Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033036 (APC)
10,214 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Uterine papillary serous carcinoma (UPSC) is an aggressive malignancy that accounts for a disproportionate number of intraabdominal failures among endometrial carcinoma patients. The histologic appearance and tendency toward intraabdominal spread resemble those of papillary serous adenocarcinoma of the ovary. Because approximately 70% of untreated ovarian carcinoma patients respond to platinum-based chemotherapy, it has been suggested that UPSC patients might respond to similar treatment regimens. Twenty patients with UPSC were treated with cisplatin, doxorubicin (Adriamycin), cyclophosphamide (PAC) chemotherapy between January 1982 and December 1989. They included 9 patients with advanced primary disease, 5 with recurrence, and 6 who received PAC as adjuvant therapy. Patients received a mean of five cycles of PAC. Only 2 of 11 patients with measurable disease greater than 2 cm achieved complete clinical responses of 12 and 31 months duration; there were no partial responses. Actuarial 5-year survival for all patients was 23%. The mean progression-free interval was 9 months. Patients with clinical stages I or II disease had a higher survival rate than those with stage III or IV disease (P = 0.003). Survival did not correlate with depth of myometrial invasion (P = 0.81) or size of residual tumor following initial surgery (P = 0.16). Estrogen or progesterone receptors were detected in 10 of 11 tumors tested. Seven of 9 patients tested had elevated serum levels of CA-125 (greater than 35 U/ml). Correlation between CA-125 value and clinical course was demonstrated in 3 of 5 patients who had serial measurements. Of all patients, 3 are currently alive; 1 has documented disease. Moderate to severe toxicity was seen in 14 patients (70%). There was one possible treatment-related death from cardiomyopathy. UPSC, despite its histologic and clinical similarities to ovarian carcinoma, was relatively resistant to PAC chemotherapy in this mixed group of patients.
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PMID:Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC). 152 8

The purpose of this study was to evaluate 5-year survival and 5-year progression-free survival in previously untreated patients with advanced ovarian cancer treated with single-agent melphalan in which very few patients underwent optimal debulking surgery (less than 2 cm residual) as compared with the patients treated with Cisplatin-based chemotherapy in which most patients underwent optimal debulking surgery. Significant increases in 5-year survival and 5-year progression-free survival were noted as we changed from the melphalan trial, in which only 14% underwent optimal debulking surgery, to PAC-H, in which 57% and the PAC trial in which 90%, respectively, underwent optimal debulking surgery. However, for those patients whose tumors were optimally debulked in the three trials, there were no statistically significant differences in median survival, median progression-free survival, 5-year survival, or 5-year progression-free survival in those patients treated with melphalan, PAC-H, or PAC. Without optimal debulking surgery, Cisplatin-based multiagent chemotherapy offered a small survival advantage. These results are similar to that reported by Gruppo Interregionale Cooperativo Oncologico Ginecologia, in which survival curves were identical for all the subgroups of chemotherapy regimens for those patients with residual disease less than 2 cm at the onset of chemotherapy whether they received (1) cyclophosphamide; (2) cyclophosphamide and Adriamycin; (3) cyclophosphamide, Adriamycin, and Cisplatin; (4) cyclophosphamide, Adriamycin, and hexamethylmelamine; (5) Cisplatin and cyclophosphamide; (6) low-dose Cisplatin; (7) high-dose Cisplatin; or (8) carboplatin.
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PMID:Five-year survival for cisplatin-based chemotherapy versus single-agent melphalan in patients with advanced ovarian cancer and optimal debulking surgery. 189 Aug 37

Postoperatively, 13 patients with stage III ovarian cancer received a combination of carboplatin and epirubicin (PE) at 300 and 60 mg/m2 respectively. The results of the 13 patients receiving the PE regimen were retrospectively compared to those of 24 patients who received the conventional PAC schedule (cisplatin, Adriamycin and cyclophosphamide at a dosage of 50, 50 and 750 mg/m2, respectively). All 37 patients had undergone radical debulking surgery including pelvic and paraaortic lymphadenectomy. At 8 months, relapse-free rates of 42.2 and 79.2% were observed in the PE and PAC groups, respectively. This difference was highly significant (p = 0.011). The data suggest that the PE combination has less antineoplastic activity than the PAC schedule and thus cannot be recommended in the adjuvant treatment of advanced ovarian cancer.
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PMID:Efficacy of adjuvant carboplatin-epirubicin chemotherapy in advanced ovarian cancer after radical surgery. 266 87

