• Journal of Gastric Cancer
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• 제23권2호
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• pp.315-327
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• 2023

Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. Materials and Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020). Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

• Radiation Oncology Journal
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• 제11권2호
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• pp.295-301
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• 1993

절제 불가능한 제 3기 비소세포 폐암에서의 MVP(Mitomycin C 6 $mg/m^2$, Vinblastine 6 $mg/m^2$, Cisplatin 60 $mg/m^2$) 복합 항암요법과 다분할 방사선 치료의 효과를 판정하기 위하여 1991년 1월부터 전향성 임의 선택연구(prospective randomized study)를 시작하였다. 본 연구는 제 III기의 비소세포 폐암중 절제가 불가능한 환자를 대상으로 하여 MVP 항암요법을 3 회 시행한 후 다분할 방사선 치료 (120 cGy/fx, BID)를 6480 cGy까지 시행하였다. 방사선 치료가 끝난 1개월 후 유도 항암요법에 부분 관해 이상의 반응을 보였던 환자를 대상으로 추가 항암요법을 시행하는 군과 계속 관찰하는 군으로 임의 분류하였다. 1992년 12월까지 48명의 환자가 등록되었으며, 이중 3명은 항암요법후 치료를 중단하였으며, 6명은 방사선 치료중 치료를 중단하거나, 개인적 사정으로 다분할 방사선 치료를 시행받지 못하여 39명의 환자에 대한분석을 시행하였다. 유도 항암요법을 마친 환자중 2명은 완전 관해를 보였으며, 21명은 부분 관해를 보여 MVP 유도항암요법에 대한 관해율은 $58\%$ (23/39)이었다. 항암요법에 부분관해를 보인 21명중 1명은 방사선 치료후 완전관해를 보였으며, 10명은 부분관해를 보였으나, 나머지 10명은 방사선 치료에 반응을 보이지 않았다. 항암요법에 반응을 보이지 않았던 16명의 환자중 9명은 방사선 치료에도 전혀 반응을 보이지 않았다. 유도항암 요법과 다분할 방사선 치료후의 관해율은 $64\%$이었다. 방사선 치료후 19명의 환자에 대하여 추가 항암요법에 대한 임의 선택을 시행하여 이중 9명은 추가 항암요법 군으로 분류되어, 3회의 추가 항암요법을 시행하였다. 아직까지는 추가 항암요법군과 관찰군 사이에 원격전이나 생존율의 차이가 관찰되지 않았다. 전체 환자의 중앙 생존은 13개월이었고, 6개월과 12개월의 생존율은 각각 $84.6\%$와 $53.7\%,\;40.3\%$이었다. 특히 유도항암요법에 부분관해 이상의 반응을 보였던 환자들은 무반응환자에 비하여 통계적으로 유의하게 증가된 생존율을 보였다(p=0.0287). 아직까지 추적 관찰기간이 짧으나, $64\%$의 높은 치료 관해율과 증가된 생존율, 그리고 합병증의 증가가 관찰되지 않는 점으로 보아 본 연구를 계속 진행함으로써 더 좋은 결과를 얻을 수 있을 것으로 기대된다.

• 대한의생명과학회지
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• 제24권3호
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• pp.150-156
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• 2018

Tankyrases are multifunctional poly (ADP-ribose) polymerases that regulate a variety of cellular processes including WNT signaling, telomere maintenance, regulation of mitosis, and many others. Tankyrases interact with target proteins and regulate their interactions and stability through poly (ADP-ribosyl) ation. In addition to their roles in telomere maintenance and regulation of mitosis, tankyrase proteins regulate tumor suppressors such as AXIN, PTEN, and AMOT. Therefore, tankyrases can be effective targets for cancer treatment. Tankyrase inhibitors could affect a variety of pathways that are carcinogenic (essential for the unlimited proliferation of human cancer cells), including WNT, AKT, YAP, telomere maintenance, and regulation of mitosis. Recently, new aspects of the function and mechanism of tankyrases have been reported and several tankyrase inhibitors have been identified. Also, it has been proposed that the combination of conventional chemotherapy agents with tankyrase inhibitors may have synergistic anti-cancer effects. Based on this, it is expected that more advanced and improved tankyrase inhibitors will be developed, enabling new therapeutic strategies against cancer and other tankyrase linked diseases. This review discusses tankyrase function and the role of tankyrase inhibitors in the treatment of cancer.

