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At least 19 recordsLinked to original sources
PubMed1991

Intermittent interpleural injection of bupivacaine and methylprednisolone for analgesia in metastatic thoracic neoplasm.

Three patients with intractable chest wall pain due to diffusely metastatic thoracic neoplasm were successfully treated with intermittent interpleural steroid injections. Intermittent administration of 0.5% bupivacaine mixed with methylprednisolone suspension (Depo-Medrol) was effective in controlling intractable pain due to metastatic cancer. Pain relief with this technique lasted for periods in excess of 3 weeks between injections. Intermittent interpleural block may be a useful addition to the therapeutic armamentarium in dealing with chronic pain due to metastatic neoplasm.

Breast Neoplasms↗
PubMedDate not supplied

[Postoperative septic complications in patients operated on for thoracic neoplasms].

The authors executed a prospective clinic study evaluating, whether at the admittance or after surgery, the immunity status of 30 patients with a thoracic neoplasm, admitted to Department of Thoracic Surgery, I School of Medicine, Naples. Only 21 of them, immunodepressed at the admittance, were accepted to trial and assigned respectively to A Group destined to surgery (10 patients) and to B check Group (11 patients). In the A Group the effectiveness of the immunotherapy was valued in the prophylaxis and in the postoperative septic complications' therapy. The global incidence of those complications was of 6 cases, of which 10% only in A Group and 45% in B Group. In the operated patients the septic complications had few repercussions on general status and were rapidly and totally dominated in strict correlation with an adequate immunoreconstitution.

Adjuvants, Immunologic↗
PubMed1983

Biopsy of thoracic neoplasms for assay of chemosensitivity. New indication for thoracotomy.

Eighty-six thoracic neoplasms, both primary and metastatic, were removed at thoracotomy from 86 patients and were tested for chemosensitivity in the clonogenic assay. Substantial tumor growth was achieved in 79% (67/86). Fifty-two percent (16/31) of the primary lung tumors and 45% (15/33) of the metastatic tumors were sensitive to at least one tested drug. Clinical correlations between in vitro chemosensitivity and in vivo response were possible in 20 patients. The assay was 83% accurate for predicting in vivo sensitivity and 86% accurate for predicting in vivo resistance. The value of the assay as it pertains to lung cancer has been demonstrated. On the basis of the results, thoracotomy is indicated in selected patients as a diagnostic procedure to obtain tissue for chemosensitivity testing.

Antineoplastic Agents↗
PubMed1984

Thoracic neoplasms: imaging requirements for diagnosis and staging.

This article reviews the pathophysiology of thoracic neoplasms and discusses current imaging recommendations for diagnosis and staging of these tumors. Particular emphasis is given to primary lung cancers, which comprise a variety of tumors of differing histologic type and behavior. The development of cost-effective diagnostic/staging sequences with continually changing imaging technology continues to be a challenging goal. Our recommendations are based on the TNM system and data from the current literature employing the experience from our institution.

Adenocarcinoma↗
PubMed1995

E-cadherin expression in primary and metastatic thoracic neoplasms and in Barrett's oesophagus.

Reduced expression of E-cadherin, a Ca(2+)-dependent cell adhesion molecule present in normal epithelium, has been associated with invasive and metastatic cancer. Immunohistochemistry was used in examining the relationship between E-cadherin expression and stage in 59 oesophageal and 52 lung cancers. Advanced-stage oesophageal cancers were associated with both reduced and disorganised E-cadherin expression (P < 0.01). Advanced-stage lung adenocarcinomas generally exhibited disorganised or reduced E-cadherin expression, but no statistical association between expression pattern and stage was found (P > 0.05). No differences in stage were seen between tumours with reduced or disorganised E-cadherin expression. Altered E-cadherin expression was detected in dysplastic, non-invasive Barrett's oesophagus. Importantly, high-level E-cadherin expression was detected in 17 of 17 lymph nodes containing metastatic cancer. E-cadherin mRNA expression was decreased in tumours with reduced protein expression, but not in tumours with disorganised expression. Expression of alpha-catenin mRNA, an E-cadherin-associated protein, was detected in tissues with altered E-cadherin protein expression. Reduced and disorganised expression of E-cadherin appear to be related to transcriptional and post-translational events respectively, and both appear to represent altered cell adhesion associated with invasion and metastasis in thoracic neoplasms.

