• 제목/요약/키워드: Combined modality treatment

검색결과 137건 처리시간 0.025초

Breast Cancer Scenario in a Regional Cancer Centre in Eastern India over Eight Years - Still a Major Public Health Problem

  • Datta, Karabi;Choudhuri, Maitrayee;Guha, Subhas;Biswas, Jaydip
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.809-813
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    • 2012
  • In spite of screening and early diagnostic tests, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. The data collected by Population Based Cancer Registry in Chittaranjan National Cancer Institute, a regional cancer centre in Kolkata, from 1997 to 2004 gives an insight about the scenario of Breast Cancer in this part of Eastern India.The total no of female breast cancer cases were steadily increasing from 1997 to 2001 and only slightly lower from 2002 to 2004. and majority were in the 40-49 year old age group during this period. The next most commonly affected age group was 50-59 years. Regarding the distribution according to treatment, the main modality was surgery and radiotherapy followed by combined surgery, chemotherapy and radiotherapy and then combined surgery and chemotherapy. The commonest type was ductal followed by lobular cancer. In this eight year study in CNCI, status of patients on last day of the respective year was assessed. Number of patients alive was 43.5% in 1997. The percentage gradually increased up to 2000 and then gradually decreased to 47.4% in 2004. Also with every passing year, percentage mortality gradually decreased from 25.7% in 1997 to 16.8% in 2004. Better pattern of care (diagnosis and treatment) was reflected in this picture. However, lost to follow up, which also implies non compliance to treatment, increased to 30.8% in 1997 to 35.8% in 2004. Due to the small number of male breast cancers, only female cases were considered. In conclusion, breast cancer continues to be a major problem in Kolkata, India.

두경부 혈관중심성 T세포 림프종의 발생주위 및 병기별 치료결과 (Optimal Treatment Results of Angiocentric T Cell Lymphoma in Head and Neck according to the Subsites and Stage)

  • 최종욱;김정준;유찬기;팽재필;김형진;정광윤;최건
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.33-36
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    • 2000
  • Objectives: Angiocentric T-cell lymphoma of the head and neck is an angiocentric and angiodestructive lymphoreticular proliferative disorder. It has been treated with various treatment modalities, but its prognosis is poor and the treatment modality is controversial. We performed this study to suggest a treatment modality with improved results. Materials and Methods: We studied 40 cases of pathologically confirmed angiocentric T-cell lymphoma from July 1984 to December 1996, 35 cases of which showed complete response after initial treatment. All the patients were divided into two groups according to treatment modality. 15 cases received radiotherapy alone (Group I) and 20 cases received radiotherapy after five cycles of CHOP-Bleo chemotherapy(Group II). We analyzed the subsites of tumor, stage, treatment modality and treatment outcome and causes of failure for each group, and compared the three-year no evidence of disease(NED) between the two groups. Results: The three-year NED of a combined chemoradiotherapy was higher than that of a radiotherapy alone (p=0.0478). The three-year NED according to groups and stage were as follows: Group I=6/15(40.0%), stage IE=5/10(50.0%), stage IIE=1/5(20%), Group II=13/20(65.0%), stage IE=9/13(69.2%), stage IIE=4/7(57.1%). Radiotherapy alone is not well effective for the nasal cavity lymphoma extended to paranasal sinus and the palate. Conclusion: We are unable to provide clear guidelines for treatment, but recommend the initial treatment with oral alkylating agents and steroids followed by radiotherapy for Ann Arbor stage II tumors and stage I of the palate lymphoma and the nasal cavity lymphoma extended to paranasal sinus.

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나팔관 인공수정 및 미세난관 성형수술 후 발생된 병합임신 1례 (A Case of Combined Pregnancy Following GIFT with Microsurgery)

  • 김은임;송정수;유정자;목영자
    • Clinical and Experimental Reproductive Medicine
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    • 제16권1호
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    • pp.103-106
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    • 1989
  • Gamete intrafollopian transfer, a varient of IVF, is becoming increasingly popular as a treatment modality for infertility in women with at least one healthy follopian tube. Although GIFT has recently been poprlarized as a safe and effective treatment in selected infertile couples, little discussion of potential complications has been published. Whereas a tubal pregnancy rate of approximately 5% has been noted for IVF, early reports of GIFT have noted ectopic pregnancy to be relativiely rare. We experienced a case of combined pregnancy following GIFT with microsurgery and now present it with brief review of related literatures.

