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)

Twenty-five cases with unresectable metastatic liver cancers were experienced in our hospital over the past five years who underwent weekly 24-hour continuous hepatic arterial infusion chemotherapy using 5-FU and CBDCA. The response rate was 20%, the median survival was 23 months, and the one/two year overall survival rates averaged 81.3/45.5%. In 77% of patients, this therapy prevented death from hepatic metastases. Moreover, since adverse effects were limited compared with bolus infusion, weekly 24-hour continuous hepatic arterial infusion chemotherapy was thought to be a favorable method.
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PMID:[Clinical evaluation of weekly hepatic arterial infusion chemotherapy in patients with unresectable metastatic liver cancer]. 1056 Mar 91

A substantial proportion of all women dying from gynaecological malignancies are aged >75 years. Many reports have indicated that the survival of these patients is decreased compared with younger patients. Differences in biological behaviour, stage of the disease at presentation, and reluctance to undergo aggressive treatment with its associated morbidity are among the factors thought to be responsible for this difference in outcomes. However, investigations also indicate that elderly patients may receive less surgical and chemotherapeutic treatment without obvious clinical rationale. This overview is aimed at providing a guideline of chemotherapy appropriate for patients with epithelial ovarian, uterine (corpus and cervix), and vulvar cancer, aged 70 to 75 years and over. Platinum-based chemotherapy is the cornerstone of drug treatment in patients with ovarian cancer. Patients aged between 70 and 75 years with a good performance status can be treated with cisplatin- or carboplatin-based chemotherapy. Carboplatin, either in combination or as a single-agent, may offer advantages in patients aged >75 years and in those with a poor performance status. For patients with early recurrence there is no standard treatment, but several cytostatic and hormonal agents can be used with palliative intent. Patients with a late recurrence are probably best retreated with a platinum-based regimen. In metastatic endometrial cancer, hormonal therapy is the first choice in tumours expressing a progesterone receptor. Poorly differentiated tumours infrequently respond to endocrine therapy. In this situation, and for patients with tumours that have become resistant to hormonal manipulation, platinum-based chemotherapy may be used. The use of carboplatin-based regimens seems preferable in elderly patients, particularly in those with a decreased performance status. The usefulness of chemotherapy in elderly patients with cervical cancer is limited. In case of recurrent or metastatic disease, the use of single agent (low-dose) cisplatin should be balanced against best supportive care. Although overall chemoradiation seems superior than radiotherapy alone in patients with locally advanced cervical cancer, the feasibility of this approach in elderly patients needs further investigation. Chemoradiation might also be considered in patients with locally advanced vulvar cancer. However, treatment-related morbidity can be considerable and randomised studies are lacking to prove a survival benefit. Our understanding of the tolerance and effectiveness of chemotherapy in elderly patients is still incomplete due to a paucity of trials that specifically focus on this subset of patients. However, there appears no argument to withhold chemotherapy based purely on age.
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PMID:Drug therapy for gynaecological cancer in older women. 1093 13

We used paclitaxel to successfully treat a patient with small-cell lung cancer resistant to multiple drugs. The patient was diagnosed with small-cell lung cancer (cT4N2M1, extensive disease) and initially treated with CDDP 80 mg/m2 (day 1) + etoposide 100 mg/m2 (day 1-3) from August 1996 (4 courses). A partial response (PR) was obtained, but there was a gradual regrowth in the primary site after 17 months. The next chemotherapy was weekly chemotherapy (CODE regimen) from May 1998 for 5 weeks, but the response was no change (NC). After the therapy, a regrowth of the primary site was observed, and a CT scan demonstrated multiple metastases of the lung and liver. From March 1999, he was administered the next chemotherapy regimen of carboplatin (CBDCA) 350 mg/m2 (day 1) + etoposide 100 mg/m2 (day 1-3) (2 courses). However, the response was NC again. From August 1999, we changed the chemotherapy regimen and administered CBDCA AUC 5 (day 1) + paclitaxel (TXL) 175 mg/m2, (day 1, 3-hour-infusion) (1 course). A chest radiograph showed an extreme shrinkage of the primary and metastatic sites. A PR was obtained, but Grade 4 neutropenia and thrombocytepenia were observed with this therapy. Thus, he was treated with TXL alone (100 mg/m2, day 1, 1-hour-infusion) in the next course. After this therapy, a chest radiograph showed a more extreme shrinkage of the primary and metastatic sites. It is suggested that combination chemotherapy using TXL is effective in the treatment of a patient with small-cell lung cancer resistant to multiple drugs.
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PMID:[Effective combination chemotherapy using paclitaxel in the treatment of a small-cell lung cancer patient resistant to multiple drugs]. 1168 Dec 53

