• Journal of Korean Academy of Nursing
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• v.37 no.3
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• pp.324-333
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• 2007

Purpose: The purpose of this study was to develop and evaluate a quality of life scale for Korean patients with cancer (C-QOL). Methods: The C-QOL was developed and validated as follows, item generation, pilot study, and psychometric tests. A total of 337 patients diagnosed with stomach, liver, lung, colon, breast, or cervix cancer were recruited. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, the SF-36, and the ECOG performance status. The obtained data was analyzed using descriptive statistics, factor analysis, multidimensional scaling (MDS), multitrait/multi-item matrix, ANOVA, t-test, and Cronbach's alpha. Results: Preliminarily twenty-six items were generated through content validity and a pilot study. Factor analysis and MDS extracted a total of 21 items with a 5-point Likert-type scale (C-QOL). The C-QOL included five subscales: physical status (6 items), emotional status (6 items), social function (3 items), concern status (2 items), and coping function (4 items). The C-QOL established content validity, construct validity, item convergent and discriminant validity, known-groups validity, reliability, and sensitivity. Conclusion: The Newly developed C-QOL is an easily applicable instrument which established psychometric properties and reflected Korean culture. It is recommended for further study to examine the responsiveness of the C-QOL using a longitudinal research design.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.11-20
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• 2006

Puroose: In order to find out whether stereotactic radiation therapy (RT) using CyberKnife (CK) could improve survival rate and lower acute toxicity compared to conventional RT. Materials and Methods: From April 2003 through April 2004, 19 patients with Eastern Cooperative Oncology Group (ECOG) performance status ${\leq}3$ and locally advanced pancreas cancer without distant metastasis, evaluated by CT or PET/CT, were included. We administered stereotactic RT consisting of either 33 Gy, 36 Gy or 39 Gy in 3 fractions to 6, 4 and 9 patients, respectively, in an effort to increase the radiation dose step by step, and analyzed the survival rate and gastrointestinal toxicities by the acute radiation morbidity criteria of Radiation Therapeutic Oncology Group (RTOG). Prognostic factors of age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9, planning target volume (PTV), and adjacent organ and vessel invasion on CT scan were evaluated by Log Rank test. Results: The median survival time was 11 months with 1-year survival rate of 36.8%. During follow-up period (range $3{\sim}20$ months, median 10 months), no significant gastrointestinal acute toxicity (RTOG grade 3) was observed. In univariate analysis, age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9 level, and adjacent organ and vessel invasion did not show any significant changes of survival rate, however, patients with PTV (80 cc showed more favorable survival rate than those with PTV>80 cc (p-value<0.05). In multivariate analysis, age younger than 65 years and PTV>80 cc showed better survival rate. Conclusion: In terms of survival, the efficacy of stereotactic radiation therapy using CK was found to be superior or similar to other recent studies achieved with conventional RT with intensive chemotherapy, high dose conformal RT, intraoperative RT (IORT), or intensity modulated RT (IMRT). Furthermore, severe toxicity was not observed. Short treatment time in relation to the short life expectancy gave patients more convenience and, finally, quality of life would be increased. Consequently, this could be regarded as an effective novel treatment modality for locally advanced, unresectable pancreas cancer. PTV would be a helpful prognostic factor for CK.

• Tuberculosis and Respiratory Diseases
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• v.62 no.3
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• pp.217-222
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• 2007

Talc pleurodesis is a safe and effective treatment for a recurrent malignant pleural effusion. However, acute hypoxemia, pulmonary edema or acute respiratory failure can develop in a small number of patients. We report 2 patients who developed fatal hypoxemia after talc pleurodesis which was necessary the control recurrent pleural effusion. The first case was an 18-year old male diagnosed with Ewing's sarcoma with bilateral lung metastases and pleural effusion. The performance status was ECOG (Eastern Cooperative Foncology Group) grade 3. Fever along with hypoxemia and leukocytosis developed 10 hours after the second talc pleurodesis on the right side for an uncontrolled pleural effusion, The patient died from respiratory failure after 13 days. The second case was a 66-year old female diagnosed with non-small cell lung cancer with a bone metastasis. Two weeks after systemic chemotherapy, she complained of dyspnea, and a pleural effusion was observed on the right side. Her performance status was ECOG grade 3. Talc pleurodesis was performed for recurrent pleural effusion, but hypoxemia developed 6 days after pleurodesis and she died from respiratory failure 10 days after pleurodesis. In conclusion, talc pleurodesis should be performed very carefully in patients with a poor performance status, in cases with repeated pleurodesis, bilateral pleural effusion, recent chemotherapy, radiotherapy and when there are parenchymal metastatic lesions present.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2355-2359
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• 2015