A) Common epithelial cancer: According to the Japanese statistics on ovarian cancer, the incidence of combined radiotherapy decreased recently from about 30% to about 5% and the combined treatment used is now mainly chemotherapy. The main drug used for combined chemotherapy is cis-DDP, especially PAC (cis-DDP, Adriamycin and Cyclophosphamide) treatment. According to our clinical experience, the survival curve of advanced cases treated with PAC in combination is better than that with former drugs. B) Endodermal sinus tumor (EST): According to our treatment results, 6 patients with EST treated in combination with radiotherapy or previous forms of chemotherapy died within 2 years. However, 4 patients with EST given combined treatment with VAC (Vincristine, Actinomycin D, Cyclophosphamide) or with PVB (cis-DDP, Vinblastine, Bleomycin) were able to survive over 2 years. The Japanese statistics show that the rate of long survival of EST patients treated in combination with VAC or with PVB is about 50%.
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PMID:[Surgery and combined chemotherapy of ovarian cancer]. 372 71

Significant and dramatic progress has been made in the diagnosis and treatment of women with ovarian carcinoma in the last 10 years, the results of which are now just being reflected in an increase in survival and cure rates. In early staged disease (Stage I and II) significant progress has been made concerning our understanding of the sites of subclinical metastasis when at surgery the tumor is clinically limited to the ovary or pelvis. A prospective study of 100 patients with Stages IA to IIB ovarian cancer who underwent restaging within 4 weeks of initial surgery will report this. Moreover, preliminary results of the first randomized therapeutic trials (melphalan versus observation; melphalan versus chromic phosphate [P-32]) in patients surgically staged and found to be Stage IA to IIB carcinoma will be discussed. For Stages IB to III, the 5-year survival rates comparing whole abdominal radiation by the moving strip technique to open field irradiation will be discussed. For advanced (Stage III and IV) ovarian carcinoma, the new techniques in debulking surgery will be illustrated. Finally, the significant progress in response rates, median duration of survival, disease-free survival, and 5-year survival rates made during the past 10 years will be presented. This will be done by comparing a unique group of 117 patients treated with melphalan alone, all of whom have been followed for 5 years or until death, to patients who received cisplatin combination chemotherapy--cyclophosphamide, hexamethylmelamine, Adriamycin (doxorubicin), and cisplatin (CHAD) or cisplatin, Adriamycin, and cyclophosphamide (PAC)--and have now been followed 3.4+ and 4+ years, respectively. What is clearly evident is that in the last decade there has been significant increase in response rates, median duration of survival, 3.4+-, 4+-, and 5-year survival rates and cure rates with the advent of debulking surgery and platinum-containing combination chemotherapy.
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PMID:Ovarian carcinoma. A decade of progress. 638 13

Thirty-nine previously untreated patients with stages III and IV ovarian carcinoma were treated with debulking surgery, followed by alternating combination chemotherapy with cisplatin, Adriamycin (Adria Laboratories, Columbus, Ohio), and cyclophosphamide (PAC); and hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil (HexaCAF). Of 19 patients with measureable disease at the onset of therapy, ten (53%) had at least a partial response to chemotherapy. Seven (18% of total) patients were found to be pathologically free of disease at secondlook surgery, but four patients relapsed 19 to 31 months after initiating therapy. The median progression-free survival period of all 39 patients entered into the study is 12 months, and the median crude survival is 21 months. The PAC/HexaCAF alternating combination chemotherapy regimen may be administered with moderate toxicity, but the treatment results are not superior to those reported for PAC or HexaCAF alone in advanced ovarian carcinoma.
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PMID:Alternating combination chemotherapy for stages III and IV ovarian carcinoma. 651 80

