• Radiation Oncology Journal
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• 제11권2호
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• pp.311-319
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• 1993

본 국립의료원 치료 방사선과 에서는 1986년 1월부터 1990년 12월까지 5년간 방사선 치료를 받은 III병기 비소세포성 폐암 37예를 대상으로 후향성 조사를 통하여 임상적 특징과 생존율을 분석하여 보고하는 바이다. 이중 29예가 사망시 또는 1991년 8월까지 추적 관찰이 가능하였으며 치료후 추적 조사기간은 최소10개월, 최고60개월 이었고, 추적율은 $78.4\%$이었다. Kaplan-Meier법에 따른 전체 환자 37예의 2, 5년 생존율은 각각 $20.6\%,\;6.9\%$이었으며 중앙생존 기간은 10개월 이었다. Performance status에 의하면 KPS가 $80\%$ 이상인 I군의 2,5년 생존율과 중앙생존기간은 각각 $29.2\%,\;9.7\%,$ 13개월 이었고, KPS가 $80\%$ 이하인 II군의 2년 생존율과 중앙 생존기간은 $13.7\%$와 7개월 로서, 통계학적으로 유의 한 차이를 보였다(p<0.05). AJCC 병기에 따른 생존율 및 중앙 생존기 간을 보면 $III_a$ 병기의 2, 5년 생존율 및 중앙 생존기간이 $29.2\%,9.7\%$및 12개월 이었고 $III_b$ 병기의 2년 생존율과 중앙 생존기간은 $8.6\%$와 10개월로 생존율의 유의한 차이를 보이지 않았다(p>0.1). 그외 조직 병리학적 유형별, 방사선 선량별, 방사선 반응군별, 항암화학요법 유무에 따른 생존율은 유의한 차이를 보이지 않았다. 결론적으로 overall 5년 생존율 및 중앙 생존기간은 $6.7\%$와 10개월 이었고 performance status 만이 통계적으로유의한 예후인자였으며, 병리조직학적 유형, 병기, 방사선 치료선량, 방사선 반응유무와 항암화학요법 등의 예후인자들은 통계학적으로 유의하지 않았다.

• Radiation Oncology Journal
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• 제33권3호
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• pp.172-178
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• 2015

Purpose: To investigate clinical outcomes of synchronous head and neck and esophageal cancer (SHNEC). Materials and Methods: We retrospectively reviewed 27 SHNEC patients treated with curative intent at a single institution. The treatment modality for individual cases was usually determined on a case by case basis. Results: The median follow-up duration for the surviving patients was 28.2 months. The most common site of head and neck cancer was hypopharyngeal carcinoma (n = 21, 77.7%). The lower esophagus was the most common location of esophageal carcinoma (n = 16, 59.3%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 57.5% and 39.6%. Major pattern of failure was locoregional recurrence in the study patients. Esophageal cancer stage, the Eastern Cooperative Oncology Group (ECOG) performance status, and pretreatment weight loss were significant prognostic factors for OS in univariate analysis. Treatment-related death was observed in two patients, and one patient developed a grade 4 late treatment-related complication. Conclusion: Although the survival outcome for SHNEC is poor, long-term survival might be achievable with aggressive treatment with stage I-II esophageal cancer and good performance.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7133-7136
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• 2013

Background: We studied Surveillance, Epidemiology and End Results (SEER) breast cancer data of Georgia USA to analyze the impact of socio-economic factors on the disparity of breast cancer treatment outcome. Materials and Methods: This study explored socio-economic, staging and treatment factors that were available in the SEER database for breast cancer from Georgia registry diagnosed in 2004-2009. An area under the receiver operating characteristic curve (ROC) was computed for each predictor to measure its discriminatory power. The best biological predictors were selected to be analyzed with socio-economic factors. Survival analysis, Kolmogorov-Smirnov 2-sample tests and Cox proportional hazard modeling were used for univariate and multivariate analyses of time to breast cancer specific survival data. Results: There were 34,671 patients included in this study, 99.3% being females with breast cancer. This study identified race and education attainment of county of residence as predictors of poor outcome. On multivariate analysis, these socio-economic factors remained independently prognostic. Overall, race and education status of the place of residence predicted up to 10% decrease in cause specific survival at 5 years. Conclusions: Socio-economic factors are important determinants of breast cancer outcome and ensuring access to breast cancer treatment may eliminate disparities.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.122-135
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• 2024

