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 regimen for improving the salvage rate for Stage IV squamous cell carcinoma of the tongue, alveolar ridge and floor of mouth is presented. This method utilizes pre-operative sensitization of the tumor and regional lymph nodes by the topical application of 5-fluorouracil (5-FU) in the form of Efudex (Roche). The drug must be used topically at the tumor skin or tumor-mucous membrane interface to utilize the sensitizing properties of skin or mucous membrane. Further response is obtained by direct injections of 5-FU into the tumor. Later intravenous (IV) drip of 5-FU can be used particularly at the time of surgical resection. During the period of preparation until sensitized to 5-FU, patients must be restored to positive nitrogen balance and concurrent infections are controlled. Because of the importance of nutrition in restoring immunity, a feeding gastrostomy for these patients is recommended. The definitive surgery must include all bone that is involved, as 5-FU alone will not sterilize the bone. Of 15 patients who underwent the regimen outlined in this study, 12 of the patients with Stage IV intra-oral squamous cell carcinoma have had their primary tumor controlled for 17 months to 5 years at the time of this report.
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PMID:Salvage of stage IV intraoral squamous cell carcinomas with preoperative 5-fluorouracil. 394 8

Eighteen patients with unresectable carcinoma of the stomach whose known malignant disease was confined to structures immediately adjacent to the primary tumor and could be encompassed within a radiotherapy field were treated with an intensive sequential combined modality regimen. The regimen consisted of 5-FU plus adriamycin chemotherapy, followed by high dose megavoltage radiation therapy with 5-FU given as a radiation sensitizer, followed by maintenance chemotherapy with 5-FU plus adriamycin plus methyl CCNU (FAMe). Our primary objective was to determine patient tolerability. Severe and prolonged anorexia, nausea, and decreased performance status occurred during and after high dose radiotherapy given twice daily in 150-170 cGy (rad) fractions when given with 5-FU. Lengthening intervals between treatment segments, and the use of one daily dose of radiation therapy combined with 5-FU or two fractions daily without 5-FU seemed to decrease nutritional complications. Control of tumor at the primary site appeared to be achieved in most patients. Distant metastases represented the predominant mode of treatment failure with only two patients currently without progression of malignant disease. Our treatment regimen as initially conceived was too toxic for general use. Improved therapeutic results in locally unresectable gastric cancer will require the development of more effective therapy for occult distant metastases.
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PMID:A pilot study to determine clinical tolerability of intensive combined modality therapy for locally unresectable gastric cancer. 404 45

This controlled trial compared to survival of 90 patients with locally advanced gastric carcinoma treated with either chemotherapy alone (5-FU and methyl-CCNU) or external radiotherapy of 5000 rad combined with the same chemotherapy. The minimum period of followup is 4 years. During the initial 12 months, combined modality therapy was associated with an increased number of early deaths attributable to progression of tumor within the radiation field, or nutritional and hematologic complications. During the second to fourth years of followup, patients treated with combined radiation therapy have shown a significantly lower death rate compared to those treated with chemotherapy alone, with eight of 45 patients alive and disease-free. Patients who received only chemotherapy, in contrast, have demonstrated a continued probability for tumor relapse and death, with three of 45 patients alive at 4 years. Palliative resection of the primary tumor was associated with an improved survival, independent of the form of postoperative therapy employed. It is possible that the superior late survival achieved with combined modality therapy in this program can be further improved with measures to decrease the toxicity of upper abdominal irradiation, and with the use of more effective forms of chemotherapy.
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PMID:A comparison of combination chemotherapy and combined modality therapy for locally advanced gastric carcinoma. Gastrointestinal Tumor Study Group. 617 13

The antineoplastic activity of vindesine was evaluated in a phase II trial in patients with small cell anaplastic bronchogenic carcinoma. All patients had been treated previously with vincristine, CCNU, cyclophosphamide, VP-16-213, methotrexate, and doxorubicin. In some of the patients, the primary tumor had also been irradiated, and some patients had received 5-FU or procarbazine. The dose of vindesine was 4 mg/m2/week iv, modified according to hematologic and neurologic side effects. Twenty-six of 32 patients included in the trial were evaluable. Objective response was observed in seven patients (27%). The median duration of response was 35 days (range, 28-90), the response occurring within 14 days after initiation of treatment. Dose modification of vindestine was necessary in 80% of the patients because of hematologic toxicity, while neurotoxicity made dose reductions necessary in about one half of the patients. The study demonstrates that vindesine is active against small cell bronchogenic carcinoma, with apparent lack of clinical cross-resistance to vincristine in previously heavily treated patients.
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PMID:Vindesine in the treatment of small cell anaplastic bronchogenic carcinoma. 626 69

Chemotherapeutic effects on the lymph node metastasis were studied in relation to the predominancy of T or N factor, extending patterns of tumor, histologic subtype, and cytologic characteristics, using cyclophosphamide, vincristine and 5-FU. N2, N3, N4 indicate ipsi-lateral, contra-lateral mediastinal, and supra-clavicular node, respectively. Chemotherapy was equally effective to the lymph node metastasis regardless a degree of progression, but survivals depended on the progression. Predominancy of both primary tumor (T) and involved lymph node (N) was analysed on chest X-rays. The Deffer response was observed in Type N than in Type T. Extending patterns of primary tumor were classified on X-ray films according to Suzuki's criteria: a longitudinal submucosal spreading along the bronchus (I): infiltration beyond the bronchial wall, extending to the depth, and fusing into a mass (III): and intermediate (II). In type I, the tumor was seen like an assembly of clubs extending along the bronchial tree, and Type III tumor showed a mass-like shadow with relatively high density and clear margin. Overall response rates were remarkably higher in Type I and lower in Type III. Type I was more frequently accompanied by large lymph node involvement than Type III. The highest response rate was obtained in Type I with N-predominancy and the lowest in Type III with T-predominancy. Responses to chemotherapy of lymph node metastasis depended upon these extending patterns. A half of Type III cases were polygonal cell type, which showed the lowest response rate in our institute. Regarding to cytologic classification by Horai, 67% response of good was found in Type I and 65% of response poor in Type III. These biological characteristics are considered to be a useful indicator for the selection of treatment modalities.
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PMID:[Chemotherapy of small cell carcinoma of the lung in relation to lymph node metastasis and extending pattern of tumor]. 630 95

