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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The staging procedures for small cell lung cancer do not differ appreciably from those for other forms of lung cancer. For practical purposes, the TNM stages are usually collapsed into a simple binary classification: limited disease and extensive disease. This study was performed to answer the question of whether fluorine-18 labelled 2-deoxy-2-D-glucose positron emission tomography (FDG-PET) imaging permits appropriate work-up (including both primary and follow-up staging) of patients presenting with small cell lung cancer, as compared with currently recommended staging procedures. Thirty-six FDG-PET examinations were performed in 30 patients with histologically proven small cell lung cancer. Twenty-four patients were examined for primary staging while four were imaged for therapy follow-up only. Two patients underwent both primary staging and up to four examinations for therapy follow-up. Static PET imaging was performed according to a standard protocol. Image reconstruction was based on an ordered subset expectation maximization algorithm including post-injection segmented attenuation correction. Results of FDG-PET were compared with those of the sum of other staging procedures. Identical results from FDG-PET and the sum of the other staging procedures were obtained in 23 of 36 examinations (6x limited disease, 12x extensive disease, 5x no evidence of disease). In contrast to the results of conventional staging, FDG-PET indicated extensive disease resulting in an up-staging in seven patients. In one patient in whom there was no evidence for tumour on conventional investigations following treatment, FDG-PET was suggestive of residual viability of the primary tumour. Furthermore, discordant results were observed in five patients with respect to lung, bone, liver and adrenal gland findings, although in these cases the results did not affect staging as limited or extensive disease. Moreover, FDG-PET appeared to be more sensitive for the detection of metastatic mediastinal and hilar lymph nodes and bone metastases. Finally, all findings considered suspicious for tumour involvement on the other staging procedures were also detected by FDG-PET. It is concluded that FDG-PET has potential for use as a simplified staging tool for small cell lung cancer.
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PMID:FDG-PET imaging for the staging and follow-up of small cell lung cancer. 1135 99

The paper presents a retrospective evaluation of 47 patients with bone metastases treated surgically during the last 10 years at our ward. The mean age of the patients was 62.5 years. There were 31 females (mean age: 62.8 years) and 16 males (mean age: 62.3 years). In 37 cases (78.8%) it as possible to establish the primary localization of the tumour: breast carcinoma--16 cases, ovary cancer 5 cases, lung cancer--5 cases, prostate cancer--5 cases, kidney cancer--2 cases, stomach cancer--1 case, vagina cancer--1 case, hepatocarcinoma--1 cases and plasmocytoma--1 cases. In 10 cases (21.1%) we were unable to establish the primary focus of the tumour. The localization of the metastases was as follows: femur--32 cases, humerus--6 cases, tibia--3 cases, lumbar spine--1 case. Patients treated very briefly after qualification for surgery, in some cases during emergency service. In 2 cases of metastases to the tibia amputations at the femur were performed. The remaining patients were treated by local excisions of the metastatic tumours, followed by: in 33 cases internal osteosynthesis and bone cement application; in 7 cases osteosynthesis, in 4 cases hip arthroplasties and posterior spine instrumentation in 1 case. In 6.4% we had poor results because of the death of 3 patients. The mean follow-up was three months. In 93.6% we had good and very good results--no pain, good function and independence during daily activities. Mean survival time was 13.5 month (range 5-28 months).
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PMID:[Efficacy of operative treatment for pathological fractures in bone metastases in relation to length and comfort of survival]. 1138 15

Palliative radiation therapy has a significant role to play in the management of several clinical syndromes commonly seen by surgeons: brain and bone metastases, spinal cord compression, thoracic symptoms caused by lung cancer, bleeding, and pain or other local symptoms caused by tumor mass effects. This article discusses the basic principles of radiation therapy and radiobiology, the potential benefits, and the adverse effects and burdens of the treatment plans for each indication. This article gives the surgeon insight as to the proper time to refer patients with advanced cancer to a radiation oncologist for palliative radiation therapy.
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PMID:The palliative uses of radiation therapy in surgical oncology patients. 1140 58

