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)

Vincristine, actinomycin D, and cyclophosphamide (VAC) were administered to 14 patients with Ewing's sarcoma. The primary tumors were treated with radiation therapy and concurrent chemotherapy. Nine patients had no visible metastases at diagnosis: two died following the development of pulmonary metastases and the rest have been free of disease for periods varying from 4 months to 4 1/2 years following completion of treatment. This contrasts with a 27% survival in patients previously treated at this center with single agent chemotherapy. Five other patients had demonstrable metastases at diagnosis: VAC chemotherapy achieved complete regression of pulmonary metastases in three for 9, 9+ and 24+ months, respectively. Following disappearance of tumor in the latter two, pulmonary irradiation was administered in an attempt to consolidate the response, but tumor recurred 6 months later. These patients eventually died of widespread disease although survival appeared prolonged in comparison to that seen in past experience. Chemotherapy was well tolerated, although three patients developed hemorrhagic cystitis, necessitating discontinuation of cyclophosphamide. The data suggest the potential for prolonged control and an increase in the cure rate with this therapeutic approach.
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PMID:Improved outlook for Ewing's sarcoma with combination chemotherapy (vincristine, actinomycin D and cyclophosphamide) and radiation therapy. 99 Nov 6

Twenty-six patients with Ewing's tumor were studied. The spine was involved in eleven patients; the clinical and roentgenologic features of these are described. Four patients had primary Ewing's tumor of the spine; one showed uniform sclerosis of a single vertebra, a hitherto unreported finding. Two showed bone destruction; one showed no bone change on plain radiographs but there was complete obstruction on myelography. Two developed spinal metastases and died shortly afterwards. One patient is alive and well eight and a half years later. Seven patients had metastases to the spine from a non-spinal Ewing's tumor. All had neurologic complications. Plain radiographs showed no bone change in five; however, a paraspinal mass or an extra-dural mass shown on myelography, were relatively common. The mean survival time following spinal involvement was four months (range 1-12 months). No correlation was evident between the site of the primary lesion, the method of treatment, and the development of spinal metastases.
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PMID:Roentgenologic aspects of spinal involvement by primary and metastatic Ewing's tumor. 99 44

Forty-seven histologically confirmed cases of Ewing's tumour are reported, with typical age, sex and skeletal distributions. The disease-free survival curves are like those for osteosarcoma of corresponding types of bone, but with higher mortality. The two-year disease-free survival rates were 24 percent for tumours of long bones and 5 per cent for those of other bones. Osseous metastases were most frequent, although the lung was the commonest single site involved. There were secondary deposits in lymph nodes in nine patients, possibly also in four more with mediastinal enlargement. Although initially radiosensitive, one-third of tumours recurred locally, almost always with the appearance of metastases. Neither whole bone irradiation nor high dosage alone ensures complete control of the primary tumour, and it is suggested that recently reported improved results of treatment should be attributed to adjuvant multi-drug chemotherapy. Inadequate control of the primary tumour diminishes the chance of survival and for some sites radical operation merits reconsideration.
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PMID:Ewing's tumour. A study of behaviour and treatment in forty-seven cases. 105 45

In recent years, cytostatic chemotherapy has been added to the treatment of primary malignant bone tumors. Long-term results are not yet available. Since many of these tumors metastasize through the blood stream, the prognosis has been poor. Now a general improvement in the total number of cures is expected. In osteogenic sarcoma, amputation or exarticulation of the involved extremities is most frequently suggested; one can, however, continue to use preoperative radiotherapy. After 3 or at the most 6 months, amputation is carried out if the patient is free of metastases. Adjuvant chemotherapy should be carried out in every case. The side effects in the irradiated area, however, are considerably increased and, as a result, immediate amputation will become more and more popular. Irradiation of the primary tumor plays a decisive role in Ewing's sarcoma, surgical removal of the tumor does not require radicality at all costs. In reticulosarcoma of the bone, surgical intervention is limited to a biopsy because of high radiosensitivity. Adjuvant chemotherapy should be carried out in every case since a generalization is to be expected in 30% of the patients. The indications for "prophylactic" radiotherapy of the lung and the neurocranium were discussed.
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PMID:[Radiation therapy and chemotherapy of primary malignant tumors of the bone (author's transl)]. 106

Contemporary clinical research is actively engaged at the conquest of residual neoplastic disease. The preliminary results of combined treatment modalities for osteogenic sarcoma, Ewing's sarcoma, rhabdomyosarcoma, breast cancer, malignant melanoma and Hodgkin's disease have shown a significant decrease in the incidence of distant metastases. In some neoplasias the decreased relapse rate was associated to improved survival. Since the problem of long-term carcinogenesis does exist, the use of prolonged adjuvant chemotherapy, at present moment, is best limited to patients at high risk of early relapse when treated only with local or local-regional modalities.
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PMID:Treatment of residual neoplastic disease in solid tumours. 106 17

