• Title/Summary/Keyword: Concurrent Treatment

Search Result 451, Processing Time 0.03 seconds

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

  • Hashemi, Farnaz Amouzegar;Akbari, Ehsan Hamed;Kalaghchi, Bita;Esmati, Ebrahim
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.9
    • /
    • pp.5385-5389
    • /
    • 2013
  • Background: For more than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultanously with radiation. Materials and Methods: Thirty women with untreated invasive squamous cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in the Radiation Oncology Department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty $mg/m^2$ gemcitabine followed by $35mg/m^2$ cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks. One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. Results: The mean age of patients was $58.1{\pm}11.8$ (29-78) years. After 3 months of treatment, 73.3%had complete and 26.7% demonstrated partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. Conclusions: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation using Gemcitabine for advanced cervical cancers.

Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy

  • Kim, Hye Young;Kang, Jeong Hee;Youn, Hyun Jo;So, Hyang Sook;Song, Chi Eun;Chae, Seo Young;Jung, Sung Hoo;Kim, Sung Reul;Kim, Ji Young
    • Journal of Korean Academy of Nursing
    • /
    • v.44 no.6
    • /
    • pp.735-742
    • /
    • 2014
  • Purpose: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. Methods: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. Results: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. Conclusion: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.

The Retrospective Study of Closed Reduction of Nasal Bone Fracture

  • Park, Han-Kyul;Lee, Jae-Yeol;Song, Jae-Min;Kim, Tae-Seup;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.36 no.6
    • /
    • pp.266-272
    • /
    • 2014
  • Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer

  • Supaadirek, Chunsri;Pesee, Montien;Thamronganantasakul, Komsan;Thalangsri, Pimsiree;Krusun, Srichai;Supakalin, Narudom
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.7
    • /
    • pp.3511-3514
    • /
    • 2016
  • Purpose: To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMT-RT) without surgery. Materials and Methods: A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January $1^{st}$, 2003 and December $31^{st}$, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMT-RT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5-fluorouracil short infusion plus leucovorin and/or capecitabine or 5-fluorouracil infusion alone. All patients received pelvic irradiation. Results: There were 5 patients (10.4%) with a complete pathological response. The 3 year-overall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (p<0.01). The respective 5 year-overall survival rates were 70.3% and 0% (p<0.01). The 5 year-overall survival rates in Gr.I for patients who received surgery within 56 days after complete CCRT as compared to more than 56 days were 69.5% and 65.1% (p=0.91). Preoperative CCRT used for 12 of 30 patients in Gr.I (40%) with lower rectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. Conclusions: The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.

Management of chronic dry cough through Ayurveda: Illustrating ayurvedic treatment principles through practice

  • Rastogi, Sanjeev
    • CELLMED
    • /
    • v.8 no.1
    • /
    • pp.2.1-2.4
    • /
    • 2018
  • A case of chronic dry cough which was tried to be treated through so many medications in a period of two months, responded very well to a simple ayurvedic remedy composing of a common formulation chosen as per the ayurvedic principles of pathogenesis and management. This case may be an eye opener to the concurrent ayurvedic clinical practice and invites ayurvedic practitioners to stick to their own principles of disease management for obtaining better responses.

Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

  • Byun, Sang Jun;Kim, Jin Hee;Oh, Young Kee;Kim, Byung Hoon
    • Radiation Oncology Journal
    • /
    • v.33 no.4
    • /
    • pp.294-300
    • /
    • 2015
  • Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent. Materials and Methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months). Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS. Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

Pseudoprogression and Pseudoresponse in the Management of High-Grade Glioma : Optimal Decision Timing According to the Response Assessment of the Neuro-Oncology Working Group

  • Chang, Ji Hyun;Kim, Chae-Yong;Choi, Byung Se;Kim, Yu Jung;Kim, Jae Sung;Kim, In Ah
    • Journal of Korean Neurosurgical Society
    • /
    • v.55 no.1
    • /
    • pp.5-11
    • /
    • 2014
  • Objective : We evaluated pseudoprogression (PsPD) following radiation therapy combined with concurrent temozolomide (TMZ), and we assessed pseudoresponse following anti-angiogenic therapy for patients with recurrent disease using the Response Assessment of the Neuro-Oncology Working Group. Methods : Patients who were pathologically confirmed as having high-grade glioma received radiotherapy with concurrent TMZ followed by adjuvant TMZ. Bevacizumab (Avastin) with CPT-11 were used as a salvage option for cases of radiologic progression. Magnetic resonance imaging (MRI) was routinely performed 1 month after concurrent radiochemotherapy (CRT) and every 3 months thereafter. For cases treated with the bevacizumab-containing regimen for progressive disease, MRI was performed every 2 months. Results : Of 55 patients, 21 (38%) showed radiologic progression within 4 weeks after CRT. Of these patients, 16 (29%) showed progression at second post-CRT MRI (etPD) and five (9%) showed improvement (PsPD). Seven of thirty-four initially non-progressed patients showed progression at the second post-CRT MRI (ltPD). No difference in survival was observed between the etPD and ltPD groups (p=0.595). Five (50%) of ten patients showed a radiological response after salvage bevacizumab therapy. Four of those patients exhibited rapid progression immediately after discontinuation of the drug (drug holiday). Conclusion : Twelve weeks following treatment could be the optimal timing to determine PsPD or true progression. MRI with gadolinium enhancement alone is not sufficient to characterize tumor response or growth. Clinical correlation with adequate follow-up duration and histopathologic validation may be helpful in discriminating PsPD from true progression.

