• The Journal of Internal Korean Medicine
• /
• v.32 no.3
• /
• pp.451-457
• /
• 2011

Progress : A 33 year old female patient diagnosed with left breast cancer stage II was admitted to EWCC (East-West Cancer Center) in November of 2009. She had planned chemotherapy. She was treated with herbal medicine, acupuncture, moxibustion and physiotherapy for a period of 4 months, from Nov 5th, 2009 to Feb 18th 2010. We evaluated the grade of chief complaints and performed blood tests periodically. Results : TKM alleviates symptoms induced by anticancer chemotherapy. Nausea, headache, dizziness and chemotherapyinduced peripheral neuropathy were reduced. Quality of life was also upward. Conclusions : This case study supports TKM's potential efficacy in treating breast cancer patients suffering from anticancer chemotherapy.

• Korean Journal of Clinical Pharmacy
• /
• v.19 no.1
• /
• pp.18-22
• /
• 2009

Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.28 no.5
• /
• pp.565-570
• /
• 2014

The purpose of this study is to report a clinical case of a patient with CIPN (Chemotherapy Induced Peripheral Neuropathy) successfully treated with Korean medicine interventions including acupuncture, herbal medicine and moxibustion. The patient is a female with CIPN who was diagnosed with ascending colon cancer and suffering from paresthesia of extremities after chemotherapy of platinum compounds. The patient was treated mainly with electroacupuncture (Ex-LE 10), indirect moxibustion and herbal medicine (Ucha-Shinki-hwan granule). The clinical outcomes were measured by NCI CTCAE grade, EORTC QLQ-C30 (CIPN20) scale and patient's assessment of symptoms. In this case, the NCI CTCAE grade was improved from II to I. The scores of global health status and functional scale in QLQ-C30 were increased and symptom scale was decreased. Especially, this case shows a noticeable decrease in sensory scale in QLQ-CIPN20. In patient's general assessment, the scale was changed from 10 to 5. Korean medical interventions including acupuncture, herbal medicine and moxibustion could potentially be an effective treatment for CIPN if further researches are conducted.

• The Journal of Korean Medicine
• /
• v.33 no.3
• /
• pp.133-146
• /
• 2012

Background: Most antitumor agents have the side effect of chemotherapy-induced peripheral neuropathy (CIPN). Cancer patients who take antitumor agents suffer from CIPN, but there is no known treatment for it. Unlike the central nerve system, the peripheral nerve can self-repair, and the Schwann cell takes this mechanism. Objectives: In this study, we researched the effect of YideungJetong-Tang (YJT) extract on taxol-induced sciatic nerve damage, through in vitro and in vivo experiments. Also, we studied the effect of YJT extract on neurite recovery and anti-inflammatory effect after compression injury of sciatic nerve in vivo. Methods: Vehicle, taxol and taxol+YJT were respectively applied on sciatic nerve cells of rat in vitro, then the cells were cultured. The sciatic nerve cells and Schwann cells were then observed using Neurofilament 200, Hoechst, ${\beta}$ -tubulin, S-$100{\beta}$, caspase-3 and phospho-Erk1/2. CIPN was induced by taxol into the sciatic nerve of rat in vivo, then YJT extract was taken orally. The axons, Schwann cells and neurites of the DRG sensory nerve were then observed using Neurofilament 200, ${\beta}$-tubulin, Hoechst, S-$100{\beta}$, phospho-Erk1/2 and caspase-3. YJT was taken orally after sciatic nerve compression injury, and the changes in axon of the sciatic nerve, Schwann cells and TNF-${\alpha}$ concentration were observed. Results: The taxol and YJT treated group showed significant effects on Schwann cell recovery, neurite growth and recovery. In vivo, YJT compared with control group showed Schwann cell structural improvement and axons recovering effect after taxol-induced Schwann cell damage. After sciatic nerve compression injury, recovery of distal axon, changes of Schwann cell distribution, and anti-inflammatory response were observed in the YJT. Conclusions: Through this study, we found that after taxol-induced neurite damage of sciatic nerve in vivo and in vitro, YJT had significant effects on sciatic nerve growth and Schwann cell structural improvement. In vivo, YJT improved recovery of distal axons and Schwann cells and had an anti-inflammatory effect.

• The Journal of Internal Korean Medicine
• /
• v.32 no.4
• /
• pp.610-615
• /
• 2011

Objectives : To observe the mitigating effects of a Traditional Korean Medicine treatment program, called Wheel Balanced Cancer Therapy (WBCT), with Adriamycin and 5-FU chemotherapy on a breast cancer patient. Methods : A 26 year old female patient diagnosed with stage IIb breast cancer was admitted to the East-West Cancer Center (EWCC) in February of 2010. She received Adriamycin and 5-FU from February 22nd, to July 20th, 2010 followed by WBCT consisting of herbal medicine, acupuncture, moxibustion and physiotherapy for 5 months. Her symptoms were measured by Common Terminology Criteria for Adverse Events (CTCAE) and her quality of life was measured by Eastern Cooperative Oncology Group (ECOG). Results : WBCT significantly alleviated chemotherapy-induced nausea, oral dryness, and peripheral neuropathy. Quality of life also significantly improved. Conclusions : This case study potentiates WBCT's significant efficacy in aiding breast cancer patients suffering from Adriamycin plus 5-FU chemotherapy induced adverse effects.

