• 제목/요약/키워드: Adjuvant chemotherapy

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Safety Analysis of Adjuvant Chemotherapy with Docetaxel Administered with or without Anthracyclines to Early Stage Breast Cancer Patients: Combined Results from the Asia-Pacific Breast Initiatives I and II

  • Kim, Sung Bae;Sayeed, Ahmed;Villalon, Antonio H;Shen, Zhen Zhou;Yau, Tsz Kok;Shah, Mazhar Ali;Hou, Meng Feng;Thuan, Tran Van;Ba, Duc Nguyen;Chao, Tsu-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.697-702
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    • 2016
  • Background: The Asia-Pacific Breast Initiatives (APBI) I and II registries were established to collect safety data for patients with early stage breast cancer receiving adjuvant docetaxel-based regimens in the Asia-Pacific region. Materials and Methods: Data from the two registries were combined to perform a safety analysis. Participants in the registry were women with early stage operable breast cancer with an intermediate or high risk of recurrence. These women received adjuvant chemotherapy that included docetaxel between 2006 and 2011. Adverse events (AEs) were recorded and analyzed. Results: Data were collected from 3,224 patients from 13 countries. The mean dose intensity of docetaxel was 24.1, 22.7, $25.1mg/m^2/week$ among patients receiving docetaxel-based monotherapy, combination therapy and sequential therapy, respectively. Granulocyte colony-stimulating factor (G-CSF) was given with docetaxel to 41.8% of women and 20.6% of women receiving prophylactic antibiotics. Adverse events were reported in 86% of patients (anthracycline-containing regimens vs. non-anthracycline regimens; 87% vs. 80%). The most common adverse events were alopecia, nausea, neutropenia, vomiting, and myalgia. Adverse events NCI CTCAE ${\geq}$Grade 3 were reported in 45.4% of patients. Serious adverse events were reported in 13% of patients, of which 2.5% led to study discontinuation. Forty-six deaths (1.4%) were reported, with no significant difference between regimens. Conclusions: The safety parameters of adjuvant docetaxel therapy used to treat sequential Asian women were comparable to those reported in clinical trials evaluating the role of adjuvant docetaxel. No unusual adverse events linked to Asia-Pacific region patients were observed.

Changes in Grip Strength and Associations with Grip Strength in Breast Cancer Survivors Treated with Adjuvant Chemotherapy

  • Son, Sungwook;Lee, Changbae;Lee, Ju Yeon;Yang, Dong Seok;Kim, Chung Reen
    • The Journal of Korean Physical Therapy
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    • 제32권3호
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    • pp.176-184
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    • 2020
  • Purpose: The aim of this study was to identify the change in hand grip strength (HGS) for consecutive 6 months in breast cancer survivors (BCS) undergoing postoperative adjuvant chemotherapy (adjCTX) and to determine the factors relevant to HGS after chemotherapy completion Methods: This study was a retrospective observational cohort study. BCS (N=38) who underwent breast cancer surgery and subsequent adjCTX were enrolled. The HGS of both sides was measured before adjCTX and 3 weeks, 2 months and 6 months after adjCTX. And we also collected body composition, anthropometric measurements, social demographics and clinical data. Then we analyzed the changes in HGS over time, and correlation of collected data with HGS at 6 months. Results: A significant increase in HGS of the unaffected side was observed within the first 3 weeks of adjCTX and maintained up to 6 months. In correlation analysis, HGS of both sides was positively correlated with the ipsilateral HGS at 3 weeks, and contralateral HGS at 6 months. And skeletal muscle mass was also positively correlated with the HGS of the unaffected side. In addition, subjects treated with targeted therapy had lower HGS of the unaffected side. However, HGS of the affected side was significantly lower in subjects with breast reconstruction and treated without radiotherapy. Conclusions: To maintain the early recovery of HGS, active and continuous exercise intervention for strengthening might be necessary.

