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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Response of intrathoracic symptoms to thoracic irradiation was evaluated in 330 patients. Superior vena caval syndrome and hemoptysis showed the best response, with rates of 86% and 83%, respectively, compared to 73% for pain in the shoulder and arm and 60% for dyspnea and chest pain. Atelectasis showed re-expansion in only 23% of cases, but this figure increased to 57% for patients with oat-cell carcinoma. Vocal cord paralysis improved in only 6% of cases. Radiation therapy has a definite positive role in providing symptomatic relief for patients with carcinoma of the lung.
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PMID:Radiation therapy in bronchogenic carcinoma. 10 98

Tumor embolization was found at autopsy in the pulmonary arteries of 33 of 331 patients dying with primary carcinoma of the lung (other than oat cell carcinoma). Venous or lymphatic vascular involvement, or both, was greater frequency of tumor embolization htan epidermoid carcinomas (16.5% vs. 5.8%). In 16 of the 33 cases, diffuse, obliterative intimal fibrosis was found in small arteries affected by the tumor embolization. Enlargement of the right cardiac ventricle was present in 26 of the 33 cases. Dyspnea as the initial symptom or as one of the major symptoms, occurred in 21 patients. The average interval between onset of dyspnea and death was 4 weeks. It is concluded that pulmonary arterial embolization is a relatively frequent complication of primary lung carcinoma, particularly adenocarcinoma, which may lead to the developemnt of pulmonary hypertension and cor pulmonale Dyspnea, occurring de novo in patients with primary lung carcinoma is an ominous sign and should alert the clinician to the possibility of arterial pulmonary tumor embolization.
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PMID:Pulmonary tumor emboli and cor pulmonale in primary carcinoma of the lung. 99 Nov 23

A retrospective study was undertaken in 1990 of 188 patients with the diagnosis of non small cell carcinoma of the lung referred to the Department of Radiation Oncology in 1984. Most patients (178/188) received a course of radiotherapy. This was definitive in 23, palliative in 148 (primary site in 113, metastases in 16, primary plus metastases in 19) and postoperative in 7. This report is a 5 year followup of the 171 patients treated by radiation alone, to assess factors that influence survival. Tumour histology was 50% squamous, 23% adenocarcinoma, 16% large cell and 4% unspecified, non small cell carcinoma. In 8% no histological diagnosis was obtained. The most common symptoms were cough (44%), dyspnoea (43%), chest pain (37%), haemoptysis (33%) and systemic symptoms (36%). Tumour stage (TNM) was assessed retrospectively as I(5%), II(8%), IIIA(18%), IIIB(22%) and IV(28%). A subgroup of 31 cases (18%) of uncertain staging (I-III) was analysed separately and in 2 cases (1%) no staging information was available. Palliative intent of treatment and poorer performance status were related significantly to increasing stage of disease. The effects of palliative treatment were recorded in 79 cases; in 71 there was a reduction in symptoms. The median survival from diagnosis was 8 months (range < 1-72). Using univariate and multivariate analyses, significant and independent prognostic factors for improved survival were good performance status, absence of systemic symptoms, lower tumour stage and curative intent of treatment (higher radiation dose). However the 5-year survival was only 2%. Long-term survival was associated predominantly with early stage disease but not with the type or intent of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Non small cell carcinoma of the lung. A retrospective study. Presented at the 41st annual meeting of the Royal Australasian College of Radiologists, September 1990, Perth. 128 99

