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)

The association of radiotherapy (RT) and chemotherapy (CT) constitutes one of the main avenues for research in therapeutic oncology. This association has two aims: (1) increase in control rate of primary tumor (this requires either the potentiation of one of the two modalities by the other or the additivity of their effect on tumor cells without a parallel increase in the toxic effects on critical normal tissues); (2) spatial cooperation (RT being used for the control of the primary tumor or of the sanctuaries, and CT for the control of the disseminated disease). In these two strategies, RT and CT should be given up to full doses in order to be effective. The main risk is an increase in the number and severity of the early and late side effects. To circumvent this problem, two possibilities are being explored: (1) use of drugs without serious toxic effects on those critical tissues which are included in the irradiated volume; and (2) avoidance of concomitant administration and introduction of a sufficiently long-time gap between the completion of one modality and initiation of the other. However, in such sequential treatment, a delay of CT until after the completion of RT, or an interruption of CT cycle during the course of RT, allows the occult metastases to increase in size; a similar delay in initiation of RT is also detrimental, as drugs are often not effective on bulky tumors. Moreover, under CT, the cells which are resistant to the cytotoxic drugs may disseminate and initiate chemoresistant metastases. Taking these disadvantages into account, a treatment protocol was proposed in 1980 in which CT and RT are given alternately, without undue delay. Chemotherapy is started with the usual scheduling of one cycle every month. Radiotherapy courses are interdigitated between CT cycles. Each course is initiated 1 week after interrupting CT and continued until 1 week before beginning the subsequent cycle of chemotherapy, and so on until completion of RT. Such split-course RT should have an effect on a tumor comparable to that of a conventional fractionation. This protocol has been used on 24 patients with non-Hodgkin's lymphoma (NHL) of diffuse histology, and 63 patients with small cell carcinoma of the lung. The 2-year relapse-free survivals are promising (in clinical stage II NHL of diffuse histology, 75%; and in small cell lung carcinomas, 33%).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Sequencing of drugs and radiation. The integrated alternating regimen. 298 74

The authors describe autopsy cases of primary extranodal non-Hodgkin's lymphoma of the oral regions in 11 (8%) of 134 patients: 10 were clinical stage IE, and one was IIE. Histologic subtypes of each lymphoma included the diffuse large cell type (8 cases), diffuse mixed type (2 cases) and Burkitt's type (1 case) according to the Japanese Lymphoma Study Group (JLSG) classification. All patients received anti-lymphomatous chemotherapy and/or radiotherapy. Nine cases had active disease, 3/9 manifesting leukemia. Nodes were involved. There was involvement of cervical lymph nodes in 7 (64%). Viscera most commonly involved were, in order of decreasing frequency: lung, kidney, pancreas, liver, spleen, heart, gastrointestinal tract, bone marrow, and adrenal gland. It is apparent that primary extranodal non-Hodgkin's lymphomas of the oral region arise in a single focus, and extensions of the disease are not random. The primary lesions spread to regional lymph nodes by way of lymphatic channels, and to extranodal organs of the intrathoracic and intraabdominal regions by contiguous direct invasion of adjacent organs and by blood-borne metastases. Wide spread dissemination at the time of death was found in 6 cases and 3 modes of spreading were observed.
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PMID:Primary extranodal non-Hodgkin's malignant lymphoma of the oral region: analysis of 11 autopsy cases. 311 85

Between 1975 and 1986, the Manchester Lymphoma Group treated 127 patients with localized (Stages I/II) high and intermediate grade non-Hodgkin's lymphoma (NHL) on one of three protocols of combined involved field radiotherapy and chemotherapy. The study included patients with widespread bulky abdominal disease providing there was no apparent spread outside the abdomen and the liver was not involved with metastatic disease. The median duration of follow-up was 70 months. The complete response rate was 86% and the overall 5-year survival was 70%. The 5-year relapse-free survival of the complete responders was 80%. Cox model multivariate analysis showed that bulk disease (greater than 5 cm), low serum albumin and gut involvement were the pretreatment factors associated with shorter survival. When remission status was included in the model the attainment of a complete response was the major determinant of long-term survival but bulk disease and gut involvement were still significant adverse predictors for survival. These factors need to be assessed when analysing results of therapy in NHL and in the design of future treatment strategies.
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PMID:Prognostic factors in stage I and II high and intermediate grade non-Hodgkin's lymphoma. 320 6

