• 제목/요약/키워드: FU

검색결과 1,670건 처리시간 0.033초

화학요법을 받는 부인암환자의 구강불편감에 관한 연구 (A study on oral discomfort in gynecological cancer patients undergoing chemotherapy)

  • 정재원
    • 대한간호학회지
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    • 제25권2호
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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유수분화기 식생지수와 SPAD값에 의한 벼 질소 수비 시용량 결정 (Determining Nitrogen Topdressing Rate at Panicle Initiation Stage of Rice based on Vegetation Index and SPAD Reading)

  • 김민호;부금동;이변우
    • 한국작물학회지
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    • 제51권5호
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    • pp.386-395
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    • 2006
  • 목표 수량과 단백질함량을 얻기 위한 질소 수비처방을 위해서는 유수형성기 전후 생체정보의 정확한 진단뿐만 아니라 유수형성기 이후 작물의 질소 축적 및 이에 따른 수량 및 미립 단백질 함량 반응이 정량화 되어야 한다. 본 연구에서는 유수분화기 생육 및 질소영양상태를 잘 대표하는 RVI green과 현재 널리 이용되고 있는 SPAD값의 유수분화기와 유수분화기 1주일전의 측정치 및 유수분화기부터 수확기까지 즉 생식생장기 지상부 질소 축적량(PNup)을 변수로 하는 수량 및 단백질함량 예측 중회귀 모델과 PNup 예측 회귀모델을 작성하여 이들의 수비 처방에의 이용 가능성을 검토하였다. 1. 유수분화기 및 유수분화기 1주일전의 RVIgreen과 SPAD값, 그리고 PNup을 이용하여 얻은 수량과 단백질함량의 중회귀모형은 어느 경우에나 모델의 결정계수($R_{2}$)가 0.9 이상으로 매우 높았다 2. 수량을 최대로 하는 생식생장기 질소흡수량(PNup)은 유수형성기 전후 RVIgreen이 증가할수록 감소하는 경향을 보였는데 본 연구의 유수형성기 전후 RVIgreen 범위로 보면 $9{\sim}13.5kg/10a$ 으로 추정되었다. 또한 PNup은 유수형 성기 전후 SPAD값과는 무관하게 $10{\sim}11kg/10a$ 범위로 나타났다. 3. 미립의 단백질함량을 7% 이하로 하는 유수형성기 질소흡수량은 유수형성기 전후 RVIgreen과 SPAD값이 증가할수록 감소하는 경향으로 어느 경우에나 $6{\sim}8kg/10a$로 추정되어 최대수량을 위한 생식생장기 질소흡수량 $9{\sim}13.5kg/10a$ 보다 크게 낮았다. 따라서 고품질 쌀 생산을 위한 수비 처방을 위해서는 수량보다도 단백질함량을 기준으로 하여 처방하여야 할 것으로 판단되었다. 4. 본 실험결과 수비질소의 회수율은 $53{\sim}83%$의 변이를 보였는데, 생식생장기 생육량이 많을 수록 회수율이 증가하는 경향이었으며, 수비 시용량이 증가함에 따라서 감소하였다. 생식생장기 천연질소공급량은 $3{\sim}4kg/10a$ 범위였으며 유수분화기 생육량이 많을 경우 증가하는 경향이었다 수비 질소시비량 및 유수분화기 생육 및 질소 영양 지표들을 예측변수로하는 PNup 예측모델을 작성하였으며 이 모델들은 적합도가 매우 높았다. 5. 영양생장기 생육 및 질소영양 상태의 비파괴적 측정치를 이용하여 목표 수량과 단백질함량에 달할 수 있도록 수비질소 시용량을 결정할 수 있을 것으로 판단되었다. 그러나 여기서 제시한 모델들이 광범위한 조건에서 이용될 수 있기 위해서는 보다 다양한 품종, 토양, 기상 조건에서 모델의 검증과 보완이 되어야 할 것으로 판단된다.

항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교 (Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment)

