• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.2
• /
• pp.923-927
• /
• 2013

Objective: This work aims to investigate the therapeutic regimen of brain metastatic cancers and the relationship between clinical features and prognosis. Methods: Clinical data of 184 patients with brain metastatic cancers were collected and analysed for the relationship between survival time and age, gender, primary diseases, quantity of brain metastatic foci, their position, extra cranial lesions, and therapeutic regimens. Results: The average age of onset was 59.1 years old. The median survival time (MST) was 15.0 months, and the patients with breast cancer as the primary disease had the longest survival time. Females had a longer survival time than males. Patients with meningeal metastasis had extremely short survival time. Those with less than 3 brain metastatic foci survived longer than patients with more than 3. The MST of patients receiving radiotherapy only and the patients receiving chemotherapy only were all 10.0 months while the MST of patients receiving combination therapy was 16.0 months. Multiple COX regression analysis demonstrated that gender, primary diseases, and quantity of brain metastatic foci were independent prognostic factors for brain metastatic cancers. Conclusions: Chemotherapy is as important as radiotherapy in the treatment of brain metastatic cancer. Combination therapy is the best treatment mode. Male gender, brain metastatic cancers originating in the gastrointestinal tract, more than 3 metastatic foci, and involvement of meninges indicate a worse prognosis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.10
• /
• pp.5699-5703
• /
• 2013

Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup2
• /
• pp.266-272
• /
• 2001

Objectives : Chemotherapy remains part of the treatment triad that includes surgery and radiotherapy for the management of glioblastomas, but disappointing results of chemotherapy have raised the suggestion that chemotherapy should perhaps be abandoned. In order to determine the chemotherapy effect given in addition to radiotherapy, we performed a randomized clinical study of irradiation alone and combination of irradiation with chemotherapy in the treatment of glioblastomas. Methods : From 1991 to 1999, 204 consecutive patients suffering from supratentorial glioblastomas were treated in our hospital. We compared the survival rates/times of these patients according to the treatment modalities[group I-67 patients treated by surgery with radiotherapy and adjuvant chemotherapy(ACNU, paclitaxel, tamoxifen, and others) ; group II-106 by surgery with radiotherapy ; and group III-31 by surgery only]. Results : The overall median survival time was 12 months, with overall survival rates at 1 and 2 year of 46.7% and 16.6%, respectively. On univariate analysis, median survival and 1- and 2-year survival rates were statistically improved by the use of chemotherapy ; group I-15 months, 75.7%, and 25.9%, group II-11 months, 39.3%, and 15.4%, and group III-3 months, 9.7%, and 6.5%, respectively(p=0.0001). But, on multivariate analysis considering compounding variables, survival was independently associated only with radiotherapy(p=0.0112). Conclusion : These results suggest that the addition of chemotherapy to radiotherapy does not affect the overall survival in glioblastomas. Mainly long-survivor glioblastoma patients might benefit by adjuvant chemotherapy, which probably means patients with initial favorable prognostic factors(young age, minimal residual tumors, good performance status). It is necessary to continue to search for an effective chemotherapy regimen to prolong survival of patients with glioblastomas.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.2
• /
• pp.161-168
• /
• 1997

Background: Cancers of the maxillary sinuses are not common and are the most difficult head and neck malignancies in which to make an early diagnosis. Objectives: This reports was conducted to evaluated the efficacy of combination therapy and the relationship between the treatment modalities and their outcome of maxillary sinus cancers. Materials and Methods: We retrospectively analyzed a clinical datas of 46 patients who were treated at the department of Otolaryngology-Head and Neck Surgery. The Catholic University of Korea over 10 years between 1987 and 1996. Results: According to AJCC TNM system, 35 patients presented with $T_4$, 10 with $T_3$, one with T1. Two patients were treated with radiotherapy alone, 4 patients with chemotherapy alone, 17 patients with radiotherapy and chemotherapy, 23 patients with combination of surgery, radiotherapy and chemotherapy. The overall 5 years survival rate for combination therapy group were 57%, but 23 patients treated with the other treatment modalities all died within 2 years except two cases with chemotherapy and radiotherapy or radiotherapy alone. There was a statistical trend for better survival and local control in those patients treated with combination therapy than others(p<0.05). Conclusion: The results of this study suggest that it may be possible to acheive better results with aggressive combination treatment including surgery in advanced cases and to avoid orbital excentration in patients with orbital invasion.

• Radiation Oncology Journal
• /
• v.13 no.2
• /
• pp.129-142
• /
• 1995

Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

• Journal of Veterinary Clinics
• /
• v.36 no.5
• /
• pp.274-277
• /
• 2019

A Miniature Schnauzer presented with bilateral mucopurulent nasal discharge and sneezing. Computed tomography of the skull revealed exudates in the nasal cavity and frontal gyrus. Nasal swab cytology showed features of an epithelial-origin tumor. Histopathologic evaluation of the biopsy specimen revealed irregular proliferation of epithelial cells and necrotized tissue. Positive immunohistochemical staining confirmed the epithelial origin of the cells. The dog was diagnosed with nasal carcinoma and was treated with a chemotherapy protocol of carboplatin and piroxicam. This report confirms the effectiveness of combination chemotherapy only without radiotherapy in a dog with nasal carcinoma and provides a guideline for providing alternative treatment.

