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

The E.O.R.T.C. Head and Neck Cooperative Group has designed a relatively complex international programme for a multidisciplinary approach to the treatment of NPC. The aim of the programme is to evaluate the usefulness of chemotherapy in preventing metastases and recurrences and, at the same time, to test other chemotherapeutic regimens and to compare them subsequently with the first one. Two contemporaneous controlled trials are foreseen: (1) long-term chemotherapy after radiotherapy for T3-4 No and T1-4 N1-3 MO cases (NPC 1) and (2) aggressive chemotherapy for MI cases and for patients who develop local or regional recurrences during the first trial (NPC 2). A search of the literature and a pilot study carried out at the Istituto Nazionale dei Tumori in Milan on advanced cases of NPC showed the following percentages of regression after various kinds of chemotherapy: cyclophosphamide, 38%; adriamycin, 39%; bleomycin, 28%; and methtrexate, 17%. On this basis, the following regimens were chosen: NPC 1 trial: cyclophosphamide (1.2 g/m2 every three weeks for 10 cycles) and a control group receiving no chemotherapy NPC 2 trial: adriamycin alone versus a combination of vinblastine + bleomycin + adriamycin. The programme was begun a short time ago, and no results are yet available.
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PMID:European Organization for Research on Treatment of Cancer (E.O.R.T.C.). Controlled trials of chemotherapy as an adjuvant or palliative treatment of nasopharyngeal carcinoma. 8 87

In attempts to heterotransplant human NPc into nude mice, using seven cultured cell lines, we have succeeded in growing a carcinoma simplex, composed of Epstein-Barr virus-determined nuclear antigen-positive and Epstein-Barr virus genome-positive cancer cells, at the injected site with two of the cell lines. These originated from a spindle-cell carcinoma (Chinese NPC-204) and from a combined-cell carcinoma (Chinese NPC-501), respectively. During the first few passages, wandering macrophages were prevalent and increased in number in response to the presence of the tumours. In conjunction with a gradual decrease in the number of wandering macrophages in the medullary sinuses, diffuse hyperplasia of lymphocytes occurred in regional lymph nodes. As a result of the release of lymphocytes and macrophages into the peripheral lymph nodes, the spleen underwent extensive change, as manifested by the collapse of the splenic cords and the formation of septa studded with granulomas. Under these conditions of immunosuppression, lymphatic metastases were observed during the periods between the 11th and 14th generations and the 24th and 30th generations with NPC-204 and between the 9th and 14th generations with NPC-501. The neighbouring lymph nodes, like the spleen, were often studded with epithelioid-cell granulomas, formed by the aggregation of macrophages around nuclear debris in the subcortical areas. We assume that the clumps of debris are the remnants of metastatic cancer cells which were probably killed by macrophages or by sensitized lymphocytes. If the lymph nodes contain a barrier of granulomas, they are not invaded by tumour cells from the cortical sinuses, except in the rare case of retrograde metastasis from the hilus. It would appear that macrophages can replace T lymphocytes, which are found in very small numbers in the nude mice used in this study, in killing tumour cells and, furthermore, in protecting the lymph nodes from the spread of metastases. Metastasis cannot occur in these nude mice when their lymphoreticular system, especially that of the spleen, is working in a stable balance.
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PMID:A histopathological study of lymphoid tissue reaction to metastatic nasopharyngeal carcinoma in nude mice. 31 Apr 17

