• Title/Summary/Keyword: advanced cancer

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The Role of External Irradiation for the Locally Advanced Papillary Thyroid Cancers (국소적으로 진행된 갑상선 유두암에서의 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.187-194
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    • 1999
  • Purpose : The aim of this study is to look for the possible efficacy of external irradiation for locally advanced papillary thyroid cancers (stage pT4 or Nl ). Methods and Materials : From August 1981 through September 1997, 91 Patients with locally advanced papillary thyroid cancers (stage pT4 or Nl ) have been treated with external irradiation and followed up at our clinic. All of the patients have been treated with surgical resection. After surgery, 23 patients received postoperative external irradiation with or without ablative radioiodine therapy, whereas the other 68 patients were treated with ablative radioiodine therapy alone. Distributions of sex, age, and stage were comparable in both irradiated and nonirradiated groups. Multivariate analysis of the influence by age, sex, stage, ablative radioiodine therapy and external irradiation on local control were peformed by using Cox's proportional hazard model. Results : Overall survival rates at 7 years were of no significant difference in both groups. There were $98.1\%$ for no RT group and $90\%$ for RT group (p=0.506). 5-year local control rates were significantly different, these were $95.2\%$ for RT group and $67.5\%$ for no RT group (p=0.0408). An analysis of the prognostic factors, age, sex, stage, and RAI were not significant variables, except for the external irradiation. Conclusion : Adjuvant postoperative external irradiation did not affect overall survival, but significantly improved local control in the patients with locally advanced papillary thyroid cancers (stage pT4 or lympy node involvement).

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The Role of RBdiotherapy for Locally Advanced Gallbladder Carcinoma (국소적으로 진행된 담낭암에서 방사선치료의 역할)

  • Shin, Hyun-Soo;Seong, Jin-Sil
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.283-292
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    • 2000
  • Purpose :A retrospective review of 72 patients with locally advanced gallbladder carcinoma, between January 1990 and December 1996, was peformed. Survival results and prognostic factors are analyzed for the patients treated with a various modalities. Materials and Methods :We patients were classified by treatment modality: group 1 included to 27 patients treated with palliative surgery alone, and group 2 for 11 patient treated with palliative surgery and radiotherapy; group 3 for 18 patients not treated by any treatment modality, and group 4 for 16 patients treated with radiotherapy alone. Age distribution ranged from 35 to 80 years with mean of 63 years. The stage was classified by TNM and Nevin's staging system; all patients had an advanced stage more than III. Palliative surgery was done in .: patients and adiuvant radiation therapy (RT) was followed in 11. For 34 patients, in whom no resection was tried, definitive RT was done in 16. Radiation delivered to tumor site and draining nodes up to 45~61.2 Gy using 10 MV linear accelerator. Chemotherapy was given to 25 patients with 5-FU based regimens. Results :Modian suwival time was 10.3 months and 3-year survival rates (3-YSR) were 13.0$\%$ in all patients. Survival rates according to the treatment modalities were as followed; in palliative surgery alone, 3-YSR was 2.5$\%$; in palliative surgery and adjuvant RT, 3-YSR was 45.5$\%$, in no treatment group, 3-VSR were 8.3$\%$; and definitive RT was 13.1$\%$. It was better survival in additional RT after palliative surgery group than palliative surgery alone (p=0.0009). It was better survival in definitive RT group than no treatment group (p=0.002). Significant prognostic factors by univariate analysis were treatment moonlities, the type of tumor and TNM stage. Significant prognostic factors by multivariate analysis were treatment modalities, the type of tumor and the presence of jaundice. Conclusion : It is suggested that RT could be potentially of effective as adjuvant treatment modalities after palliative surgery or primary treatment for locally advanced and unresectable gallbladder carcinoma.

