Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred eighty-nine patients received a four-drug combination consisting of cyclophosphamide, Oncovin (vincristine), methyl CCNU, and bleomycin (COMB), according to three different drug regimens, performed sequentially. Of the 189, 62 had a partial response (33%) including 11/33 with squamous lung cancer, 11/32 with squamous carcinoma of the head and neck, 13/15 with oat cell carcinoma of the lung, and 7/41 with malignant melanoma. The response rate for patients with squamous lung or head and neck cancer appeared to be higher at weekly bleomycin doses of 30 and 60 mg (15/33 = 45%), compared to a weekly bleomycin dose of 15 mg (7/32 = 25%). A median survival from treatment of 30 weeks was observed in oat cell carcinoma, which represents considerable prolongation over that expected from supportive care alone or single-agent chemotherapy. Toxicity included: 1) myelosuppression, resulting in hospitalization for antibiotics in 20% of patients; 2) probable bleomycin lung damage in 4% of patients; and 3) dose-limiting vincristine neuropathy in 11%. The combination of twice-weekly vincristine and bleomycin for more than 6 weeks produced a disturbing "debilitation syndrome," characterized by weakness, anorexia, weight loss, and apathy. The encouraging response rate suggests a future role for these drugs in combination, especially for vincristine and bleomycin, with other agents showing activity in squamous and oat cell carcinoma. Toxicity precludes recommendation of this combination, in the regimens tested, for broader Phase III studies.
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PMID:COMB (cyclophosphamide, oncovin, methyl-CCNU, and bleomycin): a four-drug combination in solid tumors. 5 Aug 70

We studied 71 patients with "paraneoplastic" encephalomyelitis, sensory neuronopathy, or both associated with the presence of the anti-Hu antibody in their serum. Most (78%) had small-cell lung cancer. In 9 patients no tumor was detected. Fifty-two patients (73%) had signs and symptoms of multifocal involvement of the nervous system; in 28 (39%), 2 areas, and in 24 (34%), 3 or more areas were clinically affected. Sensory neuronopathy was present in 52 patients (74%), but in only 44 (62%) did it dominate the course of the disease. Other predominant findings were: motor neuron dysfunction (14 patients, 20%), limbic encephalopathy (14, 20%), cerebellar symptoms (11, 15%), brainstem encephalopathy (10, 14%), and autonomic nervous system dysfunction (7, 10%). The presence of the anti-Hu antibody prompted a search for the tumor in 60% of the patients; the tumor when found was usually small and remained localized until death, or was demonstrated only at autopsy. Treatment using steroids and plasmapheresis, immunosuppressants, or both, did not improve the paraneoplastic symptoms. Autonomic and respiratory failure, either of central origin or secondary to neuromuscular weakness, were the principal causes of death. Patients with rapidly developing sensory neuropathy or symptoms of encephalomyelitis should be studied for the presence of the anti-Hu antibody; if the antibody is found, the possibility of small-cell lung cancer should be investigated. If a tumor is not found in the initial search, one may become evident in several months.
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PMID:Anti-Hu--associated paraneoplastic encephalomyelitis/sensory neuronopathy. A clinical study of 71 patients. 131 11

We retrospectively analyzed the charts of 58 long-term survivors of small-cell lung cancer (SCLC) (greater than 2 years) for neurological complications and their impact on the well-being of these patients. We also attempted to have patients complete a questionnaire regarding any possible neurological problems. This was done in 14 patients. Metastasis to the CNS occurred significantly less often in patients who received prophylactic cranial irradiation (PCI) in a dose of 20 Gy in five equal fractions (two of 48), compared with patients who did not receive it (four of 10) (P less than .006). Delayed neurological complications occurred in nine of 48 (19%) patients who received PCI. However, in only two patients did PCI appear to be responsible for progressive dementia. In the other seven patients (one with weakness in the arms and legs, one with transient left hemiparesis, two with hearing loss, and three with various visual disturbances), chemotherapeutic agents (mainly cisplatin and vincristine) and underlying diseases probably contributed significantly to the occurrence of these complications. In addition, these neurological disturbances were transient or ran a stable course and did not adversely affect the daily life of these patients. In comparison, amongst the 10 patients who did not receive PCI one had progressive dementia and another had hemiparesis secondary to probable brain embolism. We conclude that the use of PCI in these doses was effective in reducing the frequency of CNS metastases and had an adverse effect on the daily life and well-being only in a minority of the patients. Until results of controlled randomized studies show otherwise, PCI should continue to be used as a part of the combined modality treatment of completely responding patients with limited SCLC.
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PMID:Late neurological complications after prophylactic cranial irradiation in patients with small-cell lung cancer: the Toronto experience. 215 64

Seventeen previously untreated patients with metastatic non-small-cell lung cancer were entered in this phase I trial. Treatment consisted of a combination of acivicin and cisplatin at a starting dose of 12 and 15 mg/m2, respectively, given i.v. during 5 days and repeated every 28 days. A total of 46 cycles was given. Renal function abnormality was the dose-limiting toxicity of cisplatin with a maximum tolerated dose of 12 mg/m2. This toxicity occurred at a dose lower than expected, indicating a possible potentiation of platinum renal toxicity by acivicin. Myelosuppression was the dose-limiting toxicity of acivicin, with a maximum tolerated dose of 12 mg/m2. Other side effects included generalized weakness and gastrointestinal and neurological symptoms. In 15 patients evaluable for response seven progressed, six were stable for a median duration of 13 weeks, and two patients achieved a partial remission lasting 8 and 24 weeks, respectively. The overall response rate was 13%. The recommended phase II dose of both agents in this schedule was 12 mg/m2. The possible enhancement of cisplatin toxicity might have compromised the overall response rate of the combination and further studies using these drugs in this schedule are not recommended.
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PMID:Phase I study of acivicin and cisplatin in non-small-cell lung cancer. A National Cancer Institute of Canada study. 217 18

