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)

Over a period of 13 years, 353 cases of metastases in the brain, spinal canal or peripheral nerves were treated in 14,350 inpatients. In 79.6% of the cases, the metastases were localized intracranially, in 14.7% spinally, in 2.6% peripherally and in 3.1% in several of these sites. Solitary tumors predominated (65.7%). Of 420 intracranial metastases, 336 were located supratentorially (80%) with a slight preponderance on the left side (54.5%), 15% cerebellar, and 5% in the brainstem. Of the spinal metastases, 80% were located in the thoracic spinal cord. Almost 60% of the cases also displayed metastases outside the nervous system, mainly in the skeletal system and the lungs. The most frequent primary tumor was bronchial carcinoma (26,6%) followed by breast cancer (19.5%) and unknown primary tumor (17.6%), which was also not found on autopsy in 0.8%. Rare primary tumors were parotid and pancreatic carcinomas, testicular and bladder tumors. There are correlations between the primary tumor and the location of the metastases in the nervous system in general and in the brain in particular. The latency between diagnosis of the primary tumor and that of the metastasis was 1-3 years. In one out of three cases, the metastasis in the nervous system was the first sign of the tumor condition. In six cases, the metastasis was removed before the primary tumor and two possible kinds of primary tumors were found in seven cases. Compared to intracranial hypertension focal deficit manifestations including focal convulsions occurred twice as frequently in cerebral metastases. Spinal metastases led to CSF blockade in 20%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Metastases to the nervous system]. 405 15

Ten (23%) patients out of 43 with malignant glioma developed meningeal gliomatosis during the follow up period of at least one year. The duration between the first surgery and diagnosis of meningeal gliomatosis ranged from one to 78 weeks (median 45 weeks). In younger age group less than 20 years old, 5 (56%) out of 9 patients had meningeal gliomatosis, and on the contrary the incidence was lower in older age group above 20 years old (5 of 34, 15%). Seven (22%) out of 32 male and 3 (27%) out of 11 female patients developed meningeal gliomatosis. The primary tumor location were frontal lobe in 4 cases (including one bifrontal tumor), temporal in 2, parieto-occipital in 1, thalamus in 1, midbrain in 1, and cerebellar hemisphere in 1, respectively. Histologically, 7 tumors were anaplastic astrocytoma, and 3 were glioblastoma. The characteristic neurological findings observed during the course of meningeal gliomatosis were abnormal mental status (80%), cranial nerve palsies (50%), paraplegia (60%), stiff neck (80%), seizure (50%), and respiratory disturbance (80%), CSF cytology was positive in all 9 patients tested. CT scan demonstrated hydrocephalus (70%), and diffuse contrast enhancement of ventricular wall (60%) and basal cistern (10%). In 2 cases, block and irregular filling defect were seen by myelography. Six patients were treated by irradiation to the whole brain and/or spine, and 5, by intrathecal chemotherapy with methotrexate, cytosine arabinoside and bleomycin. However, all patients died of the tumor one to 46 weeks (median 18 weeks) after the diagnosis of meningeal gliomatosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical studies of meningeal gliomatosis]. 649 23

Osteosarcoma patients free of CNS metastases are at risk for acquiring leukoencephalopathy after receiving multiple courses of high dose intravenous methotrexate followed by oral leucovorin rescue (MTX-LV). A prospective study of the adequacy of CNS rescue of MTX biochemical toxicity by oral leucovorin was undertaken in newly diagnosed neurologically normal osteosarcoma patients. Prior to surgical resection of the primary tumor, ten patients received 4 weekly courses of MTX-LV. During the fourth weekly MTX-LV treatment, 0 and 72 hr serum and CSF determinations of MTX, 5-methyl-tetrahydrofolate (5-MTHF) and LV were made. No CSF MTX was detectable at 0 hr in any patient, but a significant elevation in CSF MTX occurred in 9/9 patients at 72 hr (mean 47.2 +/- 31.8 ng/ml or 1.04 +/- 0.7 X 10(-7) M). There was no significant change in mean CSF 5-MTHF over 72 hr despite a rise in serum 5-MTHF. MTX exceeded 5-MTHF in 6/9 patients in CSF, whereas only 3/8 patients had higher MTX in the serum at 72 hr. No acute systemic or neurotoxicity was seen. The failure of oral leucovorin to consistently elevate CSF 5-MTHF levels at 72 hr in the context of significant levels of CSF MTX may result in intermittent CNS folate deficiency. The clinical and pathological syndrome of leukoencephalopathy may be related to this phenomenon and may evolve after repeated MTX-LV treatments.
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PMID:The inability of oral leucovorin to elevate CSF 5-methyl-tetrahydrofolate following high dose intravenous methotrexate therapy. 661 87

