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)

In the investigation of suspected lung cancer bleomycin labelled with cobalt-57 and gallium-67 labelled with citrate are currently used to detect the primary tumour and to establish the presence of metastases in the lung hilum and mediastinum. A comparative study of these radio-pharmaceuticals was performed in 63 patients with proved lung cancer. 57Co-bleomycin showed the primary tumour in 58 patients (92%) and 67 Ga-citrate in 34 (54%) (p less than 0.01). The average tumour-to-lung ratio was 3.4 with 57Co-bleomycin and 1.5 with 67Ga-citrate. Proved metastases in the hilum or the mediastinum were visualised with 57Co-bleomycin scintigraphy in 16 out of 18 patients (89%) and with 67 Ga-citrate scintigraphy in only eight (45%) (p less than 0.01). These results indicate that 57Co-bleomycin scintigraphy is more suitable for detecting and staging lung cancer than is 67Ga-citrate. 57Co-bleomycin is valuable in the detection of peripheral lesions, in which a pathological diagnosis is difficult to achieve, since a positive scintigram indicates malignancy. When 57Co-bleomycin scintigraphy suggests hilar or mediastinal metastases mediastinoscopy should be carried out; but when no metastases are apparent it is reasonable to proceed directly to thoracotomy without mediastinoscopy.
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PMID:57Co-bleomycin and 67Ga-citrate in detecting and staging lung cancer. 618 33

When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy should be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.
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PMID:Open rib biopsy guided by radionuclide technique. 632 12

About 80 per cent of patients with breast cancer ultimately die of metastatic disease in the following twenty years. Distant metastases are more important as cause of death than loco-regional relapses, it is why adjuvant chemotherapy is necessary, especially in young patients and in those with extensive disease. Initial chemotherapy preceding any locoregional treatment is justified on the basis that both surgery and anesthesia lead to immuno-depression. Further, the value of initial chemotherapy has been demonstrated in many experimental and clinical trials of Nissen-Meyer, Bonadonna and Cooper. We have treated 145 patients, including 67 with inflammatory breast cancer (IBC), with 4 to 6 weeks of Velbe, Thiotepa, Methotrexate Fluorouracil and Prednisone with Adriblastine added for those patients with IBC or T greater than 7 cm, or N2 N3. Because of tumor regression of more than 50 per cent observed in 80 per cent of the patients, the majority (123 patients) then received radiotherapy alone (cobalt + iridium) and are in a complete remission in all these cases after curietherapy. Maintenance treatment with the same drugs was prescribed for 6 to 18 months depending on the initial staging. Tumor regression appears to be an important prognostic factor. Median follow-up is only 17 months, the longest one being 42 months. The overall survival at 2 years for IBC, is 90 per cent with a disease-free survival of 80 per cent. Cosmetic results are excellent. While these results are encouraging, longer follow-up is needed to confirm this improvement.
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PMID:[Breast cancer: chemotherapy preceding locoregional treatment with extension of the indications for conservative treatment]. 643 62

Seven patients with large cervical node metastases were treated at the Institut Jean-Godinot using a particular scheme of accelerated irradiation. Conventional Cobalt-60 radiotherapy was prophylactically delivered to extended volumes of the neck (50 Gy in 25 fractions over 5 weeks). Within the fields of cobalt irradiation, an electron beam field was added to increase the daily dose from 2 to 3 Gy (Fletcher's field in the field technique). The increment of dose was limited to nodal area. Since no interval separated the two irradiations, involved areas were considered to receive 70 Gy in 25 fractions over 5 weeks and non-clinically involved areas to receive 50 Gy in 25 fractions over 5 weeks. In all the cases, the malignant mass diameter exceeded 5 cm. Acute tolerance was good and no major late injury was observed during the 18 months minimum follow-up period. At the end of the treatment, a complete disappearance of the tumor was observed in six out of seven cases. At the present time, four patients are still alive without evidence of disease. Slight acceleration of irradiation by the use of a concomitant electron boost is easily feasible and may provide an improvement in local control and therapeutic ratio of large cervical malignant masses in the neck.
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PMID:The use of a concomitant electron boost (field in the field technique) in large cervical node metastases over a shortened period. 644 Nov 95

A 68-year-old man with old-standing Paget's disease of bone developed in 1975 an isolated sarcoma of the left elbow confirmed by biopsy. The sarcoma responded to irradiation and multiple chemotherapy. In August 1979, pain started along the right sciatic nerve. Clinical examination revealed a tumour deep in the right gluteal region, which was found to be another sarcoma close to the sacro-iliac joint, Cobalt irradiation produced little symptomatic improvement, and the patient died four months later, presumably of metastases. Since January 1979 the Paget's disease had been treated with dichloromethylene diphosphate with satisfactory clinical, biochemical and histological results, but the drug did not influence the course of the sarcoma.
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PMID:[Multifocal sarcoma associated with Paget's disease of bone. Effects of dichloromethylene diphosphate (author's transl)]. 645 48

