• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3587-3592
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• 2014

Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3155-3160
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• 2016

Background: L-asparaginase (ASNase) is commonly used in the treatment of acute lymphoblastic leukemia (ALL) and natural killer (NK)/T-cell lymphoma. This study was designed to describe the incidence of toxicity associated with ASNase in Asian adults. Secondary objectives were to investigate the management and impact of toxicity on subsequent ASNase use, and to compare the actual management against current recommendations. Materials and Methods: In this retrospective, multi-center, observational study, Asian patients ${\geq}18$ years old who received ${\geq}1$ dose of the native E. coli ASNase from 2008 to 2013 were included. Patients were excluded if they did not receive ASNase. Endpoints of this study were development of specific toxicities, whether ASNase was discontinued or re-challenged, and developmentg of recurrent toxicity. All data analyses were performed using SPSS version 20.0. Results: A total of 56 patients were analyzed. Mean (${\pm}SD$) age was 36.2 (${\pm}15.2$) years old, with 62.5% being males, 55.4% with ALL and 28.6% with NK/T-cell lymphoma. Hypersensitivity (12.5%) was associated with the highest incidence of toxicity (6 out of 7 patients had Grade 3 and 4 toxicity), followed by 10.7% for hepatic transaminitis, 3.6% for non-CNS thrombosis and 1.8% each for hyperbilirubinemia and pancreatitis. Hypersensitivity recurred in the 3 patients who were re-challenged with E. coli ASNase. Conclusions: ASNase is associated with a wide range of toxicities, with hypersensitivity being the most commonly observed among Asian adult patients.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.275-283
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• 2009

Objective : We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction. Methods : In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was $12.4cm^3$. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria. Results : Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age(<60 years) and tumor volume affected survival rate(p=0.03, each). Acute (${\leq}$1 month) toxicity was observed in 22% of patients, subacute and chronic (>6 months) toxicity occurred in 21 %, respectively. Less acute toxicity was observed with small tumors (<$10cm^3$. p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gy${\times}cm^3$) was a significant predictor of both acute and chronic CNS toxicities. Conclusion: Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.

• 대한한의학방제학회지
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• 제17권2호
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• pp.187-194
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• 2009

The kidney toxicities of WK-38 used for improvement of the vascular diseases, was examined using male and female Sprague-Dawley rats. The male and female rats were divided into 4 groups for intragastrical treatment with doses of 0, 5, 50, and 500 mg/kg/day for 13 weeks, respectively. In all male and female rats treated with WK-38, no mortality and gross pathological findings were shown for 13 weeks. There was substantially no change in body weight in all rats with treatment of WK-38. Urine osmolality as renal functional parameters were not exchanged in all rats treated with WK-38. The renal functional parameters including electrolytes excretory rate, creatinine clearance, and solute-free water reabsorption were significantly augmented on account of increase in urinary volume in female rats treated with WK-38, but not male. In summary, this study demonstrates that WK-38 exhibits no toxicity on kidney in all male and female rats.

• 한국수산과학회지
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• 제24권6호
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• pp.363-368
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• 1991

부산 시내 어시장에서 구입된 까치복어, Fugu xanthopterus의 조직부위별 독성과 특정부위의 독성간 상호관계를 mouse bioassay법에 의하여 비교 검토하였다. 즉, 개체당 전체 독량이 0-36,816 MU로써 개체에 따라 독성차이가 있으며, 간, 난소 그리고 내장의 평균독성은 각각 $110.0\pm25.0,\;115.0\pm33.0\;$ 및 $73.0\pm20.3\;MU/g$(평균치$\pm$표준편차)이었다 또한 각 부위별 독성의 빈도순서는 간$(88\%)$, 난소$(80\%)$ 내장$(75\%)$, 정소$(71\%)$, 담즙$(71\%)$, 껍질(54\%)$, 그리고 근육조직$(13\%)$의 순이었다. 한편 간과 내장, 껍질, 난소조직의 독성은 그 상관계수가 각각 r=0.93, r=0.79 및 r=0.83으로 뚜렷한 상관관계를 나타내었다.

• Radiation Oncology Journal
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• 제35권1호
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• pp.32-38
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• 2017

Purpose: Several accelerated partial breast radiation (APBR) techniques have been investigated in patients with early-stage breast cancer (BC); however, the optimal treatment delivery techniques remain unclear. We evaluated the feasibility and toxicity of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I BC, using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$ years, with stage I BC who underwent breast conserving surgery were enrolled in a phase I/II study evaluating APBR using IMRT. Forty eligible patients received 40 Gy in 4 Gy daily fractions. Patients were assessed for treatment related toxicities, and cosmesis, before APBR, during, and after completion of the treatment. Results: The median age was 73 years, median tumor size 0.8 cm and the median follow-up was 54 months. The 5-year locoregional control was 97.5% and overall survival 90%. Erythema and skin pigmentation was the most common acute adverse event, reported by 27 patients (69%). Twenty-six patients (65%) reported mild pain, rated 1-4/10. This improved at last follow-up to only 2 (15%). Overall the patient and physician reported worst late toxicities were lower than the baseline and at last follow-up, patients and physicians rated cosmesis as excellent/good in 93% and 86 %, respectively. Conclusion: In this prospective trial, we observed an excellent rate of tumor control with daily APBR. The acceptable toxicity profile and cosmetic results of this study support the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

