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)

Eighteen patients with unresectable carcinoma of the stomach whose known malignant disease was confined to structures immediately adjacent to the primary tumor and could be encompassed within a radiotherapy field were treated with an intensive sequential combined modality regimen. The regimen consisted of 5-FU plus adriamycin chemotherapy, followed by high dose megavoltage radiation therapy with 5-FU given as a radiation sensitizer, followed by maintenance chemotherapy with 5-FU plus adriamycin plus methyl CCNU (FAMe). Our primary objective was to determine patient tolerability. Severe and prolonged anorexia, nausea, and decreased performance status occurred during and after high dose radiotherapy given twice daily in 150-170 cGy (rad) fractions when given with 5-FU. Lengthening intervals between treatment segments, and the use of one daily dose of radiation therapy combined with 5-FU or two fractions daily without 5-FU seemed to decrease nutritional complications. Control of tumor at the primary site appeared to be achieved in most patients. Distant metastases represented the predominant mode of treatment failure with only two patients currently without progression of malignant disease. Our treatment regimen as initially conceived was too toxic for general use. Improved therapeutic results in locally unresectable gastric cancer will require the development of more effective therapy for occult distant metastases.
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PMID:A pilot study to determine clinical tolerability of intensive combined modality therapy for locally unresectable gastric cancer. 404 45

Advanced renal cell carcinoma was treated by transcatheter embolization with radioactive seeds. There were 14 patients with nonresectable or metastatic disease (stage IV) and 8 with stage II tumors treated. In 8 patients the tumor was implanted with radon seeds, complemented by 2,500 rad of external beam therapy, and 10 were treated by embolization with 125iodine seeds. The total dose delivered ranged form 1,600 to 14,000 rad. Several patients also had intra-arterial chemotherapy. Survival was improved over previously reported studies: 13 of 22 (59 per cent) at risk for 2 years and 5 of 15 (33 per cent) for 5 years. Distant metastases did not resolve but significant local palliation was achieved. Tumor size decreased in all patients, 8 of whom subsequently underwent nephrectomy. Other local effects included pain control (10 per cent), weight gain (75 per cent) and control of hemorrhage (88 per cent). Toxicity was minimal and consisted of mild nausea or pain. This approach, using a low energy emitter, allows selective high dose radiation of the tumor, while sparing the adjacent normal tissues. In contrast to renal artery occlusion with inert embolic material, subsequent nephrectomy in patients with disseminated disease is not necessary. Transcatheter embolization with radioactive seeds should be considered a reasonable palliative procedure in patients with nonresectable primary renal cell carcinoma.
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PMID:Transcatheter embolization of advanced renal cell carcinoma with radioactive seeds. 617 Jul 67

Twenty consecutive patients have been treated for palliation of pain from bony metastases with radiotherapy using a regime of multiple daily fractions. Patients received up to three treatments daily with 3-4 hour intervals between fractions. Pain was relieved in all cases and pain relief took place earlier in the treatment than with conventional daily regimes. Nausea was mild in most cases. Some factors in its aetiology are discussed. Acute skin reactions were minimal. The total dosage required and the advantages and disadvantages of the method are discussed.
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PMID:Multiple daily fractions of radiation in the palliation of pain from bone metastases. 618 72

Twenty-one patients with liver metastases of various histologies (predominantly colorectal carcinoma) underwent Infusaid pump implantation for long-term hepatic arterial 5-fluorodeoxyuridine (5-FUdR) infusion. Patients received 5-FUdR infusion on a 2-wk cycle alternating with a 2-wk saline--heparin infusion. A dosage of 0.2-0.3 mg/kg/day (average 0.23 mg/kg/day) was infused for a cumulative 5-FUdR administration of 1940 days. Six patients (29%) responded to therapy (five colorectal, one carcinoid); median response duration was 6 mo. Median survival for the treated group was 17 mo from diagnosis of liver metastases and 13 mo from pump implantation. Median survival among the six responding patients was 15 mo from diagnosis of liver metastases and 11 mo from pump implantation. Comparison of survival from the diagnosis of liver metastases of the treated group to ten patients found ineligible for the study by virtue of extrahepatic metastases revealed no significant difference in median (18 mo for ineligible group) or overall survival. However, median survival for the treated group after pump implantation (13 mo) was significantly better than the median survival of the ineligible group after evaluation for this study (4 mo). Toxicities of therapy included fatigue, anorexia, nausea, vomiting, toxic hepatitis, epigastric pain, and diarrhea. No patients died of toxicity, but six patients required hospitalization for management of pain or vomiting. No serious technical complications developed in any patient except separation of the infusion catheter at its junction with the pump in one patient, necessitating pump replacement for continuation of therapy. These survival data suggest identification of new anticancer agents for hepatic arterial infusion.
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PMID:Long-term hepatic arterial infusion of 5-fluorodeoxyuridine for liver metastases using an implantable infusion pump. 619 74

