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

Eighty-two patients underwent curative resection for squamous cell carcinoma of the esophagus. The 5-year actuarial survival rate was 33 per cent. Sixteen of 34 patients who developed secondary nodal metastases of the neck and mediastinum were irradiated with a dose of 40 to 60 Gy over 4 to 6 weeks (81 in average TDF), which probably prolonged the survival.
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PMID:Radiation therapy of secondary nodal metastases in the neck and mediastinum after resection of esophageal carcinoma. 11 40

One hundred patients with inoperable (80) or unresectable (20) bronchogenic carcinoma without evidence of spread beyond the thorax and supraclavicular nodes were planned for radical radiotherapy. Seventy-six patients received continuous irradiation (6000 rads in 30 treatments in 6 weeks, TDF 99) and 24 received split course therapy (2 courses of 2500 rads in 10 treatments with a 3 week break between courses, TDF 88). Forty-three patients had squamous cell carcinoma or adenocarcinoma and were considered to have favorable prognostic factors, while 57 patients had unfavorable prognostic factors: undifferentiated large cell or small cell carcinoma, supraclavicular metastases, SVC obstruction, superior sulcus tumors, or bone erosion in continuity with the tumor. Ninety-two patients completed the planned course of treatment. In patients completing treatment, local control of cancer within the irradiated volume was achieved in 58.5% of continuously irradiated patients and 45.4% of patients receiving split course therapy. Median survival was 1.2 months in patients not completing treatment and 12 months for the patients who completed treatment; 19% of the total group survived 3 years. Median and 3 year survivals of 14 months and 20.4% and of 9 months and 11% were observed for patients treated continuously and by the split course techniques, respectively. Corresponding survival figures for patients with favorable and unfavorable prognostic signs were 21 months and 26%, and 4 months and 11%, respectively. Implications of these data for treatment planning and patient selection for radical radiotherapy in bronchogenic carcinoma are discussed.
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PMID:Radical radiation therapy of advanced lung cancer: evaluation of prognostic factors and results of continuous and split course treatment. 22 98

Effectiveness of radiotherapy and measures for improvement of treatment were examined with regard to cervical cancer, endometrial cancer and ovarian cancer, for (1) adenocarcinoma, (2) metastatic cancer, and (3) cancer in persons of advanced age. I. (1) The prognosis of cervical adenocarcinoma is poor, but radiotherapy in combination with chemotherapy can be expected to be effective for the poorly differentiated type, metastasis to the lymph node, and deep cervical invasion. (2) Radiotherapy has limited effectiveness for endometrial cancer and needs to be employed in combination with chemotherapy for the poorly differentiated type adenocarcinoma, serous adenocarcinoma, deep uterine wall invasion, vascular invasion, and metastasis to the lymph nodes. (3) In regard to cervical cancer and endometrial cancer, identification and computation of the labeling index of S-phase cells by BrdU and examination of the localization and the changes in the appearance of tumor markers and oncogenic products showed radiosensitivity of adenocarcinoma to be poor. (4) For ovarian cancer, whole pelvic irradiation by the moving strip (MS) method in combination with chemotherapy showed satisfactory results for stage I and stage II cancers. For stage III cancers, the results was not satisfactory when the residual tumor was 2 cm or larger in size. Whole pelvic irradiation of 50-TDF or more is necessary in such cases. II. The prognosis in cases of metastasis to multiple pelvic lymph nodes is poor. For such cases, it is desirable to employ paraaortic irradiation in combination with chemotherapy, with consideration of the histologic type and progress of the cancer. III. The prognosis is poor in persons of advanced age of 70 or over.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Significance of radiotherapy in the multidisciplinary treatment of gynecological malignant tumor]. 191 74

