• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.89-94
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• 2015

The role of adjuvant chemotherapy in patients with stage II colon cancer remains a controversial issue. Adjuvant chemotherapy aims to eliminate any micrometastatic disease that may have been missed, at the time of surgery. Although one prospective study showed a small but statistically significant benefit with respect to the overall survival for those who received adjuvant chemotherapy, multiple pooled data did not demonstrate any benefit of this therapy in patients with stage II colon cancer. Current national and international guidelines for the adjuvant treatment of stage II colon dose not advise routine implementation of adjuvant chemotherapy, but rather recommend selective use of this therapy for patients with high risk of recurrence. High risk features for recurrence include T4 disease, poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, inadequate retrieval of lymph nodes, bowel obstruction, localized perforation, or positive margins. More recently, prediction tools using gene expression cancer profiles are proposed to identify patients who are most likely to have recurrence and therefore may benefit from postoperative chemotherapy in stage II colon cancer. These novel methods together with conventional prognosticators, will allow us to implement more optimized personalizing adjuvant therapy in these patients.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.172-176
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• 2004

Background and Objectives: Standard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we designed induction chemotherapy followed by definitive radiation in patients with potentially respectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival. Materials and Methods: The twenty-six patients diagnosed advanced head and neck squamous cell carcinoma, Stage III or IV (AJCC 2002) and performed organ preservation protocols in Ajou university hospital from 1994 to 2001 were included in this study. Results: Neoadjuvant chemotherapy showed an overall response rate of 84.6% and a complete remission (CR) rate was 59.1% following neoadjuvant chemotherapy and radiation. Seven of thirteen patients were able to preserve their larynges for more than two years by chemotherapy and radiation. There were no treatment related mortality after 2 cycles of induction chemotherapy. Conclusion: Although Organ preservation protocol through neoadjuvant chemotherapy and radiation need more controlled randomized study, it was considered alternative treatment modality in advanced head and neck cancer.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.363-371
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• 1994

Background: DNA content analysis of human solid tumor is now widely performed by flow cytometric study. One of the most interesting and potentially important observation in this field is that proliferative activity(S-Phase fraction of cell cycle) may profoundly affect the prognosis. Method: S-Phase fraction(SPF) have been measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, SPF of small lung cancer cell was assessed in 42 patients who died after receiving anticancer chemotherapy. Results: 1) Mean survival time of patients with small cell lung cancer was 190(${\pm}156$) days. Survival time were shortened, when TNM stage and PS scale were advanced. 2) Mean value of SPF of patients with small cell lung cancer was 27.4(${\pm}8.5$)%. SPF had nothing to do with advance of TNM stage and PS scale. 3) In each identical TNM stage, there were not statistic significance between SPF and survival times. 4) There was a tendency like that higher SPF, better chemotherapeutic response. Conclusion: We could not find statistic significance between SPF and survival times, but SPF was a good predictive factor for chemotherapeutic response.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.179-188
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• 2004

Purpose: The purpose of this study was to investigate the degree of fatigue and its related factors in cancer patients during chemotherapy. Methods: The subjects of this study consisted of 90 patients over 20 years old who were receiving chemotherapy at the injection room of the o.p.d. and ward admission care unit in a University hospital located in Gwang-ju city and data were collected from August 8th to October 2nd, 2002. Collected data were analysed using SPSS v 10.0. to obtain summary statistics for the descriptive analysis, t-test, ANOVA, pearson correlation, and multiple regression. Results: 1. Fatigue of the subjects was significantly correlated with physical distress score. and 6 items of subscale those were nausea, vomiting, anorexia, pain, and immobility, showed statistically significant correlation. 2. Fatigue of the subjects showed statistically significant differences according to a nap satisfaction. Fatigue of the subjects was significantly correlated with mood state, Also, all 5 items of subscale, which are those were anxiety, confusion, depression, energy, and anger showed statistically significant correlations. 3. Fatigue of the subjects showed statistically significant differences according to metastasis, chemotherapy cycle, post operation existence, post radiation therapy existence. There were significant negative correlation between fatigue and hematocrit and fatigue and weight change. There was no significant correlation between fatigue and spiritual well-being state. With the result to multiple regression, Immobility, Anorexia, Anger explained fatigue by, pain, and immobility showed statistically significant correlation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2971-2980
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• 2014

To find the risk of cardiovascular disease for breast cancer patients received postoperative adjuvant anticancer therapy, this study was investigated the change of serum lipid profile (total cholesterol and trigyiceride) and the 10 year risk score of ischemic heart disease. Medical data of 432 breast cancer patients diagnosed at the breast cancer center in an university hospital from January, 2003 to December, 2006 were collected and analysed. The results showed that the levels of total cholesterol and triglyceride were increased at the points of 2 and 5 years after operation. The margin of increase of total cholesterol was higher in the patients without endocrine therapy compared to them with endocrine therapy, however there were no changes in the level of triglyceride regardless of endocrine therapy. There were also no significant changes in total cholesterol and triglyceride levels between chemotherapy, radiotherapy and endocrine therapy. 10 year-risk score of ischemic heart disease was increased by 0.44%p in the final observation compared to that of a baseline.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.283-289
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• 1998

Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed by radiation therapy in locally advanced non-small cell lung cancer Materials and Methods : Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine Patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. Results : Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). Conclusion : In stage III non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.72-74
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• 2014

Pancreatic cancer is well known to have a poor prognosis and poor responses to both of chemotherapy and radiation therapy. We report a metastatic pancreatic cancer treated successfully with chemotherapy and radiation therapy. A 71-year-old female with epigastric pain and weight loss was diagnosed as advanced pancreatic cancer with main vessels invasion and multiple mesenteric lymph node's metastasis. She was taken chemotherapy of gemcitabine single regimen and radiation therapy. Although she experienced one recurrence and concomitant primary lung cancer, she has survived for over 7 years with no symptoms. The authors report this case of long term survival in metastatic pancreatic cancer after chemoradiation therapy.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.160-168
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• 2004

Background : The role of second-line chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) is known to be limited. Recently, ZD1839, the small molecule epidermal growth factor receptor-tyrosine kinase inhibitor, has been developed and has shown anti-tumor activity in patients with solid malignant tumors including lung cancer. We evaluated the response rate and toxicities of ZD1839 in patients with advanced NSCLC which has progressed after previous chemotherapy. Patients and Methods : We examined 83 patients with advanced NSCLC treated with ZD1839 for more than 1 month in Korea Cancer Center Hospital during the period from January 2002 to September 2003. All the patients were enrolled in the international expanded access program (EAP) with ZD1839 by AstraZeneca. The administered dose of ZD1839 was 250 mg once daily. Chest radiography and laboratory tests were followed-up. We evaluated the response rate, median survival, and toxicity after treatment. Results : Median age of the patients was 59 years (range 33-76). The most predominant cell type was adenocarcinoma and the most stage of the patients was IV. ECOG performance status was as follows; grade 0-1 in 10, grade 2 in 42, and grade 3 in 31 patients. Partial response was achieved in 12 patients (14.5%). Median overall survival was 9.2 (range 1.3-21.6+) months and median time to progression was 3.1 (range 1-21.2+) months. The most common adverse effect of ZD1839 was skin eruption which developed in 25 patients (25.8%). Significantly higher response rate and survival was found in patients with adenocarcinoma or good performance status. Conclusion : ZD1839 showed modest activity and tolerable toxicity in the treatment for patients with NSCLC which has progressed after previous chemotherapy.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.328-333
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• 2002

Purpose : To analyze the treatment results of concurrent chemoradiation with oral 5-FU plus Gemcitabine or Paclitaxel for unresectable pancreatic cancer. Materials & Methods : The patients, who were diagnosed by imaging modalities or by explo-laparotomy, were treated with concurrent chemoradiation. Radiotherapy was delivered to primary tumor and regional lymph nodes, and the total dose was 45 Gy. Patients received Gemcitabine $1,000\;mg/m^2$ or Paclitaxel $50\;mg/m^2$ weekly and oral 5-FU daily The total number of cycles of chemotherapy ranged from 1 to 39 (median, 11 cycles). The follow-up period ranged from 6 to 36 months, Survival was analyzed using the Kaplan-Meier method. Results : Fifty-four patients between Jan. 1999 to Nov. 2001 were included in this study. Forty-two patients who completed the planned treatment were included in this analysis. The patients' age ranged from 37 to 73 years (median, 50 years) and the male to female ratio was 30:12. Treatment was interrupted for 12 patients due to: disease progression for 6 $(50\%)$, poor performance status for 4 $(33.3\%)$, intercurrent disease for 1 $(8.3\%)$, and refusal for 1 $(8.3\%)$. Response evaluation was possible for 40 patients. One patient gained complete remission and 24 patients gained partial remission, hence the response rate was $59\%$. The survival rates were $46.7\%\;and\;17.0\%$ at 1 year and 2 years, respectively with a median survival time of 12 months. Patients treated with Paclitaxel showed superior outcomes compared to those patients treated with Gemcitabine, in terms of both response rate and survival rate although this difference was not statistically significant. Grade III or IV hematologic toxicity was shown in 8 patients $(19\%)$, while grade III or IV non-hematologic toxicity was shown in 5 patients $(12\%)$. Conclusion : Concurrent chemoradiation with oral 5-FU and Gemcitabine or Paclitaxel improves both the response rate and survival rate in patients with unresectable pancreatic cancer. A prospective study should be investigated in order to improve both the patient selection and the treatment outcome as well as to reduce the toxicity.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.213-221
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• 2008

Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.