• Title/Summary/Keyword: Hazard Factor

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Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

Evaluation of Response Modification Factors for Steel Moment Frame Buildings Subjected to Seismic Loads (지진 하중을 받는 철골 모멘트 골조 빌딩에 대한 반응수정계수의 평가)

  • Lee, Kihak;Woo, Sungwoo
    • Journal of Korean Society of Steel Construction
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    • v.18 no.5
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    • pp.585-596
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    • 2006
  • This study focuses on the seismic behavior of 3-, 9-, and 20-story steel moment resisting frame (MRF) structures designed in accordance with the 2000 International Building Code using different Response Modification factors (R factors), i.e., 8, 9, 10, 11, and 12. For a detailed case study, 30 different structures were evaluated for 20 ground motions representing the hazard level, which is equal to a 2% probability in 50 years (2% in 50 years). The results showed that the current R factors provide conservative designs for the 3- and 9-story buildings for the Collapse Prevention performance objective. the 20-story buildings, which were designed without using the minimum requirement of spectral acceleration CS prescribed in IBC 2000, did not satisfy the seismic performance for Collapse Prevention performance.

Risk of Stroke according to the Duration of Diabetes Mellitus with Hypertension (고혈압을 동반한 당뇨병에서 유병기간에 따른 뇌졸중 위험도)

  • Kim, Hee Sung
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.188-193
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    • 2020
  • Stroke is a major cause of death and disorder, and diabetes mellitus (DM) is a significant risk factor of stroke. This study examined the importance of target blood pressure (<140/<90 mmHg) management in patients with DM. Based on the data of the 6th National Health and Nutrition Examination Survey, a total of 16,389 patients aged 18 to under 80 were assessed through regression analysis to estimate the risk of stroke through blood pressure control. The prevalence of stroke according to the presence or absence of DM was higher in the diabetic group, and a longer duration of DM indicated a higher risk of hypertension and stroke. The hazard ratio of stroke was lower in the maintenance group (0.57) of target blood pressure (<140/<90 mmHg) compared to the high blood pressure group(>140/>90 mmHg). Despite the accompanying treatment for DM and hypertension, the frequency of hypertension increased, and the prevalence of stroke increased after five years of DM. Hence, effective blood pressure management at this time is important. The risk of stroke should be reduced by continuously managing blood pressure in DM.

One Dimensional Seismic Response Analysis on Sub-ground of Architectural Heritage in Seoul, Korea (서울지역 주요 문화재 하부 지반에 대한 일차원 지진응답해석)

  • Jeon, Seongkon;Kim, Dukmoon;Kwon, Youngcheul
    • Journal of the Korean GEO-environmental Society
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    • v.15 no.9
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    • pp.29-36
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    • 2014
  • Under the situation that the seismic vulnerability are a worsening problem in many world's megacities, the disaster preparedness including earthquake hazards is a matter of primary concern in the capital city of Korea, Seoul. Especially, because it is hard to move or dismantle the architectural heritages, the mitigation of earthquake damages is potentially more difficult than other structures. Moreover, in order to decide the proper preparedness plan against future earthquakes, it is very important to understand how soils pass the seismic waves to architectural heritages. In this paper, therefore, the ground condition and depth of bedrock was investigated by the MASW-method at heritages located in Seoul. Then one-dimensional seismic response analysis was conducted based on the distribution of shear wave velocity. As the major result of analyses, peak acceleration, site amplification factor and natural period are proposed in each site for recurrence period.