• 대한두경부종양학회지
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• 제21권2호
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• pp.126-131
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• 2005

Objectives: To evaluate the efficacy and safety of induction chemotherapy with docetaxel and cisplatin in locally advanced head and neck cancer. Materials and Methods: Between June 1998 and December 2004, 30 patients were enrolled and among them, 20 patients were evaluable. Patients were treated with docetaxel $75mg/m^2$ and cisplatin $60mg/m^2$ on day 1 every 21 days. Results: The median age was 71(range 54-80) years old. All 20 patients were male. Nineteen patients had pathologically squamous cell carcinoma and 1 had undifferentiated carcinoma. Fourteen of 20 patients(70%) demonstrated an objective response with two(10%) achieving a complete clinical response and eleven(60%) a partial response. The median response duration was 5.3(1.6-32.1) months and the median time to progression was 5.6(1.4-33.8) months. The median overall survival of all patients was 14(range 2.2-34) months. The median overall survival of responders was 17.5(range 5-34) months and that of non-responders was 3.2(range 2.2-23) months, but it was not statistically significant(p=0.106). During a total of 92 cycles, granulocytopenia worse than CTC(Common toxicity criteria) grade 2 occurred in 6%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non-hematologic toxicities were minor and easily controlled. Conclusion: The induction chemotherapy of docetaxel and cisplatin has moderate efficacy with acceptable toxicities in patients with locally advanced head and neck cancer.

• Radiation Oncology Journal
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• 제31권1호
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• pp.18-24
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• 2013

Purpose: The purpose of this study was to assess the clinical outcomes of hypofractionated radiotherapy (HFRT) with three-dimensional conformal technique for medically inoperable patients with early stage non-small-cell lung cancer (NSCLC) and to evaluate prognostic factors. Materials and Methods: We performed a retrospective review of 26 patients who underwent HFRT for early stage NSCLC between September 2005 and August 2011. Only clinical stage T1-3N0 was included. The median RT dose was 70 Gy (range, 60 to 72 Gy) and the median biologically equivalent dose (BED) was 94.5 Gy (range, 78.0 to 100.8 Gy). In 84.6% of patients, 4 Gy per fraction was used. Neoadjuvant chemotherapy with paclitaxel and cisplatin was given to 2 of 26 patients. Results: The median follow-up time for surviving patients was 21 months (range, 13 to 49 months). The overall response rate was 53.9%, and the initial local control rate was 100%. The median survival duration was 27.8 months. Rates of 2-year overall survival, progression-free survival (PFS), local control (LC), and locoregional-free survival (LRFS) were 54.3%, 61.1%, 74.6%, and 61.9%, respectively. Multivariate analysis showed that BED (>90 vs. ${\leq}90$ Gy) was an independent prognostic factor influencing PFS, LC, and LRFS. Severe toxicities over grade 3 were not observed. Conclusion: Radical HFRT can yield satisfactory disease control with acceptable rates of toxicities in medically inoperable patients with early stage NSCLC. HFRT is a viable alternative for clinics and patients ineligible for stereotactic ablative radiotherapy. BED over 90 Gy and 4 Gy per fraction might be appropriate for HFRT.

• Radiation Oncology Journal
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• 제36권2호
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• pp.153-162
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• 2018

Purpose: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. Materials and Methods: Total 19 patients confirmed with MF between 1999-2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. Results: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. Conclusion: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.

• 약학회지
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• 제44권4호
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• pp.300-307
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• 2000

Expression of xenobiotic-metabolizing enzymes can be altered by xenobiotics, which represents changes in the production of reactive metabolic intermediates as well as toxicities in tissues. Metabolic intermediates derived from xenobiotics are considered to produce the reactive oxygen species including drug free radicals and hydroxyl free radicals, which would be ultimately responsible for drug-induced toxicities. The effects of 1,2-benzothiazine anti-inflammatory agents on the expression of xenobiotic-metabolizing enzymes including major cytochrome P450s, microsomal epoxide hydrolase (mEH) and glutathione S-transferase (GST) were studied in the liver with the aim of providing the part of information on potential production of reactive metabolites and hepatotoxicity by the agents. The synthetic compounds 24, 36 and 39 exhibited anti-inflammatory effects in rats as assessed by the Randall-Selitto method. The anti-inflammatory effect was detected as early as at 30 min after gavaging the agents with the ED5O being noted at 80 mg/kg, which was comparable to that of ibuprofen. Treatment of rats with each compound (100 mg/kg, 3d) resulted in no significant induction in the immunochemically-detectable cytochromes P45O 1A1/2, P450 2B1/2, P45O 2 Cl1 and P45O 2El. Changes in the mEN expression were also minimal, as evidenced by both Western blot and Northern blot analyses. Hepatic GST expression was slightly increased by the agents: GST Ya protein and mRNA expression was ～1.5-fold increased after treatment with compounds 24 and 39, whereas GST Yb1/2 and Yc1/2 mRNA levels were elevated 2- to 3-fold. In summary the effects of the synthetic 1,2-benzothiazines on the expression of major P45O, mEH and G57 were not significant, providing evidence that metabolic activation of the agents, potential drug interaction and hepatotoxicity would be minimal.