Objective: To explore improved treatment by retrospectively comparing survival time of gemcitabine-based concurrent chemoradiotherapy (GemRT) versus chemotherapy (Gem) alone in patients with locally advanced pancreatic cancer (LAPC). Methods: From January 2005 to June 2010, 56 patients with LAPC from Subei People's Hospital were treated either with Gem (n=21) or GemRT (n=35). Gem consisted of 4-6 cycles gemcitabine alone (1000 mg/m2 on Days 1, 8, 15, 28-day a cycle). GemRT consisted of 50.4Gy/28F radiotherapy with concurrent 2 cycles of gemcitabine (1000 $mg/m^2$ on days of radiation 1, 8, 15, 21-day a cycle). Radiation was delivered to the gross tumor volume plus 1-1.5 cm by use of a three-dimensional conformal technique. The follow-up time was calculated from the time of diagnosis to the date of death or last contact. Kaplan-Meier methodology wes used to evaluate survival. Results: Patient characteristics were not significantly different between treatment groups. The disease control rate and the objective response rate of GemRT versus Gem was 97.1% vs 71.4%, 74.3% vs 38.1%. The overall survival (OS) was significantly better for GemRT compared to Gem (median 13 months versus 8 months; 51.4% versus 14.3% at 1 year, respectively). Conclusion: Radiation therapy at 50.4Gy with 2 concurrent cycles of gemcitabine results in favorable rates of OS. Concurrent chemoradiotherapy should be the first choice for patients with LAPC.
Park, Sangjoon;Kim, Kyung Hwan;Rhee, Woo Joong;Lee, Jeongshim;Cho, Yeona;Koom, Woong Sub
Radiation Oncology Journal
/
v.34
no.2
/
pp.128-134
/
2016
Purpose: To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC). Materials and Methods: A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration. Results: At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ${\geq}2$ toxicities were observed during or after radiotherapy. Conclusion: Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.
Aspirin and prednisolone have been used alone or in combination in the treatment of rheumatic diseases. We have investigated the significance of the difference of the anti-inflammatory and antipyretic activities between single and concurrent administration of aspirin and prednisolone in rats by using carrageenan as a phlogistic agent and brewer's yeast as a fever inducing agent. When prednisolone (9mg/kg) and aspirin (24mg/kg) were administered orally alone or in combination, both of the concurrent and single adminstration inhibited highly significantly the swelling of rat paw and the concurrent adminstraiton of aspirin and prednisolone showed the significantly higher inhibitory effects than aspirin single adminstration did, whereas there were not any significant differences between the prednisolone single adminstration and combined adminstration. The combined drug of aspirin and prednisolone marketed in Korea contains 148mg of aspirin and 1.15mg of prednisolone in a tablet. Therefore, we examined the anti-inflammatory and antipyretic activities of aspirin (150mg/kg), prednisolone (1mg/kg) and their combination. In anti-inflammatory effects, both of the concurrent and single administration inhibited higly significantly the swelling of rat paw, and the concurrent adminstration exhibited the significantly higher inhibitory effects than aspirin or prednisolon alone did. In antipyretic effects both of the concurrent and the single adminstration reduced significantly the brewer's yeast-induced fever. The effect of concurrent administration was greater than that of prednisolone single adminstration, whereas the effect of aspirin single adminstration was similar to that of combination. The results suggest that the anti-inflammatory and antipyretic effects are intensified by the concurrent adminstration of aspirin and prednisolone, but the antipyretic effects of enough doses of aspirin (150mg/kg) is comparable to that of the combination preparation.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.50
no.1
/
pp.56-59
/
2024
There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old female who presented with oral cavity squamous cell carcinoma confirmed by biopsy. Initial diagnostic workup revealed a concurrent parapharyngeal mass. Diagnostic studies and surgical therapy were tailored to account for both pathological entities. The patient was treated with a combination of surgery and adjuvant therapy. The surgical strategy was designed to address both lesions simultaneously. One year post-surgery, the patient had good response to therapy with no evidence of persistent or recurrent disease. This report discusses the outcome and treatment of a rare case of concurrent squamous cell carcinoma with a complicating parapharyngeal space tumor. It explores the diagnostic process, comprehensive workup, and the surgical management.