A monoclonal antibody, NKI/beteb, was prepared against membranes from a human melanoma metastasis, and in immunoprecipitates of melanoma cell lysates specific 100- and 7-kd glycoproteins were found. The large glycoproteins were also present in conditioned medium of melanoma cell lines. The antigen is located on the inner side of membranes of (pre)melanosomes and premelanosomelike vesicles. The antibody reacted in the immunoperoxidase test on frozen tissue sections with 27 of 28 nevocellular nevi (15/16 common, 12/12 dysplastic), 39/39 primary melanomas (3 intraepidermal, 24 cutaneous, 12 choroidal), 56/63 melanoma metastases, and 4/4 clear-cell sarcomas (melanoma of soft tissue). With sections of formalin-fixed paraffin-embedded tissues, the reaction was less sensitive. No reactivity was detected with frozen sections of 185 other tumors, except for 1 case of non-Hodgkin's lymphoma in which macrophages were positive. With the exception of melanocytes, all frozen sections of adult tissues that were tested were negative with NKI/beteb. On the basis of its tissue distribution so far, the antigen recognized by NKI/beteb seems to be a specific and sensitive diagnostic marker for cells of the melanocyte lineage.
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PMID:A monoclonal antibody specific for cells of the melanocyte lineage. 327 9

The histological diagnosis of non-Hodgkin's lymphoma (Burkitt's lymphoma excluded) in 147 children was reviewed. The most common site of presentation was in the abdomen (32.6%). The most frequent site of metastatic disease at diagnosis was the bone marrow (27.2%). The most common histology was diffuse undifferentiated non-Burkitt type (37.4%). According to the Murphy staging system, 40.1% were stage III and 27.2% were stage IV. In a nonrandomized prospective study, 121 patients were submitted to a treatment regimen (protocol 8001) and compared with 26 historical controls treated with the COP regimen, consisting of cyclophosphamide, vincristine, and prednisone. Of those patients treated with protocol 8001, nine had intestinal perforation at the site of primary disease. All patients in this group were malnourished at the time of perforation. The overall rate of initial complete remission in those patients treated with protocol 8001 was 90.7%. The duration of remission was from 16 to 108 months, with a median of 39 months. The actuarial rate of disease-free survival was 69% at 2 years and 63% at 6 years, compared with 36% at 6 years of the control group (COP) (p less than 0.01). None of the patients have relapsed after 4 years.
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PMID:Treatment of non-Hodgkin's lymphoma in Mexican children. The effectiveness of chemotherapy during malnutrition. 332 20

Eleven population-based cancer registries tabulated second cancers among 133,411 patients diagnosed with testicular cancer, ovarian cancer or Hodgkin's disease between 1945 and 1984. Overall, 3,157 second cancers were observed, as compared with 2,420 expected at least one year after the first cancer. Survivors of testicular and ovarian cancer experienced 30% and 20% more cancers respectively than the general population comparison group, and patients previously diagnosed with Hodgkin's disease had an 80% excess of cancer. No information was available either on treatment for the first cancer, or other risk factors. However, temporal patterns in the risk of specific second cancers were analysed, with particular reference to the possible role of therapy for the first cancer. Leukaemia of the acute or non-lymphatic type, which has been previously linked to alkylating agent therapy, occurred in excess following all 3 first cancers, as did non-Hodgkin's lymphoma (overall relative risks of 6.1 and 1.8 respectively, with considerably higher relative risks following Hodgkin's disease). Other cancers for which important and plausibly therapy-induced excesses occurred were lung cancer following Hodgkin's disease (relative risk 1.9), breast cancer following Hodgkin's disease (relative risk 1.4) and bladder cancer following ovarian cancer and Hodgkin's disease (relative risks 1.7 and 2.2 in women, respectively). Rarer sites at which striking excesses occurred were the salivary gland, thyroid, bone and connective tissue. There were smaller, but clear excesses for cancers of the rectum and colon following ovarian cancer and testicular cancer, skin cancer following Hodgkin's disease, and kidney cancer following ovarian cancer. Overdiagnosis, misclassification of metastases and confounding by other risk factors were all considered as explanations of observed excesses. Nonetheless, it appeared that there are clear excess risks for cancers other than acute leukaemia which must be ascribed to therapy for the first cancer, especially in view of the possible under-reporting in registry material. Case-control studies are under way to provide information on the role of specific aspects of therapy.
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PMID:Second malignancies following testicular cancer, ovarian cancer and Hodgkin's disease: an international collaborative study among cancer registries. 357 May 50

