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1. Kraeber-Bodéré F, Salaun PY, Oudoux A, Goldenberg DM, Chatal JF, Barbet J: Pretargeted radioimmunotherapy in rapidly progressing, metastatic, medullary thyroid cancer. Cancer; 2010 Feb 15;116(4 Suppl):1118-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pretargeted radioimmunotherapy in rapidly progressing, metastatic, medullary thyroid cancer.
  • Medullary thyroid cancer (MTC) patients with localized residual disease and/or distant metastases may survive for several years or rapidly progress and die of their disease.
  • Calcitonin doubling time is an independent predictor of survival, with a high predictive value in a population of patients who have not normalized their calcitonin, even after repeated surgery.
  • Several imaging methods should be proposed for patients with abnormal residual calcitonin levels persisting after complete surgery: ultrasonography and computed tomography (CT) for neck exploration, and CT for chest, abdomen, and pelvis.
  • Magnetic resonance imaging (MRI) appears to have an advantage over CT for the detection of liver metastases from endocrine tumors.
  • Moreover, MRI appears to be a sensitive imaging technique for detecting the spread of MTC to bone/bone marrow.
  • 2-Fluoro-2-deoxy-D-glucose positron emission tomography/CT could be used for staging patients with progressive MTC, with possible prognostication by standard uptake value quantification.
  • For systemic treatment of patients with rapidly progressing metastatic MTC, chemotherapy is not considered a valid therapeutic option.
  • Pretargeted radioimmunotherapy has been the only innovative treatment modality convincingly showing some survival benefit when compared with a historical untreated control group.
  • [MeSH-major] Carcinoma, Medullary / radiotherapy. Radioimmunotherapy / methods. Thyroid Neoplasms / radiotherapy


2. de Keizer B, Hoekstra A, Konijnenberg MW, de Vos F, Lambert B, van Rijk PP, Lips CJ, de Klerk JM: Bone marrow dosimetry and safety of high 131I activities given after recombinant human thyroid-stimulating hormone to treat metastatic differentiated thyroid cancer. J Nucl Med; 2004 Sep;45(9):1549-54
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  • [Title] Bone marrow dosimetry and safety of high 131I activities given after recombinant human thyroid-stimulating hormone to treat metastatic differentiated thyroid cancer.
  • Recombinant human thyroid-stimulating hormone (rhTSH) recently was introduced as a radioiodine administration adjunct that avoids levothyroxine (LT-4) withdrawal and resultant hypothyroidism.
  • The pharmacokinetics of 131I after rhTSH administration are known to differ from those after LT-4 withdrawal but are largely nondelineated in the radioiodine therapy setting.
  • We therefore sought to calculate the red marrow absorbed dose of high therapeutic activities of 131I given after rhTSH administration to patients with metastatic or inoperable locally recurrent differentiated thyroid cancer.
  • We also sought to evaluate the clinical and laboratory effects of this therapy on the bone marrow.
  • METHODS: Fourteen consecutive patients received in total 17 131I treatments (7.4 GBq).
  • Based on blood activity, renal clearance of the activity, and residence times in red marrow and the remainder of the body, the red marrow absorbed dose was calculated using the MIRD schema.
  • Additionally, we monitored for potential hematologic toxicity and compared platelet counts before and 3 mo after treatment.
  • The corresponding total red marrow absorbed dose was 1.15 +/- 0.52 Gy (range, 0.28-1.91 Gy).
  • The mean +/- SD platelet count (n = 13 treatments) was 243 +/- 62 x 10(9)/L before treatment and 233 +/- 87 x 10(9)/L 3 mo later, a slight and statistically insignificant decrease.
  • After rhTSH-aided administration of high activities of 131I, the bone marrow absorbed dose remained under 2 Gy, the level long considered the safety threshold for all radioiodine therapy.
  • CONCLUSION: Our specific findings imply that when clinically warranted, rhTSH should allow an increase in the therapeutic radioiodine activity.
  • [MeSH-major] Bone Marrow / radiation effects. Bone Marrow / radionuclide imaging. Iodine Radioisotopes / therapeutic use. Radiometry / methods. Risk Assessment / methods. Thyroid Neoplasms / drug therapy. Thyroid Neoplasms / radiotherapy. Thyrotropin / administration & dosage
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Body Burden. Chemotherapy, Adjuvant. Humans. Injections, Intramuscular. Male. Middle Aged. Platelet Count. Radiation Injuries / etiology. Radiation Injuries / prevention & control. Radiation Protection / methods. Radiopharmaceuticals / administration & dosage. Radiopharmaceuticals / pharmacokinetics. Radiopharmaceuticals / therapeutic use. Radiotherapy Dosage. Recombinant Proteins / administration & dosage. Treatment Outcome

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  • [CommentIn] J Nucl Med. 2005 May;46(5):900-1; author reply 901 [15872369.001]
  • [CommentIn] J Nucl Med. 2005 May;46(5):899-900; author reply 901 [15872367.001]
  • (PMID = 15347723.001).
  • [ISSN] 0161-5505
  • [Journal-full-title] Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • [ISO-abbreviation] J. Nucl. Med.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Radiopharmaceuticals; 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin
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3. Graf H, Paz-Filho G: [Recombinant human TSH use in differentiated thyroid cancer]. Arq Bras Endocrinol Metabol; 2007 Jul;51(5):806-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Recombinant human TSH use in differentiated thyroid cancer].
  • [Transliterated title] Uso do TSH humano recombinante no câncer diferenciado de tireóide.
  • Traditionally, the immediate treatment of patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT) is thyroid remnant ablation (TRA) with 131I, during hypothyroidism.
  • Stimulated Tg with endogenous or exogenous TSH, 9 to 12 months after the initial treatment of DTC, associated with cervical US, is able to identify low-risk patients virtually cured of their disease, in whom TSH suppression does not need to be so strict, avoiding the heart and bone complications of prolonged exogenous thyrotoxicosis.
  • Finally, in spite of the absence of randomized studies designed to evaluate the role of rhTSH in metastatic DTC disease, results of the combined treatment of rhTSH and 131I show a clinical benefit in the majority of treated patients.
  • [MeSH-major] Adenocarcinoma, Follicular / drug therapy. Carcinoma, Papillary / drug therapy. Neoplasm Recurrence, Local / drug therapy. Thyroid Neoplasms / drug therapy. Thyrotropin / administration & dosage
  • [MeSH-minor] Humans. Iodine Radioisotopes / therapeutic use. Recombinant Proteins / administration & dosage. Thyroidectomy

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  • (PMID = 17891244.001).
  • [ISSN] 0004-2730
  • [Journal-full-title] Arquivos brasileiros de endocrinologia e metabologia
  • [ISO-abbreviation] Arq Bras Endocrinol Metabol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin
  • [Number-of-references] 42
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4. Kebebew E, Clark OH: Medullary thyroid cancer. Curr Treat Options Oncol; 2000 Oct;1(4):359-67
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  • [Title] Medullary thyroid cancer.
  • Patients with clinically evident medullary thyroid cancer should have a total extracapsular thyroidectomy with bilateral central neck dissection and an ipsilateral prophylactic or therapeutic modified (functional) radical neck dissection when the primary tumor is greater than 1 cm and when the central neck nodes are positive.
  • A prophylactic contralateral neck dissection should be done when the primary tumor is bilateral and when there is extensive lymphadenopathy on the side of the primary tumor.
  • Patients who have gross, unresectable residual medullary thyroid cancer should receive postoperative external radiotherapy.
  • Patients with persistent or recurrent medullary thyroid cancer should have a complete thyroidectomy (if not done initially) and bilateral central and modified radical neck dissection, including upper mediastinal lymphadenectomy.
  • Patients who are symptomatic from distant medullary thyroid cancer metastases (diarrhea, flushing, weight loss, or bone pain) should be treated with somatostatin analogs.
  • Bone metastases should be resected if possible, and symptomatic lesions that are unresectable should be treated with external radiotherapy.
  • Chemotherapy or radioactive immunotherapy (iodine 131 labeled carcinoembryonic antigen monoclonal antibody) protocols should be considered in patients with nonoperative widely metastatic progressing medullary thyroid cancer.
  • [MeSH-major] Carcinoma, Medullary / surgery. Thyroid Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Humans. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Recurrence, Local / therapy. Prognosis. Radiotherapy Dosage. Survival Rate. Thyroidectomy

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  • (PMID = 12057161.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
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5. Owen RJ: Embolization of musculoskeletal bone tumors. Semin Intervent Radiol; 2010 Jun;27(2):111-23

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Embolization of musculoskeletal bone tumors.
  • Bone tumors may present as incidental findings, with pain or loss of function, or as fractures.
  • There is a broad range of indications for transarterial embolization (TAE) in primary or metastatic bone tumors: to reduce operative hemorrhagic risks, to simplify or allow more definitive surgery, or in the context of pain palliation, fever, bleeding, or hypercalcemic and other rheological factors.
  • Embolization may also increase tumor sensitivity to chemotherapy or radiation therapy.
  • The procedure itself is often complex with significant risk to adjacent structures and is usually part of a wider treatment strategy.
  • Catheter angiography at the time of TAE is used to determine the correct embolic agent and technique with care taken to isolate at risk structures.
  • In life-threatening situations or in preoperative embolizations of metastatic tumors, many operators opt for a combination of particulate emboli and stainless steel or platinum coils.
  • Tumor types treated include vascular metastatic lesions, commonly renal cell or thyroid, particularly in locations prone to fracture; giant cell tumors; aneurysmal bone cysts; vertebral hemangiomas, osteosarcomas; arteriovenous malformations; and osteoblastomas.
  • TAE should be considered in the treatment algorithm of primary or secondary bone tumors.

