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The Results of Postoperative Radiation Therapy for Perihilar Cholangiocarcinoma (간문부 담도암에서 수술 후 방사선 치료의 결과)

  • Lee, Yu-Sun;Park, Jae-Won;Park, Jin-Hong;Choi, Eun-Kyung;Ahn, Seung-Do;Lee, Sang-Wook;Song, Si-Yeol;Lee, Sung-Gyu;Hwang, Shin;Lee, Young-Joo;Park, Kwang-Min;Kim, Ki-Hun;Ahn, Chul-Soo;Moon, Deok-Bog;Chang, Heung-Moon;Ryu, Min-Hee;Kim, Tae-Won;Lee, Jae-Lyun;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.181-188
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    • 2009
  • Purpose: The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Materials and Methods: Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months (range, 6 to 45 months). Results: The 3-year overall survival and 3-year progression free survival rates were 30% and 8%, respectively. The median survival time was 28 months. A multivariate analysis showed that differentiation was the only significant factor for overall survival. The 3-year overall survival was 34% in R0 patients and 20% in R1 patients. No statistically significant differences in survival were found between the 2 groups (p=0.3067). The first site of failure was local in 18 patients (47%). No patient experienced grade 3 or higher acute toxicity and duodenal bleeding developed in 2 patients. Conclusion: Our results suggest that adjuvant RT might be a significant factor in patients with a positive margin following a radical resection. However, there was still a high locoregional recurrence rate following surgery and postoperative radiotherapy. Further study is necessary to enhance the effect of the adjuvant radiotherapy.

The Significance of Plasma Urokinase-type Plasminogen Activator and Type 1 Plasminogen Activator Inhibitor in Lung Cancer (폐암에서 혈장 Urokinase-Type Plasminogen Activator 및 Type 1 Plasminogen Activator Inhibitor의 의의)

  • Park, Kwang-Joo;Kim, Hyung-Jung;Ahn, Chul-Min;Lee, Doo-Yun;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.516-524
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    • 1997
  • Background : Cancer invasion and metastasis require the dissolution of the extracellular matrix in which several proteolytic enzymes are involved. One of these enzymes is the urokinase-type plasminogen activator(u-PA), and plasminogen activator inhibitors(PAI-1, PAI-2) also have a possible role in cancer invasion and metastasis by protection of cancer itself from proteolysis by u-PA. It has been reported that the levels of u-PA and plasminogen activator inhibitors in various cancer tissues are significantly higher than those in normal tissues and have significant correlations with tumor size and lymph node involvement. Here, we measured the concentration of plasma u-PA and PAI-1 antigens in the patients with lung cancer and compared the concentration of them with histologic types and staging parameters. Methods : We measured the concentration of plasma u-PA and PAI-1 antigens using commercial ELISA kit in 37 lung cancer patients, 21 benign lung disease patients and 24 age-matched healthy controls, and we compared the concentration of them with histologic types and staging parameters in lung cancer patients. Results : The concentration of u-PA was $1.0{\pm}0.3ng/mL$ in controls, $1.0{\pm}0.3ng/mL$ in benign lung disease patients and $0.9{\pm}0.3ng/mL$ in lung cancer patients. The concentration of PAI-1 was $14.2{\pm}6.7ng/mL$ in controls, $14.9{\pm}6.3ng/mL$ in benign lung disease patients, and $22.1{\pm}9.8ng/mL$ in lung cancer patients. The concentration of PAI-1 in lung cancer patients was higher than those of benign lung disease patients and controls. The concentration of u-PA was $0.7{\pm}0.4ng/mL$ in squamous cell carcinoma, $0.8{\pm}0.3ng/mL$ in adenocarcinoma, 0.9ng/mL in large cell carcinoma, and $1.1{\pm}0.7ng/mL$ in small cell carcinoma. The concentration of PAI-1 was $22.3{\pm}7.2ng/mL$ in squamous cell carcinoma, $22.6{\pm}9.9ng/mL$ in adenocarcinoma, 42 ng/mL in large cell carcinoma, and $16.0{\pm}14.2ng/mL$ in small cell carcinoma. The concentration of u-PA was 0.74ng/mL in stage I, $1.2{\pm}0.6ng/mL$ in stage II, $0.7{\pm}0.4ng/mL$ in stage IIIA, $0.7{\pm}0.4ng/mL$ in stage IIIB, and $0.7{\pm}0.3ng/mL$ in stage IV. The concentration of PAI-1 was 21.8ng/mL in stage I, $22.7{\pm}8.7ng/mL$ in stage II, $18.4{\pm}4.9ng/mL$ in stage IIIA, $25.3{\pm}9.0ng/mL$ in stage IIIB, and $21.5{\pm}10.8ng/mL$ in stage IV. When we divided T stage into T1-3 and T4, the concentration of u-PA was $0.8{\pm}0.4ng/mL$ in T1-3 and $0.7{\pm}0.4ng/mL$ in T4, and the concentration of PAI-1 was $17.9{\pm}5.6ng/mL$ in T1-3 and $26.1{\pm}9.1ng/mL$ in T4. The concentration of PAI-1 in T4 was significantly higher than that in T1-3. The concentration of u-PA was $0.8{\pm}0.4ng/mL$ in M0 and $0.7{\pm}0.3ng/mL$ in M1, and the concentration of PAI-1 was $23.6{\pm}8.3ng/mL$ in M0 and $21.5{\pm}10.8ng/mL$ in M1. Conclusions : The plasma levels of PAI-1 in lung cancer were higher than benign lung disease and controls, and the plasma levels of PAI-1 in T4 were significantly higher than T1-3. These findings suggest involvement of PAI-1 with local invasion of lung cancer, but it should be confirmed by the data on comparison with pathological staging and tissue level in lung cancer.

