• 제목/요약/키워드: adjuvant

검색결과 1,526건 처리시간 0.027초

유방암 환자에서 화학요법관련 인지기능저하의 발생률과 발생양상 (Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer)

  • 박진희;배선형;정용식;정영미
    • 대한간호학회지
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    • 제45권1호
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    • pp.118-128
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    • 2015
  • Purpose: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. Methods: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. Results: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. Conclusion: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

거대세포종의 보조 요법으로의 전기소작술 (Electrocautery as Adjuvant Treatment of Giant Cell Tumor)

  • 한정수;김세동;박성혁;김정래;신덕섭
    • 대한골관절종양학회지
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    • 제12권1호
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    • pp.15-22
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    • 2006
  • 목적: 거대세포종의 치료에서 보조요법으로 전기소작술을 시행한 환자들을 추시하여 종양학적 및 임상적 결과를 알아보고자 하였다. 대상 및 방법: 1989년부터 2004년까지 두 곳의 대학병원에서 치료한 94례의 거대세포종 중 보조요법으로 전기소작술을 시행하였던 47례를 대상으로 하였다. 수술방법은 종양부위의 피질골에 창을 충분한 크기로 내고, 큐렛과 speed bur를 이용한 철저한 소파술 후 Bovie로 전기 소작술을 시행하였고, 추시 환자의 의무기록과 방사선 사진들을 조사하여 임상적 및 종양학적 결과를 조사하였다. 결과: 평균 44개월의 추시 기간 중 국소재발은 8례(17%)에서 있었고, 폐전이는 1례에서 발견 되었다. Bovie를 이용한 전기소작술로 인한 합병증 또한 1례(화농성 슬관절염)에서 있었다. 결론: Bovie를 이용한 전기소작술은 거대세포종의 수술 중 사용하는 다른 보조요법에 비하여 비교적 간편하면서도, 재발율이 다른 방법에 비하여 높지 않다는 점에서 유용한 방법이라고 사료된다.

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Safety Analysis of Adjuvant Chemotherapy with Docetaxel Administered with or without Anthracyclines to Early Stage Breast Cancer Patients: Combined Results from the Asia-Pacific Breast Initiatives I and II

  • Kim, Sung Bae;Sayeed, Ahmed;Villalon, Antonio H;Shen, Zhen Zhou;Yau, Tsz Kok;Shah, Mazhar Ali;Hou, Meng Feng;Thuan, Tran Van;Ba, Duc Nguyen;Chao, Tsu-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.697-702
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    • 2016
  • Background: The Asia-Pacific Breast Initiatives (APBI) I and II registries were established to collect safety data for patients with early stage breast cancer receiving adjuvant docetaxel-based regimens in the Asia-Pacific region. Materials and Methods: Data from the two registries were combined to perform a safety analysis. Participants in the registry were women with early stage operable breast cancer with an intermediate or high risk of recurrence. These women received adjuvant chemotherapy that included docetaxel between 2006 and 2011. Adverse events (AEs) were recorded and analyzed. Results: Data were collected from 3,224 patients from 13 countries. The mean dose intensity of docetaxel was 24.1, 22.7, $25.1mg/m^2/week$ among patients receiving docetaxel-based monotherapy, combination therapy and sequential therapy, respectively. Granulocyte colony-stimulating factor (G-CSF) was given with docetaxel to 41.8% of women and 20.6% of women receiving prophylactic antibiotics. Adverse events were reported in 86% of patients (anthracycline-containing regimens vs. non-anthracycline regimens; 87% vs. 80%). The most common adverse events were alopecia, nausea, neutropenia, vomiting, and myalgia. Adverse events NCI CTCAE ${\geq}$Grade 3 were reported in 45.4% of patients. Serious adverse events were reported in 13% of patients, of which 2.5% led to study discontinuation. Forty-six deaths (1.4%) were reported, with no significant difference between regimens. Conclusions: The safety parameters of adjuvant docetaxel therapy used to treat sequential Asian women were comparable to those reported in clinical trials evaluating the role of adjuvant docetaxel. No unusual adverse events linked to Asia-Pacific region patients were observed.

