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)

This report compares the results up to 36 months of two sequences of radiotherapy and chemotherapy for small-cell anaplastic carcinoma of the bronchus, of limited extent (defined below). A total of 91 patients were allocated at random to treatment with radiotherapy to the primary site followed by 10 pulses of chemotherapy using cyclophosphamide, methotrexate and CCNU (RC), and 95 to two pulses of the same chemotherapy, followed by radiotherapy, followed by 8 pulses of chemotherapy (CRC). The median survival times were 36 weeks for the RC series and 45 weeks for the CRC series but there was no statistically significant difference in survival (P = 0.9, log-rank test). At 12 months, 32 (35%) of the RC and 38 (40%) of the CRC patients were alive, at 24 months, 8 (9%) and 4 (4%), and at 36 months, 7 (8%) and 1 (1%) respectively. The patients' general condition, grade of activity and respiratory assessment correlated significantly with survival. Of 38 patients reported to be in "excellent" condition at the start of treatment, 6 (16%) were alive at 3 years. Although there was evidence that the onset of metastases was slightly delayed in the CRC series, this difference had disappeared by 12 months.
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PMID:Cytotoxic chemotherapy before and after radiotherapy compared with radiotherapy followed by chemotherapy in the treatment of small-cell carcinoma of the bronchus: the results up to 36 months. 619 81

The antitumor effects of GANU have been examined in a panel of mouse tumors for which data appear to be lacking in the literature. GANU has significant activity against P388 leukemia and TLX5 lymphoma, and also against the solid tumors B16 melanoma and Lewis lung carcinoma; pulmonary metastases of this tumor are particularly sensitive to the effects of GANU. The effects of GANU on TLX5 lymphoma and Lewis lung carcinoma are less pronounced than those of BCNU and CCNU, as already reported for L1210 leukemia. In contrast with other results obtained with this tumor, chlorozotocin has a less pronounced effect than GANU, and virtually none in lung metastases of Lewis lung carcinoma.
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PMID:Antitumor effects of GANU and other nitrosourea derivatives against transplantable leukemias and solid tumors in mice. 622 44

A pregnant woman in the 29th, week of gestation was admitted to the hospital with mediastinal pressure symptoms. A tentative diagnosis of lymphoma was made and the patient was given chemotherapy (vincristine, ciclophosphamide and adriamycin) plus radiotherapy, but no objective response was obtained. During the postoperative period (cesarean section) the patient developed clinical symptoms of muscular paralysis of unknown etiopathogenesis. Biopsy of a cervical lymph node showed histological pattern of tumor of the APUD system (chemodectoma). Multiple metastases appeared in the lungs, bones, brain, heart and ovaries in spite of treatment with various chemotherapeutic agents (vincristine, actinomycin D, CCNU and DTIC). Necropsy revealed the existence of a large tumor of the thymus gland, which histopathologic structure resembles to that of carcinoid. Ultrastructural examination showed abundant granules of neurosecretion confirming an APUD tumor. Cushing-like appearance of the patient was attributed "a posterior" to ACTH released by the tumor. A review ofthe clinical features, endocrine function and anatomical localizations of carcinoid tumors is included.
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PMID:[Carcinoid tumor of the thymus gland with multiple metastases. Report of a case (author's transl)]. 625 95

Studies of patterns of failure and causes of death have been undertaken based upon the WHO histopathologic classification. In a randomized trial of thoracic irradiation +/- chemotherapy (hydroxyurea and CCNU), patterns of failure did not seem to differ by cell type; the largest group was "death without progression." A subsequent clinical trial of thoracic irradiation +/- cranial irradiation permitted a more detailed evaluation. Patients with squamous cell carcinoma had a higher rate of local failure than distant metastasis. Those with small cell carcinoma had a lower local failure rate and a high rate of distant spread. Patients with adenocarcinoma and large cell carcinoma had the lowest local failure rate, but had a high rate of distant metastasis. In 300 consecutive patients with autopsies, 75 percent with squamous carcinoma died of complications of the thoracic tumor and only one-quarter had extrathoracic dissemination; 30 percent with small cell carcinoma died of local tumor complications and 70 percent had carcinomatosis; 40 percent of patients with adenocarcinoma and large cell carcinoma died of intrathoracic complications, and 55 percent had distant metastases. Half the patients with small cell carcinoma, large cell carcinoma, and adenocarcinoma had brain metastases at autopsy. Future clinical trials should emphasize better control of the most common sites of failure.
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PMID:Causes of treatment failure and death in carcinoma of the lung. 627 Sep 19

