• Title/Summary/Keyword: Locally advanced

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Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy (유도화학요법 및 국소 치료 후 원격전이를 보인 국소 진행성 두경부암 환자군의 임상 특징 및 위험인자에 관한 연구)

  • Lee, Hye-Won;Baek, Dong-Hoon;Lee, Kyung-Nam;Cho, Eun-Jung;Kim, Hyo-Jeong;Seol, Young-Mi;Song, Moo-Kon;Choi, Young-Jin;Shin, Ho-Jin;Chung, Joo-Seop;Cho, Goon-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.177-182
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    • 2011
  • Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

Multidisciplinary Management of the Locally Advanced Unresectable Non-Small Cell Lung Cancer (수술 불가능한 국소 진행 비소세포성 폐암의 집합적 요법)

  • Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.1-10
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    • 2004
  • Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

A Detection Scheme for Random Signals under Dependent Noise Environment (종속 잡음 환경에서 확률 신호 검파 방식)

  • Kim, Kwang-Soon;Won, Dae-Han;Song, Iick-Ho;Yun, Hyung-Sik;Lee, Ju-Mi;Kim, Sun-Yong
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.37 no.1
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    • pp.69-75
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    • 2000
  • In this paper, we consider the problem of discrete-time random signal detection problem under the presence of additive noise exhibiting weak dependence The test statistic of the locally optimum detector for correlated random signals under a weakly dependent noise model is derived The performance characteristic of the locally optimum detector is analyzed and compared with that of the square-law detector in terms of the asymptotic relative efficiency.

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A Rank-Based Signal Detector in a Weakly Dependent Noise Model (약의존성 잡음모형에서 순위를 바탕으로 한 신호검파기)

  • Kim, Kwang-Soon;Yoon, Seok-Ho;Park, So-Ryoung;Lee, Joo-Shik;Song, Iick-Ho;Kim, Sun-Yong
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.37 no.1
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    • pp.76-82
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    • 2000
  • In this paper, we consider nonparametric signal detection problems under the presence of additive noise exhibiting weak dependence We derive the test statistics of the locally optimum rank detectors under a weakly dependent noise model for known and random signal cases The performance characteristic of the locally optimum rank detectors are analyzed in terms of asymptotic relative efficiency.

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Single nucleotide polymorphism of GSTP1 and pathological complete response in locally advanced rectal cancer patients treated with neoadjuvant concomitant radiochemotherapy

  • Nicosia, Luca;Gentile, Giovanna;Reverberi, Chiara;Minniti, Giuseppe;Valeriani, Maurizio;de Sanctis, Vitaliana;Marinelli, Luca;Cipolla, Fabiola;de Luca, Ottavia;Simmaco, Maurizio;Osti, Mattia F.
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.218-226
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    • 2018
  • Purpose: Standard treatment for locally advanced rectal cancer consists of neoadjuvant radiochemotherapy with concomitant fluoropyrimidine or oxaliplatin and surgery with curative intent. Pathological complete response has shown to be predictive for better outcome and survival; nevertheless there are no biological or genetic factors predictive for response to treatment. We explored the correlation between the single nucleotide polymorphisms (SNPs) GSTP1 (A313G) and XRCC1 (G28152A), and the pathological complete response and survival after neoadjuvant radiochemotherapy in locally advanced rectal cancer patients. Materials and Methods: Genotypes GSTP1 (A313G) and XRCC1 (G28152A) were determined by pyrosequencing technology in 80 patients affected by locally advanced rectal cancer. Results: The overall rate of pathological complete response in our study population was 18.75%. Patients homozygous AA for GSTP1 (A313G) presented a rate of pathological complete response of 26.6% as compared to 8.5% of the AG+GG population (p = 0.04). The heterozygous comparison (AA vs. AG) showed a significant difference in the rate of pathological complete response (26.6% vs. 6.8%; p = 0.034). GSTP1 AA+AG patients presented a 5- and 8-year cancer-specific survival longer than GSTP1 GG patients (87.7% and 83.3% vs. 44.4% and 44.4%, respectively) (p = 0.014). Overall survival showed only a trend toward significance in favor of the haplotypes GSTP1 AA+AG. No significant correlations were found for XRCC1 (G28152A). Conclusion: Our results suggest that GSTP1 (A313G) may predict a higher rate of pathological complete response after neoadjuvant radiochemotherapy and a better outcome, and should be considered in a more extensive analysis with the aim of personalization of radiation treatment.