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)

We analyzed 7 patients with so called "maligne lateral cervical cysts" regarding the controversies in the literature. Primary tumors of oropharyngeal sites were discovered in all these cases of "branchiogenic carcinoma" rising the final diagnosis of cystic metastases. Diagnostic tonsillectomy is supposed to be important to solve this problem of differential diagnosis. The issue of malignant transformation in cysts of branchial cleft origin has to be recognized as being an oncological artifact. We argue that the "maligne lateral cervical cyst" does'nt exist as a proper entity. In analogy to the principles of the treatment of oropharyngeal cancer ipsilateral neck dissection and wide local excision of the cyst followed by radiation therapy is the suggested plan of therapeutic management. Search for a possible unknown primary tumor within the oropharynx must be continued over years.
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PMID:[Clinical relevance of malignant lateral branchial cyst]. 149 87

From January 1976 to December 1986, 199 patients with oropharyngeal cancer were submitted to definitive radiotherapy. Survival and local control were analyzed and related to different parameters--i.e, T and N categories, histopathologic grading, tumor location, patients age, and radiation dose. Fifty-six per cent of patients (111/199) died from neoplastic disease within 5 years. Local progression, recurrence or metastases were observed in 149 cases (75%). Ninety-three per cent of first failures (138/149) were related to residual disease or to locoregional relapse while distant metastases occurred in 14 patients only. The majority of locoregional failures (94%) appeared within 2 years, with a mean disease-free interval of 8 months. Tumor recurrence in the primary location was observed to be the first cause of failure in 78% of relapsed patients; moreover, it was the sole cause of failure in half of the unfavorable events. On the contrary, nodal relapse appeared in 38% of treatment failures and in 12% only it was the sole cause of failure. Overall and disease-free survival were observed to depend mainly on T and N categories, while histopathologic grading was seen to affect only early response rate. No significant differences were observed depending on tumor site and patients age. Local control rates depended on total radiation dose, but the difference between low dose (NSD less than 1700) and high dose (NSD greater than 1700) was significant only for T1 and T2 patients.
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PMID:[The results of definitive transcutaneous radiotherapy in the treatment of oropharyngeal neoplasms]. 150 26

The use of modern diagnostic facilities led to a study of the physico-dosimetric, topometric and clinical aspects of radiotherapy of oropharyngeal cancer. The most effective approaches to therapy of oropharyngeal tumors with account of their site, spread and degrees of differentiation were developed. The most effective method was shown to be the combination of gamma-beam therapy (50 Gy) with electron-photon radiation (20 Gy) of an accelerator of 18-20 MeV, radiation exposure of normal tissues being lowered by approximately 10-20% as compared to that in gamma-beam therapy used alone. The use of the above method in 45 oropharyngeal cancer patients resulted in an immediate clinical effect (disappearance of a tumor and regional metastases (if any) in 60% of the patients. The 2-year survival rate calculated by actuarial curves, was 62 +/- 10%.
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PMID:[Topometric and clinico-dosimetric aspects of the radiotherapy of cancer of the oropharynx]. 335 92

Out of a series of 1666 consecutive patients with squamous cell carcinoma of oropharynx and pharyngolarynx, 1646 were evaluable at a 3-year interval following radical radiation therapy. The actuarial 3-year nodal control rate using the AJC classification was: N0 98%, N1 90%, N2 88%, N3 71% when the primary was controlled. The regional outcome is influenced by clinical features such as nodal size, multiplicity and fixity. Cervical recurrence frequency is higher for pharyngolaryngeal carcinoma than for oropharyngeal cancer. The impact of the treatment planning on regional control is discussed. Due to the of concomitant boosting of nodes, cervical metastases were treated according to a type of accelerated fractionation schedule with weekly doses of 12-15 Gy for a total of 70-85 Gy in 75% of the cases. Clear-cut dose control relationships are demonstrated for nodes larger than 3 cm in diameter. Overboosting residual cervical disease fails to yield a better nodal control. Comparative analysis is established between results obtained with this high dose per fraction radiotherapy schedule, conventional regimens of irradiation and other new approaches, combining chemical and physical agents. Therapeutic implications are also derived to define adequate field coverage.
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PMID:Regional outcome in oropharyngeal and pharyngolaryngeal cancer treated with high dose per fraction radiotherapy. Analysis of neck disease response in 1646 cases. 352 23

