• Title/Summary/Keyword: 항암약물치료

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The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

The Results of Radiation Therapy Alone vs Radiation Plus Chemotherapy of Uterine Cervix Cancer (자궁경부암에서 방사선 단독요법 및 항암화학과 방사선 병용요법의 치료성적)

  • Lee, Myung-Za;Choi, Seog-Young;Chun, Ha-Chung
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.181-189
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    • 1995
  • Pupose: Radiation therapy(RT) is conventionally standard treatment for locally advanced stage for uterine cervix cancer. Recently to improve treatment results, combined chemotherapy and radiation therapy was tried We retrospectively analysed our experience of 122 patients. Comparision of the results in 45 patients treated with RT alone and 77 patients treated with RT plus chemotherapy was made Materials and Mathods: From January 1985 to December 1991 122 patients with cervix cancer were treated with whole pelvic external RT and ICR(34 1 ICR, 77 2 ICR, 11 high dose rate ICR) in our department. Forty five patients were treated with RT alone, and 77 patients were treated with combined RT plus chemotherapy Mean age was 58 years(range:29-81). Histologic types were 111 squamous cell carcinoma, 5 large cell carcinoma, 3 adenocarcinoma, and 2 adenosquamous cell carcinoma. According to the FIGO stage 6 had stage $IA(4.9\%),$ 11 had $IIA(9.0\%),$ 37 had $IIB(30.3\%),$ 3 had $IIIA(2.5\%),$ 63 had $IIIB(51.6\%).$ and 2 had stage $IV(1.6\%).$ In 77 patients with RT Plus chemotherapy, 36 patients were treated with VBP(vinblastin, bleomycin, cisplatinum) , 39 patients with cisplatinum plus 5-FU and 2 patients with 5-FU. Results: Complete response after external RT (3960cGy-5500cGy) was achieved in 61 patients$(50\%).$ The actuarial 5 year and 9 rear survival rate was $57.8\%\;and\;53.9\%,$ respectively. Five rear actuarial survival rate was $63.1\%$with RT alone(n=45) and $55.9\%$ with RT plus chemotherapy(n=77). The 5 rear survival rate was $35.5\%$ for 1 course of ICR and $67\%$ for 2 courses of ICR. There was statistically significant advantage of survival with RT alone group who were treated with 2 courses of ICR and dose to the A Point)=8000cGy (4/25 died). In RT plus chemotherapy group, dose response was not seen and there was no difference in 5 year survival between 1 course and 2 course of ICR $(50\%\;vs\;56.8\%),$ and dose to point A less than 8000 cGy and more than 8000 $cGy(55.6\%\;vs\;55.7\%).$ There was no significant difference in survival between RT alone and RT plus chemotherapy for patients with tumor size greater than 3cm in size. Five year survival rate for early stage (Stage IB and IIA) with RT alone group and with RT Plus chemotherapy group was $60\%\;and\;77.0\%,$ respectively In advanced stage (stage IIB, IIIA, IIIB, IVA) the 5 year actuarial survival rate were $62.6\%,$ for RT alone group vs $53.6\%$ for RT plus chemotherapy group. Conclusion: Present study demonstrates that there is no survival advantage with adding chemotherapy in advanced stage of uterine cervix cancer. RT alone is considered as treatment of choice for patients with locally advanced cervix cancer. There was increased survival in RT alone group treated with RT dose above 8000 cGy to point A and 2 course of ICR. but 2 course of ICR and RT dose above 8000 cGy to point A did not affect survival advantage in RT plus chemotherapy group.

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Pathologic Change and Prognosis after Combination Therapy in Advanced Neuroblastoma (소아 신경모세포종의 치료 후 조직소견의 변화와 예후와의 관계)

  • Seo, Yeon Kyong;Jung, Yu Jin;Kim, Joon Sik;Kim, Heung Sik;Park, Woo Hyun;Choi, Soon Ok;Lee, Byung Yook;Kwon, Kun Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1107-1111
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    • 2003
  • Purpose : Neuroblastoma is a malignant neoplasm which arises from primitive sympathetic neuroblasts, and occasionally can matured from a malignant neuroblastoma into a benign ganglioneuroma. It has the highest rate of spontaneous regression of any pediatric tumor. We performed a retrospective study of pathologic features after combination therapy in advanced neuroblastoma. Prognostic effects of the individual morphologic feature and prognostic groupings according to modified Shimada classification systems were analyzed. Methods : The treatment results for six patients with neuroblastoma seen at Keimyung University from Jan. 1991 to June 2000 were analyzed. Patients were treated with a combination of chemotherapy, radiation therapy, and surgery, and classified by two major prognostic criteria based on morphological features of neuroblastoma, such as modified Shimada classification and histologic grading. Results : Three cases were classified to a good histologic group; among them, two cases survived, but one case was lost in follow-up. There were three cases classified in a poor histologic group. All of these patients expired due to sepsis and hemorrhagic pancreatitis. Conclusion : Prognostic classification due to pathologic findings had significant value in evaluating the survival rate of neuroblastoma patients.

