• Title/Summary/Keyword: Concurrent Treatment

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Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

  • Lee, Ja-Young;Kim, Sung-Hwan;Kim, Gi-Won;Yu, Mi-Na;Park, Dong-Choon;Yoon, Joo-Hee;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.30 no.1
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    • pp.20-26
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    • 2012
  • Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

Two-Stage Endovascular Repair for Concurrent Penetrating Atherosclerotic Ulcers of the Thoracic and Abdominal Aorta

  • Kong, Joon Hyuk;Baek, Kang Seok;Kwun, Woo Hyung;Kim, Young Hwan;Kim, Duk-Sil;Kim, Sung-Wan
    • Journal of Chest Surgery
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    • v.46 no.5
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    • pp.365-368
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    • 2013
  • We report a case of concurrent saccular aneurysms caused by a penetrating atherosclerotic ulcer of the thoracic and abdominal aorta that were successfully treated by staged endovascular repair. Even though surgical open repair or endovascular repair is the treatment option, use of endovascular repair is now accepted as an alternative treatment to surgery in selected patients. To prevent contrast medium-induced nephropathy and spinal cord ischemia caused by a simultaneous endovascular procedure, a saccular aneurysm of the descending thoracic aorta was excluded by stent graft, followed by the placement of a bifurcated stent graft in the infrarenal abdominal aorta one month later.

Inhibitory Effects on Platelet Aggregation and Blood Coagulation by Concurrent Administration of Trifusal and Ibudilast (Triflusal과 Ibudilast 동시처리에 의한 혈소판응집 및 혈액응고 억제효과)

  • Hwang, In-Young;Sohn, Yoon-Ah;Hwang, Seon-A;Koo, Yean-Kyoung;Kim, Sun-Young;YunChoi, Hye-Sook;Kwon, Soon-Kyoung;Jeong, Choon-Sik
    • YAKHAK HOEJI
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    • v.56 no.4
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    • pp.248-253
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    • 2012
  • This study aims to develop a novel regimen for enhanced efficacy and reduced side effect in inhibiting platelet aggregation and blood coagulation by concurrent administration of triflusal and ibudilast as anticoaggulants. The result shows this combination of triflusal and ibudilast (300~500 ${\mu}M$, respectively) has additive effect in inhibiting platelet aggregation and blood coagulation over the administration of truflusal or ibdilast as a single treatment. This pharmaceutical composition is expected to be useful for the prevention or treatment of various diseases and symptoms, for example, ischemic heart disease, ischemic cerebral infarction, arteriosclerosis, and thrombosis caused by the insertion of a stent.

Improvement of Megaesophagus after Treatment of Concurrent Hypothyroidism

  • Ko, Gyeong-Bin;Kim, Joonyoung;Choi, Hyeong-Il;Moon, Min-Young;Suh, Guk-Hyun;Kim, Ha-Jung
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.19-21
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    • 2018
  • A 7-year-old female American cocker spaniel presented with chronic regurgitation and megaesophagus on radiography at a local hospital. Dry and coarse hair coat, tail alopecia, and bradycardia were observed during physical examination. Mild, non-regenerative anemia was indicated by complete blood count (CBC) analysis. Concurrent hypercholesterolemia and hypertriglycemia were indicated by biochemistry tests. Decreased levels of total and free thyroxine (T4) and increased canine thyroid stimulating hormone (cTSH) levels were also detected. Megaesophagus was confirmed by radiographic examination. Based on the results, a diagnosis of hypothyroidism with megaesophagus was made. The patient was initially treated with levothyroxine sodium at a dosage of 0.02 mg/kg twice a day. After two weeks of treatment for hypothyroidism, the dilated esophagus returned to its original size and no further regurgitation was observed. No relapse was observed during two months of follow-up.

Concurrent chemoradiotherapy for elderly patients with stage III non-small cell lung cancer

  • Kang, Ki Mun;Jeong, Bae Kwon;Ha, In Bong;Chai, Gyu Young;Lee, Gyeong Won;Kim, Hoon Gu;Kang, Jung Hoon;Lee, Won Seob;Kang, Myoung Hee
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.140-145
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    • 2012
  • Purpose: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. Materials and Methods: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. Results: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. Conclusion: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.

Chemoradiotherapy versus radiotherapy alone following induction chemotherapy for elderly patients with stage III lung cancer

  • Kim, Dong-Yun;Song, Changhoon;Kim, Se Hyun;Kim, Yu Jung;Lee, Jong Seok;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.176-184
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    • 2019
  • Purpose: It is unclear whether adding concurrent chemotherapy (CT) to definitive radiotherapy (RT) following induction CT is a tolerable and cost effective treatment for non-small-cell lung cancer (NSCLC) patients aged 70 years or older with comorbidities. This study evaluated the actual clinical outcomes between concurrent chemoradiotherapy (CCRT) and RT alone following induction CT or not in patients (≥70 years) in a single institution's clinical practice. Materials and Methods: A total of 82 patients with unresectable stage III NSCLC between 2004 and 2016 were retrospectively analyzed. Their treatment tolerance and clinical outcomes such as overall survival (OS), locoregional recurrence (LRR), treatment toxicities and distant metastasis (DM) were evaluated. Early mortality rates were also evaluated as 4-month mortality after RT. Results: Fifty-four patients received CCRT and 28 patients received RT alone. Induction CT before RT was performed for 68.5% and 50.0% in CCRT and RT alone groups. Treatment tolerance was significantly worse in CCRT (p = 0.046). The median survival was 21.1 and 18.1 months for CCRT and RT alone, which was not statistically significant. LRR and DM were also not different. Most early deaths after CCRT were attributed to non-cancer-related mortality. Acute esophagitis of grade ≥2 occurred more following CCRT (p = 0.017). In multivariate analysis, a Charlson Comorbidity Index (CCI) of ≥5 and a weight loss of ≥5% after RT were associated with poor OS. The factors adversely affecting 4-month survival were a CCI of ≥5 and CCRT. Conclusion: There were no significant differences in OS, LRR, and DM between CCRT and RT alone treatment in elderly patients. However, there was a poorer tolerance and higher incidence of acute esophagitis in the CCRT group. Specifically, when the patients had a CCI of ≥5, RT alone seems to be reasonable with a low probability of early death.

