lactate dehydrogenase (LDH), glutamic oxalacetic transaminase (SGOT), glutamic pyruvic transaminase (SGPT), alkaline phosphatase (AP), albumin, and sodium (Na). We found no clinically significant difference in survival between patients with extensive disease with or without bone marrow involvement. Serum Na, albumin, SGOT, and uric acid were important prognostic determinants of survival. Based on the results of this study, we do not recommend routine bone marrow examinations in the staging of SCLC.
 ...
PMID:Bone marrow involvement in small cell lung cancer. Clinical significance and correlation with routine laboratory variables. 253 86

The clinical value of the three serum biomarkers neuron specific enolase (NSE), carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) were evaluated prospectively in 86 patients with small cell lung cancer (SCLC) entered into randomized clinical trials. The patients were monitored clinically very closely and biomarkers were measured before each course of chemotherapy. The correlation between disease extent and biomarker was significant for both NSE (2P: 0.001) and LDH (2P:0.05). Of those two biomarkers NSE was the most sensitive and was raised in 75% of all patients at diagnosis, in 67% of patients with limited disease, and in 86% of patients with extensive disease. All patients with three or more sites involved presented raised serum NSE levels but there was no significant correlation between definite number or specific sites known to have metastatic disease. There was a tendency towards a higher serum CEA level in extensive disease than in local disease. Only half the patients with metastatic disease had elevated (greater than 5.0 ng/ml) levels of CEA, and values above 50.0 ng/ml were unusual. In patients initially seropositive for NSE a close correlation was found during follow up between serum NSE and response (98%) or progressive systemic disease (100%). During a major response, either complete or partial, serum NSE showed minor fluctuations (mean 8 ng/ml, S.D. 1.79, range 4.6-12.1). At present serum NSE seem to be the most sensitive and valuable biomarker in the management of SCLC, while the gain by adding CEA is small. Furthermore, NSE may be a useful tool in the estimation of disease extent and response to treatment in patients in whom clinical or radiological evaluation is difficult.
 ...
PMID:Neuron specific enolase, carcinoembryonic antigen and lactate dehydrogenase as indicators of disease activity in small cell lung cancer. 253 29


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