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 April 1974, 60 patients with squamous cell carcinoma of the head and neck region, of poor prognosis and generally in advanced stages, were treated with the combination of a cytotoxic regimen--VBM (Vincristine, Bleomycin and Methotrexate) and radical radiotherapy. The essential feature of the combination is the administration of pulses of VBM synchronous with a course of fractionated external radiotherapy in order to achieve potentiation of radiotherapy. On average 4-5 pulses of VBM were given during treatment, combined with radiotherapy on a Cobalt unit. The selection, preparation and management of the patients are described. Intense mucositis and intercurrent infection provide the main problems during treatment and close management is essential. Late complications have not been a serious problem. The crude actuarial survival rate at 24 months is 61%. The probability of survival without any recurrence to 24 months following initial treatment is 46%. Local control was achieved by the initial treatment in 43 patients. These results suggest that potentiation of radiotherapy and an increased therapeutic ratio has been obtained by the addition of VBM to radiotherapy and there is a possibility that the occurrence of distant metastases has been reduced or postponed.
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PMID:Synchronous VBM and radiotherapy in the treatment of squamous cell carcinoma of the head and neck. 7 3

A malignant glioblastoma adherent to the dura mater was removed from the parieto-occipital lobe in a 12-year-old boy. The site of the tumor was subsequently irridiated by 4000 rads of Cobalt-60. Five months later the boy was readmitted complaining of pains in the pelvis an in both thighs. X-ray examination of the pelvis demonstrated multiple metastases. Investigation of bone marrow revealed replacement of normal haematopoiesis by a tumor cell population histologically identical to that of the brain tumor. Reviewing the literature 58 reports on glioblastomas with extracerebrospinal metastases could be found. Metastases were preferably localized in cervical or mediastinal lymph nodes, lungs, bones, liver, dura mater, and operative flap. It is suggested that extracerebrospinal metastases occur most frequently after the tumor has infiltrated the cranium and extracranial soft tissues. In the case reported here it is speculated that the tumor spread to extraneural tissues after invading the dural veins. The possible occurrence of extracerebrospinal metastases in glioblastoma emphasizes the necessity of additional chemotherapy.
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PMID:Extracerebrospinal metastases in glioblastoma. Case report and review of the literature. 18 58

During the past ten years, the histiogenesis of malignant histiocytomas and a group of related benign and malignant lesions have been the source of speculation. Although of heterogeneous histological appearance, it is believed that there is a common cell of origin for these neoplasms--the histiocyte. From 1966 to 1974, 16 patients were encountered who had neoplasms that fell into the general group of malignant histiocytomas. These tumors were variously located in the extremities, head, chest wall, retroperitoneum, lung, spermatic cord, and lower abdomen. Surgical treatment included radical amputations, wide local excision, pulmonary lobectomy, and nephrectomy. Cobalt therapy and chemotherapy with vincristine sulfate, cyclophosphamide, doxorubicin hydrochloride, and chlorambucil were also used. Ten of 16 patients are alive after treatment, two are alive with metastatic disease, but four have died of malignant disease.
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PMID:Malignant histiocytomas. 20 92

From the beginning of radiotherapy, efforts have been made to improve the therapeutic effects X-rays by heat. Recently, the combined therapy of heat and X-ray therapy has gained new interest because of failures of the megavoltage therapy of solid malignant tumors. Encouraged by our own animal experiments with a Walker-tumor of rats, since 1972 we have treated 52 patients with tumors of lower sensitivity. We used decimeter waves; wave length of 69 cm and a frequency of 433.92 MHz. After preheating for 3 to 5 min we added the gamma-rays of Caesium-137 or Cobalt-60 in usual rhythms. The total dose only in few cases exceeded 6000 to 6500 rads in six to seven weeks. We observed a relatively very good response for tumors of low sensitivity. The dose was between 20 and 30% lower which in the treatment of tumors of median sensitivity is acceptable. Local recurrences are rare and occurrence of distant metastases are within the characteristic development of certain malignant tumors. A prospective study has begun.
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PMID:Combined treatment of radioresistant malignant tumors with high frequency hyperthermia and gamma-rays therapy--recent results. 22 45