Comparing Role of Two Chemotherapy Regimens, CMF and Anthracycline-Based, on Breast Cancer Survival in the Eastern Mediterranean Region and Asia by Multivariate Mixed Effects Models: a Meta-Analysis

  • Ghanbari, Saeed;Ayatollahi, Seyyed Mohammad Taghi;Zare, Najaf
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5655-5661
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    • 2015
  • Purpose: To assess the role of two adjuvant chemotherapy regimens, anthracycline-based and CMF on disease free survival and overall survival breast cancer patients by meta-analysis approach in Eastern Mediterranean and Asian countries to determine which is more effective and evaluate the appropriateness and efficiency of two different proposed statistical models. Materials and Methods: Survival curves were digitized and the survival proportions and times were extracted and modeled to appropriate covariates by two multivariate mixed effects models. Studies which reported disease free survival and overall survival curves for anthracycline-based or CMF as adjuvant chemotherapy that were published in English in the Eastern Mediterranean region and Asia were included in this systematic review. The two transformations of survival probabilities (Ln (-Ln(S)) and Ln(S/ (1-S))) as dependent variables were modeled by a multivariate mixed model to same covariates in order to have precise estimations with high power and appropriate interpretation of covariate effects. The analysis was carried out with SAS Proc MIXED and STATA software. Results: A total of 32 studies from the published literature were analysed, covering 4,092 patients who received anthracycline-based and 2,501 treated with CMF for the disease free survival and in order to analyze the overall survival, 13 studies reported the overall survival curves in which 2,050 cases were treated with anthracycline-based and 1,282 with CMF regimens. Conclusions: The findings illustrated that the model with dependent variable Ln (-Ln(S)) had more precise estimations of the covariate effects and showed significant difference between the effects of two adjuvant chemotherapy regimens. Anthracycline-based treatment gave better disease free survival and overall survival. As an IPD meta-analysis in the Italy the results of Angelo et al in 2011 also confirmed that anthracycline-based regimens were more effective for survival of breast cancer patients. The findings of Zare et al 2012 on disease free survival curves in Asia also provided similar evidence.

Expression of TS, RRM1, ERCC1, TUBB3 and STMN1 Genes in Tissues of Non-small Cell Lung Cancer and its Significance in Guiding Postoperative Adjuvant Chemotherapy

  • Zou, Zhi-Qiang;Du, Yi-Ying;Sui, Gang;Xu, Shi-Ning
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3189-3194
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    • 2015
  • Background: To explore the expression of TS, RRM, ERCC1, TUBB3 and STMN1 genes in the tissues of patients with non-small cell lung cancer (NSCLC) and its significance in guiding the postoperative adjuvant chemotherapy. Materials and Methods: Real time polymerase chain reaction (PCR) was applied to detect the expression of TS, RRM, ERCC1, TUBB3 and STMN1 genes in the tissues of NSCLC patients so as to analyze the relationship between the expression of each gene and the clinical characteristics and to guide the postoperative individualized chemotherapy according to the detection results of NSCLC patients. Results: Expression of TS gene was evidently higher in patients with adenocarcinoma than those with non-adenocarcinoma (P=0.013) and so was the expression of ERCC1 (P=0.003). The expression of TUBB3 gene was obviously higher in NSCLC patients in phases I/II and IV than those in phase III ($P_1=0.021$; $P_2=0.004$), and it was also markedly higher in patients without lymph node metastasis than those with (P=0.008). The expression of STMN1 gene was apparently higher in patients in phase I/II than those in phase IV (P=0.002). There was no significant difference between the rest gene expression and the clinical characteristics of NSCLC patients (P>0.05). Additionally, the diseasefree survival (DFS) was significantly longer in patients receiving gene detections than those without (P=0.021). Conclusions: The selection of chemotherapeutic protocols based singly on patients' clinical characteristics has certain blindness. However, the detection of tumor-susceptible genes can guide the postoperative adjuvant chemotherapy and prolong the DFS of NSCLC patients.

Adjuvant Chemotherapy with or without Concurrent Radiotherapy for Patients with Stage IB Gastric Cancer: a Subgroup Analysis of the Adjuvant Chemoradiotherapy in Stomach Tumors (ARTIST) Phase III Trial

