• Title/Summary/Keyword: Combined modality therapy

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Result of Surgical Treatment of Stage IIIB Lung Cancer (제3D 병기 폐암의 수술성적)

  • 홍기표
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.173-178
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    • 2000
  • Background: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer Material and method: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. Result: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) Conclsion: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.

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The effects of Cox distraction manipulation on functional assessment measures and disc herniation index in patients with L4-5 herniated disc (칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과)

  • Kwon, Won-An;Ryu, Young-Sang;Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.4
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    • pp.727-738
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    • 2012
  • The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

The Results of Combined Modality Treatment with Transurethral Resection, Cisplatin and Radiation Therapy for Invasive Bladder Cancer (침윤성 방광암에서 경요도적절제술 및 Cisplatin과 방사선의 병용치료의 효과)

  • Oh, Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.311-317
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    • 1991
  • Ten patients with deep muscle-invading bladder carcinoma (clinical stages T3a to T4b) who were not candidates for cystectomy were treated with combined modality treatment with transurethral resection, cisplatin chemotherapy and pelvic irradiation from 1989 through 1990, and were analyzed retrospectively. All patients were not candidates for cystectomy because the tumors were judged unresectable or they were not fit for a radical cystectomy. Of the patients 5 had clinical stage T3a, 3 stage T3b and 2 stage T4b disease. The minimum follow-up was 16 months. The complete response rate is 60$\%$ for all patients. The complete responses were achieved in 4 of 5(80$\%$) with stage cT3a, in 2 of 3(67$\%$)with stage cT3b and in none of 2(0$\%$) with stage cT4b. The partial responses were achieved in 2, so an overall response rate was 80$\%$. All six patients with grade I or II transitional cell carcinoma showed complete responses. Four patients with higher grade tumors showed partial responses in 2 and no response in 2, and all died of their bladder cancer. Six patients who showed complete responses after treatment are alive and only one of them showed a local recurrence 10 months after treatment. Distant metastases developed in 3 patients: lungs in 2(cT4b) of those who were never locally free of disease and spine in 1 patient (cT3b) among those with a partial response. Two patients died of metastases to lungs. During the follow-up diarrhea occurred in one which was improved after conservative treatment. On the basis of this analysis it is suggested that combined modality treatment seems to be a tolerable regimen and can be offered with a relatively high probability of success and conservation of bladder function in those with less advanced tumors by clinical stage and low grade.

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Effect and Safety of Combined Treatment of Gambihwan and Garcinia Cambogia on Weight Loss: A Retrospective Observational Study (감비환과 가르시니아 캄보지아 병용 투여의 체중감량 효과와 안전성: 후향적 관찰연구)

  • Yoon, Sang-Hoon;Lee, Eunji;Jo, Hyunjung;Han, Yeji;Kim, Hyunho;Yun, Younghee;Choi, Ye-yong;Park, Jongseung;Leem, Jungtae
    • Journal of Korean Medicine for Obesity Research
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    • v.20 no.1
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    • pp.31-39
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    • 2020
  • Objectives: Obesity is becoming more popular disease worldwide. Because of the side effects of conventional obesity treatment modality, herbal medicine treatment is becoming more preferred. Gambihwan which including Ephedra sinica Staph is widely used in traditional Korean Medicine practice for obesity treatment. Garcinia cambogia is a kind of health functional food that has body fat reducing effect. Nowadays, ephedra and Garcinia cambogia are often used simultaneously in clinical practice of Korean Medicine. However, the effectiveness and safety of combination therapy in obesity treatment is not well established. Methods: We conducted retrospective observational study to explore effectiveness and safety of combination therapy. We evaluated effect of combined treatment of Gambihwan and Garcinia cambogia on body weight, body mass index, body fat mass, and waist hip ratio reduction. We also assessed safety via liver function test and adverse event. Results: Finally, 23 patients were included. In paired t-test, body weight significantly decreased from 64.50±14.50 kg to 62.94±13.85 kg (P<0.001) and body mass index were also significantly decreased from 24.43±3.79 kg/㎡ to 23.83±3.59 kg/㎡ (P<0.001). Body fat mass was also reduced. Aspartate transaminase and alanine aminotransferase were not significantly increased. There were no drug-induced liver injury and no severe adverse event. Conclusions: In our retrospective review, we found combination therapy of Gambihwan and Garcinia cambogia reduce body weight, body mass index and body fat mass. There were no severe adverse event and drug induced liver injury which indicated safety of combination therapy in obesity treatment.

Postoperative Radiotherapy for Locally Advanced Gastric Cancer (국소적으로 진행된 위암의 수술후 방사선 치료성적)

  • Lee Myung Za;Chun Ha Chung;Kim Insoon;Chung Tejune
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.113-119
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    • 1997
  • Purpose : Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. Material and Method : From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adiuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs) . Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively Chemotherapy was given to all patients except two. Results : Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of jnvolved/dissected Iymph node, signet ring histology showed Poor Prognosis with statistical significance. Presence of residual tumor after surgery, stageIV. split course of radiation therapy, age, number of involved Iymph node, number of Iymph node dissection and grade of tumor affected survival without statistical significance, Type of chemotherapy did not affect survival. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and I-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six Patients(8.8%) had weigh loss more than 10%. Conclusion : Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high Five-rear surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival, To evaluate role of radiation Prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.