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Five Most Common Prognostically Important Fusion Oncogenes are Detected in the Majority of Pakistani Pediatric Acute Lymphoblastic Leukemia Patients and are Strongly Associated with Disease Biology and Treatment Outcome

  • Awan, Tashfeen;Iqbal, Zafar;Aleem, Aamer;Sabir, Noreen;Absar, Muhammad;Rasool, Mahmood;Tahir, Ammara H.;Basit, Sulman;Khalid, Ahmad Mukhtar;Sabar, Muhammad Farooq;Asad, Sultan;Ali, Agha Shabbir;Mahmood, Amer;Akram, Muhammad;Saeed, Tariq;Saleem, Arsalan;Mohsin, Danish;Shah, Ijaz Hussain;Khalid, Muhammad;Asif, Muhammad;Haq, Riazul;Iqbal, Mudassar;Akhtar, Tanveer
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5469-5475
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    • 2012
  • Background and Objectives: Acute lymphoblastic leukemia (ALL) is a complex genetic disease involving many fusion oncogenes (FO) having prognostic significance. The frequency of various FO can vary in different ethnic groups, with important implications for prognosis, drug selection and treatment outcome. Method: We studied fusion oncogenes in 101 pediatric ALL patients using interphase FISH and RT-PCR, and their associations with clinical features and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL t (22; 9), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (del 1p32) were found in 89/101 (88.1%) patients. Frequency of BCR-ABL was 44.5% (45/101). BCR-ABL positive patients had a significantly lower survival ($43.7{\pm}4.24$ weeks) and higher white cell count as compared to others, except patients with MLL-AF4. The highest relapse-free survival was documented with ETV6-RUNX1 (14.2 months) followed closely by those cases in which no gene was detected (13.100). RFS with BCR-ABL, MLL-AF4, TCF3-PBX1 and SIL-TAL1 was less than 10 months (8.0, 3.6, 5.5 and 8.1 months, respectively). Conclusions: This is the first study from Pakistan correlating molecular markers with disease biology and treatment outcome in pediatric ALL. It revealed the highest reported frequency of BCR-ABL FO in pediatric ALL, associated with poor overall survival. Our data indicate an immediate need for incorporation of tyrosine kinase inhibitors in the treatment of BCR-ABL+ pediatric ALL in this population and the development of facilities for stem cell transplantation.

Prognostically Significant Fusion Oncogenes in Pakistani Patients with Adult Acute Lymphoblastic Leukemia and their Association with Disease Biology and Outcome

  • Sabir, Noreen;Iqbal, Zafar;Aleem, Aamer;Awan, Tashfeen;Naeem, Tahir;Asad, Sultan;Tahir, Ammara H;Absar, Muhammad;Hasanato, Rana MW;Basit, Sulman;Chishti, Muhammad Azhar;Ul-Haque, Muhammad Faiyaz;Khalid, Ahmad Muktar;Sabar, Muhammad Farooq;Rasool, Mahmood;Karim, Sajjad;Khan, Mahwish;Samreen, Baila;Akram, Afia M;Siddiqi, Muhammad Hassan;Shahzadi, Saba;Shahbaz, Sana;Ali, Agha Shabbir
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3349-3355
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    • 2012
  • Background and objectives: Chromosomal abnormalities play an important role in genesis of acute lymphoblastic leukemia (ALL) and have prognostic implications. Five major risk stratifying fusion genes in ALL are BCR-ABL, MLL-AF4, ETV6-RUNX11, E2A-PBX1 and SIL-TAL1. This work aimed to detect common chromosomal translocations and associated fusion oncogenes in adult ALL patients and study their relationship with clinical features and treatment outcome. Methods: We studied fusion oncogenes in 104 adult ALL patients using RT-PCR and interphase-FISH at diagnosis and their association with clinical characteristics and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL (t 9; 22), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (Del 1p32) were found in 82/104 (79%) patients. TCF3-PBX1 fusion gene was associated with lymphadenopathy, SIL-TAL1 positive patients had frequent organomegaly and usually presented with a platelets count of less than $50{\times}10^9/l$. Survival of patients with fusion gene ETV6-RUNX1 was better when compared to patients harboring other genes. MLL-AF4 and BCR-ABL positivity characterized a subset of adult ALL patients with aggressive clinical behaviour and a poor outcome. Conclusions: This is the first study from Pakistan which investigated the frequency of5 fusion oncogenes in adult ALL patients, and their association with clinical features, treatment response and outcome. Frequencies of some of the oncogenes were different from those reported elsewhere and they appear to be associated with distinct clinical characteristics and treatment outcome. This information will help in the prognostic stratification and risk adapted management of adult ALL patients.