Adenocarcinoma↗
PubMed2001

[Role of radio-guided surgery with 111In-octreotide in the treatment of thoracic neoplasms].

The study evaluates the role of radio-guided surgery (RGS) with 111In-octreotide in the treatment of lung neoplasms. RGS with octreotide appears to be useful in surgery, above all during the intraoperative staging of the tumour; it can define with greater precision the extent of the resections extended towards the lung wall and ensure a radical approach in minimal lung resections.

Adult↗
PubMed2000

Megavoltage CT-assisted stereotactic radiosurgery for thoracic tumors: original research in the treatment of thoracic neoplasms.

PURPOSE: The aim of the study was to evaluate the efficacy of stereotactic radiosurgery (SRS) for thoracic tumors with megavoltage computed tomography (MVCT) from the point of view of symptom palliation as well as local control. METHODS AND MATERIALS: MVCT-assisted positioning verification and real-time monitoring for a multileaf collimator (MLC) were used to enhance the accuracy of the thoracic SRS. Twenty-two thoracic tumors in 15 patients underwent the present treatment. All but 1 tumor were metastases from various primary malignancies. Eleven patients were symptomatic. The treatment site was the chest wall/pleura in 10 tumors, and the lung in 12 tumors. The median volume of the clinical target was 4.5 cc and the median peripheral dose was 20 Gy, for the lung tumors. For the chest wall/pleura tumors, the median volume of the clinical target was 40 cc and the median peripheral dose was 20 Gy. Conventional fractionated conformal radiation therapy (CRT) followed SRS in 10 tumors. RESULTS: Of 21 tumors eligible for evaluation, there were 13 with complete responses, 6 with partial responses, and 2 without response. Duration of local control ranged from 0.6 to 82 months with a median of 8 months, with only one local recurrence seen. Immediate palliation was obtained in most symptomatic patients. Interstitial changes in the lung were limited. Autopsy performed for a patient revealed remarkable histologic effects with minimal injuries to the lung. CONCLUSION: The geometric accuracy of MVCT-assisted SRS appeared to enhance the clinical efficacy and safety of treatment to thoracic malignancies.

Adult↗
PubMed1998

Endoscopically assisted decompression for metastatic thoracic neoplasms.

STUDY DESIGN: The author describes a technique for complete vertebrectomy and anterior decompression followed by a formal anterior column reconstruction, using readily available endoscopic instruments. This procedure is indicated in patients with radioresistant metastasis of the thoracic spine, particularly those involving the upper thoracic segments where a thoracotomy is difficult and causes a high rate of morbidity. This is also a suitable technique for patients with pulmonary disease who cannot tolerate a standard thoracotomy. OBJECTIVES: To demonstrate the feasibility and potential benefits of endoscopically controlled decompression through an extrapleural, posterolateral approach. SUMMARY OF BACKGROUND DATA: Posterolateral decompression of the thoracic spine offers potential advantages in comparison with traditional anterior-posterior procedures combining thoracotomy and posterior instrumentation, including decreased operative time, decreased morbidity, and reduced hospital stay. Results of previous studies have not demonstrated the same benefit for posterolateral decompression as for anterior vertebrectomy and decompression. Drawbacks to the traditional posterolateral decompressions have included poor visualization of the spinal cord and anterior tumor, poor access to tumor on the side contralateral to the approach, and the need to manipulate the spinal cord to completely remove adjacent tumor and tumor adherent to the dura. METHODS: Surgical indications, rationale, and technique are provided, and initial clinical results are described. RESULTS: Transpedicular decompression using endoscopy is described in five patients. The mean operative time for the combined procedure was 7.25 hours, with a mean blood loss of 1800 mL. Neurologic recovery and maintenance were excellent. Inpatient days averaged 7.5, and intensive care days averaged 2. One patient died of disease 8 months after surgery, and four were living, with disease, 3-24 months after surgery. CONCLUSIONS: Endoscopically assisted decompression can reduce morbidity, hospital stay, and treatment costs while matching the efficacy of traditional combined procedures. Endoscopy provides a readily available and easily applied tool that dramatically improves the surgeon's vision, providing light, magnification, and a direct view of remote structures.

Bone Nails↗