Twenty-five patients with gross residual chordoma after partial excision or biopsy were treated by radical radiotherapy at Royal Marsden Hospital between 1952 and 1981. The median duration of freedom from local progression following radiotherapy was 32 months. Twenty-four of the 25 patients (96%) had stabilization or reduction in symptoms. All 19 patients in whom pain was a major symptom had relief. The overall actuarial 5- and 10-year survival rates were 44% and 17%, respectively. The corresponding progression--free survival rates were 33% and 20%. Permanent cure was unusual with any radiotherapy dose, but doses higher than 55 Gy or a TDF of 90 were associated with a statistically significant improvement in duration of local control. Seven of 17 (41%) patients who received greater than 55 Gy had freedom from local progression for 5 or more years compared with only 1 of 8 patients receiving less than 50 Gy. Subtotal excision prior to radiotherapy did not appear to improve median survival or probability of long-term local control. Distant metastases were seen in 16% of the patients, derived entirely from sacrococcygeal lesions, but only half of these caused significant morbidity or death. Local control is obviously the overwhelming problem. High dose, generous volume radiotherapy is advocated.
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PMID:Radiotherapy for chordoma. 245 5

The Radiation Therapy Oncology Group (RTOG) completed a pilot study to test the feasibility of high dose of radiation therapy and its impact on tumor control and survival. From April 1, 1983 through May 1985, a total of 56 patients were treated on this protocol. All patients had locally advanced disease without distant metastases. The treatment regimen consisted of delivering 7500 cGy in 28 fractions over 5.5 weeks to the tumor, while the nodal bearing areas received 5040 cGy in the same period (daily dose to the mediastinum was 180 cGy; daily dose to gross tumor was 268 cGy). This is a considerably higher dose, with a TDF of 142 compared with a TDF of 92 (conventional fractionation of 6000 cGy in 6 weeks), which is the highest dose used in previous RTOG studies. Doses in this protocol (7500 cGy) was corrected for lung transmission whereas doses in prior RTOG protocols (6000 cGy) were uncorrected. Thus, after correction dose of 6600 cGy was calculated and coded for comparison. All short-term toxicities were acceptable, and the only major toxicity was one third-degree esophagitis in a patient with a follow-up of 12 months. Forty-four out of fifty-six patients received prescribed dose of irradiation. There were 17 complete responders and 15 partial responders, with an overall response rate of 32 out of 44 (72.7%). At the time of this report, there were 9 patients alive (NED); 5 died without tumor; and the remainder died of tumor or unknown.
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PMID:Phase I/II study of treatment of locally advanced (T3T4) non-oat cell lung cancer with high dose radiotherapy (rapid fractionation): Radiation Therapy Oncology Group Study. 284 77

125I has an energy of 27-35 keV which permits highly effective screening and makes it eminently suitable for treating ophthalmic tumours. It was first used for this in 1974 (Sealy et al., 1976), and since then a flexible system has been developed to treat a variety of such tumours including localized retinoblastoma. A gold foil backed plaque is custom built to cover the tumour(s). The turned edges reduce the dose and thus protect vital adjacent structures such as the optic nerve and lens. The iodine seeds are sealed in the plaque in a predetermined position to give the required dose. A range of doses and times have been used but the authors now aim to give a TDF of 100 to the apex of the tumour in two to three days. Ten tumours in the remaining eye of seven patients with bilateral retinoblastoma were treated. The size ranged from 3 X 3 X 2 to 10 X 10 X 6 mm. There were nine complete responses from 17-90 months and a partial response in one patient who died of metastases at ten months. Vision was maintained in all. Eight recurrent tumours in seven patients were also treated together with a subsequent new tumour in one of the patients. There were three complete responses at 28-39 months and six tumours persisted. Vision was maintained in three of seven patients. The only complication was a vitreous haemorrhage which was mild in two patients, moderate in one patient and severe in three previously treated patients. These latter three patients subsequently had the eye enucleated and were found to have recurrent tumour.
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PMID:The use of iodine-125 plaques in the treatment of retinoblastoma. 365 43

