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)

Since metastasizing breast cancer is hormone-related, hormonal therapy is based on control of tumor growth by elimination of the hormonal influence, hormone ablatives, or administration of steroid hormones to change the hormonal milieu of thehost organism. The time span during which hormonal therapy may be effective is extremely limited; therefore, this is not recommended for patients with an interval of less than 2 years between primary treatment and 1st manifestation of metastasis, patients with visceral metastasis, or women less than 5 years in the postmenopause. According to cooperative European and American studies remission rates for different types of endocrine therapy include: ovariectomy, 25-40%; adrenalectomy, 30-40%; hypophysectomy, 30-40%; androgen, 20%; and estrogens, 20-35%. Studies are underway concerning the use of antiestrogens (Nafoxidine and Tamoxifen) andinhibition of prolactin secretion. Investigations have shown that patients with proven estrogen receptors in the tumor tissue are particularly responsive to hormonal therapy. For patients with no determinable estrogen receptors, however, chemotherapy is perferable. Ovariectomy is recommended as the 1st measure for women in the premenopause, hormone additives for women longer than 5 years in the postmenopause, and for women in the 1st years after menopause ovariectomy in combination with a form of polychemotherapy. For patients with short free intervals polychemotherapy with another endocrine measure, for pleuracarcinosis and liver metastosis high corticosteroid dosages, and for metastases in the central nervous system radiatio treatment with high corticosteroid dosages are recommended.
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PMID:[Hormone therapy of breast cancer]. 18 Mar 75

Today the endocrin therapy of the advanced mastocarcinoma is in common use. Besides the already known therapy by estrogens, androgens, gestagens, and steroids, Tamoxifen, and estrogen antagonist, is a very promising therapeutic drug. In the presented study, Tamoxifen was submitted to a critical clinical control during a period of one year from 1st October 1975 until 1st October 1976. After a three months' treatment, a rate of 41% of objective remissions could be obtained. The criteria of success were estimated according to the scheme of Karnofsky. The average remission time is 5,5 months. By a determination of the estrogen receptors it would be possible to realize a therapeutic selection and to achieve a higher remission rate. The authors made an interesting observation, i.e. a probably immuno-stimulating effect which, however, still has to be submitted to further examinations. The side effects are described in detail and the indications are established. Its is astonishing that the subjective ameliorations, i.e. cessation of pains in case of generalized formation of metastases in the bones are much more frequent than the objective remissions. We came to the conclusion that the treatment by Tamoxifen is a valuable alternative in the therapy of the mastocarcinoma, above all in the postmenopausal period if the disease is advanced and incurable.
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PMID:[Effect of the estrogen antagonist tamoxifen in the treatment of advanced mastocarcinoma (author's transl)]. 34 20

Transsphenoidal hypophysectomy was performed in 212 consecutive patients with metastatic breast cancer: 11 died within 30 days, two of surgical complications and nine of advanced metastatic disease. Two patients were unevaluable because of inadequate follow-up in one and simultaneous radiation treatment in the other. Of 199 evaluable patients 42% had an objective remission. Duration of remission averaged 18+ months with 10 out of 84 patients still in remission. Presence of estrogen receptors in the tumor significantly predicted response to hypophysectomy. Of 156 patients in whom completeness of hypophysectomy was assessed, 128 were thought to have a complete removal as shown by the fact that their growth hormone and prolactin were undetectable after stimulation with arginine or chlorpromazine, respectively. Of 26 patients in whom TRH test was performed, TSH and prolactin were undetectable in 20. Of 23 patients where autopsy was performed only six had microscopic pituitary tissue remaining. Hypophysectomy induced remission in eight of 15 patients who had previously responded and then relapsed to the antiestrogen Tamoxifen and in four of 17 who had failed. Conversely, antiestrogen therapy induced remission in six of 26 patients who had previously responded to hypophysectomy and in whom serum estrogens were present in small amount. These data indicate that both gonadal and pituitary hormones play a role in the growth of some human breast cancers.
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PMID:Transsphenoidal hypophysectomy in breast cancer: evidence for an individual role of pituitary and gonadal hormones in supporting tumor growth. 50 1

Twenty-eight and 24 patients with advanced breast cancer were treated with Aminoglutethimide (AG) or AG + Tamoxifen (AG + TAM) from June 1984 to June 1989, respectively. Evaluated cases were 25 and 21 treated with AG or AG+TAM, respectively. Objective response was seen in 5/25 (20.0%) for AG treatment with 9, 13, 16, 20 and 31 months remission and 4/21 (19.1%) for AG + TAM treatment with 6, 7, 12 and 26 months remission. Response rate according to dominant site of metastases were 1/10 in soft tissue, 2/7 in bone, 2/7 in lung and pleura treated with AG, 1/9 in soft tissue, and 3/5 in lung treated with AG + TAM treatment. Two of the 5 responding patients in AG treatment group had prior tamoxifen treatment and 3 out of 4 responding patients in AG + TAM treatment group had prior chemoendocrine therapy with tamoxifen and FAC chemotherapy. Main toxic side effects were lethargy and/or rash, and drug discontinuation was required in 3 cases of AG treatment group and 2 cases of AG + TAM treatment group. Serial determination of serum hormone levels during AG or AG + TAM treatment revealed a decrease in estrone and an increase in androstenedione in many cases of both treatment groups. This data suggested that AG treatment may be favorable for endocrine treatment for advanced breast cancer patients, but the response to AG was not augmented by adding TAM.
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PMID:[Aminoglutethimide and aminoglutethimide+tamoxifen treatment for advanced breast cancer]. 141 9