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Ewing's Sarcoma of the Stomach; Rare Case of Ewing's Sarcoma and Suggestion of New Treatment Strategy

  • Kim, Hyo-Sin;Kim, Sungsoo;Min, Young-Don;Kee, Keun-Hong;Hong, Ran
    • Journal of Gastric Cancer
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    • 제12권4호
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    • pp.258-261
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    • 2012
  • Ewing's sarcoma is a neoplasm of the undifferenciated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. We present a case of gastric Ewing's sarcoma; a 35-year-old female who had no symptoms. While she was at a routine medical checkup, a protruding mass in her gastric antrum was incidentally found on esophagogastroduodenoscopy. Endoscopic ultrasonogram showed a submucosal mass on the same lesion and a laparosopic wedge resection was done. Pathologic gross findings showed a granular grape appearance tissue and histoloigc examination revealed a small round cell tumor with CD 99 immunoexpression positive. In general, a combined modality therapy for Ewing's sarcoma such as surgical resection with chemotherapy, is accepted as an effective method. However, this patient had no adjuvant chemotherapy after surgery and she has no recurrence for eleven months.

국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과 (The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer)

  • 김재철;장양숙;류삼열;박인규
    • Radiation Oncology Journal
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    • 제7권2호
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    • pp.205-211
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    • 1989
  • 1984년 7월부터 1988년 9월까지 경북대학교병원 치료방사선과에서 소세포 폐암으로 진단되어 복합화학요법 및 방사선 병용치료를 받은 27명을 대상으로 치료성적을 분석하였다. 완전관해율은 $70\%$, 부분관해율은 $22\%$, 무반응은 $8\%$였다. 여자, 수행상태 HO, 방사선량 4500cGy이상, 화학요법 4회 이상, 그리고 혈청 enolase수치 30ng/m1 이하 등에서 완전관해율이 높게 나타났으나 통계적 의의는 없었다. 중앙생존기간은 10개월이었고 1년생존율과 2년 생존율은 각각 $40.7\%$$12.2\%$였다. 생존율을 높이는 인자로는 수험상태 HO (p<005), 완전관해 (p<0.05), 하학요법 4회 이상(p<005), 방사선량 4500 cGy이상 등으로 나타났으며, 성별과 예방적 전뇌조사는 영향을 미치지 않았다.

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국한성 두경부 비호지킨스 림프종 환자에서의 다방면치료 (Multimodal Approaches in the Patients with Stage I,II Non-Hodgkin's Lymphoma of the Head and Neck)

  • 표홍렬;서창옥;김귀언;노재경
    • Radiation Oncology Journal
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    • 제13권2호
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    • pp.129-142
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    • 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.

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식도암의 근치적 치료성적 및 예후인자 (Treatment Result and Prognostic Factors in Pateints with Esophageal Cancer)

  • 정원규;김수곤;김민철;장명;문성록
    • Radiation Oncology Journal
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    • 제13권3호
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    • pp.233-241
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    • 1995
  • Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.

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외상성 하행 흉부 가성대동맥류에 대한 스텐트-그라프트 치료 - 1예 보고 - (Stent-graft Treatment for a Traumatic Pseudoaneurysm of the Descending Thoracic Aorta -A case report-)

  • 김대현;김범식;김중헌
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.373-376
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    • 2008
  • 외상성 흉부 대동맥 파열에 의한 가성대동맥류에 대한 일반적인 치료 방법은 수술이다. 그러나 환자의 전신상태가 개흉술을 통한 수술 또는 체외순환보조를 통한 수술을 시행 받기 어려운 경우에는 다른 치료 방법을 선택해야 한다. 저자들은 두부, 복부, 골반의 광범위한 다발성 손상이 동반되어 수술적 치료를 시행하기 어려웠던 대동맥파열에 의한 가성대동맥류 환자에 대하여 중재적 시술을 통해 스텐트-그라프트를 삽입하여 치료한 1예를 문헌 고찰과 함께 보고하는 바이다.