  • 지의규;하성환;박재갑;방영주;허대석;김노경
    • Radiation Oncology Journal
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    • 제20권1호
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    • pp.62-67
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    • 2002
  • 목적 : 항문암의 치료에 있어 고전적으로는 복회음부절제술이 주된 치료였으나 현재는 화학방사선병용요법이 주된 치료방법으로 정립되었다. 저자들은 서울대학교병원에서 항문암으로 치료 받은 환자의 임상적 특성을 조사하고, 치료방법에 따른 치료성적과 예후인자를 분석하고자 하였다. 대상 및 방법 : 1979년 8월부터 1990년 7월까지 서울대학교병원 치료방사선과에서 근치적 또는 수술 후 방사선 치료를 받은 42명의 환자를 대상으로 후향적으로 분석하였다. 표피양암종이 38명으로 방사선치료가 4명에서, 복회음부절제술 및 수술 후 방사선치료${\pm}$화학요법이 19명에서, 화학방사선요법이 15명에서 시행되었다. 화학방사선요법은 복합화학요법$(5-FU\;1,000\;mg/m^2\;D1\~5,\;cisplatin\;60\;mg/m^2\;D1)$을 3회 시행 후 원발병소 및 영역림프절에 50.4 Gy를 조사하였고, 양측 서혜림프절에도 동일양을 조사하였다. 잔존암이 있는 경우 복합화학요법을 3회 추가 실시하였다. 중앙추적기간은 85개월이었다. 결과 : 전체 항문암 환자의 5년 생존율은 $80.3\%$이었다. 치료방법에 따른 5년 생존율은 복회음부절제술 및 수술 후 방사선치료${\pm}$화학요법군, 화학방사선요법군에서 각각 $88.9\%,\;79.4\%$이었으며 두군간의 생존율의 차이의 통계적인 의미는 없었다(p=0.495). 화학방사선요법을 시행 받은 환자군에서의 항문보존율은 $86.7\%$였다. 예후인자 중 단변량분석에서는 연령(p=0.0164)과 수행능력(p=0.0007)이 유의성을 보였으며, 다변량분석에서는 연령(p=0.0426)과 수행능력(p=0.0068) 및 서혜림프절 전이여부(p=0.0093)가 통계학적으로 유의하였다. 결론 : 항문암의 치료에 있어서 화학방사선요법을 시행할 경우 기존에 알려진 바와 같이 복회음부절제술과 유사한 생존율을 보이며, 항문기능을 보존할 수 있는 치료 방법임을 확인할 수 있었다. 나아가 병행화학요법이 아닌 선행화학요법을 시행하여 수반되는 합병증을 줄일 수 있는 가능성을 확인하였다.

동병하치 확산을 위한 전략적 방향과 이행방안 (Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer)

  • 송호섭
    • Journal of Acupuncture Research
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    • 제27권3호
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.

모체 thyroxine 투여가 새끼 흰쥐 대뇌의 태아 알코올 효과에 미치는 영향 (Effect of maternal thyroxine treatment on the offspring's brain development with fetal alcohol effects in the rats)

  • 김복;정윤영;박상기
    • Clinical and Experimental Pediatrics
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    • 제49권6호
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    • pp.677-685
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    • 2006
  • 목 적 : 임신 기간 중 지속적으로 알코올을 섭취하는 모체에 thyroxine을 투여하여 알코올의 유해한 영향으로 인한 대뇌의 태아 알코올 효과를 개선시킬 수 있는지를 알아보고자 했다. 방 법 : 실험동물은 매일 35칼로리 정도의 알코올을 섭취한 알코올군, 알코올 대신 dextrin이 첨가된 유동액을 섭취한 정상군, 알코올군과 같은 양의 알코올을 매일 섭취하고 thyroxine을 매일 $5{\mu}g/kg$ 피하 주사한 알코올+$T_4$ 군으로 분류하였다. 임신한 흰쥐 모체가 분만이 끝나면 각 군에서 태어난 새끼들은 그 어미와 분리하여 사료와 물을 자유롭게 섭취하는 대리모에게 키우게 하였다. 한 배의 새끼 1마리씩 총 4마리를 생후 0, 7, 14, 21, 28일에 희생시켜 면역조직화학염색을 시행하여 대뇌겉질 및 해마에서 생후 연령에 따른 NPY 함유 신경세포의 발달과 성숙양상을 관찰하였다. 결 과 : 대뇌겉질에서는 알코올+$T_4$ 군에서 생후 7일에 NPY 함유 신경세포들이 알코올군과 정상군보다 더 뚜렷한 양성반응을 나타내기 시작하였으며, 생후 14일 이후부터는 대뇌겉질의 전 층에 걸쳐 광범위하게 NPY 함유 신경세포들이 관찰되었고 연령 증가에 따른 세포의 감소가 나타나지 않았으나 알코올군은 NPY 함유 신경세포가 생후 28일에 다른 군에 비해 현저히 감소하는 양상을 나타냈다. 해마에서는 알코올+$T_4$ 군에서 생후 7일부터 정상군과 유사한 분포 양상을 나타냈으며 알코올군과는 뚜렷한 차이를 보였다. 특히 생후 14일에 대뇌겉질 및 해마 모두에서 알코올+$T_4$ 군의 NPY 함유 신경세포 분포 및 신경얼기 형성이 두드러졌다. 결 론 : 임신 중 알코올 남용을 하는 모체에 지속적인 $T_4$ 투여는 그 후손들의 뇌에 분포하는 NPY 함유 신경세포의 발달을 정상 군과 유사하게 촉진시킬 수 있을 것으로 생각되며 모체 $T_4$ 투여가 특히 출생 초기의 NPY 합성에 영향을 미쳐 태아 알코올 효과를 개선시킬 수 있을 것으로 생각된다.

