• Title/Summary/Keyword: Metastatic carcinoma

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T Cell-directed Immunotherapeutic Approaches for Head and Neck Squamous Cell Carcinoma (두경부편평세포암에서의 T세포 면역치료)

  • Choi, Yoon Seok
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.7-13
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    • 2017
  • Despite improved treatment outcomes of locally advanced disease over the last 2 decades, the survival of patients with recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) remains dismal. There is a clear need for development of novel therapeutic strategies for recurrent and/or metastatic HNSCC. Recent advances in understanding tumor immunology have been directly and rapidly translated into clinical success of T cell-directed immunotherapeutic approach in the treatment of several types of solid cancers. Among them, impact of immune checkpoint inhibition using neutralizing antibodies is the most striking. A variety of immunotherapeutic strategies targeting T cells have been also studied in HNSCC, especially in recurrent and/or metastatic setting even with significant survival benefit. The present article reviews the basic concept of T cell-directed immunotherapy and the current status of such approaches in the treatment of HNSCC.

Comparative Analysis of the Seriousness of the Adverse Events and Risk of Targeted Therapy for Metastatic Renal Cell Carcinoma Among Medical Professionals (전이성신세포암 표적치료제의 부작용 심각도 및 위해에 대한 전문가그룹별 비교분석)

  • Park, Mi-Hae;Rhee, Jin-Nie;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.100-105
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    • 2011
  • The perception of the 20 adverse events of targeted therapy for metastatic renal cell carcinoma was compared among medical professionals. Thirty-seven oncologists, 167 nurses and 79 pharmacists participated in the survey, and the response rate was 61.9%, 98.2%, 84.9%, respectively. Results showed that the most serious adverse event was GI perforation (8.83 points, 10 being the most serious), whereas the least serious was anemia (5.32 points). There were significant differences among oncologists, nurses and pharmacists especially for the moderately-serious adverse event such as wound-healing complication and lymphopenia. Adverse Events Composite Score (AECS) for each targeted therapy was calculated by multiplying adverse event incidence rate and seriousness score. Sunitinib had the highest score at 6.86 point and bevacizumab had the lowest at 2.1. Among professional groups oncologists showed the lowest AECS, whereas nurses had the highest. The gap on the perception of the adverse events among medical professionals needs to be reduced to get better outcomes of medical therapies for cancer patients.

Bronchogenic Carcinoma with Multiple Subcutaneous Metastasis: one case report (다발성 피하조직 전이를 일으킨 기관지폐암 1례 보고)

  • Kim, Kyung-Woo;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.307-311
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    • 1979
  • Bronchogenic carcinoma with subcutaneous metastasis is rare, and the incidence ranged from 1.0 to 3.0 %. Therefore metastatic nodules are incidental findings in some instances. The distribution in order of frequency Is as follows: chest wall, scapular region, abdominal wall, course of spine, upper extremities and scalp etc, and mos. of nodules are between 0.5-2.0 cm in diameter. In this report, we present one case of a 54 year old male having bronchogenic carcinoma (squamous cell type) with multiple subcutaneous metastases. The metastatic nodules were located in subcutaneous tissue of right posterior chest wall ($4{\times}5$ cm), frontal scalp area (two; $2{\times}3$ cm, $0.5{\times}0.5$ cm), left scapular region ($1{\times}1$ cm) and left iliac crest ara ($1{\times}11$ cm).

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Thymic Radioiodine Uptake Mimicking Metastatic Papillary Carcinoma in the Anterior Mediastinum (갑상선암 환자에서 전종격동의 전이성 암처럼 보이는 흉선의 방사성옥소 섭취)

  • Park, Chan-H.;Lee, Myoung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.87-89
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    • 2002
  • A 30 year-old female patient with papillary thyroid carcinoma received her fifth radioiodine ablation therapy after the subtotal thyroidectomy. The scan, which was peformed one week after the last therapy, revealed residual uptake in the thyroid bed and uptake in the anterior mediastinum suggesting metastasis. However, further evaluation of the thorax with chest CT and camera-based FDG PET confirmed normal thymus without metastatic focus. Occasionally thymus remains intact in adult and has avidity for I-131 and FDG. Therefore, normal thymus (instead of metastasis) should be considered in patients with well differentiated thyroid carcinoma and anterior mediastinal radioiodine uptake.

