• The Journal of Korean Medicine
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• v.39 no.4
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• pp.177-182
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• 2018

Background: Breast cancer is a treatable disease, but some women reject conventional treatment in favor of unproven "alternative therapies," which may have serious implications for their survival. Therefore, a process is needed to lead them to more appropriate treatment choices. Case presentation: Here, we present the case of a 51-year-old Korean female diagnosed with early-stage breast cancer (stage IIB, T2N1M0) in Nov. 2015. She refused a standard surgical resection together with chemotherapy and opted instead for moxibustion by nonmedical personnel. Consequently, her preference for alternative therapy without conventional treatment exacerbated her disease. Just a little over a year later, integrative cancer treatment, including chemotherapy based on histological founding, and complementary treatment, comprised of acupuncture, moxibustion, and herbal medicine, were administered for 5 months. Finally, she successfully underwent modified radical mastectomy showing a pathological complete response. She received only adjuvant chemotherapy without any alternative medicine afterwards, and she maintained a good status without recurrence. Conclusion: In the case of breast cancer patients who are resistant to surgery and chemotherapy, integrative therapy considering adverse effects from conventional treatment should be preferred to bitter opposition to alternative medicine.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.4
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• pp.57-68
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• 2016

Objectives: This paper aims to report the effects of Korean medical treatment on a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer. Methods: An ovarian cancer patient underwent abdominal surgery and got Korean medical treatment during 7-day hospitalization. About 2 years later, with metastasis to the lymph nodes detected, she had abdominal surgery with hyperthermic intraperitoneal chemotherapy and got Korean medical treatment during 10-day hospitalization. The treatment included herbal medicine and acupuncture. Numerical Rating Scale (NRS) of symptoms was measured every morning. Results: After the treatment, sequela following surgery decreased, and general conditions improved. During 1st and 2nd hospitalization, NRS of general weakness, heartburn and dorsal chill significantly decreased (10 to 5, 10 to 5 and 10 to 2, respectively) while edema in both legs remained the same. Conclusions: This case shows that Korean medical treatment is effective for a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6565-6570
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• 2014

Objective: To observe the curative effects of rh-endostatin combined with DP regimen in treating patients with advanced esophageal cancer and analyze the correlation of CT perfusion (CTP) parameters and the expression of vascular endothelial growth factor (VEGF). Methods: Twenty patients with esophageal cancer confirmed pathologically were randomly divided into combined treatment (rh-endostatin+DP regimen) group and single chemotherapy group, 10 patients in each group, respectively. All patients were given conventional CT examination and CTP imaging for primary tumor. The level of VEGF, the size of tumor and CTP parameters (BF, BV, PS and MTT) before treatment and after 2 cycles of treatment were determined for the comparison and the correlation between CTP parameters and VEGF expression was analyzed. Results: the therapeutic effect of rh-endostatin+DP regimen group was superior to single chemotherapy group. VEGF level after treatment in rh-endostatin+DP regimen group was obviously lower than single chemotherapy group (P<0.01). The expression of VEGF had positive correlation with BF and BV but negative correlation with MTT. Compared with treatment before for rh-endostatin+DP regimen group, BF, BV and PS decreased while MTT increased after treatment (P<0.05). However, there were no significant differences between treatment before and after treatment in single chemotherapy (P>0.05). Conclusions: Rh-endostatin can down-regulate the expression of VEGF in esophageal cancer, change the state of hypertransfusion and high permeability of tumor vessels and had the better curative effect and slighter adverse reactions when combined with chemotherapy.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.179-189
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• 2019

Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.

• Journal of Gastric Cancer
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• v.11 no.3
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• pp.167-172
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• 2011

Purpose: Peritoneal seeding of gastric cancer is known to have a poor prognosis. With the diagnosis of peritoneal seeding, there is no effective treatment modality. Gastrectomy with chemotherapy or primary chemotherapy is basically one of major options for this condition. This study was conducted to compare the clinical outcomes of these treatments and to identify the better way to improve the prognosis of patients with peritoneal seeding. Materials and Methods: Between 2001 and 2007, gastric cancer patients with peritoneal seeding by preoperative or intraoperative diagnosis were reviewed retrospectively. The enrolled patients were divided as primary gastrectomy and primary chemotherapy group. Clinicopathologic characteristics and clinical outcomes of groups were analyzed and compared. Results: Fifty-four patients were enrolled. 21 patients belonged to the group of primary gastrectomy and 33 patients were to the primary chemotherapy group. Among 33 patients of the primary chemotherapy group, 17 patients were received only chemotherapy and 16 patients were received gastrectomy due to the good responses of primary chemotherapy. The 3 years survival rates were 14% in primary gastrectomy group, 55% in patients who received gastrectomy after primary chemotherapy, and 0% in patients with primary chemotherapy only. Conclusions: Although this study had many limitations, some valuable information was produced. In terms of survival benefits for the gastric cancer patients with peritoneal seeding, primary gastrectomy and additional gastrectomy after primary chemotherapy revealed the better clinical outcomes. But, prospective randomized clinical study and multi-center study should be performed to decide proper treatment for gastric cancer patients with peritoneal seeding.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3111-3116
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• 2015

