• Title/Summary/Keyword: 관찰 요법

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Treatment Outcome of Locally Advanced Non-small Cell Lung Cancer Patients Who Received Concurrent Chemoradiotherapy with Weekly Paclitaxel (Paclitaxel 매주 투여 및 방사선치료 동시요법을 받은 국소진행성 비소세포폐암 환자들의 치료 결과)

  • Kim, Su-Zy;Shim, Byoung-Yong;Kim, Chi-Hong;Song, So-Hyang;Ahn, Meyung-Im;Cho, Deog-Gon;Cho, Kyu-Do;Yoo, Jin-Young;Kim, Hoon-Kyo;Kim, Sung-Whan
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.230-236
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    • 2006
  • $\underline{Purpose}$: To analyze the response, toxicity, patterns of failure and survival rate of patients with locally advanced non-small cell lung cancer who were treated with concurrent chemoradiotherapy with weekly paclitaxel. $\underline{Materials\;and\;Methods}$: Twenty-three patients with locally advanced non-small cell lung cancer patients who received radical chemoradiotherapy from October 1999 to September 2004 were included in this retrospective study. Patients received total $55.4{\sim}64.8$ (median 64.8) Gy (daily 1.8 Gy per fraction, 5 days per weeks) over $7{\sim}8$ weeks. 50 or $60\;mg/m^2$ of paclitaxel was administered on day 1, 8, 15, 22, 29 and 36 of radiotherapy. Four weeks after the concurrent chemoradiotherapy, three cycles of consolidation chemotherapy consisted of paclitaxel $135\;mg/m^2$ and cisplatin $75\;mg/m^2$ was administered every 3 weeks. $\underline{Results}$: Of the 23 patients, 3 patients refused to receive the treatment during the concurrent chemoradiotherapy. One patient died of bacterial pneumonia during the concurrent chemoradiotherapy. Grade 2 radiation esophagitis was observed in 4 patients (17%). Sixteen patients received consolidation chemotherapy. During the consolidation chemotherapy, 8 patients (50%) experienced grade 3 or 4 neutropenia and one of those patients died of neutropenic sepsis. Overall response rate for 20 evaluable patients was 90% including 4 complete responses (20%) and 14 partial responses (70%). Among 18 responders, 9 had local failure, 3 had local and distant failure and 2 had distant failure only. Median progression-free survival time was 9.5 months and 2-year progression-free survival rate was 19%. Eleven patients received second-line or third-line chemotherapy after the treatment failure. The median overall survival time was 21 months. 2-year and 5-year survival rate were 43% and 33%, respectively. Age, performance status, tumor size were significant prognostic factors for progression-free survival. $\underline{Conclusion}$: Concurrent chemoradiotherapy with weekly paclitaxel revealed high response rate and low toxicity rate. But local failure occurred frequently after the remission and large tumor size was a poor prognostic factor. Further investigations are needed to improve the local control.

An Experimental Study on the Effect of Combined X-ray and Microwave Hyperthermia on the Rectum and Urinary Bladder of Rats (흰쥐의 직장과 방광에 X-선 조사와 마이크로파 온열요법의 효과에 관한 실험적 연구)

  • Lee, Kyung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.4 no.2
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    • pp.115-128
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    • 1986
  • Hyperthermia can enhance the radiation effect as a synergistic reaction in combined X-ray irradiation and hyperthermia; hyperthermia sensitize radioresistant S-phase cells and inhibit cellular recovery from sublethal damage. We fabricated 100 watts, 2450 MHz microwave applicator for hyperthermia and planned the method and condition of heating and measured the temperature by using Agar phantom as a preliminary test. For biological examination, 102 rats were divided into 4 groups as hyperthermia, X-ray irradiation (6Gy-15Gy), combined X-ray and hyperthermia, and normal control groups. Microscopic examination of the rectum and bladder was done and the results were as followings: 1. The microwave generator with 100 watts, 2450MHz magnetron could be heating up to $40^{\circ}{\sim}50^{\circ}C$ for one hour in living tissue. 2. The thermal distribution in tissue equivalent phantom with microwave can be maintained at $40^{\circ}{\sim}44^{\circ}C$ in area of 3cm in depth and 2-10cm in diameter. 3. In Hyperthermia alone group, there was submucosal edema of the rectum but no histologic change in the urinary bladder was seen. 4. The minimal necrosis of the mucosa was appeared in the rectum and bladder after 15 days of 6 Gy and 8 Gy irradiation respectively. The minimal necrosis of the muscle layer of rectum and bladder was appeared after 15 days of 8Gy and 60days of 10Gy irradiation respectively. 5. In combined group of radiation and hyperthermia, thermal enhancement ratio (calculated at necrosis of mucosa and muscle layer) of rectum and bladder was 1.0, and it suggest that there is no change of tolerance dose of normal rectum and bladder.