A 66-year-old postmenopausal woman presented in June 1991 with a giant ulcerated left breast tumor. She had discovered the tumor two years previously, but had never visited any medical institution. She was diagnosed as advanced breast cancer with multiple lung metastases, bone metastasis, and both supraclavicular lymph node metastases by physical examination, fine needle aspiration cytology, chest X-P, and bone scintigraphy. Incisional biopsy, performed to confirm the histological type of breast cancer and to evaluate estrogen and progesterone receptor (ER and PgR) status, revealed solid-tubular carcinoma. Both ER and PgR were highly positive at 322.6 and 228.0 fmol/mg protein, respectively. Therefore, endocrine therapy was chosen to treat this advanced breast cancer patient, although she had multiple organ metastases. Twenty mg of Tamoxifen a day was administered per os. After treatment with tamoxifen, the size of ulceration started to decreased and the dyspnea caused by multiple lung metastases was reduced. Eight weeks after, she showed partial response (PR) determined from the size of the ulceration and chest X-P. She has been maintaining PR for more than 9 months. Thus, Tamoxifen was shown to be very effective for this case of advanced breast cancer with multiple organ metastases.
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PMID:[A case of advanced breast cancer with multiple organ metastases successfully treated by tamoxifen]. 144 94

From January 1984 through December 1990, 311 patients affected with breast cancer were treated with quadrantectomy plus lymphadenectomy and radiation therapy (QUART) at the Umberto I Hospital in Mestre, Italy. The patients with positive nodes (N+) were treated with adjuvant chemotherapy (CMF) or hormonotherapy (Tamoxifen) according to pausal status. Most patients were in the 5th, 6th and 7th decades of life; 60.5% of them were over 50. Staging was always performed according to TNM classification (UICC criteria) and demonstrated mostly stage-I lesions (66.9%). Overall and disease-free (NED) survival rates were 95%; mean survival rates were 7.47 (+/- 0.138) and 7.22 (+/- 0.164) years, respectively. Ten patients died (5 from breast cancer); 6 local relapses were observed and 8 metastases. Metastases were seen mostly in patients with breast cancer in the internal quadrants (QI) N0, with no statistically significant differences relative to the other groups. This is probably due to the existence of an axillary pN0 and parasternal N+ group of patients, who receive insufficient treatment.
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PMID:[Results of conservative treatment of stage I-II carcinoma of the breast. Analysis of 311 patients]. 145 28

Between 1979 and 1987, 170 patient with stages 0, I and II breast cancer were treated with breast conservation therapy. Twenty-eight women (16%) had intraductal carcinomas, 110 (65%) stage I disease and 32 (19%) had stage II breast cancers. Seventy-five percent of the patients received no adjuvant systemic treatment, whereas 20% received adjuvant chemotherapy and 5% were given Tamoxifen. All patients received radiation therapy to the breast after lumpectomy and, when appropriate, axillary dissection. Twelve patients (7%) recurred within the treated breast, whereas two patients (1%) recurred in regional lymph nodes. Fourteen women (8%) developed distant metastases and seven women (4%) developed contralateral breast cancer. The actuarial 5 year disease-free survival was 92% for the patients with intraductal carcinoma, 90% for T1 and 65% for T2 patients. Overall actuarial survival was 100%, 96% and 87%, respectively. The St. Luke's Hospital results are comparable to those reported in the literature. We conclude that breast conservation therapy, including irradiation, is an alternative to modified radical mastectomy and that this option should be thoroughly discussed with the patient.
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PMID:Breast conservation therapy. The St. Luke's Hospital experience. 159 2

Tamoxifen is the endocrine treatment of choice for hormone-responsive early and advanced breast cancer. Newly developed biodegradable luteinizing hormone-releasing hormone super agonists represent a practical and effective treatment for metastatic disease in premenopausal women. Progestins or aromatase inhibitors are useful therapies in patients who relapse from antiestrogens. Currently, there is no indication that improved survival can be achieved by combined endocrine therapy or combined chemo-hormonal therapy.
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PMID:Pharmacologic manipulation of steroid hormones. Adjunctive therapies in cancer of the breast. 177 79

There were 62 cases of mammary carcinoma treated with the antioestrogen tamoxifen. The age of the patients ranged from 35 to 75 years. Tamoxifen was administered in a daily dosage of 30 mg (3 x 1 tablet). Treatment was carried out as monotherapy or adjuvant therapy. Treatment was carried out for 6 months with a follow-up period of further 6 months. In the group of patients with mammary carcinoma, 23 were premenopausal without metastases after radical mastectomy and sterilisation. The remaining 39 in this group were in the menopause with metastases which were in some cases untreated and in some cases treated by mastectomy, radiation and chemotherapy (CMF-scheme). All Patients were PD in relation to further radiation and/or chemotherapy. Karnofsky-index was 60 minimum. After 4 weeks' treatment with tamoxifen both an improvement in general wellbeing and a regression of the focus of the tumour was achieved. A significant improvement in wellbeing and tumour status could be established for a total of 48 cases of mammary carcinoma. Treatment was well tolerated. Only 1 case of side effects in the form of vomiting occurred.
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PMID:[Results of treatment of breast cancer with tamoxifen]. 179 26

An advanced breast cancer patient refractory to CAF (Cyclophosphamide, Adriamycin, 5-fluorouracil), 5-FU-Methotrexate sequential therapy and Tamoxifen was treated with the combination 5' DFUR, MMC, Etoposide and MPA. Complete response was obtained both against liver and lymph node metastases from 7 months after the initial treatment. A mild bone marrow suppression and appetite loss were observed as the side effect. It is suggested that the combination therapy may be useful for previously treated patients with advanced breast cancer.
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PMID:[5'-deoxy-5-fluorouridine (5'-DFUR), mitomycin C (MMC), etoposide and medroxy progesterone acetate (MPA) in a previously treated patient with advanced breast cancer]. 182 14


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