• 제목/요약/키워드: Primary cancer control

검색결과 358건 처리시간 0.028초

Tailored Sun Safety Messages for Outdoor Workers

  • Sajjad S. Fazel;Shelby Fenton;Nicole Braun;Lindsay Forsman-Phillips;D. Linn Holness;Sunil Kalia;Victoria H. Arrandale;Thomas Tenkate;Cheryl E. Peters
    • Safety and Health at Work
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    • 제14권1호
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    • pp.43-49
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    • 2023
  • Background: Messaging surrounding skin cancer prevention has previously focused on the general public and emphasized how or when activities should be undertaken to reduce solar ultraviolet radiation (UVR) exposure. Generic messages may not be applicable to all settings, and should be tailored to protect unique and/or highly susceptible subpopulations, such as outdoor workers. The primary objective of this study was to develop a set of tailored, practical, harm-reducing sun safety messages that will better support outdoor workers and their employers in reducing the risk of solar UVR exposure and UVR-related occupational illnesses. Methods: We adapted a core set of sun safety messages previously developed for the general population to be more applicable and actionable by outdoor workers and their employers. This study used an integrated knowledge translation approach and a modified Delphi method (which uses a survey-based consensus process) to tailor the established set of sun safety messages for use for outdoor worker populations. Results: The tailored messages were created with a consideration for what is feasible for outdoor workers, and provide users with key facts, recommendations, and tips related to preventing skin cancer, eye damage, and heat stress, specifically when working outdoors. Conclusion: The resulting tailored messages are a set of evidence-based, expert- approved, and stakeholder-workshopped messages that can be used in a variety of work settings as part of an exposure control plan for employers with outdoor workers.

흰쥐의 배양된 간세포에서 ethanol에 의해 유도된 p42/44 MAPkinase가 IGF system에 미치는 효과 (Effects of ethanol-induced p42/44 MAPkinase activity on IGF system in primary cultured rat hepatocytes)

  • 이선미;김종훈;강창원
    • 대한수의학회지
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    • 제46권4호
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    • pp.315-322
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    • 2006
  • Ethanol abuse is associated with liver injury, neurotoxicity, modulation of immune responses, and increased risk for cancer, whereas moderate ethanol consumption exerts protective effects against liver injury. However, the underlying signal transduction mechanisms of insulin-like growth factors (IGFs) which play an important regulatory role in various metabolism mechanisms are not well understood. We investigated the effects of ethanol-induced p42/44 activity on IGF-I secretion, IGF-I receptor and IGFBP-1 secretion using radioimmunoassay and western blotting in primary cultured rat hepatocytes. The p42/44 activity, IGF-I secretion and IGF-I receptor activity significantly accelerated compared to control at 10 and 30 min after 200 mM ethanol treatment, but then it became suppressed at 180 min. In contrast, IGFBP-1 secretion was inhibited compared to control at 30 min after 200 mM ethanol treatment, but increased at 180 min. The IGF-I secretion, IGF-I receptor and p42/44 activity at 30 min after 200 mM ethanol treatment accelerated with increasing ethanol concentration but IGFBP-1 secretion inhibited (p<0.05). The increased IGF-I secretion, inhibited IGFBP-1 secretion and IGF-IR activity by ethanol-induced temporal p42/44 activity at 30 min after ethanol treatment was blocked by treatment with PD98059. Alcohol dehydrogenase (ADH) inhibitor, 4-methylpyramazole blocked the changes of IGF-I secretion, IGFBP-1 secretion, and IGF-IR activity by ethanol-induced p42/44 activity at 30 and 180 min. Taken together, these results suggest that ethanol is involved in the modulation of IGF-I and IGFBP-1 secretion and IGF-IR activity by p42/44 activity in primary cultured rat hepatocytes. In addition, changing of p42/44 activity by ethanol was caused with ADH.

