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)

A 13-year-old girl with osteosarcoma and pulmonary metastases developed life-threatening renal toxicity, encephalopathy, and bone marrow failure following high dose methotrexate therapy. After successful treatment, high dose methotrexate therapy was continued without further problems. Recommendations for the prevention and the current management of methotrexate toxicity are discussed.
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PMID:[(Management of acute toxicity after high dose methotrexate therapy)]. 39 13

We have reviewed the literature and described experience in treating Ewing's sarcoma and osteosarcoma before and during the era of intensive systemic chemotherapy. Local control of Ewing's sarcoma may relate to increasing doses of radiation, especially when intensive chemotherapy is administered also. Problems of radiation enhancement by chemotherapy have caused us to reconsider time-dose and volume parameters in treating these patients. The role of radiation in osteogenic sarcoma is limited to patients with inoperable lesions and metastases.
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PMID:Radiation in bone sarcomas: a re-evaluation in the era of intensive systemic chemotherapy. 40 97

Methylmethacrylate bone cement was used to refill bony defects following excisional biopsy of supposed benign or semimalign bone tumors. This procedure offers several advantages: the anatomical situation at the site of the lesion will not be altered, that means the functions of the joint and the continuity and stability of the bone will be preserved; the histological examination of the tissue is possible without a hurry; the follow up of the lesion is easily possible by X-ray-examination; further therapeutic procedures can follow without restriction, for example if the histology discovered an unsuspected malignant tumor or if the follow-up revealed a recurrency. In addition a favorable effect is the necrosis of tumor cells, eventually left behind in the bone, by the action of zytotoxic monomer and heat, originated during the polymerisation of the methylmethacrylate. In benign or semimalignant bone tumors the cement has to be removed after an adequate observation period; at this occasion the cavity again is curetted and then filled with autologous bone grafts. Since 1972 we treated 13 bone lesions by this method of "temporary bone cement plugging". The lesions were 5 giant cell tumors, 2 aneurysmal bone cysts, 2 simple bone cysts, 1 osteosarcoma, 1 malignant lymphoma, and 2 metastases of hypernephroid carcinoma. In the case of osteosarcoma an amputation was performed just after the diagnosis was made. In the other cases no local recurrances up to now were seen.
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PMID:[Temporary plugging of cystic bone tumors by bone cement (author's transl)]. 46 12

The clinical, radiological and pathological features of two cases of an osteogenic tumour with long survival are described. The tumours have the histological pattern of benign osteoblastoma with other more cellular and aggressive features suggestive of a low grade osteosarcoma. They are locally invasive but the absence of metastases indicates that separation from both entities is justified clinically and pathologically. The term aggressive osteoblastoma is suggested.
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PMID:Aggressive osteoblastoma. 46 45

Eleven patients with measurable subcutaneous or pulmonary metastases were selected for a study of the effectiveness of the radiosensitizer misonidazole (MIS). Evaluable data were obtained in 6 patients and radiosensitization demonstrated in 5. Patients were irradiated either before or after MIS, and each patient acted as his own control. Response to treatment in 5 cases was assessed in terms of growth delay, and radiation doses were selected in expectation of enhancement ratios of 1.2 to 1.5. In 1 case evidence of sensitization was obtained from differential tumour clearance from 2 areas of skin irradiated before or after MIS. Results in 4/5 growth-delay studies indicated enhancement ratios ranging from 1.1 to greater than 1.5. An enhancement ratio of 1.3 was measured in a case of squamous carcinoma treated by a 10-fraction course of irradiation. Evidence of sensitization was obtained in breast carcinoma, osteosarcoma, leiomyosarcoma, prostatic carcinoma and synoviosarcoma. The results of this study support the view that MIS may improve the radiotherapeutic management of a wide range of tumours, although more extensive data are required to identify those categories of disease in which greatest benefit will be obtained, and to indicate the optimum radiation schedule.
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PMID:The quantitative response of human tumours to radiation and misonidazole. 52 30

Rhabdomyosarcoma usually presents as a soft tissue mass, which may invade adjacent bone. However, the patient presents occasionally with bony metastases. Recognition of these is important for staging and management. Fifty-eight cases have been reviewed; 14 of these had local bone invasion by the soft tissue tumour. All bones involvel were flat bones; 12 showed permeated bone destruction and two showed geographic destruction. Bone expansion was seen in half the involved bones. Twelve of the 58 cases showed secondary bone deposits, which were the presenting feature in five. Although 10 cases had permeated bone destruction, two were very well defined with a wide range of radiological appearances. The radiological differential diagnosis includes neuroblastoma, leukaemic infiltration, lymphoma, histiocytosis X, solitary and multifocal osteosarcoma and other deposits.
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PMID:The radiology of bone changes in rhabdomyosarcoma. 62 1

