• 제목/요약/키워드: Palliative treatment

검색결과 433건 처리시간 0.028초

Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

  • Kaur, Jaspreet;Goyal, Shikha;Muzumder, Sandeep;Bhasker, Suman;Mohanti, Bidhu Kalyan;Rath, Goura Kishore
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권19호
    • /
    • pp.8259-8263
    • /
    • 2014
  • Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.

비인강 점막성 악성흑색종 2예 (Two Cases of Nasopharyngeal Mucosal Malignant Melanoma)

  • 한지연;김민식;장홍석;김훈교;홍영선;이경식;김동집;박영학;조승호;서병도;윤세철
    • 대한두경부종양학회지
    • /
    • 제11권1호
    • /
    • pp.24-29
    • /
    • 1995
  • Melanoma of the mucous membrane is a rare condition and has the worse prognosis than that of any other sites. It is usually asymptomatic in early stage and difficult to find out the primary lesion by visual examination, and these facts lead to delay in diagnosis and reduce the curability. The major factor of failure in treatment of melanoma is local recurrence rather than regional spread. Because the radical procedure is difficult in head and neck lesion due to anatomical limitation, radiation therapy and chemotherapy can be used in the treatment of local recurrence. We experienced two cases of nasopharyngeal melanoma in advanced stage and treated them with radiation therapy and/or chemotherapy. And both patients showed relatively favorable response to these palliative treatments.

  • PDF

식도암 수술 후 흉곽 내 위장에 발생한 원발성 위암에 대한 광역동치료 -1예 보고 - (Photodynamic Therapy for Neoplasms in Intrathoracic Constructed Stomach)

  • 박기성;고무성;권오춘;이섭;김종기;전상훈
    • Journal of Chest Surgery
    • /
    • 제36권10호
    • /
    • pp.794-797
    • /
    • 2003
  • 광역동치료는 흉부외과 영역에서 조기 식도암, 기관 및 기관지 종양, 위장관 점막 내 종양 및 바레트식도 등에서 광감작물질의 광파장 및 광선의 암세포에 대한 선택적이고 직접적인 독성 효과를 이용한 비수술적 치료로 안전하고 효과가 있으며, 기타 진행된 폐암이나 식도암에서 보존적 요법으로도 이용될 수 있다고 여겨지고 있다. 그러나 광역동치료 후 광독성에 의한 피부 독성이 흔하여, 직사 광선의 차단 및 약물 요법이 병행되어야 한다. 저자들은 식도암 수술 후 흘곽 내에 거치된 위장에 발생한 원발성 위암에 대한 광역동치료(Photodynamic tharapy)로 좋은 결과를 얻었기에 문헌 고찰과 함께보고하고자 한다.

진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료 (Management of Recurrent Thyroid Carcinoma with Negative Diagnostic Radioiodine Whole-Body Scan)

  • 정준기
    • 대한핵의학회지
    • /
    • 제35권3호
    • /
    • pp.117-124
    • /
    • 2001
  • Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

  • PDF

Hospital-based Population of Elderly Cancer Cases in Northeastern Thailand

  • Wirasorn, K;Suwanrungruang, K;Sookprasert, A;Limpawattana, P;Sirithanaphol, W;Chindaprasirt, J
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권2호
    • /
    • pp.767-770
    • /
    • 2016
  • Background: The proportion of aged Thais (${\geq}65$ years old) is expected to be 30% by 2030, leading to an increased number of elderly cancer cases. Older individuals have distinct patterns of cancer and treatment needs. We therefore conducted the present study of new cancer cases and trends to get a perspective on the elderly cancer situation in Northeast Thailand. Materials and Methods: All new elderly cancer cases (${\geq}65$ years) registered in the hospital-based cancer registry at the Faculty of Medicine, Srinagarind Hospital, Khon Kaen University during 1993-2012 were included in the study. Results: Elderly patients accounted for 31.6% of all cancer patients and new cancer cases in the older age group increased 46% from the first to second decades. The absolute number of oldest old (80+ years) doubled. The top three cancers in males were liver and bile duct, lung, and colorectal. In females, the three most common cancers were liver and bile duct, oral cavity, and cervix. Cancers with the highest percentages of increase were thyroid, prostate, and colorectal. Conclusions: Elderly cancer cases are increasing. Treatment modalities and palliative care for older populations are urgently needed.