<니모를 찾아서> 캐릭터에 내재된 두려움과 욕망 분석: 에니어그램 성격유형론에 근거하여 (An Analysis of the Inherent Fear and Desire of the Character: Based on the Enneargram Personality Types Theory)

  • 양세혁
    • 만화애니메이션 연구
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    • 통권29호
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    • pp.1-36
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    • 2012
  • 픽사(Pixar)의 2003년 작품 <니모를 찾아서>는 흥행과 비평 면에서 크게 성공함으로써 픽사를 가장 영향력 있는 애니메이션 제작사의 위치에 올려놓았다. 특히 캐릭터 중심의 서사전략은 캐릭터 성격화와 관계성의 완성도를 크게 높임으로써 캐릭터라이징의 교과서라 할 만한 업적을 이루었다. 본 연구에서는 <니모를 찾아서>의 캐릭터에 내재된 두려움과 욕망에 주목했는데, 캐릭터 성격화와 관계성을 보다 역동적이며 입체적으로 강화하는 요소라고 여겼기 때문이다. 일반적으로 인간은 두려움과 욕망에 의해 모든 선택과 행동의 방향이 정해지기 때문에 삶이 이 두 가지 요소의 지배를 받는다고 여겨지고 있다. 이러한 관점에서<니모를 찾아서>의 캐릭터라이징은 크게 세 가지 특성을 갖고 있다. 그것은 (1) 픽사의 다른 어떤 작품보다도 캐릭터의 내재된 두려움을 명확히 하고 있으며, 그 두려움을 회피하는 노력이 서사화 된다는 점. (2) 에니어그램 성격유형에서 정립한 두려움과 욕망에 의한 성격역동과 놀랍도록 일치한다는 점. (3) 중심 캐릭터(멀린, 니모)가 서로 떨어져 있는 구출과 탈출 플롯의 특성 상, 두려움이 해소되는 방식이 중심 캐릭터간의 상호 성격역동에 의한 것이 아닌, 중심 캐릭터의 결핍을 보완하는 정신적 가치를, 주변 캐릭터(도리, 길)로 성격화하여 이루어졌다는 점이다. 선행연구 작품인 <쿵푸팬더>에서는 팬더 포의 캐릭터라이징이 너무 월등하다는 점이 역설적인 한계로 작용하지만, 중심 캐릭터(포, 시푸)의 두려움+욕망 설정과 상호 성격역동은 매우 정교하며 효과적이었다. 반면에 <니모를 찾아서>는 중심 캐릭터인 아빠와 아들간의 갈등이 해결되는 과정에서 다양한 캐릭터와 서브플롯을 선보이며 신선한 재미와 견고한 서사구조를 갖추고 있지만, 중심 캐릭터의 두려움과 욕망 설정의 완성도가 매우 뛰어남에도 불구하고, 그 해소의 과정이 다소 의존적이라는 한계를 드러내고 있다. 끝으로 본 연구가 애니메이션 캐릭터라이징과 관련하여 또 다른 접근방법이 될 수 있으리라 사료되며, 캐릭터 성격화와 관계성 설정 시 도움이 되길 희망한다.

Assessment of Breast Cancer Knowledge among Health Workers in Bangui, Central African Republic: a Cross-sectional study

  • Balekouzou, Augustin;Yin, Ping;Pamatika, Christian Maucler;Nambei, Sylvain Wilfrid;Djeintote, Marceline;Doromandji, Eric;Gouaye, Andre Richard;Yamba, Pascal Gastien;Guessy, Elysee Ephraim;Ba-Mpoutou, Bertrand;Mandjiza, Dieubeni Rawago;Shu, Chang;Yin, Minghui;Fu, Zhen;Qing, Tingting;Yan, Mingming;Mella, Grace;Koffi, Boniface
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3769-3776
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    • 2016
  • Background: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. Materials and Methods: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's ${\chi}^2$ test and ANOVA were applied to examine associations between variables with p < 0.05 being considered significant. Results: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. Conclusions: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

암화학요법을 받는 유방암 환자의 불안, 절망감 및 가족지지와의 관계 (The Relationship of Anxiety, Hopelessness, and Family Suppoort of Breast Cancer Patients Undergoing Chemotherapy)

  • 박점희;이현주;김현미;류은경
    • 기본간호학회지
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    • 제4권1호
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    • pp.147-162
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    • 1997
  • This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

