• Radiation Oncology Journal
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• v.30 no.3
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• pp.99-107
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• 2012

Purpose: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. Materials and Methods: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February 2012. Radiotherapy was delivered to the whole pelvis at a dose of 45 Gy in 25 fractions, followed by a boost of 5.4 Gy in 3 fractions to the primary tumor with 5 fractions per week. Three different chemotherapy regimens were used (5-fluorouracil and leucovorin, capecitabine, or tegafur/uracil). Tumor responses to preoperative CRT were assessed in terms of tumor downstaging and pathologic complete response (ypCR). Statistical analyses were performed to identify clinical factors associated with pathologic tumor response. Results: Tumor downstaging was observed in 28 patients (54.9%), whereas ypCR was observed in 6 patients (11.8%). Multivariate analysis found that predictors of downstaging was pretreatment relative lymphocyte count (p = 0.023) and that none of clinical factors was significantly associated with ypCR. Conclusion: Pretreatment relative lymphocyte count (%) has a significant impact on the pathologic tumor response (tumor downstaging) after preoperative CRT for locally advanced rectal cancer. Enhancement of lymphocyte-mediated immune reactions may improve the effect of preoperative CRT for rectal cancer.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.282-285
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• 2004

We report a case of advanced gastric cancer with Virchow's node and lung metastasis that responded remarkably to preoperative chemotherapy. A 47-year-old female patient was diagnosed as having incurable advanced gastric cancer with Virchow's node and multiple lung metastasis. Preoperative chemotherapy with Taxotere, CDDP and 5FU was carried out. After four courses of the regimen, the Virchow's node and the lung metastasis had disappeared, and a marked reduction of the gastric lesion was observed on the CT scan. Consequently, the patient underwent a total gastrectomy with D2 lymph node dissection. On histopathological examination, cancer cells were found to have infiltrated up to the muscle layer of the gastric wall, and 42 out of 60 resected lymph nodes were found to be metastatic. The patient received another two courses of chemotherapy after the operation. (J Korean Gastric Cancer Assoc 2004;4:282-285)

• Journal of Korean Biological Nursing Science
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• v.18 no.2
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• pp.94-101
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• 2016

Purpose: This study aimed to evaluate weight changes in women during the period of TAC (docetaxel-doxorubicin-cyclophosphamide) chemotherapy after breast surgery and the differences in weight changes by disease characteristics among Korean women with breast cancer. Methods: The design of this study was retrospective survey research. The subjects of this study were 130 patients with fully completed TAC chemotherapy between January 2012 and April 2015. Body weight before their operation, and at 3 weeks, 6 weeks, 9 weeks, 12 weeks, 15 weeks, and 18 weeks after surgery, as well as general and disease characteristics, were reviewed via their medical charts. Results: The mean age of the patients was 51.2 years. The preoperative (baseline) mean weight was $59.4{\pm}8.44$. Significant weight losses were observed in the initial (1st 3 week) period of TAC chemotherapy compared to the baseline and significant weight losses were observed with the exception of the period 6 weeks after breast surgery. There were significant differences in mean weight changes according to the stage of breast cancer, radiotherapy, and hormone therapy among disease characteristics. Conclusion: It is necessary to study weight changes after breast surgery for the long periods of TAC chemotherapy. Through the accumulated results of studies, nursing programs for breast cancer patients must be developed for the prevention of weight gain in the periods of TAC chemotherapy.

• Proceedings of the Ginseng society Conference
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• 2002.10a
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• pp.288-297
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• 2002

In this paper, we present evidence that the red ginseng from Panax ginseng C.A. Meyer inhibits the recurrence of advanced gastric cancer and shows immunomodulatory activities during postoperative chemotherapy. Flow cytometric analyses for peripheral T-lymphocyte subsets showed that the red ginseng powder restored CD4 levels to the initial preoperative values during postoperative chemotherapy. Depression of CD3 during postoperative chemotherapy was also inhibited by the red ginseng powder ingestion. This study demonstrated a 5-year disease free survival and overall survival rate that was significantly higher in patients taking the red ginseng powder during postoperative chemotherapy vs. control $(68.2\%\;vs.\;33.3\%,\;76.4\%\;vs.\;38.5\%,$ respectively, p<0.05). The mean value of serum IL-10 of the ginseng group was reduced progressively during the postoperative chemotherapy. The values of the ginseng group were close to that of the control group on postoperative months 3. These studies suggest that the red ginseng may have some immunomodulatory properties associated with CD3 and CD4 activity and interleukin 10 during postoperative chemotherapy and some potential of improving prognosis in patients with advanced gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1487-1489
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• 2012

Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

• Journal of Gastric Cancer
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• v.11 no.3
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• pp.167-172
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• 2011