A patient with stage I fallopian tube adenocarcinoma had disease recurrence in both lungs shortly after completing adjuvant therapy with intraperitoneal 32P and parenteral cyclophosphamide. She achieved a complete clinical response to cisplatin, Adriamycin, and cyclophosphamide (PAC) chemotherapy, but was subsequently found to have brain metastasis. The implications of these observations for understanding the natural history and optimal therapy of this disease are discussed.
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PMID:Adenocarcinoma of the fallopian tube: report of a case with an unusual pattern of metastasis and response to combination chemotherapy. 654 33

A retrospective analysis of 42 patients with stage III, IV, or recurrent epithelial ovarian carcinoma treated with monthly cisplatin, Adriamycin, and cyclophosphamide (PAC) was made. Of 36 patients with measurable disease, 18 (50%) achieved a clinical complete response (CR) and 12 (33%) achieved a partial response (PR) for an objective response rate of 83%. Six stage III patients remained without measurable disease after surgery and postoperative PAC and are included in the survival data. The median survival of all patients was 22 months (10 months for nonresponders), with a median duration of response of 15 months (19+ months for clinical complete responders). Of 16 patients who underwent second-look laparotomy while in clinical CR, 8 were pathologically free of disease. Of these 8 surgically staged CRs, 2 have suffered CNS relapses, while the rest remain free of disease. One additional patient, who had been found to have only microscopic disease at the time of second-look surgery, subsequently relapsed in the CNS, for a total of 3 patients with CNS relapse. We conclude that PAC is an effective regimen, but that prolonged survival of these patients may put them at greater risk for CNS relapse.
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PMID:Treatment of advanced ovarian cancer with cisplatin, adriamycin, and cyclophosphamide: effect of treatment and incidence of intracranial metastases. 668 14

The effects of pelvic and periaortic peritoneal closure or (non-closure) on morbidity and adhesion formation were prospectively compared in 102 patients with ovarian cancer who had undergone a pelvic and periaortic lymphadenectomy. Hysterectomy with bilateral salpingoophorectomy, bilateral pelvic and periaortic lymphadenectomy, omentectomy, appendectomy and lysis of pelvic adhesions for the standardization of initial adhesion scores was performed on all patients. The pelvic and periaortic peritoneum were re-approximated in group I (n = 50) patients, and left open in group II (n = 52) patients. The groups were similar for mean age, previous surgery, tumour histology and disease stage. Morbidity characteristics such as blood loss, transfusion rate, post-operative infectious and non-infectious complications, and total hospital stay were also similar. After six courses of PAC (cisplatin 50 mg/m(2), Adriamycin 50 mg/m(2), cyclophosphamide 500 Mg/M(2)) chemotherapy, all patients underwent a second-look laparotomy. Persistent cancer was detected in 49 of 102 (48.03%) patients. Adhesion scores were detected at the time of second-look laparotomy. Adhesion scores for group I (8.9 +/- 2.9) were significantly higher than the group II (peritoneum non-closure) (5.8 +/- 2.3) (P<0.01). Closing the pelvic and periaortic peritoneum did not effect morbidity, but leaving the pelvic and periaortic peritoneum open significantly decreased the adhesion formation.
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PMID:Pelvic and periaortic pertioneal closure or non-closure at lymphadenectomy in ovarian cancer: effects on morbidity and adhesion formation. 865 13

Invasive thymoma recently has been shown to be sensitive to combination chemotherapy and in some cases to be relatively indolent. Two cases of extensive thymoma which responded to primary treatment with a combination of a platinum compound (carboplatin or cisplatin), doxorubicin (Adriamycin), and cyclophosphamide (or PAC) are described. Tumor progression occurred 14 (case 1) and 60 months (case 2) after completion of initial PAC therapy and was treated with the same regimen resulting in a second remission, which lasted 6 months in case 1 and is continuing at 8 months in case 2. Similar reports of secondary responses using the same chemotherapy have been described in breast, lung, and ovarian cancers, as well as in Hodgkin's lymphomas. Our observations suggest that retreatment with the same platinum-based regimen should be considered in patients who have progressive thymomas following a previous chemotherapeutic response and a disease-free interval of greater than 12 months.
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PMID:Retreatment of recurrent invasive thymoma with platinum, doxorubicin, and cyclophosphamide. 926 13


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