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Query: UMLS:C0151825 (bone pain)
 3,118 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hundred fifteen radioisotopic bone scans ranging from initial scan only to nine scans per patient, performed on 114 patients with adenocarcinoma of the prostate between 1979 and 1984, were reviewed. Seventeen patients had positive scans, ten on initial scan and seven at follow-up. Nine patients had bone pain at the time of the first positive scan and pain developed in two patients 6 months and 2 years later, respectively. The other six patients are still asymptomatic 1 to 4 years later. False-positive scans were found in six other patients. No patient with bone pain had a negative scan. We believe that routine bone scans for prostate cancer follow-up are not cost-effective unless the patient is symptomatic. Bone scans also are indicated for initial staging and to observe disease response to protocol treatment.
Cancer 1988 Jun 15
PMID:Efficacy of follow-up bone scans in carcinoma of the prostate. 313 Jan 80

Of 297 patients with metastatic testicular and extragonadal germ cell tumours (GCT), bone involvement was detected clinically in 3% (7/251) of those at first presentation and in 9% (4/46) of relapsed cases. This difference was not statistically significant (95% confidence limits -2%; +14%). Concurrent systemic metastases, commonly involving lung (7/11 cases) and para-aortic lymph nodes (6/11), were present in all patients with bone disease. All affected patients had localized bone pain and lumbar spine was the most frequent site involved (9/11). Spinal cord compression occurred in two patients while a third developed progressive vertebral collapse after chemotherapy and required extensive surgical reconstruction. At median follow-up of 4 years, survival among patients presenting with bone disease (6/7) was similar to overall survival in the whole group (84%) and appeared better than in those with liver (18/26, 69%) or central nervous system (6/9) metastases at presentation. Back pain in metastatic germ cell tumours is often due to retroperitoneal lymphadenopathy but lumbar spine osseus metastases must be recognized early if severe potential complications, such as spinal cord compression, are to be avoided. In this series, bone metastases were not seen in the absence of widespread systemic disease suggesting all solitary bony lesions in GCT patients should be biopsied.
Br J Cancer 1988 Dec
PMID:Bone disease in testicular and extragonadal germ cell tumours. 322 81

Bone marrow necrosis is a rare and ominous complication of hematologic malignancy which is often associated with bone pain in the lower back and extremities. Widespread marrow necrosis makes a definitive diagnosis through bone marrow biopsy difficult. An accurate diagnosis is imperative in patients with promyelocytic leukemia (FAB-M3) because disseminated intravascular coagulation and hemorrhage secondary to release of tissue thromboplastins from the malignant cell population requires prompt and anticipatory therapy. The following case report describes a patient with acute leukemia and massive bone marrow necrosis which obscured the correct diagnosis of promyelocytic leukemia.
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PMID:Bone marrow necrosis obscuring the diagnosis of acute promyelocytic leukemia. 263 85

Radiotherapy is highly effective in relieving metastatic bone pain. The mechanism of action remains unclear, and tumour shrinkage may be relatively unimportant in producing analgesia. Various techniques of localized external beam therapy are in use with no consistent advantage seen for either high doses or multiple fractions. For scattered painful metastases, wide-field hemibody irradiation or the systemic administration of radioisotopes are effective but may be associated with greater toxicity than localized irradiation.
Cancer Surv 1988
PMID:Scientific and clinical aspects of radiotherapy in the relief of bone pain. 328 44

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multipotential hematopoietin. To assess the toxicity and biological activity of recombinant human GM-CSF (rhGM-CSF) in vivo, 25 patients with malignancy or bone marrow failure were treated with rhGM-CSF (specific activity approximately 5 x 10(7) U/mg) as part of a phase 1 trial. The treatment was administered by continuous intravenous (IV) infusion daily for 2 weeks at fixed dose levels and repeated after a 2-week rest period. Over the entire dose range tested (15 to 500 micrograms/m2/d), rhGM-CSF treatment was associated with dramatic increases (two- to 70-fold) in total leukocyte counts, which consisted predominantly of neutrophils, bands, eosinophils, and monocytes. Furthermore, six of the 14 patients with one or more cytopenias that received at least two cycles of treatment had multilineage responses characterized by twofold or greater increases in platelet count to a level above 100,000, twofold or greater increases in corrected reticulocyte count, and a reduced requirement for red cell transfusions. Three of these patients became independent of both red cell and platelet transfusions for 17 to 37 weeks of follow-up. Treatment was associated also with an increase in bone marrow cellularity and frequency of cycling progenitor cells. The treatment was well tolerated; side effects included constitutional symptoms and bone pain. These results demonstrated that rhGM-CSF has a significant impact on hematopoiesis in patients with advanced malignancy and also in patients with bone marrow failure.
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PMID:Stimulation of hematopoiesis in patients with bone marrow failure and in patients with malignancy by recombinant human granulocyte-macrophage colony-stimulating factor. 329 76