Prognostic Value of β-catenin Expression in Breast Cancer Patients: a Meta-analysis

  • Zhang, De-Pu;Li, Xiao-Wei;Lang, Jing-He
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5625-5633
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    • 2015
  • Background: ${\beta}$-catenin plays a crucial role in the progression of breast cancer (BC) and a prognostic role of in BC patients has been widely reported. However, controversy still remains. Materials and Methods: Identical search strategies were used to search relevant literature in electronic databases updated to July 1, 2014. Individual hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled HRs with 95%CIs were used to evaluate the strength of association between positive ${\beta}$-catenin expression in different subcellular locations and survival results of BC patients. Subgroup and meta-regression analyses were performed to explore heterogeneity. Funnel plots of Begg's and Egger's linear regression test were used to investigate publication bias. Heterogeneity and sensitivity were also assessed. All the work was completed using STATA. Results: A total of 2,204 patients from 12 evaluative studies were finally included. Pooled HRs and 95%CIs suggested that ${\beta}$-catenin expression in cytoplasm/nucleus had an unfavorable impact on both overall survival (OS) (HR: 1.93, 95%CI: 1.40-2.65) and disease free survival (DFS)/ recurrent free survival (RFS) (HR: 1.60, 95%CI: 1.20-2.13) in BC patients. However, here was no significant association between ${\beta}$-catenin expression in the membranes with OS (HR: 0.65, 95%CI: 0.42-1.02) or DFS/RFS (HR: 0.66, 95%CI: 0.38-1.13). Publication bias was absent in all of the four outcomes. Sensitivity analysis revealed that the results of this meta-analysis were robust. Conclusions: Positive ${\beta}$-catenin expression in cytoplasm/nucleus rather than in membrane is a significant prognostic factor in patients with BC who have been surgically treated.

Prognostic Value of Chemotherapy-Induced Amenorrhea in Breast Cancer: a Meta-Analysis

  • Zha, Quan-Bin;Tang, Jin-Hai;Li, Xiu-Juan;Xia, Lei;Zhang, Zhe;Ren, Zhao-Jun;Xu, Xin-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5939-5944
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    • 2015
  • Background: There is still a great deal of controversy with regard to the prognostic role of chemotherapy-induced amenorrhea (CIA) in breast cancer patients. To confirm whether CIA can serve as a useful factor in predicting clinical effects of systemic adjuvant chemotherapy, we performed this meta-analysis. Materials and Methods: Relevant studies were identified using PubMed, and Embase databases. Eligible study results were pooled and summary hazard ratios (HRs) with corresponding confidence intervals (CIs) were calculated. Subgroup analyses and an assessment of publication bias were also conducted. Results: A total of 8,333 patients from 11 published studies were identified through searching the databases. The pooled HRs for disease-free survival (DFS) suggested that CIA was associated with a significant reduction in the risk of recurrence, especially in patients with hormone receptor-positive lesions (overall HR=0.65, 95%CI 0.53-0.80, $I^2=41.3%$). When the five studies reporting the HR for overall survival (OS) were pooled (n=4193), a favorable trend was found (HR=0.69, 95%CI 0.52-0.91, $I^2=51.6%$). No publication bias was observed in this study. Conclusions: This meta-analysis suggests that CIA predicts a better outcome in premenopausal hormone receptor-positive breast cancer patients.

Mean Platelet Volume as a Prognostic Marker in Metastatic Colorectal Cancer Patients Treated with Bevacizumab-Combined Chemotherapy

  • Tunce, Tolga;Ozgun, Alpaslan;Emirzeoglu, Levent;Celik, Serkan;Bilgi, Oguz;Karagoz, Bulent
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6421-6423
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    • 2014
  • Background: Recent studies have revealed a prognostic impact of the MPV (mean platelet volume)/platelet count ratio in terms of survival in advanced non-small cell lung cancer. However, there has been no direct analysis of the survival impact of MPV in patients with mCRC. The aim of the study is to evaluate the pretreatment MPV of patients with metastatic and non-metastatic colorectal cancer (non-mCRC) and also the prognostic significance of pretreatment MPV to progression in mCRC patients treated with bevacizumab-combined chemotherapy. Materials and Methods: Fifty-three metastatic and ninety-five non-metastatic colorectal cancer patients were included into the study. Data on sex, age, lymph node status, MPV, platelet and platecrit (PCT) levels were obtained retrospectively from the patient medical records. Results: The MPV was significantly higher in the patients with mCRC compared to those with non-mCRC ($7.895{\pm}1.060$ versus $7.322{\pm}1.136$, p=0.013). The benefit of bevacizumab on PFS was significantly greater among the patients with low MPV than those with high MPV. The hazard ratio (HR) of disease progression was 0.41 (95%CI, 0.174-0.986; p=0.04). In conclusion, despite the retrospective design and small sample size, MPV can be considered a prognostic factor for mCRC patients treated with bevacizumab-combined chemotherapy.

