• Title/Summary/Keyword: Chemotherapy, adjuvant

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Juvenile Pilomyxoid Astrocytoma in the Opticohypothalamus

  • Kim, Sung-Hyun;Kang, Sam-Suk;Jung, Tae-Young;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.445-447
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    • 2010
  • Pilomyxoid astrocytoma (PMA) is a newly recognized variant of a pilocytic astrocytoma. This report describes a case of a pilomyxoid astrocytoma that occurred in the opticohypothalamus. The patient was a 18-year-old girl who complained decreased visual acuity and visual field over a period of two years. Magnetic resonance imaging (MRI) showed an irregular lobulated tumor with heterogeneous enhancement at the suprasellar region involving the hypothalamus. The mass was partially removed via the subfrontal approach. Its pathology was confirmed to be PMA. Adjuvant chemotherapy with cisplatin and vincristine was started following tumor resection. After four cycles, the mass showed a partial response to the chemotherapy. Although long-term outcome is yet to be determined, the administration of combined cisplatin and vincristine treatment seems to be an effective regimen for a pilomyxoid astrocytoma.

Weekly versus 3-weekly paclitaxel in combination with carboplatin in advanced ovarian cancer: which is the optimal adjuvant chemotherapy regimen?

  • Lee, Matilda X.;Tan, David SP
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.96.1-96.12
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    • 2018
  • The 3-weekly regimen of carboplatin and paclitaxel is the backbone of first line adjuvant chemotherapy for advanced ovarian cancer. The landmark Japanese Gynaecologic Oncology Group (JGOG) 3016 study demonstrated significant improvements in progression-free survival and overall survival with dose dense weekly administration of paclitaxel in combination with 3-weekly carboplatin. However, efforts to replicate these benefits have failed in subsequent phase III trials. Weekly paclitaxel is purported to have enhanced antitumor activity, with stronger anti-angiogenic effects, and yet is better tolerated. In this review, we explore the rationale for dose dense weekly paclitaxel, and compare the relevant trials as well as quality of life considerations. Possible reasons for the difference in outcomes between the JGOG 3016 and other studies are reviewed, with a focus on how the addition of bevacizumab, the variations between histological and molecular subtypes of epithelial ovarian cancers, and ethnic pharmacogenetic differences may potentially affect the efficacy of dose dense paclitaxel.

Clinical Application of Serum Tumor Abnormal Protein from Patients with Gastric Cancer

  • Liu, Jin;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4041-4044
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    • 2015
  • Background: To verify whether serum tumor abnormal protein (TAP) would correlate with the responsiveness of palliative chemotherapy in patients with advanced gastric cancer, and the variation of conventional serum tumor markers e.g., carcinoembryonic antigen (CEA), antigen 125 (CA125),carbohydrate antigen19-9 (CA19-9) of adjuvant chemotherapy in patients with early gastric cancer. Materials and Methods: Patients with histologically confirmed gastric cancer and treated with chemotherapy were enrolled into this study. TAP values of these patients were determined by detecting abnormal sugar chain glycoprotein in serum, combined with the area of agglomerated particles. For patients with advanced gastric cancer, responsiveness of palliative chemotherapy was compared with variation of TAP and the relation between variation of TAP and tumor markers in patients with early gastric cancer was analyzed. Results: Totally 82 gastric cancer patients were enrolled into this study. The value of TAP is more closely related to responsiveness of palliative chemotherapy for patients with advanced gastric cancer. The correlation between TAP and responsiveness to palliative chemotherapy is stronger than the correlation between several conventional serum tumor markers (CEA, CA125 and CA199). The variation of TAP was also positively correlated with the trend of CA125 in adjuvant chemotherapy. Conclusions: TAP is sensitive in monitoring the responsiveness to palliative chemotherapy in patients with advanced gastric cancer. But this result should be confirmed by randomized clinical trials for patients with gastric cancer.

Role of Adjuvant Radiotherapy in Gastric Cancer

  • Jeong Il Yu
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.194-206
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    • 2023
  • Although continuous improvement in the treatment outcome of localized gastric cancer has been achieved through early screening, diagnosis, and treatment and the active application of surgery and adjuvant chemotherapy, the necessity of adjuvant radiotherapy (RT) remains controversial. In this review, based on the results of two recently published randomized phase III studies (Adjuvant Chemoradiation Therapy In Stomach Cancer 2 and ChemoRadiotherapy after Induction chemoTherapy of Cancer in the Stomach) and a meta-analysis of six randomized trials including these two studies, the role of adjuvant RT in gastric cancer was evaluated and discussed, especially in patients who underwent curative gastrectomy with D2 lymphadenectomy. This article also reported the possible indications for adjuvant RT in the current clinical situation and in future research to enable patientspecific treatments according to the risk of recurrence.

