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 commonest malignant tumour of the stomach is gastric carcinoma. Although the incidence of this neoplasm has declined worldwide, it still ranks fifth to seventh as a cause of cancer-related deaths in the West where the overall 5-year survival from the disease remains poor and averages 5-10%. The decline in the incidence of gastric cancer during the past 4 decades is largely confined to antral tumours of the intestinal type. During this period an absolute increase in the prevalence of cancers of the upper third of the stomach has been observed. Japan is the only country where the mortality has declined proportionately more than the decreased incidence of the disease. This is attributed to a successful screening programme for the detection of early gastric cancer, better staging and probably more aggressive surgical treatment with an extended lymphadenectomy. The latter remains unproven and is currently being evaluated prospectively in a Medical Research Council trial being conducted in the United Kingdom. Surgical excision remains the mainstay of therapy. To date there has been no firm evidence that peri-operative radiotherapy imparts any therapeutic advantage. Overall survival is not improved by adjuvant combination chemotherapy although the early results of a modified FAM regimen with cisplatin are encouraging in terms of response rates. Gastric carcinoids most frequently arise in patients with pernicious anaemia due to the prolonged hypergastrinaemia. Although they can metastasize, their prognosis is good and resection is indicated even in the presence of deposits. Gastric lymphoma accounts for 0.5-3% of gastric malignancies and is the prototype of malignant lymphomas arising from mucosa associated lymphoid tissue (MALT) present in the gastrointestinal tract and other organs. The majority of these tumours are B-cell lymphomas which are slow growing and tend to remain localized until late in the course of the disease. The various accepted histological classifications are difficult to apply to MALT lymphomas which are nowadays regarded as a distinct entity the prognosis of which is determined more by stage than histological type. They frequently cause diagnostic problems because of their indolent growth characteristics and their close simulation to benign lymphoid infiltrates. In the past, the term "pseudolymphoma" was applied to those extranodal proliferations of lymphoid tissue the nature of which was uncertain. This problem has been resolved by the advent of immunocytochemical and molecular biological techniques such that it is now always possible to distinguish a reactive from a neoplastic lymphoid infiltrate.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Malignant tumours of the stomach. 170 Dec 66

We have evaluated the effect of 5-fluorouracil 600 mg/m2, doxorubicin ('Adriamycin') 40 mg/m2, and Mitomycin-C 4 mg/m2 (FAM) in two groups of patients with adenocarcinoma of the oesophagus, as either a preoperative or primary treatment. Response was assessed by barium swallow, CT scan, and measurement of metastases where present. Toxicity was as reported for FAM in gastric cancer. In the operated group 8 of 22 patients (36%) showed a partial response following two courses of FAM. Resection was completed in 20 patients, with six hospital deaths (30%). Of the 14 patients who were discharged from hospital, 8 have died (median 8 months) and 6 are alive at 12 to 27 months, with known recurrence in 1. In the non-operated group 6 of 17 patients (35%) showed a response, one complete, following one to six (mean 4.2) courses of FAM. Fifteen patients have died (median 5 months), and 2 are alive and free from disease at 12 and 17 months. Neoadjuvant therapy with FAM in adenocarcinoma of the oesophagus offers no advantage over surgery alone, although with inoperable disease FAM may be of use in palliation.
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PMID:A phase II study of 5-fluorouracil, adriamycin and mitomycin-C in adenocarcinoma of the oesophagus. 174 30

Metastasis to the liver was detected in 96 out of 1,825 patients with gastric cancer treated at our department from April 1980 to March 1990, and was respectively found to be synchronous and metachronous in 63 and 33 of the 96 patients. We compared survival durations among these 96 patients according to synchronous or metachronous metastasis by dividing them into the intermittent intra-arterial chemotherapy (FAM) group (18 patients) and non-intra-arterial chemotherapy group (78 patients). In the comparison between the intra-arterial and non-intra-arterial groups, the survival duration was determined to be significantly longer in the intra-arterial group by Wilcoxon generalized test and Cox-Mantel test (p less than 0.01). Among the patients with synchronous metastasis, a significantly longer survival duration was also observed in the intra-arterial group (p less than 0.01). The direct effect of intra-arterial chemotherapy through CT was seen in 56% of the patients in the intra-arterial group. These results indicated the usefulness of FAM hepatic infusion chemotherapy for the treatment of metastasis of gastric cancer to the liver. It is expected that therapeutic results will be much more improved by selecting more effective anticancer drugs in the future.
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PMID:[Hepatic infusion-chemotherapy of liver metastases from stomach cancer--comparative study for intraarterial group and non-intraarterial group]. 188 83

