• Title/Summary/Keyword: 항암화학 요법

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Hepatic Resection in Patients with Liver Metastasis from Gastric Cancer (위암의 간전이에 대한 간 절제 수술)

  • Jun, Kyong-Hwa;Chin, Hyung-Min
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.14-17
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    • 2009
  • The clinical significance of hepatic resection for gastric metastases is controversial, even though hepatic resection has been widely accepted as a modality for colorectal metastases. Very few patients with gastric hepatic metastases are good candidates for hepatic resection because of multiple bilateral metastases, extrahepatic disease, or advanced cancer progression, such as peritoneal dissemination or extensive lymph node metastases. Therefore, several authors have reported the clinical significance of hepatic resection for gastric metastases in a small number of patients. Considering the present results with previous reports. The number and distribution of tumors in hepatic metastases from gastric cancer was considered based on the present and previous reports. Several authors have reported significantly better survival in patients with metachronous metastasis than in those with synchronous disease. However, metachronous hepatic resection necessitates the dissection of adhesions between the pancreas, liver, and residual stomach to prepare for Pringle's maneuver. Patients with unilobar liver metastasis, and/or metastatic tumors <4 cm in diameter may be good candidates for hepatic resection. Synchronous metastasis is not a contraindication for hepatic resection. Most of the long-term survivors underwent anatomic hepatic resection with a sufficient resection margin. After hepatic resection, the most frequent site of recurrence was the remaining liver, which was associated with a high frequency of mortality within 2 years. A reasonable strategy for improvement in survival would be to prevent recurrence by means of adjuvant chemotherapy and careful follow-up studies.

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Locally Advanced Rectal Carcinoma : Curative Surgery Alone vs. Postoperative Radiotherapy and Chemotherapy (국소적으로 진행된 직장암에 대한 근치적 수술 단독 치료군과 수술후 보조적 방사선 및 항암화학요법 병행군의 치료결과 분석)

  • Ahn Seung Do;Choi Eun Kyung;Kim Jin Cheon;Kim Sang Hee
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.253-258
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    • 1995
  • Purpose : To evaluate the effects of postoperative radiotherapy and chemotherapy on the pattern of failure and survival for locally advanced rectal carcinoma, we analyzed the two groups of patients who received curative resection only and who received postoperative radiochemotherapy retro-spectively. Materials and Methods : From June 1989 to December 1992, ninety nine patients with rectal cancer were treated by curative resection and staged as B2-3 or C. Group I(25) patients received curative resection only and group II(74) patients postoperative adjuvant therapy. Postoperative adiuvant group received radiation therapy (4500cGy/25fx to whole pelvis) with 5-FU (500mg/$m^2$, day 1-3 IV infusion) as radiosensitizer and maintenance chemotherapy with 5-FU(400mg/$m^2$ for 5 days) and leucovorin (20mg/m^2$ for 5 days) for 6 cycles. Results : The patients in group I and group II were comparable in terms of age sex, performance status, but in group II $74{\%}$ of patients showed stage C compared with $56{\%}$ of group I. All patients were followed from 6 to 60 months with a median follow up of 29 months. Three year overall survival rates and disease free survival rates were $68\%,\;64\%$ respectively in group I and $64\%,\;61\%$, respectively in group II. There was no statistical difference between the two treatment groups in overall survival rate and disease free survival rate. Local recurrences occurred in $28{\%}$ of group I, $21{\%}$ of group II (p>.05) and distant metastases occurred in $20{\%}$ of group I, $27{\%}$ of group II(p>.05). The prognostic value of several variables other than treatment modality was assessed. In multivariate analysis for prognostic factors stage and histologic grade showed statistically significant effect on local recurrences and lymphatic or vessel invasion on distant metastasis. Conclusion : This retrospective study showed no statistical difference between two groups on the pattern of failure and survival. But considering that group II had more advanced stage and poor prognostic factors than group I, postoperative adjuvant radiochemotherapy improves the results for locally advanced rectal carcinoma as compared with curative surgery alone.

