• Title/Summary/Keyword: 항암화학 요법

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The Nutritional Status of the Patients with Cancer during the Chemotherapies (항암 화학치료요법중 환자의 영양상태 변화연구)

  • 양영희;권성준;김창임
    • Journal of Korean Academy of Nursing
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    • v.31 no.6
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    • pp.978-987
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    • 2001
  • The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy. Method: To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy. Result: 93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake. Conclusion: The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.

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Nodal Station as a Prognostic Factor in Resected Stage IIIA N2 Non-Small Cell Lung Cancer (절제된 IIIA N2 병기 비소세포형 폐암에 있어서 Nodal Station의 의의)

  • 김대준;김길동;김치영;정경영
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.489-496
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    • 2003
  • To clarify the prognostic implication of the location and number of the metastatic mediastinal nodes in resected stage IIIA N2 non-small cell lung cancer. Material and Method: One hundred and seventy-four patients with resected non-small cell lung cancer who eventually proved to have pathologic stage IIIA N2 disease were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In upper lobe tumors, there was no difference in 5-year survival according to the involvement of lower mediastinal nodes (32.3% vs 25.6%, p=0.86). In lower lobe tumors, no difference was found in 5-year survival according to the involvement of upper mediastinal nodes (25.1% vs 14.1%, p=0.33). There was no significant difference in 5-year survival between patients with or without metastatic subcarinal node (20.9% vs 25.6%, p=0.364). In terms of the number of metastatic mediastinal nodes, 5-year survival was better in single station group (26.3%) than multiple station group (18.3%) (p=0.048). In multiple station N2 group, the patients who received postoperative chemotherapy and radiation therapy had better 5-year survival (34.2%) (p=0.01). Cox's proportional hazards model revealed that the age $\geq$60 (O.R: 1.682, p=.006), multiple station N2 (O.R: 1.503. p=0.021), pneumonectomy (O.R: 1.562, p=0.018), postoperative chemotherapy and radiation therapy (O.R: 0.625, p=0.012) were the factors affecting the postoperative survival. Conclusion: Multiple station N2 disease was the important prognostic factor for postoperative survival in resected stage IIIA N2 non-small cell lung cancer. Postoperative chemotherapy and radiotherapy were thought to improve the survival in case of multiple station N2 disease.

Characteristics of Tuberculosis Detected during Chemotherapy for a Solid Tumor (고형암에 대한 항암화학요법 치료 중 병발한 결핵의 특성)

  • Kim, Deog Kyeom;Lee, Sei Won;Kang, Young Ae;Yoon, Young Soon;Yoo, Chul-Gyoo;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.285-290
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    • 2005
  • Background : Some malignancies including lymphoma, head and neck cancer, and lung cancer are believed to be associated with the reactivation of tuberculosis (TB) because cyclic anti-cancer chemotherapy can induce the leukopenia or immunological deterioration. This report describes the clinical characteristics and treatment response of TB that developed during cyclic anti-cancer chemotherapy in patients with a solid tumor. Materials and Methods : From January 1 2000 to July 31 2004, patients with TB diagnosed microbiologically, pathologically, or clinically during anti-cancer chemotherapy in a tertiary hospital were enrolled, and their medical records were reviewed. Patients with the known risk factors for the reactivation of TB were excluded. Results : Twenty-two patients were enrolled and their mean age was 56.5 years (range 21-78). The male to female ratio was 3.4:1 and pulmonary TB was the main variant (20 patients, 90.9%). Gastric cancer (10 patients, 45.4%) and lymphoma (4 patients, 18.2%) were the leading underlying malignancies. The other malignancies included lung cancer, head and neck cancer, breast cancer, cervix cancer, and ovary cancer. Fifteen patients (68.2%) had a healed scar on a simple chest radiograph suggesting a previous TB infection. Among these patients, new TB lesions involved the same lobe or the ipsilateral pleura in 13 patients (87.6%). An isoniazid and rifampicin based regimen were started in all the subjects except for one patient with a hepatic dysfunction. The mean duration of medication was $9.9{\pm}2.4$ months and no adverse events resulting in a regimen change were observed. With the exception of 5 patients who died of the progression of the underlying malignancy, 70.6% (12/17) completed the anti-TB treatment. Conclusion : The clinical characteristics and response to anti-TB treatment for TB that developed during anticancer chemotherapy for a solid tumor were not different from those of patients who developed TB in the general population.