Background: Combination chemotherapy of 5 fluorouracil (5-FU) and leucovorin (LV) with oxaliplatin, mainly FOLFOX regimens, has shown considerable antitumor activity and a tolerable toxicity profile in gastric cancer. The goal of this study was to retrospectively compare the efficacy and toxicity of modified FOLFOX-6 (mFOLFOX6) regimen in advanced gastric cancer (AGC) patients with good and poor performance status (PS). Materials and Methods: AGC patients receiving the mFOLFOX6 regimen including oxaliplatin $85mg/m^2$, bolus of 5-FU $400mg/m^2$ and LV $400mg/m^2$ on the first day, followed by $2400mg/m^2$ of 5- FU as a continious infusion over 46 hour for first-line treatment were eligible for the study. Results: A total 58 patients with a median age of 59.5 (32-81) were included. The median follow up of the study was 9.2 months. Thirty patients (51.7%) with an ECOG PS 0-1 were assigned to the good PS arm, while 28 patients (48.3%) with ECOG PS 2 were in the poor PS arm. Overall response rates were 36.6 and 28.8%, respectively (p=0.91). Median PFS was 6.7 and 6.3 months in good PS and poor PS arms (p=0.50) and median OS was 9.6 and 10.4 months (p=0.55). As compared with good PS arm, poor PS arm was associated with more grade 3-4 neutropenia and anemia. Dose reduction and dose delays were also significantly higher. Conclusions: In this study, mFOLFOX6 was similarly effective in both arms. Although hematologic toxicity was significantly higher in patients with poor PS, it remained manageable. Our results suggest that this regimen may be an effective treatment option for AGC patients with poor PS.

• The Journal of Korean Medicine
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• v.37 no.2
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• pp.104-109
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• 2016

Objectives: A 74-year-old male patient with unresectable advanced gastric cancer (clinical initial stage T3N+, Borrmann type III) admitted due to gastric bleeding at tumor site. On first admission day, hemoglobin level was 5.7g/dl and performance status was grade 3 according to Eastern Cooperative Oncology Group Performance Status(ECOG-PS). After performing red blood cell transfusion as an emergency treatment, hemoglobin level was increased up to 9.5g/dl. However, bleeding of oozing site was continued. For hemostasis, decoction of notoginseng radix (30g/day) was administered since day 7 after admission. The dose was elevated to 40g/day after hemoglobin level was decreased to 6.5g/dl on day 11. Since then, melena was stopped and hemoglobin level was maintained over 9.1g/dl. This case shows the hemostasis effect of decoction of notoginseng radix on gastric bleeding in unresectable advanced gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1213-1217
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• 2015

Background: Gastric cancer is the second most common cause of cancer- related deaths worldwide and ranks $11^{th}$ or $14^{th}$ among all deaths. Patients with advanced disease require supportive care along with the medical and/or surgical treatment. Aim: To assess the need for palliative care for patients with advanced tumours along with standard clinical therapy. Materials and Methods: Eighty-four patients with metastatic (stage 4) gastric cancer, including both patients who had received surgical treatment or not, were followed up in Bagcilar Training and Research Hospital, Division of Medical Oncology between 2011 and 2014. They were categorised as supportive care (-) (Group 1, n=37) and (+) groups (Group 2, n=47) and evaluated retrospectively. Results: Demographic characteristics of the patients were as follows: mean age, Group 1, $65.2{\pm}10.5$ years, Group $2,63.7{\pm}11.3$ years; male/female ratio, Group 1, 21/16, Group 2, 28/19; distribution of Eastern Cooperative Oncology Group (ECOG) performance scores of 0 and 1, Group 1, ECOG 0 (n=9) and 1 (n=14), Group 2, ECOG 0 (34) and 1 (n=13) (p<0.0001); patients receiving second-line, Group 1 (n=7) and Group 2 (n=22) (p<0.008) or third - line chemotherapy,Group 2 (n=6) (p<0.02); mortality rates, Group 1, (n=28; 75.6%) and Group 2 (n=30; 63.8%); progression-free survival (PFS) rates, Group 1, $17.4{\pm}6$ weeks, Group 2, $28.3{\pm}16.2$ weeks; statistically significant overall survival rates, Group 1, $20.8{\pm}8.2$ weeks and Group 2, $28.3{\pm}162$ weeks (p<0.01). Conclusions: The supportive care team (medical oncologist, general surgeon, internal medicine specialist, algologist, psychiatrist and radiologist) can play a role in the treatment of metastatic gastric tumours, with improvements shown in terms of the performance status of cases, eligibility of patients to be on chemotherapy programmes for longer duration and overall survival rates in Turkey.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.660-668
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• 1999