Background: This study was designed to investigate the value of CEA and CA199 in predicting the treatment response to palliative chemotherapy for advanced gastric cancer. Materials and Methods: We studied 189 patients with advanced gastric cancer who received first-line chemotherapy, measured the serum CEA and CA199 levels, used RECIST1.1 as the gold standard and analyzed the value of CEA and CA199 levels changes in predicting the treatment efficacy of chemotherapy. Results: Among the 189 patients, 80 and 94 cases had increases of baseline CEA (${\geq}5ng/ml$) and CA199 levels (${\geq}27U/ml$), respectively. After two cycles of chemotherapy, 42.9% patients showed partial remission, 33.3% stable disease, and 23.8% progressive disease. The area under the ROC curve (AUC) for CEA and CA199 reduction in predicting effective chemotherapy were 0.828 (95%CI 0.740-0.916) and 0.897 (95%CI 0.832-0.961). The AUCs for CEA and CA199 increase in predicting progression after chemotherapy were 0.923 (95%CI 0.865-0.980) and 0.896 (95%CI 0.834-0.959), respectively. Patients who exhibited a CEA decline ${\geq}24%$ and a CA199 decline ${\geq}29%$ had significantly longer PFS (log rank p=0.001, p<0.001). With the exception of patients who presented with abnormal levels after chemotherapy, changes of CEA and CA199 levels had limited value for evaluating the chemotherapy efficacy in patients with normal baseline tumor markers. Conclusions: Changes in serum CEA and CA199 levels can accurately predict the efficacy of first-line chemotherapy in advanced gastric cancer. Patients with levels decreasing beyond the optimal critical values after chemotherapy have longer PFS.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5597-5600
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• 2014

Objectives: To assess side effects on Cantharidin sodium and Shenmai injection combined with chemotherapy in treating patients with breast cancer postoperatively. Method: Patients with breast cancer receiving postoperative chemotherapy were retrospectively collected, and divided into four groups: group A with cantharidin sodium injection combined with chemotherapy; group B with Shenmai injection combined with chemotherapy; group C with both cantharidin sodium and Shenmai injection combined with chemotherapy; while group D (control group) received chemotherapy alone. All patients were administered docetaxel at a dose of $75mg/m^2$ on day 1, epirubicin hydrochloride at a dose of $60mg/m^2$ on day 1, and cyclophosphamide at a dose of $500mg/m^2$ on day 1 for 3 cycles (repeated at 21 day intervals). After ${\geq}$ three courses of treatment, quality of life and side effects were evaluated. Results: There were a total of 78 patients in this study, and the incidence of leukopenia and gastrointestinal reactions in groups A and B were lower than those in the control group and lowest in group C (p<0.05). Conclusions: Thus cantharidin sodium and Shenmai injection combined with chemotherapy reduce side effects and deserve to be further investigated in randomized clinical control trials.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.45-51
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• 2014

Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4373-4378
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• 2012

Introduction: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokines including parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occur in patients with or without bone metastases. The present study aimed to describe the effect of chemotherapy treatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia. Methods: We carried a review of medical records of breast and lung cancer patients hospitalized in years 2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia. Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis or during cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapy types and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levels at first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latest chemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data, logistic regression test for categorical variables, and Spearman correlation test, linear regression and the paired sample t tests for continuous data. Results: Of a total 1,023 of breast cancer and 814 lung cancer patients identified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lung cancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia (10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl). Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia; in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, and gemcitabine+cisplatin in lung cancer. Conclusion: Chemotherapy decreases calcium levels in breast and lung cancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.

• Journal of Gastric Cancer
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• v.8 no.2
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• pp.65-69
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• 2008

Surgery is the only curative modality for the treatment of gastric cancer. There has been no drastic improvement in the treatment of gastric cancer with chemotherapy. Clinical trials have attempted to demonstrate the benefit of the preoperative chemotherapy for gastric cancer. The benefit of the use of preoperative chemotherapy or chemoradiotherapy has been demonstrated for other solid cancers such as breast cancer, esophageal cancer and rectal cancer. Despite the rationale of the use of preoperative chemotherapy for patients with gastric cancer, the evidence of positive results with the use of preoperative chemotherapy has not been clear. Recently the British Medical Research Council Adjuvant Gastric Cancer Infusional Chemotherapy (MAGIC) study demonstrated the survival benefit of preoperative and postoperative chemotherapy. However, this study had several problems with the use of a heterogeneous population of patients, the method of surgery and the use of perioperative chemotherapy. Further studies with new drugs are warranted to determine the role of pre-operative chemotherapy for patients with gastric cancer.