• Title/Summary/Keyword: Second line therapy

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Palliative and Neoadjuvant Chemotherapy for Advanced Gastric Cancer Patients (진행성 위암에서의 항암요법에 대하여)

  • Hee Seok Moon
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.45-51
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    • 2014
  • Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.

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Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer

  • Baykara, Meltem;Coskun, Ugur;Berk, Veli;Ozkan, Metin;Kaplan, Muhammet Ali;Benekli, Mustafa;Karaca, Halit;Inanc, Mevlude;Isikdogan, Abdurrahman;Sevinc, Alper;Elkiran, Emin Tamer;Demirci, Umut;Buyukberber, Suleyman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5119-5124
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    • 2012
  • Purpose: The aim of this retrospective study was to determine response rates, progression-free survival (PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastatic non-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-line chemotherapy. Methods: We retrospectively evaluated the file records of patients treated with gemcitabine plus paclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was as follows: gemcitabine $1500mg/m^2$ and paclitaxel 150 mg/m2 administered every two weeks. Results: Forty-eight patients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; median age, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease (SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the median PFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%), and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrile neutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy. Conclusion: The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-line chemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containing chemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, this regimen was tolerated well by the patients.

Gemcitabine Plus Nedaplatin as Salvage Therapy is a Favorable Option for Patients with Progressive Metastatic Urothelial Carcinoma After Two Lines of Chemotherapy

  • Matsumoto, Kazumasa;Mochizuki, Kohei;Hirayama, Takahiro;Ikeda, Masaomi;Nishi, Morihiro;Tabata, Ken-ichi;Okazaki, Miyoko;Fujita, Tetsuo;Taoka, Yoshinori;Iwamura, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2483-2487
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    • 2015
  • This study was conducted to evaluate the effectiveness of a combination of gemcitabine and nedaplatin therapy among patients with metastatic urothelial carcinoma previously treated with two lines of chemotherapy. Between February 2009 and August 2013, 30 patients were treated with gemcitabine and paclitaxel as a second-line chemotherapy. All had received a first-line chemotherapy consisting of methotrexate, vinblastine, doxorubicin and cisplatin. Ten patients who had measurable histologically proven advanced or metastatic urothelial carcinoma of the urinary bladder and upper urinary tract received gemcitabine $1,000mg/m^2$ on days 1, 8 and 15 and nedaplatin $70mg/m^2$ on day 2 as a third-line chemotherapy. Tumors were assessed by imaging every two cycles. The median number of treatment cycles was 3.5. One patient had partial response and three had stable disease. The disease-control rate was 40%, the median overall survival was 8.8 months and the median progression-free survival was 5.0 months. The median overall survival times for the first-line and second-line therapies were 29.1 and 13.9 months, respectively. Among disease-controlled patients (n=4), median overall survival was 14.2 months. Myelosuppression was the most common toxicity. There were no therapy-related deaths. Gemcitabine and nedaplatin chemotherapy is a favorable third-line chemotherapeutic option for patients with metastatic urothelial carcinoma. Given the safety and benefit profile seen in this study, further prospective trials are warranted given the implications of our results with regard to strategic chemotherapy for patients with advanced or metastatic urothelial carcinoma.

Cognitive Processing Therapy as a First-line Treatment for Post-Traumatic Stress Disorder (인지처리치료: 외상후 스트레스 장애의 일차 치료)

  • Jin-Hee, Choi;Hyung-Seok, So;Soonjo, Hwang;Ji-Woo, Suk;Hayun, Choi;Seung-Hoon, Lee;EunYoung, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.80-98
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    • 2022
  • Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

Emotion Coding of Sijo "The Light of the Sun in June" by Lee Jin-moon (이진문의 시조 「유월 쬐는 볕」의 감정 코딩)

  • Park, Inkwa
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.3
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    • pp.203-207
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    • 2019
  • This researcher is working on coding emotional codes from the Sijos that were created. So the purpose of this study is to derive the potential for literary therapy with Sijo's emotional coding. This time, we are going to study Lee Jin-moon's Sijo "The Light of the Sun in June." In this Sijo, the code of joy is generated in the first line, the code of joy in the second line, and the code of sadness in the last line. These emotional codes can be combined in different ways in the Emotion Codon. What this combination means is that the human body can be treated with literary emotion. It is believed that we will be able to continue this research and learn a better way of life.

