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)

Cisplatin (25 to 120 mg. per m.2) was injected into the internal iliac arteries of 33 patients with locally advanced bladder cancer. Of the patients 9 were inevaluable for response to the cisplatin, since they began radiotherapy to the bladder before course 2 of cisplatin as part of a preplanned therapeutic approach. One patient received the treatment as postoperative adjuvant therapy, 1 did not return for followup and 1 with metastatic disease did not undergo repeat cystoscopy. Of 21 evaluable patients 3 (14 per cent) achieved complete remission, 12 (57 per cent) achieved partial remission, 2 (14 per cent) were stable and 4 (19 per cent) failed. The response rate was higher in patients receiving 100 to 120 mg. per m.2 per course than in patients receiving lower doses (all except 1 of whom received 60 or less mg. per m.2 per course) (86 versus 64 per cent) and it was higher in patients without prior radiotherapy or chemotherapy. The response rate in patients with previously untreated invasive transitional cell carcinoma was 88 per cent. Of the 33 patients 21 were alive at last followup, with a median duration of followup of 32 weeks. Toxicity was dose-related and local neurotoxicity was excessive at cisplatin doses of 100 to 120 mg. per m.2. Diabetic patients were particularly prone to have neurotoxicity. Other toxicity generally was not severe and consisted of ototoxicity, nephrotoxicity, myelosuppression, nausea, vomiting and diarrhea. Even elderly patients and patients with cardiac disease tolerated the treatment well. We plan to proceed with further intra-arterial cisplatin studies in which all patients except those more than 80 years old will be treated with an intra-arterial cisplatin dose of 90 mg. per m.2 per course combined with radiotherapy with or without cystectomy.
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PMID:Intra-arterial cisplatin for bladder cancer. 359 43

The possible synergism of cisplatin (P) and 5-fluorouracil was studied in 38 consecutive patients with advanced or metastatic colorectal carcinoma. Cisplatin 60 mg/m2 i.v.q. 4 weeks and fluorouracil 600 mg/m2 i.v. weekly were administered for at least 2 cycles, on an out-patient basis, to 24 males and 14 females with a median age of 57 years and a median PS of 80 (Karnofsky). Evaluable lesions were: primary unresectable tumor in 2 patients, local recurrence in 11, liver, lung, bone and soft tissue metastases in 21, 7, 2 and 3 patients respectively. With a median number of 3 cycles administered to 35 evaluable patients, 6 partial responses, 16 unchanged and 13 progressions were observed. Responses were observed in the liver (2 patients), lungs (1) and soft tissues (3). Median remission duration was 15 weeks, median duration of 'unchanged' was 12 weeks. The overall median survival was 24 weeks (30.5 weeks for responders and 22.5 weeks for non-responders). Six patients were pretreated with chemotherapy not containing cisplatin (mainly adjuvant 5-FU). None of them responded. Toxicity was very tolerable with moderate nausea, vomiting and alopecia in the majority of the patients; bone marrow toxicity was generally mild with no blood transfusions required, no complications of myelosuppression (sepsis or bleeding) and no chemotherapy-related deaths. In this experience the combination of low dose cisplatin with fluorouracil, does not appear to significantly enhance 5-FU toxicity and the response rate is not superior to that reported with 5-FU alone. However, better designed schedule combinations with optimal doses, sequences and exposure time of the 2-drug regimen, seem necessary to obtain the biochemical events that support the potentiation.
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PMID:Cisplatin and 5-fluorouracil combination chemotherapy in advanced and/or metastatic colorectal carcinoma: a phase II study. 365 87

Twenty-eight patients with advanced upper-abdominal malignancy were treated at the University of Utah on a pilot protocol involving regional hyperthermia (HT) produced by the BSD-1000 HT system and the annular phased array applicator (AA), usually driven at 60 MHz. Eighty-two percent of the patients had widespread metastatic disease, and the mean tumor burden was 2,900 cc. Seventy-nine percent of the patients received concurrent radiotherapy. Acute toxicity consisted primarily of pain within the AA aperture (43%), systemic stress (43%), and nausea or vomiting (29%). Systemic stress was the most frequent power-limiting factor (46%). There were two treatment-related complications: sciatic neuritis from intramuscular injection (one) and pleural effusion from thermometry probe placement (one). Detailed thermal mapping and thermal dosimetry were performed on 26 patients. The mean thermal dosimetry parameters were quite low. Concurrent radiation doses were also quite low (mean, 1,500 rad) to avoid toxicity of sensitive organ systems within the abdomen. The objective response rate was only 18%, all partial, but 43% of the patients achieved effective symptomatic palliation. The five objective responders did survive significantly (P = .02) longer than the 23 nonresponders.
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PMID:Abdominal regional hyperthermia with an annular phased array. 370 92