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Preparation and Characterization of Reduced Graphene Oxide with Carboxyl Groups-Gold Nanorod Nanocomposite with Improved Photothermal Effect (향상된 광열 효과를 갖는 카르복실화된 환원 그래핀옥사이드-골드나노막대 나노복합체의 제조 및 특성 분석)

  • Lee, Seunghwa;Kim, So Yeon
    • Applied Chemistry for Engineering
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    • v.32 no.3
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    • pp.312-319
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    • 2021
  • Photothermal therapy is a treatment that necrotizes selectively the abnormal cells, in particular cancer cells, which are more vulnerable to heat than normal cells, using the heat generated when irradiating light. In this study, we synthesized a reduced graphene oxide with carboxyl groups (CRGO)-gold nanorod (AuNR) nanocomposite for photothermal treatment. Graphene oxide (GO) was selectively reduced and exfoliated at high temperature to synthesize CRGO, and the length of AuNR was adjusted according to the amount of AgNO3, to synthesize AuNR with a strong absorption peak at 880 nm, as an ideal photothermal agent. It was determined through FT-IR, thermogravimetric and fluorescence analyses that more carboxyl groups were conjugated with CRGO over RGO. In addition, CRGO exhibited excellent stability in aqueous solutions compared to RGO due to the presence of carboxylic acid. The CRGO-AuNR nanocomposites fabricated by electrostatic interaction have an average size of ~317 nm with a narrow size distribution. It was confirmed that under radiation with a near-infrared 880 nm laser which has an excellent tissue transmittance, the photothermal effect of CRGO-AuNR nanocomposites was greater than that of AuNR due to the synergistic effect of the two photothermal agents, CRGO and AuNR. Furthermore, the results of cancer cell toxicity by photothermal effect revealed that CRGO-AuNR nanocomposites showed superb cytotoxic properties. Therefore, the CRGO-AuNR nanocomposites are expected to be applied to the field of anticancer photothermal therapy based on their stable dispersibility and improved photothermal effect.

Optimal Combination of Acupoints Based on Network Analysis for Chemotherapy-Induced Peripheral Neuropathy (네트워크 분석에 기반한 항암화학요법으로 유발된 말초신경병증의 최적 경혈 조합)

  • Kim, Min-Woo;Kim, Joong-Il;Lee, Jin-Hyun;Jo, Dong-Chan;Kang, Su-Bin;Lee, Ji-Won;Park, Tae-Yong;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.1
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    • pp.107-124
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    • 2022
  • Objectives This study aimed to identify optimal combinations of acupoints used to treat chemotherapy-induced peripheral neuropathy (CIPN). Methods We searched four international databases (MEDLINE, EMBASE, the Allied and Complementary Medicine Databases [AMED], and China National Knowledge Infrastructure [CNKI]) and five Korean databases (DBpia, Research Information Sharing Service [RISS], Korean Studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], and KoreaMed) to identify randomized controlled trials (RCTs) that used acupuncture to treat CIPN. Network analysis was performed on the acupoints used in more than three included articles. We constructed a network by calculating the Jaccard similarity coefficient between acupoints and applied minimum spanning tree. Then, modularity analysis, degree centrality (Cd), and betweenness centrality (Cb) were used to analyze properties of the acupoints. Results A total of 25 articles were included. 24 acupoints were extracted from 25 articles. The combinations of acupoints having the highest Jaccard similarity coefficient were {EX-UE9, EX-LE10} and {ST36, SP6}. In the modularity analysis, acupoints were classified to six modules. ST40, EX-UE11, and KI6 had the highest Cd value while ST40, GB34 had the highest Cb value. Conclusions This study found the systematic framework of acupoint combinations used in CIPN studies. This study is expected to provide new perspectives of CIPN treatment to therapists. A RCT is in progress of using the network of this study as a guideline. If significant results are derived from the RCT, it will be possible to lay the groundwork to consider acupuncture for CIPN treatment.