We administered chemotherapy in three cases of small-cell lung cancer (SCLC) with renal failure under different situations. Hemodialysis (HD) was used in 2 out of the 3 cases. Case 1 was complicated by acute renal failure from extensive bilateral tumor invasion. After chemotherapy (CBDCA + ETP) under HD, renal metastases regressed and renal function improved, although the final response was PD. In case 2, HD had been introduced for diabetic nephropathy. After 2 cycles of chemotherapy (CBDCA + ETP) under HD, the patient attained a PR. Case 3 is an example of paraneoplastic nephrotic syndrome with renal failure. Chemotherapy including CBDCA or CDDP was performed and the QOL of the patient improved. Pro-GRP and serum creatinine changed in parallel during the clinical course of 6 admissions. In conclusion, individualized therapy is necessary to increase survival time of SCLC patients with renal failure. Although chemotherapy is useful, further study is needed for the selection of suitable chemotherapeutic regimens, optimal dosage of each drug and the timing of HD.
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PMID:[Chemotherapy for small-cell lung cancer (SCLC) patients with renal failure]. 1191 35

A 63-year-old man presented to our hospital with persistent dysphagia. Radiologic and endoscopic examination disclosed a 2.0-cm exophytic tumor in the middle third of the esophagus. An endscopically obtained biopsy specimen was found to represent undifferentiated small cell carcinoma. Computed tomography of the chest, abdomen, and cervical region was performed, as were gallium and bone scintigraphy. Metastasis to an adjacent lymph node was detected, without metastasis to distant organs. After neoadjuvant chemotherapy with carboplatin (CBDCA) (400 mg/m2) and etoposide (VP-16) (100 mg/m2), endoscopy and barium-swallow esophagography showed regression. Thoracic esophagectomy then was performed with mediastinal, abdominal and cervical lymph node dissection. The resected tumor was polypoid, measuring 0.5 x 0.5 cm. The lesion consisted mainly of small anaplastic cells, but included a small focus of squamous cell carcinoma. The patient has survived for more than 7 months with no further treatment and no evidence of recurrent disease.
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PMID:Effectiveness of preoperative chemotherapy using carboplatin (CBDCA) and surgery against an esophageal small cell carcinoma. 1244 97

The aim of this study was to investigate the efficacy and toxicity of carboplatin given as monotherapy in endometrial adenocarcinoma. Cisplatin is one of the most active drugs in gynaecological cancer types, but at the cost of an associated high toxicity. In this high-risk population of endometrial cancer patients, it is necessary to have chemotherapy regimens with a low toxicity. Patients eligible for this study were those with histologically-confirmed endometrial adenocarcinoma with evidence of recurrent and/or metastatic disease. Carboplatin was administered every 4 weeks as a first- (dose: 400 mg/m(2)) or second- (dose: 300 mg/m(2)) line chemotherapy. Of the 64 patients who entered the trial, 60 were eligible, 53 patients were evaluable for toxicity and 47 for efficacy. A total of 169 cycles of carboplatin was given with a median of 2 cycles per patient (range 1-11 cycles) to a median cumulative dose of 798 mg/m(2) (range 290-3879 mg/m(2)). No grade 4 toxicity or toxic deaths occurred. White Blood Cell (WBC) toxicity grade 3 was noted five times, mainly in the radiotherapy pre-treated patients. Grade 3 non-haematological toxicity consisted mainly of nausea and vomiting (21%). There was a total of eight responses (3 Complete Responses (CR) and 5 Partial Responses (PR) with an overall response rate (ORR) of 13% (95% Confidence Interval (CI) 6-25). No responses occurred in patients treated with prior chemotherapy. In evaluable patients, the ORR in all patients (n=47) and in those receiving first-line chemotherapy (n=33) were, 17% (95% CI 8-31) and 24% (95% CI 11-42), respectively. After a median follow-up of 379 days, the median duration of response was 488 days (range 141-5303 days) with two very long responses in patients with a CR. Carboplatin has a low toxicity and is active in chemotherapy-naive advanced endometrial carcinoma patients. These results lead us to propose its use in association in first-line chemotherapy in recurrent or advanced endometrial carcinoma patients. The choice of the initial dose can be determined according to whether the patients have received prior radiotherapy treatment.
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PMID:Phase II study of carboplatin in patients with advanced or recurrent endometrial carcinoma. A trial of the EORTC Gynaecological Cancer Group. 1250 62

