• Title/Summary/Keyword: Complete response

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Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

  • Elnemr, Gamal M;El-Rashidy, Ahmed H;Osman, Ahmed H;Issa, Lotfi F;Abbas, Osama A;Al-Zahrani, Abdullah S;El-Seman, Sheriff M;Mohammed, Amrallah A;Hassan, Abdelghani A
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.807-813
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    • 2016
  • Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.

Response Evaluation after Stereotactic Ablative Radiotherapy for Lung Cancer (초기 폐암의 정위방사선치료후 반응평가 분석)

  • Choi, Ji Hoon
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.229-233
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    • 2015
  • We retrospectively reviewed lung cancer patients who were treated with stereotactic ablative radiotherapy (SABR). We investigated the value of response evaluation after treatment by measuring the volume change of tumors on serial chest computed tomography (CT) examinations. The study included 11 consecutive patients with early-stage (T1-T2aN0M0) non-small cell lung cancer (NSCLC) who were treated with SABR. The median dose of SABR was 6,000 cGy (range 5,000~6,400) in five fractions. Sequential follow-up was performed with chest CT scans. Median follow-up time was 28 months. Radiologic measurement was performed on 51 CT scans with a median of 3 CT scans per patient. The median time to partial response ($T_{PR}$) was 3 months and median time to complete remission ($T_{CR}$) was 5 months. Overall response rate was 90.9% (10/11). Five patients had complete remission, five had partial response, and one patient developed progressive disease without response. On follow-up, three patients (27.2%) developed progressive disease after treatment. We evaluated the the response after SABR. Our data also showed the timing of response after SABR.

The Effect of External Radiation Therapy in Management of Malignant Obstructive Jaundice due to Porta Hepatis Metastasis from Stomach Cancer (위암의 간문맥 전이로 발생한 악성 폐쇄성 황달에 대한 외부 방사선치료 효과)

  • Yang, Kwang-Mo;Kim, Joon-Hee;Kim, Chul-Soo;Suh, Hyun-Suk;Kim, Re-Hwe
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.339-348
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    • 1995
  • Purpose : Since 1983, authors have conducted a study to evaluate the effect of external radiation therapy and to determine affected factors in management of the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. Materials and Methods : Thirty two patients with malignant obstructive jaundice due to porta hepatis metastasis from gastric cancer were presented. We have analysed 23 patients who were treated with external radiation therapy of more than 3000cGy. The radiation dose, disease extent at developement of jaundice, total bilirubin levels before radiation therapy, differentiation of histology, combind treatment, intent of primary surgery, initial stage of gastric cancer were analyzed to determine affected factors in radiation therapy. External radiation therapy was delivered with a daily dose of 180-300cGy, 5 times a week fractionation using 4 MeV linear accelerator. The radiation field included the porta hepatis with tumor mass by the abdominal ultrasonography or CT scan. In twenty three patients received more than 3000cGy, total irradiation dose was ranged from 3000cGy to 5480cGy, median 3770cGy. Among 23 patients, 13 patients were delivered more than equivalant dose of TDF 65(4140cGy/23fx). Results : Among 23 patients, complete, partial and no response were observed in 13, 5, 5 patients, respectively. The median survival for all patients was 5 momths. The significant prolongation of median survival was observed in complete responders(11 months) as compared to partial and no responders(5 months, 5 months respectively) Out of 13 patients with complete response, 6 patients lived more than a year Among 13 patients receiving more than 4140cGy equivalent dose, complete, partial and no response were observed in 10, 2 and 1 patients, respectively. The median survival for all these patients was 9.5 months. The median survival for complete responders(10/13) was 11.5 months. Among 10 patients receiving less than 4140cGy equivalent dose, complete, partial and no response were observed in 3, 3, 4 patients, respetively. The median survival for all these patients was 4.3 months Therefore, the radiation dose affected the results of treatment. For the complete response with prolongation of survival duration, at least 4140cGy equivalant dose should be delivered to porta hepatis. In evaluation of the disease extent, 7 patients of 13 complete responders showed localized disease in porta hepatis or peripancreatic area, but all patients with partial and no response showed wide extensive disease or persistant disease of primary gastric cancer. Therefore. the patients with the localized disease were the higher probability of complete response and long term survival. This study suggested that the radiation dose and the disease extent at developement of jaundice affected in radiation therapy for malignant obstructive jaundice. There were no serious complications related to external radiation therapy. Conclusion : External radiation therapy only could achieve the palliative effect in the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. This study suggested that the prolongation of survival duration could be achived in complete responders and radiation dose, extent of disease affected the results of treatment of malignant obstructive jaundice.

