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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The palliation of bone pain is a common clinical problem once metastatic prostate cancer has escaped from hormonal control. This retrospective study compares the results of treatment using hemibody irradiation (HBI) at the Royal Marsden Hospital (27 cases) with isotope therapy using the bone-seeking isotope strontium-89 (89Sr) at Southampton General Hospital (51 cases). Prior to analysis patients were matched for potential prognostic factors (performance status, bone scan extent of disease, age, histology and duration of hormone response) to minimize the effect of treatment selection bias. Pain control assessed at 3 months was similar for HBI and matched 89Sr cases, with 63% and 52% respectively showing some benefit. Median survival was similar for these groups at 20 and 21 weeks respectively. The unmatched 89Sr group, which had more favourable prognostic factors, had a better outcome with 96% showing improvement in pain and with a median survival of 59 weeks. Subsequent univariate analysis demonstrated that performance status and extent of disease on bone scan were of overriding importance in determining outcome. Transfusion requirements were higher for the HBI group than for the matched 89Sr group (50% and 25% respectively) but other bone marrow toxicity was similar. Despite routine anti-emetic therapy 37% of patients treated with HBI had some nausea or vomiting. Although expensive, 89Sr appears as effective a treatment option as HBI. Response is most likely with either approach when patients have a good performance status and a limited extent of disease.
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PMID:Palliation of bone metastases in prostate cancer. Hemibody irradiation or strontium-89? 137 17

Twenty-nine patients with metastatic prostate cancer that had progressed following orchiectomy were treated with intravenous epirubicin 90 mg/m2 every 28 days. Their median age was 71 years (range 49-78) and the median Zubrod scale (WHO score) was 1. Two patients had soft tissue lesions, 20 had bone metastases and 7 had both. Tumour response was assessed according to the National Prostatic Cancer Project criteria. Of 29 patients, 11 (38%) achieved a partial remission. The median duration of response was 6 months and the median survival time of all patients was 9 months (range 2-27). It seemed that treatment with epirubicin was not associated with an increase in survival. Toxicity was moderate and consisted of alopecia and mild nausea/vomiting. There was no significant haematological toxicity and no clinical cardiotoxicity. It was concluded that epirubicin was active in hormone-resistant metastatic prostate cancer in approximately 33% of the patients.
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PMID:Phase II study of epirubicin in advanced hormone-resistant prostatic carcinoma. 148 91

Twenty-five patients with advanced prostatic cancer progressing after one course of endocrine treatment entered a phase II study of weekly administration of 30 mg Idarubicin orally. Twenty-two patients were evaluable for response and partial response (PR) was noted in 2 patients and stable disease (NC) in 10 patients. Median survival was 31 weeks and median time to progression was 14 weeks. Twenty-three patients were eligible in a score system combining analgetic consumption and pain reduction measured on a Visual Analogue Scale (VAS) and 30% achieved a subjective response. Fifteen patients fulfilled treatment with the planned dose and 10 patients had dose reduction to a median of 23.8 mg Idarubicin. Haematological toxicity was greater than or equal to grade 3 (WHO) in 20% of the patients. Non-haematological toxicity was dominated by nausea/vomiting with 48% grade 3 (WHO). In conclusion, Idarubicin seems of limited value in the treatment of patients refractory to first line endocrine treatment.
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PMID:Weekly oral idarubicin in advanced prostatic cancer. A phase II study. 162 55

