• Title/Summary/Keyword: Complete response

Search Result 1,062, Processing Time 0.022 seconds

Interpretation of Rectal MRI after Neoadjuvant Treatment in Patients with Rectal Cancer (수술 전 선행보조치료를 받은 직장암 환자의 직장 자기공명영상의 해석)

  • Nieun Seo;Joon Seok Lim
    • Journal of the Korean Society of Radiology
    • /
    • v.84 no.3
    • /
    • pp.550-564
    • /
    • 2023
  • MRI is currently the imaging modality of choice to evaluate rectal cancer after neoadjuvant treatment. The purposes of restaging MRI are to assess the resectability of rectal cancer and to decide whether organ preservation strategies can be applied in patients with a complete clinical response. This review article indicates the key MRI features needed to evaluate rectal cancer after neoadjuvant treatment using a systematic approach. Assessment of primary tumor response including MRI findings to predict a complete response is discussed. Additionally, MRI evaluation of the relationship between the primary tumor and adjacent structures, lymph node response, extramural venous invasion, and tumor deposits after neoadjuvant treatment is presented. Knowledge of these imaging features and their clinical relevance may help radiologists provide an accurate and clinically valuable interpretation of restaging rectal MRI.

Modified LOGIT(MLOGIT) Transformation: Prediction of $IC_{50}$ Value from Two Arbitrary Concentration Data

  • 유성은;차옥자
    • Bulletin of the Korean Chemical Society
    • /
    • v.16 no.2
    • /
    • pp.110-112
    • /
    • 1995
  • A LOGIT transformation is a method to estimate IC50 values with two arbitrary concentration data when complete dose response curves(DRCs) are not available. We propose a modified LOGIT transformation (MLOGIT) which predicts IC50 values more accurately than the conventional LOGIT method.

Correlation Between Response to Induction Chemotherapy and Subsequent Radiotherapy in Previously Untreated Patients with Squamous Cell Carcinomas of the Head and Neck (두경부의 악성종양(편평상피암) 환자에서 유도화학요법에 의한 종양의 관해와 방사선치료에 의한 관해의 상호 관계)

  • Park Woo Yoon;Yoo Seong Yul;Koh Kyoung Hwan;Cho Chul Koo;Park Young Hwan;Shim Youn Sang;Oh Kyung Kyoon;Lee Yong Sik
    • Radiation Oncology Journal
    • /
    • v.8 no.2
    • /
    • pp.207-212
    • /
    • 1990
  • To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course ($2\~3$ cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administeredd with CDDP+Bleomycin (BP) in 20, CDDP+5-FU (FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was giver conventionally with a dose of 65 to 75 Gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were $80\%$ for the tumors and $879\%$ for the nodes whereas complete reponse rates were $12\%\;and\;13\%$, respectively. Six months after radiotherapy $67\%$ of the tumors and $77\%$ of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy,39 ($81\%$) and 28 ($90\%$), respectively, achieved complete response after radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p<0.0005 in tumor, p<0.0001 in node). By reanalyzing according to disease subsets (i.e. primary site, T-stage, N-stage) this relationship was not observed at T1-T2 disease (p>0.3). Therefore the tumor or node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-T2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in $T_1-T_2$ tumors.

  • PDF

Relationship among Stress, Anxiety-depression, Muscle Tone, and Hand Strength in Patients with Chronic Stroke: Partial Correlation

  • Kim, Myoung-Kwon;Choe, Yu-Won;Kim, Seong-Gil;Choi, Eun-Hong
    • Journal of the Korean Society of Physical Medicine
    • /
    • v.13 no.4
    • /
    • pp.27-33
    • /
    • 2018
  • PURPOSE: This study was conducted to identify the relationships among stress response inventory, hospital anxiety and depression, muscle tone and stiffness, and hand strength in chronic stroke patients. METHODS: A total of 14 chronic stroke patients voluntarily agreed to this experiment and were included in this study. All measurements were performed in one day and in a room without noise. The tests conducted in this study were as follows: muscle tone and stiffness of the upper trapezius hand grip measurement. Subjects were also asked to complete surveys describing the following: stress response inventory and hospital anxiety and depression scale. RESULTS: There were significant correlations among stress response inventory and hospital anxiety and depression, stress response inventory and hand strength, and hospital anxiety and depression and hand strength (P<.05). There were high positive correlations between stress response inventory and hospital anxiety and depression (r=.979), while there were moderate negative correlations between stress response inventory and hand strength (r=-.415) and between hospital anxiety and depression and hand strength (r=-.420). CONCLUSION: The results of the present study indicate that there is a relationship among stress response inventory, hospital anxiety and depression, and hand strength in patients with chronic stroke.