In vitro synergism between interferons (IFNs) and chemotherapeutic drugs has been demonstrated, and an enhancement of IFN's antiproliferative effects when combined with cimetidine has been suggested in melanoma patients. In this pilot study, 12 patients with advanced malignant melanoma received HuIFN beta by 30 min i.v. infusion at 30 X 10(6) u/m2 day for 4 days, followed by i.v. decarbazine (DTIC) 1.0 g/m2 on day 5, repeated every 4 weeks. Oral cimetidine, 300 mg q.i.d., was given continuously. All the patients had visceral (bulky) metastases. No objective responses were observed; however, two patients had stable diseases for 16 and 20 weeks, respectively. Mild chills and fever with IFN, and mild to moderate emesis with DTIC, were noted. No additive haemopoietic or hepatic toxicity was observed. Combination of HuIFN beta, DTIC, and cimetidine is relatively nontoxic, but does not appear to have a significant antitumor activity in patients with advanced malignant melanoma.
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PMID:Combination of fibroblast interferon (HuIFN beta), carboxamide (DTIC), and cimetidine for advanced malignant melanoma. 377 95

A 55 year-old man complained of headaches, dizziness and vomiting. Neurological examination only showed a cerebellar syndrome. CT scan revealed two hyperdense round areas in the right frontal lobe and cerebellar vermis consistent with metastases and a lung carcinoma was diagnosed. Two months later he presented with typical right hemichorea. A second CT scan showed another hypodense lesion with slight contrast enhancement in the left subthalamic region. He died 6 months after clinical onset. Post mortem examination showed an adenocarcinoma of the right lung with liver metastases. Neuropathological examination revealed four intraparenchymatous metastases one of which involved the left subthalamic nucleus. Hemichorea secondary to metastatic neoplasm of the corpus Luysii is uncommon; only 6 cases have been reported previously; five of them had a post mortem examination of the brain. In three cases a CT scan was available and had demonstrated the site and nature of the lesion.
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PMID:[Hemiballismus and metastasis to the Luys' body. An anatomo-clinical case]. 378 60

Mitoxantrone (Novantrone; dihydroxyanthracenedione) is an anthraquinone previously shown to be active in human breast cancer. It appears to have less toxicity than doxorubicin. Results of this phase II-III randomized cross-over trial to determine the relative efficacy and toxicity of mitoxantrone in comparison to doxorubicin, are presented. Patients with measurable, recurrent breast cancer with limited prior chemotherapy with or without radiotherapy for metastatic disease, and who had not been exposed to prior doxorubicin, were randomized to receive either mitoxantrone or doxorubicin every three weeks with cross-over on progression. Response rates, duration of remission, time to treatment failure, and drug toxicity, including cardiac toxicity evaluated with serial radionuclide angiocardiography, were evaluated. Differences in the response rates for the two groups were not statistically significant. Neither time to treatment failure nor duration of response are significantly different (p greater than 0.05). With respect to toxicity, mitoxantrone treated patients consistently exhibited a lower incidence and less severe drug toxicity as compared to their doxorubicin-treated counterparts. Cardiac toxicity was carefully monitored and thus four patients on doxorubicin have had drug related congestive heart failure, as compared to none on mitoxantrone. In summary, mitoxantrone appears to be as active as doxorubicin in patients with stage IV breast cancer previously treated with chemotherapy; however, mitoxantrone causes significantly less nausea, vomiting, stomatitis and alopecia at doses which induce equal or greater myelosuppression than doxorubicin, and appears to be less cardiotoxic.
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PMID:A randomized trial comparing mitoxantrone with doxorubicin in patients with stage IV breast cancer. 389 78

