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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twelve patients with liver metastases from colorectal cancer were treated with 5-FUdR hepatic artery, or 5-FU i.v. infusion therapy and hyperfractionated whole liver irradiation (2,100 rad in 14 fractions, two fractions/day over a period of 9 days). All 12 patients tolerated treatments well and no unusual toxicity was noted from this therapy. Response was assessed on completion of treatment and on follow-up examinations by physical examination, repeat liver function tests (LFTS), and CT scans. Symptomatic relief was achieved in all patients. Decreased liver size and improved LFTS were noted in 10/12 (83%) of patients. CT scans showed decrease in size of metastases. Survivals ranged from 16 to 120 weeks. Infusion therapy was given either by implanted infusion pump or continuous i.v. infusion therapy, 5-FUdR 0.3 mg/kg of body weight/day or 5-FU 1,000 mg/m2/day. Hyperfractionated external radiotherapy with concomitant 5-FUdR hepatic artery of 5-FU i.v. infusion therapy for liver metastases was well-tolerated, and both subjective and objective response and quality of survival were noted. Hyperfractionated external beam irradiation with concurrent chemotherapy can be effective in palliating patients with liver metastases.
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PMID:Treatment of liver metastases with a combination of chemotherapy and hyperfractionated external radiation therapy. 295 Jul 53

Cytotoxic chemotherapy was performed in a total of 18 patients (12 men, 6 women): 5 patients with colonic carcinoma and 1 patient with unknown primary lesion received 5 x 1000 mg 5-Fluorouracil (5-FU) at 4 week interval. The 5 following patients primarily suffering from colonic carcinoma were treated with 0.5 mg/kg BW FUDR continuously at 2 week interval. 5 further patients with colonic carcinoma sequential received Mitomycin C (8 mg/m2) and 4 x 1000 mg 5-FU. 2 patients with breast cancer were treated with 500 mg/m2 Cyclophosphamide, the same amount of 5-FU and 40 mg/m2 Methotrexate every 4 weeks. Chemotherapy was well tolerated by all patients. A clinically significant response, however, was seen in only 2 patients with breast cancer. In 8 patients a liver transplantat was performed, which was followed in 3 cases by ultra-high dose Cyclosphosphamide, lethal total body irradiation and autologous bone marrow transplantation. 1 further patient received polychemotherapy. At the time of this analysis only 3 patients were still alive at 61, 30 and 26 months with only 1 perioperative death. All 3 had meanwhile developed recurrent or metastatic disease. Because of these sobering results, liver transplantation for the treatment of non-resectable liver metastases has been abandoned, and regional chemotherapy is now only applied in patients with liver metastases from breast cancer and after resection of metastases in an adjuvant setting.
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PMID:[Our therapy concept in nonresectable liver metastases]. 297 81

Isolated liver metastases of colorectal carcinomas principally can be treated by surgical intervention or cytostatic chemotherapy. Unquestionable indications for resection therapy are either solitary metastases or metastases limited to one liver lobe, since resection provides the best long-time results. In multilocular metastases or non-resectable liver metastases systemic monochemotherapy with 5-Fluorouracil (5-FU) presents respondance rates of about 20 percent with remissions lasting 3 to 6 months. Thereby a prolongation of life could not be proven statistically. Initial studies with a combination therapy of 5-FU/Folinic acid promise higher remission rates due to an increased cytotoxicity caused by a synergistic effect. Because of the mainly arterial supply of liver metastases the different procedures of regional chemotherapy-intraarterial infusion, isolated liver perfusion, chemoembolisation-provide the tumor with high drug concentrations without provoking systemic side effects. This advantage of a regional application of cytostatic drugs is reduced by the high percentage (2 to 87 percent) of extrahepatic tumor manifestations occurring after an average of 6 to 8 months.
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PMID:[Therapy concepts in colorectal liver metastases. What is proven, what is open to discussion?]. 297 48

Twenty-three previously untreated patients with bronchioloalveolar cell lung cancer who had measurable disease and distant metastases (stage IIIM1, extensive) were treated with combination chemotherapy including 5-FU, vincristine, and mitomycin. Two of 23 patients (9%) achieved partial response lasting 5 and 6 months. Two patients (9%) died of sepsis while neutropenic. The current study does not justify the use of 5-FU, vincristine, and mitomycin combination chemotherapy in patients with metastatic bronchioloalveolar cell lung cancer.
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PMID:Phase II trial of 5-FU, vincristine, and mitomycin (FOMi) in metastatic bronchioloalveolar cell lung cancer: a Southwest Oncology Group Study. 300 26

Cloned cell lines of human breast cancer can be growth inhibited by tamoxifen and this inhibition can be reversed by estrogen. We wondered whether tamoxifen inhibition of breast cancer followed by estradiol reversal would increase the efficacy of chemotherapy by increasing the fraction of rapidly cycling cells. We describe a clinical trial in which 110 patients were prospectively randomized to chemotherapy consisting of cytoxan 750 mg/m2 and adriamycin 30 mg/m2 on Day 1 plus 5-FU 500 mg/m2 and methotrexate 40 mg/m2 on Day 8 vs the same chemotherapy plus tamoxifen 20 mg/m2 Days 2-6 and premarin 0.625 mg Q 12-H X 3 on Day 7. Chemotherapy was given in 21-day cycles. 108 patients were evaluable. No difference exist for any important prognostic variables. The first 55 patients were randomized to a regimen in which 5-FU preceded methotrexate by 24 h; thereafter, all patients received methotrexate followed in 1 h by 5-FU. No difference in any response parameter was seen between these two 5-FU methotrexate schedules. No differences in percent of protocol chemotherapy administered or observed toxicity was seen between the 2 regimens. Objective response rate was nearly identical--57% without and 64% with additional hormones. Prior adjuvant chemotherapy with L-PAM had no observable effect on response rate, response duration or survival. In a limited number of patients with inflammatory breast cancer we saw a significantly higher response rate (93 vs 61%; P = 0.03) than in patients with recurrent metastatic disease. Time to progression (13 vs 17 months) and survival (17 vs 23 months) of responders significantly favored the treatment arm including tamoxifen and premarin. Greater benefits of additional tamoxifen and premarin were seen in partial vs complete responders. This may have resulted from lower doses of chemotherapy given to patients achieving a complete remission. An additive effect of hormones plus chemotherapy cannot be entirely excluded as the explanation for the improved results seen with the addition of tamoxifen for 4 days plus 1 day of premarin. We believe that our results suggest that further efforts to increase the efficacy of chemotherapy by perturbing tumor growth rates may be worthwhile.
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PMID:Increasing the response rate to cytotoxic chemotherapy by endocrine means. 2333 Jan 78

Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and 131I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of 131I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy was delivered in 2-month cycles using antibody generated in different species of animals; rabbit, pig, monkey, and bovine. Toxicity was limited to hematologic toxicity and was manifested as thrombocytopenia and leukocytopenia (3.2% Grade IV for each according to RTOG toxicity criteria). Tumor remission evaluated by CT scan digitized tumor volume analysis indicated a 26.6% partial response (PR). Tumor remission by physical examination indicated a 33.3% remission rate (25.9% PR and 7.4% complete remission (CR]. The median survival for patients who responded was 15.2 months. The actuarial median survival for the entire group of patients (metastases and previous treatment) was 6.5 months. The longest partial remission is presently more than 4 years.
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PMID:Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with 131I anti-CEA--a Radiation Therapy Oncology Group Study. 303 77

Cure of primary liver tumours remains possible only by surgery and early diagnosis will therefore continue to be important; the value of regular screening of cirrhotic patients for development of HCC by ultrasound scanning and estimation of AFP is now established. Prognosis of irresectable HCC depends largely on the general condition of the patient at the time of diagnosis and is better in the absence of cirrhosis. Radiotherapy has little role in the management of patients with HCC, but benefit with acceptable morbidity may be obtained from parenteral chemotherapy, with doxorubicin or its derivatives used as single agents, or with a combination of 5-FU and methyl-CCNU. There may be advantage from regional therapy given via the hepatic artery and early results from the combination of embolization with arterial doxorubicin are encouraging. The use of radiolabelled antibodies to tumour-related determinants of hormonal manipulation show promise. Worthwhile results from the non-surgical management of peripheral (intrahepatic) cholangiocarcinoma and primary hepatic sarcoma remain scarce. Isolated hepatic metastases from colorectal primaries may be resectable; for those that are not, results from regional chemotherapy with 5-FU or FUDR are encouraging, but cost and high morbidity currently limit more general application.
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PMID:Chemotherapy and radiotherapy of malignant hepatic tumours. 303 57

The aim of this study was to appreciate the tolerance and efficacy of a new nonoperative therapy for inoperable esophageal squamous cell carcinoma based on chemotherapy (5FU-cisplatinum) and concomitant splitcourse radiation therapy. Twenty five symptomatic patients (24 males, 1 female, mean age: 59 yrs, range: 41-72 yrs) were included. Five had 2 esophageal carcinoma, 5 an associated upper respiratory tract tumor and 2, relapse after surgery. Nine patients had a tumor limited to the esophagus (stage I or II) but were considered at high surgical risk. Sixteen had stage III disease with mediastinal involvement in 13 cases, nodal involvement in 4 and distant metastasis in 7. Treatment consisted of 2 cycles of chemotherapy with 5-FU (1 g/m2/24 h by continuous infusion for 5 days, D1-D5 and D29-D33) and cisplatinum (70 mg/m2 IV bolus on D2 and D30). Radiation therapy was concomitant in 2 courses delivering 20 grays in 5 days (D1-D5 and D29-D33). On the first day of the treatment, peroral endoscopic dilation or Nd-YAG laser therapy was applied. At the end of treatment all the patients could eat. Histoendoscopic control was performed 8 weeks after the beginning of therapy. Seventeen of the 24 patients had a complete response with negative biopsies. Of the 7 patients with metastatic disease, only 4 were evaluable for response to chemotherapy: one with hepatic metastasis had a complete response for 12 months, 2 had stable disease and one progressive disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Inoperable cancer of the esophagus: preliminary results of combined chemotherapy (5-fluorouracil-cisplatin) and radiotherapy]. 306 23

Fluorouracil is the major chemotherapy agent currently available for colon cancer. It is utilized alone or in combination in a variety of schedules, though the optimal schedule has not yet been identified. In addition to the use for metastatic disease, fluorouracil also is useful for adjuvant treatment or in combination with radiation therapy for treatment of locoregional disease.
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PMID:Colon cancer: medical therapy. 306 47

In the carcinoid syndrome, surgery is often curative when the disease is detected early and it may also provide palliation for some patients with metastatic disease. Often metastatic disease requires no treatment for months or years unless symptoms are serious or troublesome. Chemotherapy with either doxorubicin alone or streptozocin plus 5-FU achieves a response rate of about 23-33%. Hepatic artery occlusion followed by sequential chemotherapy has produced striking relief of symptoms, a higher percentage of regressions, and a longer duration of response. Somatostatin 201-995 is very effective in treating the syndrome and in preventing carcinoid crisis and has the advantage of producing virtually no significant side effects.
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PMID:The carcinoid syndrome: a treatable malignant disease. 307 20


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