• Journal of Gastric Cancer
• /
• v.4 no.2
• /
• pp.59-74
• /
• 2004

This report attempts to explain the (i) implications of comorbidity for research and practice in the fieldo of oncology, (ii) the approach for dosing of anti-cancer drugs in the presence of comorbidity, as an example of its clinical application, and finally (iii) the dosing guidelines for the anticancer drugs clinically active in gastric cancer in the presence of renal or liver dysfunction. This has resulted from the idea of approaching comorbidity in a systematic way and of integrating it with oncologic decisions. Various methods have been used to assess comorbidity. However, significant work remains to be done to analyze how various diseases combine to influence the oncologic outcome. The main end-point explored so far has been mortality, but a largely open challenge remains to correlate comorbidity with treatment tolerance and functional and quality of life, as well as to integrate it in clinical decision-making. Cancer chemotherapy in comorbidity should be considered as an example of the need for dose optimization in individual patients, and it should be determined by considering the basic principles of the pharmacokinetics and the pharmacodynamics of the agents. This review analyzes the available data on the pharmacokinetics and the toxicities of anti-cancer agents in the comorbidity population.

• IMMUNE NETWORK
• /
• v.9 no.5
• /
• pp.147-152
• /
• 2009

Ascorbate (vitamin C) is a cofactor for a number of metabolic enzymes and is an indisputable essential vitamin C for humans. However, the potential of ascorbate as an anticancer agent has been a topic of controversy. A number of previous reports have addressed both positive aspects and limitations of ascorbate in cancer therapy. In this review, we briefly summarize the potential antitumor effects of ascorbate and its prospects for clinical use.

• Proceedings of the PSK Conference
• /
• 2003.04a
• /
• pp.238.3-239
• /
• 2003

Among 4'-substituted nucleosides. Nucleocidin. 4'-azido thymidine (ADRT), 4'-fluorinated carbocyclic nucleoside. and 3'-fluoro oxetanosin analogue have demonstrated a variety of biological activities. Since the cyclopentane ring of carbocyclic nucleosides can emulate the furanose moiety. a number of these compounds exhibit interesting biological activity, particularly in the areas of antiviral and anticancer chemotherapy. (omitted)

• Proceedings of the PSK Conference
• /
• 2003.10b
• /
• pp.181.2-181.2
• /
• 2003

Inosine monophosphate dehydrogenase(IMPDH) catalyzes the $NAD^+$-dependent oxidation of IMP to XMP, the rate limiting step in the de novo biosynthesis of guanine nucleotide. Its critical role at the metabolic branch point in purine nucleotide biosynthesis makes it a useful target in the development of drugs for antiviral and anticancer chemotherapy and in immunosupressant area. Several compound with antiviral activity have been found to be inhibitors of IMPDH. For example, ribavirin, a competitive inhibitor of IMPDH, has broad spectrum antiviral activities against DNA and RNA viruses. (omitted)

• Journal of Hospice and Palliative Care
• /
• v.19 no.1
• /
• pp.70-75
• /
• 2016

Advanced incurable cancer patients receive palliative chemotherapy to prolong their life and improve quality of life. However, physicians should assess the timing to discontinue the treatment, especially near the final months of life, as palliative chemotherapy may accompany considerable toxicity. Even though there are no clear guidelines regarding the withdrawal timing for anticancer treatment in palliative setting, it is important clarify the issue for quality of care for advanced cancer patients. Here, we present two patients who received palliative chemotherapy for advanced colon cancer and non-small cell lung cancer, respectively. In both cases, it was jointly determined to stop palliative chemotherapy, and best efforts are made to relieve troublesome symptoms. The cases and up-to-date literature review will highlight the importance of the timing of discontinuation of cancer treatments when changes are being made to the health care system and hospice and palliative medicine is taking root in Korea.

• THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
• /
• v.7 no.1
• /
• pp.117-129
• /
• 2001

Objectives: We compared the therapeutic response, the treatment-related toxicity, and the improvement of subjective symptoms between the chemotherapy alone group and the western-oriental combined treatment group and evaluated the role of oriental medicine for the improvement of chemotherapy-related toxicity in the advanced gastric cancer and hepatocellular carcinoma. Methods: We evaluated 36 gastric cancer or hepatocellular carcinoma patients(chemotherapy alone group 25 patients, combined treatment group 11 patients) who had been treated in Wonju Christian Hospital and Hana Hospital of Oriental Medicine between June 1999 and October 2000. Enrolled patients' general medical records, results of laboratory and imaging studies, treatment-related toxicities, and subjective symptoms were recorded regularly according to the planned protocol. Therapeutic responses were estimated according to the WHO response criteria and the changes of tumor marker value such as CEA, CA 72-4 and AFP. Results: 1. There was no significant difference of therapeutic response by the WHO response criteria between the two groups(p=.459). 2. There was a significant decrease of tumor marker value in the combined treatment group compared to the chemotherapy alone group(p=.023). 3. There was less comprehensive treatment-related toxicity in the combined treatment group compared to the chemotherapy alone group(p=.037), but there was not a significant difference of comprehensive improvement of subjective symptoms between the two groups(p=.091). Conclusions: Based on the above results, we could expect the possibility of improvements in therapeutic response and treatment-related toxicity with the western-oriental combined anticancer treatment.

