• Title/Summary/Keyword: Therapeutic range

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A Review of Anticancer Efficacy Outcome Measures in Clinical Trials of Herbal Medicine for Cancer Patients (한약을 사용한 암환자 대상 임상시험에서의 항암 효능 평가변수 고찰)

  • Chunhoo Cheon;Min Jun Kang;Wonbin Shin;;Hyunsuk Park;Unho Yang;Unseog Yeo
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.119-130
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    • 2024
  • Objectives : The objective of this review is to examine the variety of evaluation parameters utilized in clinical trials that assess the anticancer efficacy of herbal medicine, focusing on the importance of including both symptomatic management and direct anticancer effectiveness. Methods : A detailed literature review was conducted across PubMed, Embase, and the Cochrane Library to identify clinical trials investigating the antitumor efficacy of herbal medicine. The search was performed on February 22, 2024. This review specifically examined the employed outcome measures, which were then categorized and analyzed to understand their relevance and application in evaluating the anticancer properties of herbal medicine. Results : From an initial search of 900 records, 15 clinical trials were selected for in-depth analysis after deduplication and screening. These studies evaluated the efficacy of herbal medicine across various cancers, including hepatocellular carcinoma, colorectal cancer, and breast cancer, using outcome measures such as survival rates, disease control rates, and quality of life improvements. The research spanned multiple countries, primarily in East Asia and the United States, reflecting a global interest in herbal medicine as a complementary approach to cancer treatment. The present study demonstrated that herbal medicine, especially when used alongside standard treatments, potentially improved clinical outcomes and patient well-being. Conclusions : The findings of this review highlight the need for a broader focus on the full range of therapeutic capabilities of herbal medicine, including its direct anticancer effects, in the management of cancer patients. Future oncology research involving herbal medicine should integrate a wide spectrum of clinical endpoints to fully ascertain its impact on cancer treatment and patient health.

The Effect of Hyperthermia Combined with Radiation on Crypts of the Mouse Jejunum (마우스공장 소낭선의 방사선 효과에 온열요법의 병용이 미치는 영향에 관한 실험적 연구)

  • Bae, Hoon-Sik;Park, Charn-Il;Kim, Jung-Jin
    • Radiation Oncology Journal
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    • v.5 no.1
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    • pp.13-21
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    • 1987
  • The effect of local hyperthermia of 41 to $43^{\circ}C$ for 30 minutes on radiosensitivity of normal tissue was studied utilizing jejunal crypt microcolony assay. Hyperthermia of this range enhanced the radiation effect and the effect was mainly additive without significant effect on the slopes of cell survival curves. At the isoeffect level of 20 microcolony formation, the thermal enhancement ratio was 1.02, 1.10 and 1.39 for $41^{\circ},\;42^{\circ}\;and\;43^{\circ}C$, respectively. The distribution of microcolony formation along the circumference of jejunum was not uniform, having more colonies around the mesenteric border, and this suggests the effect of uneven cooling by blood circulation.

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Hypofractionated Radiation Therapy for Early Glottic Cancer - Preliminary Results - (초기 성문암 환자에서의 소분할 조사법을 이용한 방사선치료 - 예비적 결과 -)

  • Wu Hong-Gyun;Hong Semie;Shin Seong Soo;Park Charn Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.301-305
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    • 2001
  • Purpose : This study was peformed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer Methods and Materials : From February 1999 to February 2000, 20 patients with Histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as fellows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range $31\~45\;days$). Results : Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia $(5\%)$, six cases of grade 3 hoarseness $(30\%)$. Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy. Conclusion : This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.