Spontaneous Pneumomediastinum with Concurrent Pneumorrhachis

  • Jung, Hanna;Lee, Sang Cjeol;Lee, Deok Heon;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.569-571
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    • 2014
  • Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

Analysis of Case Studies on Warts Treated with Oriental Medicine (사마귀의 한방 치료 증례연구 분석)

  • Lee, Kyou-Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.101-115
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    • 2019
  • Objectives : The purpose of this study is to analyze the use of herbal medicine as a treatment method in the case studies on warts in Korea, to identify trends in herbal medicines and herbal prescriptions according to the characteristics of individual patients and to systematically analyze concurrent therapies. Methods : Domestic databases (OASIS, RISS, NDSL, KTKP, KISS, KISTI, KISTI) were used to search for case studies related to the herbal medicine treatment of warts. There was no restriction on the time of publication. A total of 9 papers were selected. Results : A total of 13 prescriptions were presented 23 times in 18 cases. Among them, bojungikgi-tang gamibang(補中益氣湯加減方) was the most frequently prescribed. Gwakhyangjeonggi-san gamibang(藿香正氣散加減方) and Damsoeun-tang gagam were the next most frequently prescribed. 69 herbs were used in a total of 13 prescriptions. Herbs were commonly classified as heat-clearing medicine(淸熱藥), exterior-releasing medicine(解表藥), and tonifying and replenishing medicine(補益藥) in descending order. The herbs used more than 6 times included Coicis Semen(薏苡仁), Glycyrrhizae Radix et Rhizoma(甘草) (10 times), Bupleuri Radix(柴胡), and Scutellariae Radix(黃芩) (6 times). Concurrent therapies were performed except for 1 study, and they were acupuncture, moxibustion, pharmacopuncture, external agents, and cupping therapy. Conclusions : This is the first study to analyze the use of herbal medicine as a treatment method for warts in case studies performed in Korea. We hope that this study would give helpful information about the treatment of warts in clinical practices.

Feasibility and Efficacy of Concurrent Chemoradiotherapy in Elderly Patients with Esophageal Squamous Cell Carcinoma: a Respective Study of 116 Cases from a Single Institution

  • Li, Xue;Zhao, Lu-Jun;Liu, Ning-Bo;Zhang, Wen-Cheng;Pang, Qing-Song;Wang, Ping;Yuan, Zhi-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1463-1469
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    • 2015
  • Background: To evaluate the safety and efficacy of combined chemoradiotherapy or radiotherapy alone in elderly patients with esophageal carcinoma to identify the best method of treatment. Materials and Methods: One hundred and sixteen patients with esophageal carcinoma aged 70 and older who received definitive radiotherapy or chemoradiotherapy entered the study. Overall survival (OS), disease-free survival (DFS) and treatment-related toxicities were assessed. Results: The median OS of the overall population was 17.9 months. For patients treated with cCRT, sCRT and radiotherapy alone, the median OS was 22.3 months, 18.0 months and 12.4 months respectively(P=0.044). Median OS for patients treated with radiotherapy dose ${\geq}60Gy$ and <60Gy was 20.2 months and 10.9 months respectively (p=0.017). By univariate analysis, Chemoradiotherapy (include cCRT and sCRT) and radiotherapy dose ${\geq}60Gy$ were found to achieve higher survival rates compared with radiotherapy alone and radiotherapy dose <60Gy (P=0.015, P=0.017). By multivariate analysis, chemoradiotherapy (HR=1.645, P=0.022) and radiotherapy dose ${\geq}60Gy$ (HR=1.642, P=0.025) were identified as independent prognostic factors of OS. Conclusions: Definitive concurrent chemoradiotherapy could be considered as a feasible and effective treatment in esophageal carcinoma patients aged 70 and older. Radiotherapy dose 60Gy is an effective treatment option compared with standard dose radiotherapy, while higher doses are not beneficial to improve survival.

Phase II Study of Concurrent Chemotherapy with Etoposide and Cisplatin (EP) and Radiation Therapy for Unresectable Stage III Non-small Cell Lung Cancer (수술이 불가능한 제 III기 비소세포폐암에서 Cisplatin 및 Etoposide(EP)의 화학요법과 방사선요법의 병행요법(2상 임상연구))

  • Hur, Nam-Hyun;Lee, Choon-Taek;Kim, Jae-Hag;Jang, Jae-Jin;Nam, Seung-Mo;Park, Yeon-Hee;Ryoo, Baek-Yeol;Kim, Tae-You;Im, Young-Hyuck;Kang, Yoon-Koo;Kim, Mi-Sook;Yoo, Seong-Yul;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.776-784
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    • 1997
  • Background : Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC). however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, and survival of concurrent chemotherapy with etoposide and cisplatin(EP) and radiation therapy for unresectable stage III NSCLC. Method : Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide and cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. Results : Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient. The median survival was 12.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia($\geq$ grade 3, 46%). Thrombocytopenia over grade 3 was found in 11%. Radiation pneumonitis occurred in 13 patients(46%). Conclusion : Concurrent chemotherapy(EP) plus radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.

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