• Radiation Oncology Journal
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• v.24 no.2
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• pp.110-115
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• 2006

Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8715-8718
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• 2014

Background: ABVD (doxorubicin, bleomycin, vinblastine (Vb) and dacarbazine) is the standard regimen in Hodgkin's lymphoma (HL).Vincristine (O) is a mitotic spindle agent like Vb. We aimed to evaluate the efficacy and safety of O as a part of ABOD in HL. Materials and Methods: Patients who had ABOD were enrolled. Stage I-II HL were evaluated for unfavorable risk factors according to NCCN. National Cancer Institute Common Toxicity Criteria was used for toxicity. Results: Seventy-nine HL patients in our center between 2003 and 2007 were evaluated retrospectively. Median follow-up was 54 months. Most of the patients were male in their third decade. Median ABOD cycles were 6 (2-8). Primary refractory disease rate was 17.7% whereas it was 5.1% for early relapse and 5.1% for late relapse disease. Response rates were as 82.3% for complete response, 11.4% for partial response, 5.1% for stable disease and 1.3% for progressive disease. Half of relapsed patients had autologous stem cell transplantation. Estimated 5-year failure-free survival was 71% and significantly longer in early stage patients without risk factors, bulky disease or radiotherapy (RT) (p=0.05, p<0.0001, p=0.02; respectively). Estimated 5-year overall survival was 74% and significantly longer in those who had no RT (p=0.001). Dose modification rate was 5.1% and chemotherapy delay rate was 19%. There were no toxicity-related deaths. Conclusions: ABOD seems to be effective with managable toxicity in HL, even in those with poor prognostic factors.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4853-4858
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• 2015

Background: Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. Materials and Methods: Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. Results: A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of $2^{nd}$ line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. Conclusions: The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8259-8263
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• 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.

• Radiation Oncology Journal
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• v.37 no.1
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• pp.30-36
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• 2019

Purpose: This study aimed to identify the feasibility of the maximum standardized uptake value (SUVmax) on baseline 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) as a predictive factor for prognosis in early stage primary lung cancer treated with stereotactic body radiotherapy (SBRT). Materials and Methods: Twenty-seven T1-3N0M0 primary lung cancer patients treated with curative SBRT between 2010 and 2018 were retrospectively evaluated. Four patients (14.8%) treated with SBRT to address residual tumor after wedge resection and one patient (3.7%) with local recurrence after resection were included. The SUVmax at baseline PET/CT was assessed to determine its relationship with prognosis after SBRT. Patients were divided into two groups based on maximum SUVmax on pre-treatment FDG PET/CT, estimated by receiver operating characteristic curve. Results: The median follow-up period was 17.7 months (range, 2.3 to 60.0 months). The actuarial 2-year local control, progression-free survival (PFS), and overall survival were 80.4%, 66.0%, and 78.2%, respectively. With regard to failure patterns, 5 patients exhibited local failure (in-field failure, 18.5%), 1 (3.7%) experienced regional nodal relapse, and other 2 (7.4%) developed distant failure. SUVmax was significantly correlated with progression (p = 0.08, optimal cut-off point SUVmax > 5.1). PFS was significantly influenced by pretreatment SUVmax (SUVmax > 5.1 vs. SUVmax ≤ 5.1; p = 0.012) and T stage (T1 vs. T2-3; p = 0.012). Conclusion: SUVmax at pre-treatment FDG PET/CT demonstrated a predictive value for PFS after SBRT for lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6011-6017
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• 2015

Purpose: To investigate the efficacy and safety of selective radiotherapy after distant metastasis of nasopharyngeal carcinoma (NPC) treated with dose-dense cisplatin plus fluorouracil. Materials and Methods: Eligible patients were randomly assigned to a study group treated with dose-dense cisplatin plus fluorouracil following selective radiotherapy and a control group receiving traditional cisplatin plus fluorouracil following selective radiotherapy according to a 1:1 distribution using a digital random table method. The primary endpoint was overall survival (OS). Secondary endpoints were progression-free survival (PFS), objective response rate, relapse or progression rate in the radiation field and treatment toxicity. Results: Of 52 patients in the study group, 20 cases underwent radiotherapy., while in the control group of 51 patients, 16 underwent radiotherapy. The median PFS, median OS, survival rates in 1, 2 and 3 years in study and control group were 20.9 vs 12.7months, 28.3 vs 18.8months, 85.2%vs 65.9%, 62.2% vs 18.3%, and 36.6%vs 5.2% (p values of 0.00, 0.00, 0.04, 0.00 and 0.00, respectively). Subgroup analysis showed that the median OS and survival rates of 1, 2, 3 years for patients undergoing radiotherapy in the study group better than that in control group( 43.2vs24.1 months, 94.1% vs 86.7%, 82.4% vs 43.3%, 64.7% vs 17.3%, (p=0.00, 0.57, 0.04 and 0.01, respectively). The complete response rate, objective response rate after chemotherapy and three months after radiotherapy, relapse or progression rate in radiation field in study group and in control group were 19.2% vs 3.9%, 86.5% vs 56.9%, 85% vs 50%, 95% vs 81.3% and 41.3% vs 66.7% (p =0.03, 0.00, 0.03,0.30, 0.01 respectively). The grade 3-4 acute adverse reactions in the study group were significantly higher than in the control group (53.8% vs 9.8%, p=0.00). Conclusions: The survival of patients benefits from selective radiotherapy after distant metastasis of NPC treated with dose-dense cisplatin plus fluorouracil.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.357-367
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• 1997

Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.231-237
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• 2016

Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative chemotherapy (POC) on tumor resection, pathological response and postoperative complications in Iran, we designed and implemented the present retrospective cross- sectional study on 156 patients with gastroesophageal cancer (GEc) between 2013 and 2015 at Shariati Hospital of Tehran. Two groups were included, the first group had previously received preoperative chemotherapy and the second group had only undergone surgery. All patients were followed for at least one year after the operation in terms of tumor recurrence, relapse free survival and one-year survival. The two groups were eventually compared regarding tumor resection, pathological response, postoperative complications, recurrence rate and survival. The mean age was $66.5{\pm}7.3years$ and 78 percent were male. The tumor resectability, pathological response and postoperative complications in the group which received POC were 93.5%, 21.8% and 12.8%, respectively, and in the surgery alone group figures for tumor resection and postoperative complications were 76% and 29.5%, respectively. Also based on our study the 5-year survival in the POC group was better (79.5% vs. 66.5%). Using standard neoadjuvant regimens (preoperative chemotherapy/chemoradiotherapy) beforesurgery could increase tumor resectability, pathological response, and improve the general status of the patients. Therefore using POC may be recommended over surgery alone.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.598-608
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• 2023

Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. Materials and Methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

• Korean Journal of Oriental Medicine
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• v.4 no.1 s.4
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• pp.129-138
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• 1998

Angiogenesis, the formation of new blood vessels, is considered to be involved in many pathological symptoms such as diabetic retinopathy, arthritis, inflammation and solid tumour. In particular, it is thought that angiogenesis is critical for development and growth of solid tumour. Recent study shows that there is a highly significant association of microvessel density with overall survival and relapse-free survival in patients with breast tumour In this study, the inhibition effect of angiogenesis of traditional herbs used for the treatment of cancer was examined. It was found out that the extract of Agaricus blazei by boiling water is a possible inhibitor of angiogenesis. It inhibited normal developmental angiogenesis In the chorioallantoic membrane of chick embryos and also inhibited capillary-like tube formation by endotherial cells on matrigel in vitro. These results suggest that Agaricus blazei can be a potent angiogenesis inhibitor.