• Title/Summary/Keyword: Therapeutic rate

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Results of Total Body Irradiation in Allogeneic Bone Marrow Transplantation for Acute Non-Lymphocytic Leukemia (급성 골수성 백혈병에서 동종골수이식을 위한 전신 방사선 조사의 치료 결과)

  • Chung Su Mi;Choi Ihl Bohng;Kim In Ah;Kim Sung Hwan;Kang Ki Mun;Shinn Kyung Sub;Kim Choon Choo;Kim Dong Jip
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.247-253
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    • 1992
  • Between August 1987 and July 1991, 22 patients with acute nonlymphocytic leukemia have received allogeneic bone marrow transplantation (BMT) with non-T-lymphocyte-depleted marrow obtained from matched sibling donors. Of these patients, 12 patients were in first complete remission (CR) and 10 patients in second CR or greater or in relapse. All patients were treated with a preparative regimen consisting of cyclophosphamide (CTX, 60 mg/kg) or combined drugs, and 850 cGy single-dose or $150\~200$ cGy fractionated total body irradiation (TBI) administered twice daily for a total dose of $1200\~1320$ cGy. Survivors have been followed from 8 to 64.5 months (median, 24 months). The overall 2 year survival rate, relapse rate and incidence of radiation pneumonitis and graft versus host disease (GVHD) have been evaluated by age, phase of disease, initial WBC count, modality of TBI or conditioning chemotherapy. Overall 2 year survival was $58{\%}$. The median survival was 31 months and mean survival was 23.2 months. Overall survival have significant impact in patients of age >19 years old (p=0.008), patients in first CR (p=0.09). Two year survival rate is significantly correlated with age ( >19 vs $\leqq$19, $79.4\%$ vs $14.3\%$, p=0.0008), regimen of chemotherapy (CTX vs combined drug, $76.9\%\;vs\;33.3\%$, p=0.04), phase of disease (1st CR vs \geqq2nd$ CR or relapse, $83.3\%\;vs\;30\%$, p=0.01) and method of TBI (fractionated vs single dose, $70.7\%\;vs\;37.5\%$, p=0.05). The influence of French-American-British (FAB) subtypes on relapse rate is not significant, but initial WBC count > 20000/$mm^3$ is associated with increased relapse rate. There is difference in the rate of radiation pneumonitis ($14.3\%\;vs\;25\%$), GVHD ($14.3\%\;vs\;50\%$) and relapse ($21.4\%\;vs\;50\%$) according to fractionated versus single-dose TBI. As mentioned above, fractionated TBI is compatible for the preparative regimen combined with chemotherapy En allogeneic BMT of first CR patients under 41 years of age with suitable donor. Those results from a retrospective, non-randomized study clearly need additional clinical data, ideally from a randomized study.

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Current Role of Lamivudine Regarding Therapeutic Response and Resistance in Children with Chronic Hepatitis B

  • Hong, Suk Jin;Kim, Yeo Hyang;Choe, Byung-Ho;Park, Hyo Jung;Tak, Won-Young;Kweon, Young-Oh
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.2
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    • pp.80-88
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    • 2013
  • Purpose: To identify the predictive factors of long-term therapeutic response or resistance to lamivudine treatment in children and adolescents with chronic hepatitis B. Methods: Eighty one children and adolescents with chronic hepatitis B were included, who received lamivudine treatment for at least 6 months. Their condition was monitored for at least 12 months (12-88 months) thereafter. Twenty one (25.9%) were preschool children ($age{\leq}6$). For patients who had developed HBeAg seroconversion or breakthrough, univariate and multivariate analyses were used to identify the effects of age, gender, pretreatment alanine aminotransferase (ALT) and hepatitis B virus DNA levels. Results: HBeAg seroconversion occurred in 49 (60.5%) of the 81 patients after the initiation of the lamivudine therapy. In 65 patients whom were monitored for over 24 months, the seroconversion rate was significantly higher in younger patients (p=0.040), especially in those patients of preschool age ($age{\leq}6$, p=0.031). The seroconversion rate was significantly higher in higher pretreatment ALT (p=0.003). The breakthrough occurred in 21 (25.9%) of the 81. The breakthrough rate was lower in younger aged patients ($age{\leq}6$), and with higher pretreatment ALT levels, but no significant difference. Conclusion: Younger age is a good predictor of HBeAg seroconversion in children with long-term lamivudine treatment as well as high pretreatment ALT levels.

