• Radiation Oncology Journal
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• v.37 no.2
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• pp.110-116
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• 2019

Purpose: This study aimed to identify prognostic factors for locoregional recurrence (LRR) in pT3N0 rectal cancer patients who were treated with surgery alone and had negative resection margin including circumferential resection margin (CRM) for optimal indication of adjuvant radiotherapy. Materials and Methods: We reviewed patients with pT3N0 rectal cancer who were treated via upfront surgery and had no other adjuvant treatment from January 2003 to December 2012. In total, 122 patients who had negative resection margin including negative CRM were included in the analysis. Results: The median follow-up period after surgery was 60 months (range, 3 to 161 months). During this time, 6 patients (4.9%) experienced LRR at the anastomotic site (4 patients), and regional lymphatic area (2 patients). The estimated 5-year rates of overall survival, recurrence-free survival, and LRR-free survival were 96.7%, 84.6%, and 94.0%, respectively. Multivariate analysis showed that level of tumor ≤5 cm was a significant prognostic factor for LRR-free survival (LRRFS) (p = 0.04; hazard ratio = 7.08; 95% confidence interval, 1.06-47.30). Patients with level of tumor ≤5 cm had an estimated 5-year LRRFS of 66.8%, which was much higher than 2.3% in patients with level of tumor >5 cm. There was no significant factor for recurrence-free survival or overall survival. Conclusion: In T3N0 rectal cancer, adjuvant chemoradiotherapy should be recommended in patients with level of tumor ≤5 cm for better local control. However, in patients with pT3N0 disease, negative resection margin, and level of tumor >5 cm, adjuvant chemoradiotherapy should be carefully suggested.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6935-6940
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• 2013

Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamous cell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamous cell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. In addition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type of invasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also included in the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction of recurrence and decreased survival was selected. Results: The model with the best performance was composed of a combined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reaction and stromal desmoplasia (total score =10). Compared to those with score ${\leq}8$, the patients with score 9-10 had a significantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy (p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition, the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-free survival was significantly lower in the patients with score 9-10 than those with score ${\leq}8$ among the overall patients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy (p=0.047). Conclusions: In this study, a prognostic model based on a combination of pathological characteristics of invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survival in patients with early-stage cervical squamous cell carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1471-1477
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• 2015

Background: Adding taxanes to adjuvant antracycline and cyclophosphamide (AC) in combination may provide significant improvement in node-positive and high risk node-negative breast cancer (BC) patients. However, the optimal dose and the role of dose-dense (DD) chemotherapy have yet to be determined. The aim of this study was to compare the efficacy of a DD paclitaxel (P)-AC combination with conventional weekly P-AC or docetaxel D-AC combinations in patients with node-positive breast cancer. Materials and Methods: Newly diagnosed 280 node-positive BC patients diagnosed from 1998 to 2013 in three clinics were retrospectively analyzed. Demographic and medical data were collected from the medical charts. Patients were categorized to 3 groups according to treatment arms: arm A, ddAC-P; arm B, weekly P and AC combination; and arm C; T and AC combination. Adjuvant trastuzumab was added for HER2-positive patients. Kaplan-Meier survival analysis was carried out for disease free survival (DFS) and overall survival (OS). The log-rank test was used to examine the statistical significance of the differences observed between the groups. Two-sided P values <0.05 were considered statistically significant. Results: Of the total of 280 patients, 101 were in arm A, 114 in arm B and 65 in arm C.The median ages were 49, 50 and 46, respectively (p=0.11). Median follow-up was 39 (3-193) months. Stage, lymphovascular and perineural invasion, receptor patern, and menopausal status were similar in the 3 treatment arms, but HER2 positivity was significantly lower in arm A, compared to arms B and C (25.7%, 53.1%, 41.5% in arms A, B and C, respectively; p<0.001). Also grade 3 tumors were significantly less frequent in treatment arm A compared to arm B and C (27.3%, 56.8% and 49.2%, respectively, p=0.01). Afterunivariate and multivariate analysis were performed, 3-year DFS rates were 89%, 81%, and 75%, respectively (p=0.12) and three year OS rates were 96.6%, 89%, and 75% (p=0.62). Conclusions: In this study, no significant difference was found between adjuvant dose dense and conventional taxane treatment regimens.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.95-105
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• 2013

Objectives : The objective of this study was to investigate the effects of Curcuma longa $L_{INNE}$ pharmacopuncture at $ST_{36}$ on Complete Freund's Adjuvant(CFA)-induced arthritis in rats. Materials and methods : Arthritis was induced by injecting CFA subcutaneously into the left knee joint and paw, and Curcuma longa $L_{INNE}$ pharmacopuncture(CLL-A. $0.0343{\mu}g/kg$; CLL-B. $0.171{\mu}g/kg$; CLL-C. $0.343{\mu}g/kg$) was injected at $ST_{36}$ each other day for 5 times beginning on day 10 after the CFA injection. Paw edema, withdrawal response, hematological, serological and histological observation were assessed. Results : In paw edema volume all 3 groups(CLL-A, CLL-B, CLL-C) showed significant decrease compared to the CFA control group. In withdrawal response to reaction time and withdrawal response to force all 3 groups(CLL-A, CLL-B, CLL-C) showed significant increase compared to the CFA control group. In serum AST, group CLL-C showed significant decrease compared to the CFA control group. In histological observations, in all 3 groups, more normal chondrocytes were observed compared to the CFA control group and safranin O stain showed high positive reaction in the cartilage tissue close to the bone tissue. Conclusions : The results suggest that Curcuma longa $L_{INNE}$ Pharmacopuncture at $ST_{36}$ has a suppressing inflammation effect on Freund's adjuvant arthritis in rats.