Malignant Ovarian Tumor in Children (소아에 발생한 악성 난소 종양)

  • Shin, Hye-Ah;Kim, Dae-Yeon;Cho, Min-Jeong;Kim, Tae-Hoon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.134-142
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    • 2010
  • Malignant ovarian tumors in children are very rare, and consist of about 1 % of all childhood malignant tumors. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with malignant ovarian tumors. We retrospectively reviewed the medical records of children under 15 years of age with malignant ovarian tumors who had been treated surgically at Asan Medical Center between 1989 and March 2009. There were 32 patients, ranged in age at surgery from 2 to 15 years (mean; 10.4 years). The median follow-up period was 64.7 months (from 1 month to 188 months). Pathologic diagnosis were; immature teratoma (n=10), mixed germ cell tumor (n=10), and dysgerminoma (n=6). Tumor stage was classified by the staging system of the International Federation of Gynecology and Obstetrics (FIGO). The number of patients in stage I, II, III, and IV were 24 (75 %), 2 (6.2 %), 4 (12.5 %), and 2 (6.1 %), respectively. The tumor recurred in 4 patients. Seven patients of group 1 did not receive postoperative adjuvant chemotherapy, and in three of them, the tumor recurred. Twenty-five patients (group 2) underwent postoperative adjuvant chemotherapy, and there was only one recurrence. One patient who did not receive postoperative adjuvant chemotherapy and expired 10 months after operation because of tumor recurrence and distant metastasis. The overall 5-year event free survival (EFS) was 84.2 %: group 1 in 44.4 %, and group 2 in 95.7 %. Tumor recurrence was related to the postoperative adjuvant chemotherapy (p=0.004). In conclusion, proper surgical procedures with relevant postoperative adjuvant chemotherapy might improve clinical results in children with malignant ovarian tumors.

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Adjuvant Therapy of Pancreatic Cancer

  • Paik, Woo Hyun
    • Journal of Digestive Cancer Reports
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    • v.7 no.1
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    • pp.5-7
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    • 2019
  • Pancreatic cancer is a lethal disease since curative resection is available in only 20% of patients at the initial diagnosis. Even after radical resection of the cancer, most patients experience recurrence. Therefore, many clinical trials have been attempted to prevent recurrence of pancreatic cancer. The key clinical studies about adjuvant therapy of pancreatic cancer and currently available regimens in Korea will be reviewed concisely according to the chemotherapy, radiation therapy, or both.

Postoperative Adjuvant Radiotherapy for Patients with Gastric Adenocarcinoma

  • Lim, Do Hoon
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.205-209
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    • 2012
  • In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.

Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy (수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구)

  • Park, Heejung;Kil, Hyonson;Cho, Wookyoun
    • Korean Journal of Community Nutrition
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    • v.25 no.4
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    • pp.303-316
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    • 2020
  • Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.

Treatment Deintensification for Human Papillomavirus-Associated Oropharyngeal Cancer: Focused Review of Published Data (인유두종바이러스 연관 구인두암의 치료 약화 전략: 보고된 결과를 중심으로 분석)

  • Jin Ho, Kim
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.2
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    • pp.7-13
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    • 2022
  • Human papillomavirus (HPV) is a causative agent for a subset of oropharyngeal cancer (OPC). The current standard of care (SOC) for locally advanced OPC is 70 Gy definitive radiotherapy (RT) concurrent with cisplatin, which entails significant proportions of acute and late grade 3 or higher toxicities. Accordingly, discovery of favorable prognosis of HPV-related OPC has led to enthusiasm to attenuate subspecialties therapy in multidisciplinary treatment. Diverse deintensification strategies were investigated in multiple phase 2 trials with an assumption that attenuated treatments result in comparable oncologic outcome and less toxicities compared with SOC. Several trials on chemotherapy deintensification revealed that concomitant administration of cisplatin is not to be omitted or substituted for cetuximab without compromising progression-free survival or local control. A transoral robotic surgery (TORS) is investigated as alternative local treatment, but TORS plus SOC or mild deintensified adjuvant RT showed similar toxicities and inferior oncologic outcomes compared with SOC definitive RT or moderately deintensified RT. However, it has been reported that TORS plus deintensified 30-36 Gy adjuvant RT results in excellent outcome and less late toxicity compared with SOC adjuvant RT. Several phase 2 trials reported apparently equivalent progression-free survival and local control and similar adverse effects with moderately deintensified 60 Gy RT compared with SOC 70 Gy RT. Further dose reduction below 60 Gy has been investigated using biology-directed approaches, which use response to induction chemotherapy or metabolic images to triage HPV-positive OPC for deintensified RT. In summary, these trials provide valuable insights for future directions. Available evidence consistently showed that moderately deintensified RT is effective and safe for HPV-positive OPC in both definitive and adjuvant settings. Concurrent cisplatin remains an essential component without which progression-free survival is significantly compromised for advanced HPV-positive OPC. A simple incorporation of TORS to SOC may be detrimental for oncologic outcome without anticipated toxicity reduction. Given the lack of level 1 evidence, it is prudent to curb an unjustified deviation from the current SOC and limit any deintensified strategies to clinical trials and adhere to the current SOC.

New Targeted Therapy for Non-Small Cell Lung Cancer

  • Eun Ki Chung;Seung Hyun Yong;Eun Hye Lee;Eun Young Kim;Yoon Soo Chang;Sang Hoon Lee
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.1
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    • pp.1-13
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    • 2023
  • Lung cancer ranks first in cancer mortality in Korea and cancer incidence in Korean men. More than half of Korean lung cancer patients undergo chemotherapy, including adjuvant therapy. Cytotoxic agents, targeted therapy, and immune checkpoint inhibitors are used in chemotherapy according to the biopsy and genetic test results. Among chemotherapy, the one that has developed rapidly is targeted therapy. The National Comprehensive Cancer Network (NCCN) guidelines have been updated recently for targeted therapy of multiple gene mutations, and targeted therapy is used not only for chemotherapy but also for adjuvant therapy. While previously targeted therapies have been developed for common genetic mutations, recently targeted therapies have been developed to overcome uncommon mutations or drug resistance that have occurred since previous targeted therapy. Therefore, this study describes recent, rapidly developing targeted therapies.