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

We present the results of 186 breast cancer patients treated initially for locoregional disease by radiotherapy alone, combining cobalt therapy with external electron beam or interstitial iridium implants. According to the TNM classification, the patients were distributed as follows: 3 T1N0, 2 T1N1, 33 T2N0, 36 T2N1, 16 T3N0, 26 T3N1, 6 T3N2, 14 T4N0, 29 T4N1, 9 T4N2 and 12 T4N3. The 5- and 10-year survival rates (52.7% and 36.5%, respectively, for all patients) were directly correlated with the size and location of the breast tumor, and the extent of lymph node involvement. Locoregional recurrence was observed in 39.8% of the cases, metastasis alone in 26.8% of the cases, and a combination of local recurrence and distant metastasis in 14.5% of the cases. The local recurrences and metastases were directly correlated with the extent of locoregional involvement. Late complications and sequelae were mostly minor and occurred in less than 25% of the cases; severe sequelae occurred in no more than 2% of the cases. They depended on the initial tumor volume and the tumor dose. Our results, along with those in the literature, indicate that radiotherapy administered alone is a valid therapeutic option in breast cancer.
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PMID:Exclusive radical radiation therapy in breast carcinoma. 202 Jul 52

During the years 1973-1987, 75 patients were irradiated for brain metastases of unknown origin at the Institute of Oncology in Ljubljana. Of these, 35 (47%) were previously treated by surgery: Metastases were completely removed in 22 patients and partially in 7, whereas biopsy alone was performed in 6 patients. Based on the examinations carried out during radiation therapy and at the time of follow-up, the primary sites of tumor were established as follows: The lung in 40 patients, the breast in 2, melanoma in 2, and the esophagus, kidney, and parotid gland in one patient, respectively. Primary tumor could not be detected in 28 (37%) patients. Metastases were microscopically verified in 48 cases in which anaplastic carcinoma and adenocarcinoma were most frequent. All the patients were irradiated on a cobalt unit, generally with doses of 10 x 300 cGy in 2 weeks. Median survival of the 22 patients with total removal of brain metastases was 9.5 months, one-year survival being achieved in 41% of cases. In the remaining patients median survival was 3 months, whereas only 12% of the patients survived one year. The cause of death were most frequently, i.e. in 45 patients, brain metastases.
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PMID:Management of patients with brain metastases of unknown origin. 223 20

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

A high dose-rate afterloading technique (60Co) was compared with a low dose-rate packing method (226Ra) in the treatment of endometrial carcinoma stage I. In all, 1,021 patients treated during the period 1977-1986 at two Swedish gynecologic oncology centers were analyzed regarding treatment set-up, histopathologic outcome in the operative specimens, recurrence rates, survival rates and radiation side effects. Complete tumor eradication in the operative specimen was achieved in 80% after radium therapy and in 60% after irradiation by the high dose-rate technique. The overall recurrence rate was 15.7% in the radium packing series and 11.5% after cobalt afterloading treatment. The risk of pelvic recurrences increased by 2.1-2.6 if hysterectomy was replaced by dilatation and curettage. The two radiation techniques seemed to be comparable with regard to the risk of both pelvic recurrences and distant metastases. The 5-year crude survival rates were 85% in the afterloading series and 82% in the radium series. The corrected survival rates were similar (90%) for the two techniques. Age, tumor grade and uterine size were significant prognostic factors with regard to the probability of death due to cancer. Early radiation reactions had quite similar rates in the two series, whereas late radiation reactions were more frequent in the high dose-rate afterloading group in the 10-12 Gy dose fraction range, but not in the 5-8 Gy range. The radium packing method seemed to give a higher frequency of tumor-free operative specimens in this study, but with regard to recurrence rates and survival probabilities the techniques were comparable. Since the different proportion of surgery in the two series and the histopathologic evaluation might have influenced the rate of local tumor eradication in the operative specimens and the risk of pelvic recurrences the results must be assessed with great caution and only a crude comparison of the two treatment techniques could be made.
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PMID:Prognosis of endometrial carcinoma stage I in two Swedish regions. A study with special regard to the effects of intracavitary irradiation with high dose-rate afterloading technique or with low dose-rate radium. 231 Jun 1