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  • (PMID = 21629401.001).
  • [ISSN] 1098-8963
  • [Journal-full-title] Seminars in interventional radiology
  • [ISO-abbreviation] Semin Intervent Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3036517
  • [Keywords] NOTNLM ; Embolization / bone tumors / metastases
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6. Luster M, Lippi F, Jarzab B, Perros P, Lassmann M, Reiners C, Pacini F: rhTSH-aided radioiodine ablation and treatment of differentiated thyroid carcinoma: a comprehensive review. Endocr Relat Cancer; 2005 Mar;12(1):49-64
Hazardous Substances Data Bank. LEVOTHYROXINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] rhTSH-aided radioiodine ablation and treatment of differentiated thyroid carcinoma: a comprehensive review.
  • Traditionally, withdrawal of thyroid hormone has been used to attain the increase in serum TSH concentrations that are believed to optimize the trapping and retention of radioiodine for diagnostic procedures, thyroid remnant ablation and treatment of patients with differentiated thyroid cancer (DTC).
  • Recombinant human TSH (rhTSH) was developed to provide TSH stimulation without withdrawal of thyroid hormone and the associated morbidity. rhTSH has been approved as an adjunct for diagnostic procedures in patients with DTC, but is currently an experimental aid in thyroid remnant ablation and the treatment of thyroid tumours.
  • In the period 1997-2004, nearly 30 medical centres worldwide have reported on almost 400 patients with DTC who were given rhTSH in preparation for radioiodine ablation of thyroid remnants or treatment of local tumours of metastatic disease.
  • However, when 1110 MBq was administered, success rates were 81.2% in 16 patients given the standard course of rhTSH and 4-day withdrawal of thyroid hormone around the time of radioiodine administration in one study, but 54% in 70 patients in another study. rhTSH-aided treatment of persistent or recurrent local or metastatic cancer, or both, with from one to six courses of radioiodine 1000-19055 MBq, achieved 2% complete remission, 36% partial response and 27% disease stabilization rates, for a 65% clinical benefit rate, in 115 primarily elderly, late-stage patients for whom responses were reported.
  • However, in a minority of patients with central nervous system, spinal or bone metastases, or bulky thyroid remnant or neck lesions with or without poor pulmonary reserve, administration of rhTSH, like thyroid hormone withdrawal, was found to stimulate expansion of the tumour, with ensuing compression of key anatomical structures and neurological, respiratory or other clinical complications.
  • As in the case of thyroid hormone withdrawal, special attention and glucocorticoid premedication are thus warranted when rhTSH is given to patients known or suspected to have the above characteristics.
  • In conclusion, in preliminary results from open-label studies, both rhTSH-aided tumour ablation and treatment have been well tolerated and have shown efficacy in substantial proportions of patients. rhTSH-aided ablation merits further study. rhTSH-aided treatment may be preferred in patients who are at greater risk of hypothyroid complications from withdrawal of thyroid hormone or are unable to produce sufficient endogenous TSH, and warrants additional investigation in younger patients at earlier stages of thyroid cancer.
  • [MeSH-major] Cell Differentiation. Iodine Radioisotopes / therapeutic use. Thyroid Neoplasms / drug therapy. Thyroid Neoplasms / radiotherapy. Thyrotropin / therapeutic use
  • [MeSH-minor] Humans. Recombinant Proteins / therapeutic use. Thyroxine

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  • (PMID = 15788638.001).
  • [ISSN] 1351-0088
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin; Q51BO43MG4 / Thyroxine
  • [Number-of-references] 54
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7. Biondi B, Pulcrano M, Pagano L, Lombardi G: Adjuvant treatment with thyrotropin alpha for remnant ablation in thyroid cancer. Biologics; 2009;3:9-13

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant treatment with thyrotropin alpha for remnant ablation in thyroid cancer.
  • Various studies have demonstrated the safety and efficacy of recombinant human thyroid-stimulating hormone (rhTSH) for radioiodine remnant ablation.
  • On this basis, rhTSH was approved in Europe for the radioiodine ablation of low-risk differentiated thyroid cancer (DTC) during thyroid hormone therapy with L-thyroxine (L-T4).
  • Moreover, in December 2007, the US Federal Drug Administration approved the use of rhTSH for adjuvant treatment with radioiodine in patients with DTC without evidence of metastatic thyroid cancer.
  • Quality of life was found to be better with rhTSH preparation than with L-thyroxine withdrawal, thereby resulting in benefits for society as a whole.
  • Furthermore, rhTSH for radioiodine remnant ablation results in a longer effective radioiodine half-life within remnant thyroid tissue and a lower specific absorbed dose in the blood and exposure of bone marrow to X-rays.

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  • (PMID = 19707391.001).
  • [ISSN] 1177-5475
  • [Journal-full-title] Biologics : targets & therapy
  • [ISO-abbreviation] Biologics
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
  • [Other-IDs] NLM/ PMC2726080
  • [Keywords] NOTNLM ; quality of life / radioiodine (131I) remnant ablation (RRA) / ray exposure / thyroid cancer / thyrotropin
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8. Zhang Q, Cai YB, Niu XH, Hao L, Ding Y: [Surgical management of metastatic disease of long bone]. Zhonghua Wai Ke Za Zhi; 2003 Feb;41(2):134-8
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  • [Title] [Surgical management of metastatic disease of long bone].
  • OBJECTIVE: To improve the life quality of cancer patients with metastasis to long bone and to select suitable surgical treatment.
  • In 16 patients with multiple lesions, underwent surgery at bone shaft (29 patients) and bone epiphysis (26).
  • 21 patients accepted postoperative chemotherapy or radiotherapy.
  • CONCLUSIONS: Surgical treatment can effectively improve the life quality of patients with metastasis to long bone.
  • The metastatic lesions should be resected with wide or radical margin for the patients with kidney, breast, prostate and thyroid cancer.
  • [MeSH-major] Bone Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Female. Follow-Up Studies. Humans. Limb Salvage. Male. Middle Aged. Treatment Outcome

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  • (PMID = 12783678.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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9. Boyle MJ, Hornicek FJ, Robinson DS, Mnaymneh W: Internal hemipelvectomy for solitary pelvic thyroid cancer metastases. J Surg Oncol; 2000 Sep;75(1):3-10
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  • [Title] Internal hemipelvectomy for solitary pelvic thyroid cancer metastases.
  • BACKGROUND AND OBJECTIVES: Radioactive iodine (RAI) therapy remains a primary treatment modality for metastatic thyroid carcinoma, but poor tumor uptake of the agent can limit its usefulness.
  • While offering effective palliation, radiation therapy is not curative, and chemotherapy is even less useful.
  • METHODS: We describe 3 cases of thyroid cancer metastatic to the pelvic girdle that were unresponsive to RAI and other nonoperative therapies, which presented over a 15-year time period.
  • All 3 patients underwent internal hemipelvectomy with reconstruction in 2 cases using a pelvic bone allograft.
  • One patient, found postoperatively to have a positive surgical margin, developed a local recurrence at 4 months and died.
  • A second patient developed a local recurrence at 11 months and died.
  • She is alive, disease-free, and ambulatory with the aid of a cane 32 months after the original procedure.
  • CONCLUSIONS: We propose this surgical procedure in selected patients with metastatic pelvic thyroid cancer.
  • [MeSH-major] Adenocarcinoma, Follicular / secondary. Adenocarcinoma, Follicular / surgery. Bone Neoplasms / secondary. Bone Neoplasms / surgery. Hemipelvectomy. Pelvic Bones. Thyroid Neoplasms / pathology

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  • [Copyright] Copyright 2000 Wiley-Liss, Inc.
  • (PMID = 11025455.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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10. Kushchayev S, Kushchayeva Y, Theodore N, Preul MC, Clark OH: Percutaneous vertebroplasty for thyroid cancer metastases to the spine. Thyroid; 2010 May;20(5):555-60
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  • [Title] Percutaneous vertebroplasty for thyroid cancer metastases to the spine.
  • BACKGROUND: Spinal metastases secondary to thyroid cancer of follicular and parafollicular cell origin are uncommon but may require stabilization of the compromised vertebrae to prevent fracture with spinal cord injury.
  • Such treatment may also relieve pain and improve survival and quality of life.
  • SUMMARY: Percutaneous vertebroplasty (PV) is a minimally invasive, radiologically guided procedure whereby bone cement is injected into a structurally weakened vertebra to provide immediate stability.
  • The authors present two cases of thyroid cancer with spinal metastases.
  • CONCLUSION: PV is a minimally invasive spinal procedure and should be considered for patients with metastatic thyroid cancer with spinal metastases.
  • [MeSH-major] Carcinoma, Papillary, Follicular / secondary. Carcinoma, Papillary, Follicular / surgery. Spinal Neoplasms / secondary. Spinal Neoplasms / surgery. Thyroid Neoplasms / pathology. Vertebroplasty
  • [MeSH-minor] Activities of Daily Living. Analgesics / administration & dosage. Analgesics / therapeutic use. Fatal Outcome. Humans. Iodine Radioisotopes. Joint Instability. Magnetic Resonance Imaging. Male. Middle Aged. Neck Dissection. Pain / drug therapy. Pain / etiology. Palliative Care. Quality of Life. Spinal Cord Compression / etiology. Spinal Cord Compression / surgery. Thyroidectomy. Tomography, X-Ray Computed

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  • (PMID = 20450433.001).
  • [ISSN] 1557-9077
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Analgesics; 0 / Iodine Radioisotopes
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11. Molina-Garrido MJ, Mora A, Andrada E, Guillén-Ponce C, Cánovas V, Guirado-Risueño M, Pastor E, Molina MA, Molina MJ, Martín Hidalgo A, Carrato A: Multiple bone lesions resembling a metastatic origin. An unexpected diagnosis. Clin Transl Oncol; 2008 Apr;10(4):241-5
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  • [Title] Multiple bone lesions resembling a metastatic origin. An unexpected diagnosis.
  • Lytic and blastic lesions have been associated to malignant tumours, such as solid cancer (breast cancer, renal cancer, prostate cancer, malignant melanoma or thyroid tumours).
  • Although a mixed pattern with lytic and blastic lesions is due to metastatic tumour, this is not the only possible origin.
  • This case report shows the number of tests that were made in order to discover the origin of osteolytic and osteoblastic lesions and it is notable that there is not an occult neoplasia on every occasion.
  • [MeSH-major] Bone Neoplasms / secondary. Mastocytosis, Systemic / diagnosis. Mastocytosis, Systemic / physiopathology. Osteolysis / etiology
  • [MeSH-minor] Aged. Anemia / complications. Back Pain / etiology. Bone Density Conservation Agents / therapeutic use. Diagnosis, Differential. Diphosphonates / therapeutic use. Female. Humans. Hypertension / complications. Imidazoles / therapeutic use. Immunologic Factors / therapeutic use. Interferon-alpha / therapeutic use. Magnetic Resonance Imaging. Osteoporosis / complications. Osteoporosis / drug therapy. Radionuclide Imaging