Infiltration of the optic nerve is very rarely found in any form of malignant lymphoma. We report on a 24-year-old male patient suffering from non-Hodgkin lymphoma of the stomach. While recovering after treatment of the primary tumor by chemotherapy he developed papilledema in both eyes and almost total loss of vision. Radiotherapy resulted in restitution of vision within a few days. Later there was a transient acute detachment of pigment epithelium. Malignant cells in the CSF could not be detected until three months after the onset of ophthalmological symptoms. Histopathological sections revealed meningeosis sarcomatosa with infiltrations into the optic chiasm, tracts and nerves.
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PMID:[Non-Hodgkin lymphoma with infiltration of the optic nerve (author's transl)]. 708 43

The diagnosis of leptomeningeal or ventricular metastasis by cranial computerized tomography (CT) contributes to earlier treatment and sometimes alters the management of patients with intra- or extra-cranial malignancy. In 20 cases whose metastasis were spreaded via CSF seeding, the abnormal CT findings were 1) mass or nodule in the ventricles or subarachnoid space, 2) ependymal, subependymal enhancement, 3) sulcal, gyral or cisternal enhancement, 4) hydrocephalus not related to the obstruction of primary tumor, 5) falx or tentorial enhancement. In another 8 cases, the metastasis developed through hematogeneous spreading to the choroid plexus or paraventricular parenchyma. The mass or nodule within the ventricles could be well identified with enhanced CT scan. The involved ventricles, in order of frequency, were lateral, 3rd, and 4th ventricles in our series.
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PMID:[Metastasis involving the leptomeninges and ventricles of the brain--CT evaluation]. 804 Sep 29

Recombinant human (rhu) macrophage colony-stimulating factor (M-CSF) was evaluated, alone or in combination with local hyperthermia (LH), for their antitumor effects in mice inoculated with B16a melanoma cells. Several tumor related parameters and other hematopoietic and immunologic parameters were evaluated 5 weeks after subcutaneous (s.c.) inoculation of tumor cells into the right limbs of C57BL/6J male mice. RhuM-CSF was administered at 20 micrograms/injection, s.c., twice a day for 5 days/week for 2 weeks beginning 6 days after tumor cell inoculation and LH (43 +/- 0.2 degrees C) was given for 30 min twice/week for 2 weeks. Combined therapy prolonged survival of mice and caused significant inhibition of tumor growth, as measured by the volume or size of primary tumor, number and size of lung metastases, and chromatin fragment (CF) formation in tumor bearing mice, while treatment with M-CSF or LH alone had less or no effect. Combined therapy also resulted in increased numbers of splenic T-lymphocytes and the ratio of T-helper/suppressor cells, restoration of natural killer (NK) cell activity, increased numbers of peritoneal macrophages and their erythrophagocytosis capacity, and increased release or production of tumor necrosis factor (TNF)-alpha, but not interleukin (IL)-1 alpha or IL-6. These results add to previous evidence that M-CSF might be a relevant therapeutic agent in combination with other therapies in the treatment of certain malignant diseases.
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PMID:In vivo effects of purified recombinant human macrophage colony-stimulating factor in combination with local hyperthermia on tumor progression in B16a melanoma bearing mice. 814 92

A 38 year old patient developed multiple cranial nerve palsy, seizures and progressive alteration in consciousness. CSF examination revealed tumor cells and a tentative diagnosis of leptomeningeal carcinomatosis from an unknown primary tumor was made. Treatment with intrathecal methotrexate and cranial radiation therapy was started without effect. At autopsy widespread leptomeningeal gliomatosis originating from a previously unknown astrocytoma of the hippocampus was found.
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PMID:Diffuse primary leptomeningeal gliomatosis. 845 62