Extraneural metastasis of intracranial ependymoma is a rare pathological entity. Thirty one case reports were traced in the review of the literature and we record one of them. The patient was a 19-year-old male in good health until January 1981 when he was admitted to our hospital with deteriorating mental status. Admission work-up revealed bilateral papilledema, 1-hemiparesis and increased intracranial pressure signs including vomiting. CT scan demonstrated significant abnormality of enhanced mass lesion in the r-temporo-parietal area in which a displacement of the midline structure to the left occurred. R-temporo-parietal craniotomy was performed on the admission day. The globular tumor mass occupied the temporo-parietal area and invaded the cortex. Subtotal resection of the tumor and temporal lobectomy was performed. Microscopic examination of the operative specimen revealed a typical ependymoma pattern. For the next two years, he received operations twice, irradiation (total 14, 170 rads) and various chemotherapy. Two months after the fourth craniectomy, examination revealed scalp overlying the burr opening to be very tense and enlarging as if invaded by the tumor. A large mass occupied the right lateral cervical area and chest X-ray disclosed complete opacity on the right. He gradually developed severe cough and sputum and died two months later on January 1, 1984. At autopsy, the result was that tumor had invaded the subarachnoidal space and subcutaneous area. Extraneural metastases were found to be bronchial lymph nodes, C-4 vertebra, r-cervical lymph node. The histological appearance of these tumors obtained at autopsy was identical to the cerebral tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extraneural metastases of malignant ependymoma inducing atelectasis and superior vena cava syndrome--a case report and review of the literature]. 395 64

A total of 25 patients with renal cell carcinoma underwent angioinfarction of the tumor using absolute ethanol. An average of 15 ml. absolute ethanol was injected into the main renal artery through a balloon occlusion catheter. Complete cessation of renal arterial flow could be demonstrated in all cases. The post-embolization syndrome of pain, nausea, vomiting, hypertension and fever was minimal compared to other methods of renal artery occlusion. Of the patients 21 underwent post-infarction transabdominal radical nephrectomy without intraoperative or postoperative complications attributable to the injection of absolute ethanol. No damage to extrarenal tissue was noted at operation. Subsequent surgical dissection was facilitated, particularly in cases of large tumors when control of the renal pedicle often is difficult. Median blood loss was 725 ml. In light of recent reports concerning the benefit of angioinfarction and nephrectomy in metastatic disease a similar approach may be applicable to localized disease. This pilot study shows the safety of preoperative angioinfarction with absolute ethanol and may be used as a reference for future randomized prospective studies comparing angioinfarction and nephrectomy to nephrectomy alone for localized renal cell carcinoma.
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PMID:Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. 396 74

A case of nontraumatic chronic subdural hematoma due to obstruction of dural vessels by tumor cells is presented and 25 reported cases are reviewed. A 39-year-old female was referred for headache, vomiting, disturbance of consciousness and right homonymous hemianopia with macular sparing. She had undergone mammectomy for medullary nodular carcinoma of the left breast five years before. She had been treated with combined hormonal therapy and chemotherapy for the cancer metastases to the liver in preceeding six months. Hematological examination revealed drug-induced thrombocytopenia, increase of FDP in blood (80 micrograms/ml), but no abnormality of prothrombin time and fibrinogen content. Therefore in the present case there was no evidence of disseminated intravascular coagulation (DIC) after Colman's criteria. However, it was suggested that this case had compensated DIC after Cooper's criteria. CT scan showed a biconvex-shaped low and partially iso-density area over the left fronto-temporal convexity, indicative of chronic subdural hematoma, and no abnormal findings in the occipital area. After removal of the hematoma she became alert without headache and vomiting. However, seven days later she complained of headache and vomiting again. Repeated CT scan showed a larger biconvex-shaped low density area over the left hemisphere extending to the parietal region at that time. Second operation was performed, but she expired four days later. Autopsy showed systemic metastases of the medullary nodular carcinoma in the scalp, temporal muscle and dura as well as lungs, adrenal glands, ovaries and bone marrow.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nontraumatic chronic subdural hematoma due to dural metastases of breast cancer. Case report]. 406 18

Case report on a woman aged 28 years with acute multiple sclerosis. At presentation the symptoms were few and mild: frontal headache with occasional vomiting, slight speech-difficulties, increased sleepiness and slight disorientation with confusion. CT scanning revealed multiple, ring-forming hypodense lesions throughout both cerebral hemispheres suggestive of metastases.
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PMID:An unusual CT-scan appearance in multiple sclerosis. 408 17


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