가래나무로부터 세포독성물질의 분리, 구조결정.

  • 조윤기;손종근;문동철;이인자
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.248-248
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    • 1994
  • 목적 : 가래나무는 일부 민간방과 한방에서 암 치료의 목적으로 사용되고 있다. 아울러 이 식물을 대상으로 세포독성물질의 분리, 구조결정에 관한 연구는 이미 보고되어 있는 성분인 juglone이 새포독성을 나타낸다는 단편적인 보고만 있을뿐 전혀 되어있지 않은 상태이다. 본 연구는 국내에서 자생하는 가래나무 (Juglans mandchurica)로부터 세포독성물질을 분리, 구조결정함으로서 새로운 항암제 개발에 일차적인 자료를 제공하는 것을 그 목적으로 한다. 방법 : 가래나무 뿌리의 methanol 추출물을 hexane, chloroform, ethyl acetate. n-buthanol, water로 분획하고 세포독성을 측정하였으며, 이들중 ethyl acetate 분획으로부터 세포독성을 나타내는 물질들을 분리하였으며 현재 이들의 구조를 분광분석학적인 방법으로 결정하고 있다. 결과 : 현재까지 분리된 물질들은 약한 세포독성을 나타내고있으며, 그들 중 한물질의 구조를 결정하였다.

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천연물로부터 새로운 암세포 분화인자의 검색 및 그 항암작용에 관한 연구

  • 김규원
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.50-50
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    • 1993
  • 최근의 암치료용 제제는 암세포의 분화를 재개시켜서 정상적인 세포로 분화 유도하는 약재개발에 촛점을 맞추고 있으므로 본 연구에서는 F9 EC세포주에 의한 분화인자 스크리닝 시스템을 확립하고 나아가 새로운 분화 유도인자를 스크리닝 하는데 그 목표를 두고 연구를 수행하였다. 즉 F9 EC세포의 세포 배양조건을 먼저 확립하였으며 retinoic acid에 의한 F9 EC세포의 분화유도 시스템을 다음과 같이 확립하였다. 1 단계: F9 EC세포에 스크리닝할 물질의 단독처리 2 단계: 스크리닝할 물질에 dibutyryl cyclic AMP(dbc-AMP)와 theophylline을 첨가하여 처리 3 단계: 분화 marker유전자의 발현조사 그리고 이 시스템을 이용하여 천연 식물 및 해양동식물에서 추출한 성분을 대상으로 하여 새로운 분화인자의 검색을 시도한 결과, saponin, steroid 및 glycolipid계열의 물질이 분화인자로서 효과가 있음이 나타났다.

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The effect of Asparagi Tuber on Anti-cancer and Immunocytes (천문동(天門冬)이 항암(抗癌) 및 면역세포(免疫細胞)에 미치는 영향(影響))

  • Jeong, Hyun Woo;Cho, Young-Lim
    • Herbal Formula Science
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    • v.5 no.1
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    • pp.169-178
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    • 1997
  • To investigate effect of water extract of Asparagi Tuber(天門冬) on human cancer cell-lines and immunocytes, this research estimated proliferation of A431 cell line, KHOS-NP cell line, mouse thymocytes and mouse splenocytes, Nitric Oxide(NO) from macrophage, apoptosis and subpopulation of the mouse thymocytes. The result were obtained as follows ; 1. Asparagi Tuber inhibited the proliferation of A431 cell line. 2. Asparagi Tuber inhibited the proliferation of KHOS-NP cell line. 3. Asparagi Tuber accelerated the proliferation of mouse thymocytes. 4. Asparagi Tuber inhibited the proliferation of mouse splenocytes. 5. Asparagi Tuber $100{\mu}g/m{\ell}$ inhibited the production of NO from macrophages in vitro, being compared NPS+IFN treated group. 6. Asparagi Tuber inhibited the production of NO from macrophages in vivo, being compared LPS+IFN treated group. 7. Asparagi Tuber accelerated the induction of apoptosis of the mouse thymocytes. 8. In subpopulation Asparagi Tuber increased $T_H$ of the mouse thymocytes, but decreased $T_C/T_S$ of the mouse thymocytes.