How to Combine Diffusion-Weighted and T2-Weighted Imaging for MRI Assessment of Pathologic Complete Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer?

  • Jong Keon Jang;Chul-min Lee;Seong Ho Park;Jong Hoon Kim;Jihun Kim;Seok-Byung Lim;Chang Sik Yu;Jin Cheon Kim
    • Korean Journal of Radiology
    • /
    • v.22 no.9
    • /
    • pp.1451-1461
    • /
    • 2021
  • Objective: Adequate methods of combining T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) to assess complete response (CR) to chemoradiotherapy (CRT) for rectal cancer are obscure. We aimed to determine an algorithm for combining T2WI and DWI to optimally suggest CR on MRI using visual assessment. Materials and Methods: We included 376 patients (male:female, 256:120; mean age ± standard deviation, 59.7 ± 11.1 years) who had undergone long-course CRT for rectal cancer and both pre- and post-CRT high-resolution rectal MRI during 2017-2018. Two experienced radiologists independently evaluated whether a tumor signal was absent, representing CR, on both post-CRT T2WI and DWI, and whether the pre-treatment DWI showed homogeneous hyperintensity throughout the lesion. Algorithms for combining T2WI and DWI were as follows: 'AND,' if both showed CR; 'OR,' if any one showed CR; and 'conditional OR,' if T2WI showed CR or DWI showed CR after the pre-treatment DWI showed homogeneous hyperintensity. Their efficacies for diagnosing pathologic CR (pCR) were determined in comparison with T2WI alone. Results: Sixty-nine patients (18.4%) had pCR. AND had a lower sensitivity without statistical significance (vs. 62.3% [43/69]; 59.4% [41/69], p = 0.500) and a significantly higher specificity (vs. 87.0% [267/307]; 90.2% [277/307], p = 0.002) than those of T2WI. Both OR and conditional OR combinations resulted in a large increase in sensitivity (vs. 62.3% [43/69]; 81.2% [56/69], p < 0.001; and 73.9% [51/69], p = 0.008, respectively) and a large decrease in specificity (vs. 87.0% [267/307]; 57.0% [175/307], p < 0.001; and 69.1% [212/307], p < 0.001, respectively) as compared with T2WI, ultimately creating additional false interpretations of CR more frequently than additional identification of patients with pCR. Conclusion: AND combination of T2WI and DWI is an appropriate strategy for suggesting CR using visual assessment of MRI after CRT for rectal cancer.

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

  • Nosrat, Ali;Peimani, Ali;Asgary, Saeed
    • Restorative Dentistry and Endodontics
    • /
    • v.38 no.4
    • /
    • pp.227-233
    • /
    • 2013
  • Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Thermal Property Analysis of 40 mm Long Hollow Cylinders Though Measurements and Analysis of Transient Temperatures (온도 측정과 분석을 통한 40 mm 장축공동실린더의 열적특성 고찰)

  • Shin Nae-Ho;Chung Dong-Yoon;Oh Myoung-Ho;Yoo Sam-Hyeon;Nam Seok-Ryun
    • Tribology and Lubricants
    • /
    • v.22 no.4
    • /
    • pp.190-195
    • /
    • 2006
  • A simple and effective analysis method is presented for gaining a complete transient temperatures on the internal and external surfaces of a 40 mm gun tube subjected to a series of rapid firings. Two series of temperature data for both Hs and As were measured by using two rapid response k-type surface thermocouples near the firing origin and the muzzle. With other available temperature data, patterns of temperature variations of the gun tube as a function of time variable were driven through complete evaluations of the data. It is found that overall temperature gradients which increase exponentially toward saturation temperature, actually consist of a series of linear temperature gradients corresponding to the firing sequences. Under the similar firing sequences, patterns of temperature variations fur both the surface temperatures near the chamber and those near the muzzle were found to have linear temperature gradients with different values and the same response frequencies, i.e. they had peaks and lows in temperatures at the same time. The resultant complete temperature data can be used as the fundamental bases for analysis of thermoelastic properties of the materials such as thermal strain and stress, and f3r the prediction of cannon tube life-time through calculation of wear rate.