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Multidisciplinary Management of the Locally Advanced Unresectable Non-Small Cell Lung Cancer (수술 불가능한 국소 진행 비소세포성 폐암의 집합적 요법)

  • Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.1-10
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    • 2004
  • Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

Combination Treatment with Arsenic Trioxide and Sulindac Induces Apoptosis of NCI-H157 Human Lung Carcinoma Cells via ROS Generation with Mitochondrial Dysfunction (NCI-H157 폐암 세포주에서 활성산소종의 생성과 미토콘드리아 기능변화를 한 Arsenic Trioxide와 Sulindac 병합요법의 세포고사효과)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.30-38
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    • 2005
  • Background : Arsenic trioxide ($As_2O_3$) has been used to treat acute promyelocytic leukemia, and it induces apoptosis in a variety of solid tumor cell lines including non-small cell lung cancer cells. However, nonsteroidal antiinflammatory drugs (NSAID) can enhance tumor response to chemotherapeutic drugs or radiation. It was previously demonstrated that a combination treatment with $As_2O_3$ and sulindac induces the apoptosis of NCI-H157 human lung carcinoma cells by activating the caspase cascade. This study aimed to determine if a combination treatment augmented its apoptotic potential through other pathways except for the activation of the caspase cascade. Material and Methods : The NCI-H157 cells were treated with $As_2O_3$, sulindac and antioxidants such as glutathione (GSH) and N-acetylcysteine (NAC). The cell viability was measured by a MTT assay, and the level of intracellular hydrogen peroxide ($H_2O_2$) generation was monitored fluorimetrically using a scopoletin-horse radish peroxidase (HRP) assay. Western blotting and mitochondrial membrane potential transition analysis were performed in order to define the mechanical basis of apoptosis. Results : The viability of the cells was decreased by a combination treatment of $As_2O_3$ and sulindac, and the cells were protected using antioxidants in a dose-dependent manner. The increased $H_2O_2$ generation by the combination treatment was inhibited by antioxidants. The combination treatment induced changes in the mitochondrial transmembrane potential as well as the expression of the Bcl-2 family proteins, and increased cytochrome c release into the cytosol. However, the antioxidants inhibited the effects of the combination treatment. Conclusion : Combination treatment with $As_2O_3$ and sulindac induces apoptosis in NCI-H157 human lung carcinoma cells via ROS generation with a mitochondrial dysfunction.

A Case of Complete Remission after Concurrent Chemoradiotherapy for Esophageal Squamous cell Carcinoma with Solitary Bone Metastasis (고립성 골 전이를 동반한 식도편평세포암에서 동시 항암화학방사선 요법 후 완전관해를 보인 1례)

  • Woo Jin Lee;Hoon Jai Chun;Ye Ji Kim;Sun Young Kim;Min Ho Seo;Hyuk Soon Choi;Eun Sun Kim;Bora Keum;Yoon Tae Jeen;Hong Sik Lee;Soon Ho Um;Chang Duck Kim;Ho Sang Ryu
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.53-57
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    • 2013
  • There is no established treatment for esophageal carcinoma with metastasis. For the metastatic esophageal squamous cell carcinoma, chemotherapy or best supportive care according to patient's performance status are accepted as an available treatment. We report a case of complete remission after concurrent chemoradiotherapy for esophageal squamous cell carcinoma with metastatic lesion in 5th thoracic vertebrae. A 57-year-old man with ongoing dysphagia and weight loss was admitted to our hospital. On the endoscopic and radiologic imaging evaluation,the patient was diagnosed as a squamous cell carcinoma of esophagus with solitary metastatic lesion in 5th thoracic vertebrae. The patient was treated with combination chemotherapy (5-fluorouracil (5-FU) and cisplatin) and concurrent radiotherapy for two months to relieve dysphagia. Because metastatic lesion in thoracic vertebrae was located near the primary esophageal tumor, the metastatic lesion could be included within the radiation field. After concurrent chemoradiotherapy, consecutive 4 cycles of chemotherapy had been carried out. Primary esophageal tumor with metastatic lymph nodes and metastatic lesion in 5th thoracic vertebrae disappeared on follow up computed tomography (CT) and positron emission tomography-CT (PET-CT). Follow up endoscopic biopsy revealed no remnant malignant cells at previous primary cancer lesion.

