Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149925 (small cell lung cancer)
 6,491 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Etoposide has been used in the treatment of a wide variety of neoplasms, including small cell lung cancer. Kaposi's sarcoma, testicular cancer, acute leukemia, and lymphoma. Its current therapeutic use is limited by myelosuppression, particularly neutropenia. Pharmacodynamic studies of etoposide show that this toxicity can be modeled using a modified Hill equation, and that the dose intensity of etoposide can be successfully increased by adaptive control using this model. Significant influences on the degree of myelosuppression include pretreatment leukocyte count, performance status, extent of prior erythrocyte transfusions, and serum albumin level. In the past 5 years, interest has developed in a distinct subset of acute nonlymphocytic leukemia that is associated with prior exposure to etoposide. This syndrome has been described in several studies, and is characterized by the lack of a preleukemic phase, M4 or M5 morphology, and distinct translocations involving the chromosome 11q23 region.
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PMID:New perspectives on the toxicity of etoposide. 149 30

A 48-year-old man with small cell lung cancer developed ARDS, and massive pulmonary edema fluid was obtained with the fiberoptic bronchoscopy. The pulmonary edema fluid to serum ratios of total protein and albumin were 0.72 and 0.85 respectively. The ratio of LDH was higher (2.71), while that of cholesterol was lower (0.11) than that of total protein. Simultaneously, isopropyl N [I-123] p iodoamphetamine (I-123 IMP) and I-131 human serum albumin (I-131 HSA) were injected into this patient. Samples of blood and pulmonary edema fluid were collected to measure the clearance through the pulmonary microvasculature. The time activity curves of I-123 IMP and I-131 HSA in his blood samples revealed almost constant radioactivity from 5 minutes to 120 minutes after injection, while both radioactivity levels in pulmonary edema fluid samples increased with time. The clearance ratio of I-123 IMP to I-131 HSA was constant at each sampling time (mean +/- SD, 1.51 +/- 0.32). The linear correlation between I-123 IMP clearance and I-131 HSA clearance (r = 0.95, p less than 0.01) suggested that the clearance ratio of exudative plasma components may remain unchanged even if pulmonary microvasculature permeability has changed.
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PMID:[Assessment of the permeability of the pulmonary microvasculature using radiotracers in a case of adult respiratory distress syndrome]. 185 5

We thought that nutritional parameters in laboratory data might be able to express quality of life (QOL). Therefore, in 70 patients with malignant chest diseases (NSCLC, 42 patients; SCLC, 15; lung metastasis, 7; others, 6), the correlation between nutritional parameters of total protein (Tp), serum albumin (Alb), and serum (cholinesterase (ChE] and Karnofsky Performance Status scale (KPS) was investigated. Then, in 24 patients with them (NSCLC, 12; SCLC, 6; lung metastasis, 4; others 2), Alb and ChE were compared to the EORTC Core Quality of Life Questionnaire and Lung Cancer-Specific Questionnaire Module (QS). Results were as follows: 1) KPS and nutritional parameters correlated (Tp. r = 0.55, p less than 0.001; Alb, r = 0.60, p less than 0.001, ChE, r = 0.60; p less than 0.001). 2) The cores for Functional Status (FS) and Disease and Treatment-related symptoms (Sym) in QS and parameters of Alb and ChE correlate (FS v.s. Alb, p less than 0.01; Sym v.s. Alb, p less than 0.01; FS v.s. ChE, p less than 0.05; and Sym v.s. ChE, p less than 0.05). Moreover, the scores of Psychological Distress in QS and Alb showed a correlation (p less than 0.05). It is considered that nutrition and part of QOL (KPS and FS + Sym in QS, that is to say, "objective" functional activity and "subjective" functional activity and symptoms) correlate, and that nutritional parameters are useful to evaluate QOL.
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PMID:[Quality of life (QOL) and nutrition]. 202 88