• Korean Journal of Adult Nursing
• /
• v.14 no.2
• /
• pp.205-212
• /
• 2002

Purpose: The purpose of this study was to investigate the level of nausea, vomiting, anorexia, fatigue and quality of life as well as to determine the relationship between those variables and identify the influencing factors on fatigue and quality of life in stomach cancer patients receiving adjuvant chemotherapy. Method: Subjects were 94 stomach cancer patients undergoing postoperational chemotherapy in a general hospital in Seoul. Nausea and vomiting were measured with Rhodes et al(1984) and anorexia with one 5-point item. Fatigue was measured using Lee's tool(1999) except open questions. The tool for quality of life was modified based on the Quality of Life Index by Padilla et al(1983). Result: Subjects reported low level of fatigue(mean=3.86, range=0-10) compared with the results of previous researches and moderate quality of life(mean=2.64, range=1-4). Fatigue was positively correlated with nausea, vomiting and anorexia(r=.21 ~ .55, p<.05). Quality of life was negatively correlated with nausea, vomiting, anorexia(r= -.24 ~ -.45, p<.05) and fatigue (r=-.61, p<.01). Multiple regression analysis revealed that activity level, vomiting before admission, anorexia during chemotherapy and age explained 52.8% of the variance in fatigue. Fatigue, anorexia before admission, age and sex explained 50.5% of the variance in quality of life. Fatigue and quality of life were not influenced by the stage of disease, nor weight change. Conclusion: These results may contribute to a better understanding of how much the side effects of anticancer drugs can affect fatigue and quality of life in cancer patients undergoing chemotherapy. Also it is the remarkable fact that symptoms remaining after discharge such as vomiting or anorexia continued until re-admission, contributing to patients fatigue and lowered their quality of life.

• Women's Health Nursing
• /
• v.28 no.4
• /
• pp.296-306
• /
• 2022

Purpose: This study investigated the effects of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. Methods: The participants included 144 patients with gynecological cancer undergoing anticancer chemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28, 2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. Results: Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), and the most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89) was greater than the midpoint. The regression model analyzing the patients' QoL was statistically significant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001), disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms (β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL. Conclusion: Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their daily life can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care ability of patients and alleviating their limitations in daily life may improve QoL.

• Journal of Digestive Cancer Research
• /
• v.4 no.1
• /
• pp.36-38
• /
• 2016

Biliary tract cancer, a relatively rare disease, is usually found in an unresectable stage. Weekly cisplatin plus gemcitabine has been applied as a standard first-line therapy for advanced biliary tract cancer, but almost up to 3-5% patients experience drug induced renal impairment. Many anticancer medication guidelines recommend drug adjustment when kidneys are damaged, but weekly cisplatin is somewhat low dose so that there is a controversy on reducing the dose. And it is known that the cumulative dose of cisplatin is the most important factor contributing to renal impairment. Therefore, clinicians face troubles whether or not to maintain the chemotherapy. Here, we reported a patient whose renal function (eGFR) had been decreased as the number of chemotherapy increased, so her chemotherapy should be stopped. Since we held the chemotherapy on her, the disease progressed aggressively. Weekly cisplatin regimen is just 25 mg/m², so it may be meaningless to reduce this dose, and it is well known that cumulative dose of cisplatin is the most important factor contributing to renal impairment, it is better not to use cisplatin anymore. Therefore, we recommend that if the patient responds well to weekly cisplatin plus gemcitabine regimen, it would be beneficial to use gemcitabine alone.

• The Korean journal of internal medicine
• /
• v.33 no.6
• /
• pp.1182-1193
• /
• 2018

Background/Aims: Elderly patients (${\geq}80years$) with colorectal cancer (CRC) tend to avoid active treatment at the time of diagnosis despite of recent advances in treatment. The aim of this study was to determine treatment propensity of elderly patients aged ${\geq}80years$ with CRC in clinical practice and the impact of anticancer treatment on overall survival (OS). Methods: Medical charts of 152 elderly patients (aged ${\geq}80years$) diagnosed with CRC between 1998 and 2012 were retrospectively reviewed. Patients' clinical characteristics, treatment modalities received, and clinical outcome were analyzed. Results: Their median age was 82 years (range, 80 to 98). Of 152 patients, 148 were assessable for the extent of the disease. Eighty-two of 98 patients with localized disease and 28 of 50 patients with metastatic disease had received surgery or chemotherapy or both. Surgery was performed in 79 of 98 patients with localized disease and 15 of 50 patients with metastatic disease. Chemotherapy was administered in only 24 of 50 patients with metastatic disease. Patients who received anticancer treatment according to disease extent showed significantly longer OS compared to untreated patients (localized disease, 76.2 months vs. 15.4 months, p = 0.000; metastatic disease, 9.9 months vs. 2.6 months, p = 0.001). Along with anticancer treatment, favorable performance status (PS) was associated with longer OS in multivariate analysis of clinical outcome. Conclusions: Elderly patients aged ${\geq}80years$ with CRC tended to receive less treatment for metastatic disease. Nevertheless, anticancer treatment in patients with favorable PS was effective in prolonging OS regardless of disease extent.