• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4733-4738
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• 2014

Purpose: We developed and evaluated a regimen including fotemustine, teniposide and dexamethasone (FTD) for treating patients with central nervous system (CNS) lymphoma based on pharmacokinetic properties of individual agents and in combination. Patients and Methods: In a comparison study, 8 patients with primary CNS lymphoma (PCNSL) and 8 with secondary CNS lymphoma (SCNSL) were treated with FTD (comprising fotemustine 100 mg/m2, 1h infusion, day 1; teniposide 60 mg/m2, >0.5 h infusion, on day 2, 3, 4; dexamethasone 40 mg, 1h infusion, on day 1, 2, 3, 4 and 5; and methotrexate 12 mg, cytosine arabinoside 50 mg plus dexamethasone 5 mg intrathecally, on day 2 and 7). Cycles were repeated every 3 weeks. After response assessment, patients received whole brain radiotherapy. Results: Of the 8 PCNSL patients, 4 (50%) achieved CR and 3 (38%) PR, an overall response rate of 88%. Four patients (50%) were in continuing remission at the end of this study after a median follow-up of 30 months (range 10 to 56 months). Of the 8 SCNSL patients the overall response rate was 63% (CR+PR: 38%+25%). All responses were achievable with predictable toxicity mainly reflecting reversible myelosuppression. Conclusion: This study suggests that FTD could be an effective treatment for CNS lymphoma, and is worthy of further evaluation.

• Radiation Oncology Journal
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• 제9권1호
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• pp.81-85
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• 1991

폐암의 방사선 치료후 발생하는 치료부위의 섬유성 변성과 암종의 재발의 구별이 어려울때가 많으나 아직 이렇다 할 감별진단 방법이 없다. 경북대학교 병원 치료방사선과에서 1989년 1월부터 1990년 6월까지 방사선 치료를 받은 폐암 환자 중 섬유성 변성이나 재발의 가능성이 높은 22명을 대상으로 Gallium-67 스캔의 유용성을 연구하였다. 대상환자는 편평 세포암 17명, 소세포암이 3명, 선암 2명이었고, 편평 세포암은 약물치료를 하지 않았고, 소세포암은 CAV와 Vp-16및 cis-platin으로 병용치료 하였으며, 선암은 폐엽절제술을 시행하였다. 방사선 치료는 조직형과 병용치료의 양상에 따라 5~6주에 걸쳐 45~60 Gy를 투여하였으며, 치료후 정기적으로추적 검진하였다. 재발과 상관 없이 방사선 폐염이 발생한군에서는 모두 Gallium 축적을 보였고, 12명의 재발 혹은 잔여 종양이 있는 군에서는 11명 이 Gallium 축적을 보였다(92%), 무병상태의 10명 중 방사선 폐염을 가진 5명에서는 Gallium축적이 있었으나, 섬유성 변성만 있는 5명에서는 4명에서 Gallium이 축적되지 않았다(80\%). 섬유성 변성은 모두 치료 종료 후 8개월 이후에 임상적으로 출현되었다. 이 시기에 재발과 섬유성 변성의 구별이 용이하지 않고 치료방침에도 결정적 영향을 미치므로, 치료 후 1년이 지난 환자에서 Gallium-67 scan이 임상적으로 유용할 것으로 사료된다.

• Radiation Oncology Journal
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• 제8권2호
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• pp.183-188
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• 1990

비인강암은 해부학적으로 두개저부 및 중추신경계와 인접하고 있어 수술적 접근이 어렵고, 또 최근 항암제요법의 발달로 복합항암제를 이용한 항암제요법으로 반응율을 높이기 위한 여러 연구들이 진행되고 있지만, 아직까지 비인강암에 대한 치료는 방사선치료가 그 근간을 이루고 있다. 비인강암의 연령분포곡선은 30세 이후에 급격히 증가하여 45세에서 54세까지에서 수평을 이룬후 서서히 감소하는 곡선을 그리는데, 10대 내지 20대에서도 작은 증가곡선을 나타내어 bimodal curve를 그리게 된다. 30세 이전에 생긴 비인강암은 그 빈도가 매우 적어서 이에 대한 연구보고가 많지 않지만 일반적으로는 30세 이후에 생긴 비인강암과는 다른 임상양상을 보이는 것으로 보고되어 있다. 이에 저자들은 1971년부터 1987년까지 연세대학교 의과대학 치료방사선과에서 치료받았던 113명의 비인강암 환자들을 30세 이전과 30세 이후 환자군으로 구별하여, 임상적 특성 및 치료에 대한 관해율, 이에 따른 생존율 및 생존에 영향을 미치는 인자들, 그리고 치료실패양상 등을 분석 비교하여 향후 30세 이전의 비인강암 환자의 치료에 지침을 마련하고자 본 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 30세 이전의 비인강암 환자에서 치료에 대한 초기반응율이 높았다 2. 30세 이전의 비인강암 환자에서 통계적 의의는 없었으나 원격전이가 많았다. 3. 두 연령군간에 생존율의 차이는 없었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9949-9953
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• 2014

Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10413-10420
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• 2015

Side effects are an unavoidable consequence of chemotherapy drugs, during which liver injury often takes place. The current study was designed to investigate the protective effect of Astragalus polysaccharides (APS) against the hepatotoxicity induced by frequently-used chemical therapy agents, cyclophosphamide (CTX), docetaxel (DTX) and epirubicin (EPI)) in mice. Mice were divided into five groups, controls, low or high dose groups ($DTX_L$, $CTX_L$, $EPI_L$ or $DTX_H$, $CTX_H$, $EPI_H$), and low or high dose chemotherapeutics+APS groups ($DTX_L$+APS, $CTX_L$+APS, $EPI_L$+APS or $DTX_H$+APS, $CTX_H$+APS, $EPI_H$+APS). Controls were treated with equivalent normal saline for 28 days every other day; low or high dose group were intraperitoneal (i.p) injected with low or high doses of CTX, DTX and EPI for 28 days every other day; low or high dose chemotherapeutics+APS group were separately intraperitoneal (i.p) injected with chemotherapeutics for 28 days every other day and i.p with APS (100 mg/kg) for 7 days continually from the 22th to the 28th days. The body weight, serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), histopathological features, and ultrastructure morphological change of liver tissues, protein expression level of caspase-3 were estimated at different time points. With high dose treatment of DTX, CTX and EPI, weight gain was inhibited and serum levels of ALT and AST were significantly increased. Sections of liver tissue showed massive hepatotoxicity in $CTX_H$ group compared to the control group, including hepatic lobule disorder, granular and vacuolar degeneration and necrosis in hepatic cells. These changes were confirmed at ultrastructural level, including obvious pyknosis, heterochromatin aggregation, nuclear membrane resolution, and chondrosome crystal decrease. Western blotting revealed that the protein levels of caspase-3 increased in $CTX_H$ group. The low dose groups exhibited trivial hepatotoxicity. More interestingly, after 100 mg/kg APS, liver injury was redecued not only regarding serum transaminase activities (low or high dose chemotherapeutics+APS group), but also from pathological and ultrastructural changes and the protein levels of caspase-3 ($CTX_H$+APS group). In conclusion, DTX, CTX and EPI induce liver damage in a dose dependent manner, whereas APS exerted protective effects.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4169-4173
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• 2016

Background: Mesotheliomas are relatively rare tumors in Lebanon. The only previous study goes back to 14 years ago, when we published epidemiological characteristics of mesotheliomas in Lebanon, showing that the pleural location accounted for the vast majority of cases, with clear evidence of asbestos exposure from the Eternit factory of Chekka region. The objective of this current study was to estimate the incidence of mesothelioma in the past decade and to identify its epidemiological, clinical and therapeutic characteristics, making comparisons with our first study published in 2001. Materials and Methods: Between 2002 and 2014, patients diagnosed with malignant mesothelioma at Hotel-Dieu de France University Hospital were investigated. Epidemiological data focusing on asbestos exposure history were collected from medical records and interviews with the families. Results: A total of 26 patients were diagnosed with mesothelioma, 21 of which were successfully investigated. The mean age of these 21 patients is 62.5 (19-82). Only 3 (14.29%) are women. 18 (85.71%) were smokers. Among the 21 available mesotheliomas, 15 (71.4%) are pleural, while 5 (23.8%) are peritoneal and 1 (4.8%) pericardial. Only 60% of patients with pleural mesothelioma and 50% of those with an obvious exposure to asbestos lived and/or worked in Chekka region. The mean time of asbestos exposure in patients with mesothelioma is 24.5 (1-50) years and the mean latency is 37.4 (4-61) years. Of the 21 patients, 10 (47.6%) underwent surgery during their treatment, 16 (76.2%) received chemotherapy and 3 (14.3%) received best supportive care. Conclusions: Compared to the previous study (1991-2000), substantial changes in the epidemiology of mesothelioma in Lebanon were observed, such as an increase in peritoneal localizations and a lower correlation with Chekka region asbestos contamination.

• Journal of Gastric Cancer
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• 제8권1호
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• pp.47-52
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• 2008

융모막암은 임신과 연관되어 발생하는 악성 종양으로 주로 자궁에서 발생한다. 위장관에서도 융모막암이 발생할 수 있는데 매우 드물고 다른 장기의 융모암과 다른 발생 기전을 가진다. 원발성 위융모암은 치료 성적이 나쁘고 전이 속도가 빨라서 예후가 매우 나쁘다. 저자들은 혈변, 상복부 통증을 주소로 내원한 69세 여자 환자에서 수술전 진행성 저분화형 위선암으로 진단되어 위아전절제술을 시행하였으나 수술 후 위 전정부의 원발성 융모막암으로 진단된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 융모막암 치료 원칙은 수술적 절제술과 보조적 항암 화학치료이지만 생존율 증가가 입증된 치료 방법은 아직 없는 실정이다. 그러므로 저분화도를 보이거나 출혈 경향을 보이는 위암인 경우에는 융모막암의 가능성도 염두에 두고 적극적인 검사가 이루어져야 할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.72-78
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• 1993