Clinical predictive factors of pathologic tumor response after preoperative chemoradiotherapy in rectal cancer

  • Choi, Chi Hwan;Kim, Won Dong;Lee, Sang Jeon;Park, Woo-Yoon
    • Radiation Oncology Journal
    • /
    • v.30 no.3
    • /
    • pp.99-107
    • /
    • 2012
  • Purpose: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. Materials and Methods: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. Results: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. Conclusion: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.

Combined Modality Therapy with Selective Bladder Preservation for Muscle Invading Bladder Cancer (침윤성 방광암 환자에서 방광 보존 치료)

  • Youn Seon Min;Yang Kwang Mo;Lee Hyung Sik;Hur Won Joo;Oh Sin Geun;Lee Jong Cheol;Yoon Jin Han;Kwon Heon Young;Jung Kyung Woo;Jung Se Il
    • Radiation Oncology Journal
    • /
    • v.19 no.3
    • /
    • pp.237-244
    • /
    • 2001
  • Purpose : To assess the tolerance, complete response rate, bladder preservation rate and survival rate in patients with muscle-invading bladder cancer treated with selective bladder preservation protocol. Method and Materials : From October 1990 to June 1998, twenty six patients with muscle-invading bladder cancer (clinical stage T2-4, N0-3, M0) were enrolled for the treatment protocol of bladder preservation. They were treated with maximal TURBT (transurethral resection of bladder tumor) and 2 cycles of MCV chemotherapy (methotrexate, crisplatin, and vinblastine) followed by $39.6\~45\;Gy$ pelvic irradiation with concomitant cisplatin. After complete urologic evaluation (biopsy or cytology), the patients who achieved complete response were planed for bladder preservation treatment and treated with consolidation cisplatin and radiotherapy (19.8 Gy). The patients who had incomplete response were planed to immediate radical cystectomy. If they refused radical cystectomy, they were treated either with TURBT followed by MCV or cisplatin chemotherapy and radiotherapy. The median follow-up duration is 49.5 months. Results : The Patients with stage T2-3a and T3b-4a underwent complete removal of tumor or gross tumor removal by TURBT, respectively. Twenty one out of 26 patients $(81\%)$ successfully completed the protocol of the planned chemo-radiotherapy. Seven patients had documented complete response. Six of them were treated with additional consolidation cisplatin and radiotherapy. One patient was treated with 2 cycles of MCV chemotherapy due to refusal of chemo-radiotherapy. Five of 7 complete responders had functioning tumor-free bladder. Fourteen patients of incomplete responders were further treated with one of the followings : radical cystectomy (1 patient), or TURBT and 2 cycles of MCV chemotherapy (3 patients), or cisplatin and radiotherapy (10 patients). Thirteen patients of them were not treated with planned radical cystectomy due to patients' refusal (9 patients) or underlying medical problems (4 patients). Among twenty one patients, 12 patients $(58\%)$ were alive with their preserved bladder, 8 patients died with the disease, 1 patient died of intercurrent disease. The 5 years actuarial survival rates according to CR and PR after MCV chemotherapy and cisplatin chemoradiotherapy were $80\%\;and\;14\%$, respectively (u=0.001). Conclusion : In selected patients with muscle-invading bladder cancer, the bladder preservation could be achieved by MCV chemotherapy and cisplatin chemo-radiotherapy. All patients tolerated well this bladder preservation protoco. The availability of complete TURBT and the responsibility of neoadjuvant chemotherapy and chemoradiotherapy were important predictors for bladder preservation and survival. The patients who had not achieved complete response after neoadjuvant chemotherapy and chemoradiotherapy should be immediate radical cystectomy. A randomized prospective trial might be essential to determine more accurate indications between cystectomy or bladder preservation.

  • PDF

Combined Modality Therapy of Non-Hodgkin's Lymphoma of Waldeyer's Ring (Waldeyer's Ring 비호치킨 림프종의 병합요법)

  • Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
    • Korean Journal of Head & Neck Oncology
    • /
    • v.15 no.1
    • /
    • pp.22-28
    • /
    • 1999
  • Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

  • PDF