Purpose: This retrospective study aimed to assess the long-term cumulative survival rate of titanium, sandblasted, large-grit, acid-etched implants over a 10-year follow-up period and investigate the factors affecting the survival rate and change in marginal bone loss (MBL). Methods: The study included 400 patients who underwent dental implant placement at the Department of Periodontology of Seoul National University Dental Hospital (SNUDH) between 2005 and 2015. Panoramic radiographic images and dental records of patients were collected and examined using Kaplan-Meier analysis, Cox proportional hazards regression analysis, and multiple regression analysis to determine the survival rates and identify any factors related to implant failure and MBL. Results: A total of 782 implants were placed with a follow-up period ranging from 0 to 16 years (mean: 8.21±3.75 years). Overall, 25 implants were lost, resulting in a cumulative survival rate of 96.8%. Comparisons of the research variables regarding cumulative survival rate mostly yielded insignificant results. The mean mesial and distal MBLs were 1.85±2.31 mm and 1.59±2.03 mm, respectively. Factors influencing these values included age, diabetes mellitus (DM), jaw location, implant diameter, bone augmentation surgery, and prosthetic unit. Conclusions: This study found that the implant survival rates at SNUDH fell within the acceptable published criteria. The patients' sex, age, DM status, implant location, implant design, implant size, surgical type, bone augmentation, and prosthetic unit had no discernible influence on long-term implant survival. Sandblasted, large-grit, acid-etched implants might offer advantages in terms of implant longevity and consistent clinical outcomes.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.891-896
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• 2012

This study focused on infection rates and subtypes of human papillomavirus (HPV) in patients with oropharyngeal squamous cell carcinoma (OSCC), and the relationship between HPV status and prognosis of the disease. We evaluated sixty-six OSCC patients who met the enrollment criteria during the period from January 1999 to December 2009. The presence or absence of oncogenic HPV types in tumors was determined using the SPF10 LiPA25 assay. Overall survival (OS) and disease specific survival (DSS) for HPV positive and HPV negative patients were estimated using Kaplan-Meier analysis. The Cox regression model was applied for multivariate analysis. HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were type HPV-16, while other types were HPV-16/11, HPV-35, HPV-58/52, and HPV-33/52/54. Patients with HPV positive tumors were more likely to be female, non-smokers and non-drinkers (p=0.002, 0.001 and 0.001, respectively). After a median follow-up of 24.5 months, patients with HPV positive tumors had significantly better overall survival (HR=0.106[95%CI=0.014-0.787], p=0.016,) and disease specific survival (HR=0.121[95%CI=0.016-0.906], p=0.030). Patients with HPV positive OSCC have significantly better prognosis than patients with HPV negative tumors. HPV infection is an independent prognostic factor.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2851-2857
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• 2013

