Background: Many clinical trials have been conducted to evaluate sorafenib for the treatment of advanced NSCLC, but the results for efficacy have been inconsistent. The aim of this study was to evaluate the efficacy and safety of sorafenib in patients with advanced NSCLC in more detail by meta-analysis. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed after searching PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, and the proceedings of major conferences for relevant clinical trials. Two reviewers independently assessed the quality of the trials. Outcomes analysis were disease control rate (DCR), progression- free survival (PFS), overall survival (OS) with 95% confidence intervals (CI) and major toxicity. Subgroup analysis was conducted according to sorafenib monotherapy, in combination with chemotherapy or EGFR-TKI to investigate the preferred therapy strategy. Results: Results reported from 6 RCTs involving 2, 748 patients were included in the analysis. Compared to sorafenib-free group, SBT was not associated with higher DCR (RR 1.31 (0.96- 1.79), p=0.09), PFS (HR 0.82 (0.66-1.02), p=0.07) and OS (HR 1.01 (0.92-1.12), p=0.77). In terms of subgroup results, sorafenib monotherapy was associated with significant superior DCR and longer PFS, but failed to show advantage with regard to OS. Grade 3 or greater sorafenib-related adverse events included fatigue, hypertension, diarrhea, oral mucositis, rash and HFSR. Conclusions: SBT was revealed to yield no improvement in DCR, PFS and OS. However, sorafenib as monotherapy showed some activity in NSCLC. Further evaluation may be considered in subsets of patients who may benefit from this treatment. Sorafenib combined inhibition therapy should be limited unless the choice of platinum-doublet regimen, administration sequence or identification of predictive biomarkers are considered to receive better anti-tumor activity and prevention of resistance mechanisms.
Journal of the Korea institute for structural maintenance and inspection
/
v.14
no.6
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pp.238-245
/
2010
Progressive collapse is defined as a collapse caused by sectional destruction of a structural member which links to other surrounding structures. Currently the design guidelines for the prevention of progressive collapse is not available in Korea. So, structural engineers have a difficulty in evaluating progressive collapse. In this study, the static and dynamic analysis to evaluate the methods and procedures are conducted using commercial analysis program for RC moment resisting frames. According to the study, DCR value of RC moment resisting frame system based on code in Korea is over 2 and it shows that it can't provide alternate load paths due to the progressive collapse. And additional reinforcement should be considered for the progressive collapse resistance. As a result of vertical deflection and DCR value of linear static analysis and linear dynamic analysis, the results of dynamic analysis were underestimated more than the result of static analysis. Thus, the dynamic coefficient value of 2 provides conservative estimation.
Journal of the Institute of Electronics and Information Engineers
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v.51
no.11
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pp.3-10
/
2014
Direct conversion receiver(DCR) gets noticed for integration and cost reduction of wireless communication systems instead of the heterodyne receiver which uses complex filter. But DCR has several factors in performance degradation. One of them is I/Q imbalance phenomenon, that is amplitude and phase mismatch between real and imaginary part of receiver. Accordingly, researches are being carried to improve the I/Q imbalance problem. However, the tendency of the broaden bandwidth of communication systems, low pass filter(LPF) mismatch problem affects severely in I/Q mismatch phenomenon at the DCR. To study this problem, we generated 10MHz broadband signal and shifted it ${\pm}8MHz$ from the center frequency. The signal is affected by LPF mismatch and it appears as frequency selective distortion. Thus, LPF mismatch model is added to I/Q imbalance model which conventionally dealt with amplitude and phase mismatches. In addition, we proposed the compensation method for each factors of mismatch. As the simulation results, the proposed I/Q mismatch compensator resolves the frequency selective distortion which occurred by the existing LPF mismatch.
Journal of the Institute of Electronics Engineers of Korea TC
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v.45
no.11
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pp.61-68
/
2008
In this paper, we propose a RF front-end developments for vehicle UWB radar systems. UWB systems have a very narrow pulse width that is below 1ns. Therefore, UWB is designed to have broadband quality of low power several GHz and must coexist with the radio communication system. UWB's advantages include high channel capacity and data rate, because precise resolution for multi-path can easily position estimate and Rake receiver. Also, UWB has low interference because it displays broadband quality of low power. Positioning is made possible by short range accuracy, which can reduce the expense of system design. An RF front-end module is designed using the DCR(Direct ConveRsion) method and is composed in RF for vehicles at a low-cost.