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Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

Effects of Dietary Activated Charcoal Mixed with Wood Vinegar on Quality and Chemical Composition of Egg in Laying Hens (목초액 함유 활성탄의 급여가 산란계에서 계란의 품질과 화학적 조성에 미치는 영향)

  • 김관응;유선종;안병기;조태수;안병준;최돈하;강창원
    • Journal of Animal Science and Technology
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    • v.48 no.1
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    • pp.59-68
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    • 2006
  • This experiment was conducted to investigate the effects of dietary supplementation of activated charcoal (AC) mixed with wood vinegar on performance and egg quality in laying hens. A total of one hundred ninety two, 56-wk-old Lohmann brown laying hens were divided into four groups, consisting four replicates of 12 birds each and fed one of the four experimental diets containing AC 0%, AC 0.5%, AC 1%, AC 2% for 5 wks. The blood profiles and contents of total lipid and cholesterol, fatty acid profiles in egg yolk were determined. There were no significant differences in laying performance, feed intake and vitelline membrane strength among the treatments. The eggshell breaking strength and Haugh unit were significantly increased in 2% AC group compared to the other groups (P<0.05). Egg yolk index in 2% AC group was significantly higher (P<0.05) than those of the control and 0.5% AC group and yolk color was significantly improved by the dietary AC (P<0.05). The levels of serum total cholesterol, HDL-cholesterol and enzyme activities were not influenced by feeding AC. Total lipid of egg yolk in 1 % and 2% AC groups was significantly decreased (P<0.05) compared to that of the control, although there was no significant difference in yolk cholesterol. In conclusion, the addition of activated charcoal with wood vinegar in layer diet resulted in improving egg quality by means of enhancing eggshell breaking strength, Haugh unit, yolk index and yolk color.

Suitability Grouping System of Paddy Soils for Multiple Cropping -Part II : Criteria of the Suitability Grouping (다모작(多毛作)을 위한 답토양(畓土壤) 적성등급(適性等級) 구분(區分) -제(第)2보(報) : 적성등급(適性等級) 구분기준(區分基準))

  • Jung, Yeun-Tae;Park, Eun-Ho;No, Yeong-Pal;Um, Ki-Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.19 no.4
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    • pp.283-289
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    • 1986
  • To establish a suitability grouping system of paddy soils for multiple cropping of rice with other upland crops, the study was carried out after a few basic experiments. In succession to the results on basic experiment prior, the suitability system proposed and the results of application mentioned in this report were summarized as follows; 1. The factors of soil properties in the system were productivities represented by soil texture and drainage class, as well as salinity of surface and sub-soil pH of chemical properties were considered together with slope, warmth index, ground water table, parent materials etc. of soil physical or environmental conditions. The weights of the factors were combined with multiplicatively and additively so as the total marks of ideal soil to be 100. The system was composed with 5 suitability classes; over 91 mark is class I, under 60 mark class V, and each 10 point interval between classes. The limiting factors "P" (in the case that Physical properties or Productivity marks under 24), "S" (Surface slope less than 15) and "C" (Chemical condition below 15) etc. were appended up to two kinds to the classes except a part of soils in class I. 2. The areas where the warmth index exceed 110 in Yeongnam were 19% for class I, 22.7% for class II, 44.7% for class III, 11.5% for class IV, and 2.1% for class V. The rates in class I and II were slightly more than those of the whole country. 3. The points of each soil gained by the system had a positive correlation ($r=.922^{**}$) with the potential productivities.