Objective: REPS2 plays important roles in inhibiting cell proliferation, migration and in inducing apoptosis of cancer cells, now being identified as a useful biomarker for favorable prognosis in prostate and breast cancers. The purpose of this study was to assess REPS2 expression and to explore its role in esophageal squamous cell carcinoma (ESCC). Methods: Protein expression of REPS2 in ESCCs and adjacent non-cancerous tissues from 120 patients was analyzed by immunohistochemistry and correlated with clinicopathological parameters and patient outcome. Additionally, thirty paired ESCC tissues and four ESCC cell lines and one normal human esophageal epithelial cell line were evaluated for REPS2 mRNA and protein expression levels by quantitative RT-PCR and Western blotting. Results: REPS2 mRNA and protein expression levels were down-regulated in ESCC tissues and cell lines. Low protein levels were significantly associated with primary tumour, TNM stage, lymph node metastasis and recurrence (all, P < 0.05). Survival analysis demonstrated that decreased REPS2 expression was significantly associated with shorter overall survival and disease-free survival (both, P < 0.001), especially in early stage ESCC patients. When REPS2 expression and lymph node metastasis status were combined, patients with low REPS2 expression/lymph node (+) had both poorer overall and disease-free survival than others (both, P < 0.001). Cox multivariate regression analysis further revealed REPS2 to be an independent prognostic factor for ESCC patients. Conclusions: Our findings demonstrate that downregulation of REPS2 may contribute to malignant progression of ESCC and represent a novel prognostic marker and a potential therapeutic target for ESCC patients.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.62-70
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• 2019

Background: Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancers have emerged as key predictive biomarkers in EGFR tyrosine kinase inhibitor (TKI) treatment. However, a few patients with wild-type EGFR also respond to EGFR TKIs. This study investigated the factors predicting successful EGFR TKI treatment in lung adenocarcinoma patients with wild-type EGFR. Methods: We examined 66 patients diagnosed with lung adenocarcinoma carrying wide-type EGFR who were treated with EGFR TKIs. The EGFR gene copy number was assessed by silver in situ hybridization (SISH). We evaluated the clinical factors and EGFR gene copy numbers that are associated with a favorable clinical response to EGFR TKIs. Results: The objective response rate was 12.1%, while the disease control rate was 40.9%. EGFR SISH analysis was feasible in 23 cases. Twelve patients tested EGFR SISH-positive, and 11 were EGFR SISH-negative, with no significant difference in tumor response and survival between EGFR SISH-positive and -negative patients. The overall median progression-free survival (PFS) and overall survival (OS) of 66 patients were 2.1 months and 9.7 months, respectively. Female sex and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-1 were independent predictors of PFS. ECOG PS 0-1 and a low tumor burden of extrathoracic metastasis were independent predictors of good OS. Conclusion: Factors such as good PS, female sex, and low tumor burden may predict favorable outcomes following EGFR TKI therapy in patients with EGFR wild-type lung adenocarcinoma. However, EGFR gene copy number was not predictive of survival.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.661-666
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• 2015

Background: Postoperative carbohydrate antigen 19-9 (CA19-9) is an independent predictor of survival for pancreatic ductal adenocarcinoma (PDAC), and more powerful than preoperative CA19-9. However, making decisions just dependent on postoperative CA19-9 may result in necessary treatments not being performed. Materials and Methods: A total of 178 patients with resected PDAC were eligible for this retrospective study, classified into two corresponding subgroups according to postoperative CA19-9. Prognostic significance of all clinicopathologic factors was evaluated by univariate and multivariate analyses. Results: Postoperative CA19-9, preoperative CA125 and lymph node status were independent predictors. Better predictive performances for overall survival (OS) and recurrence-free survival (RFS) were achieved by postoperative CA19-9 compared to preoperative CA125 and lymph node status. Particularly, preoperative CA125 was associated with poor OS (p<0.001 for the normalized CA19-9 patients, p=0.012 for the elevated) and RFS (p=0.005 for the normalized, p=0.004 for the elevated). Moreover, preoperative CA125 levels related with survival in double-negative patients. Conclusions: Normalization of CA19-9 is not tantamount to be cured. Preoperative CA125 is a critical predictor for PDAC patients, especially in double-negative patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6001-6006
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• 2015

Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

• Radiation Oncology Journal
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• 제15권1호
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• pp.27-36
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• 1997

