• Title/Summary/Keyword: Locally advanced

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Case Study: Regression of a Residual Tumor and Prolongation of Overall Survival with Allergen-removed Rhus verniciflua Stokes after Chemoradiotherapy in Locally Advanced Non-small Cell Lung Cancer (옻나무추출물 위주의 한방치료로 국소 진행된 비소세포폐암 환자의 잔존 종양의 관해와 생존기간이 연장된 사례)

  • Kim, Kyung-suk
    • The Journal of Internal Korean Medicine
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    • v.36 no.2
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    • pp.200-206
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    • 2015
  • Objectives: The purpose of this study is to report the possibility of treatment of locally advanced non-small cell lung cancer with Traditional Korean Medicine based allergen-removed Rhus verniciflua Stokes (ARVS) following chemoradiotherapy. Methods: A patient with locally advanced non-small cell lung cancer (stage IIIB) felt chest discomfort, fatigue, and anxiety after chemoradiotherapy. To prevent recurrence, he opted to receive Traditional Korean Medicine. Results: After treatment with ARVS, the size of the residual primary cancer and a metastatic lymph node decreased, without new cancerous regions. The patient has maintained good performance and has shown prolonged overall survival. Conclusions: This report suggests that ARVS may play a therapeutic role in the treatment of locally advanced non-small cell lung cancer after chemoradiotherapy. Further studies will be needed to determine the effect of ARVS on locally-advanced unresectable non-small cell lung cancer.

A Patient with Locally Advanced Pancreatic Cancer Who Refused Additional Chemotherapy (추가 항암 치료를 거부하는 국소 진행형 췌장암 환자 1례)

  • Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.127-129
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    • 2016
  • The prognosis for pancreatic cancer patient is very poor. Patients with locally advanced disease have a median survival time of 8 to 12 months, and patients with distant metastases have significantly worse outcomes, with a median survival time of only 3 to 6 months. Approximately 30% of patients with pancreatic cancer present with locally advanced disease defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Primary treatment options in locally advanced pancreatic cancer include chemotherapy and radiotherapy. Here, we reported a patient with locally advanced pancreatic cancer who does not want further chemotherapy because of chemotherapy induced nausea and vomiting. Irreversible electroporation was performed. Irreversible electroporation was well tolerated in this case, and may be a therapeutic modality for selected patients with locally advanced pancreatic cancer.

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Surgical Treatment in Locally Advanced Thyroid Cancer - Trachea, Larynx, Esophagus Invasion Management (국소 진행된 갑상선암의 수술 - 기관 및 후두, 식도 침범의 치료)

  • Lee, Guk Haeng;Kang, Ju Yong
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.99-108
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    • 2018
  • Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

Staging with PET-CT in Patients with Locally Advanced Non Small Cell Lung Cancer is Superior to Conventional Staging Methods in Terms of Survival

  • Mutlu, Hasan;Buyukcelik, Abdullah;Erden, Abdulsamet;Aslan, Tuncay;Akca, Zeki;Kaya, Eser;Kibar, Mustafa;Seyrek, Ertugrul;Yavuz, Sinan;Calikusu, Zuleyha
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3743-3746
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    • 2013
  • Background: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes, sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was $13.0{\pm}1.9$ months in the PET-CT group, it was only $6.0{\pm}0.9$ in the others (p<0.001). The median OS values were $20.5{\pm}15.6$ and $11.5{\pm}1.5$ months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.

Comparison of Radical Cystectomy and Chemoradiotherapy in Patients with Locally Advanced Bladder Cancer

  • Ikeda, Masaomi;Matsumoto, Kazumasa;Nishi, Morihiro;Tabata, Ken-Ichi;Fujita, Tetsuo;Ishiyama, Hiromichi;Hayakawa, Kazushige;Iwamura, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6519-6524
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    • 2014
  • The aim of this study was to evaluate the clinical outcomes of radical cystectomy (RC) and concurrent chemoradiotherapy (CRT) with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with locally advanced bladder cancer (BC). From December 2000 to February 2012, 72 patients with locally advanced BC (T3-4a, N0 or N+, M0) received either RC or CRT. RC with bilateral pelvic lymph node dissection including the common iliac region as the standard procedure. Patients in the CRT group received one cycle of MVAC followed by radiotherapy with a half dose of MVAC and then two more cycles of MVAC. Standard fractionation at a daily dose of 1.8-2.0 Gy was used, with a median total dose of 50 Gy (range, 45-60 Gy). The 3-year progression-free survival (PFS) rates in the RC and CRT groups were 56.2% and 25.6%, respectively (p=-0.015) and the 3-year overall survival (OS) rates were 63.5% and 48.1% (p=0.272). Multivariate Cox proportional hazards regression analysis with application of a propensity score indicated that RC was a significant predictor of PFS (p=0.033) but not of OS (p=0.291). Among patients with locally advanced BC, PFS was significantly prolonged in the RC group compared with the CRT group. However, RC was not a significant predictor of OS. Although the sample size in this study was small, the results suggest that patient background and postoperative quality of life should be considered when choosing treatment strategy for locally advanced BC.

Locally Advanced Breast Cancer in Jamaica: Prevalence, Disease Characteristics and Response to Preoperative Therapy

  • Chin, Sheray Nicole;Green, Cheryl May Antoinette;Gordon-Strachan, Georgiana Marie;Wharfe, Gilian Helen Frances
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3323-3326
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    • 2014
  • Breast cancer is the most common cancer in Jamaican women. Locally advanced breast cancer (LABC) is associated with aggressive biology and poor prognosis, and has a predilection for African-American women. In this retrospective review, we assessed the prevalence of LABC as a breast cancer presentation in a population of mainly Afro-centric ethnicity, and determined disease characteristics and response to pre-operative chemotherapy. LABC was prevalent (20%), and had a low pathological response rate to pre-operative chemotherapy, with a high risk of disease recurrence. Increased utilization of breast cancer screening may help detect cancer at less advanced stages, and optimizing pre-operative chemotherapy is recommended to improve response rates and ultimately survival.

Systematic Analysis of Pemetrexed-based Chemoradiotherapy for Patients with Locally Advanced or Metastatic Esophageal Cancer

  • Tian, Guang-Yu;Miu, Min;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8475-8478
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    • 2014
  • Purpose: This systematic analysis was conducted to evaluate the efficacy and safety of pemetrexed-based chemoradiotherapy in treating patients with locally advanced or metastatic esophageal cancer. Methods: Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for relevant patients were identified using a predefined search strategy. Pooled response rates (RRs) were calculated. Results: For pemetrexed-based regimens, 4 clinical studies including 47 patients with locally advanced or metastatic esophageal cancer were considered eligible for inclusion. Systematic analysis showed that, in all patients, the pooled RR was 51% (24/47). Major adverse effects of grade III/IV were esophagitis, neutropenia, thrombocytopenia, anemia anorexia, fatigue, diarrhea, dysphagia and vomiting. No treatment related death occurred with pemetrexed-based treatment. Conclusion: This systematic analysis suggests that pemetrexed based radiotherapy is associated with reasonable activity and good tolerability in treating patients with locally advanced or metastatic esophageal cancer.

Moderate hypofractionated image-guided thoracic radiotherapy for locally advanced node-positive non-small cell lung cancer patients with very limited lung function: a case report

  • Manapov, Farkhad;Roengvoraphoj, Olarn;Li, Minglun;Eze, Chukwuka
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.180-184
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    • 2017
  • Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function ($FEV1{\leq}1L$).