• Title/Summary/Keyword: Chemotherapy cancer treatment

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Comparison of Fatigue and Quality of Life in the Women with Breast Cancer According to two Different Treatment Modalities : Chemotherapy vs Radiotherapy (치료 방법에 따른 유방암 환자의 피로와 삶의 질)

  • Yang, Young-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.2
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    • pp.244-252
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    • 2003
  • This study was intented to identify the differences of fatigue and quality of life in patients with breast cancer according to the different treatment modalities. Ninety-one subjects were recruited from a medical unit and a therapeutic radiologic clinic at a university hospital in Chungnam, Korea. Fatigue was measured using Lee's scale(1999) translated from Piper's Fatigue Scale and quality of life was measured using Yang's scale(2002). The women with breast cancer receiving chemotherapy were less fatigued and had better quality of life than those receiving radiotherapy(t=-2.914, p=.005; t=2.565, p=.012, respectively). The fatigue and quality of life in the women with breast cancer undergoing cancer treatments were influenced by the weight change during the past 3 months(F=24.70, p=.039). Cancer stage, metastasis and weight were not associated with fatigue and quality of life. Health professionals can help cancer patients undergoing treatments prepare to cope with the expected side effects by providing a specific treatment-related information to them. The findings of this study can contribute the knowledge of these information.

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Adjuvant Chemotherapy and Prognostic Factors in Stage II Colon Cancer - Izmir Oncology Group Study

  • Kucukzeybek, Yuksel;Dirican, Ahmet;Demir, Lutfiye;Yildirim, Serkan;Akyol, Murat;Yildiz, Yasar;Bayoglu, Ibrahim Vedat;Alacacioglu, Ahmet;Varol, Umut;Salman, Tarik;Yildiz, Ibrahim;Can, Huseyin;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2413-2418
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    • 2015
  • Background: Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Materials and Methods: One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Results: Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. Conclusions: The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.

Potential Predictors of Sensitivity to Pemetrexed as First-line Chemotherapy for Patients with Advanced Non-Squamous NSCLCs

  • Lu, Yan-Yan;Huang, Xin-En;Xu, Lin;Liu, De-Gan;Cao, Jie;Wu, Xue-Yan;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2005-2008
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    • 2013
  • Background: Pemetrexed (PEM) is effective in first-line treatment for patients with non-squamous non-small cell lung cancer (NSCLC). However there are currently no definitive determinants to certify which patients could benefit from PEM. To improve the efficacy of PEM combined with platinum as first-line therapy for advanced non-squamous NSCLC, we conducted this retrospective study to detect potential determinants of this regimen. Methods: We recruited 109 patients with advanced non-squamous NSCLC who received PEM with a platinum as first-line therapy from June 2006 to February 2013 in Jiangsu Cancer Hospital. Multiple variables (age, sex, smoking, degree of cell differentiation, hemoglobin, platinum drugs combined, positions of metastasis) were selected. Logistic regression analysis was used to analyse relationships between these variables and tumor response. Result: In univariate analysis, we found that age and platinum significantly influenced the results of PEM therapy (P<0.05). In multivariable analysis, no factors were independently significant. Conclusion: Our analysis did not suggest that the age, sex, metastasis of liver or other organs, hemoglobin, smoking history and pathological differentiation are associated with the response of PEM. We should conduct further analyses with larger sample size to reconfirm this issue.

Breakthroughs in the Systemic Treatment of HER2-Positive Advanced/Metastatic Gastric Cancer: From Singlet Chemotherapy to Triple Combination

  • Sun Young Rha;Hyun Cheol Chung
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.224-249
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    • 2023
  • Gastric cancer is heterogeneous in morphology, biology, genomics, and treatment response. Alterations in human epidermal growth factor receptor 2 (HER2) overexpression, microsatellite instability (MSI) status, programmed death-ligand 1 (PD-L1) levels, and fibroblast growth factor receptor 2 (FGFR2) can be used as biomarkers. Since the combination of fluoropyrimidine/platinum plus trastuzumab that was investigated in the ToGA trial was approved as a standard of care in HER2-positive patients in 2010, no other agents showed efficacy in the first- (HELOISE, LOGiC, JACOB trials) and second- (TyTAN, GATSBY, T-ACT trials) line treatments. Despite the success in treating breast cancer, various anti-HER2 agents, including a monoclonal antibody (pertuzumab), an antibody-drug conjugate (ADC; trastuzumab emtansine [T-DM1]), and a small molecule (lapatinib) failed to translate into clinical benefits until the KEYNOTE-811 (first-line) and DESTINY-Gastri01 (≥second-line) trials were conducted. The incorporation of HER2-directed treatment with immune checkpoint inhibitors in the form of a monoclonal antibody or ADC is now approved as a standard treatment. Despite the promising results of new agents (engineered monoclonal antibodies, bi-specific antibodies, fusion proteins, and small molecules) in the early phase of development, the management of HER2-positive gastric cancer requires further optimization to achieve precision medicine with a chemotherapeutic backbone. Treatment resistance is a complex process that can be overcome using a combination of chemotherapy, targeted agents, and immune checkpoint inhibitors, including novel agents. HER2 status must be reassessed in patients undergoing anti-HER2 treatment with disease progression after the first-line treatment. As a general guideline, patients who need systemic treatment should receive chemotherapy plus targeted agents, anti-angiogenic agents, immune checkpoint inhibitors, or their combinations.

