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

A late phase II study of CPT-11 was conducted to evaluate the antitumor effect and toxicity of CPT-11 in patients with advanced pancreatic cancer as a cooperative study of 19 institutions. From February 1990 to June 1992, 61 patients with advanced pancreatic cancer were enrolled in this study. Fifty-seven patients were evaluable for toxicity and 35 for response. CPT-11 was administered as a 100 mg/m2 weekly intravenous infusion (regimen A) or as a 150 mg/m2 every two weeks (regimen B). The response rate was 11.4% (4/35). The primary tumor showed a 10.3% (3/29) response and the liver metastases showed a 10.5% (2/19) response. The major toxicities were myelosuppression and gastrointestinal symptoms. The incidences (> or = Grade 2) of leukopenia, anemia, anorexia, nausea/vomiting, alopecia and diarrhea were 61.4% (35/57), 56.1% (32/57), 70.2% (40/57), 56.1% (32/57), 40.4% (23/57) and 36.8% (21/57), respectively. The incidence of diarrhea was higher with regimen A than with regimen B, but the antitumor activity was no different between the two regimens. These results suggested that CPT-11 has some antitumor activity against advanced pancreatic cancer.
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PMID:[A late phase II study of CPT-11, irinotecan hydrochloride, in patients with advanced pancreatic cancer. CPT-11 Study Group on Gastrointestinal Cancer]. 821 Feb 55

From October 1995 to June 1997, 19 chemotherapy-naive patients with pathology-proven locally advanced or metastatic biliary tract carcinomas (BTC) were enrolled. The regimen consisted of 5-fluorouracil (5-FU) 2600 mg/m2 and leucovorin (LV) 150 mg by weekly 24 h infusion for 6 weeks and followed by a 2 week break. The treatment was terminated if disease progressed, the patient refused or unacceptable toxicity occurred. All patients required a Port-A catheter insertion and were treated at outpatient clinics by portable infusion pumps. There were 12 males and seven females with a median age of 62 years (range 45-77). The primary tumor sites were nine intrahepatic cholangiocarcinomas (CC), three perihilar CC, one distal BTC and six gallbladder cancers. A total of 179 chemotherapy sessions were given with a mean of 9.5 (range 2-18). Eighteen patients were evaluable for response. The response rates were: 33% (six of 18) partial response (PR), 39% (seven of 18) stable disease (SD) and 28% (five of 18) progressive disease (PD). All of the patients were evaluable for toxicity. The most common toxicities were mild fatigue (nine of 19, 47%), loss of appetite (nine of 19, 47%), skin hyperpigmentation (five of 19, 26%) and diarrhea (two of 19, 11%). Only one patient had grade IV myelotoxicity with sepsis but without treatment-related death. The median time to progression was 4 months. The overall median survival time was 7.0 months. The median survival time of the PR was not reached, SD was 8.0 months and PD 3.5 months. In conclusion, weekly high-dose 5-FU with LV by 24 h infusion in an outpatient setting for patients with BTC is effective, only mildly toxic and deserves further study.
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PMID:Weekly 24 h infusion of high-dose 5-fluorouracil and leucovorin in patients with biliary tract carcinomas. 966 May 35

A late phase II clinical study of RP56976 (docetaxel) was conducted in patients with advanced/recurrent gastric cancer as a multicenter cooperative trial. Docetaxel was administered intravenously at a dose of 60 mg/m2 every 3-4 weeks. Of the 76 patients enrolled, 66 patients were eligible and 59 patients were evaluable for response. One patient showed complete response (CR), 13 patients partial response (PR), 1 patient minor response (MR), 19 patients no change (NC) and 25 patients had progressive disease (PD). The overall response rate in 59 evaluable patients was 23.7% (95% CI = 13.6-36.6%). The primary tumor showed a 4.3% (1/23) response, while the metastatic lesions in the abdomen, pelvic mass, lung, liver, and lymph nodes showed response rates of 62.5% (5/8), 33.3% (1/3), 33.3% (1/3), 14.8% (4/27), and 13.9% (5/26), respectively. About hematological toxicity, severe (Grade 3 or more) leukopenia was observed in 36 patients (56.3%) and neutropenia in 52 patients (81.3%). Other major toxicity (Grade 3 or more) included nausea/vomiting in 11 patients (17.2%), anorexia in 9 patients (14.1%), fatigue in 5 patients (7.8%), and alopecia in 7 patients (10.9%), all which were tolerable. The results show that docetaxel is an effective anticancer agent for advanced/recurrent gastric cancer.
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PMID:[Late phase II clinical study of RP56976 (docetaxel) in patients with advanced/recurrent gastric cancer: a Japanese Cooperative Study Group trial (group A)]. 979 14