Continuous-infusion Ifosfamide and Doxorubicin Combination as Second-Line Chemotherapy for Recurrent or Refractory Osteosarcoma Patients in China: a Retrospective Study

  • Huang, Yu-Jing;He, Ai-Na;Sun, Yuan-Jue;Shen, Zan;Min, Da-Liu;Yao, Yang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2391-2395
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    • 2015
  • Objective: The aim of this retrospective study was to evaluate the feasibility and efficacy of response to continuous-infusion ifosfamide and doxorubicin combination as second-line chemotherapy for patients with recurrent or refractory osteosarcoma. Materials and Methods: Eighteen recurrent or refractory osteosarcoma patients who were treated with continuous-infusion ifosfamide and doxorubicin combination between May 1999 and April 2011 were included in the analysis. Ifosfamide at $12g/m^2$ was administered by intravenous continuous infusion over 3 days, and doxorubicin $60mg/m^2$ was administered as an intravenous bolus injection on day 1. The combination therapy was repeated every 3 weeks. Treatment was continued until evidence of disease progression or unacceptable toxicity. Results: The patients (ages 7-53 years) received a total of 42 cycles of chemotherapy (median: 2 courses; range: 2-5 courses). The overall response rate was 0% and the disease control rate was 22.3%, with four patients having stable disease. The median time to progression and overall survival time were 2 months (range: 2-5 months) and 9 months (range: 3-29 months), respectively. Major severe toxicities were leucopenia 7 (38.9%), nausea and vomiting 3 (16.7%) and alopecia 9 (50%). There were no treatment-related deaths. Conclusions: In our experience, continuous-infusion ifosfamide and doxorubicin combination therapy at this dosage and schedule was found to be well tolerated and moderate effective, which could be considered as salvage therapy for patients with recurrent or refractory osteosarcoma. Further assessment is necessary to confirm the safety and efficacy of this treatment.

The Concurrent Use of Rhus verniciflua Stokes as Complementary Therapy with Second or More Line Regimens on Advanced Non-small-cell Lung Cancer: Case Series

  • Lee, Sang-Hun;Kim, Kyung-Suk;Choi, Won-Cheol;Yoon, Seong-Woo
    • The Journal of Korean Medicine
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    • v.30 no.6
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    • pp.112-117
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    • 2009
  • Objective: Rhus verniciflua Stokes (RVS) has anticancer effect confirmed by preclinical studies and historical records. We thus tried to evaluate retrospectively the effect of RVS as a complementary medicine for patients with advanced non-small-cell lung cancer (NSCLC) showing refractory to conventional chemotherapy. Patients and Methods: From June 1, 2006 to June 30, 2007, patients with advanced NSCLC who received both the standardized RVS extract and a standard course of second or more line therapy such as pemetrexed ($Alimta^{(R)}$), erlotinib ($Tarceva^{(R)}$), and gefitinib ($Iressa^{(R)}$) were checked. A total of 13 patients were eligible for the final analysis after fulfilling inclusion/exclusion criteria. Time to progression (TTP) of these patients treated with the standardized RVS extract was checked in the aftercare period. Results: Patients received RVS treatment for a median period of 296 (range 84-698) days. The median TTP was 220.5 (range 36-489) days, and three patients (23.1%) had TTP values of 15 more months. No significant side effects from RVS treatment have been observed. Conclusion: The standardized RVS extract might have synergetic effects by assisting apoptosis in advanced NSCLC with concurrent standard therapy agents, since it prolonged TTP without significant adverse effects. This study suggests that the standardized RVS extract is beneficial to patients with chemotherapy-refractory NSCLC. Further clinical trials and preclinical studies are necessary to determine the efficacy and safety of the standardized RVS extract in NSCLC.