Fifty-seven uveal malignant melanomas (T2: 36.8%; T3: 49.1%) were treated between 1983 and 1989 with Cobalt 60 or/and Ruthenium 106 Rhodium 106 plaques. The mean follow-up was 32 months (from 6 to 69 months). A diminution of tumor size was observed in 88% of the cases, either rapid and marked (57%), or slower and more moderate (31%). A multivariate study showed the radiation dose administered to the tumor edge to be the most significant parameter associated with the tumor control. Seven patients developed metastases, and the probability of survival at 60 months was 83.3%. This probability was identical to that of 59 comparable patients treated, some years before, by enucleation. The most frequent complications were radiation retinopathy (28.1%) and retinal detachment (15.8%). The treated eye was retained in 86% of cases. In 57% of treated eyes, vision remained better or equal to 0.1. The predictive parameters of vision impairment after treatment seemed to be tumor size, tumor site near the macula and the optic nerve, and the radiation dose to the tumor base. The use of Ruthenium 106 Rhodium 106 appeared to be advantageous in controlling the disease as well as in reducing the incidence of complications.
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PMID:[Oncologic and functional results of 57 malignant melanoma of the uvea treated by curietherapy]. 177 10

Cobalt60 plaque irradiation is one treatment option for patients with recurrent retinoblastoma following conventional external beam irradiation (ERT). Tumorocidal doses can be delivered without excessive risk of normal tissue injury. In patients not considered candidates for xenon arc or cryotherapy, 60Co is an alternative to enucleation. Between 1968 and 1987, 85 patients were treated with 60Co plaques, 72 of whom had failed prior ERT. Age at diagnosis ranged from 1 week to 4 years. There are 37 males and 35 females. Seventy-one patients had bilateral disease and one had unilateral. Three patients had both eyes plaqued. Prior ERT ranged from 30 to 70 Gy (mean 4200 Gy). Time from initial therapy to failure ranged from 13 to 60 months. Cobalt plaques of 10 mm, 15 mm, or 10 x 15 mm were used depending on tumor size and location. Dose prescribed to the apex of the tumor ranged from 30 to 50 Gy (median 40 Gy) given over 3 to 8 days. Twelve patients had two plaque applications; three patients had three plaque applications. All patients were followed with routine ophthalmoscopic examinations. Follow-up ranged from 2 to 22 years (mean 8.7). Seven patients died of metastatic disease; 10 patients developed non-ocular second tumors. Thirty patients required enucleation. Twenty-two patients had clear tumor progression, two patients had radiation complications, and six patients had a combination of tumor growth and complications. Cobalt60 can salvage eyes in retinoblastoma patients failing ERT. Currently, we are using I125 in an attempt to spare normal ocular tissue and reduce subsequent complications.
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PMID:Cobalt60 plaques in recurrent retinoblastoma. 186 58

All patients with locally advanced breast cancer receiving definitive irradiation (with or without surgery) at the Radiation Oncology Service, Ospedali Galliera, Genova, Italy, from 1969 through 1986, were retrospectively reviewed. Group A consisted of 187 patients, affected with stage III disease, who received radiation therapy after radical surgery. Irradiation of the chest wall and regional lymph node chains was accomplished with divergent tangential beams of Cobalt: the dose was calculated at the mid-plane of the tangential field separation and was 50Gy (2 Gy/day, 5 fractions/week), followed by additional 10-15 Gy boost to the scar. One hundred and five patients received combined hormonotherapy and/or chemotherapy. After a mean follow-up of 49+ months we observed 21 local recurrences (16 in metastatic patients); 64 patients developed only distant metastases. Actuarial survival at 5 years is 55%. Group B consisted of 36 inoperable patients who received definitive irradiation. Radiation therapy planning was very similar to that in group A, even though after 50 Gy the breast and the tumor area were boosted with restricted fields up to a total dose of 80-90 Gy. Fifteen patients received combined hormonotherapy and/or chemotherapy. At the end of the treatment overall response rate was 89%; actuarial survival at 5 years is 38%. Toxicity was generally mild and no death related to the treatment was observed. Our retrospective analysis confirms the importance of a multimodal approach to locally advanced breast cancer in order to free most patients from disease and to produce excellent local control, even though more randomized studies are necessary to improve the long-term survival of these patients.
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PMID:[Multimodal treatment of locally advanced carcinoma of the breast. Experience at the Galliera di Genova Hospital]. 224 42