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Application of Response Spectrum Analysis Method for the Estimation of the Vertical Vibration in Structures (구조물의 연직진동해석을 위한 응답 스펙트럼 해석법의 활용)

  • 이동근
    • Proceedings of the Earthquake Engineering Society of Korea Conference
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    • 1998.10a
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    • pp.12-19
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    • 1998
  • Response spectrum analysis method is widely used for seismic analysis of building structure. Analysis of structural vibration for equipment, machine and moving loads are executed by time history analysis. This method is very complex, difficult and tedious. In this study, maximum response of structure for this case are simply and fast. calculated by mode shape and response spectrum for excitation. At first, Response spectrum and time history analysis for some earthquake is carried and investigate the error of maximum displacement response for R. S. A. Secondly, The process for response spectrum analysis in excitation are calculated, and maximum model response are combined by CQC (Complete Quadratic Combination) methods. Finally, Combining maximum displacement response is compared with one of time history analysis.

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Mediastinal Paraganglioma: Complete Resection Using Video-Assisted Thoracoscopic Surgery

  • Kim, Dohun;Kim, Si-Wook;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.197-199
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    • 2014
  • Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.

Surgery of Advanced Esophageal Cancer after Chemotherapy (선행화학요법을 시행한 식도암 환자의 외과적 고찰)

  • 임수빈;이종목
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.536-541
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    • 1996
  • Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.

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Dynamic response of a hinged-free beam subjected to impact at an arbitrary location along its span with shear effect

  • Zhang, Y.;Yang, J.L.
    • Structural Engineering and Mechanics
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    • v.26 no.5
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    • pp.483-498
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    • 2007
  • In case of considering the shear effect, the complete solutions are obtained for dynamic plastic response of a rigid, perfectly plastic hinged-free beam, of which one end is hinged and the other end free, subjected to a transverse strike by a travelling rigid mass at an arbitrary location along its span. Special attention is paid to new deformation mechanisms due to shear sliding on both sides of the rigid mass and the plastic energy dissipation. The dimensionless numerical results demonstrate that three parameters, i.e., mass ratio, impact position of mass, as well as the non-dimensional fully plastic shear force, have significant influence on the partitioning of dissipated energy and failure mode of the hingedfree beam. The shear effect can never be negligible when the mass ratio is comparatively small and the impact location of mass is close to the hinged end.

Results in the Treatment of Nasopharyngeal Carcinoma Using Combined Radiotherapy (비인강 종양에 있어서 방사선 치료와 유도화학 요법)

  • Chung Su Mi;Yoon Sei Chul;Shinn Kyung Sub;Bahk Yong Whee;Kim Hoon Kyo;Lee Kyung Shik;Cho Seung Ho
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.59-63
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    • 1991
  • Thirty-one patients with previously untreated and locally advanced nasopharyngeal cancer were retrospectively reviewed for comparing the effects of radical radiotherapy alone with that of combining chemotherapy and radiotherapy from 1983 to 1989 at Kangnam 51. Mavy's hospital.23/31 were evaluable for recurrence and suwival. There were 8 patients for stage III, and 15 patients for stage IV. Eleven patients were treated with radical radiation therapy done (arm I). Twelve patients were given 1~3 courses of cisplatin-5FU or cisplatin-bleomycin-vincristine prior to radiation therapy (arm II). The two arms were comparable in patient characteristics Of 11 radiotherapy Patients, complete response was 55%(6/11) and Partial response 45%(5/11). Among 12 patients after induction chemotherapy, complete response was 25%(3/12) and partial response 75%(9/12). After subsequent radiotherapy, complete response was increased to 83%(10/12) and partial response was 17%(2/12). Treatment failure was 30%(local recurrence; 3/11, and regional recurrence; 1/11) in arm 1 and 33% (local recurrence; 1/12, regional recurrence; 2/12 and distant metastasis; 1/12) in arm ll . There was no significant difference in survival between arm I and arm II (p> 0.05). The toxicities of treatment were acceptable. More controlled clinical trials must be completed before acceptance of chemotherapy as part of a standard radical treatment for locally advanced nasopharyngeal cancer.