Review on Current Status of Use and Measurement Condition of Heart Rate Variability in Clinical Study of Korean Medicine (한의학 임상연구에서의 심박변이도 검사 활용현황과 측정조건에 대한 고찰)

  • Kim, Sang-Ho
    • Journal of Acupuncture Research
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    • v.29 no.5
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    • pp.127-137
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    • 2012
  • Objectives : The purpose of this study is to review on current status of use and measurement condition of heart rate variability(HRV) by reviewing clinical studies published in journal of Korean medicine registered Korea citraion index(KCI). Methods : One hundred twenty articles were found by searching the representative Korean databases. At first analysis was performed by current status of use(journal, academic field of corresponing author, purpose of study, disease of subject, HRV measurement devices, intervention methods and tests compared to HRV). At second analysis was performed by measurement condition(uncontrolled study, relaxation before measurement, measurement position, measurement place, measurement time period and restriction of smoking, alcohol, caffeine, meal). Results : The analysis showed that department of acupuncture & moxibustion, department of oriental neuropsychiatry are major part in journal & academic field. The purpose of study were classified under studies to verify therapeutic effect on normal subject(39%), to verify therapeutic effect on the patients(8%), to investigate characteristics of the patients(34%) and to be compared with other test(19%). Disease of subject & measurement devices in article were so various. Major intervention methods were acupuncture(61.4%), mind-body intervention(19.2%). Studies that measurement condition were not controlled were relax time(24%), measurement position(19%), measurement place(26%), measurement time period(91%) and restriction of smoking, alcohol, caffeine, meal(49%). Conclusions : This study showed that current status of use of HRV is widespread in Korean medicine but more controlled measurement conditon are needed to get more reliable result from clinical studies and to improve diagnosis and treatment of Korean medicine.

Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy (고선량율 질강 근접조사를 위한 새로운 적용구의 제작)

  • Shin, Sei One
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.123-128
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    • 2000
  • Purpose: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. Methods: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). Results: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. Conclusions: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

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The Clinical Study in 20 Cases of Patients with Chronic Prostatitis on the effects by Takrisodokeum for 1 month (탁리소독음가미(托裏消毒飮加味) 처방(處方)을 투여(投與)한 만성(慢性) 전립선염(前立腺炎) 환자(患者) 20례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Kim, man ho;Lee, Ji young;Lee, Jung Won;Cho, Chung Sik;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.11 no.1
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    • pp.103-110
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    • 2002
  • A Clinical study was done on 20 patients of chronic prostatitis who were treated by Takrisodokeum for 1 month in Dept. of Internal Medicine, Oriental Medicine Hospital, Daejon University, from 1 November. 2001 to 30 April 2002. The results were as Follows. 1. Therapeutic improvement of symptoms were distributed the voiding symptoms(81.3%), the Pain-neurological symptoms(80.0%), the others symptoms(77.6%) and the symptoms related with sexual punction(77.1%). 2. Therapeutic improvement rate of whole symptoms was 79.5%. 3. The voding symptoms was the most effectively improved and cured than any other symptoms. 4. The residual urine sensation was the most effectvely improved(93.7%) and the Urethral discharge was the less ineffectually improved(61.2%) than any other single symptoms. 5. Most symptoms of the voiding symptoms were improved over 80%. 6. According to the change of WBC counts on expressed prostatic secretion(EPS), improvement rate was 45.0% and cure rate was 15.0%.

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Effects of continuous involved weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with Hemiplegia (전자체중계를 이용한 환측 체중부하훈련이 편마비 환자의 제중지지율과 보행에 미치는 효과)

  • Lee, Suk-Min;Shim, Tae-Ho
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.7-17
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    • 2003
  • The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

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The Role of Radiotherapy in Stage I , II Intermediate Grade Non-Hodgkin's Lymphoma (I, II기 Intermediate Grade 임파종에서 방사선 치료의 역할)

  • Yun Hyong Geun;Kim Il Han;Kim Heung Tae;Ahn Yong Chan;Kim Jae Sung;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.103-109
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    • 1991
  • Radiotherapy result of 162 patients with stage I, II intermediate grade non-Hodgkin's Iymphoma was analyzed to clarify the role and limit of radiotherapy. Of 68 initial failures, 38.2% occurred in field and 61.8% occurred out of field. Proportion of in-field and out-of-field failures in stage I was 30.0% and 70.0%, respectively with involved field treatment and was 43.8% and 56.2% with extended field treatment, respectively; in stage ll , was 16.7% and 83.3%, 41.7% and 58.3%, respectively. The disease free suwival rate at S years was 48.1% for all patients and was 50.3% and 40.4% for patients with stage I and II, respectively. The survival was significantly different by stage. Bulky tumors (${\geq}10$ cm) and B symptoms didn't influence prognosis significantly. The 5 year disease free suwival with extended or wide field was better than that with involved field especially in stage I. Overall survival rates for all patients, patients with stage 1, and ll disease were 57.7%, 65.3% and 52.2% , respectively, after survival gain of the salvage chemotherapy was combined. But the overall survival of stage I disease was not better than that of stage II disease. Thus, extended field was required to achieve better disease free survival and relapsed cases might gain with chemotherapy.

