• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1513-1517
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• 2016

Background: A combination of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is one of the most effective front-line therapies to treat B-cell non-Hodgkin's lymphoma (NHL). The aim of this trial was to evaluate overall survival (OS), progression free survival (PFS) and toxicity of R-CHOP-14 compared to R-CHOP-21 in untreated stage III and IV B-cell NHL patients with Iranian ethnicity. Materials and Methods: In phase III trial, patients with previously untreated stage III and IV indolent and aggressive B-cell NHL were randomly assigned by using a minimization method to receive six to eight cycles of either R-CHOP-21 (administered every 21 days) or R-CHOP-14 (administered every 14 days with granulocyte colony-stimulating factor). Results: A total of 143 patients were randomly enrolled in our study (66 patients in R-CHOP-14 group and 77 patients in R-CHOP-21), between 2011 and 2014. The mean follow-up was 45 months at the time of treatment analysis. The 2-year and 5-year PFS rates for the R-CHOP-14 group were 83.6% vs 73.6% and for R-CHOP-21 group were 75% vs 54%. The 2-year and 5-year OS rates for R-CHOP-14 group were 98% vs 89% and for R-CHOP-21 group were 84.4% vs 67.5%. There was a significant correlation for PFS and OS in the two arms. There was no significant difference between adverse events with the two regimens. Conclusions: In our research improved survival was found with CHOP-14 as compared to CHOP-21. It is possible that drug metabolism in different races/ethnicities may be one important factor.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7923-7927
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• 2015

Background: The Cox PH model is one of the most significant statistical models in studying survival of patients. But, in the case of patients with long-term survival, it may not be the most appropriate. In such cases, a cure rate model seems more suitable. The purpose of this study was to determine clinical factors associated with cure rate of patients with breast cancer. Materials and Methods: In order to find factors affecting cure rate (response), a non-mixed cure rate model with negative binomial distribution for latent variable was used. Variables selected were recurrence cancer, status for HER2, estrogen receptor (ER) and progesterone receptor (PR), size of tumor, grade of cancer, stage of cancer, type of surgery, age at the diagnosis time and number of removed positive lymph nodes. All analyses were performed using PROC MCMC processes in the SAS 9.2 program. Results: The mean (SD) age of patients was equal to 48.9 (11.1) months. For these patients, 1, 5 and 10-year survival rates were 95, 79 and 50 percent respectively. All of the mentioned variables were effective in cure fraction. Kaplan-Meier curve showed cure model's use competence. Conclusions: Unlike other variables, existence of ER and PR positivity will increase probability of cure in patients. In the present study, Weibull distribution was used for the purpose of analysing survival times. Model fitness with other distributions such as log-N and log-logistic and other distributions for latent variable is recommended.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6573-6578
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• 2013

Background: The goal of this retrospective study was to evaluate patient characteristics, treatment modalities and prognostic factors in Turkish patients with pancreatic cancer. Materials and Methods: Between January 1997 and December 2012, 64 patients who presented to the Department of Radiation Oncology, Karadeniz Technical University, Faculty of Medicine with a diagnosis of pancreatic cancer were evaluated. The E/K ratio of the cases was 2.4/1 and the median age was 59.6 (32-80) years, respectively. Some 11 cases (18%) were stage 1, 21 (34.4%) were stage 2, 10 (16.4%) were stage 3, and 19 (31.1%) were metastatic. Results: The mean follow-up time was 15.7 months (0.7-117.5) and loco-regional recurrence was noted in 11 (40.7%) who underwent surgery while metastases were observed in 41 patients (66.1%). The median overall survival (OS) was 11.2 months and the 1, 3 and 5-year OS rates were 41.7%, 9.9% and 7.9% respectively. The median disease-free survival (DFS) was 5.2 month and the1, 2 and 5 year DFS were 22.6%, 7.6% and 3.8% respectively. On univariate analysis, prognostic factors affecting OS included status of the operation (p<0.001), tumor stage (p=0.008), ECOG performance status (p=0.005) and CEA level (p=0.017).On multivariate analysis, prognostic factors affecting survival included status of the operation (p=0.033) and age (p= 0.023). Conclusions: In the current study, age and operation status were independent prognostic factors for overall survival with pancreatic patients. Thus, the patients early diagnosis and treatment ars essential. However, prospective studies with more patients are needed for confirmation.

• 대한치과의사협회지
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• 제53권9호
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• pp.628-643
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• 2015

Purpose: The aim of this retrospective study was to compare marginal bone loss and survival rates of double short implants(multiple implant) which had been installed and restored in severely atrophic maxillary molar site without a grafting procedure. Material and Method: The subjects were patients (90 patients, 180 implants) who had been installed double short implants in severely atrophic maxillary single molar site without bone augmentation procedure from 2006 to 2014 in dental clinic in Chuncheon city. Following data were collected from dental records and radiographic panoramic views: patient's age, gender, smoking status, implant site, timing of implant installation, residual ridge height. The correlation between those factors and survival rate and marginal bone loss were analyzed. Statistical analysis was performed using Chi-square test, Student's t- test and ANOVA. Result: Eleven implants in 6 patients failed and the cumulative survival rate was 93.9%. No significant differences were found in relation to the following factors: patient's age, gender, implant site, timing of implant installation (P> .05). There were significant differences in smoking status and residual ridge height(P< .05). The average follow-up time was $45{\pm}14.7months$. The mean marginal bone loss of survived 169 implants was $0.08{\pm}0.59mm$. Conclusion: Despite the short term outcomes, the survival rate of double short implants was comparable to normal length implants. This study demonstrated that placement of double short implants without the use of bone grafting procedure for severely atrophic posterior maxilla is a simple and predictable treatment procedure.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1101-1106
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• 2013