The 5 year survival for patients with malignant intracranial non-germinoma germ cell tumors (NGGCT) which include endodermal sinus tumors, embryonal carcinomas, choriocarcinomas and immature teratomas is less than 25% following a small resection and radiotherapy. In an effort to improve the survival of these patients, an approach using an attempt at radical resection where feasible followed by multi-modality 'sandwich' therapy (chemotherapy-radiation-chemotherapy) was used to treat 18 newly diagnosed patients between 1986 and 1994 in a multi-institution study. Fourteen patients had histologically proven NGGCT and four were presumed NGGCT because of markedly elevated concentrations of serum and/or CSF alpha fetoprotoin (AFP) and/or beta human chorionic gonadatrophin (b-HCG). The primary tumor was confined to the pineal region in 12 patients, the suprasellar region in five, and a cerebral hemisphere in one. None of the patients had central nervous system metastases at diagnosis by MRI imaging of the spine and CSF cytology. Radical surgical resection was performed initially in 11 patients (gross total -6, subtotal -5): four had a biopsy and three had no surgery. All patients then received 3 or 4 cycles of neoadjuvant chemotherapy with cisplatin (100 mg/m2/cycle) and VP-16 (500 mg/m2/cycle). Of the 12 patients with evaluable disease there were 9 responses to the neoadjuvant chemotherapy (5 CR, 4 PR); 2 patients had stable disease and I progressed during chemotherapy. Six patients with no evaluable disease after a gross total resection had a continuous complete response. Seventeen patients received radiation therapy (involved field -11, involved field + craniospinal -4, involved field + whole brain -2). Twelve patients received 4 cycles post-radiation chemotherapy with vinblastine (6.5 mg/m2/cycle). bleomycin (15 U/m2/cycle), VP-16 (300 mg/m2/cycle, carboplatin (450 mg/m2/cycle). A total of four patients have died (3-progressive/recurrent disease, 1-metabolic). Four year actuarial event-free and total survival rates are 67% and 74%. This multi-modality adjuvant therapy approach appears to dramatically improve the outcome of malignant intracranial NGGCT.
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PMID:Improved prognosis of intracranial non-germinoma germ cell tumors with multimodality therapy. 904 65

Interleukin-12 (IL-12), a naturally occurring cytokine, has demonstrated antitumor activity in several murine solid tumors. The Lewis lung carcinoma was used to study the most effective scheduling of recombinant murine interleukin-12 (rmIL-12) administration with fractionated radiation therapy. The effect of the schedule of rmIL-12 administration alone or along with a 1- or 2-week fractionated radiation therapy regimen was examined. Beginning rmIL-12 prior to or at the same time as radiation therapy and extending rmIL-12 through the radiation regimen and beyond produced the longest tumor growth delays. Those treatment regimens which were most effective against the primary tumor were also most effective in decreasing the number of lung metastases on day 20. To further assess the immunotherapeutic effects from rmIL-12 administration, the efficacy of rmIL-12 with fractionated radiation therapy delivered to a right hind-limb tumor was measured as tumor growth delay in an unirradiated left hind-limb tumor. There was some difference in the tumor growth delay between the unirradiated tumor in the animals bearing an irradiated tumor in the contralateral leg, and the tumors in animals receiving rmIL-12 only. Recombinant murine granulocyte-macrophage-colony stimulating factor (rmGM-CSF) was also an antitumor agent active against the Lewis lung carcinoma and produced an additive effect in combination with fractionated radiation therapy in this tumor. rmIL-12 was a radiation sensitizer in the Lewis lung carcinoma. When rmIL-12 (45-microg/kg) and rmGM-CSF (45 microg/kg) were administered together with fractionated radiation therapy, a marked increase in tumor growth delay resulted. This treatment combination also nearly ablated lung metastases on day 20 in these animals. These results may serve as a useful guide in developing clinical protocols, including rmIL-12 and fractionated radiation therapy.
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PMID:Optimal scheduling of interleukin-12 and fractionated radiation therapy in the murine Lewis lung carcinoma. 957 83

Meningeal metastasis occurs in 3-8% of all cancer patients, producing neurologic morbidity and a high mortality. Diagnosis is best established by the demonstration of malignant cells in the cerebrospinal fluid. However, in patients with known cancer, MR scan with gadolinium may be diagnostic when subarachnoid nodules can be demonstrated in the head or spine. Therapy usually involves radiotherapy to symptomatic sites, often followed by intrathecal chemotherapy. Intrathecal chemotherapy is best delivered by an intraventricular reservoir system but can also be delivered by repeated lumbar puncture. Methotrexate, cytarabine and thiotepa are the most common agents instilled into the subarachnoid space. Their limited efficacy can be explained by their restricted spectrum of antitumor activity. Patients with leptomeningeal metastasis from leukemia, lymphoma or breast cancer tend to respond best and this may, in part, be attributed to the relative sensitivity of these primary tumor types to the agents administered intrathecally. Systemic chemotherapy may prove a more attractive alternative to intrathecal drugs since it can penetrate into bulky disease, reach all areas of the subarachnoid space, and not be restricted by CSF bulk flow. The prognosis for patients with leptomeningeal metastasis is poor, most individuals surviving a median of only about four months. Occasional patients do have prolonged survival and improvement of their neurologic function.
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PMID:Current diagnosis and treatment of leptomeningeal metastasis. 969 79


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