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Pattern of Decrease of Prostate Specific Antigen after Radical Radiotherapy for the Prostate Cancer (전립선암 환자에서 방사선치료 루 전립선특이항원 농도 변화 양상)

  • Kim Bo-Kyoung;Park Suk Won;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.136-140
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    • 1999
  • Purpose : Prostate specific antigen (PSA) is a useful tumor marker, which is widely used as a diagnostic index and predictor of both treatment and follow-up result in prostate cancer. A prospective analysis was carried out to obtain the period of PSA normalization and the half life of PSA and to analyze the factors influencing the period of PSA normalization. The PSA level was checked before and serially after radical radiotherapy. Materials and Method : Twen쇼 patients with clinically localized prostate cancer who underwent radical external beam radiotherapy were enrolled in this study. Accrual period was from April 1993 to May 1998. Median follow-up period was 20 months. Radiotherapy was given to whole pelvis followed by a boost to prostate. Dose range for the whole pelvis was from 45 Gy to 50 Gy and boost dose to prostate, from 14 Gy to 20 Gy. The post-irradiation PSA normal value was under 3.0 ng/ml. The physical examination and serum PSA level evaluation were performed at 3 month interval in the first one year, and then at every 4 to 6 months. Results : PSA value was normalized in nineteen patients (95%) within 12 months. The mean period of PSA normalization was 5.3 (${\pm}$2.7) months. The half life of PSA Of the nonfailing patients was 2.1 (${\pm}$0.9) month. The nadir PSA level Of the nonfailing Patients waS 0.8 (${\pm}$0.5) ng/ml. The period of PSA normalization had the positive correlation with pretreatment PSA level (R$^{2}$=0.468). The nadir PSA level had no definite positive correlation with the pretreatment PSA level (R$^{2}$=0.075). The half life of serum PSA level also had no definite correlation with pretreatment PSA level (R$^{2}$=0.029). Conclusion :The PSA level was mostly normalized within 8 months (85%). If it has not normalized within 12 months, we should consider the residual disease in prostate or distant metastasis. In 2 patients, the PSA level increased 6 months or 20 months before clinical disease was detected. So the serum PSA level can be used as early diagnostic indicator of treatment failure.

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Radiation Dose of Lens and Thyroid in Linac-based Radiosurgery in Humanoid Phantom (선형가속기형 방사선수술시 인형 팬텀에서 수정체 및 갑상선 선량)

  • Kim, Dae-Yong;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.517-529
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    • 1998
  • Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.

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The Results of Hvperfractionated Radiation Therapy Combined with Taxol for Paraaortic Node Recurrence in Cervix Cancer (대동맥주위 림프절에 재발된 자궁경부암에서 Taxol을 병행한 과분할 방사선치료의 결과)

  • Kim, Jun-Sang;Jang, Ji-Young;Kim, Jae-Sung;Kim, Sam-Yong;Cho, Moon-June
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.27-31
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    • 2000
  • Purpose : The aim of this study was to investigate treatment results, toxicity and efficacy of hypefractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. Materials and Methods: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hypefractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 51 years. Initial FIGO stage was 1 stage IBI, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recurrent disease with superior margin at T12, and inferior margin was between L5 and S1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m$^{3}$ to 30 mg/m$^{3}$ (median, 25 mg/m$^{3}$), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. Results : Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75$\%$ and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30$\%$ and 7 months, respectively. At 1 month after treatment, 4 (40$\%$) achieved a complete response and 6 (60$\%$) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence In 2 patients after paraaortic node irradiation. There was 2 patients with grade 3 to 4 leukopenla and 8 patients with grade 1 to 2 nausea/ vomiting which was usually tolerable with antlemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. Conclusion : hypefractionated radiation therapy combined with paclitaxel chemotherapy diosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer Therefore, present results suggest that hypefractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.

