• Title/Summary/Keyword: Combined modality treatment

Search Result 137, Processing Time 0.019 seconds

Radiation Treatment and Survival of Maxillary Sinus Carcinoma (상악동암의 방사선치료와 생존율)

  • Oh W.Y.;Kim G.E.;Suh C.O.;Loh J.K.;Hong W.P.;Kim K.M.;Lee W.S.
    • Korean Journal of Head & Neck Oncology
    • /
    • v.3 no.1
    • /
    • pp.25-35
    • /
    • 1987
  • Irradiated 88 patients of Maxillary Sinus Carcinoma at Yonsei Cancer Center for 10years between 1971 and 1980 were retrospectively analysed. The majority of patients had very advanced disease(87.5% of $T_3\;and\;T_4$) and 17% of cervical lymph node involvement. 80.6% of all patients were epidermoid type. In 44 cases(50%), irradiation alone was performed. 28 cases(32%) of postoperative radiation after incomplete surgery and the remaining 16 cases(18%) of postoperative radiation after radical surgery were done. The majority of patients except 6 cases had irradiation a dose between 60Gy and 80Gy in 30-40 fractions over 6-8 weeks. The actuarial overall 3 and 5 year survival rate were 362% and 26%, respectively. The actuarial 5 year survival rate for 44 cases of radiation alone group was 14.1%, The actuarial 5 year survival rate for 28 cases of incomplete surgery and postoperative radiation group and 16 cases of radical surgery and postoperative radiation group were 312% and 67.4% respectively. In the actuarial 5 year survival rate according to the stage, stage II, III and IV were 79.5%, 20.9% and 0%. In recent, for the improvement of survival rate of advanced Maxillary Sinus Carcinoma at Yonsei Cancer Center, combined multidisplinary or trimodal treatment modality have been applied and in near time the more excellent results expect to be analyse.

  • PDF

RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS (하악골 골절후 이차감염으로 인한 골수염시 유리 장골 이식술과 고압산소 요법을 이용한 재건 치험례)

  • Kim, Su-Nam;Lee, Dong-kuen;Lim, Chang-Joon;Yun, Seong-Pill
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.13 no.1
    • /
    • pp.110-116
    • /
    • 1991
  • Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

  • PDF

Head and neck extra nodal NHL (HNENL) - Treatment Outcome and Pattern of failure - A Single Institution Experience

  • Giridhar, Prashanth;Mallick, Supriya;Bhasker, Suman;Pathy, Sushmita;Mohanti, Bidhu Kalyan;Biswas, Ahitagni;Sharma, Atul
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.15
    • /
    • pp.6267-6272
    • /
    • 2015
  • Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.

Arthroscopic Repair for the Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열의 관절경적 봉합술)

  • Choi, Chong-Hyuk;Yoon, Han-Kook;Kim, Hyung-Sik
    • Journal of the Korean Arthroscopy Society
    • /
    • v.9 no.2
    • /
    • pp.137-142
    • /
    • 2005
  • Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

  • PDF

Microstructural Changes after Intramuscular Injection of Lidocaine and Dexamethasone (Lidocaine과 dexamethasone 혼합용액의 근육내 주사 후 조직학적 변화)

  • Jang, Seong-Min;Lee, Kyong-Eun
    • Journal of Oral Medicine and Pain
    • /
    • v.30 no.1
    • /
    • pp.25-34
    • /
    • 2005
  • A trigger point injection (TPI) has been reported to have an immediate analgesic effect, and to be one of the most widely employed treatment methods of myofascial pain. There are normal saline, local anesthetics, and steroids as the solutions frequently used in TPI. They can be used separately or in combination. Local anaesthetics have myotoxicity in proportion to its concentration. The purpose of this study was to evaluate microstructural changes in point of the myotoxic effects of the combined solution of lidocaine and dexamethasone (a local anesthetic and a steroid) after being injected into the muscle of BALB/c mice. And this study tested solutions with various concentration separately and in combination, to find out proper concentration of solution without muscular tissue damage. This study shows that lidocaine and dexamethasone combination is not histologically myotoxic in case of the concentration of lidocaine less than 1.5%. Also it is suggested from this study that this combined solution will have an analgesic and anti-inflammatory effect. Hereafter continuous study should be performed to reveal that these results can be applied to human when lidocaine and dexamethasone combination is used as an injection modality of TrP treatment.