After stratification for extent of small cell lung cancer, 109 patients were randomized to receive cycles of chemotherapy with cyclophosphamide, doxorubicin, and VP-16-213 [CAVP16 (regimen I)] or to receive CAVP16 to maximum response (minimum of three courses) and then chemotherapy with CCNU, methotrexate, vincristine, and procarbazine (COMP) alternating with CAVP16 (regimen II). A group of patients who achieved complete remission were randomized to receive whole-brain irradiation or to have observation only. Of the 44 patients with limited disease, 28 (64%) achieved a complete remission and 11 (26%) achieved a partial remission. Of the 65 patients with extensive disease, 26 (40%) achieved a complete remission and 28 (46%) achieved a partial remission. There were no significant differences between the regimens in response or survival. The projected median survival times are 14 and 10 months for limited and extensive disease, respectively. Nearly 30% of patients with limited disease will be 2-year, disease-free survivors. Twenty-nine patients were randomized to receive cranial irradiation or observation only; none of the 15 irradiated patients developed cerebral metastases, but five of 14 randomized to observation relapsed in the brain (P = 0.02). One patient died with necropsy evidence of only intracranial disease. The principal hematologic toxic effect was leukopenia. There were 31 febrile episodes (21 infectious) during neutropenia and four toxic deaths. Nonhematologic toxicity was mild. Cranial irradiation in patients who achieve complete remission delays or reduces the incidence of CNS metastases. Although alternating chemotherapy is not beneficial, combination chemotherapy with CAVP16 alone is highly effective treatment modality for small cell.
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PMID:Combination chemotherapy for small cell carcinoma of the lung: continuous versus alternating non-cross-resistant combinations. 627 87

Forty-four patients with central nervous system metastases were treated with combination chemotherapy (adriamycin, VM 26 and CCNU). The best results were obtained in breast adenocarcinoma and small cell lung carcinoma with multiple, small cerebral metastases and without concomitant visceral involvement at other sites. The potential effectiveness of this regimen to prevent cerebral metastases is discussed.
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PMID:Combination chemotherapy for metastatic brain tumors. 627 87

This retrospective study deals with 168 patients with small cell lung cancer (SCLC) who were treated at the NCI March 1973 and July 1977 with intensive chemotherapy. Results showed that 12 per cent of all the patients were disease-free for more than 40 months (25% of the limited disease and 3% of the extended stage disease patients which were treated. Complete remission was essential to prolonged survival. The development of a complete remission was favored by a satisfactory initial general condition, localised disease or presence of only one site of metastatic disease. Initial treatment included the following combinations: cyclophosphamide, methotrexate and CCNU. High doses are necessary. However, above a certain level, the toxicity increased without a corresponding increment in activity. Addition of another association without cross-resistance (vincristine-adriamycine-natulan or VP-16 and isophosphamide) may induce a complete remission in cases where only a partial remission was obtained initially. In limited disease, radiotherapy seemed to prolong disease-free survival. This lead the authors to study the use of initial radiotherapy, at the rate of 40 grays in 3 weeks in 15 fractions, at the same time as chemotherapy. The radiotherapist must take certain precautions in the use of this double treatment: reshaped fields and insertion of a spinal cord block above 2 000 rads. In extended disease, thoracic irradiation seemed to be of no benefit. Pilot studies are not underway using intensive chemotherapy with multiple tumor site irradiation and autologous marrow implants 48 per cent of all patients with SCLC will develop cerebral metastatic disease (44% intracranial, 13% leptomeningeal, 9% epidural). At 30 months, 75 percent of those who did not receive prophylactic irradiation developed cerebral disease whereas only 40 per cent of the patients who received a prophylactic dose of 30 grays developed cerebral disease. Inspite of the indisputable but incomplete local benefit of prophylactic brain irradiation, it did not prolong survival. Important biological studies are underway at the NCI. - Cell clone cultures have been established. These were enhanced by the addition of arginine vasopressive (AVP) and bombesine. These two substances may be considered as markers of APUD system and are secreted by the SCLC. Bombesine has been isolated in all the cultures tested. This possible marker was perhaps responsible for the anorexia and cachexia in these patients. - These cultures have allowed for identification of deletion 3p (14-23) chromosome anomalies in all the samples examined. - In vitro chemotherapy studies of these cultures have been carried out. Their correlation with clinical results were encouraging (100% negative p/n; 75% positive p/n). - Lastly, monoclonal AC have been prepared. Inspite of their imperfect specificity and heterogeneity with regard to tumor cells, their potential advantages were considerable.
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PMID:Experience of the National Cancer Institute (USA) in the treatment and biology of small cell lung cancer. 628 Jul 95

