Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A method of treating the primary site of recto-anal cancers using an en face electron beam in combination with an internal lead shield in the anus has been developed. Dose measurements using lithium fluoride thermoluminescent dosimetry indicate that the internal anal shield reduces the dose to the uninvolved anal wall by up to a factor of two while leaving the dose to the primary tumor site unaffected. Because the internal anal shield is placed in the anus during treatment, this system leads to a more precise daily positioning of the shield compared to the setup using an external shield alone. This technique has been used to treat two patients with anal cancer who tolerated the treatment well with no acute side effects. Both patients are now disease free, more than 30 months after their radiation treatment, without any treatment-related sequelae.
 ...
PMID:A simple technique for irradiation of recto-anal cancers with electrons using an internal anal shield. 193 33

A prosthesis was designed to protect the intestinal loop from external beam radiation therapy when post-operative radiation is indicated. It is a silicone inflatable balloon, which, when implanted displaces the intestinal loops out of the pelvic irradiation field. The prosthesis can be deflated between each course of irradiation, without surgery. The device has been used in 8 patients: 6 patients with recurrent pelvic tumor (2 rectal cancers, 1 anal cancer, 1 cancer of the endometrium, 1 cervical carcinoma, 1 ovarian carcinoma), 2 patients with primary tumor (1 malignant paraganglioma, 1 cervical carcinoma). Radiotherapy was administered by means of high power appliances. After radiotherapy, the prosthesis was deflated, then removed through a 3 cm incision under local or peridural anesthesia. The tolerance of the small intestine to the radiation therapy has been satisfactory in each case with no bowel injury due to radiation. Therefore, this simple device might be useful to prevent bowel injury during postoperative radiation in the treatment of abdominal and retroperitoneal tumor masses.
 ...
PMID:[New surgical procedure for the protection of the small intestine before postoperative pelvic irradiation]. 237 97

Following documented evidence of the synergism of 5-fluorouracil (5-FU) and radiation therapy and an additive effect with mitomycin and irradiation, pilot studies have demonstrated the potential for definitive radiation therapy in the management of squamous cell and basaloid carcinomas of the anal canal, allowing sphincter preservation. Our study explored the long-term effectiveness of combined therapy at this disease site and examined the feasibility of a Radiation Therapy Oncology Group study involving concomitant radiation therapy and chemotherapy. Between 1983 and 1987, 79 assessable patients with any primary tumor stage of anal canal carcinoma were treated by external-beam irradiation combined with mitomycin given by bolus iv injection and 5-FU given by continuous infusion. Radiation was delivered to the perineum and pelvis to a total dose of 4,080 cGy in 4.5-5 weeks. The inguinal nodal areas received 4,080 cGy, calculated at a 3-cm depth in the center of the nodal area. A 96-hour infusion of 5-FU was started on days 2 and 28 of the irradiation at a dose of 1,000 mg/m2 over 24 hours, and a bolus injection of mitomycin was administered on day 2 at a dose of 10 mg/m2. The overall survival rates are 97% at 1 year and 73% at 3 years. Patients with lesions less than 3 cm in diameter and those treated strictly according to the protocol did significantly better than those with larger lesions and those whose treatment did not comply with the protocol. The interim outcome of the study demonstrates that this combined therapy is effective for patients with anal cancer and allows preservation of the sphincter and of sexual function.
 ...
PMID:Definitive irradiation and chemotherapy for radiosensitization in management of anal carcinoma: interim report on Radiation Therapy Oncology Group study no. 8314. 272 50

The frequency of gastrointestinal (GI) cancers mandates innovative and individualized therapies. Chemotherapy used as sole treatment for these diverse malignancies has not been generally successful in providing palliation or improving patient survival. Radiotherapy has been more successful at controlling local manifestations of disease, but the high incidence of systemic metastases in most malignancies limits the impact of this modality on curability. Combinations of radiotherapy and chemotherapy may prove to be more valuable than single modality treatment in improving local control of tumors, decreasing systemic disease, and improving patient tolerance to treatment. A model for this approach is the current management of anal cancer, in which combined modality therapy has largely supplanted primary surgery. Data from trials in other primary tumor sites strongly suggest further exploration of combined treatments--surgical, radiotherapeutic, and chemotherapeutic--in GI malignancies. Nearly 25% of all malignancies diagnosed in the United States each year involve the GI tract; thus, there is a powerful imperative for the development of new therapeutic strategies in these diseases. Any discussion of the role of chemotherapy in GI cancers must necessarily be broad, because assessment must include diseases with highly variable surgical curability, histologies, and sensitivities to chemotherapeutic agents. In addition, whereas it has been quite easy to perform standard phase II trials in colorectal cancer, other disease sites, such as the esophagus, the pancreas, and the biliary tract, have been much less extensively studied. In spite of these limitations, there is a wealth of data in the literature concerning the use of chemotherapy in GI malignancies. This article, while not exhaustive, describes the current status of chemotherapy for these diverse diseases, with emphasis on the role of mitomycin C.
 ...
PMID:Chemotherapy in gastrointestinal malignancies. 329 19

We have examined the level of the c-myc transcript in 6 esophageal, 16 gastric, 19 colorectal and 1 anal cancer tissue samples; these included four lymph nodes and six hepatic metastases obtained surgically. The esophageal cancer tissues were without an increase of the c-myc transcript, some of the gastric cancer samples showed a two to three fold increase and most of the colorectal and the one anal cancer samples showed a two to ten fold increase when compared with a normal mucosal layer. Therefore, the level of the c-myc transcript in human gastrointestinal malignancies shows organ dependency. Local, lymphatic, and hepatic metastases showed little difference in the level of c-myc mRNA from that of the primary tumor.
 ...
PMID:Expression of the c-myc gene in human gastrointestinal malignancies. 361 99