초기 성문암 환자에서 소분할조사법의 방사선 치료 결과와 예후 인자 (A Result and Prognostic Factors of Hypofractionation Radiation Therapy in Early Glottic Cancer)

  • 이미조;김헌정;김우철;노준규
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.132-138
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    • 2005
  • Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

구강 설 편평 상피 세포암의 임상적, 치료적 고찰 (Clinical and Therapeutic Aspects of Squamous Cell Carcinoma of Oral Tongue)

  • 류삼열;이창걸;박인규;서창옥;김귀언;노준규
    • Radiation Oncology Journal
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    • 제5권2호
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    • pp.105-110
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    • 1987
  • 구강 내 설암은 설의 전방 삼분의 이에서 발생하는 것으로 근치적 요법으로는 수술과 방사선 치료가 그 근간을 이루어 왔으며, 같은 병기에서 두 요법간의 완치율은 거의 동일한 것으로 보고되고 있다. 특히 조기병소(T1, T2)에서는 이 두 요법간에 비슷한 국소 퇴치율을 보이므로 치료법의 선택에는 그 치료로 인해 발생하는 기능적 손상 및 미용적 결손을 최소화하는데 역점을 두어야 할 것이다. 그러므로 큰 기능적 손상 없이 용이하게 절제할 수 있는 첨단부 및 배부의 작은 병소를 제외하고 대부분의 조기병소는 방사선 요법으로 정상적인 발성 및 연하작용을 유지하며 치료할 수 있다. 그러나 비교적 진행된 병소(late T2, T3) 중 하부 침윤이 심하지 않으면 방사선 치료만으로 완치될 수 있으며 수술은 방사선 치료 후 재발암의 구원요법으로 유보해 두는 것이 바람직할 것이다. 방사선 치료의 방법으로는 외부 조사법 외에 자입요법 등이 있으나 최대의 국소 퇴치를 위해서는 자입요법이 필수적인 것으로 나타났다. 이러한 자입요법으로 치료기간을 단축할 수 있음은 말할 것도 없고 투여되는 선량을 증가시킴으로서 국소 퇴치율의 향상을 기대하고 나아가 생존율을 높일 수 가 있을 것이다.

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Predictive Value of Serum Insulin-like Growth Factor-1 in Hepatocellular Carcinoma

  • Elmashad, Nehal;Ibrahim, Wesam Salah;Mayah, Wael Wahid;Farouk, Mohamed;AboAli, Lobna;Taha, Atef;Elmashad, Wael
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.613-619
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    • 2015
  • Background: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Insulin-like growth factor-1 (IGF-1) levels reflect hepatic function and are inversely correlated with the severity of background chronic liver disease. Objective: This study evaluated whether basal serum IGF-1 levels can predict prognosis of HCC patients according to different risks of disease progression. Materials and Methods: A total of 89 patients with hepatocellular carcinoma (HCC) were recruited in 3 groups: Group I, 30 HCC patients receiving sorafinib; Group II, 30 HCC patients with best supportive care; and Group III include 29 patients undergoing transcatheter arterial chemoembolization (TACE). All patients were investigated for serum levels of AST, ALP, Bb, Cr, BUN, AFP and IGF-I. Results: Patients with disease control had significantly higher baseline IGF-1 levels 210 (185-232.5) ng/mL (p value<0.01) than did patients without disease control. Low basal IGF-1 levels were associated with advanced HCC, such as multiple tumors and advanced stage, and low IGF-1 levels predicted shorter TTP and overall survival in patients treated with TACE. Conclusions: The levels of serum IGF-1, expressed as continuous values, may be helpful for accurately assessing hepatic function and the prognostic stratification of patients with HCC.

스마트폰 앱을 활용한 동료지지가 유방암 생존자의 건강행위와 체질량지수에 미치는 효과 (The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors)

  • 박가은;이해정;김현열
    • 대한간호학회지
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    • 제49권5호
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    • pp.550-561
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    • 2019
  • Purpose: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). Methods: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. Results: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=-3.24, p=.005), physical activity (t=-4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=-3.01, p=.005), intake of vegetables (t=-2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. Conclusion: The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.