Kim, Suna;Yoon, Dae-Young;Park, Hyung Chul;Yoon, Giwan;Lee, Sang-Gug
ETRI Journal
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v.36
no.1
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pp.12-21
/
2014
In this paper, we propose a new digital blind in-phase/quadrature-phase (I/Q) mismatch compensation technique for image rejection in a direct-conversion receiver (DCR). The proposed image-rejection circuit adopts DC offset cancellation and a sign-sign least mean squares (LMS) algorithm with a unique step size adaptation both for a fast and precise I/Q mismatch estimation. In addition, several performance-optimizing design considerations related to accuracy, speed, and hardware simplicity are discussed. The implementation of the proposed circuit in an FPGA results in an image-rejection ratio (IRR) of 65 dB, which is the best performance with modulated signals, along with an adaptation time of 0.9 seconds, which is a tenfold increase in the compensation speed as compared to previously reported circuits. The proposed technique will be a promising solution in the area of image rejection to increase both the speed and accuracy of future DCRs.
Su, An;Zhang, Jing;Pan, Zhan-He;Zhou, Qi-Ming;Lv, Xia
Asian Pacific Journal of Cancer Prevention
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v.14
no.3
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pp.1841-1846
/
2013
Anti-angiogenic agents have played crucial roles in the treatment of ovarian cancer in recent years, but potential benefits of endostatin have been largely unexplored. The present retrospective study evaluated its efficacy and toxicity with two cohorts of patients with platinum-resistant recurrent ovarian cancer. One cohort received gemcitabine plus endostar (rh-endostatin), and the second cohort received gemcitabine regimen alone, with totals of 31 and 27 patients, respectively. The main endpoints were disease control rate (DCR), PFS, overall survival (OS) and safety. There were statistically significant differences in DCR (70.9% vs. 40.7%; P = 0.02) and PFS (6.3 months vs. 3.2 months, P = 0.001) between the two cohorts. Though the endostar cohort also improved median OS by 2.1 months, there was no statistically significant difference compared with gemcitabine alone cohort in this case (12.5 months vs. 10.4 months, P = 0.201). Treatment was well tolerated for most patients, and toxicity of endostar was negligible. Gemcitabine plus endostar significantly improved the prognosis in patients with platinum-resistant recurrent ovarian cancer, especially in those with malignant effusion. The endostar-containing regimen is recommended in this setting.
Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.
Background: Soft tissue sarcomas (STS) are a heterogeneous group of tumors, and approximately 40-50% of patients with STS develop metastatic disease. The median overall survival of those patients was 12 months and their 5-year survival rate was 8%. Therefore, study on more effective treatment, especially the targeting therapies, is urgently needed. Objective: To evaluate the efficacy and safety of Endostar$^{(R)}$ combined with chemotherapy in patients with advanced STS. Methods: A retrospective case-series study was conducted in Cancer Institute of PLA, Xinqiao Hospital. A total of 71 patients suffering from advanced STS (IIB - IV) were included, of whom 49 cases treated with chemotherapy alone were defined as the control group and the rest 22 cases treated with the traditional chemotherapy combined with Endostar$^{(R)}$ were defined as the test group. The short-term therapeutic effects including objective response rate (ORR), disease control rate (DCR) and safety were evaluated in the two groups. In the follow-up, progression-free survival (PFS) and overall survival (OS) were also observed. Results: In the test and control groups, the ORR was 18.2% and 12.2%, respectively (P=0.767), and the DCR was 86.4% and 61.2%, respectively (P=0.034). The median time to progression in the test and control groups was 120 days and 70 days with significant difference (P = 0.017), while the median overall survival was 452 days and 286 days without significant difference (P=0.503). The one-year survival rate in the test group and control group was 56.2% and 35.4%, respectively, while the two-year survival rate was 30.2% and 26.5%, respectively. No significant difference in the side effects was found between the two groups. Conclusions: Endostar$^{(R)}$ combined with chemotherapy resulted in a higher DCR and longer PFS in the patients with advanced STS, and the toxicity was tolerable.