위령선약침이 Collagen, Adjuvant, LPS 및 PLA2 유발 류머티스성 관절염에 미치는 영향 (The Effect of $Clematidis$ Radix Herbal-acupuncture Solution, on Collagen, Adjuvant, Lipopolysaccharide and Phospholipase $A_2$ Induced Rheumatoid Arthritis in Mice)

  • 이진석;김경호;이승덕;김갑성
    • Journal of Acupuncture Research
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    • 제29권1호
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    • pp.127-137
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    • 2012
  • Objectives : The purpose of this study is to investigate the effect of $Clematidis$ radix herbal-acupuncture solution, on collagen, adjuvant, lipopolysaccharide and phospholipase A2 induced rheumatoid arthritis in mice. Methods : Arthritis index was measured for mouse that was injected subcutaneously in solution mixed chicken type II collagen with Freund's complete adjuvant. We injected Freund's complete adjuvant into right posterior part of the sole of a ICR mouse foot, which was measured by plethysmometer. The solution mixed $CRHS$ with Tris-HCI, $CaCl_2$, substrate, enzyme was done a chemical action for thirty minutes, and then inhibitory activity of PLA2 enzyme was expressed with inhibition percentage by utilizing isolated arachidonic acid. COX-2 was induced by adding LPS to RAW 264.7 cell, and COX-2 activity was measured by western blot analysis and $PGE_2$ Biotrak kit. Results : $CRHS$ also inhibited Freund's complete adjuvant induced chronic rheumatoid arthritis in mice. $CRHS$ showed significant inhibition of type I and type II $PLA_2$ activities in a dose dependent manner. Furthermore, $PGE_2$ production was decreased with $CRHS$ and lipopolysaccharide-induced COX-2 protein expression was significantly inhibited by $CRHS$. Conclusions : These results suggest that $CRHS$ has an therapeutic effect on drug induced-rheumatoic arthritis by inhibiting $PLA_2$ and COX-2 activities.

Impact of Adjuvant Chemotherapy Cycles on Prognosis of Resectable Stomach Cancer: A Retrospective Analysis

  • Zhang, Wen-Ying;Zhang, Wen-Jun;Bai, Yu;Yuan, Hai-Hua;Liu, Feng;Gao, Jun;Gong, Yan-Fang;Jiang, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.381-386
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    • 2013
  • Aims: The aim of this study was to investigate the effects of adjuvant chemotherapy cycles on the prognosis of patients with post-operative stomach cancer through retrospective analysis. Methods: A total of 128 patients with gastric cancer who underwent gastrectomy, followed by adjuvant chemotherapy consisting of epirubicin, cisplatin or oxaliplatin, leucovorin, and 5-fluorouracil, according to a defined schedule, were divided into three groups according to the number of chemotherapy cycles: Group I (<6 cycles); Group II (6 cycles); and Group III (>6 cycles). Results: The 5-year overall survival (OS) was 20.8% in Group I, 45.0% in Group II, and 42.9% in Group III, with a median follow-up of 43 months. The 5-year relapse-free survival (RFS) was 15.1% in Group I, 40% in Group II, and 40% in Group III. The OS and RFS in Groups II and III were significantly better than in Group I (OS, p = 0.002 and p=0.003; RFS, P<0.001 and P=0.002). There was no difference in OS (p = 0.970) or in RFS (p = 0.722) between Groups II and III. Multivariate Cox hazard analysis determined that the number of adjuvant chemotherapy cycles was an independent factor that influenced OS and RFS. Conclusion: Six cycles of adjuvant chemotherapy gave encouraging outcomes in patients with resectable gastric cancer. Further prospective randomized controlled investigations are warranted in a multi-center setting.

Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • 제34권3호
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

유향정통산이 Carrageenin 유발 급성 염증과 Adjuvant 유발 관절염에 미치는 영향 (Effects of Yuhyangjeongtong-san on the Carrageenin-induced Acute Inflammation and Adjuvant-induced Arthritis)

  • 안희빈;정수현;김순중;박동수;서일복
    • 한방재활의학과학회지
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    • 제23권3호
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    • pp.55-68
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    • 2013
  • Objectives This study was to investigate the effects of Yuhyangjeongtong-san on the carrageenin-induced acute inflammation and adjuvant-induced arthritis in rats. Methods Acute inflammation was induced by injection of 2% carrageenin 0.15 ml into right hind foot of rats. Control group was carrageenin injected and taken distilled water, treated group was carrageenin injected and taken Yuhyangjeongtong-san by orally once. 2 hours after injection, plantar temperature and paw volume were measured. 3 hours after, counts of white blood cell (WBC) were performed. Arthritis was induced by injection of complete freund's adjuvant (CFA) into base of tail. Control group was CFA injected and taken distilled water, treated group was CFA injected and taken Yuhyangjeongtong-san by orally for 10 days. 0,5,10 day, body weight, thickness of ankle joint and paw edema were measured. 10 day, counts of WBC, $interleukin-1{\beta}$ ($IL-1{\beta}$) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) level were analysed. Histochemical study of NADPH-d and immunohistochemical study of c-fos were performed. Results In the carrageenin-induced acute inflammation, neutrophils of treated group were significantly decreased compared with control group. In the adjuvant-induced arthritis, paw edema, total counts of WBC and TNF-${\alpha}$ level in paw exudates were significantly decreased compared with control group, and the number of c-fos positive neurons of treated group was significantly decreased compared with control group. Conclusions On the basis of these results, we concluded that Yuhyangjeongtong-san have anti-arthritic and anti-inflammatory effects.