There are few reports about the methods, amounts, and kinds of dosage about intermittent intra-arterial chemotherapy of liver metastases from primal pathological type's squamous cell carcinoma. Because they are less than liver metastases from adenocarcinoma of colon or stomach. Although it is important of other factors about the operative method of primary focus and metastases of the other parts, it is possible that those cases obtained the good prognosis and protected liver failure, if those liver metastases could be controlled well. In our department from January 1987 to December 1989, 9 cases of inoperative liver metastases of squamous cell carcinoma (esophagus: 4 cases, larynx: 3 cases and cervix of uterus 2 cases) were treated of intra-arterial infusion chemotherapy of FAM (5Fu 500 mg/week, ADM 30 mg/4 weeks and MMC 4 mg/2 weeks) and CDDP methods (only CDDP 10 mg/week). Cases of esophagus carcinoma were treated with FAM method. On the CT-scan one of the cases showed the reduction rate of more than 50% and was a Progressive Response (PC), and the SCC tumor marker decreased in 2 cases. However, 2 other cases died of liver failure. Cases of larynx were treated with FAM and CDDP methods. However, on the CT-scan all of the cases showed No Change (NC) nor decrease in SCC. But thinking of prognosis FAM was better than CDDP. Cases of cervix of uterus were treated with the FAM and CDDP methods. FAM was not different than the CDDP in the prognosis and effect.
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PMID:[Study of intermittent intra-arterial infusion chemotherapy in liver metastases from squamous cell carcinoma]. 188 84

From April 1983 to April 1989, 123 cases of liver metastases from colorectal cancer were treated. Forty-three cases underwent hepatic resection. Forty had 5-FU, MMC, and ADM infusion chemotherapy through arterial catheter (FAM i.A.). The remaining had other treatment. In this study, 43 cases of hepatic resection and 32 out of 40 cases of FAM i.A. were evaluated. Thirty-nine of the 43 had major hepatic resection with regional lymph nodes dissection and 4 had partial hepatectomy. Regional lymph-nodes metastases were seen in 5 out of 39 dissected (12.8%). Small liver metastases which could not be diagnosed before or at surgery, were existed in 4 of 15 multiple liver metastases (26.7%). Three-year survival rates, calculates by Kaplan-Meier's method, were 53.5% in all, 57.4% in the solitary, and 42.8% in the multiple metastases. Three-year survival rates of the recurrences were 55% in the extra-hepatic and 24.5% in the hepatic recurrences. FAM i.A. was completed in 32 unresectable liver metastases. Responses of the FAM i.A. were observed in 21/32 (65.6%). Fifty percent survival rates were 11.7 months in all and 22.2 months in 13 cases without extra-hepatic lesions. Considering risk factors (multiple or large solitary metastases, unrecognized small liver metastases, lymph nodes metastases), major anatomic hepatectomy with lymph nodes dissection may be the treatment of choice for liver metastases from colorectal cancer. FAM i.A. had a good local response.
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PMID:[Treatment of liver metastases from colorectal cancer--major hepatic resection and continuous hepatic arterial infusion chemotherapy]. 211 62

The clinical efficacy and indications for Angiotensin II (AT II)-induced hypertension chemotherapy were evaluated as a drug delivery system in 101 patients with advanced carcinoma. The sites of primary tumor studied included stomach (44), pancreas (18), colon (16), esophagus (6), bile duct (4), liver (3), breast (7) and 3 other single organs. Seventy four cases had distant metastases (lymph node (25), liver (29), peritoneum (16), and lung (4)). Additionally, the protocol was used 12 cases as postoperative adjuvant chemotherapy and 15 cases following exploratory laparotomy. The blood pressure was elevated to a level 1.5 times base-line. The regimens used consisted of MMC + ADR (55), FAM (38) and CDDP (8). The dosages administered were MMC 7 mg/m2, ADR 14 mg/m2 and 5-FU 350 mg/m2. The cancer chemotherapy protocol with AT II was repeated for an average of 2.6 cycles with a 2-3 week interval. The drug concentration in tumor tissues was increased 1.7 fold by AT II treatment. The response rate was 15.8% (CR 7 and PR 9), and in those patients with lymph node, liver and peritoneal metastases was 48.0, 6.9 and 6.3%, respectively. The serum levels of tumor markers decreased in 9 patients. Subjective symptoms, such as hoarseness, edema and pain, were improved. The mean survival in patients with distant metastasis who responded was 343 days, and in nonresponders was only 168 days (p less than 0.05). The side effects of this therapy were slight, typically being grade 1 and 2. Thus, the chemotherapeutic agents studied in conjunction with AT II were effective in patients with lymph node metastasis. Additionally, this regimen could be performed safely with minimal side effects.
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PMID:Clinical evaluation of chemotherapy under angiotensin II-induced hypertension in patients with advanced cancer. 213 Jul 94