Her, Misuk;Kim, Hwan;Seo, Young-Kyung;Yang, Changsop;Lee, Mi-Young;Jang, Ik-Soon;Jung, In Chul
Journal of Oriental Neuropsychiatry
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v.28
no.3
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pp.195-206
/
2017
Objectives: To evaluate the effects of concurrent therapy with cognitive behavior therapy and person-centered counseling in addition to general Korean herbal medicine treatment for a patient with anorexia nervosa. Methods: A patient diagnosed with anorexia nervosa was treated with Korean herbal medicine treatment, cognitive behavior therapy, and person-centered treatment. The results were evaluated through a feeding interview, self-checklist, beck depression inventory (BDI) and InBody test. Results: After the treatment period, the treatment effects such as improvement of dietary restriction and elimination behavior, weight gain, and reduced depression were confirmed. Conclusions: This study suggests that concurrent therapy together with cognitive behavior therapy, person-centered counseling, and general Korean herbal medicine treatment is effective on patients with anorexia nervosa.
Lee, Hye-Jae;Yoon, Nan-He;Park, So Hyun;Shin, Seungwon;Park, Minjung
Journal of Society of Preventive Korean Medicine
/
v.25
no.2
/
pp.1-11
/
2021
Objective : The purpose of this study is to analyze Korean patients' characteristics, who were concurrently treated with both Korean herbal medicines and Western chemical medicines using nation-wide database. Method : Using the patients sample data (HIRA-NPS 2018) provided by Health Insurance Review and Assessment Service, a group of patients who co-administered Korean herbal and Western medicines was selected, and their basic characteristics, diagnosis, and prescribed chemical medicines were analyzed. Results : Out of the 1,481,921 sample population, 17,629 patients (1.2%) were selected as a concurrent medication group. Compared to the whole sample, the concurrent medication group was composed of more women (65.8% vs. 51.1%), the more elderly people (65 or older years old) (44.5% vs. 14.6%), and the higher prevalence of chronic diseases (49.1% vs. 22.2%). The most frequent diagnosis treated with Western medicines was mental and behavioral disorders, musculoskeletal and circulatory disorders. Frequently used drugs among concurrent medication group were anti-anxiety drugs, gastric ulcer treatment drugs, and senile diseases treatment drugs. Conclusion : The evidence reported in this study is expected to provide herb-drug interaction researchers with important reference to set the priorities of research topics in the future.
Objectives : In order to observe clinical effects, carboxytherapy and electroacupuncture, we analyzed relation effect and patients' character, and researched correlation among reduction of BFM(Body Fat Mass), WHR(Waist-Hip Ratio) and AC(Arm Circumference). Methods : Among outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental medicine hospital, Dae-Jeon university from January to September, 2008 for obesity treatment and abdominal fat, 44 subjects were chosen and carboxytherapy and electroacupuncture were practiced concurrently. Results : 1. The group under the concurrent practice of carboxytherapy and electroacupuncture showed significant decrease in BFM, BFR(Body Fat Rate), WHR and AC. 2. The group under the concurrent practice of carboxytherapy and electroacupuncture did not show statistical significance but showed decrease in BFM, WHR. The degree of decrease was proportional to that of obesity. 3. As AC decreased, BFM, WHR reduction tended to increase as well in the group under the concurrent practice of carboxytherapy and electroacupuncture. 4. Compared to the group under the sole practice of electroacupuncture, the group under the concurrent practice of carboxytherapy and electroacupuncture showed less change in BFM reduction and greater change in WHR reduction. Conclusions : From the above results, the concurrent practice of carboxytherapy and electroacupuncture had an effect on obesity and reducing abdominal fat, but did not show statistically significant decrease compare to the sole practice of electroacupuncture.
These studies were attempted to investigate the preventive effect of Ganoderma lucidum extract administered concurrently with glutathione on the liver damage induced by carbon tetrachloride ($CCl_4$) in rats. S-GOT and S-GPT activities of all the pre-treatment groups were significantly decreased, as compared with those of the control intoxicated by $CCl_4$. The concurrent administrations of Ganoderma lucidum extract with glutathione (100+100mg/kg, 200+100mg/kg, and 400+100mg/kg, respectively) were more effective than the individual administrations. i.e., Ganaderma lucidtcm extract (100, 200 and 400mg/kg, respectively) and glutathione (100, 200 and 400mg/kg, respectively). On the determination of lipid-peroxidation in liver, the concurrent administrations of Ganoderma lucidum extract with glutathione (100+100mg/kg, and 200+100mg/kg, respectively) significantly reduced the liver TBA values. Although hepatic cellular necrosis and fatty acid deposit were remarkably increased by $CCl_4$ intoxication, the concurrent administration of Ganoderma lucidum extract with glutathione (200+100mg/kg) reduced the pathological changes of parenchymal cell necrosis and fatty changes around centrilobalar area of the control. These findings indicate that the concurrent administrations of Ganoderma lucidum extract with glutathione showed better improvements than the individual administrations of them in all pathological aspects, in particular, against hepatitis and hepatic necrosis due to the cellular necrosis and fatty infiltration.