A total of 20 patients with loco-regional non-small-cell lung carcinoma were entered into a study of irradiation (3.0 Gy x 15 doses to a total dose of 45 Gy given in 4 fractions per week on days 1, 2, 4 and 5 of each week) and cisplatin given at a dose of 40 mg/m2 on day 3 of each week for a total of three infusions. One patient who had stage 1 disease showed a complete response to therapy and is alive and clear of disease at 35 months. In 19 patients with stage 3 disease, the complete response rate was 16% and the partial response rate was 42%. The rate of 1-year survival was 42% and the rate of 2-year survival was 11%; the median survival of these patients was 11 months. Relapse occurred, mostly at metastatic sites, in 10 of the 11 patients who responded to therapy. Acute toxicity was modest and tolerable by our patients. No severe late toxicity was encountered, and none of the patients developed grade 3 dyspnoea (an inability to walk 100 yards because of breathlessness) while clear of recurrent disease. Changes in lung function observed at follow-up examinations were similar to those seen after irradiation alone. Weekly administration of cisplatin is therefore feasible in patients receiving a continuous course of irradiation. The high relapse rate observed in responding patients indicates the need for evaluation of the efficacy of combination chemotherapy in the adjuvant or neo-adjuvant setting.
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PMID:Concurrent radiation and weekly cisplatin for non-small-cell lung cancer--a phase I/II study. 838 87

A 57-year-old man was admitted with dyspnea and bloody sputum. The chest X-ray showed unilateral alveolar infiltration, and alveolar cell carcinoma was suspected. Physical examination showed orthopnea and a loud systolic murmur, and the echocardiogram showed mitral valve prolapse. A chest X-ray 4 days later revealed bilateral infiltration. The cardiac catheterization showed pulmonary congestion and the capillary wedge pressure revealed a prominent V wave. Papanicolaou's test of sputum was negative. These findings suggested heart failure due to mitral regurgitation rather than lung carcinoma. The patient underwent mitral valve replacement because of his refractoriness to the medical treatment. During the operation, the chordae tendineae of the anterior mitral leaflet was found to be completely ruptured. The mechanisms of unilateral pulmonary edema could not be ascertained, but the effect of posture and gravity was thought to be a possible mechanism.
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PMID:[A case of unilateral pulmonary edema associated rupture of mitral chordae tendineae]. 155 65

Spontaneous regression of a malignant tumor is a rare phenomenon, especially in advanced lung cancer. We reported a case of spontaneous regression of lung cancer with tracheal stenosis due to tumor invasion and multiple skin metastases. A 60-year-old man was admitted to our hospital on September 10, 1985, because of a dry cough. A chest roentgenogram showed a mass shadow in the right upper lung field. Bronchoscopic examination revealed tracheal stenosis due to the tumor mass, and transbronchial aspiration cytology (TBAC) yielded a diagnosis of large cell carcinoma of the lung. In spite of treatment by chemotherapy with cisplatin and vindesin and irradiation, dyspnea deteriorated and multiple skin metastases appeared. After Nd-YAG laser irradiation via a broncho-fiberscope to maintain his airway and ethanol injection into the skin metastases, his dyspnea improved and he was discharged on February 6, 1986. Two months after discharge all skin metastasis had completely disappeared, and the primary lesion also regressed and finally disappeared on chest roentgenogram until August, 1986. The mechanism of regression is unclear, but now he has been free of tumor clinically for four years.
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PMID:[A case of spontaneous regression of lung cancer with skin metastasis]. 164 18

A 78-year-old man was admitted to our hospital with dyspnea in June 1988, and diagnosed as having small-cell lung carcinoma by cytological findings of pleural effusion. He was treated three times with CAV (cyclophosphamide, doxorubicin, vincristine) therapy and a partial response was achieved. In March 1989, he was again admitted complaining of right dull hypochondralgia accompanied by enlargement of primary tumor in the right lower lobe of the lung and metastases to mediastinal and intraabdominal lymph nodes. Because it was an aged and recurrent case, he was treated with continuous five-day infusion of etoposide, 30 mg/m2/day and CDDP, 18.5 mg/m2/day. After the second course, subjective symptoms clearly disappeared and swelling of mediastinal and intraabdominal lymph nodes was markedly reduced on computed tomography. No severe side effects except for moderate myelosuppression, alopecia and nausea were observed. This regimen appears useful in the treatment of small-cell lung carcinoma in elderly patients.
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PMID:[Successful treatment of a pretreated elderly case of small-cell lung carcinoma with continuous five-day intravenous infusion of cisplatin plus etoposide]. 165 91

