• 제목/요약/키워드: 진행성 위암

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원발성 위암과 후두암, 폐암 병발의 1례 (A Case of Triple Primary Cancers in Stomach, Larynx, and Lung)

  • 최주영;장혜정;이민진;심성신;류연주;문진욱;이진화;천은미;장중현
    • Tuberculosis and Respiratory Diseases
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    • 제61권3호
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    • pp.279-284
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    • 2006
  • 다발성 원발성 악성종양은 최근 발생 빈도가 증가하고 있으며 이는 암의 진단 방법의 개선 및 인구의 고령화, 유해물질에 대한 노출증가에 기인한다. 국내에서도 다발성 원발성 악성종양에 대한 연구가 진행되어왔으며, 김등, 윤등이 보고하였다. 그러나 삼중복암의 발생하는 빈도는 매우 낮은 것으로 보고되어있다. 저자들은 이화여대 동대문 병원 내과에 입원한 다발성 원발성 위암, 후두암, 폐암 환자의 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

식은 땀을 호소하는 진행성 암 환자에서 비스테로이드성 항염증 제제를 이용한 치료 (Non-Steroid Anti-Inflammatory Agents for Management of Cold Sweating in Advanced Cancer Patients)

  • 최혜정;송하나;강정훈
    • Journal of Hospice and Palliative Care
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    • 제19권4호
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    • pp.331-334
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    • 2016
  • 목적: 진행성 암 환자에서 발열이 동반되지 않은, 암성 발한에서 NSAID (non-steroid anti-inflammatory drug) 치료 효과를 알아보고자 함이 목적이다. 방법: 다음과 같은 조건을 만족하는 환자를 대상으로 후향적으로 의무 기록을 조사하였다. 1) 수술적 절제나 항암방사선 치료로 완치가 불가능한 진행성 암 환자 2) 숫자평가등급 4점 이상의 식은 땀을 호소하며 발열이 동반되지 않은 환자 3) 식은 땀의 원인이 될 만한 감염이 없고, 마약성 진통 및 호르몬 차단제를 현재 최근 1개월 이내 새롭게 사용하지 않는 환자 4) 식은 땀 치료를 위해 NSAID를 사용하고, NRS 평가가 치료 전 후 시행한 환자. 결과: 총 13명의 환자가 등록되었다. 남자가 9명(69%)이었고, 평균 59세(범위: 50~71)였다. 암종별 빈도는 담도암, 췌장암, 위암, 전립선암 순이었다. 치료 전 환자들의 식은 땀은 평균 NRS 6.5 (최소값: 4, 최대값: 10) 이었고, 치료 후에는 NRS 1.9 (최소값: 0, 최대값: 5)이었다. 평균 추적 관찰 기간은 9.1일이었다. 결론: 진행성 암 환자에서 열이 동반되지 않은 중등도 이상의 식은 땀 환자에서 NSAID는 효과적인 치료방법이다.

위에 발생한 신경내분비 종양의 임상병리학적 고찰 (The Clinicopathologic Characteristics of Neuroendocrine Tumor of the Stomach)

  • 이철민;신연명
    • Journal of Gastric Cancer
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    • 제8권4호
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    • pp.204-209
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    • 2008
  • 목적: 위에 발생하는 신경내분비 종양은 국내에서도 그 보고가 드문 매우 독특한 조직형인데, 이 종양의 임상병리학적 특징들에 대해 알아보고자 하였다. 대상 및 방법: 1999년 1월부터 2007년 8월까지 고신대학교 의과대학 외과학교실에서 위암으로 수술받은 4,159예 중 신경내분비 종양으로 진단받은 13예를 대상으로 의무기록 및 조직 표본을 후향적으로 분석하였다. 결과: 위 신경내분비 종양은 남자 11예, 여자 2예였고, 평균나이는 54.9세(42~72)였으며, 주증상은 상복부 통증과 속쓰림이 많았다. 점막 또는 점막하 종양 2예를 제외하고 나머지 9예는 모두 근육층 이상을 침범한 진행성이었고, 종양의 평균 크기는 7.0 cm (0.7~15)였다. WHO 분류법에 의한 내분비 종양의 유형은 제 3형이 8예, 제 4형이 4예, 제 1형이 1예였다. 림프절 전이는 11예에서 있었고, 추적 기간내 재발한 4명의 환자 모두 제 3형과 제 4형이었고, 재발한 장기는 간이 2예, 다장기(복막, 폐) 1예, 다장기(간, 췌장, 십이지장) 1예였고, 생존 기간은 평균 12.8개월이었다. 결론: 위에 발생하는 신경내분비 종양은 진단 당시 진행된 경우가 많았고 간 전이를 잘 하였으며 예후가 나쁜 독특한 조직형이다.