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Radiation Therapy of Primary Carcinoma of the Vagina (원발성 질암의 방사선치료)

  • Huh, Seung-Jae;Shin, Kyung-Hwan;Ahn, Yong-Chan;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.63-67
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    • 1995
  • A retrospective study was carried out of 20 patients with histologically proven invasive carcinoma of the vagina from 1979 to 1993; 17 cases with curative primary radiotherapy and three cases with postoperative radiotherapy. The five and ten year overall survival rates were $79\%$ and $53\%$, respectively. Survival was strongly correlated with stage. Five year survival rates of stage I, stage II, and stage III, IV were $100\%$, $78\%$, and $0\%$, respectively. Eight patients experienced recurrences: five within the irradiated volume, two distant metastasis, and one combined both local and distant metastasis. There was no significant late complication. From these data, radiation is effective in the management of the vaginal cancer patients and optimum treatment modality and total dose recommendation are made.

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Improved Survival of a Patient with Gastric and Other Multiple Metastases from Ovarian Cancer by Multimodal Treatment: A Case Report

  • Hwangbo, Seonmi;Kwon, Oh Kyoung;Chung, Ho Young;Yu, Wansik
    • Journal of Gastric Cancer
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    • v.15 no.3
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    • pp.218-221
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    • 2015
  • Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

Bladder Preservation by Combined Modality Therapy for Invasive Bladder Cancer : A Five-Year Follow-up (근침윤성 방광암에서 화학방사선 병용을 통한 방광보존치료)

  • Cho Jae Ho;Lim Jihoon;Seong Jinsil;Pyo Hong Ryull;Koom Woong Soup;Suh Chang Ok;Hong Sung Jun
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.359-368
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    • 2001
  • Purpose : To determine the long-term results of bladder-preserving approach by transurethral resection of the bladder (TURB), systemic chemotherapy, and radiation therapy for muscle-invasive bladder cancer Methods and materiaals : From 1991 Jan. through 1994 Dec., 25 patients with muscle invading clinical stage T2 to T4NxM0 bladder cancer were treated with induction by maximal TURB and (arm 1, n=4) three cycles of chemotherapy [MVAC(methotrexate, vincristine, adriamycin, ciplatin)] followed by 64.8 Gy of radiation with concomitant cisplatin, or two cycles of chemotherapy [MCV (methotrexate, ciplatin, vincristine)] after irradiation with concomitant cisplatin (arm 2, n=14), or concurrent chemoradiation only (arm 3, n=7). Tumor response was scored as a clinical complete response (CR) when the cystoscopic tumor-site biopsy and urine cytology results were negative. Those with less than a CR underwent cystectomy. The median follow-up of all patients was 70 months. Resulst : Most treatment toxicities were mild to moderate. Grade 3 acute hematologic toxicity and chronic cystitis were observed in only 1 and 2 patients, respectively. Overall 5 year survival was $67.3\%$. Complete remission rate was $80\%$ (20/25). Sixty-three percent of all survivors retained their bladders. In multivariate analysis, prognostic factors that significantly affect survival were T-stage (p=0.013) and Complete remission (p=0.002). Conclusion : Combined modality therapy with TURB, chemotherapy, and radiation has a $67.3\%$ overall 5 year survival rate. This result is similar to cystectomy-based studies for patients of similar clinical stages.

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An Experimental Study on the Effectiveness of Microwave Hyperthermia Combined with Radiation on the Small and Large Intestine in rats (흰쥐의 장조직에 X-선 조사와 마이크로파 온열요법의 효과에 관한 실험적 연구)

  • Ahn, Kyung-Sook;Lee, Kyung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.83-95
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    • 1987
  • The synergistic effect of combining radiation therapy and hyperthermia kills significantly more cells than using either modality alone. The reason for enhanced cell killing from the combined treatment is that the two modalities are complementary. For histopathological exmination, 102 rats were divided into 4 groups as hyperthermia, radiation, hyperthermia combined with radiation and normal control groups. The effect of prior irradiation (6-15 Gy of X-ray) on the response of small and large bowel of rats to $40^{\circ}C-44^{\circ}C$ (for 30 minutes) microwave (2450 MHz) hyperthermia was investigated. The musculature of the small and large intestine remained intact and the circumference of the histological sections were not significantly altered by the heated at $43^{\circ}C$ for 30 minutes. Thermal enhancement ratios of normal tissue is 1.0 Thermal enhancement ratio was not increased in combination therapy by evaluation of histopathologic changes in small and large intestine.

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Treatment Results in Patients with Salivary Gland Malignancy (타액선 악성 종양 환자에 대한 치료성적)

  • Song Dal-Won;Ahn Jae-Hyun;Sohn Jin-Sik;Kim Tae-Jong;Ahn Byung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.46-51
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    • 2000
  • Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

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