Serum copper levels (SCL) and serum zinc levels (SZL) were evaluated in 19 patients with sarcomas, 12 of which were osteosarcomas at various stages. Patients with primary or metastatic osteosarcoma had elevated SCL, whereas amputated osteosarcoma patients who were clinically tumor-free had nearly normal SCL. Patients with primary osteosarcoma had elevated SZL, those with metastases had depressed zinc levels, and amputated patients who were clinically tumor-free and nearly normal SZL. Thus, the ratio of SCL:SZL in metastatic osteosarcoma patients is higher than in patients with primary osteosarcoma. SCL and SZL are compared to clinical histories for selected patients. Patients with the more advanced disease and poorest prognoses had the most elevated SCL and highest SCL:SZL ratios. It appears that the determination of SCL and SZL in osteosarcoma patients may be of value in prognosis and therapy evaluation; furthermore, the ratio of SCL:SZL may be useful in discriminating between patients with primary and metastatic osteosarcoma.
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PMID:Copper and zinc levels in serum from human patients with sarcomas. 76 64

In conclusion, then, we would answer the seven questions raised earlier concerning transfer factor as follows: Certianly, as shown by clinical results, it does exist. It does have a definite immunologic effect in humans, boosting cell-mediated immunity, as shown by a rise in the level of active T cells. Its clinical effects have been demonstrated repeatedly, and it should become useful in still other clinical situations as further research provides more effective therapeutic modalities. Transfer factor from selected donors appears to provide prophylaxis against metastasis when administered to osteosarcoma patients with no clinically evident metastases at the time of surgical removal of the primary tumor; whether this treatment is superior to chemotherapeutic prophylaxis is conjectural and controversial. Its mechanism of action has not been demonstrated as yet, although many theories exist. The best evidence is that the effects are both specific and nonspecific. It appears to be produced by T lymphocytes. The exact nature of the substance we call "transfer factor" remains to be elucidated. Further research should provide more conclusive answers to these questions.
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PMID:Dialyzable transfer factor in the treatment of human osteosarcoma: an analytic review. 79 87

Recent advances in the use of chemotherapy for treatment of osteosarcoma have altered out pessimism in this disease. Results are presented from 3 groups of investigators using different agents as adjuvant chemotherapy following immediately upon amputation of the primary. The Roswell Park Memorial Institute began a regime, immediately after amputation, of adriamycin 30 mg/M2 for 3 doses and given every 4-6 weeks. This study was subsequently expanded in a cooperative group (ALGB) and the results on 20 patients analyzed. At 19 months approximately 75 per cent are free of any pulmonary metastases compared with 10-25 per cent expected from amputation alone. Similar results have been obtained by other Centers using different chemotherapeutic agents. In Boston Children's Hospital high dose Methotrexate with citrovorum factor is used. In 12 of these patients local control of the primary by surgery was obtained and of these only 1 developed pulmonary metastases during an observation time of 23 months. At the M. D. Anderson Hospital multi-drug combinations were used including Cyclophosphamide, Vincristine, L-Phenylalamine Mustard and Adriamycin. They reported a survival rate of 55 per cent (10 out of 18). All of these neoplastic agents have toxic side effects but when carefully used these effects are minimized and the quality of life is quite good. Many questions must be answered by future controlled long term follow-up studies.
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PMID:Chemotherapy of osteosarcoma. 105 62

Regrettably amputation remains to the present day an essential part of treatment in osteosarcoma of the limb bones. Only by its inclusion in the therapeutic regime can the present best level of about 20 per cent survival be achieved in any large group of patients. Preliminary biopsy is essential and there is no evidence that it is harmful even if followed by a delay of many days before definitive treatment. In patients treated initially by radiotherapy, selective amputation some 6 months later only in patients free of metastases, carries just as good a prognosis for the group as a whole as initial primary amputation in all patients. This method, first described by Cade, is widely practiced in the United Kingdom and spares many patients who develop early metastases following initial radiotherapy from unnecessary mutilating surgery shortly before inevitable death. Local recurrence may follow retention of a femoral stump following amputation for osteosarcoma at the most common site in the lower femoral metaphysis. There are cogent arguments in favor of hip disarticulation in such patients although they do not include evidence of greater survival. The balance between the two procedures is finely drawn but is weighted in favor of disarticulation.
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PMID:The surgical management of primary osteosarcoma. 105 65


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