Primary chemotherapy in carcinoma of the breast is justified by the high risk of distant metastases, immunodepression related to surgery and the experimental studies and clinical trials of Nissen-Meyer in 1967, and Fisher in 1968. Chemotherapy was associated with loco-regional Patey-type surgery (20 patients) or radiotherapy with cobalt and irridium (43 patients) in 63 cases of breast cancer, 33 of which were T4 or in exarcerbation. Initial chemotherapy comprised 3 to 6 infusions of Velbe, Thiotepa, Methotrexate, 5-Fluoro-uracil, prednisone plus adriamycine in the severe forms. Over 50 p. 100 tumour regression was observed in 80 p. 100 of patients without major toxicity reactions. In all cases of radiotherapy alone, the tumour disappeared completely in the two months after the end of radiotherapy. Only one of the 63 patients relapsed at the 8th month and she died. The follow-up period now ranges from 3 to 29 months (average 12 months). These results are encouraging but only a larger series will allow definite conclusions to be drawn.
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PMID:[Primary chemotherapy in breast cancer. Preliminary results]. 647 66

A method has been devised for evaluating the rate and extent of regression of the first 100 consecutive patients with a posterior uveal melanoma that we had managed by Cobalt-60 plaque radiotherapy at Wills Eye Hospital. It was found that the "average" posterior uveal melanoma in the series did not regress rapidly to a flat, depigmented scar but shrank slowly and persisted as a residual mass approximately 50% of the thickness of the original tumor at 54 months following Cobalt-60 plaque radiotherapy. We also found that the rate and extent of regression of the tumors in patients who subsequently developed metastatic melanoma were not appreciably different than the rate and extent of regression of the tumors in patients who remained well systemically. These observations indicate that the rate and extent of regression of posterior uveal melanomas following Cobalt-60 plaque radiotherapy are poor indicators of the prognosis of the affected patients for subsequent development of clinical metastatic disease.
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PMID:Regression of posterior uveal melanomas following cobalt-60 plaque radiotherapy. 652 1

The results of treatment of the first 100 patients with uveal melanomas treated with 106-Ruthenium applicators in Essen are presented. The mean follow-up period was 2 years; 80 of the patients presented with choroidal melanomas and 20 with melanomas of the ciliary body. Five of the 100 patients had metastatic disease originating from the primary uveal melanoma. Compared to 60-cobalt therapy, therapeutic results are similar in terms of tumor regression, but the incidence of complications was significantly lower. In 16 patients the eye with the tumor had to be removed, because of tumor growth (12), neovascular glaucoma (3), and vitreous hemorrhage (1). Visual acuity did not decrease in 20% of the cases treated. In the light of our results 106-Ruthenium therapy seems to be a reliable method of tumor treatment in tumors with a maximum prominence not exceeding 8 mm.
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PMID:[Treatment of malignant melanomas of the uvea with 106-ruthenium applicators. Report on the first 100 Essen cases]. 652 3

Given that metastatic hepatic malignancy remains as a significant cause of death, with a median survival after diagnosis of only 7 months despite treatment, there exists a need for some effective treatment modality. Internal radiotherapy in the form of yttrium-90 microspheres infused into the hepatic artery appears to be a promising method of therapy. One criterion required for the success of this treatment is that of a differentially greater arterial supply to tumor as opposed to liver tissue. This arterial hypervascularity of tumor has been demonstrated before. However, some conflict has been reported as to the maintenance of this state as tumor size increases. Using 15 micrometers Cobalt-57 microspheres for studying salivary adenocarcinoma implants in DA rat livers, these experiments have demonstrated a constant blood flow in the tumor periphery of 3.9 times that within the normal hepatic parenchyma, regardless of tumor size. Also demonstrated is a progressive decrease in central tumor arterial blood flow after a tumor diameter of 6 mm has been exceeded. Arterial hypervascularity of liver tissue adjacent to the tumor has been demonstrated while an intermediate zone of liver tissue appeared hypovascular, suggesting the presence of shunting. In three humans with metastatic liver disease, hepatic artery infusion of particulate radiotracer has demonstrated the peripheral tumor hypervascularity and relative central tumor hypovascularity with good correlation obtained with the images of the metastases on conventional colloidal hepatic scintigraphy. This method allows assessment of the patient's suitability for internal radiotherapy by enabling assessment of the tumor vascularity and the degree of potentially dangerous extrahepatic irradiation.
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PMID:Internal radiotherapy for hepatic metastases II: The blood supply to hepatic metastases. 668 44

The clinical records of 66 patients with T4 (for skin infiltration or ulceration) breast cancer not larger than 5 cm treated with primary radiotherapy at the Istituto Nazionale Tumori of Milan from 1968 through 1977 were reviewed. The tumor measured no more than 3 cm in 19 patients and 3-5 cm in 47 patients. In the first group axillary involvement was lower (32% vs 55%) and mean age was older (68 years vs 58). Thirty-four patients were irradiated with orthovoltage and 32 with cobalt, at full doses. In 22 of 66 patients (33.3%) a Halsted radical mastectomy was carried out after completion of radiotherapy. No medical treatment was planned. The incidence of locoregional and distant metastases was the same in both groups of patients, but that of patients with smaller T4 (up to 3 cm) demonstrated a better prognosis in terms of absolute survival at 5 years (71.3% vs 34.7%). T4 breast cancer of 3-5 cm had very poor results quite similar to those of historical large series of T4 carcinomas of any size; therefore they should be treated by the same aggressive combined modality approach adopted for locally advanced breast cancer. On the contrary, small T4, up to 3 cm, in older women could be treated by tumorectomy followed by radiotherapy at full doses; systemic medical therapy (hormonal manipulation or chemotherapy) should be decided according to endocrine receptor investigation and general conditions.
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PMID:Small size T4 breast cancer. Natural history and prognosis. 679 58


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