Ninety-five patients with biopsy proven adenocarcinoma of the pancreas were treated with split course radiation therapy. Fifty-five patients had disease confined to the peripancreatic tissues and lymph nodes. Forty patients had metastatic disease. The intended radiation therapy scheduled consisted of two courses of 25 Gy in 10 fractions each followed by a 3 to 4 week rest period. Depending on the response and the patient's clinical status, another 10 Gy in 5 fractions was administered as a final boost. The median survival in patients with metastatic disease was 3 months and the median survival in patients with localized disease was 8 months. Twenty-seven of the fifty-five patients with localized disease received chemotherapy (5 FU or FAM) combined with radiotherapy. There was no significant difference in median survival between the patients treated with radiation alone and those with combined radiation and chemotherapy. The median survival for patients with localized disease receiving 25, 50, and 60 Gy were 3, 7, and 12 months respectively. After a dose of 50 Gy in 20 fractions, CT scan showed no evidence of tumor in 6%, smaller tumor size in 31%, stable tumor size in 41%, and tumor growth in 22% of patients. The split course radiation therapy was well tolerated and no late complications were detected. The medical and economic advantages of using split course radiation therapy and in using CT scan response to plan boost therapy are discussed.
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PMID:Split course radiation therapy for adenocarcinoma of the pancreas. 245 7

Because of the high rate of response in colorectal liver metastases, intra-arterial chemotherapy was studied in 14 patients with isolated breast cancer liver metastases. After extrahepatic metastasization had been ruled out, a catheter was placed surgically and connected to a cytostatic pump (in two cases) or to a subcutaneous infusion chamber (in 12 cases). Every four to six weeks, the patients with an infusion chamber received a modified FAM treatment (fluorouracil, doxorubicin, mitomycin C) for three days continuously. In 11 out of 14 patients (79%) a clear tumor reduction was observed (duration of remission 11 months). In an average of six cycles of chemotherapy administered, a total of 50% of the patients manifested local side effects (including two cases of toxic hepatitis, one case of biliary sclerosis). Systemic side effects were negligible. Termination of therapy was necessitated by three catheter tip migrations and two thromboses of the hepatic artery. Extrahepatic metastases occurred in six patients. Here, the average latency period between diagnosis of the primary tumor and that of liver metastasis was significantly shorter (x = 9 months) than in the other patients (x = 39 months). Intra-arterial chemotherapy thus represents a therapeutic method which, although complicated, is extremely effective in selected patients with isolated breast cancer liver metastases. A final evaluation must be subject to a randomized comparison with a systemic therapy.
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PMID:[Regional therapy of isolated liver metastases from breast cancer]. 313 53

An infusion chamber was implanted subcutaneously in 18 patients for intravenous systemic treatment and in 20 for intra-arterial treatment of the liver. Intravenous catheters were introduced via the cephalic vein, intra-arterial ones via the gastroduodenal artery, after exclusion of extrahepatic metastases. Six manageable complications were observed during a total implantation time of 102 months for i.v. treatment and usage over 500 days: three temporary occlusions; one infection; two extravasations. The intra-arterial chemotherapy, largely for hepatic metastases of breast carcinoma, was undertaken according to a modified FAM schema (fluorouracil, adriamycin, mitomycin C): It achieved a high response rate with two full and eleven partial remissions. Complications were rare, except for 4 temporary occlusions. Systemic side effects were almost completely absent, local toxicity was low. One problem was the fixation of the needle which connects to the infusion chamber. This was true for both intravenous and intra-arterial treatment.
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PMID:[Continuous intravenous or intra-arterial administration via a subcutaneous implantable infusion chamber. Preliminary clinical experiences with particular reference to intra-arterial chemotherapy]. 369 59

Twenty-three patients with advanced measurable gastric cancer were treated with FAM-chlorozotocin in an attempt to demonstrate improvement in rate and duration of response over FAM (5-fluorouracil, Adriamycin and mitomycin C). Six (26%) partial responses were recorded with a median duration of two months. FAM-chlorozotocin was well tolerated with moderate myelosuppression as the major dose-limiting toxicity; the leukocyte nadir was 3.0 X 10(3)/mm3 (range, 0.9-6.0) and the platelet nadir was 100 X 10(3)/mm3 (range, 45-100). The authors were unable to find significant differences in prognostic factors such as performance status, sites of metastatic disease, intensity of therapy to account for the discrepancy in response rates between FAM (42%) and FAM-chlorozotocin (26%).
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PMID:The effect of sequential addition of the nitrosourea, chlorozotocin, to the FAM combination in advanced gastric cancer. 621 35


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