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)

A proton beam with the energy of 100-130 Mev, the range up to 40-100 mm and diameter up to 6 cm was used for radiation therapy of breast cancer metastases to the bones adjoining the vital organs or normal tissues with low tolerance (the skull, sternum, ribs, jaw, etc.). Medium fractionation regimens were used for the single doses of 4-10 Gy. The number of fractions was from 1 to 7, the summary dose 17-28 Gy that corresponded to 35-46 Gy of classic fractionation designed by the TDF factor. The first experience of the irradiation of bone metastases has shown that general and local reactions to proton irradiation correspond to a dose delivered and irradiation regimen and do not differ from those in conventional radiation. A marked therapeutic effect was obtained in all the patients. The formation of bigger diameter proton beams and of a deeper range is required for the irradiation of large zones of bone metastases.
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PMID:[Proton irradiation of bone metastases]. 633 Apr 88

Proceeding from the drawing of maps with biologically isoeffective percentage doses the authors provide a dosimetric substantiation of gamma-beam irradiation of different parts of the bony skeleton using the following irradiation scheme: a single dose of 4 Gy, 5-6 fractions daily. It has been shown that to choose a therapeutic plan in the utilization of a nonstandard scheme of fractionation, the calculation of the TDF factor by Orton's tables is safe and illustrative. By way of example are given maps of isoeffective doses used in the irradiation of bone metastases in breast cancer patients with metastases to different parts of the skeleton.
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PMID:[Dosimetric basis of mean fractionation in the irradiation of bone metastases in breast cancer]. 683 53

Epithelioid sarcoma is an uncommon tumor characterized by its appearance in the distal extremities (especially the forearm, wrist, and ankle), the tendency to recur locally, and high probability of spread to regional lymph nodes. Most patients have been treated surgically, and the potential role of radiation therapy alone or combined with surgery is not well defined. The authors treated eight patients with epithelioid sarcoma. Four patients were male; patients ranged in age from 7 to 66 years (median, 54.5). Six patients had upper extremity lesions, and two had lower extremity lesions. Median maximum tumor dimension was 3.0 cm. Three patients had Grade 2 lesions, and the others had grade 3 lesions. Regional lymph nodes were involved initially or during the course of the disease in five of our eight patients (62%). Five patients were treated following surgery for primary or recurrent tumor, with a median dose of 68 Gy (TDF 109). Four were NED with follow-up at 18, 24, and 84 months, respectively, and the other patient failed locally and in regional nodes at 6 months (treated successfully by salvage amputation) and is now living at 96 months with distant metastases. One patient treated pre-amputation with 50 Gy (TDF 81) is NED at 12 months. Two patients received radiation therapy alone, with a median dose of 65 Gy (TDF 104). One patient with a 22-cm primary died with persistent local disease as well as metastases, and the other died with distant metastases but with local control at 18 months. Four patients with local control did not undergo amputation, and all have unimpaired function of the affected extremity. Local control and survival for this group of patients is similar to that for other patients with upper extremity or high grade sarcomas. The authors concluded that radiation combined with surgery achieves a low rate of local recurrence, and a high likelihood of maintaining a functional extremity and good cosmesis.
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PMID:Radiation therapy of epithelioid sarcoma. 688 70

A total of 223 patients with 498 symptomatic osseous metastases treated by radiotherapy between July 1985 and June 1991 were retrospectively analyzed. Most sites, 409 (82%), were irradiated by conventional fractionation, while the remaining 89 sites were irradiated by dose-increment fractionation, low-dose short schedules or hyperfractionation. The total dose ranged from 5.4 to 74 Gy (mean, 41.4 Gy). Daily pain assessment was done by patients themselves on an 11-point scale, i.e., 10: pretreatment pain, 0: disappearance of pain following radiotherapy. In addition, improvement in performance status (PS) and the duration of complete pain relief were assessed. The following results were obtained. 1) Pain relief: Of 498 evaluated sites, complete pain relief and partial pain relief were achieved in 403 sites (81%) and 64 sites (13%), respectively. No significant difference was seen in the incidence of complete pain relief between weight-bearing bone and non-weight-bearing bone. Patients with PS 1, 2 or 3 were significantly superior to those with PS 4 in terms of complete pain relief (P < 0.05-0.001). The complete response rate increased in accordance with the dose delivered, i.e., 49% at 20 Gy, 70% at 30 Gy and 77% at 40 Gy, in all of the 498 sites irradiated; 60%, 86% and 95% of 403 sites, respectively, achieved complete pain relief. Regarding the fractionation regimens, dose-increment fractionation was superior to both conventional fractionation and low-dose short schedules in terms of complete pain relief rate. 2) Improvement of PS: Of 223 evaluated patients, PS was improved 1 to 3 steps in 162 (73%) at the completion of radiotherapy. The improvement rates of patients with PS 2 or 3 were significantly better than those with PS 4 (P < 0.025, 0.001). 3) Duration of complete pain relief: Of 288 appraisable sites, the recurrence of pain was recognized in 23 (9%) at intervals of 3 to 21 months (median, 5 months). On the other hand, the duration of pain relief was 16 to 79 months (median, 32 months) in 26 sites of survivors, and 1 to 28 months (median, 5 months) in 239 sites of decreased patients. The mean total dose was 48.5 Gy (TDF: 82) to 62 sites with a duration of pain relief of more than 13 months. 4) Re-irradiation to the same site: Of 14 sites retreated after initial complete response with a total dose of 30 to 50 Gy (mean, 48 Gy), 11 (79%) were in weight-bearing bone and 9 (64%) responded completely. 5) Patients with unsatisfactory pain relief (pain score > or = 6): Of 31 sites, 27 (94%) were in patients with PS 4, and 19 (61%) received a total dose below 30 Gy. 6) The 11-point scale for patient self-assessment of pain relief following radiotherapy was thought to be useful and easy to adopt in general clinics.
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PMID:[Radiotherapy for symptomatic osseous metastases: special reference to the analysis of patients achieved complete pain relief]. 810 47


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