Enterocutaneous fistulae that develop in patients with cancer represent a difficult management situation, which is often complicated by prior treatment including surgery, radiation therapy, and chemotherapy. A fistula may in turn delay potentially beneficial treatment of the underlying malignancy. To provide a better understanding of this problem, we reviewed the National Institutes of Health experience with enterocutaneous fistulae in adult patients with cancer. The medical records of patients with cancer who developed a fistula from the gastrointestinal tract during the period 1980 through 1994 were reviewed. Etiology, management, outcome, and impact on further treatment were assessed. Twenty-five patients with gastrointestinal fistulae were identified. The most common primary tumor site was the colon/rectum in males and the ovary in women. The majority of patients had metastatic disease at diagnosis and a history of prior therapy and presented with anorexia and weight loss. The fistula was usually single, most commonly developed from the jejunum/ileum (13 patients) or colon/rectum (6 patients), and occurred postoperatively after procedures on the small bowel (10 patients) or colon (8 patients). Malnutrition and sepsis developed in 60 per cent of patients. Thirty-day mortality was 16 per cent and correlated with prior radiation therapy, location and output from the fistula, and hypoalbuminemia. An enterocutaneous fistula negatively impacted on the provision of further therapy for the majority of patients (63%). Enterocutaneous fistula in the patient with cancer occurs most frequently in the setting of extensive prior therapy and is associated with prolonged morbidity. Identification of high-risk patients and early management of fistulas once they develop may prevent delays in subsequent cancer therapy and decrease morbidity.
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PMID:Enterocutaneous fistula in cancer patients: etiology, management, outcome, and impact on further treatment. 984 47

Over the past 18 years, our laboratory has been interested in the pathogenesis of energy imbalance caused by a variety of diseases. Our view is that a clear understanding of the various factors causing negative energy balance, which in turn results in malnutrition, is the most effective way of designing preventive and therapeutic nutritional strategies. Thus, in cancer, one of the common factors is anorexia, due either to the primary tumor or to the effects of cancer therapy. Currently there is little evidence of increased resting energy expenditure in children with cancer, except in cases with very high tumor burden. Conversely, there are suggestions of a failure to down-regulate resting energy expenditure in the presence of reduced food intake in patients with cancer. Damage to the gastrointestinal tract, due to the effects either of the tumor or of tumor therapy, may result in maldigestion and/or malabsorption. Thus, as a result of a combination of reduced intake, reduced absorption and increased needs, the child with cancer may become malnourished. Prevention and treatment are dependent on the type of cancer and the pathogenesis of the negative energy balance. In broad terms, we try as far as possible to use external routes. With the advent of percutaneously placed gastrostomies and gastrojejunal tubes, we use these methods increasingly to provide nutritional support. Only in patients whose gastrointestinal tract cannot be used do we turn to i.v. feeding. In these patients, the placement of a central venous line is required, but great care must be taken to avoid infection. Whatever form of nutritional support is used, whether enteral or parenteral, we measure the body composition and energy expenditure in the patient, so that the nutritional therapy can be tailored to the child's specific needs. Using these approaches, we are having significant success in preventing and reversing malnutrition in children with cancer and those undergoing bone-marrow transplantation.
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PMID:Aggressive oral, enteral or parenteral nutrition: prescriptive decisions in children with cancer. 987 84

A late phase II clinical study of RP56976 (docetaxel) in patients with advanced or recurrent gastric cancer was performed to evaluate the anti-tumor activity and clinical toxicity as a multicenter cooperative trial. Docetaxel was administered intravenously at a dose of 60 mg/m2 every 3-4 weeks. Of 72 patients enrolled, 63 patients were eligible and 59 patients were evaluable for response. The anti-tumor effects obtained complete response (CR) in one patient partial response (PR) in 13, minor response (MR) in 3, no change (NC) in 20, and progressing disease (PD) in 22 patients. The overall response rate in 59 patients was 23.7% (14/59). For 14 CR or PR cases, a response appeared 10 to 107 days (median 33.5 days) and 1 to 8 (median 2) times of dosing after the initial administration. The response rate was 9.5% in the primary tumor, 31.3% livers, 50.0% abdominal tumor, and 24.1% lymph nodes, respectively. The major adverse reactions were gastrointestinal symptoms including nausea/vomiting, anorexia, fatigue, alopecia and fever. Leukocytopenia and neutrocytopenia were also observed with a high incidence, but they recovered after 8 days from the nadir. The results show that docetaxel is an effective anti-tumor agent for advanced or recurrent gastric cancer. It is necessary to conduct another clinical trial by concomitant administration with other anti-tumor agents.
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PMID:[A late phase II clinical study of RP56976 (docetaxel) in patients with advanced or recurrent gastric cancer: a cooperative study group trial (group B)]. 1009 45