Current strategies for treatment of small cell carcinoma of the lung are based on the concept of the disease as a systemic condition, requiring systemic treatment. Small cell carcinoma is considerably more sensitive to anticancer drugs than other bronchogenic neoplasms. The most widely used agents are cyclophosphamide, adriamycin, vincristine, CCNU, methotrexate, and VP 16-213. The superiority of combination chemotherapy over single drug treatment has been documented in prospective randomized trials. With suitable drug regimens, partial or complete remissions can be achieved in 80-90% of untreated cases, resulting in three- to five-fold prolongation of median survival. Radiotherapy may improve control of intrathoracic disease and reduce the incidence of cerebral metastases but this treatment does not increase median survival. In spite of impressive initial responses, long-term results are disappointing, with a 2-year disease-free survival rate of approximately 5 to 10%. Improvement of treatment results may be expected from the use of sequential combination chemotherapy with drugs administered at maximally tolerated doses. A high intensity of treatment calls for increased attention to supportive measures against infections and other complications. The ultimate role of surgery, brain and/or chest irradiation, and immunotherapy as adjuvants to chemotherapy remains to be defined.
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PMID:Treatment of small cell carcinoma of the lung. 628 35

The results of combined chemotherapy and chemoradiotherapy of 158 patients with small cell lung cancer are presented. Adriamycin was used as one of the components of the induction chemotherapy of 98 out of the 158 patients. Chemoradiotherapy (nitrosomethylurea, methotrexate, CCNU, adriamycin, vincristine, DTIC, radiotherapy) was performed according to 4 schemes and combined chemotherapy (cyclophosphamide, adriamycin, methotrexate, or CCNU, cyclophosphamide, methotrexate plus adriamycin, vincristine, natulan) was performed according to 2 schemes. The total efficacy (complete and partial regression) of the 6 schemes averaged to 80 per cent. The number of patients with complete regression amounted to 29 per cent. Long-term survival for more than 2 years was observed in 17 per cent of the patients. No signs of metastases or relapses for 5 years were recorded in 6 per cent of patients. Adriamycin is one of the most active antitumor drugs in combined chemotherapy and chemoradiotherapy of small cell lung cancer.
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PMID:[Adriamycin in the combined chemotherapy of small-cell lung cancer]. 631 82

Inoperable non- microcellular primary bronchial carcinomas have been reputed up to now to be chemo-resistant. The introduction of Cis-platinum into a polychemotherapy protocol leads to revision of this concept. The authors report the preliminary results of a polychemotherapy protocol (including Cis-platinum, Vindesine, CCNU, Cyclophosphamide) associated, in cases of non- metastasized carcinomas, with radiotherapy to the tumour itself, the mediastinum and the supraclavicular fossae. These results confirmed the value of such chemotherapy in forms with metastases. In localised inoperable forms, conclusions could be reached only on the basis of a randomised comparative trial of chemotherapy + radiotherapy versus radiotherapy alone.
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PMID:[Preliminary results concerning the value of chemotherapy in the treatment of inoperable bronchial carcinoma (excluding small-cell anaplastic carcinoma)]. 637 40


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