The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.22
no.2
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pp.39-49
/
2009
Objective : Phyllostachyos Folium (PF) has been used to treat patients with febrile disease consuming the body fluids marked by fever with restlessness, thirst etc. In the theory of herbology, PF can clear away heat and promote the production of the body fluids, relieve restlessness. Recently PF is known to have anti-bacterial, anti-oxidantic effects. Methods : The present study was carried out to investigate the effects of PF on solid tumor in mice in terms of immune-potentiating and direct cytotoxic action of PF in vitro and vivo study. The present author investigated thymocyte and splenocyte proliferation to confirm immune-potentiating activity of PF and also investigated tumor/body weight ratio and survival rates in tumor bearing mice. Result : In this study, administration of PF decreased tumor/body weight ratio significantly, and prolonged survival duration compared to non-treated control. In addition, treatment with PF suppressed proliferation rate of Sarcoma 180 (S-180) cells significantly, and elevated proliferation rates of thymocytes isolated from normal mice. These results were co-related with in vivo study. Conclusion : In conclusion, these results suggest that PF is useful to treat patient with solid tumor, because PF has direct toxic action for tumor cell and immune -potentiating action for T cells. Further study will need to elucidate exact mechanisms related in anti-cancer action of PF.
This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap using a vascular tissue transfer. Flap prefabrication was prepared with a transposition of the central pedicles of right auricle on the calvarium of the New Zealand white rabbit. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the right lateral border of parietal bone. The prefabricated flap was elevated as a $2{\times}2cm$ sized island flap and reposed in place in 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. Five days after flap repositioning, the flap viability and vascularity were evaluated with microangiography and histological study quantitatively. The flap survival was increased in accordance with the implanted period of the pedicle. New vessels developed around the implanted pedicle in the 2nd week, and overall vascularization of the flap was accomplished in the 3rd week. The flap with 4 weeks of implantation period, however, showed the same survival rate as the control group. In conclusion, prefabricated periosteo- fascial flap can be created with a vascular tissue transfer, and the optimal duration of the pedicle implantation is more than 4 weeks to obtain adequate flap survival.
Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.23
no.1
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pp.158-168
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2010
Objective : Jeungson-Ojeok-Hwan Bijukbang(JOH) has been used to treat patients with tumor etc. In the theory of Korean medicine, JOH can treat Juk-Chui. JOH is known to have treat Juk-Chui. Juk-Chui is analogous to tumor. Methods : For these reasons, the present study was designed to investigate the effects of JOH on solid tumor in mice in terms of immune-potentiating and direct cytotoxic action of JOH in vitro and vivo study. The present author investigated thymocyte and splenocyte proliferation to confirm immune-potentiating activity of JOH and also investigated tumor/body weight ratio and survival rates in tumor bearing mice. Results : In this study, administration of JOH decreased tumor/body weight ratio significantly, and prolonged survival duration compared to non-treated control. In addition, treatment with JOH suppressed proliferation rate of Sarcoma 180 (S-180) cells significantly, and elevated proliferation rates of thymocytes isolated from normal mice. These results were co-related with in vivo study. Conclusion : these results suggest that JOH is useful to treat patient with solid tumor, because JOH has direct toxic action for tumor cell and immune-potentiating action for T cells. Further study will need to elucidate exact mechanisms related in anti-cancer action of JOH.