We report a case in which lung adenocarcinoma with multiple pulmonary metastases was completely responsive to combination chemotherapy with carboplatin (CBDCA) and weekly paclitaxel (TXL). CBDCA AUC = 5 (day 1) and TXL 75 mg/m2 (day 1, 8, 15) were infused over 1 hour after short premedication on an outpatient basis. Administration was continued for 3 weeks followed by 1 week rest. The patient was a 54-year-old woman who suffered from lung adenocarcinoma with mediastinal lymph node metastases, stage III A, and underwent complete resection. However, multiple pulmonary metastases were found 3 years after operation. On an outpatient treatment, she was treated with CBDCA combined with weekly TXL for 6 cycles. The multiple pulmonary metastases had completely disappeared after 2 cycles and CEA decreased to within normal limit after 5 cycles. The toxic events were anemia (grade 2), leucocytopenia (grade 2) and alopecia (grade 3). No major adverse effects such as hypersensitivity reaction or peripheral neuropathy were observed.
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PMID:[Lung adenocarcinoma with multiple pulmonary metastases completely responsive to combination chemotherapy with carboplatin and weekly paclitaxel--a case report]. 1451 12

Over the past 20 years, combined treatment with radiotherapy and second-generation chemotherapy drugs was extensively studied in patients with locally advanced NSCLC and became the standard over radiotherapy alone in patients with good performance status. Radiosensitizing properties of cisplatin have been identified in the laboratory. Close temporal administration of cisplatin and radiation is mandatory for enhanced antitumor efficacy, but results in significant toxicity to normal tissues. Early clinical studies demonstrated that the concurrent administration of cisplatin during STD-RT was feasible, with acceptable esophageal toxicity, and had the potential of significantly improving locoregional control. Carboplatin administered concurrently with accelerated HFX-RT was responsible for a higher rate of esophageal toxicity. Further improvement in survival also requires an effective treatment of micro-metastatic disease through full-dose delivery of cytotoxic drugs and the addition of at least one more active drug in conjunction with cisplatin and radiotherapy to further improve locoregional control of the disease. In most clinical studies, etoposide was the second drug of choice because of its own radiosensitizing properties and possible synergy with cisplatin. In numerous phase II studies, concurrent radiotherapy and PE resulted in reproducible results in terms of local control (30%-40%), median survival (15-18 months), survival at 2 years (35%-40%), and survival at 5 years (25%-30%). In phase III studies, these results were shown to be superior to radiotherapy alone and to induction chemotherapy followed by STD-RT. The question of the potential benefit of HFX-RT combined with PE has been addressed in phase II and III studies. At this time, there is no firm evidence that concurrent chemotherapy with HFX-RT is superior to concurrent chemotherapy with STD-RT in terms of local control and survival. Only a significant benefit in terms of local control or survival would justify the significant increase of esophageal toxicity observed with HFX-RT, which remains the main limiting factor of concurrent chemoradiotherapy with PE. Studies on postinduction surgery after concurrent chemoradiotherapy have been of major interest, demonstrating that a complete pathologic response rate of 25% to 30% could be achieved with a relatively low dose of radiation (45 Gy) and that downstaging was a major determinant for improved long-term survival. Long-term survival after trimodality treatment, however, does not appear to be significantly different from what can be achieved with concurrent chemoradiotherapy alone in phase II studies. Whether postinduction surgery is beneficial to patients with histologically proved stage III (N2) and stage IIIB patients was the question addressed in a large, recently completed phase III intergroup trial and of which the results are eagerly awaited. Over the past 10 years, further progress in radiation technology has been accomplished through three-dimensional treatment planning, multileaf collimators, and electronic portal imaging devices, leading to high-precision conformal radiotherapy and dose escalation and (it is hoped) to improved local control. Intensity-modulated radiotherapy and respiratory gating remain to be evaluated. Accurate delineation of critical organs and pretreatment analysis of toxicity-predicting factors allow for better protection of normal intrathoracic tissues such as lung and esophagus and, it is hoped, will lead to a significant reduction in the incidence of radiation esophagitis and pneumonitis. Third-generation drugs such as taxanes, vinorelbine, and gemcitabine have demonstrated high response rates in NSCLC patients with favorable toxicity profiles. These drugs have also shown major radiosensitizing properties in the laboratory and in the clinical setting, often leading, however, to excessive radiosensitization and unacceptable normal tissue toxicities when administered at full dose concurrently with radiotherapy. Weekly administration of these drugs at reduced doses during a full course of conformational radiotherapy up to 70 Gy or more, however, resulted in encouraging results in several phase II studies, with median survival in excess of 20 months and 2- and 3-year survival rates near 50% and 40%, respectively. The respective benefits of either induction or consolidation full-dose chemotherapy with these drugs, before or after concurrent chemoradiotherapy with second- or third-generation chemotherapy, are presently being evaluated in phase III studies. As a result of improved survival and enhanced local control, most of these studies show a significant increase in the incidence of brain metastases. Because the brain is often the first site of relapse after concurrent chemoradiotherapy with or without surgery, the issue of prophylactic cranial irradiation is currently being addressed in a phase III trial.
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PMID:Radiotherapy and chemotherapy in locally advanced non-small cell lung cancer: preclinical and early clinical data. 1500 80