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눈꺼풀로 전이된 진행성 위암 (Metastatic eyelid cancer from gastric adenocarcinoma)

  • 정지윤;구은주;이재창;송재이;고성애;이경희;배영경
    • Journal of Yeungnam Medical Science
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    • 제33권2호
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    • pp.142-145
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    • 2016
  • Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.

항암플러스 투여 후 호전된 진행성 위암 환자 증례보고 (Case Report of Advanced Gastric Cancer Patient Treated with Hang-Am Plus)

  • 박재우;유화승;조종관;이연월
    • 혜화의학회지
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    • 제19권2호
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    • pp.153-158
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    • 2011
  • Objective : To investigate the therapeutic effects of HangAm-Plus (HAP) on advanced gastric cancer patient. Methods : A 53 year old male patient diagnosed with advanced gastric cancer (T3N3M1) was admitted to EWCC (East-West Cancer Center) on Nov. 20008. He had refused to go through the standard cancer regimen after having total gastrectomy on Jul 2008. The patient was treated with HAP (3,000 mg/day) for the period of 11 months from Nov 27th, 2008 to Oct 10th, 2009. Computed tomography (CT) and endoscopy were used to evaluate the disease progression of the patient. Results : HAP treatment was well tolerated by the patient. Patient has shown 25 months of stable disease condition up until now. Conclusion : This case study supports HAP's potential efficacy in treating advanced gastric cancer patients.

한방치료와 화학·방사선요법을 병행하여 완전 관해된 진행성 위암 환자 1례 (A Case Report of Complete Response of Advanced Gastric Carcinoma Patient Treated with Korean Medicine Treatment in Conjunction with Chemoradiation Therapy)

  • 이재찬;윤호영;유화승;방선휘
    • 대한암한의학회지
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    • 제19권1호
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    • pp.25-32
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    • 2014
  • Objectives : The purpose of this study is to report the effect of Korean Medicine Treatment (KMT) on the advanced gastric carcinoma (AGC) patient. Method : One advanced gastric carcinoma patient was treated by Korean Medicine Treatment composed of pharmacopuncture, acupuncture and herbal medicine. At the same time, he received chemotherapy (S-1 and Cisplatin) and radiotherapy. The effect of KMT was measured by scanning with Computed tomography (CT) and Esophagogastroduodenoscopy (EGD). Response was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) Committee classification. Result : The tumor was disappeared after the treatment during 13 months (Complete Response (CR)). As treatment was performed, chemoradiation therapy induced complication was alleviated. Conclusion : This case provides us a possibility that Korean Medicine Treatment offers potential benefits for advanced gastric carcinoma patient.

간농양에 의한 패혈성 합병증과 동반된 진행성 위암 (Liver abscess and septic complications associated with advanced gastric cancer)

  • 윤건중;최영;김민재;이재신;고의원;주연호
    • Journal of Yeungnam Medical Science
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    • 제32권1호
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    • pp.38-41
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    • 2015
  • Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.