The patient was a 80-year-old male with advanced gastric cancer (Type 3) accompanied by multiple liver and lymph node metastases. Histological findings in the stomach showed poorly differentiated adenocarcinoma. He had nausea, vomiting and anorexia due to pyloric stenosis, and was treated with 600 mg of UFT E granules/day orally for 5 consecutive days followed by 2 drug-free days (weekly-5 method), and 2 mg of lentinan intravenously twice a week. After 4 weeks of treatment, the primary tumor and metastatic lesions of the liver and lymph nodes were markedly reduced. His symptoms had completely disappeared along with lessening of the pyloric stenosis after 6 weeks of treatment. The patient survived for 7 months in a state of CR and PR. The adverse effects were very mild and negligible. A weekly-5 method of UFT, in comparison with conventional daily administration, may induce maximal antitumor effects with minimal adverse effects.
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PMID:[A case of advanced gastric cancer (type 3) with pyloric stenosis, multiple liver and lymph node metastases responding to UFT-E granules and lentinan]. 1066 Jul 41

We treated a case of unresectable gastric cancer in which peritoneal lavage cytology and the primary tumor responded to combined chemotherapy by intravenous, intraarterial and intraperitoneal injection. The patient was a 61-year-old male with loss of appetite. He underwent laparotomy for gastric cancer in November, 1997. An intraperitoneal catheter was set without gastrectomy because of the unresectability due to extensive peritoneal dissemination and local invasion to pancreas. The patient was given combined chemotherapy using 5-FU 6,000 mg i.v., CDDP 360 mg i.p. and 5-FU 10,500 mg ia by the catheters in the supra vena cava, right gastroepiploic artery and peritoneal cavity. One month after laparotomy, peritoneal lavage cytology had changed to class I from class V, and the primary tumor had been reduced to 10 mm in size from a diffusely infiltrating tumor. His quality of life in appetite and activity was improved for 13 months.
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PMID:[A case of stage IV gastric cancer responding to combined chemotherapy by intravenous, intraarterial and intraperitoneal injection]. 1110 47

Cancer patients, families, clinicians, and health-policy administrators need accurate information about the prognosis of survival of terminally ill cancer patients. The aim of this study was to compare survival times and prognostic factors, and develop a new prognostic index for terminally ill cancer patients. This prospective study was performed on 91 patients with solid tumor, and therefore, no longer subjects of anti-cancer therapy. Association was sought between survival times and a range of clinical characteristics. The median survival time of 91 terminal cancer patients was 54.0 days. Univariate analysis showed that 11 factors provide statistically significant prognostic survival information. Multivariate analysis adjusted for the primary tumor site demonstrated that severe anorexia (aRR 1.95, 95% C.I. 1.24-3.05), severe diarrhea (aRR 3.49, 95% C.I. 1.10-11.05), and mild confusion (aRR 1.94, 95% C.I. 1.15-3.27) are independent negative predictors of survival. The Terminal Cancer Prognostic score (TCP score), which was based on three predictors proved to be a significant predictor. The TCP score might be a useful index for predicting survival.
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PMID:Development of terminal cancer prognostic score as an index in terminally ill cancer patients. 1141 Jul 86

We report the case of a patients with a metachronous cystic pancreatic metastasis from an undifferentiated large cell lung carcinoma two years after the primary tumor had been surgically removed. Clinically, he presented with epigastric pain, fever, weakness and anorexia. The patient was operated and a palliative cystogastrostomy was performed after an intraoperative biopsy had been informed as positive for carcinoma. Six months later the patient died. Pancreatic metastases from lung carcinoma are found in approximately 7-9% of patients deceased of this neoplasm. Clinical and radiological findings simulate primary pancreatic tumors, being epigastric pain, jaundice and upper digestive bleeding the most frequent symptoms. They represent stages of advanced systemic disseminated tumoral disease, and because of this reason total or partial surgical curative resections will only be performed in a few cases of patients with isolated metastasis, criteria of resectability and without evidence of extended disease to other organs or systems. In the most of the cases, the treatment will only be palliative, even medical or surgical.
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PMID:[Pancreatic cystic metastasis from pulmonary carcinoma. Report of a case]. 1146 3


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