Lung cancer is commonly associated with multiorgan metastasis, and bone is a frequent metastatic site for lung cancer. Nevertheless, no bone metastasis model of lung cancer with multiorgan dissemination is available, which could provide opportunity to study the molecular pathogenesis. We examined the abilities of eight human lung cancer cell lines injected intravenously into natural killer (NK) cell-depleted SCID mice to generate metastatic nodules in bone and multiple organs, and explored the correlation of the parathyroid hormone-related protein (PTHrP) with the bone metastasis. Although all the small-cell carcinoma cell lines (SBC-5, SBC-3, SBC-3/ADM, H69, H69/VP) formed metastatic nodules in multiple organs (liver, kidney, and lymph nodes), only SBC-5 cells reproducibly developed bone metastases. Squamous cell carcinoma (RERF-LC-AI) cells metastasized mainly into the liver and kidneys, whereas adenocarcinoma (PC-14, A549) mainly produced colonies in the lungs. As assessed by X-ray photography, the osteolytic bone metastases produced by SBC-5 cells were detected as early as on day 28, and all recipient mice developed bone metastasis by day 35. The expression of PTHrP in eight cell lines was directly correlated with the formation of bone metastasis. No correlation was observed between the formation of bone metastasis and the expression of other metastasis-related cytokines (IL-1, IL-6, IL-8, IL-10, IL-11, TNF-alpha, VEGF, M-CSF). Consistent with the formation of bone metastasis by SBC-5 cells, the levels of PTHrP and calcium in the mouse serum were increased in a time-dependent manner, suggesting that PTHrP produced by human lung cancer may play a crucial role in the formation of bone metastasis and hypercalcemia. These findings indicate that a bone metastasis model of SBC-5 cells may be useful for clarifying the molecular aspects of the metastatic processes in different organ microenvironments and the development of therapeutic modalities for lung cancer patients with bone metastases.
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PMID:Bone metastasis model with multiorgan dissemination of human small-cell lung cancer (SBC-5) cells in natural killer cell-depleted SCID mice. 1141 46

Skeletal metastases are one of the major clinical problems for the oncologist. Over the last several decades bone scintigraphy has been used extensively in detecting bone involvement since it can provide information about disease location, prognosis and the effectiveness of treatment. Bone scan offers the advantage of total body examination, and images bone lesions earlier than other techniques. In this paper the main clinical problems related to the most common applications of bone scan in breast, prostate, lung cancer and other tumours are discussed. The experience carried out at the National Cancer Institute of Milan by using bone SPECT to detect single bone metastases is reported. One hundred and eighteen patients with bone metastases (from different tumour types: breast, lung, prostate, lymphomas, etc.) were studied by planar scintigraphy, SPECT and other radiological modalities (CT, MRI or X-rays). The overall performances of bone SPECT were sensitivity: 90.5% (19/21), specificity 92.8% (90/97), positive predictive value 73% (19/26), negative predictive value 97.8% (90/92), accuracy 92.4% (109/118). Considering breast cancer, the most frequent pathology in our series, and the lumbar spinal tract, the most common skeletal segment involved, the figures of merit of SPECT were: sensitivity 100% (4/4), specificity 95.3% (41/43), positive predictive value 66.7% (4/6), negative predictive value 100% (41/41), accuracy 95.7% (45/47). In conclusion bone SPECT showed very good performances, in particular improving the predictive value of planar scan in the diagnosis of vertebral metastases.
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PMID:Bone scintigraphy and the added value of SPECT (single photon emission tomography) in detecting skeletal lesions. 1145 73

Cancer commonly metastasizes to bone and up to 80% of breast, prostate, and lung cancer patients will have bone metastases. The site and distribution of bone metastases, and the presence of skeletal complications such as pathologic fracture and spinal cord compression affect the patient's prognosis. In many cases, bone metastases are too advanced to be eliminated through chemotherapy or radiotherapy; in these cases, treatment is given to relieve or prevent further symptoms. Several treatments are used in palliative care, including radiation therapy, systemic radiopharmaceuticals, chemotherapy, hormone therapy, and bisphosphonates. Radiotherapy remains the treatment of choice, and radiation treatment given in a single fraction has proven to be an efficient and cost-effective alternative to traditional multifraction radiotherapy courses. Analgesics are important in palliative therapy because they relieve pain while administering and awaiting the relief of pain from treatment. Furthermore, analgesics will relieve persistent levels of pain if complete pain relief is not achieved with therapy. Currently, bone pain is not adequately treated by many physicians and up to 79% of patients experience severe pain in the period before palliative therapy.
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PMID:Bone metastases: approaches to management. 1154 73