Clinical Features of Patients with Stage IV Gastric Cancer (4기 위암 환자의 임상적 특성)

  • Kim, Yoo Seok;Kim, Sung Soo;Min, Young Don
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.91-96
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    • 2008
  • Purpose: The early detection of gastric cancer and accuracy of preoperative staging has currently been on the increase due to the development of endoscopy and imaging techniques, but there are still many cases of advanced gastric cancer detected at the first diagnosis and there are also many cases of stage IV gastric cancer diagnosed after a postoperative pathological examination. Although the prognosis of stage IV gastric cancer is very poor, this study was performed to determine the value of the use of aggressive treatment determined after a clinical analysis. Materials and Methods: We retrospectively analyzed 150 patients that were diagnosed with stage IV gastric cancer among 1376 patients who underwent a laparotomy for gastric cancer from January 1994 to December 2006. Results: Of the 150 patients with stage IV gastric cancer who underwent a laparotomy, there were 104 men and 46 women. The mean patient age was 57.8 years (age range, 28~93 years). A subtotal gastrectomy or total gastrectomy was performed in 119 patients and 31 patients underwent an explorative laparotomy. The mean survival time of patients that underwent a gastrectomy and patients that did not undergo a gastrectomy was 722 days (range, 14~4,559 days) and 173 days (range, 16~374 days), respectively this result was statistically significant. When patients that underwent a gastrectomy were classified according to the TNM stage, the mean survival time of 33 patients with stage T4 disease was 534 days (range, 17~3,378 days) and the mean survival time of 63 patients with stage N3 disease was 521 days (range, 14~4,190 days), but there was no statistical significance. Chemotherapy was administered to 98 patients and 52 patients did not receive chemotherapy. The mean survival time of patients that received chemotherapy was 792 days (range, 36~4,559 days) and the mean survival time of patients that did not receive chemotherapy was 243 days (range, 14~2,413 days), with statistical significance. Conclusion: If there is no evidence of distant metastasis in stage IV gastric cancer, one can expect improvement of the survival rate by the use of aggressive treatment, including curative gastric resection with radical lymph node dissection and chemotherapy.

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Clinicopathologic Characteristics of Stage IV Early Gastric Cancer (IV기 조기위암의 임상병리학적 특성)

  • Kim, Min Kuk;An, Ji Yeong;Choi, Min Gew;Noh, Jae Hyung;Sohn, Tae Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.136-140
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    • 2008
  • Purpose: Stage IV early gastric carcinoma (EGC) is a rare disease. We report here on 10 cases of EGC that showed metastasis in more than 15 lymph nodes. Materials and Methods: A total of 8354 cases of gastric carcinoma in patients who underwent surgical procedures between January 2001 and January 2007 at Samsung Medical Center were studied, and 10 cases were classified as stage IV EGC. We investigated their clinicopathologic characteristics. Results: There were 5 males and 5 females. Their ages at operation ranged from 46 to 76 years with a mean age of 61. All of the 10 patients had undergone curative resection for gastric cancer. The pathological diagnosis confirmed that all of the patients had tumor confined to the submucosa. The median size of the tumors was 5.3cm and the mean number of dissected nodes was 45.5 with a mean number of 22.2 involved nodes. Six cases were classified as the diffuse type and 4 were classified as the intestinal type by Lauren's classification. Histologically, 3 cases were signet ring cell carcinoma, 3 were poorly differentiated, 2 were moderately differentiated and 2 were well differentiated adenocarcinoma. Endolymphatic invasion was found in 9 cases. The median follow-up was 31 months. Adjuvant chemotherapy was done in 9 patients, and the patient who did not receive chemotherapy died by cerebrovascular accident. 2 patient had recurrence of gastric cancer and 7 survived without recurrence. Conclusion: More cases should be collected and further studies on the molecular and cellular tumor characteristics are required to characterize these tumors that show aggressive lymphatic spread.

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Prognostic Factors in Liposarcomas: A Retrospective Study of 52 Patients (지방육종의 예후 인자: 52예 후향적 연구)

  • Chung, Yang-Guk;Kang, Yong-Koo;Bahk, Won-Jong;Rhee, Seung-Koo;Lee, An-Hi;Park, Jung-Mee;Kim, Min-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.14-20
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    • 2010
  • Purpose: To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas. Materials and Methods: Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation. Results: The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis. Conclusion: Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.