Of 485 cases of NPC collected from the files of our institute between March 1969 and December 1974, 82 (17%) were in children and adolescents (0--19 years old). This relatively high frequency of NPC in young people was not suggested by reports from high-incidence areas (Southern China, for example) but appears to be a characteristic feature of areas of intermediate incidence (Uganda, Kenya, Sudan, Tunisia). NPC is the tumour that occurs most frequently in young people between 1 and 20 years old in Tunisia, showing a peak in those 16 years of age. The male:female sex ratio was 3:1. Advanced stages of the disease occured frequently; no clinical anomalies were noted in this age group. The 'nasopharyngeal' type of carcinoma was the histological form seen most frequently; poorly-differentiated squamous-cell carcinomas were not uncommon; and well-differentiated squamous-cell carcinomas were not seen in this series. The five-year survival rate was 32.5% for children and only 20% for adults. This can perhaps be explained by the fact that the 'nasopharyngeal' type of tumour has a better prognosis than other histological types, and, compared to adults, younger patients more frequently have distant metastases (37%) than local recurrences (18.5%). A paraneoplastic syndrome, consisting of hypertrophic pulmonary osteoarthropathy with occasional generalized lowering of pituitary function, was seen in 12 of the patients. This syndrome has been described only in children, and no cases were found in our series of adult NPC patients. Epidemiological, clinical and histological aspects suggest that NPC in young people is different from that found in adults.
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PMID:Nasopharyngeal carcinoma in children and adolescents in Tunisia: clinical aspects and the paraneoplastic syndrome. 73 Jan 88

Cervical nodal metastasis from occult carcinomas represents a diagnostic challenge. This is a common presentation of undifferentiated nasopharyngeal carcinoma (UNPC), but metastatic carcinomas from other sites must be considered. UNPC has the distinguishing feature of a close association with Epstein-Barr virus (EBV). Since the polymerase chain reaction (PCR) can detect EBV in archival tissues, it offers significant advantages over previous methods for the detection of viral genomes. Its extreme sensitivity allows analysis of small samples from needle aspirates. Using the polymerase chain reaction to amplify EBV sequences from archival tissues, 15 of 18 NPC samples were positive for EBV. Of these 18, 14 of 14 with UNPC were positive, 1 of 2 with squamous cell carcinoma (SCC) were positive, and 10 of 2 with adenocarcinoma were positive. All 6 UNPC metastatic to lymph nodes were positive. Carcinoma metastatic to cervical nodes from 17 of 17 non-UNPC occult primaries lacked EBV. This demonstrates the utility of EBV detection by the polymerase chain reaction in the evaluation of patients with metastases to neck nodes from occult primary carcinomas in order to identify cases of UNPC.
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PMID:Epstein-Barr virus detection in neck metastases by polymerase chain reaction. 131 10

Based on the clinical data of a retrospective study of 659 NPC patients with routine computed tomography of the nasopharyngeal region, a refinement of Ho's stage-classification for NPC is proposed with reduction in the number of overall stages without sacrificing the accuracy in predicting prognosis in the short term. Classifying the cervical lymph nodal metastasis into supraclavicular (Ho's N3) and above supraclavicular (Ho's N1 + N2) and the nasopharyngeal primary into early (Ho's T1 + T2n + T20) and advanced (Ho's T2p + T3 + T3p) forms the conceptual backbone of the present proposed modification of the original Ho stage-classification. Power in predicting the occurrence of distant metastases and the local failures has been enhanced by the proposed T-stage and N-stage re-grouping. Retrospective comparison between Ho's and the UICC stage-classifications showed a more even patients number distribution among the overall stages and a greater power in predicting NPC prognosis for the former. Prospective studies to compare the value of the different stage-classifications are required for recommendation of a single classification for general acceptance to facilitate comparison of treatment results between centres.
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PMID:A proposed modification of the Ho stage-classification for nasopharyngeal carcinoma. 185 15

NPC is unique among head and neck cancers, in that it is radiocurable and moderately chemosensitive. Modern diagnostic techniques have facilitated tumor definition, with consequent improvement in staging accuracy and radiotherapy planning. Our standard radiotherapy technique incorporates routine prophylactic neck irradiation of early tumors. Special techniques for more advanced tumors are described. Neoadjuvant cis-platinum-containing chemotherapy has proved useful in controlling regional and distant metastatic disease.
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PMID:Radiotherapy and chemotherapy for nasopharyngeal carcinoma. 235 Oct 87