Transposition of the contralateral submaxillary gland to the submental region is proposed as a method for preventing asialia following salivary gland irradiation during radiotherapy for oropharyngeal cancer. Good results were obtained in the majority of cases treated, salivary secretion being conserved, as confirmed by scintigraphy, but the method should be reserved for patients with oropharyngeal cancer without lymph node metastases on the contralateral side.
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PMID:[Prevention of post-irradiation xerostomia by submaxillary gland transposition]. 712 83

The prognostic significance of lymph node metastases was evaluated in an unselected material of 427 oropharyngeal cancer patients treated primarily with radiotherapy. At first referral, palpable lymph node metastases were present in 60% of the patients. After irradiation, 60% of all palpable nodes had disappeared. As many as 50% of the nodes initially palpable in N3 patients vanished after irradiation. Recurrences were significantly increased in patients primarily with lymph node metastases (N1-3) compared with N0 patients; recurrences in the primary tumour site were (56% vs. 43%) in neck lymph nodes (40% vs. 9%) and in distant metastases (14% vs. 5%). Surgery was performed in 98 of 256 patients (38%) with recurrent or metastatic disease. The 5-year disease-free survival rate after radiotherapy for N0 patients was an improvement (44%) on that of N1-3 patients (23%). The N-stage is an important prognostic factor for oropharyngeal cancer patients.
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PMID:The impact of lymph node metastases on the results of treatment by primary radiotherapy and secondary surgery in oropharyngeal cancer. 749 89

January, 1994, through January, 1995, eighteen patients (17 men; median age: 59.9, range: 32-73) with biopsy-proved squamous cell carcinoma (n = 15), adenocarcinoma (n = 2) or undifferentiated carcinoma (n = 1) of the esophagus were treated with concurrent chemo-radiotherapy. All patients had inoperable lesions for unresectable disease (11 patients) or concomitant illness (7 patients); median Karnofsky score was 70 (range: 60-80). According to the 1988 American Joint Committee on Cancer Staging system, one patient was graded as Stage IIA (T2N0 + oropharyngeal cancer T4N1), two Stage IIB (T2N1), twelve Stage III (8 T3N1, 1 T4N0, 3 T4N1) and three Stage IV (2 T3N0M1, 1 T4N0M1). Treatment consisted of two courses of chemotherapy by cisplatin (75 mg/m2 i.v. on days 1 and 29) and 5-FU (1000 mg/m2/24 hours by continuous infusion from days 1 to 4 and from days 29 to 32) along with one course of concomitant radiotherapy at 45 Gy (1.8 Gy per fraction, one fraction per day and 5 fractions a week). After 15-30 days, the patients were treated with a boost dose of 7 Gy by high-dose-rate intraluminal brachytherapy. All patients are assessable for toxicity and seventeen for response. The combined treatment was generally well tolerated, with only one case of WHO grade III toxicity (thrombocytopenia). Eight of the eighteen patients had a complete response (47%); four a partial response (24%); four a minimal response (24%) and one showed stable disease (5%). Only one patient developed local progression, and four distant metastases. All the eight patients with CR are alive without local recurrence (two distant metastases) with a mean follow-up of 6 months. This treatment regimen provides good local tumor resolution with no major toxicity. The value of this study protocol will be determined by the rate of long-term survivors.
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PMID:[The combined radiochemotherapy of inoperable esophageal neoplasms: a feasibility study]. 864 59