TTFA의 마우스 공장 소낭선에 대한 방사선 방호작용 (Protective Effects of Trithioformaldehyde against Radiation Damage of Mouse Jejunal Crypt Cells)

  • 이종화;권준택;조병헌
    • 대한약리학회지
    • /
    • 제24권2호
    • /
    • pp.217-220
    • /
    • 1988
  • Patt등이 1949년 처음으로 cysteamine과 히utathione등이 정상조직의 방사선 내성을 증가시킨다는 사실을 규명한 이후로 많은 방사선 방어제가 연구되어 왔으나, 그들의 독성때문에 임상적적용이 매우 제한되었다. 본 실험에서는 3개의 sulfur기를 지닌 환상구조의 Trithioformaldehyde(TTFA)를 합성하여 방사선 조사 후 생존율에 대한 영향과 마우스 공장 소낭선 세포에 대한 방호 효과를 관찰하였다. TTFA 2.0 g/kg을 방사선 조사 15분 전에 복강내로 투여하고 800 rad를 조사한 후 30일간 관찰했을 때 78%의 생존율을 보였다. 또, 공장 소낭선에 대한 실험에서 TTFA는 1.0g/kg과 2.0g/kg에서 공장 소낭선에 대한 protection factor가 각각 1.17와 1.23 임을 나타냈다.

  • PDF

Bone Metastasis from Gastric Cancer: The Incidence, Clinicopathological Features, and Influence on Survival

  • Turkoz, Fatma Paksoy;Solak, Mustafa;Kilickap, Saadettin;Ulas, Arife;Esbah, Onur;Oksuzoglu, Berna;Yalcin, Suayib
    • Journal of Gastric Cancer
    • /
    • 제14권3호
    • /
    • pp.164-172
    • /
    • 2014
  • Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases. Materials and Methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed. Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors. Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.

췌장암 한의 임상진료지침 개발 예비 연구 (Preliminary Study for Development of Korean Medicine Clinical Practice Guideline for Pancreatic Cancer)

  • 박수정;유화승;유준상
    • 대한암한의학회지
    • /
    • 제22권1호
    • /
    • pp.1-11
    • /
    • 2017
  • Objectives: The purpose of this study is to investigate preliminarily for development of the Korean medicine clinical practice guideline (CPG) for pancreatic cancer through the analysis of existing CPGs. Methods: Through searching the medical database such as Pubmed, SCOPUS, CNKI, Google Scholar, etc. The global CPGs within recent three years were collected and analyzed. In particular, recommendations related to the Korean medicine or Chinese medicine were made primarily in the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine. Results: The six CPGs were mentioned in this study. The academic societies and organizations developing the CPGs were located in China, Japan, Europe and America. The contents of the CPGs were the clinical questions and statements, surgical therapy, adjuvant therapy, radiation therapy, chemotherapy, palliative medicine, risk assessment, palliation and supportive care, follow-up and recurrence, Tumor-Node-Metastasis (TNM) staging. In the Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine, the etiology, mechanisms, herbal drugs, Chinese medicine assessment, complication, syndrome differentiation (SD), Chinese medicine treatment were described. Conclusions: In order to develop the proper Korean medicine CPG for pancreatic cancer and to adapt the correct integrative treatment program on the pancreatic cancer, institutional arrangements for cooperation with Korean medical communities and standardization of SD should be performed.

First Data On Direct Costs of Lung Cancer Management in Morocco

  • Tachfouti, N.;Belkacemi, Y.;Raherison, C.;Bekkali, R.;Benider, A.;Nejjari, C.
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권4호
    • /
    • pp.1547-1551
    • /
    • 2012
  • Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

Prognostic Factors in First-Line Chemotherapy Treated Metastatic Gastric Cancer Patients: A Retrospective Study

  • Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Guven, Mehmet;Nas, Necip;Yunce, Muharrem;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제13권8호
    • /
    • pp.3869-3872
    • /
    • 2012
  • Background: The majority of patients with gastric cancer in developing countries present with advanced disease. Systemic chemotherapy therefore has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyze prognostic factors for survival in advanced gastric cancer patients undergoing first-line palliative chemotherapy. Methods: We retrospectively reviewed 107 locally advanced or metastatic gastric cancer patients who were treated with docetaxel and cisplatin plus fluorouracil (DCF) as first-line treatment between June 2007 and August 2011. Twenty-eight potential prognostic variables were chosen for univariate and multivariate analyses. Results: Among the 28 variables of univariate analysis, nine variables were identified to have prognostic significance: performance status, histology, location of primary tumor, lung metastasis, peritoneum metastasis, ascites, hemoglobin, albumin, weight loss and bone metastasis. Multivariate analysis by Cox proportional hazard model, including nine prognostic significance factors evident in univariate analysis, revealed weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level to be independent variables. Conclusion: Performance status, weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level were identified as important prognostic factors in advanced gastric cancer patients. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.