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Factors Affecting Quality of Sleep in Breast Cancer Patients Receiving Chemotherapy in the Outpatient Settings (외래에서 항암화학요법을 받는 유방암 환자의 수면의 질 영향요인)

  • Choi, Yooun-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.562-570
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    • 2019
  • The purpose of this study was to identify the factors influencing the quality of sleep in breast cancer patients receiving chemotherapy in the outpatient settings. The data were collected from 203 patients with breast cancer receiving chemotherapy in the outpatient settings at one tertiary hospital in B City. Stress, fatigue and depression were negatively correlated with quality of sleep (r=-.369, p=.001; r=-.565, p=.001; r=-.526, p=.001, respectively). Fatigue(${\beta}=-.387$, p<.001) was one of the biggest impact factors on quality of sleep which explained 31.6% of the variance of the sleep quality, followed by the experience of sleep disturbances prior to the diagnosis of breast cancer(${\beta}=-.178$, p<.002) and depression(${\beta}=-.231$, p<.004). In total, all of the antecedent variables explained significantly 37.4% of the variance of the sleep quality. Thus, in order to improve the quality of sleep, integrative nursing interventions need to be developed to reduce fatigue and depression among them, including an proactive system to screen out the patients with the experience of sleep disturbances prior to the diagnosis with breast cancer and to provide adequate pharmacological and/or non-pharmacological sleep interventions prior to the chemotherapy.

Characteristics of BCNU-loaded PLGA Wafers (BCNU를 함유한 생분해성 PLGA 웨이퍼의 특성분석)

  • 안태군;강희정;이진수;성하수;정제교
    • Polymer(Korea)
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    • v.26 no.5
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    • pp.691-700
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    • 2002
  • Interstitial therapy using biodegradable polymeric device loaded with anticancer agent can deliver the drug to the tumor site at high concentration, resulting in an increase of therapeutic efficacy. 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU, carmustine) is most commonly used as chemotherapeutic agent for brain tumors. The design of implantable device is regarded as an important factor lot the efficient delivery of antitumor agent to targeting site. In order to control the release profile of drug, the release pattern of BCNU with the changes of various dimension and additives was investigated. The PLGA wafers containing 3.85, 10, 20 and 30% of BCNU were prepared in various shape (diameter of 3, 5 and 10 mm, thickness of 0.5, 1 and 2 mm) by direct compression method. In vitro drug release profile of BCNU-loaded PLGA wafers could be controlled by changing the dimension of wafers such as initial drug content, weight, diameter, thickness, volume and surface area of wafers, as well as PLGA molecular weight and additives. Drug release from BCNU-loaded PLGA wafers was facilitated with an increase of BCNU-loading amount or presence of poly(N-vinylpyrrolidone)(PVP) or sodium chloride (NaCl). The effects of various geometric factors and additives on the BCNU release pattern were confirmed by the investigation of mass loss and morphology of BCNU-loaded PLGA wafers.

Concurrent Chemoradiotherapy in Locally Advanced Carcinoma of The Uterine Cervix : A Phase I/II Prospective Study (국소적으로 진행된 자궁경부암의 방사선치료와 복합 항암화학요법의 동시치료 결과)

  • Kang One Chul;Choi Eun Kyung;Chung Weon Kuu;Kim Jong Hoon;Chang Hyesook;Kim Yong Man;Kim Young Tak;Nam Joo Hyun;Mok Jung-Eun;Lee Moo-Song
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.311-323
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    • 1998
  • Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

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The Study of Normal Tissue Complication Probability(NTCP) for Radiation Pneumonitis by Effective Volume Method (유효체적 방법과 임상분석을 통한 방사선에 의한 정상 폐조직의 부작용 확률에 관한 연구)

  • Ahn Seung Do;Choi Eun Kyung;Yi Byong Yong;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.243-249
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    • 1997
  • Purpose : In radiation therapy, NTCF is very importart indicator of selecting the optimal treatment plan. In our study, we tried to find out usefullness of NTCP in lung cancer by comparng the incidence of radiation pneumonitis with NTCP. Materials and Methods : From August 1993 to December 1994, thirty six patients with locally advanced non=small cell lung cancer were treated by concurrent chemoradiation therapy. Total dose of radiation therapy was 6480cGy (120cGy, bid) and chemotherapeutlc agents were mitomycin C. vinblastion, cisplatin (2 cycles, 4 weeks interval). We evaluated the development of raniation pneumonitis by CT scan, chest x-rar and clinical symptoms. We used grading system of South Western Oncology Group (SWOG) for radiation pneumanitis. Dose Volume Histograms (DVH) were analyzed for ipsilateral and whole lung, Non uniform DVH was translated to uniform DVH by effective volume method. With these data, we calculated NTCP for ipsilateral and whole lung. Finally we compared the clinical results to NTCP. Results : Eight of thrity six patients developed radiation pneumonitis. Of these 8 patients , 6 had grade I severity and 2 had grade II. The average NTCP value cf the patients who showed radiation pneumonitis was significantly higher than that uf the patients without pneumonitis $(66\%\;vs.\;26.4\%)$. But the results of pulmonary function test was not correlated with NTCP. Conclusion : NTCP of lung is very good indicator for selecting rival treatment planning in lung cancer. According to the results of NTCP, it may be possible to adjust target volume and optimize target dose. In the near future, we are going to anaiyze the effect of hyperfractionation and concurrent chemotherapy in addition to NTCP.

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