Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chemoembolization has become the preferred treatment for patients with inoperable, hypervascular hepatic malignancies in the Far East, but controversial elsewhere. In vivo microscopy in addition to other experimental procedures are used in this presentation to better understand the mechanisms involved in chemoembolization. In chemoembolization Lipiodol acts as a contrast material, a vehicle for chemotherapy and an embolic agent. Although not optimal, Lipiodol injected into the hepatic artery, traverses the peribiliary plexus to the portal veins resulting in a dual embolization. Chemoembolization creates ischemia, slows arterial flow and increases the contact time between the infusate and the neoplasms, increasing the tumor cell kill. However, the vascular occlusion also produces infarction and fibrosis compounding the already existing cirrhosis frequently associated with hepatocellular carcinoma. Lipiodol/ethanol (3:1) injected into the segmental or lobar hepatic artery supplying the neoplasm also gains access to the associated portal venous branches causing focal ablation. This preoperative approach is easier to perform than direct portal vein occlusion, with less parenchymal damage and comparable hypertrophy of the remnant liver frequently necessary for adequate hepatic function following resection. Polymer-drug conjugates, e.g. PG-TXL, have considerable potential for intra-arterial delivery especially with the dramatic increase in concentration of the drug in the tumor and its efficacy. Using in vivo microscopy especially with green fluorescent protein (GFP) gene as an efficient and non-toxic tumor cell marker, the events leading to hepatic metastases can be documented which will serve to better evaluate these varied techniques of chemoembolization.
 ...
PMID:Hepatic chemoembolization: clinical and experimental correlation. 1092 54

We used paclitaxel to successfully treat a patient with small-cell lung cancer resistant to multiple drugs. The patient was diagnosed with small-cell lung cancer (cT4N2M1, extensive disease) and initially treated with CDDP 80 mg/m2 (day 1) + etoposide 100 mg/m2 (day 1-3) from August 1996 (4 courses). A partial response (PR) was obtained, but there was a gradual regrowth in the primary site after 17 months. The next chemotherapy was weekly chemotherapy (CODE regimen) from May 1998 for 5 weeks, but the response was no change (NC). After the therapy, a regrowth of the primary site was observed, and a CT scan demonstrated multiple metastases of the lung and liver. From March 1999, he was administered the next chemotherapy regimen of carboplatin (CBDCA) 350 mg/m2 (day 1) + etoposide 100 mg/m2 (day 1-3) (2 courses). However, the response was NC again. From August 1999, we changed the chemotherapy regimen and administered CBDCA AUC 5 (day 1) + paclitaxel (TXL) 175 mg/m2, (day 1, 3-hour-infusion) (1 course). A chest radiograph showed an extreme shrinkage of the primary and metastatic sites. A PR was obtained, but Grade 4 neutropenia and thrombocytepenia were observed with this therapy. Thus, he was treated with TXL alone (100 mg/m2, day 1, 1-hour-infusion) in the next course. After this therapy, a chest radiograph showed a more extreme shrinkage of the primary and metastatic sites. It is suggested that combination chemotherapy using TXL is effective in the treatment of a patient with small-cell lung cancer resistant to multiple drugs.
 ...
PMID:[Effective combination chemotherapy using paclitaxel in the treatment of a small-cell lung cancer patient resistant to multiple drugs]. 1168 Dec 53

The patient was a 55-year-old woman who had unresectable advanced gastric cancer with celiac lymph node metastases and invasion of pancreas. The lesions were considered surgically incurable, so she was placed on neoadjuvant chemotherapy consisting of TS-1 and low-dose CDDP, for a total of 3 courses of TS-1 (100 mg/day, 12 weeks) and 2 courses of low-dose CDDP (10 mg/day, 100 mg). The only side effect of this chemotherapy was light anorexia, and the patient maintained a good QOL. After chemotherapy, the tumor had decreased partially in size, but there was little change in the abdominal lymph node metastases. She was considered to have little response and underwent palliative distal gastrectomy, because of the incomplete dissection of abdominal lymph node metastases. After the operation, she was treated with 2 courses of TS-1 100 mg/day (3 weeks administration and 2 weeks rest) and CDDP 70 mg or 50 mg/body (day 8). She had grade 3 anorexia. After discharge, she was treated by combined therapy of TS-1 100 mg/day (2 weeks administration and 2 weeks rest) and TXL 60 mg/body (day 1, 8, 15). After 2 courses of TS-1/TXL therapy, the abdominal lymph node metastases had decreased in size and the tumor markers were reduced remarkably: CEA 146.1-->26.9 ng/ml, and CA19-9,351.5-->210.6 U/ml. The patient received 5 courses of TS-1/TXL therapy, and she had no trouble with side effects. She maintained a good QOL. TS-1/TXL therapy was associated with few adverse events in hospital visits, and thought to be an effective adjuvant chemotherapy against advanced gastric cancer.
 ...
PMID:[A case of advanced gastric cancer with invasion of pancreas effectively treated by combined chemotherapy of TS-1 and paclitaxel (TXL)]. 1235 52