Gallium nitrate, an agent known to inhibit bone resorption, was evaluated in patients with bidimensionally measurable hormone-refractory prostatic cancer. The starting dose was 200 mg/m2 iv by continuous infusion over 7 days. Two patients (10%; 95% confidence limits, 0%-22%) achieved short partial remissions of 1 and 6+ months, while seven of 23 (30%; 95% confidence limits, 14%-52%) showed a diminution of bone pain. Serial indices of bone turnover including serum calcium, phosphorus, and urinary hydroxyproline excretion showed a significant decrease at the completion of the infusion which returned to baseline prior to the next cycle. The data suggest the effect on bone was too short to produce consistent improvement. Reasons for the dissociation of pain relief and antitumor activity are discussed.
Cancer Treat Rep 1987 Oct
PMID:Gallium nitrate in prostatic cancer: evaluation of antitumor activity and effects on bone turnover. 330 78

Prostate cancer is the most frequent malignancy in elderly men. Common presentations include asymptomatic prostate nodules, unexplained bone pain or bladder outlet obstruction. Histologic grading clearly influences the prognosis. Either potency-saving subcapsular prostatectomy or radiation therapy is effective in treating localized disease. New prospects for hormonal therapy of metastatic prostate cancer include antiandrogens and gonadotropin-releasing analogs.
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PMID:Prostate cancer. 331 38

The correlation between response of metastatic bone lysis and bone pain, various biochemical markers of bone metabolism, and radiological and scintigraphic findings was investigated in 49 women with breast cancer included in a calcitonin supportive therapy trial. All patients had dominant skeletal disease and were on stable systemic treatment (cytotoxic or hormonal) for a least 6 months before the first response evaluation. Bone pain correlated poorly with treatment response. Changes in sclerotic metastases did not show any apparent relation to changes in lytic lesions. A correlation between bone scans and lytic activity on radiographs was found. The absolute level of biochemical bone markers did not correlate with treatment response, but seemed instead to reflect the rate of bone turnover. The relative level of bone markers with respect to baseline showed better correlation to treatment response. The best conventional marker of disease activity was urinary hydroxyproline/creatinine. Propeptide of Type III procollagen (PIIINP), a novel marker reflecting collagen turnover, promises to be at least as sensitive as hydroxyproline. Stable and regressing patients had the same prognosis and significantly longer survival than progressors.
Cancer 1987 Dec 15
PMID:The response evaluation of bone metastases in mammary carcinoma. The value of radiology, scintigraphy, and biochemical markers of bone metabolism. 331 77

Response criteria and the reporting of results in clinical trials on drug therapy of stage D prostate cancer were evaluated by examination of studies listed in the Index Medicus 1980-1984. During this 5-year period, 70 studies (51 phase II and 16 phase III) were listed, comprising 3184 evaluable patients. Among 346 patients reported as having evaluable disease according to the WHO criteria, 198 had well-defined evaluable disease. A variety of response criteria were used, the NPCP criteria being the most frequent. Only three studies included solely patients with evaluable disease according to the WHO criteria. Reporting of results was often inadequate. The value of the most frequently used response parameters such as acid phosphatase, bone scan, per-rectal ultrasound, CT scan, bone pain and performance status is discussed. A system to standardise the reporting of results is proposed.
Eur J Cancer Clin Oncol 1987 Feb
PMID:Prostate cancer: evaluation of response to treatment, response criteria, and the need for standardization of the reporting of results. 332 96

Eleven previously untreated patients with stage D prostate cancer were treated with ketoconazole in a dosage of 400 mg p.o. every 8 h. s-Testosterone was used as a measure of antiandrogen effect. Nine patients had a reduction in s-testosterone to castrate levels (less than 2.9 nmol/l) within 3 days. In the remaining two patients, dose escalation of ketoconazole to 400 mg every 6 h did not lead to sufficient reduction in s-testosterone. Two patients had a complete response and four patients had a partial response of 6/11. Additionally, two patients had bone pain relief without normalization of acid phosphatase. Side-effects and adverse reactions were prominent, causing discontinuation of the treatment in nine patients. It is concluded that high-dose ketoconazole is effective in disseminated prostate cancer, but the high frequency of side-effects makes it less attractive than conventional hormone manipulations like castration or estrogens.
Eur J Cancer Clin Oncol 1988 Mar
PMID:High-dose ketoconazole to untreated stage D prostate cancer. 338 45


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