Profile and Survival of Tongue Cancer Patients in "Dharmais" Cancer Hospital, Jakarta

  • Sutandyo, Noorwati;Ramli, Ramadhan;Sari, Lenny;Soeis, Dewi Syafriyetti
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1971-1975
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    • 2014
  • Background: Tongue cancer is still a major health problem in most developing countries around the world. Statistics shown the number of tongue cancers, especially in early age, to be increasing, with poor survival. Objective: To analyze the characteristic profile of tongue cancer patients in Indonesia as well as the survival rate. Materials and Methods: A cross sectional study was conducted in Dharmais National Cancer Hospital by collecting general, clinical, and survival data of tongue cancer patients from medical records for January 2009 to April 2012. Results: Tongue cancer incidence increased year by year. The average age of tongue cancer patients was 47.5 years, and males predominated, accounting for 64.5% of cases. Most patients presented at an advanced stage (69.6%). The histopathology type was squamous cell carcinoma in the vast majoriy (96.8%). The therapies applied were surgery (45.6%), radiation (63.6%) and chemotherapy (57.6%). The survival rate after one year is 60.6% and after two years was 12.1%. In addition, median survival of tongue cancer patients was 20 months (95% confidence interval 9.07-30.9). The significant factor affecting survival was size of tumor with a hazard ratio of 3.18 (95% CI, 1.02-9.93; p 0.046) for largest versus smallest categories. Conclusions: In each year, the number of tongue cancer incidents in Indonesia is increasing. The age of tongue cancer patients in Indonesia is younger compared to other countries. Moreover, the survival rates are not high.

Prognostic Significance of Preoperative Anemia, Leukocytosis and Thrombocytosis in Chinese Women with Epithelial Ovarian Cancer

  • Chen, Ying;Zhang, Lei;Liu, Wen-Xin;Liu, Xiang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.933-939
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    • 2015
  • Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8%. Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ${\geq}1cm$, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover, EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively, preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease-specific survival for EOC patients.

KRAS Mutation as a Biomarker for Survival in Patients with Non-Small Cell Lung Cancer, A Meta-Analysis of 12 Randomized Trials

  • Ying, Min;Zhu, Xiao-Xia;Zhao, Yang;Li, Dian-He;Chen, Long-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4439-4445
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    • 2015
  • Background: Because there is no clear consensus for the prognostic implication of KRAS mutations in patients with non-small cell lung cancer (NSCLC), we conducted a meta-analysis based on 12 randomized trials to draw a more accurate conclusion. Materials and Methods: A systematic computer search of articles from inception to May 1, 2014 using the PubMed, EMBASE, and Cochrane databases was conducted. The enrollment of articles and extraction of data were independently performed by two authors. Results: Our analysis was based on the endpoints overall survival (OS) and progression-free survival (PFS). Nine records (All for OS, 7 for PFS) comprising 12 randomized trials were identified with 3701 patients who underwent a test for KRAS mutations. In the analysis of the pooled hazard ratios (HRs) for OS (HR: 1.39; 95% confidence interval [CI] 1.23-1.56) and PFS (HR: 1.33; 95% CI 1.17-1.51), we found that KRAS mutations are related to poor survival benefit for NSCLC. According to a subgroup analysis stratified by disease stage and line of therapy, the combined HRs for OS and PFS coincided with the finding that the presence of a KRAS mutation is a dismal prognostic factor. However, the prognostic role of KRAS mutations are not statistically significant in a subgroup analysis of patients treated with chemotherapy in combination with cetuximab based on the endpoints OS (P=0.141) and PFS (P=0.643). Conclusions: Our results indicate that KRAS mutations are associated with inferior survival benefits for NSCLC but not for those treated with chemotherapies integrating cetuximab.