Effects of Foot Massage and Supportive Communication by Hospice Volunteers on Depression, Anxiety, and Mood of Cancer Patients Who Undergo Intravenous Chemotherapy at Out-patient Department (호스피스 자원봉사자의 발마사지와 지지적 의사소통이 외래 항암화학요법 환자의 우울, 불안 및 기분에 미치는 효과)

  • Hur, Hea-Kung;Song, Hee-Young
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.232-242
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    • 2010
  • Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

Vinorelbine Monotherapy on Advanced Non-small Cell Lung Cancer (진행성 비소세포폐암 환자에서 Vinorelbine의 단독요법)

  • Kim, Myung-Hoon;Park, Hee-Sun;An, Jin-Yong;Kwon, Sun-Jung;Lee, Yun-Sun;Jeong, Sung-Su;Kim, Ju-Ock;Kim, Sung-Young
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.475-484
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    • 2002
  • Background : Unresectable non-small cell lung cancer has a poor response to chemotherapy and has an unfortunate prognosis. More effective and less toxic cytotoxic agents are needed to improve the outcome of these patients. The efficacy and safety of vinorelbine monotherapy in these advanced lung cancer patients was evaluanted. Materials and Methods : Sixteen patients with non-small cell lung cancer in stage III or IV, who received vinorelbine alone as an initial anticancer chemotherapy from June 1996 to December 2000 were enrolled in this study. Vinorelbine was given intravenously at a dose 30mg/$m^2$ every week. Results : A mong the sixteen patients, six had a partial response(38%) and the median survival was 16 weeks. The median response duration was 27 weeks (95% CI 6-47), and the time to progression was 16 weeks(95% CI 6-26). Among a total of 112 cycles, neutropenia(WHO grade 3 or 4) and anemia(grade 3) occurred in 9% and 3%, respectively. Only 1 patient required hospitalization for neutropenic fever. Non-hematologic toxicity was minor and was easily controlled. Conclusion : Vinorelbine monotherapy was well tolerated, and moderately effective in patients with advanced non-small cell lung cancer.

Nausea/Vomiting and Self-care in Patients with Cancer on Chemotherapy (항암화학요법환자의 오심.구토 및 자가간호 실태)

  • Kim Hye-Jin;Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.2
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    • pp.180-185
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    • 2005
  • Purpose: The purpose of this study was to investigate the incidence and self care practice for nausea/vomiting in patients with cancer during chemotherapy. Method: The participants were 100 patients with cancer over 20 years of age who visited the outpatient department or were hospitalized for chemotherapy Self care in the case of nausea and vomiting was measured by the Dodd's scale. Data were analyzed using the SAS program and the following statistics were used frequency, percentage, unpaired t test, and Pearson correlation coefficient. Results: The ratio of the occurrence of nausea/ vomiting in the participants was 70.0%. The incidence of nausea/ vomiting was significantly higher for women than for men. The incidence of nausea/ vomiting was also higher for patients with cancer not in the gastro-intestinal system (GIS) compared to that for patients with GIS cancer. The incidence of nausea/ vomiting positively correlated with anorexia, skin injury, and fatigue. Conclusion: The ratio of occurrence of nausea/ vomiting for the participants was 70.0%. The incidence of nausea/ vomiting was higher fur women and patients with cancer not in the GIS. The incidence of nausea/ vomiting positively correlated with anorexia, skin injury, and fatigue. The results indicate that nausea/vomiting is a frequent symptom, particularly in women and there is a need to provide interventions to decrease the effects of this symptom.

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The Effects of Teatree Oil Gargling on Oral Cavity Micro-Organism Growth and Perceived Discomfort of Patient Receiving Chemotherapy (티트리 오일을 이용한 구강함수가 화학요법을 받는 암 환자의 구강상태와 불편감 및 구강세균집락에 미치는 효과)

  • Kim, Nam Cho;Kim, Hee Jung
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.276-286
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    • 2005
  • Purpose: The study is to investigate the effects of tea tree oil gargling on oral cavity micro-organism growth and on the perceived discomfort of patients receiving chemotherapy. Methods: A nonequivalent control group non-synchronized design was used to determine the effects of tea tree oil gargling on oral cavity for 20 second after using it for one week, twice a day. The sample consisted of two groups of patients receiving chemotherapy : 19 patients in experimental and 20 patients in control group. The instruments used in the study were Oral Assessment Guide(OAG), a measure of perceived symptoms on oral cavity, and a test of oral mucosal micro-organism culture. The data were analyzed using chi-square test, repeated measure of ANOVA, and Pearson correlation coefficient. Results: There was no significant difference between the two groups in micro-organism culture test of oral mucosa. The experimental group showed a lower number and fewer kinds of micro-organisms than the control group. Conclusion: It is considered that use of tea tree oil is effective in infection control of the oral cavity.

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