Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prognosis of colon cancer, after curative resection, is mainly related to the outcome of metastases, and especially of liver metastases. It is generally accepted that adjuvant medical therapy is important in order to prevent the incidence of metastatic recurrences. The aim of the present review is to analyse the conclusions of the main recent randomized trials assessing the comparative value of different adjuvant protocols. The results obtained using either systemic infusion, the classical one, or intraportal infusion, which is mainly designed to prevent liver metastases, are reported. On the basis of the review, we can conclude that: adjuvant chemotherapy using combined drugs (MF, MOF) did not prove to be more active than 5-FU alone. The beneficial action of a combined 5-FU + levamisole regimen has been clearly demonstrated for patients with a Dukes C tumour. According to a unique and limited trial, intraportal adjuvant therapy has been shown to be effective for patients with Dukes B tumours, but this remains to be confirmed. On the basis of the present data, new adjuvant programs using combined chemotherapeutic and immunotherapeutic coupounds, and combined systemic and loco-regional infusion, could be developed.
 ...
PMID:[Prevention of hepatic metastases in radically operated colonic cancers]. 206 93

From April 1983 to April 1989, 123 cases of liver metastases from colorectal cancer were treated. Forty-three cases underwent hepatic resection. Forty had 5-FU, MMC, and ADM infusion chemotherapy through arterial catheter (FAM i.A.). The remaining had other treatment. In this study, 43 cases of hepatic resection and 32 out of 40 cases of FAM i.A. were evaluated. Thirty-nine of the 43 had major hepatic resection with regional lymph nodes dissection and 4 had partial hepatectomy. Regional lymph-nodes metastases were seen in 5 out of 39 dissected (12.8%). Small liver metastases which could not be diagnosed before or at surgery, were existed in 4 of 15 multiple liver metastases (26.7%). Three-year survival rates, calculates by Kaplan-Meier's method, were 53.5% in all, 57.4% in the solitary, and 42.8% in the multiple metastases. Three-year survival rates of the recurrences were 55% in the extra-hepatic and 24.5% in the hepatic recurrences. FAM i.A. was completed in 32 unresectable liver metastases. Responses of the FAM i.A. were observed in 21/32 (65.6%). Fifty percent survival rates were 11.7 months in all and 22.2 months in 13 cases without extra-hepatic lesions. Considering risk factors (multiple or large solitary metastases, unrecognized small liver metastases, lymph nodes metastases), major anatomic hepatectomy with lymph nodes dissection may be the treatment of choice for liver metastases from colorectal cancer. FAM i.A. had a good local response.
 ...
PMID:[Treatment of liver metastases from colorectal cancer--major hepatic resection and continuous hepatic arterial infusion chemotherapy]. 211 62

Intra-arterial infusion chemotherapy using an implantable reservoir was used for 22 patients with liver metastasis from September 1986 to March 1990. The material consisted of 8 subjects with gastric cancer and 14 with colorectal cancer. One had metastasis in one lobe (H1), 10 had a few scattered metastases in both lobes (H2) and 11 had numerous metastases in both lobes (H3). In 5 cases, a reservoir was implanted to prevent the recurrence after hepatectomy. Infusion catheter was placed in the proper hepatic artery in 5 cases via the gastroduodenal artery at laparotomy and it was carried out subcutaneously via the femoral artery in 17 cases. In all cases intra-arterial infusion of 5-FU was continuously administered followed by intermittent one shot injection of ADM. The clinical effectiveness of the therapy was well evaluated. One-year cumulative survival rate of all cases by Kaplan-Meier method was 55% and that of H2 cases was 78%. No recurrence was noted in post hepatectomy cases. Eight cases (36.3%) showed remarkable complications, which made it impossible to continue intra-arterial infusion chemotherapy: hepatic artery occlusion (3 cases), infection (2 cases), abdominal pain (1 case), hematoma in the implanted site (1 case) and dislocation of the infusion catheter (1 case). From the present study, it is considered that intra-arterial infusion chemotherapy is a useful procedure for the control of liver metastasis. Regimens for improved chemotherapy and the maintenance of more useful and safer catheters should therefore be investigated for further development of the therapeutical estimation.
 ...
PMID:[Clinical evaluation and problem of intra-arterial infusion chemotherapy of liver metastasis from digestive organ cancer]. 211 5