Pemetrexed as a Component of First-, Second- and Third-line Chemotherapy in Treating Patients with Metastatic Lung Adenocarcinoma

  • Huang, Xin-En;Tian, Guang-Yu;Cao, Jie;Xu, Xia;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Shi, Lin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6663-6667
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    • 2013
  • Purpose: The current research was conducted to investigate the efficacy and safety of pemetrexed given continuously as a basement agent for first-, second- to third line chemotherapy of patients with metastatic lung adenocarcinoma. Patients and Methods: Patients with metastatic lung adenocarcinoma who were diagnosed in Jiangsu Cancer Hospital and Research Insitute, were enrolled. All received pemetrexed 500 $mg/m^2$ (intravenous; on day 1), and another chemotherapieutic agent every 3 weeks until disease progression, or intolerable toxicity. Then the patients were changed to a second line chemotherapy that was still based on pemetrexed 500 $mg/m^2$ and another chemotherapeutic agent differing from the first line example, until disease progression, or intolerable toxicity. When third line chemotherapy was needed, pemetrexed 500 $mg/m^2$ and another new chemotherapeutic agent were combined until disease progression. Evaluation of efficacy was conducted after two cycles of chemotherapy using the Response Evaluation Criteria for Solid Tumors. Toxicity was recorded according to NCI Criteria for Adverse Events version 3.0. Results: From January 2010 to September 2013, 15 patients were enrolled. Their median age was 56 years (range 43 to 77 years). Eight patients were male and 7 female. Five patients (33.3%) achieved PR, while 6 patients (40.0%) remained stable, no CR on first line; and 1 PR (7.7%), 5 stable (38.5%) were recorded when pemetrexed was ordered in second line; 5 patients (41.7%) were stable after pemetrexed was combined in third line; no complete response was observed. Main side effects were grade 1 to 2 neutrophil suppression and thrombocytopenia. Other toxicities included elevated transaminase and oral mucositis, but no treatment related death occurred. Conclusions: Pemetrexed continuously as a basement agent from first-, second- to third line chemotherapy is mildly effective in treating patients with metastatic lung adenocarcinoma with tolerable toxicity.

Health Related Quality of Life (HRQoL) among Breast Cancer Patients Receiving Chemotherapy in Hospital Melaka: Single Centre Experience

  • Chean, Dang Chee;Zang, Wong Kuo;Lim, Michelle;Zulkefle, Nooraziah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5121-5126
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    • 2016
  • Objective: To investigate the impact of chemotherapy on quality of life (QoL) among breast cancer patients and to evaluate the relationship with age, cancer stage and presence of any comorbidity. Methods: A prospective study was conducted among breast cancer patients receiving chemotherapy in Hospital Melaka from 1st January 2014 to 31st July 2014. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was given to patients to fill in prior chemotherapy (baseline) and after the third cycle of chemotherapy. Socio-demographic and clinical data were collected and analyzed using SPSS version 20. Result: Respondents were 32 female patients [mean age (SD): 49.7(9.93) years]. They reported a significant lower global health status (P < 0.01) and significant higher symptoms of nausea and vomiting (P < 0.01), loss of appetite (P = 0.028) and diarrhea (P = 0.026) after the third cycle of chemotherapy as compared to baseline. Compare to, this study showed significant better emotional functioning (P < 0.01) and social functioning (P < 0.01) than the EORTC QLQ-C30 Reference Values 2008 for breast cancer cases. Under symptom scales higher scores were noted for appetite loss (P = 0.017), nausea and vomiting (P < 0.01). Age, stage and comorbidity had no clear associations with global health status in our patients (P > 0.05). Conclusion: Chemotherapy did reduce the QoL of breast cancer patients. Management of chemotherapy-induced loss of appetite, diarrhea, nausea and vomiting should be improved for a better outcome.

Traditional Korean Medical Treatment for Chemotherapy-induced Peripheral Neuropathy - a Case Report (항암제 투여 후 발생한 수족비증(手足痺症) 환자 치험례)

  • Yoo, Seung-Yeon;Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.83-89
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    • 2007
  • Chemotherapy has many known side effects. Neuropathy is a common side effect when using cisplatin. The clinical course varies and depends on the agents used and their cumulative dose. Although symptoms can resolve completely, in most patients chemotherapy-induced peripheral neuropathy is either only partially reversible or completely irreversible. Current management for chemotherapy-induced peripheral neuropathy is symptomatic relief using membrane stabilizing medications and antidepressants. Dysaesthesia and pain involving the feet and hands are described in traditional korean medicine. In traditional korean medicine, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. We report a case of a 52 years old female patient treated with acupuncture and bleeding treatment for the goal of improving the symptoms of chemotherapy induced peripheral neuropathy. Further study and other medical method will be needed in order to improve the effect and determine the long-term effect of traditional korean medicine in treating Chemotherapy-induced Peripheral Neuropathy.

