• Title/Summary/Keyword: Neoadjuvant Treatment

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Ultrasound-Guided Intervention for Breast Lesions (유방 병변에 대한 초음파 유도하 중재 시술)

  • Eun Young Ko
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.332-344
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    • 2023
  • The role of ultrasound-guided interventions in the diagnosis and treatment of breast lesions is gaining importance and prevalence, particularly as the instances of non-palpable breast lesion detection, breast-conserving surgery, and neoadjuvant chemotherapy are increasing. This review attempts to summarize the types and techniques of breast ultrasound-guided interventional procedures, such as biopsy, tissue marker insertion, and preoperative localization, and their indications. Furthermore, we highlight the pro and cons of the most commonly used procedures with the intention of promoting their use in clinical practice.

Limb Salvage with Tumor prosthesis for Osteosarcoma of Distal Tibia and Fibula (경골 및 비골 원위부 골육종의 종양삽입물을 이용한 사지구제술)

  • Lee, Han-Koo;Lee, Sang-Hoon;Kim, Dong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.23-29
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    • 1995
  • Recently limb-salvage operation is widely used for the treatment of malignant bone tumor. But distal leg is out of range of limb-salvage operation due to its technical problem. We report satisfactory limb-salvage operation with tumor prosthesis in 3 cases of osteosarcoma of the distal tibia and fibula. Two cases involved in the tibia and 1 case in the fibula. Average age at operation was 23 years. Neoadjuvant and adjuvant chemotherapy were performed in all 3 cases. We used custom made tumor prosthesis which is designed by Seoul National University Orthopaedic Department. Overall Functional Evaluations by Enneking rating system were good in all 3 cases. All cases are CDF(continuosly disease free since the surgical procedure) state at mean follow-up 2 year and 9 months. In conclusion limb-salvage with tumor prosthesis is useful treatment modality for malignant bone tumor of distal tibia and fibula. Good functional results and few complications suggests limb salvage of distal lower leg may be replaceable with B-K amputation.

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Multimodal Treatment of Pleuropulmonary Blastoma -Two case report- (흉막폐아세포종(Pleuropulmonary Blastoma) -치험 2예 보고-)

  • 박준석;한정호;구홍회;김진국
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.614-618
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    • 2003
  • Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm, found solely in childhood. The usual symptoms are dyspnea, chest discomfort, recurrent respiratory infections, fever, dry cough, and chest pain. The progress of PPB is usually aggressive and its progress is generally poor. Lymphatic spread to the hilar and mediastinal nodes can occur Distant metastasis is found in brain, bones, and intra-abdominal organs. Surgical resection is the treatment of choice. When the disease Is too extensive for surgical resection, neoadjuvant chemotherapy can be used. We report 2 cases of pleuropulrnonary blastoma in children successfully treated with multimodal therapy.

Relationships between Anxiety, Depression, Low Anterior Resection Syndrome, and Quality of Life Following Lower Anterior Resection for Rectal Cancer (저위전방절제술을 받은 직장암 환자의 불안, 우울, 저위전방절제증후군, 삶의 질과의 관계)

  • Lee, Eun;Kim, Keum Soon
    • Perspectives in Nursing Science
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    • v.11 no.1
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    • pp.74-85
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    • 2014
  • Purpose: The purpose of this study was to investigate the relationships between anxiety, depression, low anterior resection syndrome, and quality of life after lower anterior resection for rectal cancer. Methods: The participants of this study were 105 rectal cancer patients who visited the outpatient department of a hospital in Seoul for treatment or follow-up consultations. Data were collected using self-reported questionnaires and clinical records. To measure the variables, the Hospital Anxiety and Depression Scale, Low Anterior Resection Syndrome Score, and Quality of Life Questionnaire-Core 30 were utilized. Data were subsequently analyzed using the SPSS/WIN 20.0 program. Results: Low anterior resection syndrome was more severe among patients whose cancer was located closer to the anus, and had a greater range of resection in those who received neoadjuvant treatment. When anxiety, depression, and low anterior resection syndrome score were higher, quality of life scores were lower. Conclusion: These results suggest that low anterior resection syndrome may negatively impact quality of life. Therefore, it is necessary to provide patients with symptom management support/assistance through evidence-based nursing interventions, and evaluations of low anterior resection syndrome to relieve anxiety and depression, and thus enhance quality of life.