A Case Report of Korean Medicine Treatment of a Lung Cancer Patient with Chemotherapy-induced Peripheral Neuropathy (편평상피세포 폐암 환자의 항암화학요법에 의해 유발된 말초신경병증에 대한 한방치험 1례)

  • Kim, Kyun Ha;Kim, Min-hwa;Heo, Gi-yoon;Lee, Chan;Cho, Im-hak;Kang, Hee-kyung;Kim, So-yeon;Park, Seong-ha;Yun, Young-ju;Lee, In;Han, Chang-woo;Hong, Jin-woo;Kwon, Jung-nam;Choi, Jun-Yong
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1341-1348
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    • 2021
  • The purpose of this study is to report the effect of Korean medicine on a squamous cell lung cancer patient with chemotherapy induction peripheral neuropathy (CIPN). A 61-year old male patient, who had received 4 cycles of chemotherapy after lung surgery from squamous cell lung cancer, was treated with acupuncture and herbal medicines, including Uchasingi-hwan and Samchilchoongcho-capsule, to control CIPN and dyspnea on exertion. The degree of pain was assessed by a numeric rating scale (NRS). After receiving acupuncture and herbal medicines, the NRS score for CIPN symptoms was reduced from 4 to 1 and the NRS score for dyspnea on exertion decreased from 3 to less than 1. Korean medicine could therefore be useful in reducing peripheral neuropathy occurring after chemotherapy and dyspnea after lobectomy.

Diagnosis and Treatment of Gastric MALT Lymphoma (위 MALT 림프종의 진단 및 치료에 대한 고찰)

  • Tae Ho Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.82-88
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    • 2015
  • Gastric lymphoma comprises 1-6% of all gastric malignant neoplasms and among them 50% is gastric MALT lymphoma. The 60-70% of MALT lymphomas is diagnosed at early, localized diseased state. Gastric MALT lymphoma is assumed that it progress slowly with indolent course. It presents nonspecific symptoms such as epigastric pain, dyspepsia, nausea and vomiting. It is rarely associated with serious complication such as gastrointestinal bleeding or perforation. The definite diagnosis of gastric MALT lymphoma should be made with histopathologically. Wotherspoon score is used to differential diagnosis with Helicobacter pylori associated gastric inflammatory change. Gastric MALT lymphoma is associated with Helicobacter pylori infection with supported by epidemiologic and histopathologic studies. Gastric MALT lymphoma is characterized with genetic aberrations such as trisomy 3, trisomy 18, chromosomal translocations t(11;18), t(1;14), t(14;18), t(3;14). Appropriate clinical staging is essential to determine the optimal treatment strategy for gastric MALT lymphoma. Lugano International Conference classification has been applied widely. Helicobacter pylori eradication is used as the first line treatment for gastric MALT lymphoma independent of the stage. The complete remission has been achieved in 60-90% of the stage I/II1 patients with Helicobacter pylori eradication only. The treatment options for the patients with refractory to eradication are radiotherapy, chemotherapy and/or immunotherapy with the complete remission rate of 75% to 100%. The incidence of gastric MALT lymphoma can be expected to down by virtue of the decrease of Helicobacter pylori infection rate. Further basic and clinical research is necessary to advance in determine the pathogenesis and management.

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A Case Report of Colonic Mucinous Adenocarcinoma in 27 Year Old Patient (27세 남자환자에서 발견된 대장의 점액선암종 1례)