• The Korea Journal of Herbology
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• v.36 no.5
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• pp.15-27
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• 2021

Objectives : The processing of Pinelliae Tuber and Arisaematis Rhizoma is a crucial step to reduce the severe acrid irritation mainly due to the needle-like crystals (raphides). Ginger, alum and bile juice have been used as adjuvant materials for the processing. Methods : Bibliographic research on ancient processing and experimental processing was performed to investigate the toxicity reduction mechanisms of the processing with ginger, alum and bile juice. Results : Ginger has been a major adjuvant for the processing of Pinelliae Tuber, followed by alum and bile juice since Song (宋) and Myeong (明) dynasties, and Arisaematis Rhizoma has been mainly used as Damnamseong (膽南星). The raphides consisting of calcium oxalate, lectin, agglutinin and polysaccharides can induce acrid irritation and the inflammatory reactions. The lipophilic components in the ginger denatured the structure of raphides and 6-gingerol-contained ginger extract attenuated the inflammatory reaction. The calcium ion (Ca²⁺) of calcium oxalate was substituted to the aluminium ion (Al³⁺) of the alum, which damaged the calcium oxalate structure. Lectin attached to the surface of raphides was dissolved in alum solution and consequently its structure was denatured. The cholate in the bile juice formed the complex with the oxalate anion or the calcium cation. Moreover, the enzymes activated by Lactobacillus or Bifidobacterium during the fermentation promoted the fragmentation of oxalate. Conclusion : The adjuvant materials damaged the raphides by denaturing or degrading the calcium oxalate, resulting in the reduction of acrid irritation. Further experimental studies would support the toxicity reduction mechanism of the processing.

• Preventive Nutrition and Food Science
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• v.19 no.2
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• pp.59-68
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• 2014

The extracts and pure saponins from the roots of Platycodon grandiflorum (PG) are reported to have a wide range of health benefits. Platycosides (saponins) from the roots of PG are characterized by a structure containing a triterpenoid aglycone and two sugar chains. Saponins are of commercial significance, and their applications are increasing with increasing evidence of their health benefits. The biological effects of saponins include cytotoxic effects against cancer cells, neuroprotective activity, antiviral activity, and cholesterol lowering effects. Saponins with commercial value range from crude plant extracts, which can be used for their foaming properties, to high purity saponins such as platycodin D, which can be used for its health applications (e.g., as a vaccine adjuvant). This review reveals that platycosides have many health benefits and have the potential to be used as a remedy against many of the major health hazards (e.g., cancer, obesity, alzheimer's) faced by populations around the world. Methods of platycoside purification and analysis are also covered in this review.

• Preventive Nutrition and Food Science
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• v.19 no.1
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• pp.10-18
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• 2014

In this study, Woongjin fermented red ginseng extract (WFRG) was evaluated for its potential ability to act as an adjuvant for the immune response of mice. For the in vitro study, macrophages were treated with serial concentrations ($1{\mu}g/mL$, $10{\mu}g/mL$, and $100{\mu}g/mL$) of WFRG. For in vivo studies, mice were administered different concentrations (10 mg/kg/day, 100 mg/kg/day, and 200 mg/kg/day) of WFRG orally for 21 days. In vitro, the production of nitric oxide and TNF-${\alpha}$ by RAW 264.7 cells increased in a dose-dependent manner. In vivo, WFRG enhanced the proliferation of splenocytes induced by two mitogens (i.e., concanavalin A and lipopolysaccharide [LPS]) and increased LPS-induced production of TNF-${\alpha}$ and IL-6, but not IL-$1{\beta}$. In conclusion, WFRG has the potential to modulate immune function and should be further investigated as an immunostimulatory agent.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4683-4688
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• 2014

Background: Breast conservation treatment (BCT) has long been recognised to provide survival outcomes equivalent to mastectomy for the treatment of breast cancer. However, published reports of BCT rates in Asian communities are lower than those from Western countries. This study sought to investigate the eligibility and utilisation of BCT in a predominantly Asian population. Materials and Methods: All patients treated surgically by a single surgeon at a private medical facility between 2009 and 2011 were included in the study. Patients were deemed to have successful BCT if they underwent breast conserving surgery with pathologic clear margins and completed all recommended adjuvant treatment. Those who did not complete adjuvant treatment were excluded from the analysis. Results: Data from a total of 161 patients who underwent treatment during the study period were analysed. The mean age was 48.8 years. One hundred and six patients (65.8%) were of Chinese ethnicity, 12 were Indian (7.5%), 11 were Malay (6.8%), 18 were Caucasian (11.2%) and 14 (8.7%) were of other Asian ethnicity. One hundred and thirty-eight women (85.7%) underwent BCT. Of the 23 (14.3%) who underwent mastectomy, 8 (5.4%) elected to undergo a mastectomy despite being eligible for BCT. In total, it was assessed that 146 of 161 patients (90.7%) were eligible for BCT and utilisation was 94.5%. Conclusions: In this study, eligibility, utilisation of BCT and eventual successful breast conservation rates are similar to published rates in Western communities. Additional research is needed to investigate the reasons for the lower published BCT rates in Asian countries and determine ways to improve them.

• Radiation Oncology Journal
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• v.30 no.4
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• pp.213-217
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• 2012

Purpose: To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Materials and Methods: Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). Results: The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Locoregional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Conclusion: Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.29-35
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• 2015

Purpose: To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. Materials and Methods: We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). Results: The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. Conclusion: The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.