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The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer (국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과)

  • Kim Jae Cheol;Jang Yang Suk;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.205-211
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    • 1989
  • From July 1984 to September 1988, 27 patients with limited stage small cell lung cancer were treated with combined modality (combination chemotherapy Plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 27 patients, 19$(70\%)$ achieved a complete response, 6$(22\%)$ a partial response, and 2$(8\%)$ no response. Female, performance status HO, serum enolase level below 30ng/ml, radiation dose over 4500 cGy, and 4 or more cycles of chemotherapy had a favorable effect on the rates of complete response, although there were no statistical differences according to the variables. Median survival time was 10 months and overall 1- and 2-year survival rates were $40,7\%$ and $12.2\%$, respectively. Complete response (p<0.05), performance status HO (p<0.05), 4 or more cycles of chemotherapy (p<0.05), and radiation dose over 4500 cGy had a significantly favorable effect on 2-year survival rate. Prophylactic cranial irradiation or sex had no effect on survival. The results of this study suggest that radiation treatment should be combined with combination chemotherapy in the therapeutic strategy of SCLC of limited stage.

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The Result of Radiotherapy in Glottic Cancer (성문암의 방사선치료)

  • Cho, Moon-June;Kim, Il-Han;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.3 no.2
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    • pp.131-136
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    • 1985
  • A retrospective analysis of 29 patients with glottic cancer, treated at the Department of Therapeutic Radiology, Seoul National University Hospital. $97\%$ of the patients was male. Of the 29 patients, stage $T_1N_0M_0$ comprised $31\%$, $T_2N_0M_0\;52\%$, and stage $T_3N_0M_0\;14\%$. Local control rate with radical readiotherapy was $78\%$ for stage $T_1N_0M_0,\;60\%$, for stage $T_2N_0M_0$, and $50\%$ for stage $T_3N_0M_),\;57\%$ of the patients with the radiation failure was salvaged by surgery. The overall 3 year survival rate was $89\%$ for the $T_1N_0M_0,\;80\%$ for stage $T_2N_0M_0$, and $50\%$ for stage $T_3N_0M_0$. Among the survivors: $88\%$ of $T_1N_0M_0\;75\%$ of $T_2N_0M_0,\;and\;50\%$ $T_3N_0M_0$ had an intact larynx and natural voice. It is concluded that radiotherapy is a highly effective method as the primary treatment of the early glottic cancer, emphasized on preserving of the larynx and natural voice.

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Radiotherapy Results of Carcinoma of the Cervix with Positive Resection Margin (절제연 양성 자궁경부암의 수술후 방사선치료)

  • Huh Seung Jae;Kim Won Dong;Wu Hong Gyun;Kim Dae Yong;Ha Sung Whan;Ahn Yong Chan;Kim Il Han;Park Charn Il
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.317-322
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    • 1996
  • Purpose : Patients with cervical cancer who have positive resection margins after radical hysterectomy are at increased risk for local recurrence. The result of postoperative pelvic radiotherapy for cervix cancer with positive resection margins were analyzed to evaluate the role of radiotherapy. Materials and Methods : Between n 1979 and 1992, 60 patients of cervix carcinoma were treated with postoperative radiotherapy after radical hysterectomy and pelvic lymphadenectomy because of positive vaginal (48 patients) or parametrial resection margins (12 patients). Patients were treated with external beam radiation therapy (EBRT) alone (12 Patients) or EBRT plus vaginal ovoid irradiation (VOI) (48 patients). The median followup period was 55 months. Results : The 5-year actuarial disease free and overall survival rates for all patients were $75.2\%$, $84.1\%$, respectively. The overall recurrence rate was $23\%$ (14/60). In 48 patients with Positive vaginal resection margins, the pelvic recurrence was $8\%$ (4/48). Distant metastasis was $15\%$(7/48). Of the 43 patients with positive vaginal resection margins treated with EBRT and VOI, recurrence rate was $21\%$(9/43) , while recurrence rate was $40\%$(2/5) in the EBRT only treated group. In 12 patients with positive parametrial margins, three patients ($25\%$) had distant metastases. The most significant prognostic factor was lymph node metastasis. Complications resulting from radiotherapy occurred at a rate of $32\%$(19/60) and grade III complications occurred in three patients ($5\%$). Conclusion : Postoperative radiotherapy can produce excellent pelvic control rates in patients with positive resection margins. In patients with positive vaginal margins, whole pelvic EBRT and VOI is recommended.

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