Purpose: Peritoneal seeding of gastric cancer is known to have a poor prognosis. With the diagnosis of peritoneal seeding, there is no effective treatment modality. Gastrectomy with chemotherapy or primary chemotherapy is basically one of major options for this condition. This study was conducted to compare the clinical outcomes of these treatments and to identify the better way to improve the prognosis of patients with peritoneal seeding. Materials and Methods: Between 2001 and 2007, gastric cancer patients with peritoneal seeding by preoperative or intraoperative diagnosis were reviewed retrospectively. The enrolled patients were divided as primary gastrectomy and primary chemotherapy group. Clinicopathologic characteristics and clinical outcomes of groups were analyzed and compared. Results: Fifty-four patients were enrolled. 21 patients belonged to the group of primary gastrectomy and 33 patients were to the primary chemotherapy group. Among 33 patients of the primary chemotherapy group, 17 patients were received only chemotherapy and 16 patients were received gastrectomy due to the good responses of primary chemotherapy. The 3 years survival rates were 14% in primary gastrectomy group, 55% in patients who received gastrectomy after primary chemotherapy, and 0% in patients with primary chemotherapy only. Conclusions: Although this study had many limitations, some valuable information was produced. In terms of survival benefits for the gastric cancer patients with peritoneal seeding, primary gastrectomy and additional gastrectomy after primary chemotherapy revealed the better clinical outcomes. But, prospective randomized clinical study and multi-center study should be performed to decide proper treatment for gastric cancer patients with peritoneal seeding.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3595-3600
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• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• Journal of Gastric Cancer
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• v.14 no.4
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• pp.266-270
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• 2014

Purpose: Palliative gastrectomy and chemotherapy are important options for peritoneal seeding of gastric cancer. The treatment stage IV gastric cancer patient who respond to induction chemotherapy, is converted to gastrectomy (conversion therapy or conversion surgery). This study explored the clinical outcomes of gastric cancer patients with peritoneal seeding who had undergone conversion therapy. Materials and Methods: Between 2003 and 2012, gastric cancer patients with peritoneal seeding, as determined by preoperative or intraoperative diagnosis were reviewed retrospectively. Clinicopathologic characteristics and clinical outcomes of patients with peritoneal seeding were analyzed. Results: Forty-three patients were enrolled. Eighteen patients had undergone conversion surgery and 25 patients continued conventional chemotherapy. Among the 18 conversion patients, 10 received clinically curative resection. The median follow-up period was 28.5 months (range 8 to 60 months) and the total 3-year survival rate was 16.3%. The median survival time of the patients who received clinically curative conversion therapy was 37 months, and the 3-year survival rate was 50%. The median follow-up for non-curative gastrectomy patients was 18 months. No patient treated using chemotherapy survived to 3 years; the median survival time was 8 months. The differences in survival time between the groups was statistically significant (P<0.001). Conclusions: In terms of survival benefits for gastric cancer patients with peritoneal seeding, clinically curative conversion therapy resulted in better clinical outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1589-1593
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• 2012

Objective: To investigate liver fibrosis, TGF-${\beta}1$ levels and curative effects on hepatocellular carcinoma (HCC) with small and conventional dose perfusion chemotherapy by transcatheter arterial chemo embolization (TACE). Methods: Thirty-six hepatocellular carcinoma patients not indicated for surgical resection underwent super-selective transcatheter arterial chemoembolization, divided into small dose (n=15) and conventional dose (n=21) chemotherapy groups. Results: With conventional doses, four indices of liver fibrosis focusing on hyaluronate acide (HA), human procollagen type-III (hPC-III), collagen type-Ⅳ (Ⅳ-C) and transforming growth factor-${\beta}l$ (TGF-${\beta}1$) were obviously increased postoperative compared with preoperative (P<0.01); in contrast, with small doses there were no significant differences except for TGF-${\beta}1$. Five year survival demonstrated no significant differences between the two groups (P>0.05). Conclusion: To hepatocellular carcinoma patients treated by TACE, reducing doses of chemotherapy drugs can reduce progress of liver fibrosis, without impacting on five year survival.

• Journal of Gastric Cancer
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• v.14 no.1
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• pp.39-46
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• 2014

Purpose: According to current guidelines, perioperative chemotherapy is an integral part of the treatment strategy for advanced gastric cancer. Randomized controlled studies have been conducted in order to determine whether perioperative chemotherapy leads to improved R0 resection rates, fewer recurrences, and prolonged survival. The aim of our project was to critically appraise three major studies to establish whether perioperative chemotherapy for advanced, potentially resectable gastric cancer can be recommended on the basis of their findings. Materials and Methods: We analyzed the validity of the three most important studies (MAGIC, ACCORD, and EORTC) using a standardized questionnaire. Each study was evaluated for the study design, patient selection, randomization, changes in protocol, participating clinics, preoperative staging, chemotherapy, homogeneity of subjects, surgical quality, analysis of the results, and recruitment period. Results: All three studies had serious shortcomings with respect to patient selection, homogeneity of subjects, changes in protocol, surgical quality, and analysis of the results. The protocols of the MAGIC and ACCORD-studies were changed during the study period because of insufficient recruitment, such that carcinomas of the lower esophagus and the stomach were examined collectively. In neither the MAGIC study nor the ACCORD study did patients undergo adequate lymphadenectomy, and only about half of the patients in the chemotherapy group could undergo the treatment specified in the protocol. The EORTC study had insufficient statistical power. Conclusions: We concluded that none of the three studies was sufficiently robust to justify an unrestrained recommendation for perioperative chemotherapy in cases of advanced gastric cancer.