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)

Radiation Therapy Oncology Group (RTOG) protocol 7706 was a randomized Phase III study designed to test the value of elective (prophylactic) pelvic irradiation in addition to prostatic irradiation in patients with carcinoma of the prostate with no clinical evidence of tumor extension through the capsule. Eligible patients were those who had clinical Stage T1bNOMO (A2) or T2NOMO (B), who did not have curative surgery, and who had no evidence of lymph node metastases. Assessment of the regional lymphatics was mandatory but, at the discretion of the investigator, lymphangiography (LAG) or staging lymphadenectomy (SL) could be used. A total of 445 eligible and analyzable patients were entered in the study between 1978 and 1983 when the study was closed. The median follow-up was 7 years; minimum follow-up was 5 years. There were no significant differences in survival or local control whether treatment was administered to the prostate or to the prostate and pelvic lymph nodes. The nodal status for 117 (26%) patients was assessed by staging lymphadenectomy (SL) whereas for 328 (74%) patients it was assessed by lymphangiography (LAG). Pretreatment characteristics felt to have impact on survival were evaluated and found to be free of serious imbalance between the staging lymphadenectomy and lymphangiography groups. Compared to the lymphangiography group, the staging lymphadenectomy group showed better overall survival (87% to 76% at 5 years, p = .02), better disease-free survival (76% to 63% at 5 years, p = .008) and better metastases-free survival (88% to 82% at 5 years, p = .04). There was no difference between the groups in local control. The lymphangiography evaluation of pelvic nodes was clearly inferior for demonstration of the absence of pelvic node metastasis as reflected by reduced survival and increased metastasis.
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PMID:Impact of surgical staging in evaluating the radiotherapeutic outcome in RTOG phase III study for A2 and B prostate carcinoma. 280 56

The interim results of the randomised, Phase III trial of Zoladex against castration in the management of patients with metastatic carcinoma of the prostate is discussed. Trials commenced in October 1984 and incorporated 359 patients when recruitment ceased in January 1986. The preliminary report concerns the first 240 patients who had a minimum of 3 months follow-up. Entry criteria included patients who had no previous treatment with the exception of first-line localised radiotherapy and those who had distant bone or soft tissue metastases. Fourteen patients were excluded on the basis of protocol violations. The objective assessment of response was based on the British Prostate Group Criteria and was performed monthly for the first 3 months and 3-monthly thereafter. Pre-treatment disease characteristics of patients in both groups were similar at entry and there were no significant differences in the subjective response data of patients between the orchidectomy (n = 106) and the Zoladex group (n = 120). Objective response rates at 12 and 24 weeks of treatment were also identical for both treatment groups. Serum testosterone concentrations were below the 'castrate' level (less than 2 nmol/L) for Zoladex group as well as the orchidectomy group up to 48 weeks. The drug was well-tolerated with minimal side effects, those resulting from testosterone withdrawal were similar in both groups. The report therefore indicates clearly that this partical formulation of LH-RH analogue provides a valuable alternative to the surgical procedure in the treatment of carcinoma of the prostate.
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PMID:Treatment of patients with advanced cancer of the prostate: phase III trial, zoladex against castration; a study of the British Prostate Group. 296 38

A patient with small-cell carcinoma of the prostate is described. The patient's clinical course and the tumor's pattern of metastases were similar to those seen in small-cell carcinoma of the lung. There was a complete, though brief, remission on chemotherapy with cyclophosphamide, doxorubicin hydrochloride (Adriamycin), and vincristine.
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PMID:Small-cell carcinoma of prostate. Transient complete remission with chemotherapy. 299 47

From 1978 to 1983 the Radiation Therapy Oncology Group conducted a study to evaluate the role of elective pelvic lymph node irradiation in carcinoma of the prostate. Eligible patients were those with clinical Stage A2 (occult disease with more than 3 positive chips and poorly differentiated tumor) and Stage B without clinical (lymphangiogram) or biopsy evidence of lymph node involvement. The patients were randomized to receive 6.5 weeks of either prostatic bed irradiation only 6500 cGy at 180-200 cGy per treatment or pelvic node irradiation to 4500 cGy with a boost of 2000 cGy to the prostatic bed bringing the total dose to 6500 cGy. As of February, 1988, the median follow up has been 7 years and there were 445 analyzable cases who were evaluated for local control, incidence of distant metastases, ned (no evidence of disease) survival and survival. The results of the study revealed no statistically significant benefit of elective pelvic irradiation.
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PMID:Elective pelvic irradiation in stage A2, B carcinoma of the prostate: analysis of RTOG 77-06. 305 56