The purpose of this study is to ascertain the role of neck surgery and radiation therapy for cervical lymph node metastasis in oropharyngeal cancer patients. We reviewed 217 previously untreated patients with squamous cell carcinoma of the oropharynx who were treated at the Cancer Institute Hospital in Tokyo between 1971 and 1995. The N stage distribution was; N0: 83(38.2%), N1: 42(19.4%), N2a: 23(10.6%), N2b: 27(12.4%), N2c: 33(15.2%), and N3: 9(4.2%). A predominance of cervical node metastases in level II and III was revealed and there were no skip metastases outside of level II and III. The control rate of cervical metastasis for each N stage was; N0: 96.9%, N1: 90.0%, N2a: 76.5%, N2b: 62.5%, N2c: 50.0%, and N3: 0%. Definitive irradiation provided sufficient treatment for small nodes, when the primary tumor growth was well controlled by radiation therapy. Neck dissection was necessary for more advanced neck metastases. Selective limited neck dissection (level II and III) is recommended for N0 and N1 patients, and modified or classical RND is considered to be better for most cases with N2 and N3.
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PMID:[Treatment strategy for cervical node metastasis from squamous cell carcinoma of the oropharynx]. 1094 53

To evaluate the usefulness of chemoradiotherapy for oropharyngeal cancer, we retrospectively analyzed disease-free survival (DFS) and acute toxicities of the patients treated with this therapy. Between 1990 and 1998, 15 patients were treated with alternating chemoradiotherapy (CRT). Chemotherapy (CT) mainly consisted of 5-fluorouracil 700 mg/m2 (i.v.) on days 1-5 and nedaplatin 100-140 mg/m2 (i.v.) on day 6. Chemotherapy was administered before the beginning of radiotherapy. One cycle of this treatment consisted of CT and a subsequent 27 to 36 Gy of radiotherapy, as a general rule, two cycles were performed. Radiotherapy was delivered in single daily fractions of 1.8 to 2 Gy, to a total dose of 54 to 75 Gy for local lesions and 45 to 86.3 Gy for nodal metastases in the neck. As a historical control, 52 patients treated with curative radiotherapy between 1971 and 1990 were analyzed and compared with the CRT group in terms of DFS. The complete response rate with CRT was 100%. The three-year DFS were 87% and 38% with CRT and RT, respectively. There was a significant difference between the two groups (p = 0.0081). The most frequent and severe acute toxicity was mucositis, with grade 3-4 occurring in 47%. Acute hematologic toxicities were mild. Therefore, this CRT is considered to be an effective and tolerable treatment, and is expected to improve survival for oropharyngeal cancer patients.
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PMID:[Alternating chemoradiotherapy for oropharyngeal cancer]. 1114 65

The records of 87 patients with squamous cell carcinoma of the oropharynx, treated between 1971 and 1998 at Kitasato University Hospital, were reviewed with the aim of investigating further directions for oropharyngeal cancer treatment. The patients were divided into four major treatment groups: a radiotherapy group; an operation group; a simultaneous chemoradiotherapy group; and a combination treatment group. The 5-year cumulative survival rates for Stages I-IV were 75%, 78%, 68% and 41%, respectively. None of the T4 cases survived for > 5 years. The survival rates of patients with anterior and posterior wall cancers were higher than those with lateral and superior wall cancers. All patients in the operation group survived for 5 years. The survival rates for the combination treatment, radiotherapy and chemoradiotherapy groups were 80%, 57% and 52%, respectively. The 5-year cumulative local control rates for T2-T4 tumors were 61%, 58% and 0%, respectively. The combination therapy (80%) and chemoradiotherapy (66%) groups had significantly higher local control rates than the radiation group (33%). The 5-year cumulative regional control rate according to N classification was approximately 80%, except for N2 lymph nodes, for which only 60% of patients were free of regional recurrences. Approximately 15% of patients with oropharyngeal cancer had either distant metastases or double cancer. We conclude from this review that simultaneous chemoradiotherapy is a good initial therapy for Stages Tl-T3 oropharyngeal cancer. However, for T4 tumors, further combinations of both chemoradiotherapy and surgery and the development of new anticancer drugs for use in chemoradiotherapy, immunotherapy or gene therapy may be needed.
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PMID:Assessment of oropharyngeal cancer. 1221 90


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