One hundred and ten patients with primary epidermoid cancers of the anal canal were treated in a series of prospectively designed, nonrandomized protocols of split-course radiation therapy with concurrent administration of 5-fluorouracil (5-FU) with or without mitomycin. The addition of mitomycin was associated with improved primary tumor control rates (87 vs. 58% at 4 years, p = 0.005) and improved 4-year actuarial cause-specific survival (80 vs. 64%, p = 0.02). Hematologic toxicity was the most frequent acute side effect of mitomycin use. No long-term toxicity was attributed to mitomycin only. Mitomycin appeared to benefit patients principally through improved control of cancer in the irradiated volume; there was no evidence of reduced risk of extrapelvic metastases. Several investigators have reported high rates of control of epidermoid anal cancers with preservation of anorectal function following concurrent treatment with mitomycin, 5-FU, and radiation. Mitomycin's role in anal cancer is being evaluated in a randomized clinical trial by the Radiation Therapy Oncology Group. The mechanisms of any interactions between mitomycin and radiation or other cytotoxic drugs in clinical practice remain to be determined.
 ...
PMID:Mitomycin in anal canal carcinoma. 848 59

Anal cancer is an uncommon tumor with an incidence of about one case per 100,000 in most countries. Its incidence seems to be increasing because of exposure to human immunodeficiency virus (HIV) and human papillomavirus (HPV). Traditional pretreatment evaluations include physical examination and CT imaging of the pelvis. Current treatment guidelines include fluorodeoxyglucose positron emission tomography integrated with computed tomography (FDG-PET/CT) as part of the standard pretreatment workup of patients diagnosed with anal cancer. At diagnosis, FDG-PET/CT is used to evaluate primary tumor size, lymph node status and to evaluate for distant metastases. FDG-PET/CT can also be used for radiation therapy treatment planning by clearly defining sites of metabolically active tumor. Posttherapy FDG-PET/CT to determine response to therapy is highly predictive of long-term clinical outcomes. This imaging modality can also be used to evaluate sites of recurrent disease. FDG-PET/CT is an imaging modality which greatly affects the management of patients with anal cancer.
 ...
PMID:FDG-PET/CT: new horizons in anal cancer. 1939 79

Carcinoma of the anal canal is a relatively rare cancer with a low propensity for metastasis. A literature review identifies two cases of brain metastases from anal cancer. The authors present the case of a 63-year-old female with poorly differentiated squamous cell carcinoma of the anal canal who presented with a solitary dural-based enhancing lesion of the right parietal area. The patient underwent craniectomy and tumor resection. Histopathology confirmed the cerebral lesion to be a poorly differentiated squamous cell carcinoma, consistent with the known primary tumor of the anal canal. Although exceptionally rare, the presence of a cerebral lesion in a patient with carcinoma of the anal canal should raise the possibility of metastatic disease. Treatment decisions in patients with newly diagnosed dural-based enhancing lesions and known anal cancer should bear in mind the possibility of metastatic disease.
 ...
PMID:Anal cancer with cerebral metastasis: a case report. 2044 May 37

Complete local response to radio- and chemoradiation for anal cancer was improved due to use of high-energy dosage of intraluminal brachytherapy (complete clinical regression (chemoradiation)--85.7%; combined irradiaton--75%). No signs of tumor progression have been reported in 20 survivors (median duration--21.6 months) (mean recurrence-free survival--12.5 months). Loco-regional relapse was in 4, local--2 patients. Intrapelvic lymph nodes were involved in 2 cases of previously morphologically confirmed regression of primary tumor. 18-month-long recurrence-free survival was in 86.3%, colostomy-free--91.6%. When combined with distant irradiation (+/-chemotherapy), brachytherapy is a relatively effective, safe and well tolerated procedure.
 ...
PMID:[Use of high-energy intraluminal brachytherapy in radio- and radiochemotherapy for anal cancer]. 2080 52

Concurrent administration of chemotherapy and radiotherapy has been increasingly used in cancer treatment, leading to improvements in survival as well as quality of life. Currently, it is a feasible preference, often regarded as the standard therapeutic option, for many locally confined solid tumors, including anal, bladder, cervical, esophageal, gastric, head and neck, lung, pancreatic and rectal cancers. In patients with these tumors, combined modality therapy improves local tumor control and survival while, in some instances, obviating the need for surgical removal of the organ of origin. The scientific rationale for the use of chemoradiation derives from the preclinical and clinical observations of synergistic interactions between radiotherapy and chemotherapy. When chemotherapy and radiotherapy are administered together, the chemotherapeutic agents can sensitize the cancer cells to the effects of ionizing radiation, leading to increased tumor-killing effects within the radiotherapy field. This, in turn, can improve local control of the primary tumor and, in some cancers, render surgical resection unnecessary. In other cases, patients with tumors that were initially considered unresectable are able to undergo curative interventions after completing chemoradiation. The chemotherapy component can address any potential micrometastatic disease that, without therapy, leads to an increased risk of distant recurrence. A large body of evidence exists that supports the use of chemoradiotherapy in gastrointestinal cancers. In fact, one of the first tumor types in which the superior efficacy of chemoradiation was described was anal cancer. Since then, chemoradiotherapy has been explored in other gastrointestinal malignancies with superior outcomes when compared with either radiation or chemotherapy alone. This article aims to recapitulate the clinical evidence supporting the use of chemoradiotherapy in a variety of gastrointestinal tumor types.
 ...
PMID:Chemoradiation therapy in the management of gastrointestinal malignancies. 2141 4


1 2 Next >>