Between 1964 and 1981, seventy-two Japanese patients with gastric cancer associated with hepatic metastases, in whom the primary tumor had been resected, were treated in a nonrandomized manner at the Second Department of Surgery, Kyushu University Hospital. Fourteen received hepatic arterial infusion (HAI) of 5-FU and Mitomycin C (MMC) combined with systemic chemotherapy, 26 combination systemic chemotherapy of MMC, Futraful and PSK, 18 single drug (MMC) therapy, and 14 no chemotherapy. The average survival was 264 days in HAI combined with systemic chemotherapy, 208 in the combination systemic chemotherapy, 156 in the single drug therapy and 135 in those given no chemotherapy. One year survival and nine month survival rates were 21.4 per cent and 42.9 per cent in HAI combined with systemic chemotherapy, 11.5 per cent and 19.2 per cent in the combination systemic chemotherapy, 5.6 per cent and 11.1 per cent in the single drug therapy and 7.1 per cent and 14.3 per cent in the no chemotherapy group, respectively (HAI vs single drug therapy and no chemotherapy, p less than 0.01). Five of 14 patients treated with HAI combined with systemic chemotherapy showed a partial response (greater than 50 per cent reduction in tumor size), and the average survival time was 335 days, while that of nonresponders was 224 days. Six of 14 patients treated with combination infusion therapy with MMC and 5-FU survived 314 days, as compared to 201 days for patients with infusion of 5-FU alone.
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PMID:Combination of hepatic arterial infusion and systemic chemotherapy for gastric cancer with synchronous hepatic metastases. 642 97

A recently developed metastatic tumor model was used to study the therapeutic response of liver metastases derived from intrasplenically growing LLT. Treatment was performed on the day following surgical removal of the 'primary tumor'. The life-span of tumor-bearing animals and the number and volume of liver metastases were measured. Cyclophosphamide and 13324 (a new bifunctional nitrosoureido derivative) proved to be most effective. Some other drugs (5-FU, MeCCNU, Lycurim) showed a temporary regression in the formation of macrometastases without influencing the life-span. Adriamycin was slightly more effective given i.p. than i.v.
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PMID:Chemotherapeutic sensitivity of liver metastases from intrasplenically-growing Lewis lung tumor. 644 44

Dextran-coated charcoal competitive binding assays and Scatchard analysis revealed the presence of high-affinity, low capacity binding sites for dexamethasone in cytosol preparations from Lewis lung tumors. In vitro studies with live cells indicated approximately 9000 nuclear binding sites/cell for the ligand-receptor complex. In vivo inhibition of cell proliferation by dexamethasone, methylprednisolone and triamcinolone acetonide was found to be dose-dependent. Changes in the [3H]-TdR labeling index, mitotic index and saturable cytosol receptor sites after dexamethasone treatment in vivo suggested a dose-dependent G1 progression delay which, after cessation of dexamethasone treatments, was apparently reversible. Resumption of cell-cycle progression was characterized by synchronous progression through S-phase and correlated temporally with receptor site desaturation. In vivo studies indicated that the effectiveness of vincristine given after dexamethasone was highly sequence-dependent, with the most effective sequence interval being coincident with the interval of maximal S-phase cellularity. Other studies indicated sequential chemotherapy with dexamethasone, vincristine and 5-Fu could be effectively employed, following primary tumor excision, to increase animal survival.
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PMID:Receptor-mediated antiproliferative effects of corticosteroids in Lewis lung tumors. 653 2

The Southwest Oncology Group evaluated 51 patients with a histologic diagnosis of metastatic adenocarcinoma and an occult primary tumor. Even though all patients received an extensive diagnostic evaluation, only six (12%) primary sites were found. Thirty-six patients whose primary tumor sites remained occult were randomized to receive either 5-FU or combination chemotherapy (5-FU, doxorubicin, and cyclophosphamide [FAC]). There were no responses in either group. The median survival with 5-FU was 105 days and with FAC was 95 days. Toxicity with FAC was more common and more severe.
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PMID:Management of patients with metastatic adenocarcinoma of unknown origin: a Southwest Oncology Group study. 661 95

A retrospective study of 37 colorectal cancer patients with synchronous liver metastases was made. Of these patents, 6 who had undergone primary tumor removal were treated with considerable success by hepatic arterial infusion of 5-FU and mitomycin C. Ten patients who underwent primary tumor excision were treated by oral chemotherapy using fluorinated pyrimidines. These patients survived about 23 months. On the other hand, 12 patients after primary tumor removal without cancer chemotherapy survived for about 10 months. Six patients without antitumor treatment for both primary tumor and hepatic metastasis survived about 5.2 months. The overall results of this study suggest that intrahepatic arterial infusion is of practical importance for hepatic metastases from colorectal cancer and that oral chemotherapy is indeed effective for selected patients.
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PMID:Comparative efficacy of antitumor treatment for liver metastases from colorectal cancer. 679 9


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