A single blood sample method was used to measure total skeletal activity during routine radionuclide bone scans in 114 patients with known carcinoma of the prostate. The method is based on the measurement of radioactivity in plasma after administration of 99mTc MDP and 51Cr EDTA, providing an assessment of total skeletal activity independent of renal function. The results showed a significant elevation of skeletal activity in patients with untreated bone metastases when compared with patients with no metastatic spread. Significant elevation with increasing extent of metastases was also shown, the highest activity being in patients with diffuse metastatic spread (superscan). Patients with treated metastatic disease showed significantly lower skeletal activity than patients with untreated bone metastases. The method requires the use of two radiopharmaceuticals injected as a mixture and potential errors may arise from pharmaceutical instability. In addition, elevation of total skeletal activity may be caused by coexistent metabolic bone disease. The results suggest that the measure may provide quantitative information in the assessment of the activity of bone metastases from prostatic carcinoma.
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PMID:A single plasma sample method to assess disease activity in patients with bone metastases from carcinoma of the prostate. 309 18

We have investigated the hypothesis that carcinoma of the prostate with skeletal metastases is associated with increased bone resorption. In 54 affected patients a close correlation was observed between serum activity of alkaline phosphatase and urinary excretion of hydroxyproline (r = +0.818; P less than 0.001), comparable to that seen in Paget's disease of bone. The administration of synthetic salmon calcitonin (100 U subcutaneously) induced a significant fall in serum calcium and urinary excretion of hydroxyproline, proportional to the prevailing rate of bone turnover, as assessed by serum alkaline phosphatase or hydroxyprolinuria. Administration of the diphosphonate, etidronate, also decreased hydroxyprolinuria, suggesting that urinary hydroxyproline reflected increased rates of bone resorption in this disorder. Histology of bone in sites adjacent to and distant from skeletal metastases showed increased histological indices of bone resorption. These results suggest that the skeletal disease associated with prostatic carcinoma is characterized by generalized increases in bone resorption as well as focal increases in bone formation.
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PMID:Biochemical and histological evidence that carcinoma of the prostate is associated with increased bone resorption. 310 81

Buserelin (B) is a synthetic nonapeptide analogue of native LHRH. Upon continued administration it reliably lowers the serum testosterone level to less than 100 ng/dl. It has been used in a clinical trial for the treatment of patients with stage C, D1, and D2 prostate cancer. Analysis of efficacy of testosterone suppression and toxicity included all 207 buserelin-treated patients. A comparison with historical controls from two National Prostate Cancer Project (NPCP) studies considered only the 147 evaluable patients with distant metastases (stage D2). All patients received buserelin, 500 micrograms q 8 hours subcutaneously (s.c.) for the first 7 days and then elected to take 200 micrograms s.c. daily or 400 micrograms q 8 hours by the intranasal (i.n.) route. Seventy-three percent elected s.c. administration. Only 2% changed the route of administration. The serum testosterone (T) level increased during week 1 in both the s.c. (426 ng/dl) and the i.n. (521 ng/dl) group but reached castrate (less than 100 mg/dl) levels by 4 weeks in 90% of patients. Subsequently, the likelihood of having a T level greater than 100 was higher for those treated by the i.n. than the s.c. route. The mean T level 4 and 12 months after therapy for the s.c. treated patients was 29 and 28. These values were 61 and 53 for those taking i.n. buserelin. This difference may in part be due to poor compliance. Toxicity was minor. Twelve percent of 151 s.c. treated patients had at least one episode of reaction at the injection site. None required discontinuation of the agent. Seventy-two percent experienced hot flushes; this was the same for both the s.c. and i.n. groups. Only 2 of 207 patients had a severe exacerbation of symptoms (spinal cord compression) during the first week of therapy. The criteria for response to therapy were those of the NPCP. There was no significant difference in the percentage of patients achieving a response when comparing the B-treated D2 patients to the NPCP D2 patients treated with DES, 3 mg daily, or orchiectomy. More of the B-treated patients entered with pain, a poor performance status, and weight loss than the DES/orchiectomy group. Nonetheless, the progression-free survival did not differ among the treatments. In summary, buserelin reliably lowers the serum T level by week 4 in 95% of men. Treatment efficacy is equivalent to a historical group treated with either DES or orchiectomy.
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PMID:Efficacy of buserelin in advanced prostate cancer and comparison with historical controls. 313 44