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Systematic Review of Research Progress on Borderline Resectable Pancreatic Cancer: A Bibliometric and Visualized Analysis (경계성 절제가능형 췌장 연구 동향에 대한 체계적인 문헌 고찰: 계량서지학적 분석 및 시각화된 분석)

  • Jae Keun Park;Ji Woong Hwang
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.23-30
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    • 2024
  • Borderline resectable pancreatic cancer, an intermediate stage between a completely resectable state and an unresectable state, requires a multidisciplinary treatment approach. This study aimed to elucidate the main characteristics and recent research trends regarding borderline resectable pancreatic cancer to gain further insights into them. Data from published papers about borderline resectable pancreatic cancer were collected from Web of Science (2014-2023) for the analysis. This study included 355 papers; data on major countries, publishing organizations, and keywords were collected and analyzed. Furthermore, R studio and VOSviewer were used for the qualitative and quantitative analyses of keywords. Publication of papers on borderline resectable pancreatic cancer was observed to be increasing annually by 12.8%, with the United States and Japan being the main publishing countries. In 2014, keywords related to surgery and chemotherapy were dominant; however, a shift toward more integrative approaches, such as neoadjuvant therapy, was observed over time. This study demonstrates rapidly evolving trends and paradigm changes in the research and management of borderline resectable pancreatic cancer. Thus, the results of this study are expected to contribute to establishing future research strategies and improving patient treatment outcomes.

The Status and Treatment Outcomes in Patients with Hypopharyngeal Cancer: A Nationwide Population-based Study (하인두암 환자들의 발생 현황 및 치료 방법에 따른 결과 분석: 국민건강보험공단 자료를 이용한 연구)

  • Kim, Hyun-Bum;Han, Kyung-Do;Joo, Young-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.19-24
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    • 2021
  • Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment (항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교)

  • Chie Eui Kyu;Ha Sung Whan;Park Jae-Gahb;Bang Yung-Jue;Heo Dae Seog;Kim Noe Kyeong
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.62-67
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    • 2002
  • Purpose : This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy Plus radiotherapy versus abdominoperineal resection and Postoperative radiotherapy for anal cancer. Materials and Methods : Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy $(APR+RT{\pm}CT)$, and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil $(1,000\;mg/m^2\;bolus\;on\;D1\~5)$ and cisplatin $(60\;mg/m^2\;bolus\;on\;D1)$ followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Results : Overall five-year survival rates were $80.3\%$, 88.9 and $79.4\%$ for entire patients, $APR+RT{\pm}CT$ group, and the CRT group, respectively. No significant difference was found between the two groups (p=0.49). Anus preservation rate for the CRT group was $86.7\%$. Age (0=0.0164) and performance status (p=0.0007) were found to be significant prognostic factors by univariate analysis. Age (p=0.0426), performance status (p=0.0008), and inguinal lymph node metastasis (e=0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. Conclusion : This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of chemotherapy with a cisplatin based regimen rather than a concurrent regimen may lead to a decrease in complications.

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

  • Stankevica, Jekaterina;Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5237-5240
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    • 2012
  • Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.

Phase II Study of Preoperative Intra-Arterial Epirubicin, Etoposide, and Oxaliplatin Combined with Oral S-1 Chemotherapy for the Treatment of Borrmann Type 4 Gastric Cancer

  • Xiang, Xiao-song;Su, Yu;Li, Guo-li;Ma, Long;Zhou, Chang-sheng;Ma, Ru-feng
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.395-407
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    • 2020
  • Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.

Osteosarcoma in Patients Older than 40 Years (40대 이후에 발생한 골육종)

  • Rhee, Seung-Koo;Woo, Yong-Kyun;Kang, Yong-Koo;Song, Seok-Whan;Chung, Yang-Guk;Lee, An-Hi;Yoo, Jin-Young;Chung, Do-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.169-177
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    • 1999
  • Osteosarcoma in patients older than 40 years are rare, however they have different clinical, radiological and pathological features from those of younger patients. Sometimes accurate histologic diagnosis is not easy, which is important in determining the correct surgical treatment and appropriate chemotherapy. Since January 1995, 11 patients with osteosarcoma occurring in patients older than 40 years have been diagnosed, treated and followed up for more than 6 months. In contrast to osteosarcoma in children and adolescents, only 4 cases(36.4%) were conventional types, while the others included 2 malignant fibrous histiocytoma-like types, 2 small cell types, 2 periosteal osteosarcomas and 1 giant cell-rich type. Seven cases showed purely osteolytic or predominantly osteolytic bony lesions and 8 were in Enneking stage IIB. Performed surgical treatments included 2 amputations, 6 wide resections and reconstructions, and one curettage and autogenous bone graft. In the remaining 2 cases, definitive surgical treatments included not carried out because of old age, multifocal involvement or poor medical tolerance. Neoadjuvant and adjuvant chemotherapies were performed in 9 of 11 patients. At last follow-up, there were 6 continuously disease-free survivals, 3 alive with diseases and 2 died of diseases. The overall cumulative 4-year survival rate calculated using Kaplan-Meier's productlimit method was 59.3%. For improved oncologic outcomes and survivals, early and accurate diagnosis, surgical treatment with adequate margin and neoadjuvant and adjuvant chemotherapy will be necessary.

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