During a clinical trial of duration of chemotherapy in small cell lung cancer (SCLC), 71 of 610 patients (11.6%) died in the first 3 weeks. Chemotherapy consisted of cyclophosphamide 1 g m-2 i.v. day 1, etoposide 100 mg t.d.s. orally days 1-3, vincristine 2 mg i.v. day 1. The time of death was found to be nonrandomly distributed within the first chemotherapy cycle, with a peak incidence between days 7 and 12 after chemotherapy. Patients were matched with controls who were the next cases entered into the study who did not die in the first 3 weeks. Patients dying early were more likely to have clinical hepatomegaly (P less than 0.0001), and ECOG score greater than or equal to 1 (P less than 0.00001). As a group these patients also had a higher alkaline phosphatase (P less than 0.0002), an elevated blood urea (P less than 0.00001) and a lower serum albumin (P less than 0.0001) than controls. It is probable that infection contributes to the death of these already ill patients at a time when the blood count is low. Early deaths have been noted in two other large trials using regimens including etoposide. Prophylactic antibiotics or dosage modification may prevent the early death of these high risk patients.
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PMID:Patients at risk of chemotherapy-associated toxicity in small cell lung cancer. 254 22

Conventional staging in small cell lung cancer (SCLC) is only of limited prognostic value and is often based on elaborate investigations. We have carried out univariate and multivariate analysis of possible prognostic factors at presentation in 333 consecutive patients with SCLC. Fifteen parameters were found to have individual prognostic significance, of which the most powerful were serum albumin, bone marrow aspirate, disease extent and performance status (all P less than 0.00005). Factors which were not of prognostic significance included age, sex, SVC obstruction, and pleural involvement. Multivariate analysis excluded many factors including bone marrow aspirate as not being independently variable, and a simple combination of clinical performance status, serum albumin and alanine transaminase could be used to define 3 groups (good; medium; poor) of better prognostic significance (survival at 1 year 50% vs. 27% vs. 3%) than conventional limited/extensive disease staging (1 year survival 48% vs. 18%). Other simple combinations of biochemical parameters including plasma sodium and alkaline phosphatase achieved almost as good prognostic groupings. We suggest that consideration should be given to replacing the conventional limited/extensive disease staging system with a simpler system along the lines we have described.
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PMID:Prognostic factors in small cell lung cancer: a simple prognostic index is better than conventional staging. 282 70

Seventy-seven prognostic factors influencing survival time in patients with unresectable lung cancer treated from 1964 to 1983 at Aichi Cancer Center Hospital were analyzed using univariate analysis by log rank test and multivariate analysis by proportional hazard model of Cox. Statistical significance using univariate analysis was identified in 19 factors in small cell lung cancer patients, and in 40 factors in non-small cell lung cancer patients. The string prognostic factors determined by multivariate analysis were, in the order of importance, serum LDH level, chest pain, peripheral lymphocyte count, bone marrow metastasis, brain metastasis, age, and performance status in small cell lung cancer patients. These 7 factors had a p value of less than 0.01. On the other hand, they were the number of metastatic sites, performance status, serum albumin level, serum LDH level, sex, BUN level, N category according to TNM staging system in non-small cell lung cancer patients, with a p value of less than 0.001. The most important prognostic factors were serum LDH level in small cell lung cancer, and the number of metastatic sites and performance status in non-small cell lung cancer. A metastasis to bone marrow or brain was a more important prognostic factor than overall M category in small cell lung cancer patients, and the number of metastatic sites rather than clinical stage classification or TNM staging system in non-small cell lung cancer patients with respect to staging system. Accurate evaluation of the treatment results in unresectable lung cancer patients must take the strong prognostic factors into account.
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PMID:[Prognostic factors in unresectable lung cancer]. 284 34