Goserelin acetate implant is a newly approved depot formulation of a luteinizing hormone-releasing hormone (LHRH) agonist indicated for palliation of advanced prostate cancer. LHRH superagonists suppress gonadotropin release from the pituitary gland by causing down-regulation of receptors. The sustained-release dosage form contains goserelin acetate dispersed in a biodegradable copolymer matrix and is designed to release active drug over 28 days. Pharmacokinetic studies have demonstrated that, despite nonzero order release of goserelin from the matrix, goserelin acetate implant maintains serum concentrations of testosterone in the range normally found in castrated men (less than 2 nmol/L) throughout the recommended 28-day dosing interval. Response rates similar to those for orchiectomy and estrogen administration have been demonstrated. Combination therapy with either diethylstilbestrol or flutamide has produced favorable results, although the major advantage appears to be a reduction in the tumor flare seen during the first week of LHRH agonist therapy rather than an increase in response rate or survival. Adverse effects are similar to other LHRH agonists and include tumor flare during the first week of therapy, decreased libido, decreased erectile potency, hot flashes, and gynecomastia. In combination with flutamide, additional adverse effects include diarrhea, nausea, vomiting, and elevated hepatic aminotransferases, all of which can be attributed to flutamide administration. Local reactions are minimal; however, some patients require a local anesthetic before goserelin acetate implant injection. The recommended dose is 3.6 mg administered subcutaneously into the upper abdominal wall every 28 days. The average wholesale cost is approximately +320 per month. Formulary addition is recommended.
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PMID:Goserelin acetate implant: a depot luteinizing hormone-releasing hormone analog for advanced prostate cancer. 183 21

The therapeutic efficacy and safety of various doses of leuprorelin acetate depot were determined in an open, multicentre study of patients with locally advanced or metastatic prostatic cancer (stages C, D1 or D2). Patients were randomly assigned to receive 3.75 mg (30 cases), 7.5 mg (eight cases), 15 mg (eight cases) and 30 mg (one patient) leuprorelin acetate depot administered subcutaneously once every 4 weeks. Of the 43 patients evaluable, two (5%) had complete remission, 23 (53%) partial remission and 13 (30%) patients stable disease. No significant differences were observed in response rates in relation to dose, disease stage or previous hormonal therapy. Disappearance or improvement in bone pain and urinary symptoms occurred in 63% and 79% of cases, respectively. Serum androgen concentrations decreased rapidly and persistently to castration levels, without significant differences for different doses. Treatment was well tolerated with a low incidence of mild side-effects - gynaecomastia (16%), nausea/vomiting (13%) and diarrhoea (2%). It is concluded that 3.75 mg leuprorelin acetate depot given subcutaneously once every 4 weeks is able to produce hormonal effects in all patients, an overall objective response comparable to that obtained using higher doses.
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PMID:Leuprorelin acetate depot in advanced prostatic cancer: a phase II multicentre trial. 210 83

Ten patients with relapsed and hormone-resistant prostate cancer were given intra-arterial infusion with, mainly, cisplatin using the reservoir system. The tip of the indwelling infusion catheter was inserted from the femoral artery into the internal iliac artery or common iliac artery. The opposite end of the infusion catheter was connected to a reservoir implanted subcutaneously at the thigh portion. Combination chemotherapy using methotrexate, adriamycin and cisplatin (MAC therapy) was mainly performed. According to criteria of the Jpn. Assoc. for Cancer Ther., the response rate was 23%, including 3 or PR cases. Regarding the survival rate, the 1-year survival rate was 66.7% and the 2-year rate was 33.3%. Concerning adverse reactions, nausea, vomiting and anorexia were noted in all cases. Stomatitis, leukopenia and thrombocytopenia were also found in 38%. We consider that the IA-MAC therapy is one of the most useful regimen for the treatment of the relapsed and/or hormone-resistant prostate cancer.
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PMID:[Intra-arterial chemotherapy of relapsed and hormone-resistant prostate cancer using reservoir system]. 238 65