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절제 불가능한 진행성 위암 환자에서 Etoposide, Adriamycin 및 Cisplatin-II (EAP-II)와 Etoposide, Leucovorin 및 5-Furorouracil (ELF) 복합 화학요법의 치료효과에 대한 후향적 연구 (Retrospective Study on the Therapeutic Effects of an Etoposide, Adriamycin, Cisplatin-II (EAPII) versus an Etoposide, Leucovorin, 5-Furorouracil (ELF) Combination Chemotheraphy in Unresectable Gastric Cancer)

  • 문희석;강윤세;김연수;박기오;이엄석;성재규;이병석;노승무;송규상;조준식;신경숙;정현용
    • Journal of Gastric Cancer
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    • 제3권3호
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    • pp.122-127
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    • 2003
  • Purpose: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn't duplicate the result. the purpose of this study was to evaluate the relative efficacy & toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. Materials and Methods: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/$m^{2}$ IV for $1\∼5 days$), adriamycin (20 mg/$m^{2}$ IV for $1\∼5 days$) and cisplatin (20 mg/$m^{2}$ IV for $1\∼5 days$) and Twenty-eight patients receieved ELF chemotherapy : etoposide (100 mg/$m^{2}$ IV for $1\∼3 days$), leucovorin (20 mg/$m^{2}$ IV for $1\∼5 days$) and 5-FU (500 mg/$m^{2}$ IV for $1\∼5 days$). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient..ELF means 4.1 cycles per patient Results: Total respones rates were $5.4\%$ in the ELF group and $3.6\%$ in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value<0.05), and themedian overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis & hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: $27.6\%$ in ELF vs $54\%$ in EAP-II; Leukopenia: $8.5\%$ in ELF vs $19\%$ in EAP-II; nausea & vomiting: $45.9\%$ in ELF vs $67.8\%$ in EAP-II. Conclusion: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer (J Korean Gastric Cancer Assoc 2003;3:122-127)

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Decitabine in the Treatment of Acute Myeloid Leukemia and Myelodysplastic Syndromes, Which Combined with Complex Karyotype Respectively

  • Gao, Su;Li, Zheng;Fu, Jian-Hong;Hu, Xiao-Hui;Xu, Yang;Jin, Zheng-Ming;Tang, Xiao-Wen;Han, Yue;Chen, Su-Ning;Sun, Ai-Ning;Wu, De-Pei;Qiu, Hui-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6627-6632
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    • 2015
  • Background: We conducted a study exploring the clinical safety and efficacy of decitabine in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), combined with a complex karyotype. Materials and Methods: From April 2009 to September 2013, a total of 35 patients with AML/MDS combined with a complex karyotype diagnosed in the First Affiliated Hospital of Soochow University were included for retrospective analysis. All patients were treated with decitabine alone ($20mg/m^2$ daily for 5 days) or combination AAG chemotherapy (Acla 20mg qod*4d, Ara-C $10mg/m^2$ q12h*7d, G-CSF $300{\mu}g$ qd, the dose of G-CSF adjusted to the amount in blood routinely). Results: In 35 patients, 15 exhibited a complete response (CR), and 6 a partial response (PR), the overall response rate (CR+PR) being 60% (21 of 35). Median disease-free survival was 18 months and overall survival was 14 months. In the 15 MDS patients with a complex karyotype, the CR rate was 53.3% (8 of 15); in 20 AML patients with complex karyotype, the overall response rate was 65% (13 of 20). The response rate of decitabine alone (22 cases) was 56.5% (13 of 22), while in the combination chemotherapy group (13 cases), the effective rate was 61.5% (8 of 13)(P>0.05). There are 15 patients with chromosome 7 aberration, after treatment with decitabine, 7 CR, 3 PR, overall response rate was 66.7% (10 of 15). Of 18 patients with 3 to 5 kinds of chromosomal abnormalities, 66.7% demonstrated a response; of 17 with more than 5 chromosomal abnormalities, 52.9% had a response. In the total of 35 patients, with one course (23 patients) and ${\geq}$two courses (12 patients), the overall response rate was 40.9% and 92.3% (P<0.05). Grade III to IV hematological toxicity was observed in 27 cases (75%). Grade III to IV infections were clinically documented in 7 (20%). Grades I to II non-hematological toxicity were infections (18 patients), haematuria (2 patients), and bleeding (3 patients). With follow-up until September 2013, 7 patients were surviving, 18 had died and 10 were lost to follow-up. In the 6 cases who underwent allogeneic hematopoietic stem cell transplantation (HSCT) all were still relapse-free survivors. Conclusions: Decitabine alone or combination with AAG can improve outcome of AML/MDS with a complex karyotype, there being no significant difference decitabine in inducing remission rates in patients with different karyotype. Increasing the number of courses can improve efficiency. This approach with fewer treatment side effects in patients with a better tolerance should be employed in order to create an improved subsequent chance for HSCT.