Since 1973 there have been more than 20 reported cases of malignant and about 200 cases of benign hepatic adenomas associated with oral contraception (OC). This article reports on the case of a 45 year old woman on OC from 1967 to 1971. In 1979 she was admitted to the hospital in the 36th week of her 9th pregnancy for nausea, vomiting, and pain. Cesarean section delivered her of a healthy baby girl, and celiotomy exposed an enlarged liver with several tumors. Resection was not possible and the woman died after 3 days. Necropsy showed numerous tumors and metastases and primary hepatic carcinoma. Even though 8 years had elapsed between OC termination and the onset of cancer, the connection between exposure to OC and liver cancer must be suspected. The time lag might be attributed to delayed development of the neoplasm rather than to its slow growth.
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PMID:A case of hepatoma in pregnancy associated with earlier oral contraception. 627 30

A trial of combination chemotherapy using mitoxantrone-cyclophosphamide was started in 1983. Sixteen patients with widely metastatic cancer of the breast, including one man, received mitoxantrone, 10 mg/m2 intravenously (IV) over 30 minutes on day 1, followed by cyclophosphamide, 200 mg/m2 by mouth (PO) daily in divided doses on days 3 to 6. It is too early to evaluate four patients at present. The remaining 12 received three or more courses of treatment, and three of these patients achieved a complete response. Another four patients went into partial remission, amounting to an overall response rate of 58%. The other evaluable patients showed stable disease with improved symptoms. Hematologic toxicity was mainly granulocytopenia, but thrombocytopenia occurred in two patients. Alopecia, nausea, and vomiting were attributed to the cyclophosphamide component of the therapy. Mitoxantrone appeared to have no cardiac toxicity. It was concluded that mitoxantrone-cyclophosphamide is an effective chemotherapeutic combination with minimal toxicity and should be further studied in larger controlled trials.
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PMID:Mitoxantrone and cyclophosphamide in advanced breast cancer: a pilot study. 638 60

In a phase-II study 46 patients with advanced colorectal cancer were treated with the new nitrosourea ACNU [1-(2-chloroethyl)-1-nitroso-3 (4-amino-2-methyl-5-pyrimidinyl)methyl-3-nitrosourea]. From 43 evaluable patients, 86% presented distant metastases and 14% an unresectable primary tumour or a recurrent tumour. 24 patients presented a colon and 19 a rectal cancer. Prior anticancer drug treatment was given to 34 patients (79%), 11 (26%) were pretreated with a nitrosourea. ACNU was administered every 4-6 weeks as a single intravenous push injection of 100 mg/m2. Most patients received 2-3 courses. From 43 evaluable patients, one patient achieved a complete and 3 a partial remission (CR + PR 9%). 5 patients reached a minimal regression (tumour regression of less than 50%) and 5 a no change for at least 2 months. The median duration (time from beginning of ACNU therapy until tumour progression) of the 14 responders was 132 days. The median survival time was significantly longer for responders in comparison to patients with progressive disease (9.8 versus 4.1 months). The dose limiting toxicity was delayed bone marrow suppression predominantly in the form of thrombocytopenia. 22/42 patients (52%) presented a thrombocytopenia of under 50.000/mm3 with a nadir after 27 days. Leucocytopenia under 2.000/mm3 were observed in 22/40 patients (30%). A fall of haemoglobin of more than 2 g/dl was seen in 71%. Nausea or vomiting over 1-2 days were found in 59% of the treatment courses. Other drug related side effects were not encountered. ACNU has a similar activity in colorectal cancer as BCNU and CCNU.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Phase II study of the water-soluble nitrosourea compound ACNU in advanced colorectal carcinomas]. 639 65