Gastrointestinal malignancy may spread to peritoneal surfaces in the absence of lymphatic or hematogenous metastases. To treat peritoneal carcinomatosis, a uniformly lethal disease process, extensive cytoreductive surgery and i.p. chemotherapy were combined. Early postoperative i.p. chemotherapy was instilled in the first few days after the surgical procedure in an attempt to treat anatomic sites that would be sealed off by postoperative adhesions. Mitomycin C was given on the first postoperative day at two doses, 10 and 12 mg/m2. 5-Fluorouracil was given on postoperative days 2-5 at 15 and 20 mg/kg, respectively. Median area under the curve ratio i.p./i.v. was 117 for 5-fluorouracil and 21.6 for mitomycin C. Elevated intraportal levels of drug were observed for i.p. 5-fluorouracil but not for mitomycin C. The marked pharmacokinetic advantage of postoperative i.p. suggests that this treatment strategy should be considered in a clinical trial in patients at risk for progression of peritoneal carcinomatosis.
 ...
PMID:Early postoperative intraperitoneal chemotherapy as an adjuvant therapy to surgery for peritoneal carcinomatosis from gastrointestinal cancer: pharmacological studies. 211 20

The effects of preoperative treatment by continuous intravenous infusion of Tegafur, the antagonist of DNA synthesis, were histopathologically studied in 34 patients with gastric cancer. Histologically the treatment was found to be effective in 41.2% of patients with cancer invasion in the mucosa, 58.8% in the submucosa, 61.3% in the muscularis propria, 59.3% in the subserosa and 86.9% of those with metastatic lymph nodes. The treatment was effective, when assessed in terms of the histological type of cancer, in 90.9% of cancers of the differentiated type (papillary adenocarcinoma, well differentiated tubular adenocarcinoma and moderately differentiated tubular adenocarcinoma) and 47.8% of those of the poorly differentiated type (poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet-ring cell carcinoma), showing a higher rate of efficacy in the differentiated type cancers. Meanwhile, even among patients with cancer of poorly differentiated type, a high efficacy rate (90.0%) was found in those with metastatic cancer of the lymph nodes. No relationship was found between the total doses of Tegafur and histological effects. There was a tendency, however, for a higher frequency of a good response in patients administered more than 4,000 mg of Tegafur. In the patients with a histologically positive effect, 5-FU concentration in the tumor tissue was higher than 0.071 microgram/g. However, some patients showed no response despite a high concentration. This finding suggested that sensitivity to 5-FU and 5-FU metabolism vary depending on the tumor. The inhibitory effect of Tegafur on DNA synthesis is produced through inhibition of thymidylate synthase (TS) by the Tegafur metabolite FdUMP.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Histopathological studies on antitumor effect of tegafur administered by continuous intravenous infusion]. 211 40

In the Center of Surgery of the Justus-Liebig-University Giessen and in the General Hospital in Nuremberg from 1983 to 1987 21 patients with metastases of a colorectal carcinoma were treated with chemoembolization (CHE). The on average survival period of patients treated with chemoembolization after non-successful application of regional chemotherapy amounted to 6 months. The total survival period of these patients amounted to 17.4 months. Since March 1987 chemoembolization has been applied as initial therapy. The on average survival period of the patients, initially treated with cheomoembolization at present amounts to 14 months. 4 of these patients additionally got chemotherapy by the portal vein after CHE. The survival period of 2 patients, having been resected several times after CHE, at present comes to 27 months. These results are the base for a clinical study, in which CHE is combined with the portal venous infusion of a cytostatic agent (Folin acid 5-FU).
 ...
PMID:[Chemoembolization of colorectal liver metastases]. 212 18