Since 1964, 66 consecutive patients with Ewing's sarcoma have been treated at the National Cancer Institute with local irradiation of the primary site combined with adjuvant regimens of progressively more intensive systemic chemotherapy. Actuarial survival rates for the total series show a 56% 2-year and 35% 5-year survival. The 43 patients without clinically detectable metastases at diagnosis have 64% 2-year and 52% 5-year survival rates. The current protocol, alternating high-dose pulses of adriamycin and cyclophosphamide-vincristine, is providing improved disease-free survival as compared to previous protocols, and indicates further progress toward the ultimate goal of complete tumor eradication. In addition to the problems of diagnostic accuracy in evaluating treatment results, other major factors influencing prognosis include initial metastatic disease, site of the primary tumor, age at diagnosis, and presence of systemic symptoms. At least these, and probably others, must be taken into account in developing randomized prospective trials for determination of optimal adjuvant therapy.
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PMID:Combined modality therapy of Ewing's sarcoma. 110 74

A case of Ewing's Sarcoma originating the great toe is reported. Because of the rarity of its appearance outside the pelvis and long tubular bones, Ewing's Sarcoma is often misdiagnosed when it occurs in the distal portion of the extremities. Ewing's Sarcoma may be difficult to distinguish from infection. Biopsy is recommended for any indolent or refractory lesions presumed to be infectious. Bone scanning with Technetium Polyphosphate is a useful tool for diagnosis and evaluation of this tumor. Vigorous integrated chemotherapy and radiotherapy had little effect in this patient with metastatic disease.
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PMID:Ewing's sarcoma of the great toe. A case report. 127 42

Primitive neuroectodermal tumor (PNET) is a small round cell malignancy arising in soft tissue and bone, predominantly in older children and adolescents. We report the cytomorphologic features and findings of ancillary studies of eight fine needle aspiration (FNA) biopsies from three patients (7-year-old male, 12-year-old female, 9-year-old female). Two of the biopsies suggested the initial diagnosis of PNET of the chest wall, while the remaining six documented recurrent or metastatic disease. In one of these cases the primary diagnosis made by FNA biopsy enabled the pediatric oncologists to give specific therapy for the unresectable tumor and achieve remission. Local recurrences included the chest wall (two cases), pleura (one case) and pericardium (one case), while metastatic disease involved the supraclavicular lymph node and breast. All the cases consisted of small malignant cells with a high nuclear/cytoplasmic ratio and hyperchromatic nuclei without prominent nucleoli. Homer Wright rosettes were seen in only two of the aspirates, and neuropil and ganglion cells were not present. Ancillary studies, including electron microscopy (two cases), immunocytochemistry (four aspirates from two cases) and cytogenetics (11/22 translocation, one case) performed on the aspirated material were aids in making a specific diagnosis and excluded other small round cell tumors of childhood, such as malignant lymphoma, rhabdomyosarcoma and Ewing's sarcoma. The differential diagnosis between PNET and neuroblastoma can be difficult on the basis of an FNA biopsy alone, although light microscopic morphologic differences exist. Clinical features (e.g., age, primary site, metastatic patterns), catecholamine levels, electron microscopy and cytogenetics are necessary in establishing the correct diagnosis.
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PMID:Fine needle aspiration cytology of primitive neuroectodermal tumors. A report of these cases. 132 99

Solitary cerebellar metastatic tumors are rarely reported in the literature. We reviewed 240 posterior fossa tumors treated in the past eight years. There were 11 cases of solitary metastases in the cerebellum. The primary tumor was lung cancer in five cases and breast carcinoma in two cases; the remaining three cases had colon cancer, nasopharyngeal carcinoma (NPC) and Ewing's sarcoma, respectively. All patients underwent craniectomy and gross total excision of the tumor. Seven patients survived less than one year, two cases died in the second year, and one case of NPC survived for more than two years. The only survival is a case of Ewing's sarcoma who underwent surgery 14 months ago. The symptoms and signs of all patients improved satisfactorily after surgery. Four patients received postoperative irradiation to the posterior fossa and two cases of lung cancer had a thoracotomy for the primary lung lesion; however, the survival period was not prolonged. We suggest that a cancer patient or a patient in the fifth to seventh decades of life presenting headache, gait disturbance and vomiting should promptly undergo a computed tomography (CT) scan of the head. In selected cases, surgical intervention for solitary metastatic tumors in the tiny posterior fossa may be the best initial treatment. Adjuvant therapies should then be added according to the type of tumor.
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PMID:Solitary cerebellar metastases: analysis of 11 cases. 136 66

The records of 30 adult patients with Ewing's sarcoma (ES) of bone treated between 1980 and 1990 at the Institut Curie were studied retrospectively; the diagnosis was reevaluated by histological and immunohistochemical analysis, using HNK and anti-neuron specific enolase (NSE) antibodies. The immunohistological analysis disclosed a significant staining of neoplastic cells in only few of our cases and is therefore of limited interest in the diagnosis of ES. Three groups of patients have been considered according to their clinical presentation: axial, peripheric and initial metastatic disease. The global prognosis is poor: the survival rate is 70% after a follow-up period of one year, and 23% after three years. The evolution was severe for patients with pelvic localization and/or initial metastatic disease. In contrast, five of six patients who are currently free of disease after a mean follow-up period of 42 months presented initial peripheric lesion. Four of these six patients were treated by a combination of surgical, chemical and radiation therapies.
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PMID:[Ewing's sarcoma of bone in adults: an anatomic-clinical study of 30 cases]. 139 54


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