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Assessment of 8-isoprostane (8-isoPGF2α) in Urine of Non-Small Cell Lung Cancer (NSCLC) Patients Undergoing Chemotherapy

  • Johns, Nutjaree Pratheepawanit;Johns, Jeffrey Roy
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.775-780
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    • 2012
  • 8-isoprostane (8-$isoPGF_{2{\alpha}}$) is a reliable marker and considered a gold standard for lipid peroxidation. There are very few reports of 8-isoprostane levels in cancer patients, and in patients undergoing chemotherapy. Oxidative stress is however expected and has been observed in patients with cancer. This study measured 8-isoprostane levels in urine by ELISA of 25 patients undergoing chemotherapy for advanced non-small cell lung cancer, at cycles 1, 2, and 3 of treatment. It considers the creatinine clearance of the patients, and correction of 8-isoprostane levels by creatinine clearance, and overnight urine volume methods. The average 8-isoprostane levels in urine increased more than 6 to 12 fold on chemotherapy treatment, from $532{\pm}587$ pg/mL at cycle $1,6181{\pm}4334$ at cycle 2, and $5511{\pm}2055$ at cycle 3. Similar results were obtained if 8-isoprostane levels were corrected for overnight urine volume, giving averages of $285{\pm}244{\mu}g$ at cycle $1,4122{\pm}3349$ at cycle 2, and $3266{\pm}1200$ at cycle 3. No significant difference was seen in average total overnight urine volume or number of urinations between chemotherapy cycles except for a large variation in urine volume between cycle 2 and 3. Creatinine levels were significantly different only between cycles 1 and 2 (p=0.016). In conclusion, cisplatin therapy has been shown to induce high levels of lipid peroxidation in lung cancer patients and can be assessed from the 8-isoprostane marker in overnight urine, with or without urine volume correction.

ERCC1 Expression Does Not Predict Survival and Treatment Response in Advanced Stage Non-Small Cell Lung Cancer Cases Treated with Platinum Based Chemotherapy

  • Ozdemir, Ozer;Ozdemir, Pelin;Veral, Ali;Uluer, Hatice;Ozhan, Mustafa Hikmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4679-4683
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    • 2013
  • Background: ERCC1 is considered as a promising molecular marker that may predict platinum based chemotherapy response in non small cell lung cancer patients. We therefore investigated whether its expression is indeed associated with clinical outcomes in advanced stage NSCLC patients. Materials and Methods: Pretreatment tumor biopsy samples of 83 stage 3B and 4 non-small cell lung cancer patients treated with platinum based chemotherapy were retrospectively analyzed for immunohistochemical ERCC1 expression. None of the patients received curative surgery or radiotherapy. Results: By calculating H- scores regarding the extent and intensity of immunohistochemical staining of tumor biopsy samples, ERCC1 expression was found to be positive in 50 patients (60.2%). ERCC1 positive and negative groups had no statistically significant differences regarding treatment response, progression free survival and overall survival (respectively p=0.161; p=0.412; p=0.823). Conclusions: In our study we found no association between ERCC1 expression and survival or treatment response. The study has some limitations, such as small sample size and retrospective analysis method. There is need of more knowledge for use of ERCC1 guided chemotherapy regimens in advanced stage NSCLC.

Korean Medicine-based Integrative Oncology Therapies on adverse effects of Chemotherapy in Non-Small Cell Lung Cancer : 2 Cases (한의기반 통합암치료로 비소세포폐암 환자의 항암화학요법 후유증 개선 2례)

  • Ji-yoon, Yeom;Su-bin, Ahn;Su-jung, Park;Seung-yun, Oh
    • Journal of Korean Traditional Oncology
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    • v.27 no.1
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    • pp.57-66
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    • 2022
  • Objective: To report the improvements with Korean medicine-based integrative cancer therapies on adverse effects of adjuvant chemotherapy in non-small cell lung cancer patients. Method: There were two patients complained cough, rhinorrhea, numbness, general weakness, nausea and dyspepsia after chemotherapy. They got treated centered on Korean medicine including herbal medicine, acupuncture, electro-acupuncture, pharmacopuncture, moxibustion, hand and foot bath. They were also treated Western immunotherapies like Thymosin at regular intervals. The symptoms were measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care(EORTC QLQ C-15 PAL) and their subjective assessments. Results: Their chief complaints were relieved and their quality of life scores was improved even though they have been receiving chemotherapy continuously. Conclusion: These cases revealed a possibility that Korean medicine-based integrative cancer therapies could improve some symptoms after chemotherapy in non-small cell lung cancer.