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  • (PMID = 18411200.001).
  • [ISSN] 1699-048X
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Bone Density Conservation Agents; 0 / Diphosphonates; 0 / Imidazoles; 0 / Immunologic Factors; 0 / Interferon-alpha; 6XC1PAD3KF / zoledronic acid
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12. Maisano R, Pergolizzi S, Cascinu S: Novel therapeutic approaches to cancer patients with bone metastasis. Crit Rev Oncol Hematol; 2001 Dec;40(3):239-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Novel therapeutic approaches to cancer patients with bone metastasis.
  • Bone metastases are a common event in advanced cancer.
  • Breast, lung, prostate and thyroid neoplasms have striking osteotropism.
  • Bone metastatic cancer may be associated with catastrophic consequences for the patients.
  • Therefore, new strategies are warranted in order to reduce the incidence of bone metastases and to palliative established skeletal disease.
  • External beam radiation therapy, endocrine treatments, chemotherapy, bisphosphonates and radioisotopes are all important.
  • Bisphosphonates have become the treatment of choice for tumor-induced hypercalcaemia and more recently they have been used alone or in combination with cytotoxic agents in the palliative treatment of patients with bone metastases.
  • Currently, new bisphosphonates that are a hundred times more powerful with respect to clodronate and pamidronate are under investigation.
  • The treatment of metastases to bone and mechanisms of pain relief after radiation therapy are poorly understood.
  • Up to date, there are not standard criteria for the irradiation of bone metastases and bone pain relief may be reached using a variety of fractionation schemes.
  • Radionuclide therapy is the systemic use of radioisotopes for bone pain.
  • [MeSH-major] Bone Neoplasms / secondary. Bone Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Diphosphonates / therapeutic use. Humans. Hypercalcemia / etiology. Radiotherapy, Adjuvant / adverse effects. Radiotherapy, Adjuvant / methods

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  • (PMID = 11738947.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Diphosphonates
  • [Number-of-references] 79
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13. Roman S, Mehta P, Sosa JA: Medullary thyroid cancer: early detection and novel treatments. Curr Opin Oncol; 2009 Jan;21(1):5-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Medullary thyroid cancer: early detection and novel treatments.
  • PURPOSE OF REVIEW: Medullary thyroid cancer (MTC) is derived from the parafollicular cells of the thyroid.
  • Understanding the molecular biology behind specific mutations of the RET gene and their prognostic implications have led to the establishment of tailored treatment modalities for certain patients.
  • We review the most recent studies on the molecular biology, calcitonin screening, diagnosis, imaging, and treatment of MTC.
  • RECENT FINDINGS: Newly identified rearranged during transfection point mutations have helped with MTC prognosis and have resulted in the establishment of new treatment guidelines.
  • Screening for MTC in the United States with basal serum calcitonin for patients with thyroid nodules would cost $11,793 per life-year saved (LYS), compared with colonoscopy and mammography screening.
  • For metastatic or recurrent disease, neck ultrasound, chest computed tomography scan, liver MRI, bone scintigraphy, and axial skeleton MRI have been proven superior to 18F-FDG PET/computed tomography.
  • For patients with nonoperable metastatic disease, novel chemotherapeutic agents, such as vandetanib, targeting rearranged during transfection, vascular endothelial growth factor receptor and epidermal growth factor receptor, are showing promise.
  • SUMMARY: There have been several recent advances in the diagnosis, molecular biology, imaging, and treatment options of MTC.
  • By potentially downstaging of disease, and treating metastatic disease more effectively, overall survival and outcomes of patients may improve.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Medullary / diagnosis. Carcinoma, Medullary / drug therapy. Fluorodeoxyglucose F18. Thyroid Neoplasms / diagnosis. Thyroid Neoplasms / drug therapy
  • [MeSH-minor] Calcitonin / blood. Humans. Positron-Emission Tomography. Prognosis. Tomography, X-Ray Computed

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  • (PMID = 19125012.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18; 9007-12-9 / Calcitonin
  • [Number-of-references] 41
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14. Haugen BR, Kane MA: Approach to the thyroid cancer patient with extracervical metastases. J Clin Endocrinol Metab; 2010 Mar;95(3):987-93
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  • [Title] Approach to the thyroid cancer patient with extracervical metastases.
  • Patients with distant, or extracervical, metastases from differentiated thyroid cancer require multimodality diagnostic, therapeutic, and monitoring approaches.
  • Whereas cure is the initial goal, especially in those with small, radioiodine-avid pulmonary metastases, improved survival and management of symptoms become the primary objective in many patients with persistent disease, especially those with bone metastases.
  • Levothyroxine therapy with suppression of serum TSH is a primary therapy in all patients with advanced differentiated thyroid cancer, and this therapy has been shown to improve overall survival and slow disease progression.
  • Radioiodine is also an important systemic therapy for those patients with radioiodine-avid disease who respond to this targeted therapy.
  • In this review, we compare standard fixed-dose radioiodine therapy vs. the dosimetric approach.
  • Directed therapy such as external beam radiotherapy, surgery, and embolization is generally considered for large or painful lesions.
  • Careful collaborations with multiple specialties through tumor boards or other mechanisms help to optimize complex management decisions in these patients with advanced thyroid cancer.
  • Multimodality monitoring focused on the organ of interest such as pulmonary [computed tomography (CT)], bone (magnetic resonance imaging, CT, bone scan), and brain (CT, magnetic resonance imaging) metastases as well as general metastatic surveillance (bone scan, (18)F-fluorodeoxyglucose-positron emission tomography) aid decision making about careful monitoring vs. directed or systemic therapy. (18)F-fluorodeoxyglucose-positron emission tomography imaging has an additional role in patient prognosis and guiding directed therapy for fluorodeoxyglucose-avid lesions.
  • Patients with symptomatic disease should receive directed therapy with the goal of symptom relief.
  • Patients with progressive metastatic disease should be considered for clinical trials or targeted systemic therapy (sorafenib or sunitinib), although these agents are not Food and Drug Administration (FDA) approved for patients with thyroid cancer.
  • The goals of therapy for patients with extracervical metastases should be to improve survival, relieve symptoms, and decrease the morbidity of disease progression and limit the morbidity associated with therapy.
  • [MeSH-major] Bone Neoplasms / secondary. Bone Neoplasms / therapy. Carcinoma, Papillary, Follicular / secondary. Carcinoma, Papillary, Follicular / therapy. Thyroid Neoplasms / pathology. Thyroid Neoplasms / therapy
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Bone Density Conservation Agents / therapeutic use. Combined Modality Therapy. Diphosphonates / therapeutic use. Disease Progression. Female. Humans. Magnetic Resonance Imaging. Neoplasm Staging. Prognosis. Radiotherapy. Thyroidectomy. Time Factors. Treatment Outcome

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  • (PMID = 20203334.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Bone Density Conservation Agents; 0 / Diphosphonates
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15. Paes FM, Serafini AN: Systemic metabolic radiopharmaceutical therapy in the treatment of metastatic bone pain. Semin Nucl Med; 2010 Mar;40(2):89-104
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  • [Title] Systemic metabolic radiopharmaceutical therapy in the treatment of metastatic bone pain.
  • Bone pain due to skeletal metastases constitutes the most common type of chronic pain among patients with cancer.
  • Approximately 65% of patients with prostate or breast cancer and 35% of those with advanced lung, thyroid, and kidney cancers will have symptomatic skeletal metastases.
  • The management of bone pain is extremely difficult and involves a multidisciplinary approach, which usually includes analgesics, hormone therapies, bisphosphonates, external beam radiation, and systemic radiopharmaceuticals.
  • In patients with extensive osseous metastases, systemic radiopharmaceuticals should be the preferred adjunctive therapy for pain palliation.
  • In this article, we review the current approved radiopharmaceutical armamentarium for bone pain palliation, focusing on indications, patient selection, efficacy, and different biochemical characteristics and toxicity of strontium-89 chloride, samarium-153 lexidronam, and rhenium-186 etidronate.
  • We also perform a concise appraisal of the other available treatment options, including pharmacologic and hormonal treatment modalities, external beam radiation, and bisphosphonates.
  • Finally, the available data on combination therapy of radiopharmaceuticals with bisphosphonates or chemotherapy are discussed.
  • [MeSH-major] Bone Neoplasms / complications. Bone Neoplasms / secondary. Pain / complications. Pain / radiotherapy. Radiopharmaceuticals / metabolism. Radiopharmaceuticals / therapeutic use
  • [MeSH-minor] Animals. Diphosphonates / therapeutic use. Hormones / therapeutic use. Humans. Patient Selection