Enhanced Susceptibility of Human Squamous Cell Carcinoma to Photodynamic Therapy Combined with Administration of Cisplatin

  • 안진철
    • 대한의생명과학회지
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    • 제14권2호
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    • pp.83-89
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    • 2008
  • We have compared the antitumor effect of photodynamic therapy (PDT), using 5-aminolevulinic acid (ALA) as the photosensitizer, combined with cisplatin (CDDP) on AMC-HN3 human squamous cell carcinoma. AMC-HN3 cells were cultured and then incubated with various concentrations of CDDP and ALA. 632 nm diode laser was given at $6.0J/cm^2$ followed by incubation for 24 hours. The evaluation of cell viability was done by MTT assay. In vivo CDDP was injected intraperitoneally 24 hours prior to PDT. The anti-tumor effects of each treatment were measured by tumor volume change. Cell viability were 44.29% for the cisplatin-mediated chemotherapy group $(6.25{\mu}g/ml)$, 77.22% for ALA-PDT group, and 15.06% for the Combination therapy group. In vivo, the antitumor effect of photodynamic therapy was enhanced by combination of Cisplatin-mediated chemotherapy. Photodynamic therapy combined with administration of Cisplatin appears to enhance antitumor effect and to be a useful treatment modality.

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다중영상기기의 응용 소프트웨어 (Multimodality and Application Software)

  • 임기천
    • Nuclear Medicine and Molecular Imaging
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    • 제42권2호
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    • pp.153-163
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    • 2008
  • 다중영상기기는 1990년대 초에 처음 개발되어 현재 주요 영상 장비 회사에서 상품으로 개발되어 판매되고 있다. 단순한 소프트웨어적인 정합과 융합을 통해 해부학적 영상과 기능적 영상의 상호 보완하는 단계에서 발전하여 하드웨어적으로 정합하는 하드웨어의 개발은 새로운 연구의 시작이다. 다중영상기기의 발전 이전에는 해부학적 구조를 보여주는 영상 장비와 기능적 영상을 표현하는 장비가 각각 고 분해능과 고 해상도로 많은 발전을 이루어 왔다. 현재는 각 영상 장비의 특징을 살려 효과적으로 결합시킨 다중영상기기의 개발이 활발하게 이루어지고 있다. 다중영상기기는 단순하게 두 장비를 결합시키는 개념에서 기능적 영상에서 필요한 감쇠 보정을 하면서 동시에 해부학적 위치를 융합 영상 형태로 표현하는 새로운 영상 장비로 발전하고 있다 다중영상기기의 특징을 살릴 수 있는 프로토콜이 개발되고 하드웨어적으로도 상호 보완적으로 결합되고 있다. 실제로 PET/CT와 같은 다중영상기기는 임상적으로 중요한 역할을 하고 있으며 PET 영상기기를 대체하고 있다. PET/CT 스캐너는 PET에서 나오는 기능적 영상과 CT에서 나오는 해부학적 영상뿐만 아니라 융합 영상을 함께 보여 주므로 임상적으로 유용한 정보를 제공하고 있다. 현재 SPECT/CT는 아직 보급이 많이 되지 않았으나 PET/CT와 같이 임상적으로 유용한 SPECT와 CT 장비가 결합된 상품들이 나오고 있어 그 시장이 점점 성장할 것으로 기대된다. 다중영상기기는 각각의 단독 영상장비에서 갖고 있는 문제뿐만 아니라 두 영상 장비를 결합시키므로 인해 새로운 문제들이 발생하고 있다. 대표적으로 호흡에 의한 움직임, 조영제의 영향, 금속 물질의 영향과 환자의 피폭에 관한 문제가 있다. 이를 해결하기 위해 새로운 프로토콜과 프로세싱 방법이 개발되고 있다. 뇌를 동시에 촬영할 수 있는 PET/MR의 개발은 뇌 과학에 많은 발전을 줄 것으로 기대된다. PET/MR의 개발은 PET/CT 에서 촬영한 영상의 일부분을 대체할 것으로 예상된다. MR 영상이 CT 영상보다 우수한 분해능을 보이는 분야에서는 PET/MR을 이용한 검사와 연구가 활발하게 진행될 것으로 보인다. 해부학적 영상과 기능적 영상을 결합시킨 융합 영상을 함께 제공하는 다중영상기기는 환자의 질병을 진단뿐만 아니라 치료 후의 효과를 보는데 있어서 중요한 역할을 할 것으로 기대된다. 또 앞으로 검사 목적에 맞는 다양한 다중영상기기의 개발이 이루어질 것으로 기대된다.