Park, Jung-Hyun;Nam, Woong;Kim, Hyung Jun;Cha, In-Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.43
no.3
/
pp.166-170
/
2017
Objectives: To define the risk of occult cervical metastasis of maxillary squamous cell carcinoma (SCC) and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients. Materials and Methods: Sixty-seven patients with maxillary SCC and cN0 neck were analyzed retrospectively, including 35 patients with maxillary gingiva and 32 patients with maxillary sinus. Results: Of 67 patients, 10 patients (14.9%) had occult cervical metastasis. The incidence of occult cervical metastasis of maxillary gingival SCC was higher than that of maxillary sinus SCC (17.1% and 12.5%, respectively). The 5-year overall survival rate was 51.9% for the END group and 74.0% for the non-END group. The success rate of treatment for regional recurrence was high at 71.4%, whereas that for local or locoregional recurrence was low (33.3% and 0%, respectively). Conclusion: The incidence of occult cervical metastasis of maxillary SCC was not high enough to recommend END. For survival of cN0 patients, local control of the primary tumor is more important than modality of neck management. Observation of cN0 neck is recommended when early detection of regional recurrence is possible irrespective of the site or T stage. The key enabler of early detection is patient education with periodic follow-up.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.47
no.4
/
pp.291-314
/
2021
Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.
Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
Korean Journal of Head & Neck Oncology
/
v.15
no.1
/
pp.22-28
/
1999
Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.
Choi, Jong Hyun;Choi, Juwhan;Chung, Sang Mi;Oh, Jee Youn;Lee, Young Seok;Min, Kyung Hoon;Hur, Gyu Young;Shim, Jae Jeong;Kang, Kyung Ho;Lee, Hyun Kyung;Lee, Sung Yong
Tuberculosis and Respiratory Diseases
/
v.82
no.3
/
pp.211-216
/
2019
Background: Docetaxel is one of the standard treatments for advanced non-small cell lung cancer. Docetaxel is usually administered in a 3-week schedule, but there is significant toxicity. In this phase II clinical study, we investigated the efficacy and safety of a 4-weekly schedule of docetaxel monotherapy, as first-line chemotherapy for advanced squamous cell carcinoma in elderly lung cancer patients. Methods: Patients with stage IIIB/ IV lung squamous-cell carcinoma age 70 or older, that had not undergone cytotoxic chemotherapy were enrolled. Patients received docetaxel $25mg/m^2$ on days 1, 8, and 15, every 4 weeks. Primary endpoint was the objective response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity profiles. Results: A total of 19 patients were enrolled. Among 19 patients, 17 were for evaluated efficacy and safety. In the intent-to-treat population, ORR and disease control rate (DCR) were 11.8% and 47.1%, respectively. In the response evaluable population, ORR was 16.7% and DCR was 66.7%. Median PFS and OS were 3.1 months and 3.3 months, respectively. There were three adverse grade 3/4 events. Grade 1 neutropenia was reported in one patient. Conclusion: Our data failed to demonstrate efficacy of a 4-weekly docetaxel regimen, in elderly patients with a poor performance status. However, incidence of side effects, including neutropenia, was lower than with a 3-week docetaxel regimen, as previously reported.
Kim, Min Sung;Nam, Yoon Kwon;Kim, Dong Soo;Gong, Seung Pyo
Fisheries and Aquatic Sciences
/
v.17
no.3
/
pp.385-390
/
2014
Abalone immortal cell lines can be used to study the physiological properties and disease mechanisms of abalone at the cellular and molecular level. As a first step for the final goal to establish abalone immortal cell lines, we examined various initial culture conditions for primary cell populations derived from Haliotis discus hannai radula tissue. The survival rate after cell isolation procedures using the enzymatic method was as low as $9.95{\pm}2.37%$. Based on three different experimental conditions for H. discus hannai radula-derived cell culture, we found that the salinity of the media and the presence of growth-promoting factors were important to support radula-derived primary cell populations during the initial culture. The growth factor-containing media adjusted to 35 psu salinity could induce 100% (8 out of 8 trials) initial cell attachment, and the rate of cell attachment reached 50-70%. The data obtained from this study will provide useful information for developing immortal cell lines from abalone species.
We have explored the impact of altering the Ras-cAMP pathway on cell survival upon oxidative exposures. A hyperactivated Ras mutant of Saccharomyces cerevisiae, intrinsically more sensitive to heat shock than the wild type, was investigated with regard to oxidative stress. In this paper we report that the response of iral, ira2-deleted mutant (IR2.53) to an oxidant, such as hydrogen peroxide (H2O2) or menadione is more sensitive than that of the wild type. IR2.53 showed a dramatic decrease in survival rate when challenged with 0.1 mM H2O2 for 30 min. The greater sensitivity of IR2.53 was also noticed with treatment of 0.01 mM menadione. Prior to oxidative stresses by these oxidants, both the wild type and the mutant were preconditioned with a mild heat shock (37 ℃, 30 min), resulting in improved survivals against oxidative stresses. Rescue of IR2.53 from menadione stress by heat pretreatment was more clearly demonstrated than that from H2O2 treatment. On the other hand, no significant difference was observed between the wild type and the IR2.53 mutant in their survival rates upon paraquat treatments. These findings imply that the mechanism by which H2O2 and menadione put forth their oxidative effects may be closely associated with the cAMP-Ras pathway whereas that of paraquat is independent of the Ras pathway. Finally, the level of glutathione (GSH) was measured enzymatically as an indicator of antioxidation and compared with the survival rate. Taken all these together, this study provides an insight into a mechanism of the Ras pathway regulated by several oxidants and suggests that the Ras pathway plays a crucial role in protection of cell damage following oxidative stress.