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The Immunological Effect of Mistletoe Extract on Gastric Cancer Patients (미슬토 추출물(Mistletoe Extract)이 위암환자의 수술 후 면역기능에 미치는 효과)

  • Yang, Sung-Woo;Shin, Dong-Gue;Kim, Il-Myung;Yoon, Seong-Min;Lee, Yong-Jik;Heo, Su-Hak;Kim, Tae-Hee
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.167-173
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    • 2007
  • Purpose: Mistletoe (Viscum album L.) extract is one of the most widely used agents in alternative cancer therapeutic regimens in Europe. This study was conducted to determine the effect of mistletoe extract on immune function in gastric cancer patients. Materials and Methods: Ten patients that had undergone a curative gastrectomy were enrolled in the prospective study. ABNOBAviscum $Q^{(R)}$ was injected subcutaneously three times a week from postoperative-day 7 to week 16 with an increasing dose. All of the patients simultaneously received chemotheraphy with mitomycin, oral 5-FU and a cisplatin regimen. The WBC count, differential count, lymphocyte/WBC ratio and the level of cytokines (IL-$1{\beta}$, IL-2, IL-6, IFN-$\gamma$, TNF-$\alpha$) were checked in the peripheral blood preoperatively, at postoperative week 8 and at postoperative week 16. Results: The WBC and neutrophil counts significantly decreased after treatment on week 8 and week 16 (P=0.001), but the total eosinophil count was slightly increased (P=0.15). The total lymphocyte count also decreased during treatment but the lymphocyte/WBC ratio was slightly increased without statistical significance (P=0.91). The cytokine levels did not significantly change during treatment. Conclusion: It is somewhat difficult to determine the direct effect of mistletoe therapy on immune function as the effect may be compromised by the concurrent chemotherapy. It can be assumed that the slightly increased lymphocyte/WBC ratio and eosinophil count may be a result of the immunomodulatory effect of the mistletoe extract.

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Analysis of Treatment Failures in Early Uterine Cervical Cancer (조기 자궁경부 악성종양의 치료실패에 대한 분석)

  • Kim Joo-Young;Lee Kyu-Chan;Choi Hyung-Sun
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.285-291
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    • 1991
  • One hundred and twenty six patients with early uterine cervical cancer who had been treated at Departmen of Radiation Oncology of Korea University Hospital from Jan.1981 to Dec.1988 were analysed retrospectively by the treatment result and pattern of of failures. All patients had stage Ia to IIa disease and were grouped whether they had combination of operation and postop irradiation or radiation therapy alone. 1) Sixty six patients belonged to the combination treatment group and 60 patients to the radiation alone group. 2) Combination group consisted of $18.1\%$(12/66) stage Ia, $71.2\%$(47/66) stage Ib and $10.6\%$ (7/66) stage IIa patients. There were no stage Ia, 18.8$\%$(l1/60) stage Ib and 81.6$\%$(49/60) stage IIa patients for RT alone gronp. 3) There were total 23$\%$(29/126) treatment failures,13 patients in combination group and 16 patients in RT alone group. In 66 patients of combination group, they were found to have 5 locoregional failures, 7 distant failures and 1 at both sites. In 60 patients of RT alone group, 9 locoreginal failure and 7 distant failures occured. Eighty six percent (25/29) of total failures appeared within 18 month after completion of treatment. About 60$\%$ of the patients with regional recurrences which were located at pelvic side wall or pelvic lymph nodes paesented their recurrent disease after 1 year of completion of treatment, whereas same percent of distant failures appeared within 6 month. 5) In RT alone group, the first sites of distant failure were mostly para-aortic lymph node and/or left supraclavicular lymph node (71.4$\%$,5/7). In combination group, various sites such as inguinal lymph node, mediastinal lymph node, liver, lung and bone appeared first or at the same time with para-aortic and supraclavicular lymph node metastasis. 6) Logistic regression analysis was done for multivariate analysis of the factors contributing to locoregional and distant failures. In combination group, adequacy of the resection margin and the presence of positive pelvic node were found to be the most significant factors (p=0.0423 & 0.0060 respectively). In RT alone group, less than complete regression of the tumor at the end of treatment was the only significant contributing factor for the treatment failures (p=0.0013) with good liklihood ratio.

