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

Colony-stimulating factors (CSFs) are hematopoietic growth hormones that stimulate the production, maturation, and function of white blood cells. The best studied are granulocyte-macrophage CSF (GM-CSF) and granulocyte CSF (G-CSF), both of which can be produced by recombinant DNA technology. Clinical indications for these agents include bone marrow failure secondary to administration of chemotherapeutic drugs or radiation, bone marrow transplantation, and a variety of congenital or iatrogenic neutropenias. Toxicity in usual clinical doses is mild, and consists mainly of bone pain and constitutional symptoms such as fever, headache, and myalgias. Interleukin-2 (IL-2) is a lymphokine that stimulates that multiplication of several types of killer cells. These cells can recognize and destroy foreign substances, such as tumors, without destroying normal cells. Major applications of IL-2 include treatment of patients with renal cell carcinoma, in whom the overall objective response rate is 15-30 percent, and malignant melanoma with response rates of about 18 percent. Combination therapy with other biologics and conventional cytotoxic drugs may increase IL-2's efficacy against these tumors. Toxicity is generally severe, but reversible. Hemodynamic toxicity, consisting of hypotension, edema, weight gain, and decreased renal function, is most characteristic. Suggestions are given for pharmacologic management of these and other IL-2 toxicities.
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PMID:Clinical use of biologic response modifiers in cancer treatment: an overview. Part II. Colony-stimulating factors and interleukin-2. 171 21

Twenty-nine cases of bone metastases from renal cell carcinoma were examined. Eight had metastatic bone pain as the initial symptom and were diagnosed that the primary lesion was in a kidney. In eight cases bone metastases appeared after treatment of the primary site. Seven had only bone metastases and another 22 cases had multiple metastases in organs such as the lung and lymph node when the bone metastasis was found. Curable surgical treatment was performed in only 2 cases. The survival curve of these patients were: 1 year; 41 per cent, 2 year; 30 per cent and 3 year; 15 per cent. Bone scan used for detection of bone metastases of carcinoma frequently ends with false positive results. CT scan and angiography are available for differential diagnosis of bone metastasis. We examined 6 cases (9 lesions) of bone metastases from renal cell carcinoma (3 pelvic bones, 2 lumbar bones, 2 femurs and 2 humerus). All lesions were hypervascular by angiography and were easily diagnosed as bone metastases. For early detection of bone metastases from renal cell carcinoma, angiography is useful because hypervascularity and tumor stain are easily detected even in such small lesions as 2 cm. Angiography was also useful for chemoembolization.
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PMID:[Evaluation of bone metastases from renal cell carcinoma]. 205 4

With a progress of image diagnosis method asymptomatic renal cancers have much chance to be disclosed, but renal carcinoma of which symptoms were caused by metastatic lesion are discovered as an initial symptom has not been decreased. In this paper we reported additional 4 patients who visited our hospital with an initial symptom of metastatic bone pain and were diagnosed that the primary lesion was the kidneys. We further conducted a follow-up study on 4 patients reported previously and discussed on renal cancer with bone metastasis as the initial symptom. Case 1 was a 51-year-old man with lumbar metastasis, case 2 was a 34-year-old woman with vertebral metastasis, case 3 was a 77-year-old man with femur metastasis and case 4 was a 65-year-old woman with femur metastasis. In three of the 4 patients except for case 1, extirpations of the primary lesions were performed. Case 3 and 4 received internal fixation for metastatic lesion in bone. In occasionally four cases, the prognosis was relatively favorable even in advanced renal carcinoma with bone metastasis, so surgical procedures should be made positively for relief of pain in metastatic lesion, maintenance of function and prevention of bone fracture.
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PMID:[Renal cancer with bone metastasis as initial symptom]. 235 60

Adenocarcinoma of the kidney is an unusual tumor, both in its biological behavior and in its response to radiation treatment. Historically, these tumors have been considered to be radioresistant, and the role of radiation therapy remains questionable in the primary management of this disease. However, radiation treatment is routinely used in the palliation of metastatic lesions for relief of symptoms. Therefore we have undertaken a review of our experience in the treatment of this disease to determine the effectiveness of radiation in its palliation. From 1956 to 1981, 125 patients with metastatic lesions from hypernephroma have been treated in the Department of Radiation Therapy at Thomas Jefferson University Hospital. Most patients were referred for relief of bone pain (86), brain metastasis (12), spinal cord compression (9), and soft tissue masses (18). Total doses varied from 2000 rad to a maximum of 6000 rad. Response to treatment was evaluated on the basis of relief of symptoms, either complete, partial or no change. Our results indicate a significantly higher response rate of 65% for total doses equal to or greater than a TDF of 70, as compared to 25% for doses lower than a TDF of 70. No difference in response was observed either for bone or soft tissue metastasis or visceral disease. This leads us to believe that metastatic lesions from adenocarcinomas of the kidney should be treated to higher doses to obtain maximum response rates. Analysis of these results are presented in detail.
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PMID:Radiation therapy in the treatment of metastatic renal cell carcinoma. 241 57

We retrospectively reviewed the roentgenographic and pathologic staging of 64 patients with renal cell carcinoma to assess the role of the various staging modalities (ie, angiography, venacavography, bone scanning, ultrasound, computed tomography [CT], and magnetic resonance imaging). Specific attention was directed at detecting vena cava thrombus and metastatic bone disease, factors with a significant impact on the therapeutic approach. The findings support the role of CT as the principle tool for overall staging and the observation that venacavography is not indicated if CT has excluded caval thrombus. Similarly, routine bone scans are not warranted in the absence of an elevated alkaline phosphatase level or bone pain. The key to the more efficient utilization of imaging resources is understanding the capabilities of the technology available.
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PMID:Staging renal carcinoma. What is sufficient? 291 Feb 51