We treated a patient with lung adenocarcinoma who responded to chemotherapy with vinorelbine (VNR) plus carboplatin (CBDCA) on an outpatient basis. The patient was a 68-year-old man. He visited a local physician complaining of wet coughing, headache and general fatigne. The symptoms remained unchanged and the patient was admitted to our department for treatment in June 2000. A massive shadow in the right upper lobe and multiple cerebral metastases were found. Based on this, the diagnosis was lung adenocarcinoma (T3N2M1, clinical stage IV). Whole-brain irradiation and systemic chemotherapy were initiated from July 2000. The patient received 1 course of systemic chemotherapy with vindesine (VDS) plus cisplatin (CDDP) on an inpatient basis. This regimen was replaced with combination therapy of paclitaxel (TXL) plus CBDCA in the outpatient setting, along with VNR plus CBDCA due to side effects caused by TXL. The cerebral metastases almost disappeared due to whole-brain irradiation. Chest CT after 3 courses revealed a reduction in primary tumor size. The VNR plus CBDCA combination therapy was continued for a further 6 courses. As the result, neither the primary tumor nor the cerebral metastases enlarged. The combination therapy with VNR plus CBDCA seems to be a useful regimen that can maintain high QOL and be conducted for a long term on an outpatient basis.
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PMID:[Advanced non-small cell lung cancer responded to both vinorelbine and carboplatin over long-term outpatient treatment]. 1544 64

A 77-year-old man presented with complaints of dysuria, nocturia and painless nodule on his penis. Laboratory examination revealed elevated serum prostate-specific antigen (PSA) and CA19-9. Pathological examinations on prostate and penile biopsy specimens revealed prostate adenocarcinoma with penile metastasis. The patient was diagnosed as having prostate cancer stage D2 (T4N1M1) with bone, lymph node and penile metastases. There was no response to initial hormonal therapy with the surgical castration and diethylstilbestrol. However, decrease of the tumor size, as well as PSA and CA19-9 values were achieved after the combined chemotherapy with Estramustine, Paclitaxel and Carboplatin.
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PMID:[Prostate cancer with penile metastasis: a case report]. 1636 13


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