A 55-year-old woman had progressive lower extremity weakness. She had an 80-pack-per-year history of cigarette smoking. Electromyographic findings were consistent with the Lambert-Eaton myasthenic syndrome. Despite a normal chest x-ray, normal laboratory studies, and negative bronchoscopy, investigation for lung cancer was pursued. The final thoracotomy and pathology reports indicated a diagnosis of oat cell carcinoma. After treatment with chemotherapy and radiation therapy, clinical and electrophysiologic findings have resolved. Two years after diagnosis, the patient remains in good health without evidence of recurrence.
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PMID:Lower extremity weakness as the initial manifestation of lung cancer. 217 19

A 63-year-old man with Eaton-Lambert syndrome manifested by marked respiratory failure was reported. He began to notice blepharoptosis and diplopia in September, 1987, followed by weakness and easy fatigability in bulbar, neck and limb muscles in association with impotence by February, 1988. On admission in August, 1988, Gowers' sign, decreased tendon reflexes and muscle weakness improved by the injection of edrophonium were found. Anti-acetylcholine receptor antibody was negative. Single muscle action potential evoked in the thenar muscle was abnormally low in amplitude with the stimulation of the median nerve: repetitive nerve stimulation study revealed the waning at the low rates, but the waxing at the high rate (30 Hz), suggesting the diagnosis of Eaton-Lambert syndrome. Early gastric cancer (adenocarcinoma) was diagnosed from needle biopsy specimens in August, 1988, but no other neoplasm including thymoma or lung cancer was found. After subtotal gastric resection in September, 1988, he failed into respiratory failure, requiring artificial ventilation for seven months. Plasmapheresis and drugs such as anticholinesterase, guanidine hydrochloride, and corticosteroid were ineffective for the recovery from weakness in respiratory muscle. Lung cancer was suspected, based on a chest X-ray in March, 1989, and one month later he died of pneumonia. At autopsy, small cell carcinoma of the lung was observed, but there was neither recurrence nor metastasis of the gastric cancer. Emphasis was placed on the respiratory failure in Eaton-Lambert syndrome which has rarely been reported.
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PMID:[Eaton-Lambert syndrome manifested by respiratory failure associated with small cell carcinoma of the lung]. 217 52

The mortality of 3458 cotton industry workers originally enrolled in a study of respiratory symptoms in the period 1968-1970 was followed to the end of 1984. Both the total mortality and the mortality from respiratory disease were less than expected, and they both decreased as length of service increased. However, for the subjects who initially reported byssinotic symptoms, the mortality from respiratory disease was slightly raised overall, and it increased with length of service. These patterns of mortality indicate a survivor effect (ie, a tendency for those with respiratory weakness to leave the industry), together with a long-term effect reflected in respiratory mortality on the health of those workers susceptible to the effects of cotton dust. The mortality from lung cancer was lower than expected, and it decreased with length of service. This finding is consistent with other observations that exposure to cotton dust may reduce the risk of lung cancer.
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PMID:Mortality of workers in the British cotton industry in 1968-1984. 235 94

From January 1975 to December 1986, 415 patients were operated for primary lung cancer. Postoperative pulmonary complications were observed in 83 patients and among them 48 patients (57.8%) suffered from difficulty in expectoration. Postoperative expectoration mostly depends on the ability of coughing. To evaluate cough dynamics, expiratory flow-rate and volume at voluntary maximal cough were measured. The more expiratory flow rate and volume a cough has, the more effective it is for expectoration. In those patients with decreased FEV1.0, or respiratory muscle weakness because of emaciation and aging, or severe pain in the wound, the cough dynamics was decreased. By cleaning retained secretions in the respiratory tract, postoperative pulmonary complications would be prevented. However in cases where the decrease in postoperative cough dynamics is predictable, application of limited resection should be considered as well.
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PMID:[Pulmonary complication after resection of lung cancer--difficulty in expectoration and cough dynamics]. 260 Apr 61

The purpose of this study was to investigate the physical, psychological, and interactional aspects of lung cancer associated with suffering. A sample of 30 adults with primary pulmonary malignancies was obtained from an oncology clinic and from the practice of a thoracic surgeon. The subjects had been treated with chemotherapy, surgery, and/or radiation. A structured interview was conducted with each subject to determine the incidence of suffering associated with lung cancer. A five-point Likert-type scale was used to quantify the subjects' responses. The highest level on the scale, "Very Much" suffering, was reported to be associated with lung cancer by 50% of the sample. Ten percent of the sample reported no suffering. The following were reported to be the sources of greatest suffering: disability, pain, anxiety, changed daily activities, and weakness/fatigue. There were no statistically significant differences beyond the 0.05 level in reported suffering among groups treated with surgery, chemotherapy, or radiation. There was a statistically significant difference (p = 0.028) between groups with known metastatic disease and no known metastatic disease in the amount of suffering associated with the psychological aspects.
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PMID:The suffering associated with lung cancer. 271 31

A case of radiation myelitis developed 1 year and 5 months after radiotherapy for lung cancer is reported. A 75-years old male was given a dose of 70 Gy to the tumor with a fraction dose of 2 Gy, 5 times per week. He developed the weakness and disturbance of sense in bilateral lower extremities, which gradually worsened in spite of a variety of treatment. Some discussions on tolerance dose, fraction dose and fraction number are made as well as technique of irradiation.
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PMID:[A case of radiation myelitis following radiotherapy in lung cancer]. 272 2


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