  • Woo Sun Rou;Ju Seok Kim;Sun Hyung Kang;Hee Seok Moon;Jae Kyu Sung;Hyun Yong Jeong
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.69-72
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    • 2018
  • Mucinous adenocarcinoma occurs in 1.6-25.4% of patients with colorectal cancer. We report a case of a 27-year-old man with negative findings on initial colonoscopic biopsy, but finally diagnosed with mucinous adenocarcinoma of the colon. After undergoing an abdominal CT due to persistent abdominal pain, he was transferred to our hospital. The abdominal CT showed a diffuse and irregular wall thickening in the distal transverse colon. Due to the edema and stenosis of colonic wall, it was difficult to insert the colonoscope into the proximal region; a biopsy revealed chronic colitis with lymphofollicular hyperplasia. Transverse colectomy and lymph node dissection were performed. The diagnosis was mucinous adenocarcinoma of approximately 20×4.5 cm. Compared to adenocarcinoma, mucinous adenocarcinoma is found in a younger population with an advanced stage and is less responsive to palliative chemotherapy. Therefore, recalcitrant abdominal pain even in young people warrants early detection through appropriate examinations such as abdominal CT and colonoscopy.

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Berberine Suppresses Hepatocellular Carcinoma Proliferation via Autophagy-mediated Apoptosis (베르베린을 처리한 간세포암에서 자가포식 경로와 관련된 세포자멸사)

  • Yun Kyu Kim;Myeong Gu Yeo
    • Journal of Life Science
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    • v.34 no.5
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    • pp.287-295
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    • 2024
  • Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality worldwide, necessitating novel therapeutic strategies. The chemotherapeutic agents used to treat HCC patients are toxic and have serious side effects. Therefore, we investigated the efficacy of anticancer drugs that reduce side effects by targeting tumor cells without causing cytotoxicity in healthy hepatocytes. Berberine, an isoquinoline alkaloid derived from plant compounds, has emerged as a potential candidate for cancer treatment due to its diverse pharmacological properties. The effect of berberine on HepG2 cell viability was determined using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide assay. HepG2 cell proliferation was determined through a colony-forming assay. The effects of berberine on HepG2 cell migration were evaluated using a wound-healing assay. Berberine inhibited the proliferation of HepG2 cells, as well as colony formation and migration. Berberine treatment increased the expression of autophagy-related genes and proteins, including Beclin-1 and LC3-II, and elevated the activities and mRNA expression of Caspase-9 and Caspase-3. Additionally, in experiments utilizing the Cell-Derived Xenograft animal model, berberine treatment reduced tumor size and weight in a concentration-dependent manner. These results demonstrate the potential of berberine as a versatile anticancer agent with efficacy in both cellular and animal models of hepatocellular carcinoma. The findings herein shed light on berberine's efficacy against HCC, presenting opportunities for targeted and personalized therapeutic interventions.

Comparison of Esophageal Cancer Radiation Therapy Plans Using Volumetric Modulated Arc Therapy (체적 조절 호형 방사선치료(VMAT)를 활용한 식도암 치료계획 비교)

  • Won-Young Jeong;Jae-Bok Han;Young-Hyun Seo;Jong-Nam Song
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.249-256
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    • 2024
  • The study aimed to evaluate the efficacy of treatment plans using full Arc and Partial Arc Coplanar volumetric modulated arc therapy and Non-Coplanar volumetric modulated arc therapy to minimize radiation treatment side effects, such as pneumonia, and protect normal organs in esophageal cancer radiotherapy. 30 patients who underwent Concurrent Chemoradiotherapy for esophageal cancer were included. Compared planning target volume, lung, heart, spinal cord and total monitor units among three treatment plans: fVMAT(2 Full Arc), pVMAT(4 Partial Arc), and ncVMAT(2 Partial Arc + 2 Non-Coplanar Arc). All plans met the PTV criteria, showing uniform distribution. The average dose to the heart was 5.8 Gy for fVMAT, 6.97 Gy for pVMAT, and 7.6 Gy for ncVMAT, with the lowest value in fVMAT, which was statistically significant. However, the average lung dose was 9.01 Gy for fVMAT, 7.71 Gy for pVMAT, and 7.12 Gy for ncVMAT, with V5Gy(%) values of 52.22%, 38.61%, 36.35% and V10Gy(%) values of 37.8%, 27.33%, 24.15% respectively. ncVMAT showed the lowest values, while fVMAT had the highest, with statistical significance. In conclusion, ncVMAT effectively reduces lung radiation exposure in esophageal cancer radiotherapy, potentially reducing the incidence of side effects such as pneumonia. However, considering factors like setup accuracy and treatment time, applying an appropriate treatment plan may lead to better outcomes.