• Radiation Oncology Journal
• /
• v.2 no.2
• /
• pp.221-228
• /
• 1984

The recogition that the vast majority of patients with small cell lung cancer have distant metastatic disease at the time of diagnosis lead to the use of systemic chemotherapy and consequent major improvement in survival, but recently evaulated treatment strategies, integration of large field chest irradiation with chemotherapy lead to the improved the local control and relapse free survival in limited SCLC. Therefore, it is logical to combine the two modalities in an effort to maximize the therapeutic effect. Authors performed the combination chemotherapy of CAV (Cyclophosphamide, Adriamycin, an6 Vincristine) and radiotherapy of primary tumor and regional lymphatics with prophylatic cranial irradiation in 42 patients of limited SCLC, from Mar. 1978 to Dec. 1982 Seoul National University Hospital. The results are as follows : 1. CR and PR after 2 cycles chemotherapy is $7\%$ and $43\%$, respectively however, subsequent response to radiotherapy is $38\%$ and $43\%$ in CR and PR. 2. Overall median survival peroid is 8.6 months. 3. 1 year and 2 years survival rate is $46.3\%$ and $20.5\%$, respectively. 4. Incidence of proven brain metastasis is $5\%$.

• Imaging Science in Dentistry
• /
• v.30 no.4
• /
• pp.287-292
• /
• 2000

A case of dento-maxillofacial abnormality involving a 10-year-old male patient with a history of esthesioneuro-blastoma is presented. This patient had been treated with 54 Gy /sup 60/Co-gamma-radiation to the nasal cavity for 6 weeks and 6 cycles of combination chemotherapy of Cyclophosphamide, Cisplatin, Adriamycin, VM-26 (Tenipo-side), and DTIC (Dacarbazine) when he was 16 months of age. Five years after cessation of cancer therapy, he was disease free and transferred for extensive dental care to Kyung Hee University Dental Hospital. A clinical and radiologic follow-up over last 4 years showed root stunting, premature closure of the root apices, microdontia, developmental arrest, small crowns, and partial anodontia. Maxillofacial morphology evaluated by cephalometric analysis showed deficiency of maxillary development.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.16
• /
• pp.7025-7029
• /
• 2015

Background: The optimal sequence and extent of multimodality therapy remains to be defined for extrapulmonary small cell carcinoma because of its rarity. The purpose of our study was to assess the response to neoadjuvant chemotherapy followed by chemoradiation/radiation in patients with extrapulmonary small cell carcinoma. Materials and Methods: Four consecutively diagnosed patients were included in this study. The primary tumor site was oropharynx in three patients and esophagus in one. The patients with the limited disease were treated with chemotherapy followed by concurrent chemoradiation (n=2) or radiotherapy (n=1). The patient with the extensive disease with the primary site in vallecula was treated with chemotherapy and palliative radiotherapy to the metastatic site. Results: The median follow-up was 22.5 months (range, 8-24 months). Three patients with the limited disease (base of tongue, n=2; esophagus, n=1) were in complete remission. The patient with the extensive disease died of loco-regional tumor progression at 8 months from the time of diagnosis. Conclusions: The combination of chemotherapy and radiotherapy is the preferred therapeutic approach for patients with extrapulmonary small cell carcinoma. Induction chemotherapy followed by concurrent chemoradiation or radiation provides a good loco-regional control in patients with limited disease.

• Radiation Oncology Journal
• /
• v.8 no.2
• /
• pp.261-267
• /
• 1990

Twenty patients with biopsy-proven Waldeyer's ring lymphoma were treated with radiotherpy between 1984 and 1990 at the Department of Radiation Therapy, Inje University Paik Hospital and seventeen evaluable patients were analysed retrospectively. Dose of radiation ranged from 35 to 50 Gy to Waldeyer's ring structure with an additional 5 and 10 Gy boost dose to the primary site. The lower cervical nodes received 35 to 60 Gy. The median follow-up period was 24 months (range;9 to 80 months). The 5-year overall survival rate was $50.2{\%}$ and 5-year disease free survival rate was $47.1{\%}$. The final local control rate was $82.4{\%}$. The relapse developed average 10 months after treatment. Most of relapses were systemic ($87.5{\%}$). The patients with stage I disease fared better than advance stage. The favorable histology of lymphoma showed better prognosis than unfavorable histology. There was no significant difference in survival rate between radiotherapy alone and combination of chemotherapy and radiotherapy in early stage lymphomas. But of the patients with advanced stage, those who received chemotherapy and radiotherapy had better prognosis than those treated with radiotherapy alone.