Patients who are at risk for developing an orbital recurrence after enucleation of the eye for retinoblastoma are those with full thickness choroidal invasion or further extension into the sclera or extension into the optic nerve beyond the lamina cribrosa. The authors have treated these patients routinely with external irradiation to the orbit but this usually resulted in a dry contracted socket that often would not accept a prosthesis. An orbital implant was designed with 125I seeds in an attempt to improve the cosmetic result. It consisted of seven rows of 125I seeds, six of which were partially screened and implanted around the periphery of the orbit so that the contents were irradiated whilst reducing the dose to the bony orbit. The seventh central row was unscreened. A metal disc, with 125I seeds sealed to the posterior surface, was sutured beneath the eyelids thus protecting them and the accessory lacrimal glands. A TDF of 90-100 over two to three days was given. Thirteen patients have been treated, nine prophylactically and four therapeutically. Three of the latter patients have died of metastases but no local recurrences have been seen. All 13 patients were left with a moist socket that accepted a prosthesis.
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PMID:Improved cosmesis in retinoblastoma patients treated with iodine-125 orbital irradiation. 365 44

Fifty patients with small cell lung cancer were treated by radiotherapy mainly with maintenance chemotherapy. Relative survival for all cases combined was 34.6% for one year, 5.9% for three years, and 6.6% for five years; in the curative irradiation group, the corresponding figures were 72.2%, 12.5% and 13.6%. The cause of death in the palliative group was local lesion in 32% and multiple metastases in 43%. But in the curative irradiation group, it was local lesion in 22% and multiple metastases in 56%. Long-term survivors more than two years were all in the curative irradiation group, of the intermediate cell type and almost all had received over 50 Gy total dose, over 80 for TDF, within a two-month treatment period.
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PMID:[Problems in the treatment of small cell lung cancer from the standpoint of the cause of death]. 609 46

From 1965 to 1980, 35 patients were treated by radiation for palliation of symptoms related to metastatic renal cell carcinoma. The male:female ratio was 1.9:1. Eighty-six percent (30/35) of the patients were over 40 years of age at initial presentation. Sixty-three percent (22/35) of the patients showed symptoms of metastatic disease within three years of diagnosis of the primary malignancy. Sixty sites were irradiated in the 35 patients: 36 sites of metastatic bone pain, 14 obstructing and/or palpable masses, and ten sites treated for symptoms due to central nervous system (CNS) metastases. Efficacy of treatment was assessed at serial follow-up visits beginning one month after completion of radiotherapy. Bone pain responded at 77% of the treated sites. Mass effect responded in 64%. Disappointing results were obtained with CNS metastases. There was only a 30% response of brain and spinal cord lesions within the dose range that these patients were treated. No correlation between TDF equivalent dose of radiation administered and frequency of palliative response was found. In those sites where a response of bone pain to radiation was observed, 86% of the responses lasted the remainder of the patient's life. No correlation was found between TDF equivalent dose of radiation administered and duration of response. Radiation may be a useful palliative tool for bone pain and mass effect from metastatic renal cell carcinoma. Inordinately high doses need not be used to achieve the desired effect.
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PMID:The role of radiation therapy in the management of metastatic renal cell carcinoma. 618 7

The results of radiotherapy in the treatment of primary lung cancer is presented with reference to metastases in regional lymph nodes. The study involved 382 patients with histologically proven lung cancer of all cell types who, between 1945 and 1955, initially underwent definitive radiotherapy with TDF's of more than 70. The evaluable patients comprised 66 for N0, 177 for N1 and 139 for N2. Cumulative five-year survival rates for N0, N1 and N2 were 23.9%, 6.1% and 5.6%, respectively. Although surgical treatment before radiotherapy did not significantly improve a cumulative five-year survival rate for each N category, it kept patients alive longer for the median survival time (month). In 89 patients with involved mediastinal lymph nodes that specific sites were identified at the time of the surgical treatment (pN2), prolonged survival was obtained by radiotherapy if lymphatic spread was absent in the sites of #1, #2, #3, #5 and #6. If present, however, none of patients were alive at the post-treatment time of three years. As to 155 patients with stage III disease comprising T3 and/or N2, both cumulative five-year survival rate and median survival time showed better results in the group of N2 disease than those in T3.
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PMID:[Results of radiotherapy of primary lung cancer with reference to metastases in regional lymph nodes]. 630 94


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