• Title/Summary/Keyword: Combined modality treatment

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Clinical Study of Acupucture Effect on Microtraumatic Injuries of the Knee Joint (슬관절 미세손상환자의 침치료에 관한 임상적 고찰)

  • Woo, Young-Min;Lee, Jin-Heon;Kim, Jean-Moon;Nam, Young
    • Journal of Acupuncture Research
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    • v.17 no.4
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    • pp.88-99
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    • 2000
  • Objectives : This study was performed to evaluate the clinical effect of acupuncture on microtraumatic injuries of the knee joint. Methods : Among the outpatients with knee joint pain who visited to Department of Acupuncture & Moxibustion, National Medical Center from February 2000 to September 2000, we selected 15 cases that showed normal finding in both X-ray and neurological examination, and that were categorized into microtraumatic injuries by the physical examination based on the Cyriax's orthopedic medicine. During acupuncture therapy, the patients were ordered to move involved side actively. The effect was assessed through questionnaires of CNRS(Cincinnati Knee Rating System). Results : We investigated 11 female and 4 male patients. The most common distribution of age was 30's(40%). The most commom duration of symtoms was from 3 to 5 months(40%). The most common microtraumatic injury was pes anserinus bursitis(33.3%), and followed by iliotibial band friction syndrome(20%), and patellar tendinitis(20%). In the CNRS, the mean number of before treatment was 60.6 and after was 66.5. 10 cases among the 15 patients were improved(66.6%). Conclusions : These results suggest that the acupuncture therapy combined with active movements of involved side was effective treatment modality on microtraumatic injuries of the knee joint.

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Importance of PET/CT Scan Use in Planning Radiation Therapy for Lymphoma

  • Milana, Mitric-Askovic;Marko, Erak;Miroslav, Latinovic;Tihomir, Dugandzija
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2051-2054
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    • 2015
  • Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.

Imaging Cancer Metabolism

  • Momcilovic, Milica;Shackelford, David B.
    • Biomolecules & Therapeutics
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    • v.26 no.1
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    • pp.81-92
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    • 2018
  • It is widely accepted that altered metabolism contributes to cancer growth and has been described as a hallmark of cancer. Our view and understanding of cancer metabolism has expanded at a rapid pace, however, there remains a need to study metabolic dependencies of human cancer in vivo. Recent studies have sought to utilize multi-modality imaging (MMI) techniques in order to build a more detailed and comprehensive understanding of cancer metabolism. MMI combines several in vivo techniques that can provide complementary information related to cancer metabolism. We describe several non-invasive imaging techniques that provide both anatomical and functional information related to tumor metabolism. These imaging modalities include: positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) that uses hyperpolarized probes and optical imaging utilizing bioluminescence and quantification of light emitted. We describe how these imaging modalities can be combined with mass spectrometry and quantitative immunochemistry to obtain more complete picture of cancer metabolism. In vivo studies of tumor metabolism are emerging in the field and represent an important component to our understanding of how metabolism shapes and defines cancer initiation, progression and response to treatment. In this review we describe in vivo based studies of cancer metabolism that have taken advantage of MMI in both pre-clinical and clinical studies. MMI promises to advance our understanding of cancer metabolism in both basic research and clinical settings with the ultimate goal of improving detection, diagnosis and treatment of cancer patients.

Two Cases of Nasopharyngeal Carcinoma Treated with Co-60 HDR ICR (강내 조사를 이용한 비인강압 치험2예)

  • Shin, Sei-One;Kang, Cheol-Hoon;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.197-201
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    • 1990
  • The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system(RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.

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Synchronous Carotid Body and Glomus Jugulare Tumors : A Case Report and Review of Literature

  • Md Atikur Rahman;Tejas Venkataram;Riad Habib;Nwoshin Jahan;Farid Raihan;Shamsul Alam;Ehsan Mahmood;Giuseppe E Umana;Bipin Chaurasia
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.122-129
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    • 2024
  • Paragangliomas are rare neuroendocrine tumors that are usually benign in nature. They may be either familial or sporadic in their occurrence. Numerous neuroendocrine tumors are collectively included under the umbrella of paragangliomas. Among them, carotid body tumors and glomus jugulare tumors are extremely rare. Thus, we present a rare case of 29-year-old male who was admitted with hearing difficulties and tinnitus in the left ear, with swelling on the left side of the neck. Based on clinical and radiological findings, a diagnosis of left-sided glomus jugulare with carotid body tumor was made. The patient underwent a two-stage surgery with an interval of approximately 2 months. Histopathology revealed a paraganglioma. Herein, we present the clinical features, imaging findings, management, and a brief review of literature on the classification, evaluation, and management of carotid body and glomus jugulare tumors. Paraganglioma is a slow-growing tumor. The synchronous occurrence of carotid body and glomus jugulare tumors is infrequent. Microsurgical resection remains the primary treatment modality. Therefore, our patient underwent two-stage surgery. The rarity of occurrence and the proximity and adherence to vital neurovascular structures have resulted in the treatment of paragangliomas remaining a challenge.