Background: Lung cancer continues to increase and one half of all cases of lung cancer occur in patients age 65 years and older. However, it seems that lung cancer is less treatable in elderly patients because of co-morbid illness or poor tolerance of surgery and chemotherapy. The intention of this study is to seek an adequate treatment approach for lung cancer in the elderly through an understanding of its characteristics. Method: The clinical data of 207 patients who were diagnosed with histologically proven lung cancer at the department of internal medicine in Seoul Municipal Boramae Hospital between September 1994 and August 1998 were retrospectively analyzed according to their age groups; group I$\geq$65 years(n=122) and group II<65 years(n=85). Results: The peak incidence of age was 7th decade(36.2%) and male age 65 years and older were 42% of all patients. Although dyspnea was more common in group I(26%) than in group II(11%)(p=.0l), there were no significant difference in other symptoms, stage, and histologic type between two groups. Group I significantly had more patients with poor performance(ECOG 3&4) than group II(35.2% vs.12.9%, p=.000). The percentage of patients with non-small cell carcinoma received supportive care only was significantly higher in group I than in group I(74% vs. 35%, p=.000). However, survival of patients who had curative intent treatment was similar between two groups(median survival 11.3 mos vs. 23 mos, p>.05). The histologic subtype, stage and performance status were significant prognostic factors affecting survival, but age itself was not. Conclusion : Lung cancer is prevalent in the elderly and aggressive diagnosis and treatment should be considered in elderly patients with good performance status.

• Journal of Korean Academy of Nursing
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• v.39 no.5
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• pp.683-692
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• 2009

Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

• Journal of Sasang Constitutional Medicine
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• v.25 no.4
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• pp.432-441
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• 2013

Objectives Despite the treatment with antibiotics, patients with sepsis has a high mortality (80%) in the underlying disease group. The aim of this study was to report the improvement of septic condition of the cholangiocarcinoma patient after the treatment with Handayeolso-tang, Fel Tauri, and antibiotics. Methods We retrospectively reviewed the medical records. The patient's subjective symptoms such as chilling and abdominal pain were evaluated by NRS and the performance status was evaluated by ECOG. This case was literally compared with relevant published studies on prognosis of sepsis. Results Despite poor prognostic factor(MEDS score 18), the patient's symptoms such as fever, chilling, abdominal pain, and diarrhea and ECOG(Eastern Cooperative Oncology Group) improved. The patient was hemodynamically stabilized on 3rd day from the treatment, and her laboratory test results were normalized on 7th day. Conclusions A female patient of metastatic cholangiocarcinoma came to the hospital for cholangitis, later causing septic shock. Both her symptoms and laboratory tests showed significant improvement after the treatment of antibiotics, Handayeolso-tang and Fel Tauri. To our knowledge, this is the first case reporting the synergistic combination of Korean oriental medicine and Western medicine approaching to sepsis.

• Journal of Korean Traditional Oncology
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• v.24 no.2
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• pp.33-41
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• 2019

Objectives : The purpose of this case report is to examine clinical application of Traditional Korean medicine including aconitum ciliare decaisne pharmacopuncture for cancer pain caused by bone metastasis of non small cell lung cancer. Methods : The patient diagnosed as non small cell lung cancer was treated with pharmacopuncture, acupuncture, electroacupuncture and herbal medicine. We used NRS(Numeric rating scale) and ECOG PS(Eastern Cooperative Oncology Group Performance Status) to observe the effect of the treatment. Results : After the treatment, NRS of cancer pain and ECOG PS score decreased. Also, the frequency of using rapid-onset opioids decreased. Conclusions : This study suggests Traditional Korean medicine treatment including aconitum ciliare decaisne pharmacopuncture is effective in cancer pain control caused by metastasis to bone with multiple organs with non small cell lung cancer.