Health Indicators Related to Disease, Death, and Reproduction

  • Choi, Jeoungbin;Ki, Moran;Kwon, Ho Jang;Park, Boyoung;Bae, Sanghyuk;Oh, Chang-Mo;Chun, Byung Chul;Oh, Gyung-Jae;Lee, Young Hoon;Lee, Tae-Yong;Cheong, Hae Kwan;Choi, Bo Youl;Park, Jung Han;Park, Sue K.
    • Journal of Preventive Medicine and Public Health
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    • 제52권1호
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    • pp.14-20
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    • 2019
  • One of the primary goals of epidemiology is to quantify various aspects of a population's health, illness, and death status and the determinants (or risk factors) thereof by calculating health indicators that measure the magnitudes of various conditions. There has been some confusion regarding health indicators, with discrepancies in usage among organizations such as the World Health Organization the, Centers for Disease Control and Prevention (CDC), and the CDC of other countries, and the usage of the relevant terminology may vary across papers. Therefore, in this review, we would like to propose appropriate terminological definitions for health indicators based on the most commonly used meanings and/or the terms used by official agencies, in order to bring clarity to this area of confusion. We have used appropriate examples to make each health indicator easy for the reader to understand. We have included practical exercises for some health indicators to help readers understand the underlying concepts.

Therapeutic Effect of Gamma Knife Radiosurgery for Multiple Brain Metastases

  • Lee, Chul-Kyu;Lee, Sang-Ryul;Cho, Jin-Mo;Yang, Kyung-Ah;Kim, Se-Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제50권3호
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    • pp.179-184
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    • 2011
  • Objective : The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods : We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up. Results : The overall median survival after GKRS was $9.1{\pm}1.7$ months. Among various factors, primary tumor control was a significant prognostic factor ($11.1{\pm}$1.3 months vs. $3.3{\pm}2.4$ months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor control. The actuarial peritumoral edema reduction rate was 22.4% at 6 months. Conclusion : According to our results, GKRS can provide beneficial effect for the patients with multiple (4 or more) brain metastases, when systemic cancer is controlled. And, careful dosimetry is essential for local tumor control. Therefore, GKRS can be considered as one of the treatment modalities for multiple brain metastase.

Radiotherapy for initial clinically positive internal mammary nodes in breast cancer

  • Kim, Jina;Chang, Jee Suk;Choi, Seo Hee;Kim, Yong Bae;Keum, Ki Chang;Suh, Chang-Ok;Yang, Gowoon;Cho, Yeona;Kim, Jun Won;Lee, Ik Jae
    • Radiation Oncology Journal
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    • 제37권2호
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    • pp.91-100
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    • 2019
  • Purpose: Internal mammary lymph node (IMN) involvement is associated with poor prognosis in breast cancer. This study investigated the treatment outcomes of initial clinically IMN-positive breast cancer patients who received adjuvant radiotherapy (RT), including IMN irradiation, following primary breast surgery. Materials and Methods: We retrospectively reviewed data of 95 breast cancer patients with clinically detected IMNs at diagnosis treated with surgery and RT between June 2009 and December 2015. Patients received adjuvant RT to the whole breast/chest wall and regional lymph node (axillary, internal mammary, and supraclavicular) areas. Twelve patients received an additional boost to the IMN area. Results: The median follow-up was 43.2 months (range, 4.5 to 100.5 months). Among 77 patients who received neoadjuvant chemotherapy, 52 (67.5%) showed IMN normalization and 19 (24.6%) showed a partial response to IMN. There were 3 and 24 cases of IMN failure and any recurrence, respectively. The 5-year IMN failure-free survival, disease-free survival (DFS), and overall survival (OS) were 96%, 70%, and 84%, respectively. IMN failure-free survival was significantly affected by resection margin status (97.7% if negative, 87.5% for close or positive margins; p = 0.009). All three patients with IMN failure had initial IMN size ≥1 cm and did not receive IMN boost irradiation. The median age of the three patients was 31 years, and all had hormone receptor-negative tumors. Conclusion: RT provides excellent IMN control without the support of IMN surgery. Intensity-modulated radiotherapy, including IMN boost for breast cancer patients, is a safe and effective technique for regional lymph node irradiation.

폐암의 방사선치료 결과 (Result of Radiation Therapy for the Lung Cancer)

  • 김주영;최명선;서원혁
    • Radiation Oncology Journal
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    • 제7권2호
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    • pp.213-225
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    • 1989
  • An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.

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