This 74-year-old female suddenly complained of severe headache, nausea, vomiting and dizziness on June 19, 1981. She was brought to nearby hospital. During the following six days, the state of consciousness gradually worsened and left-sided hemiparesis and convulsion attack arose and she was admitted to our clinic on June 25, 1981. Cerebral angiograms revealed an aneurysm of the right middle cerebral artery. Diagnosis of subarachnoid hemorrhage due to the rupture of an aneurysm was tentatively made and conservative therapy was done. On the second hospital day, she had nasal bleeding and began to excrete tar-like stool. Laboratory examination revealed thrombocytopenia, increase of FDP and prolongation of prothrombin time. Her liver and renal functions gradually worsened after this episode. On the 13th hospital day, she expired. General autopsy showed wide spread adenocarcinoma with metastases to the lung, lymph nodes and bones. Examination of the head revealed an unruptured aneurysm and bilateral diffuse subdural clotted hemorrhage. The dura was tightly adherent to the skull and partially thickened. No abnormal findings were found in the brain. On microscopical examination of the dura, there were fresh hemorrhage and many of the innumerable dilated small vessels contained tumor in the inner dural layer. Even by extensive examination, the origin of the malignancy could not be identified. We concluded that the initial symptoms just like of subarachnoid hemorrhage were due to the dural metastasis and subdural hematoma. Sixteen cases of subdural hematoma secondary to metastatic neoplasm were reported previously. We made some discussion about the pathogenesis and symptomatology of this type of subdural hematoma.
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PMID:[Subdural hematoma due to metastatic dural carcinomatosis associated with DIC--a case report]. 662 89

Ifosfamide (Z 4942) is an alkylating agent with the structure of a cyclophosphamide analog. Preliminary studies performed in our hospitals demonstrate the releasing effect of Ifosfamide for persistent pain caused by metastases of the prostatic cancer at various regions. Ifosfamide was given 2 grams a day intravenously with hydration and alkalization for consecutive 5 days. The regimen was performed every 3 or 4 weeks. Pain has disappeared in 7 of 10 cases within 2 or 3 courses. Pain of other 3 cases has also greatly reduced. The effective rate for the primary lesion of the prostatic carcinoma in stage C and D is 30.7%. Side effects were nausea, vomiting, hair loss and leukopenia.
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PMID:[Treatment of pain caused by metastases of reactivated prostatic cancer with ifosfamide]. 663 95

Combination three-drug chemotherapy with adriamycin (ADM), cyclophosphamide (CPM), and 5-fluorouracil (5-FU) was performed in 24 cases of advanced bladder cancer who underwent surgical treatment, and three cases with recurrent or metastatic bladder cancer. The average age (25 men and 2 women) was 53. Of the 24 cases, nine were in stage T2, 10 in T3, and five in T4. One course consisted of a combination of 30 mg/m2 of ADM, 300 mg/m2 of CPM, and, 250 mg of 5-FU, administered five times. The combination was administered to three groups: every day for 5 days consecutively in group A, twice a week for 21/2 weeks in group B, and once every 4 weeks for 16 weeks in group C. After injection of ADM, CPM, and 5-FU, 200 mg/day of 5-FU was administered PO daily in all three groups. The 5-year survival rate of the 24 cases (apart from 3 cases with measurable metastatic tumor) was 58%. The 5-year survival rate for stage T2 was 88%, and that for stage T3 was 62.5%; all patients with stage T4 disease died before 3 years and 6 months. Partial response was seen in two out of three patients with recurrent or metastatic disease. Alopecia was observed in all cases as a side-effect of the chemotherapy. Also anorexia, nausea, and myelosuppression were observed in many cases, though the degree was tolerable. However, there were no disorders of the cardiovascular system, except for one case with transient hypotension.
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PMID:Combination chemotherapy for advanced bladder cancer with adriamycin, cyclophosphamide, and 5-fluorouracil. 664 Aug 34


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