• 대한소아치과학회지
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• 제28권2호
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• pp.316-322
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• 2001

감각신경아세포종으로 생후 1년 6개월부터 약 1년간 6주기의 화학요법과 생후 1년 6개월에 29회에 걸친 방사선 조사(AP 4540 R+LAT 1080 R : total 5620 R)를 받은 후, 후유증으로 상악치아 및 상악골의 발육장애를 보이는 10세 남아의 임상적, 방사선학적 관찰 및 치료 후 다음과 같은 지견을 얻었기에 보고하는 바이다. 1. 성장중인 어린이에서 악성종양의 치료를 위한 방사선 조사는 연조직 및 경조직(골, 연골, 치아)등의 성장장애를 유발할 수 있으므로 시술 전 충분한 고려가 필요하다. 2. 치배의 손상은 치관 및 치근의 형성장애를 유발하고 이에 따라 치조골의 성장장애가 나타나므로 치근이 없는 치아일지라도 치조골의 흡수를 억제하기 위하여 hawley type의 부분의치 등을 이용하여 잔존시켜야 한다. 3. 향후 성장이 완료된 이후(만 18세 이상)에 무치근 치아 및 무치악 부위에 틀니(denture)나 임플란트 등의 보철수복이 필요할 것으로 여겨진다.

• Journal of Korean Biological Nursing Science
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• 제16권3호
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• pp.251-257
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• 2014

Purpose: Little is known about appropriate interval periods between the heparin flushing of implanted ports after completion of chemotherapy. The purpose of this study was to describe the current status of interval of heparin flushing for maintenance of an implanted port in solid tumor patients. Methods: We performed a retrospective review of all patients who had undergone implanted port removal in 2012 at the Seoul St. Mary's Hospital. The subjects were 90 patients who, after completion of chemotherapy, retained their ports for extended periods of time. Results: The mean number of flushes of heparin was 4. Compliance with visits for implanted port maintenance varied with the individual, and the mean accession times were in the range between 13 days and 243 days. The overall mean time between flushes was 66 days. One patient showed resistance during flushing. Conclusion: Our results demonstrate that extending the flushing interval to a maximum of 8 weeks remains medically safe. Less frequent heparin flushing of an implanted port decreases medical expenditure and the workload of medical professionals; it also improves the patient's satisfaction.

• BMB Reports
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• 제50권8호
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• pp.417-422
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• 2017

Cisplatin is the most effective and widely used chemotherapeutic agent for many types of cancer. Unfortunately, its clinical use is limited by its adverse effects, notably bone marrow suppression leading to abnormal hematopoiesis. We previously revealed that neuropeptide Y (NPY) is responsible for the maintenance of hematopoietic stem cell (HSC) function by protecting the sympathetic nervous system (SNS) fibers survival from chemotherapy-induced bone marrow impairment. Here, we show the NPY-mediated protective effect against bone marrow dysfunction due to cisplatin in an ovarian cancer mouse model. During chemotherapy, NPY mitigates reduction in HSC abundance and destruction of SNS fibers in the bone marrow without blocking the anticancer efficacy of cisplatin, and it results in the restoration of blood cells and amelioration of sensory neuropathy. Therefore, these results suggest that NPY can be used as a potentially effective agent to improve bone marrow dysfunction during cisplatin-based cancer therapy.

• 동서간호학연구지
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• 제27권2호
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• pp.185-194
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• 2021

Purpose: This study aimed to investigate the effects of fatigue, anxiety, depression, and cognitive function on the quality of life of gastrointestinal cancer patients receiving chemotherapy. Methods: Data were collected from a total of 141 participants. The measurements used were Functional Assessment of Chronic Illness Therapy for fatigue (FACIT-F), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy for cognitive function (FACT-Cog). Results: Significant correlations were found among fatigue, anxiety, depression, cognitive function, and quality of life. The mean score of quality of life was 59.60 out of 108, and 68% of the variance in QOL was explained by fatigue, anxiety, depression, and cognitive function. Cognitive function was the most influential factor (β=.30), followed by anxiety (β=-.27), depression (β=-.24), and fatigue (β=-.18). We found that the better the cognitive function, the lower the anxiety and depression, and the lower the degree of fatigue, the higher the quality of life. Conclusion: A nursing program for managing the changes in fatigue, anxiety, depression, and cognitive function should be provided to enhance maintenance and the improvement of the quality of life for gastrointestinal cancer patients who receive chemotherapy.