Sixty-two cases of orbital and periorbital palpable neoplasms were analyzed cytologically. The material was obtained by our technique of simply introducing a fine injection needle in the tumor mass without aspiration. Fifty-six of these tumors had a subsequent histologic diagnosis by surgical procedure or biopsy. Forty-nine of the 56 cytologic diagnoses (87%) were concordant with the histologic findings with regard to malignancy and its variety. In three other cases the diagnosis of malignancy was only achieved by surgical procedure or biopsy (5%). In two cases, there were false-malignant results (4%), one corresponding to a meningioma and the other related to a reactive lymphoid hyperplasia. There was one false-benign (2%) result in a case of non-Hodgkin's lymphoma. In one patient, the cytologic material was insufficient for diagnosis (2%). In six other cases, the initial cytologic examination was ultimately confirmed either by biochemical studies or by biopsies of nodal metastases. No orbital hemorrhage was observed after fine-needle sampling. This outpatient technique is highly accurate and permits diagnosis in a few minutes.
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PMID:Cytologic diagnosis of orbital and periorbital palpable tumors using fine-needle sampling without aspiration. 372 Apr 78

True annular malignancies of the small bowel with mucosal destruction and shelflike margins are generally thought to be caused by primary adenocarcinoma. At our institution, 18 annular malignancies were diagnosed radiographically in the small bowel by enteroclysis (16 cases) and conventional small bowel follow-through studies (2 cases) between 1977 and 1984. However, pathologic data revealed only 4 primary adenocarcinomas with 10 metastatic lesions (6 colon cancers, 2 malignant melanomas, 1 lung cancer, and 1 cervical cancer), 2 leiomyosarcomas, 1 non-Hodgkin's lymphoma, and 1 malignant carcinoid tumor. While these lesions may be indistinguishable radiographically, annular carcinomas tended to be short, relatively nonobstructing lesions; annular metastases (except those from malignant melanoma) tended to be highly obstructing lesions with significant narrowing and/or angulation of the bowel. Leiomyosarcomas, lymphoma, and metastases from malignant melanoma tended to be longer lesions with extensive ulceration, wider channels, and little or no evidence of obstruction. Nevertheless, surgical resection or biopsy of the lesion is ultimately required for a definitive diagnosis.
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PMID:Annular malignancies of the small bowel. 379 59

The sonographic findings observed in eight patients with metastatic tumors in the breast were reviewed. Solitary breast nodules were present in four patients; multiple metastases were seen in the other four patients, with bilateral lesions in two of them. A total number of 20 breast masses was appreciated. All lesions had a round or oval shape and hypoechoic, solid echopattern, when compared with the surrounding breast parenchyma. In three patients, they presented with many small medium-level internal echoes while, in the other five patients they were almost anechoic, with only a few low-level echoes within. Regular and well-defined margins were seen in four patients; in the remaining four patients, irregular walls were seen. The posterior walls of the lesions were well defined, and great acoustic attenuation was never seen. In one case, slight acoustic enhancement was present posterior to the lesions from non-Hodgkin's lymphoma. Multiple masses in the same patient always had the same sonographic features. While evaluating a breast mass in a patient with a known malignancy elsewhere in the body, the absence of an acoustic shadow posterior to the lesion may allow the metastatic nature of the disease to be considered as a diagnostic possibility.
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PMID:Metastatic tumors in the breast: sonographic findings. 388 89

Between 1919 and 1981, 16 children with primary cardiac tumors (8 rhabdomyomas, 5 fibromas, 2 myxomas, and 1 rhabdomyosarcoma) and 59 children with secondary tumors of the cardiovascular system were seen at The Hospital for Sick Children in Toronto. Distant metastases in 45 children of the latter group, in descending order of frequency, were from non-Hodgkin's lymphoma, neuroblastoma, soft tissue and bone sarcoma, Wilms' tumor, and hepatoma, and involved the myocardium and pericardium. In the remaining 14 children, tumor thrombi from Wilms' tumor (9 cases), adrenal (2 cases) and hepatocellular carcinoma (2 cases), and endodermal sinus tumor (1 case) extended directly into the great veins and/or cardiac chambers. Children with primary and secondary tumors often present with nonspecific clinical, plain radiographic, electrocardiographic, and M-mode echocardiographic findings. Early recognition, utilizing special diagnostic procedures such as two-dimensional echocardiography, computerized axial tomography, angiocardiography, and inferior venocavography, followed by elective surgical resection of tumor under cardiopulmonary bypass and/or radiation and chemotherapy, offers patients with cardiovascular tumors the best chance of cure.
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PMID:Primary and secondary tumors of childhood involving the heart, pericardium, and great vessels. A report of 75 cases and review of the literature. 401 74


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