The value of Cobalt-57 bleomycin (57Co-BLM) scintigraphy in the detection of lymph node metastases in the hilum and mediastinum was investigated in 132 patients with peripherally located lung cancer. In one half of the patients with metastases, these were visualized. Specificity was 98%. These results were better than those obtained with chest radiography and conventional roentgen tomography. 57Co-BLM scintigraphy is routinely used in the staging of patients with lung cancer, obviating the need for mediastinoscopy.
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PMID:57Co-bleomycin scintigraphy for the staging of lung cancer. 246 75

Our study analyze retrospectively 102 patients (96 male and 6 female), affected by laryngeal carcinoma with histological lymph node metastases, who came under observation from 1978 to 1984. All patients underwent partial (25 cases) or total (77 cases) laryngectomy with functional neck dissection and postoperative radiotherapy with functional neck dissection and postoperative radiotherapy. Irradiation to the neck was administered, employing Cobalt 60, through two lateral opposing fields or an anterior and two posterior fields for a total dose of 50-60 Gy (fraction of 2 Gy for 5 days/week). According to UICC classification (1982) the distribution of cases was as follow: 4 T1, 28 T2, 54 T3, 16 T4. Relatively to the localization of the tumours we had 63 supraglottic, 35 glottic and 4 subglottic involvement. The histological grading was certified in 68 cases: 12 G1, 39 G2, 17 G3; extracapsular spread was found in 20/54 cases (37%). The actuarial global and NED survivals of the whole study were respectively 68.5% and 59.8% for 3 years and 56.5% and 48.2% for 5 years. In relation to the T the global and NED survival for 5 years 67.7% and 61.8% for T1-T2 and 53.1% and 46.4% for T3. The recurrences, observed in 26 patients were found, after 3 years follow up, in 25% of G1, 20.5% of G2 and 47.1% of G3. With relation to the integrity of the nodal capsule N-recurrences were found in 20% of R+ and 5.9% of R-. At the end of the Authors underline the importance of postoperative radiotherapy in the treatment of histological N+ cancers of the larynx and the significance of histological grading and extra-capsular spread in cervical nodes as prognostic factors.
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PMID:[Results of functional latero-cervical dissection associated with post-operative radiotherapy in 102 cases of carcinoma of the larynx with lymph node metastases]. 276 33

Between January 1982 and June 1985, 105 patients with brain metastases of malignant solid tumours were treated in the Robert Janker Clinic. In order to optimize the overall response rates, concomitant radiotherapy and cytostatic chemotherapy was used. In most cases the primary tumour was located in the breast or the lung. Radiotherapy was performed with a Cobalt 60 equipment. The whole brain was irradiated in daily fractions of 15 Gy up to total dose of 45 Gy. Using a slit-course technique this dose was distributed to the three cycles of chemotherapy and given simultaneously, i.e. 15 Gy/ by course. The chemotherapeutic regimen consisted of ifosfamide daily for five days at 2g/m2 and the nitrosurea derivative carmustin (BCNU) at 30 mg/m2 on days 1, 3 and 5. After a free interval of four to five weeks the concomitant radiotherapy and chemotherapy was repeated twice. The tolerance of the treatment was generally good; no severe haematological or gastrointestinal complications occurred. There was a complete and permanent alopecia in all patients caused by the radiation. All patients received a cranial computerized axial tomographic scan prior to and after the treatment. According to the criteria of the International Union Against Cancer, there was a complete remission in 26 of the 105 patients and a partial remission in 49; 19 patients showed a stable disease. Only 12 of the 105 treated patients had a progression of their metastases. Only patients with partial or complete remissions after the treatment belong to the "long-term" survivors.
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PMID:Simultaneous radiotherapy and chemotherapy in the treatment of brain metastases of malignant solid tumours. 366 11


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