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PET/CT planning during chemoradiotherapy for esophageal cancer

  • Seol, Ki Ho;Lee, Jeong Eun
    • Radiation Oncology Journal
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    • v.32 no.1
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    • pp.31-42
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    • 2014
  • Purpose: To evaluate the usefulness of positron emission tomography/computed tomography (PET/CT) for field modification during radiotherapy in esophageal cancer. Materials and Methods: We conducted a retrospective study on 33 patients that underwent chemoradiotherapy (CRT). Pathologic findings were squamous cell carcinoma in 32 patients and adenocarcinoma in 1 patient. All patients underwent PET/CT scans before and during CRT (after receiving 40 Gy and before a 20 Gy boost dose). Response evaluation was determined by PET/CT using metabolic tumor volume (MTV), total glycolytic activity (TGA), MTV ratio (rMTV) and TGA ratio (rTGA), or determined by CT. rMTV and rTGA were reduction ratio of MTV and TGA between before and during CRT, respectively. Results: Significant decreases in MTV ($MTV_{2.5}$: mean 70.09%, p < 0.001) and TGA ($TGAV_{2.5}$: mean 79.08%, p < 0.001) were found between before and during CRT. Median $rMTV_{2.5}$ was 0.299 (range, 0 to 0.98) and median $rTGAV_{2.5}$ was 0.209 (range, 0 to 0.92). During CRT, PET/CT detected newly developed distant metastasis in 1 patient, and this resulted in a treatment strategy change. At a median 4 months (range, 0 to 12 months) after completion of CRT, 8 patients (24.2%) achieved clinically complete response, 11 (33.3%) partial response, 5 (15.2%) stable disease, and 9 (27.3%) disease progression. $SUV_{max}$ (p = 0.029), $rMTV_{50%}$ (p = 0.016), $rMTV_{75%}$ (p = 0.023) on intra-treatment PET were found to correlate with complete clinical response. Conclusion: PET/CT during CRT can provide additional information useful for radiotherapy planning and offer the potential for tumor response evaluation during CRT. $rMTV_{50%}$ during CRT was found to be a useful predictor of clinical response.

Probabilistic sensitivity analysis of multi-span highway bridges

  • Bayat, M.;Daneshjoo, F.;Nistico, N.
    • Steel and Composite Structures
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    • v.19 no.1
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    • pp.237-262
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    • 2015
  • In this study, we try to compare different intensity measures for evaluating nonlinear response of bridge structure. This paper presents seismic analytic fragility of a three-span concrete girder highway bridge. A complete detail of bridge modeling parameters and also its verification has been presented. Fragility function considers the relationship of intensities of the ground motion and probability of exceeding certain state of damage. Incremental dynamic analysis (IDA) has been subjected to the bridge from medium to strong ground motions. A suite of 20 earthquake ground motions with different range of PGAs are used in nonlinear dynamic analysis of the bridge. Complete sensitive analyses have been done on the response of bridge and also efficiency and practically of them are studied to obtain a proficient intensity measure for these types of structure by considering its sensitivity to the period of the bridge. Three dimensional finite element (FE) model of the bridge is developed and analyzed. The numerical results show that the bridge response is very sensitive to the earthquake ground motions when PGA and Sa (Ti, 5%) are used as intensity measure (IM) and also indicated that the failure probability of the bridge system is dominated by the bridge piers.