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Studies on the Effect of Low Temperature Treatment at Meiotic, Heading and Seedling Stage in Paddy Rice (수도의 장해형 냉해에 관한 연구)

  • Hong-Suk Lee;Hyung-Yull Cho;Pyeong-Ki Yim;Hoon Heu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.15
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    • pp.85-97
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    • 1974
  • In order to clarify the inducing conditions and cause of sterility in rice plants, 4 varieties were cooled at 3 different levels of temperature combined with 3 different levels of treatment period. And 19 varieties were tested to examine the varietal difference of cold resistance. The results obtained were summarized as follows; 1. There were significant varietal differences in the effect of cooling treatment at meiotic stage. Suwon 213-1 was induced heavy sterility by 3 day cooling treatment at 17.5$^{\circ}C$ whereas Hayayuki, Nongpaik and Jinheung were induced a little sterility by 3 day cooling treatment at 15$^{\circ}C$ and 5 day treatment at 17.5$^{\circ}C$. The per cent of grain fertility was correlated significantly with the delayed days to heading, the degree of panicle extraction (Suwon 213-1, Nongpaik, Jinheung), culm length (Nongpaik, Suwon 213-1), and Auricle distance (Suwon 213-1). The degree of sterility was able to be estimated from the linear regression equation between the degree of panicle extraction (distance from panicle neck to flag leaf) and fertility percentage. In the case of heavy cold damage by the treatment of low temperature at meiotic stage, the rice plant had somewhat lower pollen density per anther, small and ununiform anther and pollen in size, and more sterile pollen grains. Suwon 213-1 showed anthesis in almost all spikelets, while Nongpaik, Jinheung and Hayayuki indicated considerable number of indehisced anther at 5 days after heading. 2. The fertility were not generally higher in cooling treatment at heading stage than at meiotic stage treatment. And significant correlation was found between the percentage of grain fertility treated at above two stages. Nongpaik and Jinheung were not affected in percentage of fertility by 5 day treatment at 15$^{\circ}C$ when these were treated at heading stage. Indehisced anthers were not found in Suwon 213-1 and Hayayuki, but Nongpaik and Jinheung showed more anthers which did not show anthesis 3. There was different varietal response to low temperature which was indicated by the decrease of grain fertility resulted from cooling treatment at meiotic stage. Jaekeun and Jinheung did not show low fertility but Milseong, Suwon 210, Satominoli and Suwon 213-1 showed outstanding decrease in fertility percentage by the cooling treatment at meiotic stage. The varieties which had low fertility were likely to have low pollen density per anther, abnormal anthers, small size po]]en grains and many sterile pollens. 4. Remarkable varietal difference of cold resistance was found in heading stage cooling treatment. Nongpaik, Jinheung, Jaekeun, Paltal, Akibare, Milseung and Palkeong were not affected in grain fertility by cooling treatments but Nonglimna No. 1, Suseong, Hayayuki, Suwon 213-1 and Suwon 210 showed significantly high sterility as treated by cool temperature. Most of the varieties showed higher fertility by cooling treatment at heading stage than meiotic stage but Hayayuki, Suseong and Nonglimna No.1 showed lower fertility when these were treated at heading stage than meiotic stage. There were two grops of varieties in the response to cooling treatment, one was somewhat non-anthesised and the other showed full anthesis. 5. In cold injury test of young seedlings, the result of observation was not accorded with the degree of growth inhibition. As a general, Palkeum and Suseong were highly torelant to cool temperature but Suwon 213-1, Jaekeun, Paltal, Shirogane, Palkeong, Mankyung were highly susceptible. 6. There is no significant correlation between the degree of young seedling cold damage and or the degree of growth retardation at seedling stage and grain fertility resulted from coding treatment both heading and meiotic stage.

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Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.