Definitive radiation therapy was administered to 577 patients with histologically confirmed carcinoma of the prostate localized to the pelvis between January 1967 and December 1983. All patients were available for a minimal 3-year follow-up, and the median period of observation is 6.5 years. The actuarial survival without tumor in stages A2 and B at 5 years was 78% and at 10 years 60%. In stage C, the corresponding survival figures were 60% at 5 and 40% at 10 years. The overall actuarial survival in stage B patients was 76% at 5 and 56% at 10 years, which is similar to the life expectancy of a comparable cohort of normal males. In stage C, the actuarial survival was 65% at 5 and 35% at 10 years. The pelvic failure rate in stage A2 was 12% (5 of 41), 17% in stage B (31 of 185), 28% (93 of 328) in stage C, and 48% (11 of 23) in stage D1. Distant metastases were noted in 12% of the patients with stage A2, 20% stage B, 42% stage C, and 65% stage D1. In stage B, patients who had control of the pelvic tumor exhibited an 85% actuarial 5-year survival and a 60% one at 10 years. This compares with an actuarial survival of 30% at 5 and 10 years when there was evidence of pelvic recurrence alone or combined with distant metastases. In stage C patients with pelvic tumor control, actuarial survival was 81% at 5 and 50% at 10 years, in comparison with 25% at 5 and 10% at 10 years when there was development of pelvic recurrence or distant metastases or a combination of both. There was a strong correlation between the survival and appearance of distant metastases with the histologic degree of differentiation of the tumor in all stages. However, the probability of tumor control in the pelvis was not significantly correlated with this parameter. The administration of hormones concomitantly with radiation therapy did not significantly influence the probability of tumor control, appearance of distant metastases, or survival. Major sequelae of therapy were noted in 2.2% of the patients, whereas minor sequelae were observed in approximately 12% of the patients. Radiation therapy has been shown to be an effective therapeutic alternative to radical prostatectomy or hormonal manipulation in patients with carcinoma of the prostate.
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PMID:Definitive radiation therapy in carcinoma of the prostate localized to the pelvis: experience at the Mallinckrodt Institute of Radiology. 317 6

Prostate carcinoma was previously thought to be a rare source of orbital metastasis. We studied a clinical series of eight cases of orbital metastases from prostate carcinoma. Presenting symptoms included proptosis, pain, diplopia, eyelid swelling, decreased vision, ptosis, and red eye. The mean age at onset was 72.1 years. In three of the eight patients, evaluation of the orbital masses led to the diagnosis of prostate carcinoma. Of the six patients in whom computed tomography was performed, four had predominantly osteoblastic lesions. In our experience, the rapid development of an osteoblastic orbital lesion in an elderly man is highly suggestive of metastatic prostate carcinoma.
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PMID:Orbital metastases from prostate carcinoma. 317 51

In 62 patients with histologically confirmed carcinoma of the prostate bone scintigraphy, radiographic survey and serum prostatic acid phosphatase determinations were carried out to evaluate the progression of the disease and to compare the relative sensitivity of the diagnostic tools. Thirty-five patients had scintigraphic evidence of skeletal metastases, whereas abnormal X-ray survey and elevated prostatic acid phosphatase levels were found in only 4 and 19 patients, respectively, all of whom had positive scintigraphic findings. Radiographic evidence of metastases was not found in any of the patients with normal scintigraphy, while elevated prostatic acid phosphatase was found in two patients. It is concluded that bone scintigraphy is far more sensitive than either radiographic survey or determination of prostatic acid phosphatases in the diagnosis of skeletal involvement in prostatic carcinoma, and should be the method of choice for this purpose.
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PMID:Bone scintigraphy, radiographic survey and prostatic acid phosphatase in patients with prostatic carcinoma. A comparison of sensitivity. 328 71


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