Pathological fractures will be encountered in increasing frequency due to more patients with cancer, surviving a longer period. The skeleton is the third most frequent localization for metastases. Breast cancer is still the most common primary tumor, but bone metastases from lung cancer seem to be diagnosed more and more. Despite of finding metastases most often in the spinal column, fractures are seen mostly at the femoral site. A pathological fracture and, in almost all cases, an impending fracture are absolute indication for operation. An exact definition of an "impending fracture" is still lacking; it is widely accepted, that 50 per cent of bone mass must be destroyed before visualization in X-ray is possible, thus defining an impending fracture. The score system by Mirels estimates the fracture risk by means of four parameters (localization, per cent of destructed bone mass, type of metastasis, pain). Improving quality of life, relieving pain, preferably with a single operation and a short length of stay are the goals of (operative) treatment. For fractures of the proximal femur, prosthetic replacement, for fractures of the subtrochanteric region or the shaft, intramedullary nails are recommended. Postoperative radiation therapy possibly avoids tumor progression. In patient with a good long term prognosis, tumor should be removed locally aggressive.
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PMID:[(Impending) pathological fracture]. 1201 95

The purpose of the paper is to outline the current treatment strategies in lung cancer focusing on the possibile role of radiotherapy. METHOD: It defines the place of radiotherapy at the main histological types and stadiums proposing indications according to evidence based medicine. CONCLUSIONS: Radiotherapy is mandatory in non-operated NSCLC st. I-II in perioperative or palliative management of superior sulcus tumours; in the combined modality treatment of limited SCLC and in postoperative adjustment of resected single brain metastasis of lung cancer. It is optional after NSCLC segmentectomy; in palliation or postoperative adjuvation of NSCLC st. III Radiotherapy can be chosen as a part of best supportive care at NSCLC st. IV extensive SCLC and in case of multiple brain or localised lytic bone metastases.
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PMID:[Radiotherapy in lung cancer. Mandatory or optional?] 1205 Jul 48

We summarise the physical and pharmacokinetic properties of the radionuclides used. The effect on pain from bone metastases caused by prostate cancer, breast cancer, and lung cancer is well documented. A review of the literature does not substantiate a clinically significant difference in the palliative effect produced by any of the radionuclides used. The effect achieved with nuclides is the same as that seen after external radiation. Radionuclides seem to reduce the number of new painful sites from bone metastases, and, as such, use of nuclides is expected to reduce the need for repeated external palliative radiation.
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PMID:[Palliation of pain from bone metastases with radioactive isotopes]. 1208 48

We encountered a case of lung cancer in which symptoms due to orbital metastasis were recognized. A 55-year-old man presented with a chief complaint of double vision. Orbital MR image demonstrated a right intraorbital mass with bone destruction, which resulted in oculomotor nerve palsy and optic nerve disturbance. Chest CT scan showed a 4 cm mass in the right S6, which was diagnosed on biopsy as a poorly differentiated adenocarcinoma. A whole-body scintigram revealed multiple bone metastases: the right orbital wall, the lower cervical spine, the left knee joint, and so on. Based on the clinical findings, we believed that the orbital tumor was a metastasis from the lung. Systemic chemotherapy and irradiation of the right orbital tumor and the left knee joint were performed. Though a favorable response was achieved in ocular movement, the patient died 3 months after initial treatment because of progression of the primary lesion. Including this case, seventeen reported cases in which lung cancer metastasized to the orbit in Japan were also reviewed.
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PMID:[A case of primary lung cancer with initial symptoms due to orbital metastases]. 1269


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