  • Kim, Youjin;Kim, Kyoung-Mee;Choi, Min Gew;Lee, Jun Ho;Sohn, Tae Sung;Bae, Jae Moon;Kim, Sung;Lee, Su Jin;Kim, Seung Tae;Lee, Jeeyun;Park, Joon Oh;Park, Young Suk;Lim, Ho Yeong;Kang, Won Ki;Park, Se Hoon
    • Journal of Gastric Cancer
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    • 제18권4호
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    • pp.348-355
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    • 2018
  • Purpose: We aimed to discuss the roles of radiation and chemotherapy as adjuvant treatment in patients with staged IB GC who were enrolled in the adjuvant chemoradiotherapy in stomach tumors (ARTIST) trial. Materials and Methods: Among the 458 patients who were enrolled in the ARTIST trial, 99 had stage IB disease. The patients were randomly assigned to receive either adjuvant chemoradiotherapy with capecitabine plus cisplatin (XP, n=50) or chemoradiotherapy (XPRT, n=49). Survival analyses were performed in accordance with the AJCC 2010 staging system. Results: According to the AJCC 2010 system, stage migration from IB to II occurred in 71% of the patients; 98% of the T2 N0 cases were reclassified as T3 N0, and 42% of the T1 N1 cases were reclassified as T1 N2. When comparing survival outcomes between the XPRT and XP arms for stage IB cancer (AJCC 2002), no significant difference in 5-year disease-free survival (DFS) between the 2 arms was found. (median 5-year DFS, not reached, P=0.256). The patients classified as having stage IB cancer (AJCC 2002) and reclassified as having stage II cancer (AJCC 2010) exhibited worse prognoses than those who remained in stage IB, although the difference was not statistically significant (5-year DFS rate, 83% vs. 93%). When we compared 5-year DFS in 70 patients with stage II (AJCC 2010), the addition of radiotherapy to XP chemotherapy did not show better outcome than XP alone (P=0.137). Conclusions: The role of adjuvant chemoradiotherapy in the treatment of stage IB GC (AJCC 2002) warrants further investigation.

소세포폐암에서 수술 후 복합화학요법의 성적 (Adjuvant Chemotherapy after Surgical Resection for Small-Cell Carcinoma of Lung)

  • 김학렬;정종훈;김휘정;양세훈;정은택
    • Tuberculosis and Respiratory Diseases
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    • 제57권5호
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    • pp.443-448
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    • 2004
  • 연구배경 : 소세포폐암은 성장과 전이가 매우 빨라 치료방법으로서 외과적 절제술은 일반적으로 고려되지 않는다. 특히 화학요법의 반응율은 매우 높으나 장기 생존율은 매우 극히 낮다. 부검에 의하면 소세포폐암의 치료 실패의 원인은 원격전이보다 국소재발이 높다. 이에 저자들은 소세포폐암 중 5%정도에 그치는 TNM I, II병기의 환자들에게 수술로서 국소재발을 줄이고, 화학요법으로서 원격전이를 막고자 하는 방법을 시도하였다. 방 법 : 원광대학 병원에서 진단받은 10명의 소세포폐암 환자(TNM I병기 5례, II병기 5례)를 대상으로 수술한 후 복합 화학요법을 6회 시행한 후 생존율을 확인하였다. 결 과 : 10례 중 (관찰기간 23~179개월), 1례는 술후 폐렴으로, 1례는 화학요법 중단으로, 2례는 대뇌 재발 전이로서, 1례는 폐렴으로 사망하였고 5례는 생존중이다. 전군의 중앙 생존기간은 26개월이며 2년과 5년 생존율은 68.6%, 46.7%였으며, 술후 화학요법을 실시치 못한 1례를 제외한 9례의 2년과 5년 생존율은 76.2%, 50.8%였다. TNM I, II병기간의 생존율의 차이는 없었다. 결 론 : TNM I, II 병기의 소세포폐암 환자에서 근치적 절제술을 시행한 후 복합 화학요법을 시행하여 장기 생존율을 향상시킬수 있다고 판단된다.

절제 불가능한 제 3 기 비소세포 폐암의 MVP 복합 항암요법과 다분할 방사선 치료 -추가 항암요법에 대한 임의 선택 - (Hyperfractionated Radiotherapy Following Induction Chemotherapy for Stage III Non-Small Cell Lung Cancer -Randomized for Adjuvant Chemotherapy vs. Observation-)