Adaptive Image Rescaling for Weakly Contrast-Enhanced Lesions in Dedicated Breast CT: A Phantom Study (약하게 조영증강된 병변의 유방 전용 CT 영상의 대조도 개선을 위한 적응적 영상 재조정 방법: 팬텀 연구)

  • Bitbyeol Kim;Ho Kyung Kim;Jinsung Kim;Yongkan Ki;Ji Hyeon Joo;Hosang Jeon;Dahl Park;Wontaek Kim;Jiho Nam;Dong Hyeon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1477-1492
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    • 2021
  • Purpose Dedicated breast CT is an emerging volumetric X-ray imaging modality for diagnosis that does not require any painful breast compression. To improve the detection rate of weakly enhanced lesions, an adaptive image rescaling (AIR) technique was proposed. Materials and Methods Two disks containing five identical holes and five holes of different diameters were scanned using 60/100 kVp to obtain single-energy CT (SECT), dual-energy CT (DECT), and AIR images. A piece of pork was also scanned as a subclinical trial. The image quality was evaluated using image contrast and contrast-to-noise ratio (CNR). The difference of imaging performances was confirmed using student's t test. Results Total mean image contrast of AIR (0.70) reached 74.5% of that of DECT (0.94) and was higher than that of SECT (0.22) by 318.2%. Total mean CNR of AIR (5.08) was 35.5% of that of SECT (14.30) and was higher than that of DECT (2.28) by 222.8%. A similar trend was observed in the subclinical study. Conclusion The results demonstrated superior image contrast of AIR over SECT, and its higher overall image quality compared to DECT with half the exposure. Therefore, AIR seems to have the potential to improve the detectability of lesions with dedicated breast CT.

The Role of Postoperative Pelvic Radiation Therapy in Rectal Cancer (직장암에 있어서 수술후 방사선치료의 역할)

  • Ahn, Yong-Chan;Kim, Jae-Sung;Yun, Hyong-Geun;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.93-102
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    • 1991
  • To evaluate the role of postoperative pelvic radiation therapy in rectal cancer, a retrospective analysis was done on 189 patients with modified Astler-Coiler stages B2+3, Cl , and C2+3 who were treated from February 1979 to June 1980. Forty-seven patients were staged as B2+3,17 as Cl, and 125 as C2+3. As a curative resection,41 received low anterior resection,143 received abdomino-perineal resection, and five received pelvic exenteration. The survival and disease-free survival rates of the total patients at five year were $45.3\%\;and\;44.1\%$, respectively. The stage was an important prognostic factor for survival and disease-free survival: the survival rates at five year were $63.4\%$ in stage B2+3, $62.4\%$ in C1, and $37.2\%$ in C2+3 (p<0.005): the disease-free survival rates at five year were $55.7\%$ in B2+3, $65.7\%$ in C1, and $30.4\%$ in C2+3, respectively (p<0.01). The liver was the most frequently involved organ of recurrence followed by the lung and the perineum. The patients who received low anterior resection achieved better disease-free survival but were more prone to late radiation bowel morbidities than those who received abdominoperineal resection. Postperative Pelvic radiation therapy Proved to be effective in locoregional disease control but did not prevent the appearance of distant metastasis, which was of major concern in advanced stages. Patterns of treatment failure, and factros relating to radiation morbidity are discussed, and therapeutic options for better results are proposed.

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Analysis of Exploratory Thoracotomy in Non-Small Cell Lung Cancer (원발성 폐암에서의 시험적 개흉술의 분석)

  • 허재학;성숙환;김영태
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.536-542
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    • 1999
  • Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

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Bioactive Component Analysis, Antioxidant Activity, and Cytotoxicity on Cancer Cells on Rubus crataegifolius Clones by Region (지역별 산딸기 열매의 유용물질 함량, 항산화 활성 및 암세포 성장억제 효능 분석)