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  • (PMID = 20113678.001).
  • [ISSN] 1558-4623
  • [Journal-full-title] Seminars in nuclear medicine
  • [ISO-abbreviation] Semin Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Diphosphonates; 0 / Hormones; 0 / Radiopharmaceuticals
  • [Number-of-references] 111
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16. Biondi B, Cooper DS: Benefits of thyrotropin suppression versus the risks of adverse effects in differentiated thyroid cancer. Thyroid; 2010 Feb;20(2):135-46
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Benefits of thyrotropin suppression versus the risks of adverse effects in differentiated thyroid cancer.
  • BACKGROUND: Despite clinical practice guidelines for the management of differentiated thyroid cancer (DTC), there are no recommendations on the optimal serum thyrotropin (TSH) concentration to reduce tumor recurrences and improve survival, while ensuring an optimal quality of life with minimal adverse effects.
  • The aim of this review was to provide a risk-adapted management scheme for levothyroxine (L-T4) therapy in patients with DTC.
  • The objective was to establish which patients require complete suppression of serum TSH levels, given their risk of recurrent or metastatic DTC, and how potential adverse effects on the heart and skeleton, induced by subclinical hyperthyroidism, in concert with advanced age and comorbidities, may influence the degree of TSH suppression.
  • SUMMARY: A risk-stratified approach to predict the rate of recurrence and death from thyroid cancer was based on the recently revised American Thyroid Association guidelines.
  • A stratified approach to predict the risk from the adverse effects of L-T4 was devised, taking into account the age of the patient, as well as the presence of preexisting cardiovascular and skeletal risk factors that might predispose to the development of long-term adverse cardiovascular or skeletal outcomes, particularly increased heart rate and left ventricular mass, atrial fibrillation, and osteoporosis.
  • Nine potential patient categories can be defined, with differing TSH targets for both initial and long-term L-T4 therapy.
  • CONCLUSION: Before deciding on the degree of TSH suppression during initial and long-term L-T4 treatment in patients with DTC, it is necessary to consider the aggressiveness of DTC, as well as the potential for adverse effects induced by iatrogenic subclinical hyperthyroidism.
  • In patients with high-risk DTC and an equally high risk of adverse effects, long-term treatment with L-T4 therapy should be individualized and balanced against the potential for adverse effects.
  • In patients with an intermediate risk for thyroid cancer recurrence and a high risk of adverse effects of therapy, the degree of TSH suppression should be reevaluated during the follow-up period.
  • Normalization of serum TSH is advisable for long-term treatment of disease-free elderly patients with DTC and significant comorbidities.
  • [MeSH-major] Thyroid Neoplasms / therapy. Thyrotropin / adverse effects. Thyrotropin / blood. Thyroxine / adverse effects
  • [MeSH-minor] Aged. Aged, 80 and over. Atrial Fibrillation / chemically induced. Bone Density / drug effects. Female. Heart / drug effects. Heart Rate / drug effects. Humans. Hyperthyroidism / complications. Middle Aged. Practice Guidelines as Topic. Risk. Risk Factors. Secondary Prevention

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  • (PMID = 20151821.001).
  • [ISSN] 1557-9077
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-71-5 / Thyrotropin; Q51BO43MG4 / Thyroxine
  • [Number-of-references] 118
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17. Kovatcheva RD, Hadjieva TD, Kirilov GG, Lozanov BS: Recombinant human TSH in radioiodine treatment of differentiated thyroid cancer. Nucl Med Rev Cent East Eur; 2004;7(1):13-9
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  • [Title] Recombinant human TSH in radioiodine treatment of differentiated thyroid cancer.
  • BACKGROUND: Recombinant human TSH (rhTSH) has been developed to facilitate the follow-up for persistent or recurrent differentiated thyroid cancer (DTC), avoiding the hypothyroid symptoms after the withdrawal of Levothyroxine (L-T4) suppressive therapy.
  • MATERIAL AND METHODS: To analyse the effect of rhTSH in providing stimulation of radioiodine uptake (RAIU) for the ablation of thyroid remnant and/or malignant thyroid tissue in patients with metastatic DTC.
  • Ten subjects (4 women, 6 men), mean age 53 years, with DTC (7 papillary, 2 follicular and 1 Hürthle-cell), requiring radioiodine therapy (RIT) were studied.
  • Nine of them had a positive diagnostic whole body scan (dWBS) or CT for thyroid remnant, lymph nodes and/or distant metastases.
  • The post-therapy WBS (pthWBS) showed:.
  • 1) additional metastatic lesions in 3 patients with positive dWBS, 2) lung nodular metastases in 1 patient with negative dWBS, 3) similar image as the dWBS in 4 patients, 4) negative image in 1 patient with positive dWBS.
  • CONCLUSION: RhTSH is a safe and promising method for the stimulation of RAIU in patients with thyroid remnant and/or persistent or recurrent DTC, avoiding L-T4 withdrawal.
  • [MeSH-major] Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Radiation Tolerance / drug effects. Thyroid Neoplasms / drug therapy. Thyroid Neoplasms / radiotherapy. Thyrotropin / administration & dosage
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant / methods. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Radiation-Sensitizing Agents / administration & dosage. Recombinant Proteins / administration & dosage. Recombinant Proteins / genetics. Treatment Outcome

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  • (PMID = 15318305.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin
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18. Schlumberger M, Sherman SI: Clinical trials for progressive differentiated thyroid cancer: patient selection, study design, and recent advances. Thyroid; 2009 Dec;19(12):1393-400
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  • [Title] Clinical trials for progressive differentiated thyroid cancer: patient selection, study design, and recent advances.
  • Treatment of metastatic differentiated thyroid cancer is first based on the use of radioiodine and thyrotropin-suppressive thyroid hormone treatment.
  • The recent availability of molecular-targeted therapies has lead to reconsideration of the treatment strategy in differentiated thyroid cancer patients with distant metastases who are resistant to radioiodine therapy.
  • In those with progressive disease, treatment with kinase inhibitors should be offered preferably in the context of a prospective trial.
  • [MeSH-major] Lung Neoplasms / radiotherapy. Lung Neoplasms / secondary. Thyroid Neoplasms / drug therapy
  • [MeSH-minor] Bone Neoplasms / drug therapy. Bone Neoplasms / radiography. Bone Neoplasms / secondary. Carcinoma, Papillary / drug therapy. Carcinoma, Papillary / genetics. Clinical Trials as Topic. Disease Progression. Humans. Iodine Radioisotopes / therapeutic use. Lymphatic Metastasis. MAP Kinase Signaling System / drug effects. Patient Selection. Randomized Controlled Trials as Topic. Research Design. Thyrotropin / antagonists & inhibitors. Thyroxine / therapeutic use. Tomography, X-Ray Computed

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  • (PMID = 20001721.001).
  • [ISSN] 1557-9077
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 9002-71-5 / Thyrotropin; Q51BO43MG4 / Thyroxine
  • [Number-of-references] 65
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19. Lamonica D: Iodine 131 ((131)I) as adjuvant therapy of differentiated thyroid cancer. Surg Oncol Clin N Am; 2004 Jan;13(1):129-49
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  • [Title] Iodine 131 ((131)I) as adjuvant therapy of differentiated thyroid cancer.
  • An aggressive approach is advocated, except in situations widely accepted to be low risk (i.e., female patients <40 y, with tumors <1.0 cm confined to the gland).
  • The loss of iodine-concentrating ability removes systemic radioiodine from the therapeutic equation and thereby virtually eliminates chances for cure.
  • The role of chemotherapy in non iodine responsive DTC is still in question, and a benefit in advanced disease has not been established.
  • For non iodine-concentrating tumor that cannot be approached surgically, external beam therapy remains an option, both within the neck and for dominant foci of distant metastatic tumor (i.e., brain and bone).
  • Although its acute and long-term side-effect profile is not especially worrisome relative to other forms of systemic cancer therapy, the administration of (131)1 is not entirely without risk.
  • [MeSH-major] Iodine Radioisotopes / therapeutic use. Thyroid Neoplasms / radiotherapy
  • [MeSH-minor] Catheter Ablation. Humans. Lymphatic Metastasis. Prognosis. Radiometry. Radiotherapy, Adjuvant. Risk Assessment. Thyroxine / therapeutic use

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  • (PMID = 15062366.001).
  • [ISSN] 1055-3207
  • [Journal-full-title] Surgical oncology clinics of North America
  • [ISO-abbreviation] Surg. Oncol. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; Q51BO43MG4 / Thyroxine
  • [Number-of-references] 71
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20. Cabanillas ME, Waguespack SG, Bronstein Y, Williams MD, Feng L, Hernandez M, Lopez A, Sherman SI, Busaidy NL: Treatment with tyrosine kinase inhibitors for patients with differentiated thyroid cancer: the M. D. Anderson experience. J Clin Endocrinol Metab; 2010 Jun;95(6):2588-95
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  • [Title] Treatment with tyrosine kinase inhibitors for patients with differentiated thyroid cancer: the M. D. Anderson experience.
  • OBJECTIVES: Until recently, treatment options for patients with progressive, radioactive iodine-resistant differentiated thyroid cancer (DTC) have been limited.
  • Anderson Cancer Center's experience with the off-label use of these tyrosine kinase inhibitors for DTC.
  • METHODS: Adult patients were included if they had a diagnosis of radioactive iodine-refractory DTC, were treated with single agent sorafenib or sunitinib, and had both baseline and at least one follow-up scan for restaging purposes.
  • The primary endpoints were radiographic response and progression-free survival (PFS).
  • Secondary objectives were tissue-specific radiographic responses and correlation of Tg with overall response.
  • Fifteen patients (nine women, six men) met inclusion criteria, with a median age of 61 yr (range, 38-83 yr).
  • Eight patients had papillary and seven had follicular thyroid carcinoma.
  • Sorafenib was used in 13 and sunitinib in two, including one patient who failed prior sorafenib therapy.
  • All patients had evidence of progressive disease (PD) before start of therapy, with a median PFS of only 4 months.
  • Pleural disease and nonirradiated bone metastases demonstrated PD.
  • CONCLUSIONS: Sorafenib and sunitinib appear to be effective in patients with widely metastatic, progressive DTC, with most patients achieving SD or PR, despite having PD at baseline.
  • The most noticeable responses occurred in the lungs in contrast with minimal changes in nodal metastases and PD in pleural and nonirradiated bone metastases, suggesting a tissue-specific response to therapy.
  • Log Tg significantly correlated with response to treatment and therefore may have value as a surrogate marker of response.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Protein Kinase Inhibitors / therapeutic use. Protein-Tyrosine Kinases / antagonists & inhibitors. Thyroid Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Benzenesulfonates / administration & dosage. Benzenesulfonates / therapeutic use. DNA Mutational Analysis. Disease Progression. Disease-Free Survival. Female. Humans. Indoles / administration & dosage. Indoles / therapeutic use. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Metastasis. Niacinamide / analogs & derivatives. Off-Label Use. Phenylurea Compounds. Pyridines / administration & dosage. Pyridines / therapeutic use. Pyrroles / administration & dosage. Pyrroles / therapeutic use. Survival Analysis. Thyroglobulin / blood. Tomography, X-Ray Computed. Treatment Outcome