Park, Choel-Kyu;Kim, Kyu-Sik;Oh, In-Jae;Tseden-Ish, Manaljav;Choi, Yoo-Duk;Kwon, Yong-Soo;Kim, Yoo-Il;Lim, Sung-Chul;Kim, Young-Chul
Tuberculosis and Respiratory Diseases
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v.67
no.3
/
pp.191-198
/
2009
Background: Pemetrexed, a multi-targeted antifolate has been used as a second line treatment against non-small cell lung cancer (NSCLC). We aimed to clarify the efficacy and survival according to line of treatment, histologic type, and expression of thymidylate synthase (TS). Methods: Ninety-eight patients were treated with pemetrexed as a second line treatment (n=43) or as an additional course of treatment (n=55). TS expression was studied with immunohistochemistry and graded as 0 to 3 based on the extent of expression. Results: The response rate (RR) in 98 subjects was 10.2% and the disease control rate (DCR=PR+SD) was 30.6%. RR and DCR were 12.7% and 32.7% in non-squamous cell carcinoma (NSQC) compared to 7.0% and 27.9% in squamous cell carcinoma (SQC) (p>.05). No significant differences in RR and DCR were observed between a second line group (4.7%, 20.9%) and a further line group (14.5%, 38.2%). A similar trend was observed in the 88 response evaluable subjects. TS was expressed in 28.6% (grade 1), 24.5% (grade 2) and 7.1% (grade 3), respectively, and it was not expressed in 39.8% of subjects. TS expression rate was significantly higher in the SQC (72.1%) compared to NSQC (50.9%, p=0.033). However, the efficacy of pemetrexed was not significantly different by the extent of TS expression. Conclusion: Pemetrexed showed efficacy, not only in a second-line setting, but also in further lines of treatment for NSCLC. The efficacy of pemetrexed tended to be higher in patients with NSQC compared to SQC. TS expression rate was significantly higher in SQC compared to NSQC.
Pyeong Hwa Kim;Chong Hyun Suh;Ho Sung Kim;Kyung Won Kim;Dong Yeong Kim;Eudocia Q. Lee;Ayal A. Aizer;Jeffrey P. Guenette;Raymond Y. Huang
Korean Journal of Radiology
/
v.22
no.4
/
pp.584-595
/
2021
Objective: Immune checkpoint inhibitor (ICI) therapy has shown activity against melanoma brain metastases. Recently, promising results have also been reported for ICI combination therapy and ICI combined with radiotherapy. We aimed to evaluate radiologic response and adverse event rates of these therapeutic options by a systematic review and meta-analysis. Materials and Methods: A systematic literature search of Ovid-MEDLINE and EMBASE was performed up to October 12, 2019 and included studies evaluating the intracranial objective response rates (ORRs) and/or disease control rates (DCRs) of ICI with or without radiotherapy for treating melanoma brain metastases. We also evaluated safety-associated outcomes. Results: Eleven studies with 14 cohorts (3 with ICI combination therapy; 5 with ICI combined with radiotherapy; 6 with ICI monotherapy) were included. ICI combination therapy {pooled ORR, 53% (95% confidence interval [CI], 44-61%); DCR, 57% (95% CI, 49-66%)} and ICI combined with radiotherapy (pooled ORR, 42% [95% CI, 31-54%]; DCR, 85% [95% CI, 63-95%]) showed higher local efficacy compared to ICI monotherapy (pooled ORR, 15% [95% CI, 11-20%]; DCR, 26% [95% CI, 21-32%]). The grade 3 or 4 adverse event rate was significantly higher with ICI combination therapy (60%; 95% CI, 52-67%) compared to ICI monotherapy (11%; 95% CI, 8-17%) and ICI combined with radiotherapy (4%; 95% CI, 1-19%). Grade 3 or 4 central nervous system (CNS)-related adverse event rates were not different (9% in ICI combination therapy; 8% in ICI combined with radiotherapy; 5% in ICI monotherapy). Conclusion: ICI combination therapy or ICI combined with radiotherapy showed better local efficacy than ICI monotherapy for treating melanoma brain metastasis. The grade 3 or 4 adverse event rate was highest with ICI combination therapy, and the CNS-related grade 3 or 4 event rate was similar. Prospective trials will be necessary to compare the efficacy of ICI combination therapy and ICI combined with radiotherapy.
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