  • Choi, Eun-Young;Kim, Eun-Hee;Lee, Jae-Bong;Kim, Hyeu-soo;Kim, Moon-Sup;Lee, Su-gwang;Kim, Sea-Hyun;Lee, Uk;Kim, Dong-Kwon;Lee, Jin-Tae
    • Journal of Korean Society of Forest Science
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    • v.105 no.2
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    • pp.193-201
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    • 2016
  • This study was carried out to analyze the nutritional composition, bioactive components, antioxidant activity, and cytotoxic assay of cancer cells on Rubus crataegifolius (RC) : R. crataegifolius from Jangseong (RC-J), R. crataegifolius from Hwaseong (RC-H), R. crataegifolius from Ulsan (RC-U), R. crataegifolius from Sunchang (RC-S), and R. crataegifolius from Pohang (RC-P). The peroximate composition had the largest amount of carbohydrate content among all kinds of RC. As far as the mineral contents of RC, Calcium comprised the highest amount ($996.6{\mu}g/g{\pm}0.8%$) and Natrium the lowest ($6.2{\mu}g/g{\pm}1.0%$). A total of 26 kinds of free amino acids and 18 kinds of component amino acids were analyzed in RC. The results of electron donating were high scavenging effects of 80% in water extract (RC-UW) and 82.6% in ethanol extract (RC-UE) in $500{\mu}g/ml$ concentration from RC-U. Also, the cytotoxic effects of cancer cells B16F10 (RC-UW and RC-PE), H1299 (RC-SW and RC-PE), and MCF-7 (RC-JW and RC-SE) appeared in RC. Therefore, we confirmed that new varieties may possibly be developed with functional materials.

Methylation of P16 and hMLH1 in Gastric Carcinoma (위암에서 P16 및 hMLH1 유전자의 메틸화)

  • Sung, Gi-Young;Chun, Kyung-Hwa;Song, Gyo-Yeong;Kim, Jin-Jo;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.228-237
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    • 2005
  • Purpose: We investigated the impacts of the methylation states of the P16 and the hMLH1 genes on pathogenesis and genetic expression of stomach cancer and their relationships with Helicobater pylori infection, and with other clinico-pathologic factors. Material and Methods: In our study, to detect protein expression and methylation status of the P16 and the hMLH1 genes in 100 advanced gastric adenocarcinomas, used immunohistochemical staining and methylation-specific PCR (MSP) and direct automatic genetic sequencing analysis. Results: Methylation of the P16 gene was observed in 19 out of 100 cases (19%) and in the 18 of those cases (94.7%) loss of protein expression was seen. We were sble to show that loss of P16 gene expression was related to methylation of the P16 gene (kappa coefficient=0.317, p=0.0011). Methylation of the hMLH1 gene was observed in 27 cases (27%), and in 24 cases of those 27 cases (88.8%), loss of protein expression was seen, which suggested that loss of protein expression in the hMLH1 gene is related to methylation of hMLH1 gene (kappa coefficient=0.675, P<0.0001). Also methylation of the hMLH1 gene was related to age, size of the mass, and lauren's classification. Conclusion: We found that methylation of DNA plays an important role in inactivation of the P16 and the hMLH1 genes. The methylation of the hMLH1 genes is significantly related to age, size of the mass, and lauren's classification.

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Telomerase Activity in Primary Lung Cancers (원발성 폐암에 있어서 Telomerase 활성도에 대한 연구)

  • Yun, Sang-Myung;Kwak, Kyung-Rok;Hwang, Jee-Yoon;Park, Sam-Seok;Jeon, Doo-Soo;Kim, Cheol-Min;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.195-203
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    • 1999
  • Background: Telomerase enzyme activity is not detected in most normal cells, a phonomenon believed to be associated with limitations on cellular proliferation. Since this activity is detected in nearly all human tumor, including lung cancers, it has been suggested that telomerase activation may be coupled to acquisition of malignant phenotype. In this study, we determined whether telomerase activity was associated with tumor pathologic stage. Methods: Primary tumor specimens obtained by bronchoscopic biopsies from 33 patients were analyzed. Telomerase activity was measured by means of a modified Telomeric Repeat Amplication Protocol(TRAP) assay. Results: Telomerase activity was detected in 23 of the 27 non-small-cell lung cancer and 5 of 6 small-cell lung cancer. A few primary tumors did not appear to have detectable telomerase activity. Positive associations were found between the telomerase-positive rate and tumor stage(p<0.05). Conclusion: High telomerase activity is detected frequently in primary lung cancers that exhibit high tumor cell proliferation rates and advanced pathologic stage.

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