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중서의결합치료소아백혈병사로(中西醫結合治療小兒白血病思路) -중서의 결합으로 소아백혈병 치료에 대한 접근-

  • Seok Hyo-Pyeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.71-75
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    • 2001
  • 백혈병은 조혈계통의 악성 증식성 질환으로서 현재까지 주로 화학약물요법에 의존하고 있는 실정이다. 화학약물요법은 백혈병 세포를 소멸시킬 수 있지만 또한 인체에 여러 가지 독성 반응 및 부작용을 일으키기도 한다. 따라서 중서의결합으로 백혈병 치료에 접근하는 것은 중요한 의미를 갖는다. 중의학에서 소아 백혈병을 치료하는 경우 청열해독법(淸熱解毒法), 부정보허법(扶正補虛法), 활혈화어법(活血化瘀法)을 주로 사용한다. 청열해독법은 백혈병의 조기치료에 주로 활용되는데, 인체의 저항력을 증강시켜 화학약물요법을 실시하는 동안 흔히 나타날 수 있는 감염증상을 예방하는 효과를 얻을 수 있다. 부정보허법(扶正補虛法)은 주로 화학약물요법의 유도 완화기 및 치료효과의 유지를 위하여 활용되는데, 이는 인체의 면역력을 향상시켜 화학약물요법이 인체에 미치는 손상을 경감시킬 수 있다. 활혈화어법(活血化瘀法)은 미세순환을 개선시키는 작용을 하며 골수의 조혈기능을 촉진하고 면역기능을 조절하며 또한 일부 활혈화어제(活血化瘀劑)는 백혈병 세포에 직접적인 억제효과를 보인다. 소아백혈병에 대하여 화학약물요법을 진행하는 동안 중약을 같이 병행하는 경우 다음과 같은 과정으로 나누어 실시할 수 있다. 1. 유도완화치료(화학요법)단계: 이와 같은 치료과정은 대개 화학약물요법으로 인한 극심한 독성반응이나 주작용을 나타내게 되는데, 이 과정에서 중약치료를 병행하면 신속하게 증상을 개선시킬 수 있다. 만약 구토나 설사와 같은 소화계 부작용이 나타나면 화위강역법(和胃降逆法)을 활용하고, 감염 증상이 나타나면 부정(扶正)과 거사법(祛邪法)을 병행할 수 있다. 화학약물요법을 진행한 후 신체가 극도로 허약해지고 골수의 기능이 심하게 억제되는 경우는 주로 부정(扶正)시키는 중약을 사용하면서 익기양혈제(益氣養血劑)를 곁들이고 보조적으로 단삼(丹蔘), 당귀(當歸), 천궁(川芎), 계혈등(鷄血藤) 등과 같은 활혈화어제(活血化瘀劑)를 사용하여 골수의 조혈기능을 회복시킨다. 2. 치료효과의 유지단계: 본 과정에서는 중약치료에 있어서 부정(扶正)과 거사법(祛邪法)을 병행한다. 화학약물요법을 실시하는 동시에 거사제(祛邪劑)를 중용(重用)함으로써 화학약물요법의 효과를 강화시킨다. 화학약물요법이 끝난 뒤 부정(扶正)시키는 약물을 중용(重用)하여 인체의 면역기능을 증강시키고 백혈병세포를 억제시킨다. 3. 치료효과의 유지 및 강화단계: 치료효과의 유지단계에서는 변증논치(辨證論治)의 원칙에 입각하여 항암효과가 있는 중약을 활용할 수 있는데, 예를 들어 백화사설초(白花蛇舌草), 산자고(山慈?), 청대(靑黛), 용규(龍葵) 등을 사용할 수 있고, 육신환(六神丸)을 장기적으로 복용하여도 된다. 소아백혈병 치료에 있어서 중서의결합의 치료법을 활용하는 경우 다음과 같은 내용에 주안점을 둘 수 있다. 화학약물요법을 진행하는 과정에서 중약을 병행하여 투여하는 경우 사진합삼(四診合參)을 근간으로 종합적인 분석을 통하여 병인(病因)을 살피어 치료에 임하도록 한다. 약물의 선택과 처방의 구성은 반드시 변증논치(辨證論治)의 원칙하에 이루어져야 한다. 화학약물요법과 중약치료를 병행하는 과정에서 변증(辨證)과 변병(辨病)이 서로 결합되고 부정(扶正)과 거사법(祛邪法)을 병행하여 활용한다. 정체관(整體觀)에서 출발하여 환자를 관찰하는 동시에 특징적인 증후(證候)에 대한 변증논치(辨證論治)도 중요하며, 또한 백혈병 환자의 유형(類型)이나 임상 혈액검사 소견, 골수의 양상, 화학요법의 진행단계 및 환자의 연령과 체질 등을 충분히 가만하여 종합적인 분석을 토대로 치료법을 선택하여야 중약요법과 화학약물요법의 협동적인 효과를 증폭시키고 백혈병치료에 새로운 전기를 마련할 수 있을 것이다.