Estramustine phosphate, an anti-prostatic cancer agent, was investigated on eleven patients to evaluate the efficacy in a treatment of advanced breast cancers. The daily dose of medication was 840 mg. According to criteria of Japan Society for Cancer Therapy, none was assessed as CR, three as PR, four as NC and PD. The response rate was 27.3%. There was no differences in response rates among estrogen receptor status. A favourable response was observed in postmenopausal patients but no response in premenopausal, as well as a good response in lesions of soft tissue and lung, a poor response in lesions of liver and bone. As to toxicity of estramustine phosphate, gastrointestinal disorders such as nausea, vomiting and diarrhea were noted frequently during the treatment, and a long term administration was not able to perform in premenopausal patients because of vaginal bleeding and discharge, and pain in breast. The estramustine phosphate therapy for advanced breast cancers was regarded as one of modalities for a treatment of postmenopausal patients as a second line therapy. This is the first report in Japan discussing the efficacy of estramustine phosphate for a treatment of breast cancer.
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PMID:[Clinical evaluation of estramustine phosphate in the treatment of patients with advanced breast cancers]. 239 6

The authors reported a case of subdural effusion secondary to dural metastasis of prostatic cancer. A 61-year-old man was referred for headache, vomiting and gait disturbance. He had undergone hormonal therapy for prostatic cancer. He showed a mild left hemiparesis and anemia without bleeding. CT-scan disclosed a multilobular crescent shaped low density area in the right hemisphere. Under the diagnosis of chronic subdural hematoma, burr hole irrigation therapy was performed. Xanthochromic fluid was evacuated from the subdural space, in which no tumor cells were shown to exist. CT-scan on the 21st day disclosed a low density area, which was diagnosed as recurrent chronic subdural effusion. Therefore, craniotomy was performed to evacuate the subdural fluid and to explore the dura mater. Removal of the red hemorrhagic tumor at the dura mater and the fluid was performed. The patient died of heart failure in the 16th month despite complete recovery after the second operation. Histopathological examination of the tumor revealed adenocarcinoma at the outer part of the dura mater and the adjacent skull bone, where capillaries were embolized with tumor cells. However, no tumor cells were found in the subdural fluid. The authors could find in the literature 30 cases of subdural hematoma or effusion secondary to dural metastasis of carcinoma. The pathogenesis of the subdural hematoma in this case might be due to circulatory disturbance at the dura mater brought about by the invasion of the tumor or tumor cells emboli in the capillaries.
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PMID:[A case of subdural effusion secondary to dural metastasis of prostatic cancer: case report]. 239 13

From October 1985 to December 1986, 25 patients with advanced prostatic carcinoma were entered in a phase II trial and were administered fluorouracil (F) 600 mg/m2, on days 1 and 2, doxorubicin (A) 40 mg/m2, on day 1, and cisplatin (P) 90 mg/m2, on day 1, every month. The response was evaluated after three cycles of chemotherapy according to National Prostatic Cancer Project criteria. There were no complete remission, 1 partial remission, 13 stabilizations, 11 progressions. Toxicity was assessed using WHO criteria. Alopecia and vomiting were universal; there were 11 grade 1 anemias, 2 aplasias, and 1 grade 1 renal toxicity. A FAP regimen appears to exert a marginal effect in advanced prostatic carcinoma.
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PMID:Phase II trial of combination chemotherapy with fluorouracil (F), doxorubicin (A), and cisplatin (P) (Fap) in hormonally resistant metastatic prostatic adenocarcinoma. 258 4

We treated 16 patients who had hormone refractory metastatic prostate cancer with 400 mg. ketoconazole orally every 8 hours. None of the patients had an objective response, although 6 (37.5 per cent) had stable disease (2 of whom had a subjective decrease in bone pain). The median duration of stable disease was 6.8 months (range 2 to 12 months) and side effects were seen in 14 patients. Nausea, vomiting or anorexia was noted in 10 patients, rash and pruritus in 2, transient abnormal liver function tests in 1 and transient pulmonary infiltrates in 1. Nine prior studies investigating the use of ketoconazole in hormone refractory metastatic prostate cancer were reviewed. Only 1 complete response was reported. A partial response was noted in 14 per cent of the patients. Most of the patients had stable or progressive disease. High dose ketoconazole as a single agent appears to have limited use in patients who have failed prior systemic therapy.
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PMID:High dose ketoconazole for the treatment of hormone refractory metastatic prostate carcinoma: 16 cases and review of the literature. 265 29


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