Objectives: This systematic review aimed to put the case reports of lung cancer on Korean medicine (KM) together and adopt the results in clinical practice. Methods: Researches were searched using the PubMed, EMBASE, OASIS, KoreanTK, KISTI, RISS, KISS, and NDSL. The search term were 'lung cancer' and KM. There was no restriction in year. Results: 1. Among the 48 studies, 68 patients were reported in total. The types of lung cancer were non-small-cell lung cancer (n=41) and small-cell lung cancer (n=6). 2. The number of patients who received KM therapy alone was 40. On the other hand, 25 patients were treated with KM and chemotherapy simultaneously. All case reports used herbal medicine except 2 studies. Other types of treatment were acupuncture, moxibustion, pharmacopuncture, cupping, meditation, etc. 3. Several efficacy evaluation variables were used such as tumor size, changes of symptoms, duration of survival, the quality of life, and so on. The safety was evaluated by checking adverse effects using blood test. 4. Regarding the tumor response, partial response was reported in 12 cases, stable disease was in 22 cases, 50% of the total cases, which is a high level of tumor response. Furthermore, all 11 cases with the evaluation on the length of survival showed prolonged survival than the expectancy of corresponding stage, with the stable quality of life. Conclusion: We have found that the applicability of KM for treatment of lung cancer through this review. Evidence based medicine can be realized by checking cases and applying them in clinical practice.
Purpose: This study aimed to evaluate the effectiveness of the partial split-flap technique with a K-incision on vertical guided bone regeneration (vGBR) and to retrospectively analyze the clinical and radiographic outcomes of dental implantation using this approach. Methods: In total, 78 patients who received 104 dental implants with vGBR, categorized as (1) pre-GBR and post-implantation and (2) simultaneous GBR and implantation, were enrolled. Data analysis was based on periapical radiographs, clinical photos, and dental records. The 2-sample t-test was used to compare the 2 surgical procedures. Results: The baseline vertical bone level, augmented bone height (ABH), and treatment duration were significantly higher in the pre-GBR procedure group. The survival rates of the implants were 96.1% and 94.8% in implant- and patient-based analyses, respectively. In Cox regression analysis, high rates of implant failure were found in the presence of ABH of ≥4 mm, smoking, and diabetes. Conclusions: Within the limitations of this retrospective study, the partial split-flap technique using a K-incision for vGBR showed stable clinical outcomes and favorable dental implant survival.
Cho Jung-Hyo;Kang Wee-Chang;Son Chang-Gue;Lee Yeon-Weol;Yoo Hwa-Seung;Lee Nam-Heon;Yun Dam-Hee;Cho Chong-Kwan
The Journal of Korean Medicine
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v.25
no.4
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pp.152-160
/
2004
Objective : Recently, an increasing portion of cancer patients use various therapies of complementary and alternative medicine (CAM) including traditional oriental medicine, which is believed to improve the consequence of cancer according to clinical experience and laboratory data. But the clinical-based systemic statistic validity of these therapies is lacking, so this study was aimed to validate the traditional oriental therapies (TOT) for terminally ill cancer patients. Patients and methods : This retrospective study was performed on 273 patients who were diagnosed with terminally ill cancer in Korea and treated with TOT in the oriental hospital of Daejeon University, from March 1997 to June 2003. We examined the median duration of the terminal period and the correlations between 9 factors and survival of terminally ill cancer patients. Results : During the study period, we could confirm 142 patients' death (52.01%) in 273 subjects. The median length of survival in terminally ill cancer patients was 16 weeks (95%CI 14.0∼20.0) and 40.15% (95%CI 40.07∼40.22) of patients had survived more than 24 weeks. According to Cox's proportional hazard model including gender, age, conventional therapies (chemotherapy, radiotherapy and surgery), performance status and clinical symptoms as independent variables, history of conventional therapies (RR 0.581, 95%CI 0.381∼0.885), higher performance status (RR 1,855, 95%CI 1.454∼2.366) and absence of ascites and pleural effusion (RR 1.631, 95%CI 1.047∼2.538) showed independent prognostic value of survival. Conclusion : Our findings suggest that TOT offer potential benefits for cancer patients at the terminal stage.
Ihn, Kyong;Hyung, Woo Jin;Kim, Hyoung-Il;An, Ji Yeong;Kim, Jong Won;Cheong, Jae-Ho;Yoon, Dong Sup;Choi, Seung Ho;Noh, Sung Hoon
Journal of Gastric Cancer
/
v.12
no.4
/
pp.243-248
/
2012
Purpose: To evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size. Materials and Methods: From November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine ${\leq}10$ cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed. Results: The postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival. Conclusions: Laparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.
Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.
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