A 70-year-old male complained of pain in the left neck. A tumor of about 8 cm in diameter was detected by contrast CT in the region extending from the anterior to upper mediastinum. For definitive diagnosis, biopsy was performed under CT guidance, and the patient was diagnosed as having anaplastic carcinoma in the thymus (T4, N1, M0, stage IVb). Since surgical treatment was judged to be impossible because of infiltration into large blood vessels, the patient underwent chemotherapy by intra-arterial injection (CDDP, ADM) and radiotherapy (45 Gy), and obtained a CR. Metastasis to the spleen was detected during the follow-up period, but a CR was obtained by chemotherapy by intra-arterial injection (CDDP) and systemic chemotherapy (TXL). Generally, the prognosis for carcinoma in the thymus is poor, and the prognosis for anaplastic carcinoma in the thymus is considered especially poor. However, chemotherapy by intra-arterial injection of carcinostatics such as CDDP can be applied to patients in whom surgical treatment is impossible.
 ...
PMID:[A case of thymic carcinoma responded to intra-arterial chemotherapy combined with radiation therapy]. 1246 97

We report a case in which lung adenocarcinoma with multiple pulmonary metastases was completely responsive to combination chemotherapy with carboplatin (CBDCA) and weekly paclitaxel (TXL). CBDCA AUC = 5 (day 1) and TXL 75 mg/m2 (day 1, 8, 15) were infused over 1 hour after short premedication on an outpatient basis. Administration was continued for 3 weeks followed by 1 week rest. The patient was a 54-year-old woman who suffered from lung adenocarcinoma with mediastinal lymph node metastases, stage III A, and underwent complete resection. However, multiple pulmonary metastases were found 3 years after operation. On an outpatient treatment, she was treated with CBDCA combined with weekly TXL for 6 cycles. The multiple pulmonary metastases had completely disappeared after 2 cycles and CEA decreased to within normal limit after 5 cycles. The toxic events were anemia (grade 2), leucocytopenia (grade 2) and alopecia (grade 3). No major adverse effects such as hypersensitivity reaction or peripheral neuropathy were observed.
 ...
PMID:[Lung adenocarcinoma with multiple pulmonary metastases completely responsive to combination chemotherapy with carboplatin and weekly paclitaxel--a case report]. 1451 12

The patient was a 73-year-old man with unresectable advanced gastric cancer and celiac and supraclavicular lymph node metastases. Neoadjuvant chemotherapy consisting of paclitaxel (TXL) and CDDP was administered. TXL (80 mg/m2) and CDDP (25 mg/m2) was administered weekly on day 1, 8 and 15 as 1 cycle. After 4 cycles of TXL/CDDP administration, the lymph node metastases and gastric tumor had decreased almost completely in size and distal partial gastrectomy was performed. After surgery, the patient was treated with 4 courses of TXL/CDDP and has survived without recurrence to the present. TXL/CDDP is associated with few adverse events in hospital visits, and is thought to be an effective chemotherapy against advanced gastric cancer.
 ...
PMID:[A case of advanced gastric cancer effectively treated by combined chemotherapy of paclitaxel (TXL) and CDDP]. 1511 4

With the availability of new chemotherapeutic agents such as S-1 and paclitaxel (TXL) for advanced gastric cancer, the development of a strategy for a third-line chemotherapy is urgently needed. We treated a patient with recurrent gastric cancer using TXL, irinotecan hydrochloride (CPT-11) and cisplatin (CDDP) as a third-line chemotherapy. The patient was a 46-year-old man who had undergone total gastrectomy for advanced gastric cancer with lymph node metastases. For postoperative recurrence, he was first treated with S-1 as an outpatient; however, tumor markers increased, and para-aortic lymph node metastasis was revealed by thoracic and abdominal CT scan. A second-line therapy with weekly TXL and CDDP was then added, but resulted in PD. Therefore, combination chemotherapy with TXL, CPT-11 and CDDP was started biweekly as a third-line chemotherapy. TXL (80mg/m2) was infused over 1 hour after short premedication, followed by CPT-11 (25mg/m2) and CDDP (15mg/m2) over 30 min. After 6 courses of this therapy, the serum AFP and TPA returned to normal, and the size of the metastatic para-aortic lymph nodes reduced. The effect of this therapy was judged as PR and the toxicity of this regimen was tolerable. The patient has undergone 10 courses of this therapy and is maintaining a clinical PR. The patient was able to resume his full social activities. TXL, CPT-11 and CDDP combination chemotherapy may be useful and safe for patients with recurrent gastric cancer, even after first-or second-line therapy with S-1 or taxanes.
 ...
PMID:Third-line chemotherapy with paclitaxel, irinotecan hydrochloride and cisplatin for recurrent gastric cancer: a case report. 1578 61