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  • [CommentIn] J Clin Endocrinol Metab. 2010 Jun;95(6):2621-4 [20525911.001]
  • [CommentIn] Nat Rev Endocrinol. 2010 Aug;6(8):418 [20681071.001]
  • (PMID = 20392874.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzenesulfonates; 0 / Indoles; 0 / Phenylurea Compounds; 0 / Protein Kinase Inhibitors; 0 / Pyridines; 0 / Pyrroles; 0 / sunitinib; 25X51I8RD4 / Niacinamide; 9010-34-8 / Thyroglobulin; 9ZOQ3TZI87 / sorafenib; EC 2.7.10.1 / Protein-Tyrosine Kinases
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21. Chatal JF, Campion L, Kraeber-Bodéré F, Bardet S, Vuillez JP, Charbonnel B, Rohmer V, Chang CH, Sharkey RM, Goldenberg DM, Barbet J, French Endocrine Tumor Group: Survival improvement in patients with medullary thyroid carcinoma who undergo pretargeted anti-carcinoembryonic-antigen radioimmunotherapy: a collaborative study with the French Endocrine Tumor Group. J Clin Oncol; 2006 Apr 10;24(11):1705-11
Hazardous Substances Data Bank. Calcitonin .

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  • [Title] Survival improvement in patients with medullary thyroid carcinoma who undergo pretargeted anti-carcinoembryonic-antigen radioimmunotherapy: a collaborative study with the French Endocrine Tumor Group.
  • PURPOSE: No effective therapy is currently available for the management of patients with metastatic medullary thyroid carcinoma (MTC).
  • PATIENTS AND METHODS: Twenty-nine patients with advanced, progressive MTC, as documented by short serum calcitonin doubling times (Ct DTs), received an anti-carcinoembryonic antigen (CEA)/anti-diethylenetriamine pentaacetic acid (DTPA) -indium BsMAb, followed 4 days later by a 131I-labeled bivalent hapten.
  • RESULTS: OS was significantly longer in high-risk, treated patients (Ct DT < 2 years) than in high-risk, untreated patients (median OS, 110 v 61 months; P < .030).
  • Treated patients with bone/bone-marrow disease had a longer survival than patients without such involvement (10-year OS, 83% v 14%; P < .023).
  • Toxicity was mainly hematologic and related to bone/bone-marrow tumor spread.
  • Ct DT and bone-marrow involvement appear to be prognostic indicators in MTC patients who undergo pRAIT.
  • [MeSH-major] Calcitonin / blood. Radioimmunotherapy / methods. Thyroid Neoplasms / radiotherapy
  • [MeSH-minor] Antibodies, Monoclonal / therapeutic use. Humans. Indium / therapeutic use. Pentetic Acid. Prognosis. Survival Analysis

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  • [CommentIn] J Clin Oncol. 2006 Jul 10;24(20):e37; author reply e38 [16829644.001]
  • [CommentIn] J Clin Oncol. 2006 Apr 10;24(11):1653-5 [16549818.001]
  • (PMID = 16549819.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 045A6V3VFX / Indium; 7A314HQM0I / Pentetic Acid; 9007-12-9 / Calcitonin
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22. Béhé M, Behr TM: Cholecystokinin-B (CCK-B)/gastrin receptor targeting peptides for staging and therapy of medullary thyroid cancer and other CCK-B receptor expressing malignancies. Biopolymers; 2002;66(6):399-418
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  • [Title] Cholecystokinin-B (CCK-B)/gastrin receptor targeting peptides for staging and therapy of medullary thyroid cancer and other CCK-B receptor expressing malignancies.
  • Nuclear medicine is engaged with the detection of pathological processes with the help of radionuclides.
  • An interesting approach is to target antigens, symporters, or receptors with diagnostic and therapeutic radionuclides.
  • Different peptide receptors like somatostatin, bombesin/GRP or VIP are (over)expressed on cancer cells, and are therefore an ideal target for the diagnosis and therapy in nuclear medicine with radiolabeled peptides.
  • The staging of metastatic medullary thyroid cancer (MTC) with the conventional radiological procedures is sometimes difficult.
  • The high sensitivity of the pentagastrin stimulation test in detecting primary or metastatic MTC indicates the presence of tumor, but its localization is often not possible.
  • This reaction of the tumor cells to the pentagastrin stimulation test suggests a widespread expression of the corresponding receptor type on human MTC.
  • Indeed, autoradiographic studies demonstrated cholecystokinin (CCK)-B/gastrin receptors not only in over 90% of MTCs, but in a high percentage of small cell lung cancers, stromal ovarian, and potentially a variety of other tumors, including gastrointestinal adenocarcinomas, neuroendocrine tumors, and malignant glioma.
  • The aim of our recent work was to develop and systematically optimize suitable radioligands for targeting CCK-B receptors in vivo and to investigate their role in the staging and therapy of MTC and other CCK-B receptor expressing malignancies.
  • For this purpose, a variety of CCK/gastrin-related peptides, all having in common the C-terminal CCK receptor binding tetrapeptide sequence -Trp-Met-Asp-PheNH(2) or derivatives thereof, were investigated.
  • Their stability and affinity were studied and optimized in vitro and in vivo; their biodistribution and therapeutic efficacy were tested in preclinical models.
  • Radiometal-labeled derivatives of minigastrin showed excellent targeting of CCK-B receptor expressing tissues in animals and healthy human volunteers.
  • Preclinical therapy experiments in MTC-bearing animals showed significant antitumor efficacy.
  • In a subsequent clinical study, 75 MTC patients with metastatic MTC were investigated; 43 suffered of known, 32 of occult disease.
  • The normal organ uptake was essentially confined to the stomach (and to a lower extent, to the gallbladder and, in premenopausal women, to normal breast tissue) as a result of CCK-B receptor specific binding, and to the kidneys as excretory organs.
  • All tumor manifestations known from conventional imaging were visualized as early as 1 h p.i., with increasing tumor-to-background ratios over time; at least one lesion was detected in 29/32 patients with occult disease (patient-based sensitivity 91%).
  • Among them were local recurrences, lymph node, pulmonary, hepatic, splenic, and bone (marrow) metastases.
  • Eight patients with advanced metastatic disease were injected in a dose-escalation study with potentially therapeutic activities of a (90)Y-labeled minigastrin derivative at 4-6-weekly intervals (30-50 mCi/m(2) per injection for a maximum of four injections).
  • These data suggest that CCK-B receptor ligands may be a useful new class of receptor binding peptides for diagnosis and therapy of a variety of (CCK-B receptor expressing) tumor types.
  • They allow for a sensitive and reliable staging of patients with metastatic MTC.
  • Initial therapeutic results are promising, but nephrotoxicity is a major concern to be solved.
  • [MeSH-major] Peptides / metabolism. Peptides / therapeutic use. Radiopharmaceuticals. Receptors, Cholecystokinin / metabolism. Thyroid Neoplasms / classification. Thyroid Neoplasms / drug therapy

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  • [Copyright] Copyright 2003 Wiley Periodicals, Inc.
  • (PMID = 12658727.001).
  • [ISSN] 0006-3525
  • [Journal-full-title] Biopolymers
  • [ISO-abbreviation] Biopolymers
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gastrins; 0 / Ligands; 0 / Peptides; 0 / Radiopharmaceuticals; 0 / Receptor, Cholecystokinin B; 0 / Receptors, Cholecystokinin; 0 / Receptors, Somatostatin; 60748-07-4 / minigastrin; 7A314HQM0I / Pentetic Acid
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23. Wong JYC, Chu DZ, Yamauchi DM, Williams LE, Liu A, Wilczynski S, Wu AM, Shively JE, Doroshow JH, Raubitschek AA: A phase I radioimmunotherapy trial evaluating 90yttrium-labeled anti-carcinoembryonic antigen (CEA) chimeric T84.66 in patients with metastatic CEA-producing malignancies. Clin Cancer Res; 2000 Oct;6(10):3855-63
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  • [Title] A phase I radioimmunotherapy trial evaluating 90yttrium-labeled anti-carcinoembryonic antigen (CEA) chimeric T84.66 in patients with metastatic CEA-producing malignancies.
  • The purpose of this Phase I dose escalation therapy trial was to evaluate the toxicities, biodistribution, pharmacokinetics, tumor targeting, immunogenicity, and organ and tumor absorbed dose estimates of cT84.66 labeled with 90Y.
  • Patients with metastatic CEA-producing malignancies were first administered 5 mCi 111In-labeled DTPA-cT84.66 (5 mg), followed by administration of the therapy dose of 90Y-labeled DTPA-cT84.66 1 week later.
  • The therapy infusion was immediately followed by a 72-h administration of DTPA at 250 mg/m2/24 h.
  • Patients were administered up to 3 cycles of therapy every 6 weeks.
  • Twenty-two patients received at least one cycle of therapy, with one individual receiving two cycles and two receiving three cycles of therapy.
  • Reversible leukopenia and thrombocytopenia were the primary dose-limiting toxicities observed.
  • Thirteen patients developed an immune response to the antibody.
  • Dose estimates to tumor ranged from 66 to 1670 cGy (8.7 to 52.2 cGy/mCi 90Y) for each cycle of therapy delivered.
  • Patients with extensive hepatic involvement by tumor demonstrated unfavorable biodistribution for therapy with rapid blood clearance and poor tumor targeting.
  • Average tumor doses when compared with red marrow doses indicated a favorable therapeutic ratio.
  • This trial represents an important step toward further improving the therapeutic potential of this agent through refinements in the characteristics of the antibody and the treatment strategies used.
  • Future trials will focus on the use of peripheral stem cell support to allow for higher administered activities and the use of combined modality strategies with radiation-enhancing chemotherapy drugs.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Carcinoembryonic Antigen / blood. Colorectal Neoplasms / radiotherapy. Colorectal Neoplasms / therapy. Lung Neoplasms / radiotherapy. Radioimmunotherapy / methods. Radioisotopes / therapeutic use. Thyroid Neoplasms / radiotherapy. Yttrium Radioisotopes / therapeutic use
  • [MeSH-minor] Animals. Bone Marrow / radiation effects. Humans. Immunoglobulin G / metabolism. Liver / radiation effects. Mice. Pentetic Acid / pharmacology. Recombinant Fusion Proteins / metabolism. Time Factors