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

  • Yang, Kyungmi;Park, Won;Huh, Seung Jae;Bae, Duk-Soo;Kim, Byoung-Gie;Lee, Jeong-Won
    • Radiation Oncology Journal
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    • 제35권1호
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    • pp.39-47
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    • 2017
  • Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

족삼리(足三里)($ST_{36}$).신수(腎兪)($BL_{23}$)에 대한 당귀약침이 Freund's Adjuvant로 유발된 백서(白鼠)의 관절염에 미치는 영향 (The Effect of Angelica gigas NAKAI Pharmacopuncture at $ST_{36}$ and $BL_{23}$ on Freund's Adjuvant Arthritis in Rats)

  • 류미선;윤여충;김재홍
    • Journal of Acupuncture Research
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    • 제27권5호
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    • pp.25-34
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    • 2010
  • Objectives : The purpose of this study is to investigate that effect of Angelica gigas NAKAI pharmacopuncture(AGN-Ph) by concentration at $ST_{36}$(足三里) and $BL_{23}$(腎兪) in Freund's adjuvant rats. Methods : The experimental model of arthritis was induced by injection of Freund's adjuvant into Sprague Dawley(SD) rats. After arthritis was induced, AGN-Ph was injected by concentration at $ST_{36}$ and $BL_{23}$ of rats every other day for 6 times. Thereafter, edema rate, body weight, IFN-${\gamma}$, TNF-${\alpha}$, hematologic assay were measured. Results : The results were as follows, 1. After 3 times AGN-Ph treatment, the mean of edema rate was significantly decreased in AGN-Ph group 3 than control group. And after 6 times AGN-Ph treatment, the mean of edema rate was significantly decreased in AGN-Ph group 1, 2, 3 than control group. 2. The mean of body weight was significantly increased in AGN-Ph group 1, 3 than control group and saline group. 3. The mean of IFN-${\gamma}$ was significantly increased in AGN-Ph group 3 than control group. 4. The mean of TNF-${\alpha}$ was significantly increased in saline group than control group. But the mean of TNF-${\alpha}$ in AGN-Ph group 2, 3 showed no significance compared with control group's. 5. In hematologic assay, levels of WBC, RBC, Hemoglobin, Hematocrit showed no significance in all groups. Conclusions : These results are suggest that the Angelica gigas NAKAI pharmacopuncture(AGN-Ph) at $ST_{36}$ and $BL_{23}$ has a suppressing inflammation effect on Freund's adjuvant arthritis in rats.

한국산 겨우살이 Lectin B-chain의 면역증강 효과 (Immunoadjuvant Activity of Korean Mistletoe Lectin B-chain)

  • 허선미;안효선;김규대;김영훈;김인보;윤택준;김종배
    • 생약학회지
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    • 제42권3호
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    • pp.246-252
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    • 2011
  • Korean mistletoe Lectin (KML-C) is composed of A and B sub-chain. B chain binds to carbohydrates on cell surface and A chain hinders translation and induces an apoptosis as a RIP (ribosome inactivating protein). KML-C has very strong biological activities, it has seriously limits to use as a cancer therapy or adjuvant because of its toxicity to normal cells. This study is therefore conducted to see if B chain of KML-C might have immunological activity, especially adjuvant activities with less toxicity. We isolated B chain from KML-C using the lactose affinity chromatography, and examined their immunoadjuvant activity. The isolated B-chain did not show any cytotoxicity against tumor cell, RAW264.7, and P388D1 while KML-C had a very strong toxicity. This non-toxic effect was observed also by in-vivo study. Both humoral and cellular immunities were observed ; the antibody titer was increased when the mice were immunized with B-chain used as adjuvant like Freund's adjuvant, indicating that B chain of mistletoe lectin alone might be used for adjuvant; it also increased DTH in cellular immunity. These results suggest that B-chain of KML-C might be used for adjuvant used for the production of antibody or vaccine with less toxicity.