Most of the symptoms from a malignant tumor are caused by local invasion by the tumor, or obstruction, either at the site of the primary disease or by metastases. However, tumors can produce symptoms at a remote site. Patients with gastrointestinal malignancy may present with symptoms which include dysphagia, nausea, vomiting, abdominal pain, diarrhea, bleeding and ascites. Palliation gastrectomy delays or prevents these symptoms. About 30% of gastric carcinomas are inoperable at the time of presentation. Chemotherapy is rarely effective in the palliation of gastric carcinoma. Laser irradiation can be delivered to assay site accessible to fibreoptic endoscopy, which is an advantage over endocavity irradiation or diathermy fulguration. Ascites is a common and disabling implication in patients with advanced malignant disease. Spironolactone will increase urinary sodium excretion significantly and control their ascites. If spironolactone fails to control, useful control can be achieved by draining the ascites. Patients with carcinoma of the lung may present with symptoms that include cough, bloody sputum and dyspnoea. Pain in the chest wall is usually secondary to invasion of the parietal pleura, ribs or intercostal nerves. Lesions in the medial portion of the right upper lobe, or mediastinal metastases, may invade or compress the superior vena cava, causing venous hypertension with oedema of the head and arms. The patients may complain of dyspnoea, dysphagia, stridor and headaches. Radiotherapy can be expected to improve the quality of life for these patients. Successful palliation of symptoms is almost related to tumor regression. The problems of obstruction and bleeding from malignant tumor is common. Recently, laser techniques have been applied to aid in palliation of these problems. Malignant effusion may occur early and be the first signs of metastases. The aim of therapy is to evacuate the fluid and induce pleural adhesion. One of the sad situations that we have to face is the patient with recurrent cancer which complains of various symptoms. The relief of symptoms is the most important palliative therapy to them.
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PMID:[Palliative therapy in cancer. 3. Palliation of the symptoms from a malignant tumor (1)]. 169 82

A 76-year-old man with spindle cell (squamous) carcinoma of the lung developed fatal respiratory failure after limited thoracic irradiation at a total dose of 18 Gy. He developed severe pulmonary toxicity, which presented as dry cough, dyspnea, and pulmonary infiltrates extending beyond the radiation field. Microscopically, a transitional form of squamous to spindle-shaped cells was observed in the primary tumor, located at right S8. Immunohistochemical examination showed positive staining of spindle cells for keratin, vimentin, and EMA, but not for desmin. These results indicate that the spindle cells had characteristics of squamous epithelial cells, and differed from carcinosarcoma. Distant metastatic lesions were composed of only the spindle cell component.
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PMID:[A case of spindle cell (squamous) carcinoma (WHO) of the lung]. 180 85

We prospectively studied patients with lung carcinoma and borderline lung functions (forced expired volume [FEV1] of less than 1500 ml or a dyspnoea score of 2 [7] at presentation), who were treated with high dose irradiation. Patients were divided into those with suprahilar and hilar tumours. Lung perfusion was assessed in upper, middle and lower zones for each lung at presentation. The ipsi-lateral upper and middle zone were regarded as at risk from irradiation in patients with suprahilar tumors and the whole ipsi-lateral lung in patients with hilar tumors. Lung function was measured at presentation (18 patients) at 4-6 month follow up (16 evaluable patients = group 1) and again at 10-12 month follow up (10 evaluable patients = group 2). A worsening of the dyspnoea score (3 in group 1 and 2 in group 2) occurred only in patients with a greater than 10% decrease in transfer factor irrespective of the change in FEV1. A statistically significant correlation was found between decreased transfer factor at follow up and the perfusion in the lung zones regarded as at risk from irradiation at presentation (Spearman's rank correlation). There was no correlation between perfusion and changes in the FEV1. Patients in whom lung perfusion was less than 35% in the zones at risk tended not to have decreased transfer factor at follow up. These findings indicate that worsening in the patients' dyspnoea score after irradiation is dependent on decreased transfer factor rather than FEV1 and that patients with borderline lung functions may be treated with irradiation if the perfusion in the zones at risk from radiation is less than 35%.
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PMID:Lung cancer in patients with borderline lung functions--zonal lung perfusion scans at presentation and lung function after high dose irradiation. 228 42


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