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

• 대한골관절종양학회지
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• 제18권1호
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• pp.1-6
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• 2012

목적: Marjolin 궤양으로 발생한 편평 상피암의 치료결과에 대해 원발성 편평 상피암과 비교 분석하고자 한다. 대상 및 방법: Marjolin 궤양에 의한 편평 상피암으로 치료받았던 14예를 대상으로 하였으며, 같은 기간 치료받았던 원발성 편평 상피암 20예를 대조군으로 하였다. 평균 연령은 61.2세였으며, 남자 24예였고, 여자가 10예였다. 두 군간의 발생 부위, 조직학적 분류, 병기, 치료 방법, 전이, 재발, 생존율에 대해 비교 분석하였다. 결과: 평균 추시 기간은 54.8개월(12-168개월)이었다. 국소 재발은 6예에서 발생하였고, 5예는 Marjolin 궤양 군에서, 나머지 1예는 원발성 편평 상피암 군에서 발생하였다. 최초 진단 후 국소 재발까지의 평균 기간은 9개월(2-20개월)이었다. 전이는 총 6예에서 발생하였는데 이들 중 2예(14.3%)는 Marjolin 궤양 군에서, 나머지 4예(20.0%)는 원발성 편평 상피암 군에서 발생하였다. 전이 또는 국소 재발은 총 10예에서 발생하였는데 이들 중 6예는 Marjolin 궤양 군에서, 나머지 4예는 원발성 편평 상피암 군에서 발생하였다. 5년 무병 생존률은 Marjolin 궤양 군에서는 64.3%였고, 원발성 군에서는 95%였다. 결론: Marjolin 궤양에 동반된 편평 상피암은 적극적인 치료에도 불구하고 높은 재발율 및 사망률을 보이므로, 치료 결과를 향상시키는 새로운 치료법에 대한 연구가 요구된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2857-2860
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• 2016

Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

• Tuberculosis and Respiratory Diseases
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• 제41권4호
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• pp.363-371
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• 1994

연구배경: 종양세포는 세포의 분열성장이 증가되므로, 세포분열주기 중 S-phase fraction(SPF)의 변화를 생각할 수 있다. 소세포폐암 환자에서 종양세포의 생물학적 특성인 SPF의 변화와 생존기간, 그리고 항암화학요법에 대한 반응의 정도를 비교하였다. 방법: 1990년 1월부터 1991년 12월까지 원광의대 부속병원에서 원발성 소세포폐암으로 진단받고나서, 2회 이상의 화학요법을 실시받은 후, 최소 2년 이상의 후향적 추적에 의해 사망이 확인된 42예를 대상으로 하였다. SPF 분석방법은 paraffin에 보관된 병리조직을 처리하여, 유식세포분석법에 의한 DNA histogram으로 분석 하였다. 결과: 1) 대상군의 평균 생존기간은 190(${\pm}156$)일이었고, TNM 병기, PS scale 이 진행할 수록 생존기간은 유의하게 단축되었다. 2) 대상군의 평균 SPF는 27.4(${\pm}8.5$)% 였으며, TNM 병기, PS scale의 진행에 따른 차이는 없었다. 3) 암세포의 SPF와 생존기간과의 관계는 발견되지 않았다. 4) 암세포의 SPF가 높을 수록 화학요법에 대한 반응의 정도는 양호하였다. 결론: 소세포폐암 환자에서 암세포의 SPF와 생존기간과는 관계가 없었고, 암세포의 SPF가 높을 수록, 화학요법에 대한 반응의 정도는 양호하였다. SPF는 항암화학요법 반응의 예측인자로서의 의의가 있다고 판단된다.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.334-341
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• 2001

Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5653-5657
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• 2014

Background: To evaluate factors which effect treatment interruption during concurrent chemoradiotherapy (CCRT) and overall survival in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. Materials and Methods: Between January 2006 and December 2007, 107 patients with stage IB2-IVA as FIGO staging, 2000, were treated with CCRT in Srinagarind Hospital. Factors which caused treatment interruptions and impacted on overall survival were reviewed and analyzed. Results: Twenty of 107 patients had treatment interruption during CCRT in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. The causes of treatment interruption were as follows: hematologic toxicity was found in 16 of 20 cases, 12 cases with grade 2 and 4 cases with grade 3; three of 20 cases had gastrointestinal toxicities, 1 case with grade 2 and 2 cases with grade 3; one case had grade 3 skin toxicity. The mean total treatment time of the uninterrupted and interrupted groups were significantly different (78.98 days vs 161.80 days, p <0.001). The patients who could tolerate ${\geq}5$ cycles of cisplatin administration had significantly higher mean white blood counts (WBC) ($9,769cells/mm^3$ vs $7,141cells/mm^3$, p=0.02). The mean initial hemoglobin (Hb) in the uninterrupted group was significantly higher than the interrupted group (11.5 mg% vs 10.3 mg%, p=0.03). Other factors including age, KPS, initial platelets, initial serum creatinine levels showed no statistical significance. The 3-year overall survival of the uninterrupted group was better than in the interrupted group (78.6% vs 55.0%, p=0.03). Conclusions: The initial Hb and WBC levels were significantly correlated with treatment interruption during CCRT in patients with uterine cervical cancer. The 3-year overall survival of the uninterrupted group was significantly better than interrupted group. These factors may then be used indirectly to predict the outcomes of treatment.