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  • (PMID = 11051230.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United States / PHS HHS / / 33572; United States / PHS HHS / / P01 43904
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Carcinoembryonic Antigen; 0 / Immunoglobulin G; 0 / Radioisotopes; 0 / Recombinant Fusion Proteins; 0 / Yttrium Radioisotopes; 7A314HQM0I / Pentetic Acid
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24. Langsteger W, Heinisch M, Fogelman I: The role of fluorodeoxyglucose, 18F-dihydroxyphenylalanine, 18F-choline, and 18F-fluoride in bone imaging with emphasis on prostate and breast. Semin Nucl Med; 2006 Jan;36(1):73-92
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  • [Title] The role of fluorodeoxyglucose, 18F-dihydroxyphenylalanine, 18F-choline, and 18F-fluoride in bone imaging with emphasis on prostate and breast.
  • Diagnostic imaging has played a major role in the evaluation of patients with bone metastases.
  • The imaging modalities have included bone scintigraphy, computed tomography, magnetic resonance imaging, and most recently PET/CT, which can be performed with different tracers, including fluorodeoxyglucose (FDG), 18F-fluoride, 18F-choline (FCH), and 18F-DOPA (dihydroxyphenylalanine).
  • For most tumors the sensitivity of FDG in detecting bone metastases is similar to bone scintigraphy; additionally it can be used to monitor the response to chemotherapy and hormonal therapy.
  • 18F-Fluoride may provide a more sensitive "conventional" bone scan and is superior for FDG nonavid tumors, but, nevertheless, FDG in "early disease" often has clear advantages over 18F-fluoride.
  • Although more data need to be obtained, it appears that FCH is highly efficient in preoperative management regarding N and M staging of prostate cancer once metastatic disease is strongly suspected or documented.
  • For neuroendocrine tumors and in particular in medullary thyroid cancer, DOPA is similar to 18F-fluoride in providing high quality information regarding the skeleton.
  • [MeSH-major] Bone Neoplasms / radionuclide imaging. Bone Neoplasms / secondary. Breast Neoplasms / radionuclide imaging. Choline. Dihydroxyphenylalanine / analogs & derivatives. Fluorodeoxyglucose F18. Prostatic Neoplasms / radionuclide imaging

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  • (PMID = 16356797.001).
  • [ISSN] 0001-2998
  • [Journal-full-title] Seminars in nuclear medicine
  • [ISO-abbreviation] Semin Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Fluorine Radioisotopes; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 2C598205QX / fluorodopa F 18; 63-84-3 / Dihydroxyphenylalanine; N91BDP6H0X / Choline
  • [Number-of-references] 132
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25. Chiewvit P, Danchaivijitr N, Sirivitmaitrie K, Chiewvit S, Thephamongkhol K: Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis? J Med Assoc Thai; 2009 Jun;92(6):818-29
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  • [Title] Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?
  • OBJECTIVE: To determine the role of Magnetic Resonance (MR) imaging for the investigation ofpatients with suspected metastasis to the spine by bone scintigraphy.
  • MATERIAL AND METHOD: Retrospectively reviewed with comparison was made between Technetium-99m Methylene Diphosphonate (99(m)Tc-MDP) bone scintigraphy and corresponding spine MR images in 48 cases of vertebral metastasis at Siriraj Hospital.
  • The intervals between bone scintigraphy and MR images did not exceed 1 month.
  • The authors studied between January 2005 and December 2006 Bone scintigraphy were performed with planar imaging of the entire body and MR imaging was performed with the 1.5 tesla and 3.0 tesla scanner using standard techniques with T1-, T2-weighted images and fat-suppressed T1-weighted images with intravenous administration of gadopentetate dimeglumine.
  • The MR imaging findings were studied: location (cervical or thoracic or lumbar or sacrum spine), number of lesions (solitary or multiple lesions), pattern of enhancement (homogeneous or inhomogeneous), involvement of spinal canal, compression of spinal cord, extradural extension, other incidental findings such as pulmonary metastasis, pleural effusion, lymphadenopathy The final diagnosis was confirmed clinically and followed-up for further management (radiation or surgery) or followed-up by MR imaging (1 month-16 months) and bone scintigraphy (5 months-12 months).
  • Primary neoplasms include breast cancer (n=11), colorectal cancer (n=7), lung cancer (n=6), prostate cancer (n=5), nasopharyngeal cancer (n=5), head and neck cancer (n=3), thyroid cancer (n=2), liver cancer (n=2), esophagus cancer (n=1), bladder cancer (n=1), retroperitoneum cancer (n=1), medulloblastoma (n=1), cervical cancer (n=1), ovarian cancer (n=1), malignant melanoma (n=1).
  • The result of bone scintigraphy and MR imaging is used to evaluate vertebral metastasis: in 44 lesions of bone scintigraphy positive for vertebral metastasis, 40/44 lesions (91%) which MR imaging reveal vertebral metastasis.
  • In 24 lesions of negative of bone scintigraphy for vertebral metastasis, the authors found that 14/24 lesions (58%) showed positive of vertebral metastasis from MR imaging.
  • In this group, the authors recommended a further investigation because 58% of negative bone scintigraphy lesions are depicted by only MR imaging.
  • MR imaging demonstrated metastatic cord compression in 16 cases.
  • CONCLUSION: The authors conclude that the MR imaging is more efficient than the bone scintigraphy in detecting vertebral metastasis, especially in the cases that bone scintigraphy are equivocal or negative for vertebral metastasis in high clinical suspicion.
  • Furthermore, MR imaging is important for the further treatment planning such as radiation therapy or systemic chemotherapy.
  • Although MR imaging is useful in the detection of early metastasis that are localized completely in the bone marrow cavity routinely bone scintigraphy remains that most cost-effective method for examination of the entire skeleton.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Diphosphonates. Female. Humans. Male. Middle Aged. Neoplasm Metastasis / radionuclide imaging. Organotechnetium Compounds. Radionuclide Imaging. Retrospective Studies. Spinal Cord Compression. Young Adult

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  • (PMID = 19530588.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Diphosphonates; 0 / Organotechnetium Compounds; 0 / technetium 99m methylene bisphosphonate
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26. Tagaya N, Nakagawa A, Mori S, Tachibana M, Kakihara Y, Hamada K, Suzuki N, Kubota K: [Experience with capecitabine in patients with anthracycline and/or taxane-resistant recurrent breast cancer]. Gan To Kagaku Ryoho; 2005 Aug;32(8):1135-8
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  • [Title] [Experience with capecitabine in patients with anthracycline and/or taxane-resistant recurrent breast cancer].
  • We evaluated the safety and efficacy of capecitabine in 12 patients with anthracycline and/or taxane-resistant metastatic breast cancer on an outpatient basis.
  • Their mean age was 57 years, and they previously received chemotherapy consisting of anthracycline in 7 cases, taxane in 12 and doxifluridine in 8.
  • The recurrent sites were lymph node in 9 cases, lung in 6, skin in 5, pleural effusion in 4, liver, bone and pleura in 3, brain and CBS in 2, and thyroid, ascites and pericardial effusion in one, respectively.
  • The mean time to treatment failure was 6.5 months.
  • Capecitabine had satisfactory effects with tolerable adverse events for anthracycline- and/or taxane-resistant metastatic breast cancer.
  • [MeSH-major] Anthracyclines. Antimetabolites, Antineoplastic / therapeutic use. Breast Neoplasms / drug therapy. Deoxycytidine / analogs & derivatives. Drug Resistance, Neoplasm. Taxoids
  • [MeSH-minor] Administration, Oral. Capecitabine. Female. Floxuridine / therapeutic use. Fluorouracil / analogs & derivatives. Humans. Middle Aged

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  • (PMID = 16121915.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Antimetabolites, Antineoplastic; 0 / Taxoids; 039LU44I5M / Floxuridine; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil; V1JK16Y2JP / doxifluridine
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27. Kurebayashi J, Sonoo H, Inaji H, Nishimura R, Iino Y, Toi M, Kobayashi S, Saeki T: Endocrine therapies for patients with recurrent breast cancer: predictive factors for responses to first- and second-line endocrine therapies. Oncology; 2000;59 Suppl 1:31-7
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  • [Title] Endocrine therapies for patients with recurrent breast cancer: predictive factors for responses to first- and second-line endocrine therapies.
  • Breast cancer patients have been treated with four different hormonal agents, antiestrogen, progestin, luteinizing hormone-releasing hormone agonist and aromatase inhibitor, during the past 7 years in Japan.
  • To investigate the efficacy of these agents for the treatment of recurrent breast cancer patients, we conducted a retrospective multi-institute survey in Japan.
  • The clinico-pathological data of 131 patients, who received endocrine therapy as first-line treatment between 1993 and 1998, were collected from seven institutes.
  • The median age of the patients was 55 (range 27-92) years, 75% of their primary tumors were estrogen receptor (ER)-positive or unknown, and 95% of the dominant metastatic sites were bone, soft tissue or lungs.
  • The objective response rate to first-line endocrine therapy was 42.7%, and that to second-line therapy 42.5% (17 of 40 patients).
  • Multiple regression analyses of predictive factors for a response to first- and second-line endocrine therapies indicated two independent factors, ER status of the primary tumors and dominant site of metastasis, for the former, and one independent factor, a response to first-line endocrine therapy, for the latter.
  • Analysis of relationships between sequences of use of hormonal agents and objective response rates revealed that the choice of first-line hormonal agent did not influence the overall efficacy of first- and second-line endocrine therapies.
  • Overall survival after first recurrence in patients with tumors exhibiting an objective response or stable disease to first-line endocrine therapy was significantly better than that in patients with tumors exhibiting progressive disease (p < 0.01).
  • These findings suggest that an adequate selection of recurrent breast cancer patients referring the ER status, dominant site of metastasis and a prior response to endocrine therapy may contribute to better clinical outcomes of the patients.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Estrogen Receptor Modulators / therapeutic use
  • [MeSH-minor] Disease-Free Survival. Female. Humans. Neoplasm Recurrence, Local. Predictive Value of Tests. Regression Analysis. Risk Factors. Treatment Outcome