Lee, Hyo Chun;Kim, Yeon Sil;Oh, Se Jin;Lee, Yun Hee;Lee, Dong Soo;Song, Jin Ho;Kang, Jin Hyung;Park, Jae Kil
Radiation Oncology Journal
/
v.32
no.3
/
pp.147-155
/
2014
Purpose: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. Materials and Methods: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). Results: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age ${\geq}66$ years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. Conclusion: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.
Hwang, Ki Eun;Kim, So Young;Jung, Jong Hoon;Park, Seong Hoon;Park, Jung Hyun;Kim, Hwi Jung;Kim, Hak Ryul;Yang, Sei Hoon;Jeong, Eun Taik
Tuberculosis and Respiratory Diseases
/
v.61
no.2
/
pp.143-149
/
2006
Background: Irinotecan (topoisomerase I inhibitor) is effective as a monotherapy against small-cell lung cancer(SCLC). Cisplatin is also an important drug against SCLC. A phase II study of irinotecan combined with cisplatin was carried out to evaluate the efficacy and toxicity of this combined regimen as a first line treatment in patients with extensive SCLC. Methods: Thirty-nine patients with previously untreated extensive SCLC were enrolled in this study. Irinotecan $60mg/m^2$ was administered intravenously on days 1, 8 and 15, and in combination with cisplatin $60mg/m^2$ on day 1 and every 28 days thereafter. Four cycles of chemotherapy were given to the patients. Results: The overall response rate was 77% with a complete response (CR) rate of 8%. The median survival time, 1- and 2-year survival rate were 14.8 months, 60.9% and 27.6%, respectively. The median progression free survival time, 6-and 12-month progression free survival rate were 8.4 months, 75% and 18.8%, respectively. The WHO grade 3 or more toxicity encountered were leukopenia (23%), diarrhea (26%). Two patients changed their chemotherapeutic regimen and one patient died from severe diarrhea. Conclusion: The combination of irinotecan and cisplatin is effective as a first line therapy in extensive SCLC is effective, but has severe or fatal diarrhea as toxicity.
The effects of X-ray irradiation and the thyroid gland on the erythropoietic system were studied in the white male rabbits. The total body irradiation was done in doses of 250 r and 500 r to each of 5 rabbits for 10days. The factors were 220KV, 10mA, FLI/4 Cu+1 mmAI(HVL:2.0 mm Cu) 50 cm F.S.D. The thyroid dysfunction was experimentally induced, by giving 2mg of thyroid tablets per kg body weight for 15 days in 5 rabbits for hyperthyroidism and by giving 1.5 mC of $^{131}I$ per kg body weight in another 5 rabbits for hypothyroidism. Fourteen healthy rabbits were used as control. The hematologic changes and ferrokinetic data obtained from $^{59}Fe$ and apparent half survival of the red blood cells obtained from $^{51}Cr$ were compared. Following were the results: A. X-ray irradiated group; 1. There were no significant changes in hematologic findings except for leucopenia. A slight decrease of red blood cells was observed in 500 r irradiated animals. 2. The decreases in the iron turnover rates of the plasma and red blood cells as well as in the red cell renewal rate were found in both groups. A :significant decrease of the red cell iron utilization rate was observed in the 500 r irradiated animals. 3. The apparent half survival times of the red blood cells were slightly, in the 250 r ($12.1{\pm}0.80$ days), and markedly shortened in the 500 r irradiated animals ($9.8{\pm}1.38$ days), the normal being $14.0{\pm}1.6$ days. 4. It appears, therefore, that the anemia caused by X-ray irradiation is due to the inhibition of hemopoietic function and the excess destruction of the red blood cells. B. Thyroid dysfunction group; 1. The slight increases of the red blood cell count and circulating blood volume with the normal serum iron level were observed in the hyperthyroid group, while the decreases of the red and white blood cell counts, hemoglobin and hematocrit values with a marked decrease of the serum iron level in the hypothyroid group. 2. A marked decrease of the plasma iron disappearance rate with increases of plasma iron turnover, red cell iron utilization and red cell iron turnover were observed in the hyperthyroid group, while the marked delay and decreases in the hypothyroid group. 3. The apparent half survival times of the red blood cells were almost the same with the control in the hyperthyroid group, ($14.0{\pm}1.58$ while a marked shortening in the hypothyroid group $10.6{\pm}0.30$. 4. It was reconfirmed that the thyroid hormones bear a close relationship with the erythropoietic system, namely, the latter is stimulated by the former. The lack of the thyroid hormones thus induces the bone marrow depression leading to anemia the major cause of which, therefore, is not hemolysis.
Objective : To evaluate the effect of Astragalus Membranaceus Extrac (AME) on myelosuppression, activity and immune modulation in 5-fluorouracil (5-FU) treated mice. Method : We carried out complete blood count, histological analysis of bone marrow, and cell colony forming assay for hematopoietic progenitor to evaluate the effect of AME on myelosuppression and conducted swimming test, survival rate, nitric oxide (NO) assay, 51Cr release assay in natural killer cell, mRNA expression of $IL-1{\beta}$, IL-2, IL-4, IL-6, IL-10, $TNF-{\alpht}$, $IFN-{\gamma}$, $TGF-{\beta}$ and GM-CSF in spleen cells to evaluate the effect of AME on quality of life (QOL). Results : AME improved 5-FU induced myelosuppression and peripheral blood count was recovered effectively, had significant efficacy to protect against chemotherapy induced marrow-destruction and on hematopoiesis compared with the control group, improved increase survival rate and the swimming time, had a stimulatory effect on macrophage activation and NK cell activity, and up-regulated cytokine gene transcription (IL-2, IL-6, $IFN-{\gamma}$) in murine immunologic system. Conclusion : We can conclude that AM is an effective herbal agent for improvement of myelosuppression and QOL in 5-FU treated mice.
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