Biochemical Changes of Liver Function in Patients with Hepatocellular Carcinoma Following Radiotherapy and Hyperthermia (진행된 원발성 간암 환자에서 방사선 치료 및 온열 요법에 따른 간 기능의 변화)

  • Oh Young Taek;Seong Jinsil;Shin Hyun Soo;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.109-117
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    • 1993
  • To analyze biochemical changes of liver function following combined radiotherapy and hyperthermia, we reviewed retrospectively 37 patients with hepatocellular carcinoma treated with radiotherapy and hyperthermia between July 1988 and December 1990 at Department of Radiation Oncology, Yonsei University College of Medicine. Mean age was 52.7 years and male to female ratio was 11:1. The patients were classified as follows; to A and B group by Child's classification, to M and L group by irradiated volume, and subclassified into BM, BL, AM and AL group according to the combination of Child's classification and irradiated volume. Radiation dose to the primary tumor was 3060 cGy with daily 180 cGy, 5 fraction per week using 10 MV or 4 MV linear accelerator. Hyperthermia (Thermotron RF-8) was performed more than 4 times in all patients. Biochemical parameters including albumin (Alb), total bilirubin (T. Bil), aspartate aminotransferase (AST or SGOT), alanine aminotransferase (ALT or SGPT), and alkaline phosphatase (ALP) were regularly followed from 1 week before the treatment to 3 months after the treatment. The results are summerized as follows; 1) In all the patient, mean ALP level peaked at 1 month, decreased at 2 months, slightly increased at 3 months after the treatment. Mean SGOT and SGPT levels peaked at 1 month after the treatment. Mean T. Bil level increased continuously and highest at 3 months after the treatment. Mean Alb level did not show significant changes.; 2) Mean ALP level retured to normal level at 3 month after the treatment in A but increased in B group and the differences were statistically significant (p<0.01). Mean SGOT and SGPT levels peaked 1 month in A and 2 months after the treatment in B group. All the biochemical parameters did not show significant difference between M and L group. Mean ALP level increased at 3 months after the treatment in BM and BL groups and decreased in AM and AL groups. Mean SGOT level increased at 3 months after the treatment in BL groups.; 3) Hepatic failure occurred within 3 months after the treatment in 4 patients, all of whom were in BL group. It is suggested that pre-treatment liver function and irradiated volume influence biochemical changes of liver in patients with hepatocellular carcinoma following combined radiotherapy and hyperthermia, and this treatment modality appears generally to be safe but might cause hepatic failure particularly in patient with poor liver function and large treatment volume.

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Treatment Outcome for Head and Neck Squamous Cell Carcinoma in a Developing Country: University Malaya Medical Centre, Malaysia from 2003-2010

  • Wong, Yoke Fui;Yusof, Mastura Md;Ishak, Wan Zamaniah Wan;Alip, Adlinda;Phua, Vincent Chee Ee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2903-2908
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    • 2015
  • Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage. Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia. Conclusions: The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

Treatment of MFH(Malignant fibrous histiocytoma) in Extremity (사지에 발생한 악성섬유조직구종의 치료 경험)

  • Kang, Jong Hwa;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.439-445
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    • 2008
  • Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

Epidermoid Carcinoma of the Larynx - Twenty-year Experience with 263 Cases - (후두(候頭) 유표피암(類表皮癌) - 20년간(年間) 263 치험례(治驗例)를 중심(中心)으로 -)

  • Park Yoon-Kyu;Yoo Bong-Ok;Seel David J.;Lee Young-Sik;Chun Kyung-Doo
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.15-24
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    • 1987
  • This study is limited to epidermoid carcinoma arising in the larynx. The 623 patients in this series comprised 1.6% of all malignant neoplasms seen during the 20-year period .from 1965 to 1984 ; it comprised 13.2% of all cancers of the head and neck registered during this period. The male: female ratio was 11:1, and the highest incidence was in the fifth decade of life. Analysis by anatomical site revealed that 51.7% were supraglottic, 36.1% glottic, and 6.8% subglottic in oriain. One-hundred eighty-nine(79%) were clinically Stage III or Stage IV lesions at the time of the first visit. Of the total of 263 cases, 113 refused treatment, 4 definite radiation for $T_1$. lesion,21 underwent palliative therapy only, and 125 underwent surgical management with intent to cure. This surgical category included 53 patients who had surgical treatment only and 72 who underwent combined therapy(preoperative radiation, postoperative radiation, or inductive chemotherapy followed by surgery and postoperative radiation). The surgical management varied from partial laryngectomy to widefield laryngectomy and ipsilateral neck dissection. In 14.4% pathologically positive node or nodes were found in the clinically negative contralateral neck nedes. Such contralateral spread was most common in supraglottic site of origin(222%). Combined modality of management was compared to single therapy. Although results at three years showed no difference in determinate disease-free survival between patients treated by surgery only and those treated by surgery followed by postoperative radiation therapy at 5 years a statistically significant difference emerged, only 36% of those receiving surgery alone surviving as compared to 65.4% in the surgery with radiation group.

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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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