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  • [Copyright] Copyright 2000 S. Karger AG, Basel
  • (PMID = 11096354.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Receptor Modulators
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28. Estrada-Sánchez G, Ochoa-Carrillo FJ, Altamirano-Ley J: [(18)FDG PET/CT imaging in primary breast lymphoma and breast cancer]. Cir Cir; 2008 Jul-Aug;76(4):279-86
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  • [Title] [(18)FDG PET/CT imaging in primary breast lymphoma and breast cancer].
  • [Transliterated title] (18)FDG PET/CT en linfoma primario de mama y cáncer de mama.
  • BACKGROUND: Of women between 15 and 29 years of age, 13.6% will die from breast cancer.
  • For women between 30 and 64 years of age, 19% will die from breast cancer.
  • METHODS: We studied 1728 oncological patients and 295 patients were included, 293 with breast cancer (17%) and two patients with primary breast lymphoma (0.1%).
  • SUVmax for the primary tumor was 4.2 +/- 2.6 SD.
  • Mean SUVmax for patients with primary breast lymphoma were 3.2 and 1.4.
  • Sites of metastases were lymph nodes in the neck (4.4% SUVmax 2.7), internal mammary lymph nodes (5% SUVmax 5.3), mediastinum (8.3% SUVmax 5.0), retroperitoneal (6 % SUVmax 5.4), ipsilateral axilla (94% SUVmax 4.5), contralateral axilla (4.4% SUVmax 2.8), pectoral muscle (10.2% SUVmax 2.6), pleura (4.4% SUVmax 3.9), lung (32.3% SUVmax 2.9), liver (19.1% SUVmax 4.5), bone (36.7%), adrenal gland (4.4% SUVmax 2.4), brain (4.4%), spleen and contralateral breast, one case each.
  • One patient presented thymic hyperplasia after chemotherapy.
  • The incidence of a second primary was 4.7%, 2.1% ovarian, 1.4% lung, 0.3% lymphoma, 0.3% endometrium, 0.3% pancreas and 0.3% thyroid.
  • CONCLUSIONS: Mean SUVmax for the primary tumor was similar to that reported in the literature.
  • Values for metastatic bone lesions are higher in this study.
  • [MeSH-major] Breast Neoplasms / radionuclide imaging. Carcinoma / radionuclide imaging. Positron-Emission Tomography. Tomography, X-Ray Computed
  • [MeSH-minor] Adult. Bone Neoplasms / radiography. Bone Neoplasms / radionuclide imaging. Bone Neoplasms / secondary. Brain Neoplasms / radiography. Brain Neoplasms / radionuclide imaging. Brain Neoplasms / secondary. Breast Neoplasms, Male / radiography. Breast Neoplasms, Male / radionuclide imaging. Cost-Benefit Analysis. Female. Fluorine Radioisotopes. Fluorodeoxyglucose F18. Humans. Hyperplasia. Lymphatic Metastasis / radiography. Lymphatic Metastasis / radionuclide imaging. Lymphoma, Non-Hodgkin / radiography. Lymphoma, Non-Hodgkin / radionuclide imaging. Male. Mammography. Neoplasms, Multiple Primary / radiography. Neoplasms, Multiple Primary / radionuclide imaging. Radiopharmaceuticals. Retrospective Studies. Sensitivity and Specificity. Thymus Gland / pathology. Thymus Gland / radionuclide imaging

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  • (PMID = 18778536.001).
  • [ISSN] 0009-7411
  • [Journal-full-title] Cirugía y cirujanos
  • [ISO-abbreviation] Cir Cir
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Mexico
  • [Chemical-registry-number] 0 / Fluorine Radioisotopes; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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29. Okubo S, Sonoo H, Hirono M, Nomura T, Udagawa K, Ikeda M, Nakashima K, Tanaka K, Kurebayashi J: [Therapeutic effects of Anastrozole in patients with advanced and recurrent breast cancer]. Gan To Kagaku Ryoho; 2004 Oct;31(10):1527-31
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  • [Title] [Therapeutic effects of Anastrozole in patients with advanced and recurrent breast cancer].
  • We reviewed therapeutic effects and harmful side effects in 33 patients with advanced or recurrent breast cancer who underwent treatment with Anastrozole 1 mg/day in our department.
  • The Performance Status was 0-2, and there was 1 case of advanced breast cancer and 32 cases of recurrent breast cancer.
  • Metastatic sites were in multiple organs in 9 cases, in the lung only in 1 case, in bone only in 12 cases, and in soft tissue only in 10 cases.
  • First-line therapy was used in 10 cases, second-line therapy in 6 cases, and above third-line therapy in 17 cases.
  • The clinical benefit rates for first-line were 60%, second-line 83.3% and above third-line therapy 58.8%.
  • The response rate for patients with breast cancer resistant to Anthracyclines and/or Taxanes was 20%.
  • Time-to-progression ranged from 2 to 28 months (median, 11 months), and overall survival ranged from 7 to 30 months (median, 15 months).
  • In this study, we confirmed the availability and safety of Anastrozole, which was suggested to be a useful drug in salvage therapy for patients having resistance to Anthracyclines and/or Taxanes, not only but also useful as a first- or second-line therapy.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Neoplasm Recurrence, Local / drug therapy. Nitriles / therapeutic use. Triazoles / therapeutic use
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cholesterol / blood. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Metastasis. Receptors, Estrogen / analysis. Receptors, Progesterone / analysis. Salvage Therapy. Survival Rate

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  • (PMID = 15508444.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Nitriles; 0 / Receptors, Estrogen; 0 / Receptors, Progesterone; 0 / Triazoles; 2Z07MYW1AZ / anastrozole; 97C5T2UQ7J / Cholesterol
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30. Robbins RJ, Voelker E, Wang W, Macapinlac HA, Larson SM: Compassionate use of recombinant human thyrotropin to facilitate radioiodine therapy: case report and review of literature. Endocr Pract; 2000 Nov-Dec;6(6):460-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Compassionate use of recombinant human thyrotropin to facilitate radioiodine therapy: case report and review of literature.
  • OBJECTIVE: To describe the use of recombinant human thyrotropin (thyroid-stimulating hormone) (rhTSH) to assist in radioiodine therapy in a patient with thyroid carcinoma who was unable to produce sufficient endogenous thyrotropin when hypothyroid and to review the related literature.
  • Some of his metastatic lesions disappeared and his serum thyroglobulin level decreased after the first rhTSH-assisted dose of (131)I was administered.
  • Swelling of some of the metastatic thyroid cancer lesions developed when the patient was hypothyroid and after rhTSH was administered, the latter being much more rapid in onset.
  • CONCLUSION: Therapeutic doses of radioiodine can be delivered with the assistance of rhTSH administration while patients continue to take suppressive doses of thyroxine.
  • Metastatic thyroid carcinoma lesions can swell rapidly after administration of rhTSH.
  • Its safety and efficacy in assisting radioiodine therapy have not been fully determined.
  • [MeSH-major] Adenocarcinoma, Follicular / radiotherapy. Adenocarcinoma, Follicular / secondary. Bone Neoplasms / radiotherapy. Bone Neoplasms / secondary. Iodine Radioisotopes / therapeutic use. Thyroid Neoplasms / pathology. Thyrotropin / therapeutic use
  • [MeSH-minor] Brain Neoplasms / radiotherapy. Brain Neoplasms / secondary. Brain Neoplasms / surgery. Drug Synergism. Empathy. Humans. Male. Middle Aged. Recombinant Proteins. Thyroxine / therapeutic use

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  • (PMID = 11155220.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Recombinant Proteins; 9002-71-5 / Thyrotropin; Q51BO43MG4 / Thyroxine
  • [Number-of-references] 17
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31. Schmidt M, Baum RP, Simon T, Howman-Giles R: Therapeutic nuclear medicine in pediatric malignancy. Q J Nucl Med Mol Imaging; 2010 Aug;54(4):411-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic nuclear medicine in pediatric malignancy.
  • The following review aims to provide contemporary information on therapeutic nuclear medicine procedures in paediatric malignancies.
  • Neuroblastoma is the most common paediatric extra cranial solid cancer characterized by meta-iodobenzylguanidine (mIBG) avidity in >/=90% of patients.
  • There exists approximately a 30-year experience with I-131-mIBG treatment.
  • Ongoing efforts include a more standardized approach including dosimetric data for patient selection and treatment guidance of I-131-mIBG therapy.
  • These features constitute the basis of the clinical use of peptide receptor radionuclide therapy (PRRNT) using radiolabeled somatostatin analogues.
  • Osteosarcoma is the most common primary bone tumour in children usually treated with chemotherapy and surgery.
  • In palliative situations bone seeking radionuclide therapies (strontium-89 [Sr-89], rhenium-186 hydroxyethylene diphosphonate [Rh-186 HEDP] and Samarium-153-ethylene diamine tetramethylene phosphonic acid [Sm-153-EDTMP]) may be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation).
  • Thyroid cancer is a rare childhood malignancy with an approximate incidence of 0.54 per 100000 per year but is the most frequent tumour of endocrine glands in children and adolescents.
  • Management includes radioiodine therapy but there are some distinct differences in comparison to adult thyroid cancer management.
  • [MeSH-major] Neoplasms / radiotherapy. Radiopharmaceuticals / therapeutic use
  • [MeSH-minor] 3-Iodobenzylguanidine / adverse effects. 3-Iodobenzylguanidine / therapeutic use. Adolescent. Antineoplastic Agents / therapeutic use. Bone Neoplasms / radiotherapy. Cell Line, Tumor. Child. Combined Modality Therapy. Humans. Iodine Radioisotopes / therapeutic use. Neuroblastoma / drug therapy. Neuroblastoma / radiotherapy. Neuroendocrine Tumors / drug therapy. Neuroendocrine Tumors / metabolism. Osteosarcoma / radiotherapy. Radiotherapy Dosage. Receptors, Somatostatin / metabolism. Thyroid Neoplasms / radionuclide imaging. Thyroid Neoplasms / radiotherapy