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
    • /
    • v.5 no.2
    • /
    • pp.83-95
    • /
    • 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.

  • PDF

Treatment outcome of postoperative radiotherapy for retroperitoneal sarcoma

  • Lee, Hyun-Jin;Song, Si-Yeol;Kwon, Tae-Won;Yook, Jeong-Hwan;Kim, Song-Cheol;Han, Duck-Jong;Kim, Choung-Soo;Ahn, Han-Jong;Chang, Heung-Moon;Ahn, Jin-Hee;Jwa, Eun-Jin;Lee, Sang-Wook;Kim, Jong-Hoon;Choi, Eun-Kyung;Shin, Seong-Soo;Ahn, Seung-Do
    • Radiation Oncology Journal
    • /
    • v.29 no.4
    • /
    • pp.260-268
    • /
    • 2011
  • Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

Management of Laryngeal Contact Granuloma (후두 접촉성 육아종의 치료)

  • Ko, Moon-Hee;Son, Young-Ik;Jang, Jeon-Yeob;So, Yoon-Kyoung;Chung, Man-Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.19 no.2
    • /
    • pp.128-132
    • /
    • 2008
  • Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

  • PDF

Treatment and Outcomes of Ewing Sarcoma in Turkish Adults: A Single Centre Experience

  • Seker, Mehmet Metin;Kos, Tugba;Ozdemir, Nuriye;Seker, Ayse;Aksoy, Sercan;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.1
    • /
    • pp.327-330
    • /
    • 2014
  • Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

Prognostic factores in the treatment of lung cancer related to postoperative radiochemoimmunotherapy; BPM therapy[PS-K] of lung cancer followed by surgery (폐암절제례의 예후와 면역요법)

  • 김광택
    • Journal of Chest Surgery
    • /
    • v.26 no.1
    • /
    • pp.47-53
    • /
    • 1993
  • The high relapse rate after curative surgery of lung cancer suggests that tumor cells are remained at the site of resection and in the distant organs. Postoperative radiochemoimmunotherapy including protein-bound polysaccharide PS-K[Copolang] and/or chemotherapy to improve the prognosis in lung cancer has been adopted. The patients with lung cancer who were treated with a combined modality therapy after surgery were reviewed to determine the effects of adjuvant immunotherapy[PS-K] and the relationship between midterm survival and clinicopathologic variables. During the past 5 years, 95 patients with lung cancer underwent resective operation. Of them, 30 cases were curative surgery, 29 were relative curative surgery, and the remainders were non-curative surgery. Postoperative combination therapies consisted of three types of therapies: postoperative BRM[biological response modifiers] with PS-K [Copolang] 50 mg/kg for 24 weeks[Group 1], chemoimmunotherapy with chemotherapy[a combination of cisplatin, etoposide, vindesine] and PS-K [Group 2], radioimmunotherapy with postoperative prophylactic irradiation to the mediastinum at total dose of 54 Gy-60 Gy and PS-K [Group 3] and surgery without adjuvant therapy[Group 4]. Twenty months survival rates of localized disease [Stages I and II] treated with PS-K, with radioimmunotherapy and no therapy were 73 %, 60 %, and 50 %, respectively [p [0.05]. Three-year survival rates of regionally advanced cases [stage Ilia and IIIb] were 23 % in Group 1.57 % in Group 2.20 % in Group 3, and 0 % in Group 4, respectively.According to above results, we suggest that postoperative combination therapy including PS-K might improve the prognosis of lung cancer. The similar survival pattern of patients with squamous cell carcinoma and adenocarcinoma treated with BRM, chemoimmunotherapy or radioimmunotherapy need to evaluate the role of postoperative immunotherapy[PS-K] in randomized studies.

  • PDF