  • 최은경;장혜숙;안승도;양광모;서철원;이규형;이정신;김상희;고윤석;김우성;김원동;송군식;손광현
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.295-301
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    • 1993
  • 절제 불가능한 제 3기 비소세포 폐암에서의 MVP(Mitomycin C 6 $mg/m^2$, Vinblastine 6 $mg/m^2$, Cisplatin 60 $mg/m^2$) 복합 항암요법과 다분할 방사선 치료의 효과를 판정하기 위하여 1991년 1월부터 전향성 임의 선택연구(prospective randomized study)를 시작하였다. 본 연구는 제 III기의 비소세포 폐암중 절제가 불가능한 환자를 대상으로 하여 MVP 항암요법을 3 회 시행한 후 다분할 방사선 치료 (120 cGy/fx, BID)를 6480 cGy까지 시행하였다. 방사선 치료가 끝난 1개월 후 유도 항암요법에 부분 관해 이상의 반응을 보였던 환자를 대상으로 추가 항암요법을 시행하는 군과 계속 관찰하는 군으로 임의 분류하였다. 1992년 12월까지 48명의 환자가 등록되었으며, 이중 3명은 항암요법후 치료를 중단하였으며, 6명은 방사선 치료중 치료를 중단하거나, 개인적 사정으로 다분할 방사선 치료를 시행받지 못하여 39명의 환자에 대한분석을 시행하였다. 유도 항암요법을 마친 환자중 2명은 완전 관해를 보였으며, 21명은 부분 관해를 보여 MVP 유도항암요법에 대한 관해율은 $58\%$ (23/39)이었다. 항암요법에 부분관해를 보인 21명중 1명은 방사선 치료후 완전관해를 보였으며, 10명은 부분관해를 보였으나, 나머지 10명은 방사선 치료에 반응을 보이지 않았다. 항암요법에 반응을 보이지 않았던 16명의 환자중 9명은 방사선 치료에도 전혀 반응을 보이지 않았다. 유도항암 요법과 다분할 방사선 치료후의 관해율은 $64\%$이었다. 방사선 치료후 19명의 환자에 대하여 추가 항암요법에 대한 임의 선택을 시행하여 이중 9명은 추가 항암요법 군으로 분류되어, 3회의 추가 항암요법을 시행하였다. 아직까지는 추가 항암요법군과 관찰군 사이에 원격전이나 생존율의 차이가 관찰되지 않았다. 전체 환자의 중앙 생존은 13개월이었고, 6개월과 12개월의 생존율은 각각 $84.6\%$$53.7\%,\;40.3\%$이었다. 특히 유도항암요법에 부분관해 이상의 반응을 보였던 환자들은 무반응환자에 비하여 통계적으로 유의하게 증가된 생존율을 보였다(p=0.0287). 아직까지 추적 관찰기간이 짧으나, $64\%$의 높은 치료 관해율과 증가된 생존율, 그리고 합병증의 증가가 관찰되지 않는 점으로 보아 본 연구를 계속 진행함으로써 더 좋은 결과를 얻을 수 있을 것으로 기대된다.

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Positive Effects of Oral β-Glucan on Mucositis and Leukopenia in Colorectal Cancer Patients Receiving Adjuvant FOLFOX-4 Combination Chemotherapy

  • Karaca, Halit;Bozkurt, Oktay;Ozaslan, Ersin;Baldane, Suleyman;Berk, Veli;Inanc, Mevlude;Duran, Ayse Ocak;Dikilitas, Mustafa;Er, Ozlem;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3641-3644
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    • 2014
  • The present study aimed to determine the effect of oral ${\beta}$-glucan on mucositis and leukopenia in 62 consecutive patients with colorectal cancer treated with an adjuvant FOLFOX-4 regimen. The patients were retrospectively evaluated in 2 groups: one group received ${\beta}$-glucan and the other did not (control group). Leucocytes, neutrophils, and platelets were evaluated before and 1 week after chemotherapy and oral mucositis and diarrhea were noted. Leucocyte and neutrophil counts after chemotherapy in the ${\beta}$-glucan group were $7,300/mm^3$ and $3,800/mm^3$, respectively, and the reductions, as compared to baseline, were not significant (p=0.673 and 0.784). The median platelet count was $264,000/mm^3$ after chemotherapy in the ${\beta}$-glucan group and the reduction, as compared to baseline, was borderline significant (p=0.048). In the control group, reduction in leucocyte, neutrophil, and platelet counts was statistically significant. Oral mucositis and diarrhea were less common in the ${\beta}$-glucan group. We conclude that ${\beta}$-glucan can be used to reduce the adverse effects of chemotherapy.