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  • (PMID = 20823809.001).
  • [ISSN] 1824-4785
  • [Journal-full-title] The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutical Chemistry and Biology
  • [ISO-abbreviation] Q J Nucl Med Mol Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Iodine Radioisotopes; 0 / Radiopharmaceuticals; 0 / Receptors, Somatostatin; 35MRW7B4AD / 3-Iodobenzylguanidine
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32. Cady B: Regional lymph node metastases, a singular manifestation of the process of clinical metastases in cancer: contemporary animal research and clinical reports suggest unifying concepts. Cancer Treat Res; 2007;135:185-201

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Regional lymph node metastases, a singular manifestation of the process of clinical metastases in cancer: contemporary animal research and clinical reports suggest unifying concepts.
  • The multistep complex metastatic cascade in cancer has been extensively studied in recent years.
  • In addition, the concept of metastatic organ specificity has been elaborated.
  • Histological studies in clinical situations have become far more sophisticated, enabling the frequent discovery of minor collections of cells in bone marrow and lymph nodes.
  • Pertinent clinical evidence of the selective nodal metastatic pattern exists in differentiated thyroid cancer in younger, low-risk patients, yet none of the published risk group definitions indicate that lymph node metastases have a relationship to thyroid cancer survival.
  • The lymph node metastatic frequency without distant organ metastases in these two human cancers help cement the understanding gained from laboratory and animal research regarding metastatic specificity and hopefully will help place the role of lymph node metastases generally and their surgical removal on a more scientifically and logically based understanding.
  • More broadly, the elaboration of the frequency of metastatic cell dissemination to distant organs as well as lymph nodes, and comprehension of the metastatic cascade with metastatic specificity may reorient our understanding of the evolution from metastatic cells to clinical metastatic disease.
  • Additionally, these concepts reemphasize that lymph node metastases are indicators, not governors, of distant metastases and survival, and add the assumption that metastatic tumor cells and tumor cell clusters, and perhaps even micrometastases in other organs, are themselves only indicators and not governors of distant metastases and survival in human cancers since they represent dormant metastases prior to their host microenvironmental changes that, on rare occasions, lead to angiogenesis and clinical metastases.
  • Thus, the future may allow us to abandon some aspects of our surgical or systemic attack on clinical cancer metastases, such as lymph node removal or use of toxic chemotherapy, but open the door to more physiological and hopefully less traumatic approaches to the highly manipulable multistep genetic and physiological process of metastatic development.
  • The future biological models of clinical cancer behavior will have to incorporate aspects of understanding the intricate metastatic cascade, and particularly the host microenvironmental factors that permit or prevent progressive growth of dormant cells or cell clusters to clinical metastases.

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  • [ReprintOf] Ann Surg Oncol. 2007 Jun;14(6):1790-800 [17342568.001]
  • (PMID = 17953417.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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33. Demetri GD, Heinrich MC, Fletcher JA, Fletcher CD, Van den Abbeele AD, Corless CL, Antonescu CR, George S, Morgan JA, Chen MH, Bello CL, Huang X, Cohen DP, Baum CM, Maki RG: Molecular target modulation, imaging, and clinical evaluation of gastrointestinal stromal tumor patients treated with sunitinib malate after imatinib failure. Clin Cancer Res; 2009 Sep 15;15(18):5902-9
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  • EXPERIMENTAL DESIGN: In this open-label, dose-ranging, phase I/II study, 97 patients with metastatic imatinib-resistant/intolerant GIST received sunitinib at doses of 25, 50, or 75 mg/d on one of three schedules.
  • Serial tumor imaging was done using computed tomography and [18F]fluoro-2-deoxy-d-glucose positron emission tomography scanning.
  • Decreased tumor glycolytic activity was shown in most patients within 7 days of starting sunitinib using [18F]fluoro-2-deoxy-d-glucose positron emission tomography.
  • Sunitinib treatment was associated with reduced tumor cell proliferation by >25% in 52% of cases analyzed and reduced levels of phospho-KIT in tumor biopsies (indicating target modulation).
  • The recommended dose schedule was 50 mg/d for 4 weeks followed by 2 weeks off treatment.
  • On the 50-mg dose across all schedules, 79% of PK-evaluable patients achieved total drug trough concentrations above the target concentration (50 ng/mL) within 14 days of dosing.
  • CONCLUSION: Cellular and molecular analyses showed that sunitinib clinical activity is associated with inhibition of KIT in GIST following imatinib failure, illustrating the rational approach used to develop a therapy aimed at the underlying oncogenic signaling pathway aberrancy.

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  • (PMID = 19737946.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA127003-020005; United States / NCI NIH HHS / CA / P50 CA127003-030005; United States / NCI NIH HHS / CA / CA127003-020005; United States / NCI NIH HHS / CA / CA127003-010005; United States / NCI NIH HHS / CA / 1P50CA127003-02; United States / NCI NIH HHS / CA / CA 47179; United States / NCI NIH HHS / CA / CA127003-030005; United States / NCI NIH HHS / CA / P50 CA127003; United States / NCI NIH HHS / CA / P01 CA047179; United States / NCI NIH HHS / CA / P50 CA127003-010005
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzamides; 0 / Indoles; 0 / Piperazines; 0 / Pyrimidines; 0 / Pyrroles; 0 / sunitinib; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
  • [Other-IDs] NLM/ NIHMS193713; NLM/ PMC3417101
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34. Pallini R, Sabatino G, Doglietto F, Lauretti L, Fernandez E, Maira G: Clivus metastases: report of seven patients and literature review. Acta Neurochir (Wien); 2009 Apr;151(4):291-6; discussion 296

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • FINDINGS: Of 46 patients who underwent surgery for clivus bone tumours, seven proved to harbour a metastasis.
  • The primary tumours associated were lung adenocarcinoma (n = 2), prostate carcinoma (n = 2), skin melanoma (n = 1), hepatocarcinoma (n = 1) and lung squamous cell carcinoma (n = 1).
  • In spite of radiotherapy and chemotherapy, the mean survival was 12 months.
  • On literature review, 27 examples of metastases located in the clival bone were found.
  • Including our series, the most common primary tumours were prostate cancer (26.4%), thyroid carcinoma (11.7%) and hepatocarcinoma (11.7%).
  • CONCLUSION: Though exceedingly rare, metastases involving the clivus should be considered in the differential diagnosis with clivus chordoma.
  • The metastatic lesion might be a late and single expression of the primary tumour.
  • The trans-sphenoidal approach is the ideal procedure to establish a histopathological diagnosis.
  • [MeSH-minor] Abducens Nerve Diseases / etiology. Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Liver Neoplasms / pathology. Lung Neoplasms / pathology. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Metastasis. Prognosis. Prostatic Neoplasms / pathology. Skin Neoplasms / pathology. Survival Rate. Tomography, X-Ray Computed

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  • (PMID = 19259614.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Austria
  • [Number-of-references] 30
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35. Nabeshima S, Kishihara Y, Nabeshima A, Yamaga S, Kinjo M, Kashiwagi S, Hayashi J: Poorly differentiated adenocarcinoma with signet-ring cells of the Vater's ampulla, without jaundice but with disseminated carcinomatosis. Fukuoka Igaku Zasshi; 2003 Jul;94(7):235-40
Hazardous Substances Data Bank. LEUCOVORIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The histological findings from bone marrow showed metastasis of adenocarcinoma with signet-ring cells, although the primary site was unknown.
  • To reduce tumor cells in number and improve DIC, 11 cycles of 5-Fluorouracil and leucovorin therapy were done, and the patient survived for 12 months.
  • Autopsy showed a 0.8 cm diameter, poorly differentiated adenocarcinoma with the signet-ring cell type in the lamina propria of the Vater's ampulla.
  • Many metastatic foci and micro tumor emboli were found in the lung and in bone marrow.
  • The sections of the stomach, the gallbladder, urinary bladder, prostate, and thyroid gland showed no malignant cells.
  • These findings suggest that the origin of the cancer may have been located in the Vater's ampulla.
  • This is a rare case of an ampullary tumor of poorly differentiated adenocarcinoma with the signet-ring cell type, without jaundice but with multiple metastasis.
  • 5-Fluorouracil and leucovorin were effective for increasing survival time and improving quality of life.
  • [MeSH-major] Ampulla of Vater. Bone Marrow Neoplasms / secondary. Carcinoma, Signet Ring Cell / pathology. Common Bile Duct Neoplasms / pathology. Lung Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Disseminated Intravascular Coagulation / complications. Disseminated Intravascular Coagulation / drug therapy. Fatal Outcome. Fluorouracil / administration & dosage. Humans. Jaundice. Leucovorin / administration & dosage. Male. Middle Aged. Neoplastic Cells, Circulating / pathology. Quality of Life

  • MedlinePlus Health Information. consumer health - Lung Cancer.
  • Hazardous Substances Data Bank. FLUOROURACIL .
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  • (PMID = 14509231.001).
  • [ISSN] 0016-254X
  • [Journal-full-title] Fukuoka igaku zasshi = Hukuoka acta medica
  • [ISO-abbreviation] Fukuoka Igaku Zasshi
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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