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In vivo and in vitro Confirmation of Dose Homogeneity in Total Body Irradiation with Thermoluminescent Dosimeter (인체 및 인형 팬톰에서 전신방사선조사시 열형광선량계(TLD)를 이용한 선량분포 균일성 확인)

  • Chie Eui Kyu;Park Suk Won;Kang Wee-Saing;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.321-328
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    • 1999
  • Purpose : Total body irradiation (TBI) or whole body irradiation is used to acquire immune suppression, to treat malignant lymphoma and leukemia, and as an conditioning regimen for bone marrow transplantation. For these purposes, many methods were developed to obtain homogenous dose distribution. The objective of this study was to analyze and confirm the accuracy and the homogeneity of the treatment setup, the parallel opposed lateral technique, currently used in Seoul National University Hospital. Materials and Metheods : Surface dose data, measured with a thermoluminescent dosimeter, of 8 patients among 10 patients, who were given total body irradiation with the parallel opposed lateral technique between September 1996 to August 1998, at Seoul National University Hospital were analyzed. Surface doses were measured at the head, neck, axilla, thigh, and ankle level. Surface and midline doses were measured with similar set-up and technique in the Humanoid phantom. Results : Measured surface doses relative to prescribed dose for the head, neck, axilla, thight, and ankle leve were $91.3{\pm}7.8,{\;}98.3{\pm}7.5,{\;}95.1{\pm}6.3,{\;}98.3{\pm}5.5$, and $95.3{\pm} 6.3\%$, respectively. The midline doses of the head, neck, axilla, thigh, and ankle level estimated from the surface-to-midline ratios in the Humanoid Phantom were $103.4{\pm}9.0,{\;}107.8{\pm}10.5,{\;}91.1{\pm}6.1,{\pm} 93.8{\pm}4.5,{\;}and{\;}104.5{\pm}9.3\%$, respectively. Measured surface doses and estimated midline doses ranged from $-8.9\%$ to $+7.8\%$. Midline doses at the neck and the axilia level deviated more than $5\%$ from the prescribed doses. The difference of the estimated midline doses at the neck and the axilla level and the actual doses were attributed to the thickness differences between the Humanoid phantom and the patients. Conclusion Distribution of the midline doses as well as the suface doses were measured to be within $-8.7\~{\pm}7.8\%$ range. Actual dose distribution in the patient is expected to be better than the measured dose range mainly attributed to thickness difference between the patient and the Humanoid phantom.

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Stereotactic Radiosurgery of 26 Intracranial Arteriovenous Malformations with Linear Accelerator (뇌동정맥기형 26예의 선형가속기를 이용한 뇌정위다방향 단일방사선치료)

  • Yoon Sei Chul;Suh Tae Suck;Jang Hong Seok;Choi Kyu Ho;Kim Moon Chan;Shinn Kyung Sub;Bahk Yong Whee
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.21-26
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    • 1992
  • From July 1988 through November 1991,26 patients with inoperable arteriovenous malformations were treated with 6 MV linear accelerator at the Kangnam St. Mary's Hospital, Catholic University Medical College. There were 5 females and 21 males with median age of 29 years (range: $6\~63$ years) and median follow up times of 15 months (range: $4\~40$ months). The arteriovenous malformation volumes treated ranged from 1 cm diameter to 3.5 cm rectangular size. The prescribed doses at the isocenter varied from 15 to 30 Gy and were given as a single fraction. To date, all patients performed follow-up not only clinically but also through CT or angiography based radiologic modalities every 6 month. A complete obliteration was achieved in 6 ($23\%$) and partial obliteration in 8 ($31\%$) and no change in 1 ($4\%$). We observed 14 ($54\%$) responsiveness of arteriovenous malformations after radiosurgery by 2 years afterward. Whereas, the decision of the remaining 11 ($42\%$) patients was considered too early to expect the therapeutic response following radiosurgery. No complications through treatment related were observed, yet. Our initial outcome in these first 26 patients with arteriovenous malformations is recommended further follow-up.