• Journal of Digestive Cancer Research
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• 제10권2호
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• pp.107-111
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• 2022

In 2019, coronavirus disease (COVID-19), which originated in Wuhan, has spread worldwide. In most people, COVID-19 symptoms are not severe. However, the mortality rate and severity were high in risk groups such as in older people and patients with underlying diseases. As patients with cancer are one of the risk groups, the vaccination for COVID-19 is emphasized in these patients. However, COVID-19 vaccines are not tested enough in special groups such as in patients with cancer because these vaccines are developed at an unprecedented speed. This causes confusion about whether patients undergoing chemotherapy should be vaccinated or not. In this study, international guidelines and studies were reviewed. Most of the studies recommended vaccination. No evidences of any negative effects for the efficacy or safety were recorded in patients undergoing cytotoxic, targeted, and immune agents. However, in critical conditions such as cytopenia, vaccination must be decided according to the patient's condition. COVID-19 vaccines were also recommended for patients on surgery or radiation therapy. If possible, vaccine is given before surgery to avoid confusion between surgical complications and side effects of the vaccine. The radiation recall phenomenon after vaccination has been reported in some cases of radiation therapy. Clinicians should consider these situations before vaccinating each patient. We hope that clearer guidelines will be established by accumulating verified data.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.5947-5954
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• 2012

The cancer stem cell (CSC) model states that cancers are organized in cellular hierarchies, which explains the functional heterogeneity often seen in tumors. Like normal tissue stem cells, CSCs are capable of self-renewal, either by symmetric or asymmetric cell division, and have the exclusive ability to reproduce malignant tumors indefinitely. Current systemic cancer therapies frequently fail to eliminate advanced tumors, which may be due to their inability to effectively target CSC populations. It has been shown that embryonic pathways such as Wnt, Hedgehog, and Notch control self-renewal and cell fate decisions of stem cells and progenitor cells. These are evolutionary conserved pathways, involved in CSC maintenance. Targeting these pathways may be effective in eradicating CSCs and preventing chemotherapy or radiotherapy resistance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.209-215
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• 2006

Preoperative neoadjuvant chemotherapy using cisplatin and 5-FU is generally given in oral and maxillofacial cancer. At tissue level both inflammation and fibrosis occur after chemotherapy. The cellular changes mimic those of a granulating wound, with activated macrophages and fibroblasts replacing the malignant cells as they are erradicated. Stromal cells, together with extracellular matrix components, provide the microenvironment that is pivotal for tumor cell growth, invasion, and metastatic progression. Vascular endothelial growth factor(VEGF), an important regulator of angiogenesis in cancer, induces mitogenesis of vascular endothelial cells, and vascular permeabilization and microvessel formation in a tumor are associated with tumor nutrition and oxygenation. Also, they are associated with chemotherapeutic drug delivery. Oxygen delivery to tumor appears to rely on a network of microvessels, On the other hand, the tumor microvessel is clearly an important factor in chemotherapeutic drug delivery to cancer cells, and the efficacy of drug delivery can be high in richly vascularized tumors. So, this study was conducted to evaluate the effect of neoadjuvant chemotherapy on microvessel density from 11 patients with tongue cancers. Our results showed that neoadjuvant chemotherapy was seemed to decrease VEGF expression in tumor cells, however, it did not significantly alter VEGF expression in tumor-associated macrophages. Also, Neoadjuvant chemotherapy had little effect on the microvessel density using CD34, and tumor-associated macrophage level using CD68. Thus, tumorassociated macrophages seem to be the key factor associated with the maintenance of microvessel density after neoadjuvant chemotherapy in tongue cancer.