Radiotherapy in Supraglottic Carcinoma - With Respect to Locoregional Control and Survival - (성문상부암의 방사선치료 -국소종양 제어율과 생존율을 중심으로-)

  • Nam Taek-Keun;Chung Woong-Ki;Cho Jae-Shik;Ahn Sung-Ja;Nah Byung-Sik;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.108-115
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    • 2002
  • Purpose : A retrospective study was undertaken to determine the role of conventional radiotherapy with or without surgery for treating a supraglottic carcinoma in terms of the local control and survival. Materials and Methods : From Jan. 1986 to Oct. 1996, a total of 134 patients were treated for a supraglottic carcinoma by radiotherapy with or without surgery. Of them, 117 patients who had completed the radiotherapy formed the base of this study. The patients were redistributed according to the revised AJCC staging system (1997). The number of patients of stage I, II, III, IVA, IVB were $6\;(5\%),\;16\;(14\%),\;53\;(45\%),\;32\;(27\%),\;10\;(9\%)$, respectively. Eighty patients were treated by radical radiotherapy in the range of $61.2\~79.2\;Gy$ (mean : 69.2 Gy) to the primary tumor and $45.0\~93.6\;Gy$ (mean : 54.0 Gy) to regional lymphatics. All patients with stage I and IVB were treated by radiotherapy alone. Thirty-seven patients underwent surgery plus postoperative radiotherapy in the range of $45.0\~68.4\;Gy$ (mean : 56.1 Gy) to the primary tumor bed and $45.0\~59.4\;Gy$ (mean : 47.2 Gy) to the regional lymphatics. Of them, 33 patients received a total laryngectomy (${\pm}lymph$ node dissection), three had a supraglottic horizontal laryngectomy (${\pm}lymph$ node dissection), and one had a primary excision alone. Results : The 5-year survival rate (5YSR) of all patients was $43\%$. The 5YSRs of the patients with stage I+II, III+IV were $49.9\%,\;41.2\%$, respectively (p=0.27). However, the disease-specific survival rate of the patients with stage I (n=6) was $100\%$. The 5YSRs of patients who underwent surgery plus radiotherapy (S+RT) vs radiotherapy alone (RT) in stage II, III, IVA were $100\%\;vs\;43\%$ (p=0.17), $62\%\;vs\;52\%$ (p=0.32), $58\%\;vs\;6\%$ (p<0.001), respectively. The 5-year actuarial locoregional control rate (5YLCR) of all the patients was $57\%$. The 5YLCR of the patients with stage I, II, III, IVA, IVB was $100\%,\;74\%,\;60\%,\;44\%,\;30\%$, respectively (p=0.008). The 5YLCR of the patients with S+RT vs RT in stage II, III, IVA was $100\%\;vs\;68\%$ (p=0.29), $67\%\;vs\;55\%$ (p=0.23), $81\%\;vs\;20\%$ (p<0.001), respectively. In the radiotherapy alone group, the 5YLCR of the patients with a complete, partial, and minimal response were $76\%,\;20\%,\;0\%$, respectively (p<0.001). In all patients, multivariate analysis showed that the N-stage, surgery or not, and age were significant factors affecting the survival rate and that the N-stage, surgery or not, and the ECOG performance index were significant factors affecting the locoregional control. In the radiotherapy alone group, multivariate analysis showed that the radiation response and N-stage were significant factors affecting the overall survival rate as well as locoregional control. Conclusion : In early stage supraglottic carcinoma, conventional radiotherapy alone is an equally effective modality compared to surgery plus radiotherapy and could preserve the laryngeal function. However, in the advanced stages, radiotherapy combined with concurrent chemotherapy for laryngeal preservation or surgery should be considered. In bulky neck disease, all the possible planned neck dissections after induction chemotherapy or before radiotherapy should be attempted.