연구배경 : 원발성 폐암의 전이 병소 발견은 병변 자체와 위험한 합병증을 예방하기 위한 치료 계획의 수립에 중요하다. 원발성 폐암은 임파절, 부신, 뇌, 간장, 뼈로 잘 전이되며 뼈중에서는 주로 두개골, 척추, 늑골 그리고 장골 등을 침범한다. 편평상피암에서의 골전이는 다른 폐암에 비하여 비교적 낮은 빈도로 알려져 있으며 특히 원위부 족지골에의 전이는 매우 드물다. 방법 : 저자등은 연세대학교 의과대학 세브란스병원에서 우측 제 5 원위부 족지골에만 전이 병소가 발견된 폐암 1 예를 경험하였다. 결과 : 처음 편평상피암의 진단시에 T4N3MO의 상태였으며 세 번째 항암제 투여시 처음으로 원격 전이가 제 5 원위부 족지골에 국한되어 발견되었다. 단순 골사진과 전신 골 주사검사상 우측 제 5 원위부 족지골의 국소적 이상 소견이 관찰되었으며 제 5 족지의 절단 조직검사에서 폐의 편평상피암이 전이된 병변임을 병리조직학적으로 확인할 수 있었다. 결론 : 본 증례의 특징은 뼈중에서도 통상적으로 전이가 잘되는 두개골, 철추, 늑골이나 장골이외에 제 5 원위부 족지골에 처음 전이가 된 것이다. 따라서 원발성 폐암 환자에서 이학적 검사상 국소적인 염증같은 이상 소견이 발견되면 가능성은 비록 적더라도 전이성 병변을 의심해 보는 것이 필요하리라고 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1603-1609
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• 2014

Background: The response to treatment and overall survival (OS) of patients with acute myeloid leukemia (AML) is variable, with a median ranging from 6 months to 11.5 years. TP53 is associated with old age, chemotherapy resistance, and worse OS. Using genetic sequencing, we set out to look at our own experience with AML, and hypothesized that both TP53 mutations and SNPs at codon 72 would mimic the literature by occurring in a minority of patients, and conferring a worse OS. Materials and Methods: We performed a pilot study of randomly selected, newly diagnosed AML patients at Mount Sinai Medical Center, diagnosed from 2005-2008 (n=10). TP53 PCR sequencing was performed using DNA from bone marrow smears. Analysis was accomplished using Mutation Surveyor software with confirmation of the variants using the COSMIC and dbSNP databases. Results: Fewer than half of the patients harbored TP53 mutations (40%). There was no significant difference in OS based on gender, AML history, risk-stratified karyotype, or TP53 mutation. There were possible trends toward improved survival among patients less than 60 (11 vs 4 months, p=0.09), Hispanics (8 vs 1 months, p=0.11), and those not harboring SNP P72R (8 vs 2 months, p=0.10). There was a significant improvement in survival among patients with better performance status (28 vs 4 months, p=0.01) and those who did not have a complex karyotype (8 vs 1 months, p=0.03). The most commonly observed TP53 mutation was a missense N310K (40%) and the most commonly observed SNP was P72R (100.0%). Conclusions: Our study confirms previous reports that poor PS and the presence of a complex karyotype are associated with a decreased OS. In our cohort, TP53 mutations were relatively common, occurring more frequently in male patients with an adverse karyotype. Although there was no significant difference in survival between TP53 mutated and un-mutated patients, there was a possible trend toward worse OS among patients with SNP P72R. Larger studies are needed to validate these findings.

• 한국발생생물학회지:발생과생식
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• 제18권4호
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• pp.197-212
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• 2014

Osteosarcoma (OS) is one of the most common malignant primary bone tumors and NF-${\kappa}B$ appears to play a causative role, but the mechanisms are poorly understood. OS is one of the pleomorphic, highly metastasized and invasive neoplasm which is capable to generate osteoid, osteoclast and osteoblast matrix. Its high incidence has been reported in adolescent and children. Cell signal cascade is the pivotal functional mechanism acquired during the differentiation, proliferation, growth and survival of the cells in neoplasm including OS. The major limitation to the success of chemotherapy in OS is the development of multidrug resistance (MDR). Answers to all such queries might come from the knock-in experiments in which the combined approach of miRNAs with NF-${\kappa}B$ pathway is put into use. Abnormal miRNAs can modulate several epigenetical switching as a hallmark of number of diseases via different cell signaling. Studies on miRNAs have opened up the new avenues for both the diagnosis and treatment of cancers including OS. Collectively, through the present study an attempt has been made to establish a new systematic approach for the investigation of microRNAs, bio-physiological factors and their target pairs with NF-${\kappa}B$ to ameliorate oncogenesis with the "bridge between miRNAs and NF-${\kappa}B$". The application of NF-${\kappa}B$ inhibitors in combination with miRNAs is expected to result in a more efficient killing of the cancer stem cells and a slower or less likely recurrence of cancer.