The pre-treatment serum levels of neuron-specific enolase (NSE), phosphohexose isomerase (PHI) and circulating immune complexes (CC) as tumour markers were compared to measurements of standard haematology and biochemical indices in 73 patients with lung cancer, as an aid to differentiation of tumour type, estimating disease extent, predicting response to therapy and prognosis. Elevated NSE greater than or equal to 12.5 ng ml-1, PHI greater than or equal to 55 mgl-1 levels were observed in 55% of cases for NSE, 90% for PHI and 49% for CC. NSE was significantly elevated in 61% (25/41) of patients with SCLC (P less than 0.005) compared to 41% (13/32) with NSCLC. CC levels were significantly raised in 72% (23/32) of patients with NSCLC (P less than 0.05) compared to 32% with SCLC. The levels of NSE and PHI were not related to tumour stage but CC was significantly raised in limited compared to extensive disease in SCLC (P less than 0.05). Serum albumin was significantly lower in NSCLC compared to SCLC, and median values of alkaline phosphatase, gamma-glutamyltranspeptidase and aminoaspartate transferase were significantly higher in patients with extensive disease. The pre-treatment serum values of NSE, PHI, and CC did not predict the response to therapy or prognosis in the 73 patients with lung cancer. The most important prognostic factor was the number of abnormal routine laboratory parameters (greater than 4) in this group of patients.
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PMID:The value of tumour markers in lung cancer. 290 54

During a randomized trial of total parenteral nutrition (TPN) in patients with small cell lung cancer, we evaluated the short- and long-term effects of 4 weeks of TPN on nutritional assessment parameters. All 119 patients who were accrued to the study received the same chemotherapy and radiotherapy protocol which extended over a 1-year period: 57 patients received TPN; and 62 served as controls. At base line, patients with greater than 5% pretreatment weight loss had significantly lower levels of serum albumin, total iron-binding capacity, and creatinine/height index. TPN administration led to a significant increase in mean caloric intake and weight compared with controls (P less than 0.0001). In the short-term study, body fat, as measured by triceps skinfold thickness, was maintained, and there was a small increase in arm muscle circumference. Serum albumin and hematocrit decreased but promptly returned to pretreatment levels when TPN was stopped. There were no long-term differences in any of the nutritional assessment parameters between the two groups.
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PMID:Limited impact of total parenteral nutrition on nutritional status during treatment for small cell lung cancer. 298 69

Altered cellular immune function has been demonstrated in patients with lung cancer, including decreased numbers of circulating lymphocytes and changes in the percentage of lymphocytes in various functional subsets. We quantitated lymphocyte subsets in 54 patients with lung cancer including patients with limited (stages 1 and 2) nonsmall cell lung cancer (NSCLC, n = 23), advanced (stage 3) NSCLC (n = 16), and small cell cancer (SCLC, n = 15). Serum albumin was decreased in 15 lung cancer patients, and lymphocyte subsets were separately evaluated in these patients. Lymphocyte populations in cancer patients were compared to those of nonsmokers and a smoking patient population. No difference from smokers was noted in patients with limited NSCLC. Patients with SCLC and advanced NSCLC had significantly decreased numbers of T-helper and T-suppressor cells (p less than 0.05). Patients with lung cancer and hypoalbuminemia had the greatest decrease in number of circulating T-helper cells (p less than 0.001). B-lymphocytes were also decreased in patients with advanced NSCLC and patients with hypoalbuminemia (p less than 0.05). A decrease in population of T-lymphocytes subsets is frequent in patients with SCLC, advanced NSCLC, and lung cancer patients with hypoalbuminemia.
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PMID:Lymphocyte subsets in lung cancer. 303 22

Pretreatment laboratory parameters were analyzed as prognostic factors in patients with small cell lung cancer. Serum lactic dehydrogenase activity, serum albumin concentration, PPD skin reaction, and peripheral lymphocyte count were of prognostic importance. When these factors were evaluated by multivariate analysis together with performance status and disease extent, lactic dehydrogenase and albumin were the most influential factors related to survival.
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PMID:Pretreatment serum albumin concentration and lactic dehydrogenase activity as prognostic factors in patients with small cell lung cancer. 629 59


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