Follow up results of residue and regression of metastatic cervical lymph nodes in NPC after radiotherapy are presented. All the 453 cases have been followed for more than five years. According to WHO's criteria, the relative 5 year survival rate was 43.9%. 389 of 453 had had lymph node metastases in the neck at the beginning of treatment. At the end of radiation, immediate regression rate of lymph nodes was 53.2%, which was related to lymph node size before radiotherapy. Five year survival rate of those whose lymph node metastases disappeared completely was 48.8% (group 1). There were 182 cases with residual nodes at the conclusion of radiation (140 recorded in detail). The regression rate of nodes was 96.4% (135/140) and the 5 year survival rate of these 140 patients was 40.0% (group 2). There is no significant difference and the long term results are similar in the two groups. Total recurrence rate in the neck was 4.4%: 5.3% in group 1 and 3.8% in group 2 (P greater than 0.05). The treatment results of the local cervical lesions are the same, too. In 182 cases with residual lesions, 121 with 147 clinically evaluable residual nodes, 0.5 approximately 3 cm in diameter, were followed. The regression time of these residual nodes was 2.5 approximately 2.7 months as to geometric mean (the regressive confidence limit 95%). To sum up, according to the routine cervical target dose, some nodes remaining at the of radiation seem to require no boost dose in order to avoid delayed radiation complications. But the residual nodes which recur during follow up would require a prompt retreatment.
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PMID:[Analysis of residue and regression of metastatic cervical lymph nodes in NPC after radiotherapy]. 344 68

Coronavirus-like particles are found within the cytoplasm of NPC tumor cells, within the cytoplasm of the tumor cells of the regional metastases, and within tumor cells grown on nude mice. For the immunologic identification of the coronaviruses, the cultures of human tracheal epithelium (MRC-C) were used and inoculated with a known coronavirus strain. Whereas blood sera from NPC patients (n = 73) contain significantly elevated antibody titers against corona viruses, unselected sera from patients without NPC showed a low antibody titer (n = 83). Only patients suffering from infectious mononucleosis (n = 40) showed a titer pattern similar to that of NPC patients. For demonstration of antigen-antibody reaction within the NPC tumor cell cytoplasm, sera with a high antibody content against coronaviruses deriving from other than NPC patients or anticoronavirus sera from rabbits were used. By indirect immunofluorescence, the NPC tumor cells showed a bright cytoplasmic fluorescence. No fluorescence was seen when tumor cells were exposed to human sera with known low or absent corona antibody titer or to normal rabbit sera. The results indicate that next to a DNA virus infection (EBV), an RNA virus infection (coronavirus) may play a role in NPC as well as in infectious mononucleosis.
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PMID:Coronavirus-associated antibodies in nasopharyngeal carcinoma and infectious mononucleosis. 626 32

This investigation is to study red marrow dose measurement for the 60Co gamma-ray treatment of nasopharyngeal carcinoma with the aid of Rando phantom. The energy of scattered radiation in space and in tissue was investigated by means of half-value layers with thermoluminescent dosimeters. Other related factors such as field size, SSD, and orientation of primary beams were also investigated. In the non-metastases cases, the red marrow dose is 26 +/- 6 rads which is about 0.40% tumor dose excluding the marrow at the NPC site. For the metastases cases, the red marrow dose is still about 0.40% tumor dose. If the red marrow at the NPC site is included, the red marrow dose is about 14.5% tumor dose for both non-metastases and metastases cases.
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PMID:Red marrow dose measurement in phantom for tele-irradiation of the nasopharynx by cobalt-60 unit. 653 14

Twenty-seven patients (24 men, 3 women; ages: 39-74 years) were diagnosed as having squamous cell carcinoma of the nasopharynx (NPC) as confirmed by pathologic findings of biopsies. In addition, three of the 27 patients had metastases to neck lymph nodes. The results of 2-4-hour SPECT images of the head and neck after intravenous injection of 15-20 mCi of Tc-99m (V) DMSA were compared with normal Tc-99m (V) DMSA images and CT of heads and necks. The results showed that of the 27 NPC cases, none of the patients had a significant uptake of Tc-99m (V) DMSA. However, in the three cases complicated with metastases of neck lymph nodes, the metastatic lesions could be detected by Tc-99m (V) DMSA. Our results challenge previous reports in which carcinomas of the head and neck were detected by Tc-99m (V) DMSA. The tumor-seeking agent Tc-99m (V) DMSA is not a good choice for the detection of NPC among malignancies of the head and neck.
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PMID:The detection of nasopharynx carcinoma in technetium-99m (V) dimercaptosuccinic acid SPECT imaging. 838 92


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