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Gaze Effects on Spatial and Kinematic Characteristics in Pointing to a Remembered Target

  • Ryu, Young-Uk;Kim, Won-Dae;Kim, Hyeong-Dong
    • Physical Therapy Korea
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    • v.13 no.4
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    • pp.23-29
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    • 2006
  • The purpose of the present study was to examine gaze effects on spatial and kinematic characteristics during a pointing task. Subjects were asked to watch and point to an aimed target (2 mm in diameter) displayed on a vertically mounted board. Four gaze conditions were developed as combinations of "seeing-aiming" in terms of the eye movements: Focal-Focal (F-F), Focal-Fixing (F-X), Fixing-Focal (X-F), and Fixing-Fixing (X-X). Both the home target and an aimed target were presented for 1 second and then were disappeared in F-F and X-F. In X-F and X-X, only an aimed target disappeared after 1 second. Subjects were asked to point (with index finger tip) to an aimed target accurately as soon as the aimed target was removed. A significant main effect of gaze was found (p<.01) for normalized movement time. Peripheral retina targets had significantly larger absolute error compared to central retina targets on the x (medio-lateral) and z (superior-inferior) axes (p<.01). A significant undershooting to peripheral retina targets on the x axis was found (p<.01). F-F and X-F had larger peak velocities compared to F-X and X-X (p<.01). F-F and X-F were characterized by more time spent in the deceleration phase compared to F-X and X-X (p<.01). The present study demonstrates that central vision utilizes a form of on-line visual processing to reach to an object, and thus increases spatial accuracy. However, peripheral vision utilizes a relatively off-line visual processing with a dependency on proprioceptive information.

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The effect of Group art therapy with ceramics on aggression and impulse of juvenile delinquent

  • Nah, Eun Jeong;Ryu, Jung Mi
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.8
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    • pp.85-94
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    • 2016
  • The purpose of this research is to clarify the effect that group art therapy with ceramics affects aggression and impulse for juvenile delinquent. The experimental domain of this study was implemented with 24 juvenile delinquent suspended from protective dispositions for them who were in long-term juvenile sheltered housing about for 12 years. These subjects were selected from among juvenile delinquent between 14 to 20 years age who were entrusted from court to the Juvenile Protection Education Institute located in G area. 12 people were randomly assigned each experimental domain and control domain; experimental group was implemented group art therapy with ceramics whereas there was anything to control group. The program was designed once a week and 90minutes each 12 sessions. The result of this study show that control group at variable related aggression was not significantly changed at posttest. In case of experimental group, here was significantly changed as a whole, also sub factor such as physical aggression showed considerable change so that the first hypothesis was supported In addition, experimental group showed the considerable change at sub factor of motor impulsiveness so that the second hypothesis was supported whereas control group at impulse variable was not significantly changed during pretest and posttest. This study results conclude that the juvenile delinquent participating group art therapy with ceramics represents the effect on reduction of aggression and motor impulsiveness. We expect this result will be used as further base line data for juvenile delinquent.

Phase II Clinical Study on the GEMOX Regimen as Second-line Therapy for Advanced Ovarian Cancer

  • Yuan, Shao-Fei;Zhang, Lian-Ping;Zhu, Lin-Jia;Chen, Wen-Jun;Zheng, Wei-E;Xiong, Jian-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3949-3953
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    • 2013
  • Aim: To investigate the effectiveness and adverse effects of gemcitabine by fixed-dose rate infusion plus oxaliplatin (GEMOX regimen) as second-line therapy for advanced ovarian cancer. Methods: 64 patients with advanced ovarian cancer were divided into an experimental group (44 cases) and a control group (20 cases). The experimental group was treated with continuous intravenous infusion of gemcitabine at 1000 $mg/m^2$ with a fixed-dose rate of 10 $mg/m^2/min$, on days 1 and 8 and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, repeated every 3 weeks. The control group was treated with intravenous infusion of gemcitabine at 1000 $mg/m^2$ within 30 min on days 1 and and oxaliplatin at 100 $mg/m^2$ on day 1, IVGTT, again repeated every 3 weeks. CT scans or MRI were used for review every 1-2 cycles. Results: The effective rate in the experimental group was significantly high than control group (43.2% vs 35.0%; P < 0.05), with no obvious difference of hematologic or non-hematologic toxicity between the two groups (P > 0.05). Conclusion: GEMOX regimen is very effective to treat advanced ovarian cancer, with low toxicity, good tolerance and improved life quality in patients.