In a series of 146 cases of endometrial carcinoma stage I an afterloading technique using high dose-rate cobalt-60 sources has been evaluated for preoperative intracavitary irradiation. The uterine cavities were visualized by hysterograms and the target volumes were calculated. Absorbed doses were estimated at the surface of the target volume and within the uterine cavity. Surgery was performed six weeks after radiotherapy and the operative specimens were examined by a whole-organ sectioning technique. The frequency of residual carcinoma was assessed in relation to reference doses, minimum doses in the target and the position of the treatment catheter. The dose per fraction at the reference point, the minimum absorbed dose at the anterior surface of the target, the anterior-posterior diameter of the target volume and the position of the treatment catheter within the uterine cavity were found to be significant for tumor eradication. The irradiation technique and the histopathologic findings with reference to the operative specimen were significant for the rate of vaginal metastases but not for tumor recurrences at other sites. Radiation reactions involving the urogenital organs were few (4.8%). The most serious radiation reaction was obstruction of the small bowel (5.5%). The absorbed dose per fraction was the most important single risk factor for this complication.
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PMID:Preoperative intrauterine irradiation of endometrial carcinoma stage I. A clinical and radiographic evaluation of the bulb technique. 233 75

From 1968 to 1987, 123 consecutive patients with nonmetastatic choroidal melanoma were treated with cobalt-60 plaques. One hundred sixteen patients were followed up for a mean of 3.8 years. Twenty patients had local failure, and 14 patients had distant failure. Complications included 32 cataracts, and seven enucleations were required. Local recurrence did not correlate with tumor height, tumor volume, dose, or dose rate. Increased volume (P = .004) and height (P = .01) correlated with increased rates of distant metastases. Dose adjusted for volume did not correlate with the rate of metastases.
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PMID:Ocular melanoma: total dose and dose rate effects with Co-60 plaque therapy. 235 1

Indications for radiotherapy radiotherapy of hepatic metastases are limited. Only secondary hepatic focii in clinical or subclinical disseminated cancer of the ovary are systematically irradiated after curative chemotherapy. Liver radiotherapy in all patients with cancer of the ovary and its beneficial effect permitted a lifting of the longstanding ban on irradiation of this organ. Other indications are the hepatic metastases of lymphomas, seminomas, radiosensitive tumors and carcinoid tumors. For hepatic metastases of other histopathological origins, the indications are much more restrained. Principal interest is palliation of pain. High-energy cobalt 60 unit or linear accelerator delivered doses up to a maximum of 25 gray over 2 1/2 to 3 weeks in daily fractions through two portals of entry irradiating the total liver biomass. Use of flashes apparently must be eliminated because they may speed up the fatal outcome of disease in severe cancer patients. Radiotherapeutical tolerance is generally very satisfactory, nonetheless this depends upon the overall health picture in patients debilitated by disease and sometimes adjuvant chemotherapies. Finally, concomitant combination therapeutical modalities, such as local or regional chemotherapies administered by catheterisation of the hepatic artery associated with radiotherapy, have not yielded encouraging enough results to be proposed.
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PMID:[Radiotherapy of secondary liver cancers]. 240 50

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

From 1967 to 1977, 72 patients with small cell carcinoma of the lung were seen. Thirty-five of these patients had unilaterally localized lesions (limited disease) and were treated with cobalt 60 radiation therapy (6,000 rad in six weeks) followed by chemotherapy consisting of cyclophosphamide (Cytoxan), vincristine, methotrexate and lomustine (CCNU) (Group A). The remaining 37 patients with extensive disease were treated with similar chemotherapy alone, or in combination with local palliative radiotherapy to the symptomatic area (Group B). For Group A the five-year survival rate was 20 percent, while for both groups combined, it was only 5 percent.During this same period 560 patients with non-small cell carcinomas were treated. The five-year survival rate for those patients with operable, resectable lesions was 33 percent, while for those with unilateral, inoperable, unresectable lesions, it was 10 percent. Thus, it would appear that the results in limited small cell and non-small cell carcinomas of the lung utilizing high-dose radiotherapy followed by chemotherapy are comparable, and that limited small cell carcinoma of the lung patients with high-dose radiotherapy followed by chemotherapy can survive longer than those patients with stage III, non-small cell lung carcinoma.While the two- to five-year survival rates in small cell carcinoma demonstrate no appreciable differences, in non-small cell carcinomas there are significant two- to five-year survival differences. These improved results probably are due to the increased sensitivity of small cell carcinoma to high-dose local radiotherapy and to the chemotherapeutic vulnerability of circulating and microscopic metastatic cancer cells.
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PMID:Cure rates in small cell and non-small cell carcinoma of the lung utilizing high-dose radiotherapy and chemotherapy. 301


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