Whole-liver Radiotherapy Concurrent with Chemotherapy as a Palliative Treatment for Colorectal Patients with Massive and Multiple Liver Metastases: a Retrospective Study

  • Yin, Hang;Lu, Kai;Qiao, Wen-Bo;Zhang, Hai-Yang;Sun, Di;You, Qing-Shan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.4
    • /
    • pp.1597-1602
    • /
    • 2014
  • The purpose of this study was to investigate whether whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases. From January 2007 to December 2012, 19 patients who exhibited massive (with a longest diameter > 5 cm) and invasive liver metastases and multiple metastases were treated with radiotherapy and concurrent chemotherapy. The total radiation dose was 53.4 Gy (range 38.8 Gy-66.3 Gy). All of the patients received a continuous intravenous dose of 5 fluorouracil (5-FU) 225 mg/m2 concurrently with radiation. The median survival time was 19 months. The 1- and 2- year overall survival rates were 78.3% and 14.3%, respectively. Of all of the patients who presented with abdominal pain, 100% experienced a decrease in pain. Decreases in the rates of ascites and jaundice were confirmed by ultrasound and bilirubin levels. No cases of Grade 4 or 5 acute or late toxicity were recorded. There were only two cases of Grade 3 toxicity (elevated bilirubin). These data provide evidence that whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases.

Concurrent Cisplatin and Radiotherapy in Refractory Patients to Induction Chemotherapy and Recurrent Head and Neck Cancer (유도항암요법에 반응치 않는 환자와 재발한 두경부암환자에서 Cisplatin과 방사선 동시치료)

  • Kim Hoon-Kyo;Kang Jin-Hyoung;Lee Kyung-Sik;Kim Dong-Jip;Chang Hong-Suk;Yoon Sei-Chul;Cho Seung-Ho;Sub Byung-Do
    • Korean Journal of Head & Neck Oncology
    • /
    • v.8 no.1
    • /
    • pp.21-24
    • /
    • 1992
  • In patients with locally advanced head and neck cancers who do not respond to induction chemotherapy and who have locoregional recurrence after local treatment subsequent radiotherapy alone does not have any additative effect. The theoretical rationale and promising clinical response of concurrent chemoradiotherapy in patients with the head and neck cancers have been recently conducted Ten patients(9 stage IV, q stage III) were treated with concurrent chemoradiotherapy(radiotherapy start from day 1 of chemotherapy; cisplatin $100mg/m^2$ intravenously every 3 weeks for $3{\sim}4$ cycles on day 1.22 and 43..). Four patients achieved complete response(CR) and overall response rate was 80% (8/10). The major toxicities we re leukopenia (90%), nausea/vomiting(80%), stomatitis(80%) and peripheral neuropathy(30%). Most of these side effects were mild to moderate and reversible.

  • PDF

Sensory Neural Hearing Loss after Concurrent Cisplatin and Radiation Therapy for Nasopharyngeal Carcinoma (비인강암 환자에서 Cisplatin과 방사선 병합치료시 발생하는 감각신경성 청력손실)

  • Oh Young-Taek;Koh Joong-Hwa;Choi Jin-Hyuk;Kang Seung-Hee;Chun Mi-Son
    • Korean Journal of Head & Neck Oncology
    • /
    • v.14 no.1
    • /
    • pp.15-19
    • /
    • 1998
  • Objectives: It is expected that the combined cisplatin and radiation therapy for nasopharyngeal carcinoma produces more sensory neural hearing losses compared to radiation therapy alone. The purpose of this study was to evaluate the incidence of sensory neural hearing losses after concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. Materials and Methods: From Jun. 1994 to Mar. 1997, 10 patients were available for this study with the following eligibility criteria: 1) The patients received concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma. 2) There was no pre-existing auditory disease except serous otitis media due to nasopharyngeal carcinoma. 3) They had normal sensorineural hearing function on the pretreatment pure tone audiogram. 4) Pure tone audiograms were performed at least one time after treatment between 6months to 1 year follow-up without local recurrence. Results: At 1 year follow-up, 3 patients complained of decreased hearing capacity. Sensorineural hearing losses were developed in 15 ears out of 20(75%) and were more frequent and severe in high frequency area on pure tone audiogram. Conclusion: The concurrent cisplatin and radiation therapy for nasopharyngeal carcinoma may produce sensorineural hearing losses more frequently compared to historical data of radiation therapy alone and close evaluations with regular audiograms are necessary even in patients without symptoms and signs of hearing impairment.

  • PDF