The use of bone scans in the evaluation of renal cell carcinoma has become routine in many centers. In a retrospective analysis of 42 patients undergoing radical nephrectomy for renal cell carcinoma, we analyzed the cost-effectiveness of routine preoperative bone scans. Although these scans accurately predict metastatic disease to bone, they are not cost-effective as a routine preoperative tool because they do not alter outcome. In selected patients with bone pain and no other positive staging studies, preoperative bone scans may be of value in the decision to perform extirpative surgery.
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PMID:Staging of renal cell carcinoma: cost-effectiveness of routine preoperative bone scans. 298 77

Radionuclide bone scans were obtained as part of the routine evaluation of 85 patients with renal cell carcinoma. Twenty-nine patients (34%) were found to have metastatic disease at presentation. Bone scans were abnormal in 27 of these 29 patients for a sensitivity of 93 per cent; of the remaining 56 without metastatic disease, 48 had normal bone scans for a specificity of 86 per cent. In all patients whose abnormal bone scans indicated metastatic disease, there were either clinical signs (bone pain), laboratory findings (elevated alkaline phosphatase), or routine radiographic procedures (chest roentgenogram, intravenous pyelogram, or angiogram) suggesting disease metastatic to bone. Although bone scanning was useful for confirming clinically or radiographically suspected metastatic disease, it did not influence the staging of the renal cell carcinoma in any patient. We therefore conclude that bone scans should be used to confirm the presence and to determine the extent of osseous metastases in patients with renal cell carcinoma but are unnecessary as a routine staging procedure.
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PMID:Value of routine radionuclide bone scans in renal cell carcinoma. 406 Mar 82

Pamidronate is a second generation bisphosphonate used for treating tumor-induced hypercalcemia and for preventing the development of new bone metastasis. A 47-year-old man with renal cell carcinoma was admitted in our institution because of hypercalcemia with multiple metastasis in bone, lung and lymph nodes. After embolization of the right renal artery, the patient was treated with pamidronate and interferon-alpha. Intravenous pamidronate significantly reduced bone pain and normalized the serum calcium level. The pulmonary metastasis responded to interferon therapy after 2 months of therapy. Radical nephrectomy was then carried out. Paraaortic lymph nodes were found to be necrosed completely. Ossification of osteolytic lesions was observed after two months of therapy and metastatic lesions in the lung showed complete remission (CR) after six months of therapy.
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PMID:[Effect of pamidronate and interferon-alpha on bone and lung metastases and hypercalcemia in a patient with renal cell carcinoma]. 897 39

The clinical data of 91 patients with bone metastases were reviewed. The renal cell carcinoma and prostatic carcinoma were diagnosed respectively in 53% and 47% of the patients. 48% of the patients had tumour size stage T3 and 71% had histopathological stage II (G2). 21% of the patients presented a bone pain. In patients with renal cell carcinoma, the level of serum bone alkaline phosphatase and erythrocyte sedimentation rate were correlated with the concentration of serum ferritin (respectively p = 0.008 and p = 0.055). The relationship between the histopathological grade (G) and the stage of tumour size (T), and the concentration of serum ferritin was noted. In patients with prostatic carcinoma, the relationship between general condition and the concentration of prostatic specific antigen (PSA) as well as the relationship between PSA and the intensity of bone pain were observed. Only relationship between the histopathological grade and the concentration of PSA had a statistical significance (p < 0.05).
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PMID:[Bone metastasis in patients with urogenital neoplasms]. 938 10

Bone is a preferred site of metastasis for many solid tumors, and the complications associated with bone metastases can result in significant skeletal morbidity including severe bone pain, pathologic fracture, spinal cord compression, and hypercalcemia of malignancy (HCM). Bisphosphonates are the current standard of care for preventing skeletal complications associated with bone metastases. Clinical trials investigating the benefit of bisphosphonate therapy have used a composite end point defined as a skeletal-related event (SRE) or bone event, which typically includes pathologic fracture, spinal cord compression, radiation or surgery to bone, and HCM. Bisphosphonates have been shown to significantly reduce the incidence of these events in patients with bone metastases. Zoledronic acid (Zometa; Novartis Pharmaceuticals Corp.; East Hanover, NJ), pamidronate (Aredia; Novartis Pharmaceuticals Corp.), clodronate (Bonefos; Anthra Pharmaceuticals; Princeton, NJ), and ibandronate (Bondronat; Hoffmann-La Roche Inc.; Nutley, NJ) all have demonstrated efficacy superior to that of placebo in patients with breast cancer. Zoledronic acid is the only bisphosphonate that has been compared directly with pamidronate, and it was shown by multiple event analysis to be significantly more effective at reducing the risk of an SRE. In patients with prostate cancer, clodronate, etidronate (Didronel; Procter and Gamble Pharmaceuticals, Inc.; Cincinnati, OH), and pamidronate have demonstrated transient palliation of bone pain. However, zoledronic acid is the only bisphosphonate to demonstrate both significant and sustained pain reduction and a significantly lower incidence and longer time to onset of SREs compared with placebo. Zoledronic acid is also the only bisphosphonate to demonstrate efficacy in patients with bone metastases from a variety of other solid tumors, including lung cancer and renal cell carcinoma. In conclusion, bisphosphonates effectively reduce skeletal complications in patients with bone metastases from breast cancer, and zoledronic acid has demonstrated the broadest clinical activity in patients with a wide variety of tumor types.
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PMID:Bisphosphonates: clinical experience. 1545 26


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