Retinoic Acid Redifferentiation Therapy for Papillary Carcinoma of Thyroid with Negative Radioiodine Uptake (방사성옥소 섭취를 보이지 않은 갑상선 유두암에서 Retinoic acid 치료)

  • Bae, Sang-Kyun;Yum, Ha-Yong
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.393-397
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    • 2001
  • Surgery, radioiodine therapy, and thyroxine treatment represent established therapeutic measures of proven efficacy for the treatment of well-differentiated thyroid cancer. However, in some cases, dedifferentiation is noted and it makes tumors refractory to conventional treatment. Recently, retinoic acid redifferentiation therapy was evaluated in several in vitro and in vivo studios. We report a patient with papillary carcinoma in whom metastatic lesions became radioiodine negative on high-dose therapy. Redifferentiation therapy with retinoic acid induced radioiodine uptake in some of metastatic tissues. Side effects such as xerostomia and cheilosis were mild. We recommend retinoic acid redifferentiation therapy as an option for the treatment of thyroid cancer with negative radioiodine uptake after high-dose radioiodine therapy.

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A Case of Bilateral Tonsillar Cancer Discovered in Metastatic Carcinoma of Unknown Origin (원발미상의 경부 전이암에서 발견된 양측 편도암 1예)

  • Choi, Jeong-Seok;Lim, Jae-Yol;Han, Chang-Dok;Kim, Young-Mo
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.16-18
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    • 2012
  • Ipsilateral tonsillectomy and panendoscopy-guided biopsy following imaging studies are considered a standard procedure in the search for a primary origin in patients with cervical metastatic carcinoma of unknown origin(MUO). However, many authors recommended bilateral tonsillectomy for the determination of the primary site of a MUO, because cervical metastasis may occur contralateral to tonsillar carcinoma. The authors attempted to address the clinical implications of using routine bilateral tonsillectomy to determine the primary site of MUOs based on a case report of cervical MUO that was finally diagnosed as a bilateral synchronous tonsillar carcinoma with cervical metastasis after a diagnostic work-up that included bilateral tonsillectomy.

A Case of Nasopharyngeal Carcinoma with Metastatic Axillary Node after Concurrent Chemoradiotherapy (치료 후 액와 림프절의 전이를 보인 비인강암 1례)

  • Hong, Hyun-Jun;Lee, Won-Il;Park, Mi-Na;Chung, Eun-Ji;Kim, Yong-Tai;Choi, Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.43-46
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    • 2009
  • Nasopharyngeal carcinomas are epithelial neoplasm derived from nasopharyngeal mucosa. Nasopharyngeal carcinoma involved cervical lymph nodes frequently. However, nasopharyngeal carcinoma with metastatic axillary node after concurrent chemoradiotherapy was reported rarely. We report the patients who was a 34-year-old man diagnosed as nasopharyngeal carcinoma. He was treated by concurrent chemo-radiotherapy. But axillary node metastasis was found after treatment in 2 years. After surgical resection of axillary lymph node, there is no evidence of disease.