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Injection Therapy for Calcific Tendinitis of Shoulder Under the Sonographic Guidance (초음파하 극상근 석회화 건염 주사 요법)

  • Nam, Ki Young;Moon, Young Lae;Yang, Kyung Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.10-13
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    • 2008
  • Purpose: To evaluate the efficiency of needling and injection technique without steroid for symptomatic calcific tendinitis of the shoulder. Material and Methods: We chose 12 symptomatic calcific tendinitis patients, whose ages ranged from 35 to 64. Procedure ware dry needling and injection of prolotherapic agent near the lesion. Results: All the case revealed prominent improvement without limitation of shoulder function, especially in active painful stage. Conclusion: Sonographic injection technique for calcific tendinitis would be one of the good modality not only for symptomatic relieve but also good functional recovery.

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Effects of Bibliotherapy of Dotard Dementias Old Adults (독서요법이 경증 치매노인에게 미치는 효과)

  • Hwang, In-Dam;Park, Joon-Shik
    • Journal of Korean Library and Information Science Society
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    • v.41 no.4
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    • pp.383-402
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    • 2010
  • This study was conducted to investigate the effectiveness of bibliotherapy on the levels of cognitive function, depression, and social behavior in the elderly with mild dementia. For this quasi-experimental research, a total of 166 subjects the age of from 90 to 65 were selected of the 166, were divided into the experimental group and control group for six months. These findings confirmed that the dementia Bibliotherapy program made a contribution to improve cognitive function and social behavior, and to reduce depression in the elderly with mild dementia. Therefore, it is recommended that this program be used in clinical practice as an effective Bibliotherapy program for the elderly with mild dementia.

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A Study of Folk Remedies in Type II Diabetic Patients (우리나라 당뇨환자들의 민간요법 실태)

  • 조미란;조여원
    • Journal of Nutrition and Health
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    • v.31 no.7
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    • pp.1151-1157
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    • 1998
  • Many type II diabetic patients use folk remedies to. treat diabetes in Korea. The physiology, pathology, usage, and prescriptions of folk remedies are not well established, and the effects of those remedies were handed down by word of mouth of experienced persons. Most of these remedies can cause unexpected side effects if consumed in large amounts since patients lack scientific backgrounds and the precise effects as well as the possible side effects have not been proven. The purpose of this survey was to investigate the prevalence of diabetic f31k remedies used by adult diabetic patients who use diet therapy to treat diabetes. This information can be used for a basic scientific approach to diabetic f31k remedies. The results of the survey were as follows : 1) Thiry-nine patients(53.4%) out of a total of 75 patients, answered that they used folk remedies. 2) There were 54 kinds of folk remedies f3r diabetes, and the most popular ones are silk worm powder, red jinseng, silkworm pupa, raw lentils, and cabbage, that to accounted for 97.4% of the experienced group. 3) The most common way to be exposed to folk remedies were recomnendations by friends and relatives, and through the mass communication such as TV, newspaper, magazine. As fir as the effects of the flok remedies goes, 17% answered that they experienced positive effects in controlling blood glucose levels and 5.7% reported negative effects. Moreover, 17.1% answered that they experienced side effects like stomach ache and bloating. 4) The 82.9% of the experienced group answered that they used silkworm powder, which was the most popular one in folk remedies. 5) 75% of the experienced group patients showed positive responses to folk remedies, saying that they will try new folk remedies if introduced. Even 66.7% of inexperienced group showed their interest saying that they will try new folk remedies.

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