목적 : 국소진행된 III기 비소세포성 폐암에서 방사선감작제로서의 저용량 Cisplatin과 방사선 동시병합요법의 효과를 알아보고자하여, 관해율, 전체생존율, 무병생존율 및 치료에 따른 부작용을 방사선 단독치료군과 후향적으로 비교분석하였다. 대상 및 방법 : 1992년 4월부터 1994년 3월까지 32명의 III기 비세포성 폐암환자(IIIa 12명, IIIb 19명)가 항암제 및 방사선동시병합요법을 받았다. 방사선치료는 3000cZGy/10회를 2주간에 걸쳐 시행한 뒤 3주후에 2500cGy/10회를 추가하였으며, 방사선감작제로 ciplatin $6mg/m^2$를 매일 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개월로 중간값은 24개월이었다. 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개워로 중간값은 24개월이었다. 방사선단독치료군 32명(IIIa 13명, IIIb 19명)은 매일 170-200cGy씩 총 5580-7000cGy (중간값 5960cGy) 치료받았으며, 추적관찰기간은 36개월에서 105개월로 중간값은 62개월이었다. 결과 : cisplatin-방사선동시요법군이 방사선 단독치료군에 비해 유의하게 높은완전반응률 (18.8% vs. 5.6% 및 낮은 조사야내 재발율(25% vs. 47%을 나타내었다. 2년 전체생존율은 Cisplatin-방사선동시요법군이 17%, 방사선단독치료군이 9.4%로 유의한 차이는 보이지 않았다. 국소재발 없는 2년 무병생존율(16.5% vs. 5.3% 및 원격전이 없는 2년 무병생존율(17% vs. 4.6%도 두군간에 유의한 차이를 보이지 않았다. 그러나 Karnofsky performance scale 80 이상인 환자군만을 대상으로 분석한 결과, cispltin-방사선동시요법군이 방사선단독치료군에 비해 유의하게 높은 2년 전체생존율을 보였다(62.5% vs. 15.6%. 전체생존율에 영향을 미치는 예후인자로 cisplatin-방사선동시요법군에 있어서 performance status 및 조직학적 진단유형(상피세포암 cs. 비상피세포암)으로 나타났고, 방사선단독치료군 (22% vs. 6%에 비해 유의하게 높은 빈도를 나타내었다. Grade 2 이상의 혈액학적 독성은 Cisplatin-방사선동시요법군에 방사선단독치료군에 비해 높은 빈도를 나타내었다(25% vs. 15.6%. 방사선단독치료군에 비해 cisplatin-방사선동시요법군에서, RTOG/ECOG Grade 2 이상의 폐독성의 빈도(31% vs. 19%나 WHO Grade 3 이상의 폐섬유화의 빈도(38% vs. 25%의 유의한 증가는 관찰되지않았다. 방사선치료부위의 면적이 $200m^2$ 이상이었던 경우, 두군 모두에서 폐독성 빈도의 유의한 증가를 보였다. 결론 : cisplatin-방사선동시병합요법이 방사선단독치려ㅛ군에 비해 높은 국소제어율을 나타내었으나, 전체생존율이나 무병생존율의 유의한 증가는 보이지 않았다. KPS 80이상인 환자군에 있어서는 cisplatin-방사선동시요법군이 방사선단독군에 비해 높은 전체생존율을 보였다.cisplatin-방사선동시병합요법군에서 급성부작용이 증가되는 경향을 보였으나, 방사선에 의한 폐독성의 유의한 증가는 관찰되지 않았다. cisplatin-방사선동시병합요법군이 방사선단독치료군에 비해 1년 이내에 조기사망율이 높은 반면, 2년이상 장기생존율이 높은 경향을 보여, 이러한 환자군에 대한 장기적인 추적조사를 통해 생존율에 대한 본 치료의 영향을 좀더 명확하게 평가할 수 있을것으로 기대되며, 향후 치료효과를 증가시키기위해 large fraction size의 split course RT 대신 continuous course의 conventional RT 혹은 hyperfractionated RT와 Cisplatin의 동시병합요법 등이 고려되어야할 것으로 사료된다.