Long-term Efficacy of Microwave Hyperthermia Combined with Chemoradiotherapy in Treatment of Nasopharyngeal Carcinoma with Cervical Lymph Node Metastases

  • Kang, Min;Liu, Wen-Qi;Qin, Yu-Tao;Wei, Zhu-Xin;Wang, Ren-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7395-7400
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    • 2013
  • Objective: The long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating nasopharyngeal carcinoma (NPC) with metastatic foci in cervical lymph nodes was evaluated. Methods: A total of 154 cases of N2 or N3 stage NPC were randomized into two groups: hyperthermia group (76 cases) and control group (78 cases). Both received cisplatin chemotherapy and radiotherapy. In addition, the hyperthermia group further received microwave hyperthermia to the metastatic cervical nodes with different patterns (before or after radiotherapy), heating temperatures (T90< $43^{\circ}C$ and $T90{\geq}43^{\circ}C$) and hyperthermia episodes (< 4 times, 4-10 times and > 10 times). Results: The 3-month and 5-year complete response (CR) rates of cervical lymph nodes in the hyperthermia group were significantly higher than those in the control group. The 5-year disease-free survival (DFS) rate and the 3-year / 5-year overall survival rate in the hyperthermia group were also significantly higher. There was no significant difference in 5-year metastatic rates. In the hyperthermia group, the 3-month and 5-year CR rates of T90< $43^{\circ}C$ treatment were significantly lower than with $T90{\geq}43^{\circ}C$ treatment. The CR rate was highest when the hyperthermia was performed 4-10 times. There were no significant differences in 3-month and 5-year CR rates between hyperthermia before or after radiotherapy treatment. Conclusion: Microwave hyperthermia combined with chemoradiotherapy can increase local control, DFS and 3, 5-year overall survival rates of patients with N2 ~ N3 stage NPC. The heating temperature should be over $43^{\circ}C$ with hyperthermia repeated 4-10 times.

Characterization of the MicroRNA Expression Profile of Cervical Squamous Cell Carcinoma Metastases

  • Ding, Hui;Wu, Yi-Lin;Wang, Ying-Xia;Zhu, Fu-Fan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1675-1679
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    • 2014
  • Objectives: MicroRNAs (miRNAs) are important regulators of many physiological and pathological processes, including tumorigenesis and metastasis. In this study, we sought to determine the underlying molecular mechanisms of metastatic cervical carcinoma by performing miRNA profiling. Methods: Tissue samples were collected from ten cervical squamous cancer patients who underwent hysterectomy and pelvic lymph node (PLN) dissection in our hospital, including four PLN-positive (metastatic) cases and six PLN-negative (non-metastatic) cases. A miRNA microarray platform with 1223 probes was used to determine the miRNA expression profiles of these two tissue types and case groups. MiRNAs having at least 4-fold differential expression between PLN-positive and PLN-negative cervical cancer tissues were bioinformatically analyzed for target gene prediction. MiRNAs with tumor-associated target genes were validated by quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results: Thirty-nine miRNAs were differentially expressed (>4-fold) between the PLN-positive and PLN-negative groups, of which, 22 were up-regulated and 17 were down-regulated. Sixty-nine percent of the miRNAs (27/39) had tumor-associated target genes, and the expression levels of six of those (miR-126, miR-96, miR-144, miR-657, miR-490-5p, and miR-323-3p) were confirmed by quantitative (q)RT-PCR. Conclusions: Six MiRNAs with predicted tumor-associated target genes encoding proteins that are known to be involved in cell adhesion, cytoskeletal remodeling, cell proliferation, cell migration, and apoptosis were identified. These findings suggest that a panel of miRNAs may regulate multiple and various steps of the metastasis cascade by targeting metastasis-associated genes. Since these six miRNAs are predicted to target tumor-associated genes, it is likely that they contribute to the metastatic potential of cervical cancer and may aid in prognosis or molecular therapy.

Analysis on Clinical Characteristics and Influencing Factors of Patients with Locoregionally Advanced Nasopharyngeal Carcinoma

  • Zheng, Wei;Xu, Yuan-Ji;Qiu, Su-Fang;Zong, Jing-Feng;Huang, Ling-Ling;Huang, Chao-Bin;Lin, Shao-Jun;Pan, Jian-Ji
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4393-4399
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    • 2015
  • Background: To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods: A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC. Results: The 1-, 3- and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3- and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor. Conclusions: Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.