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A study on the Knowledge and Attitudes of Abortion in 3 Junior College's Freshmen (일부 전문대학 여학생들의 인공유산에 대한 지식 및 태도에 관한 연구)

  • Kim, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.313-332
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    • 1996
  • This study was conducted to grasp the condition of freshman's knowledge and attitudes on abortion and to offer the basic materials to prevent abortion in family planning and health promotion. The objects were comprised of 290 who volunteered from 3 Junior colleges. The material of this study was by questionaire(chronbach a=.8589, .8959) suited to the purpose of this research which has been made through studying references. All the questionaires were collected immediately without explanation. The data was collected from the 29th of April to the 17th of May in 1996. Analysis of the data was done utilizing SPSS program for percentage, $mean{\pm}$ standard deviation and ANOVA. The results are as follows: 1. General features of the objects of study. Mean age was 20.47, mean of brothers and sisters was 2.93. Those who had no experience in abortion with her mother was 59.0%, and the middle social level was the highest (95.5%). 2. The conditions of attitudes about abortion. 5 points were given to 'very affirming' and, 1 point was given to 'strong denial' the total average was 4.00, and the range was $4.83\sim2.99$. 3. The condition of knowledge about abortion. 5 point were given to 'very affirming' and, 1 point was given to 'strong denial', the total average was 2.75, the range was $3.65\sim2.18$. Also knowledge of abortion was 6.2 points. Knowledge of medical and therapeutic abortion was 9.4 points. Knowledge of the physical complications of abortion was 3.4 points. 4. Correlation between general features and attitude variables. Age groups may have a higher affirmative attitude score in abortion(F=8.097, p<.000). The having 2 sisters group may have a low attitude towards abortion(F=10.34l, p<.000). Experience in abortion with mother group may have a lower affirmative score concerning abortion (t=8.925, p<.000). 5. Correlation between general features and knowledge variables. Age groups may have a higher knowledge score in abortion (F=10.829, p<.000). The having brothers group may have more high knowledge in abortion(F=2.534, p<.050). The $22\sim23$ years group may have higher knowledge in abortion (F=3.075, p<.028). The having more than 2 sisters group have more higher knowledge in abortion(F=5.605, p<.004). The having more the 3 brothers group may have higher knowledge the physical complications in abortion(F=4.022, p<.019). 6. Correlation between regions of the major variables and knowledge, attitude variables. There was no significance in the statistics.

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Aneurysms Presenting with Neural Compression : Response to Treatment with Guglielmi Detachable Coils Embolization (뇌동맥류에 의한 신경 압박의 GDC 색전 치료 반응)

  • Park, Jin Young;Ahn, Jung Yong;Huh, Ryoong;Choi, Hun Kyu;Lee, Byung Hee;Shin, Moon Soo;Chung, Bong Sub
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1491-1498
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    • 2000
  • Objectives : Embolization of intracranial aneurysms by using Guglielmi detachable coils(GDC) is proving to be a safe method of protecting aneurysms from rupture. Occasionally, patients with unruptured intracranial aneurysms present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. In the present study, the authors conducted a retrospective review to evaluate the response to GDC embolization in a series of 6 patients presenting with cranial nerve dysfunction due to mass effect. Patients and Methods : Aneurysms were classified by size, shape, and amount of intraluminal thrombus. Patients were classified by duration of symptoms prior to GDC treatment(range<1 month to>4 years). Clinical assessment was performed within days of the GDC procedure and at later follow-up appointments(range 5-16 months, mean 9 months). Results : In the immediate post-GDC embolization period, one of the five patients had transient worsening of third nerve palsy, which later improved to better than baseline status. Two patients who presented with third nerve deficit from a internal carotid artery-posterior communicating artery junction aneurysm had complete recovery. One patient who presented with hemiparesis and dysarthria from a giant mid-basilar aneurysm showed improvement of these symptoms. One patient who presented with sixth cranial nerve deficit from a cavernous aneurysm showed no change at the 8-months follow-up examination. Conclusion : The endovascular treatment of intracranial aneurysms by using GDC is suggested as an alternative therapeutic method for improving or alleviating neurological deficits produced by mass effect.

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