The clinical efficacy and indications for Angiotensin II (AT II)-induced hypertension chemotherapy were evaluated as a drug delivery system in 101 patients with advanced carcinoma. The sites of primary tumor studied included stomach (44), pancreas (18), colon (16), esophagus (6), bile duct (4), liver (3), breast (7) and 3 other single organs. Seventy four cases had distant metastases (lymph node (25), liver (29), peritoneum (16), and lung (4)). Additionally, the protocol was used 12 cases as postoperative adjuvant chemotherapy and 15 cases following exploratory laparotomy. The blood pressure was elevated to a level 1.5 times base-line. The regimens used consisted of MMC + ADR (55), FAM (38) and CDDP (8). The dosages administered were MMC 7 mg/m2, ADR 14 mg/m2 and 5-FU 350 mg/m2. The cancer chemotherapy protocol with AT II was repeated for an average of 2.6 cycles with a 2-3 week interval. The drug concentration in tumor tissues was increased 1.7 fold by AT II treatment. The response rate was 15.8% (CR 7 and PR 9), and in those patients with lymph node, liver and peritoneal metastases was 48.0, 6.9 and 6.3%, respectively. The serum levels of tumor markers decreased in 9 patients. Subjective symptoms, such as hoarseness, edema and pain, were improved. The mean survival in patients with distant metastasis who responded was 343 days, and in nonresponders was only 168 days (p less than 0.05). The side effects of this therapy were slight, typically being grade 1 and 2. Thus, the chemotherapeutic agents studied in conjunction with AT II were effective in patients with lymph node metastasis. Additionally, this regimen could be performed safely with minimal side effects.
 ...
PMID:Clinical evaluation of chemotherapy under angiotensin II-induced hypertension in patients with advanced cancer. 213 Jul 94

Liver metastasis in nude mice was studied using LoVo, a cell line developed from a patient with adenocarcinoma of the colon. LoVo cells injected into the spleen of 4-week-old nude mice showed 100% tumorigenicity in the spleen and metastases to the liver. This system was used to study ways in which to improve the efficacy of 5-FU, which was used in combination with alpha-2a interferon. Our results show that interferon can potentiate the effect of 5-FU in inhibiting liver metastases. Either drug given alone did not show comparable inhibition.
 ...
PMID:Inhibition of liver metastases in nude mice by the combined action of 5-fluorouracil and interferon. 213 Oct 49

Primary and metastatic hepatic tumours--evaluation of tumour regression or response under regional cytostasis with sonography and fine needle puncture histology. The results obtained through the use of regional liver perfusion with a 5-FU-BCNU application on non-resectable hepatic metastases of colorectal tumours following primary curative removal of the primary tumour and primary hepatocellular carcinomas display comparable results to those specified in the literature after the use of 5-FUDR. The effectivity of the cytostasis regime is checked using histological criteria. The ultrasonically guided fine needle puncture can prove the success of the cytostasis regime on the basis of cytomorphologic criteria more reliably than has been the case up to now. Patients displaying histological signs of tumour regression have a significantly longer survival time than those displaying no signs of regression (12 +/- 9.2 vs 4.5 +/- 2.2 months; p less than 0.05).
 ...
PMID:[Primary and metastatic liver tumors--evaluation of tumor regression and response with regional cytostatic drug therapy by sonography and fine needle puncture histology]. 216 47

Overall prognosis of pancreatic adenocarcinoma is still very poor with median survival around 10 months after radical surgery in operable patients, or after full-dose radiation therapy in non-surgical candidates. In metastatic disease, multidrug chemotherapy regimens give a response rate of around 30% with median survival of 10 months. Random trials conducted by the GITSG in inoperable cases have shown improved results for chemoradiation with 5-FU for radiotherapy alone and a doubling of median survival with a 1-year survival of 40% vs 10%. Incorporation of Adriamycin in these combined modality protocols does not improve the results in terms of survival. Chemoradiation also shows improved results compared with chemotherapy alone. In patients amenable to radical surgery, adjuvant post-operative treatment with chemoradiation gave superior results over surgery alone with a doubling of median survival and a significant improvement of a two-year survival rate (42% versus 15%). Intra-operative radiation therapy leads to better local control but without a significant improvement in survival. With a better understanding of radio-chemotherapy interactions and mechanisms of radiosensitization through continuous infusion of fluorouracil and/or cisplatinum, these encouraging results should be confirmed within the next few years.
 ...
PMID:[Combination radiotherapy and chemotherapy in cancer of the pancreas. Review of the literature and prospects]. 218 46


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>