Background: Many recent results of clinical trials show that pre-operative concurrent chemoradiotherapy and surgical resection could increase the survival of N2 positive stage IIIA non-small cell lung cancer. This study was performed to assess the feasibility, toxicity, and affect rates of concurrent chemoradiotherapy and surgical resection in N2 positive stage IIIA non-small cell lung cancer. Material and Method: Thirty-one patients who underwent preoperative concurrent chemoradiotherapy for N2 positive stage IIIA non-small-cell lung cancer from May 1997 to April 1999 were entered into the study. Mean age was 61 yrs(43∼70 yrs), There were 24 men and 7 women. The confirmation of N2 disease were achieved through mediastinoscopic biopsy(24) and CT scans(7). Induction was achieved by two cycles of cisplatin and etoposide(EP) plus concurrent chest radiotherapy to 45 Gy. Resections were done at 3 weeks after the complection of preoperative concurrent chemoradiotherapy. Resections were performed in 23 patients, excluding 5 refusals and 3 distant metastasis. Result: All patients were compled the thoracic radiotherapy except one who had distant metastasis. Twenty three patients were completed the planned 2 cycles of EP chemotherapy, and 8 patients were received only 1 cycle for severe side effects(6), refusal(1), and distant metastasis(1). There was one postoperative mortality, and the cause of death was ARDS. Three patients who had neutropenic fever and one patient who had radiation pneumonitis were required admission and treatment. Esophagitis was the most common acute side effect, but relatively well-tolerated in most patients. The complection rate of concurrent chemoradiotherapy was 74%, resection rate was 71%, pathologic complete remission rate was 13.6%, and pathologic down-staging rate was 68%. Conclusion: Morbidity related to each treatment was acceptable and many of the patients have benefited down staging of its disease. Further prospective, preferably randomized, clinical trials of larger scale may be warranted to confirm the actual benefit of preoperative concurrent chemoradiotherapy and surgical resection in N2-positive stage IIIA non-small cell lung cancer.
Purpose : We performed a retrospective analysis to compare short term results of induction chemotherapy-radiotherapy versus concurrent chemo-radiotherapy in patients with locally advanced nasopharyngeal carcinoma. Materials and Methods : From Oct. 1989 to May 1998, 62 patients with locally advanced nasopharyngeal carcinoma were treated with induction chemotherapy followed by radiotherapy (induction group) or concurrent chemo-radiotherapy (concurrent group). Induction chemotherapy was done for 50 patients, and concurrent chemotherapy for 12 patients. Age, sex, performance status, and pathologic types were evenly distributed between two groups. Stage distribution showed $32\%$ with IIB, $32\%$ with III, and $38\%$ with IV in induction group, and $50\%,\;33.3\%,\;and\;16.7\%$ in concurrent group, respectively. Chemotherapy regimen was CF (cisplatin and 5-FU) in both groups, and drug delivery method also same. Cisplatin $100\;mg/m^2$ was intravenously infused on day 1, and 5-FU $1,000\;mg/m^2$ on day $2\~6$. This was repeated at 3 weeks interval. At the end of radiotherapy, total cycles of chemotherapy were $1\~3$ (median 2) in both groups. Conventionally fractionated radiotherapy with daily fraction size $1.8\~2.0\;Gy$ and 5 fractions/week was done. Total dose was $69.4\~86\;Gy$(median 73.4 Gy) for induction group, and $69.4\~75.4\;Gy$ (median 70.8 Gy) for concurrent group. Follow-up time was $9\~116$ months (median 40.5 months) for induction group, $14\~29$ months (median 21 months) for concurrent group, respectively. Results : Overall 2 year survival rate (2YSR) for all patients was $78.7\%$. According to treatment modality, 2YSR were $77\%$ for induction group, $87\%$ for concurrent group (p>0.05). 2 year disease-free survival rate were $56\%$ and $81\%\;(p>0.05)$, respectively. Complete response to treatment were $75.5\%$ for induction group and $91.7\%$ for concurrent group, but there was no statistical difference. The incidence of grade $3\~4$ hematologic toxicity during radiotherapy was not differ between two groups, but grade 2 leukopenia was more frequent in concurrent group $(18\%\;vs\;66.7\%)$Grade $3\~4$ mucositis was more frequent in concurrent group $(4.0\%\;vs\;33.3\%)$. Overall incidence of grade $3\~4$ acute toxicity during radiotherapy was more frequent in concurrent group $(6.0\%\;vs\;41.7\%,\;p=0.005)$. Conclusion : Concurrent chemo-radiotherapy showed a trend of improvement in short-term survival and in treatment response when compared with induction chemotherapy-radiotherapy in locally advanced nasopharyngeal carcinoma. More controlled randomized trial are needed.
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