진행성 위암에 대한 면역 요법의 최신 지견 (Recent Progress in Immunotherapy for Advanced Gastric Cancer)

  • 손병석
    • Journal of Digestive Cancer Research
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    • 제10권1호
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    • pp.22-30
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    • 2022
  • Immune checkpoint inhibition has been established as a new treatment option for various types of carcinoma, and many clinical trials are being actively conducted as a treatment for advanced or metastatic gastric cancer, either as a monotherapy with an immune checkpoint inhibitor or as a combination therapy with standard chemotherapy. In the CheckMate-649 clinical trial to confirm the efficacy of the combination of nivolumab and chemotherapy (FP) in advanced gastric cancer and gastroesophageal junction cancer, nivolumab group showed improvement in overall survival in programmed death ligand 1-positive cancer patients compared with placebo group. Also, the combination therapy of pembrolizumab, trastuzumab and chemotherapy (FP) in first-line treatment was tested through the KEYNOTE-811 trial. The pembrolizumab group showed 22.7% of improvement in objective response rate compared with placebo group. Accordingly, the combination of nivolumab/pembrolizumab with standard chemotherapy was approved for the first-line treatment. In KEYNOTE-059 trials for patients with progressive disease after at least two lines of chemotherapy, pembrolizumab monotherapy showed improvement in objective response rate and overall survival, and the use of pembrolizumab was approved for the third-line or more treatment. In this article, we review the result of clinical trials related to immune checkpoint inhibitors that have been recently introduced in the treatment of gastric cancer.

말기 암 환자에서 완화적 진정 증례 토론 (Palliative Sedation for Terminal Cancer Patient)

  • 김도연
    • Journal of Hospice and Palliative Care
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    • 제11권2호
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    • pp.106-110
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    • 2008
  • 완화적 진정은 임종이 임박한 불응성 증상을 가진 환자들에게 고려될 수 있는 치료이지만 부적절한 진정으로 인한 윤리적인 문제가 쟁점이 된다. 본 증례는 수차례항암화학요법과 완화적 방사선 치료에도 불구하고 진행되는 다발성 뼈 전이를 동반한 전이성 위암을 가진 50세 남자에게 완화적 진정을 시행했던 예를 권고안에 비추어 후향적 검토하였다. 환자는 표준적인 통증경감치료에 불응성으로 판단되었고 환자의 의사결정능력 부족으로 환자보호자에게 완화적 진정에 대한 치료 목적 및 예견되는 부작용을 설명한 후 midazolam으로 완화적 진정을 시작하였다. 본 증례에 통하여 완화적 진정의 적응, 완화적 진정의 시작 전 의사 결정, 완화적 진정 시작, 완화적 진정 시작 후의 돌봄에 대한 토의를 하였고 국내실정을 반영한 권고안 마련을 제의하는 바이다.

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절제 불가능한 진행성 위암 환자에서 Etoposide, Adriamycin 및 Cisplatin-II (EAP-II)와 Etoposide, Leucovorin 및 5-Furorouracil (ELF) 복합 화학요법의 치료효과에 대한 후향적 연구 (Retrospective Study on the Therapeutic Effects of an Etoposide, Adriamycin, Cisplatin-II (EAPII) versus an Etoposide, Leucovorin, 5-Furorouracil (ELF) Combination Chemotheraphy in Unresectable Gastric Cancer)

  • 문희석;강윤세;김연수;박기오;이엄석;성재규;이병석;노승무;송규상;조준식;신경숙;정현용
    • Journal of Gastric Cancer
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    • 제3권3호
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    • pp.122-127
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    • 2003
  • Purpose: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn't duplicate the result. the purpose of this study was to evaluate the relative efficacy & toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. Materials and Methods: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/$m^{2}$ IV for $1\∼5 days$), adriamycin (20 mg/$m^{2}$ IV for $1\∼5 days$) and cisplatin (20 mg/$m^{2}$ IV for $1\∼5 days$) and Twenty-eight patients receieved ELF chemotherapy : etoposide (100 mg/$m^{2}$ IV for $1\∼3 days$), leucovorin (20 mg/$m^{2}$ IV for $1\∼5 days$) and 5-FU (500 mg/$m^{2}$ IV for $1\∼5 days$). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient..ELF means 4.1 cycles per patient Results: Total respones rates were $5.4\%$ in the ELF group and $3.6\%$ in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value<0.05), and themedian overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis & hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: $27.6\%$ in ELF vs $54\%$ in EAP-II; Leukopenia: $8.5\%$ in ELF vs $19\%$ in EAP-II; nausea & vomiting: $45.9\%$ in ELF vs $67.8\%$ in EAP-II. Conclusion: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer (J Korean Gastric Cancer Assoc 2003;3:122-127)

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