• The Journal of Internal Korean Medicine
• /
• v.37 no.1
• /
• pp.77-89
• /
• 2016

Objectives: The aim of this study was to develop a standard instrument of pattern identification and evaluation for chemotherapy-induced peripheral neuropathy (CIPN).Methods: The advisory committee for this study was organized by 12 professors of traditional Korean medicine from the Korean Association of Traditional Oncology. The items and structure of the instrument were designed based on a review of previous publications. We revised the instrument in consultation with the advisory committee and received additional advice via email.Results: We divided the symptoms and signs of CIPN into four pattern identifications: wind arthralgia (風痺), cold arthralgia (寒痺), dampness arthralgia (濕痺), and arthralgia of the deficiency type (虛痺). We obtained the mean weights to reflect the standard deviations from each symptom of the four pattern identifications, which were scored on a 5-point scale by the advisor committee. After we obtained the answers to discrimination between variable symptoms (變症) and ordinary symptoms (素症) from the 12 experts, we gained the final weight from the combination of the ratio of pattern identification to the number of total answers of the advisory committee and the mean weight.Conclusions: The Instrument on Pattern Identification and Evaluation for CIPN was developed through a discussion between 12 experts. There was a limitation that the validity and reliability of this instrument have not been proven. However, the significance of this study was that it is the first Instrument on Pattern Identification and Evaluation aimed at assessing CIPN in traditional Korean medicine.

• The Journal of Internal Korean Medicine
• /
• v.43 no.4
• /
• pp.751-760
• /
• 2022

Objective: To show a decrease in tumor recurrence and improvement in quality of life in patients with recurrent cervical cancer. Method: A 58-year-old female patient diagnosed with recurrent cervical cancer in February 2021 was treated for 14 months with integrative cancer treatment (ICT) to decrease the tumor size and improve chemotherapy-induced peripheral neuropathy (CIPN) and nausea. The patient underwent chemotherapy or concomitant chemoradiation therapy (CCRT) with ICT. Radiologic outcomes were assessed by abdomen & pelvis computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the 14 months of treatment, the size and metabolic activity of the recurrent tumor decreased and underwent partial remission based on RECIST. The NRS scores for CIPN and nausea were improved, and the ECOG score improved from grade 2 to 1. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a synergetic effect with chemotherapy or radiotherapy for recurrent cervical cancer.

• The Journal of Korean Medicine
• /
• v.41 no.3
• /
• pp.247-259
• /
• 2020

Objectives: This review aims to investigate clinical studies related to bee venom pharmacopuncture for cancer patients and to analyze the research trend for further study. Methods: We searched for clinical studies using bee venom pharmacopuncture therapy on patients with cancer through the electronic databases including Pubmed, Cochrane library, OASIS, KISS, NDSL, and KMBASE. There was no restriction on language and publication date, and after selection/exclusion process, the study design, target disease, intervention details including acupoints, treatment frequency and period, outcomes, study results and adverse events were extracted. Results: Thirteen clinical studies were finally selected. There were a randomized controlled trial RCT about the effect of sweet bee venom pharmacopuncture on cancer-related pain, and three case series about chemotherapy-induced peripheral neuropathy. In case reports, there were nine studies about oligodendroglioma, plexiform neurofibroma, breast cancer, prostate cancer, lung cancer, urachal adenocarcinoma, malignant melanoma, and atypical squamous cells of undetermined significance. The bee venom therapy affected the improvement of outcomes such as symptoms, quality of life, tumor response, and lab findings. Conclusions: The present study found that bee venom therapy is applicable to the treatment of cancer patients, and showed some effect on various symptoms. However, due to insufficient number and quality of studies, well designed and high-quality clinical trials are necessary to confirm the effectiveness and safety of bee venom pharmacopuncture therapy in patients with cancer.

• The Korean Journal of Pain
• /
• v.34 no.1
• /
• pp.27-34
• /
• 2021

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major reason for stopping or changing anticancer therapy. Among the proposed pathomechanisms underlying CIPN, proinflammatory processes have attracted increasing attention. Here we assessed the role of prostaglandin D2 (PGD2) signaling in cisplatin-induced neuropathic pain. Methods: CIPN was induced by intraperitoneal administration of cisplatin 2 mg/kg for 4 consecutive days using adult male Sprague-Dawley rats. PGD2 receptor DP1 and/or DP2 antagonists were administered intrathecally and the paw withdrawal thresholds were measured using von Frey filaments. Spinal expression of DP1, DP2, hematopoietic PGD synthase (H-PGDS), and lipocalin PGD synthase (L-PGDS) proteins were analyzed by western blotting. Results: The DP1 and DP2 antagonist AMG 853 and the selective DP2 antagonist CAY10471, but not the DP1 antagonist MK0524, significantly increased the paw withdrawal threshold compared to vehicle controls (P = 0.004 and P < 0.001, respectively). Western blotting analyses revealed comparable protein expression levels in DP1 and DP2 in the spinal cord. In the CIPN group the protein expression level of L-PGDS, but not of H-PGDS, was significantly increased compared to the control group (P < 0.001). Conclusions: The findings presented here indicate that enhanced PGD2 signaling, via upregulation of L-PGDS in the spinal cord, contributes to mechanical allodynia via DP2 receptors in a cisplatin-induced neuropathic pain model in rats, and that a blockade of DP2 receptor activation may present a novel therapeutic target for managing CIPN.

• Journal of Digestive Cancer Research
• /
• v.5 no.2
• /
• pp.73-85
• /
• 2017

Background: To compare the quality of life (QoL), the convenience of chemotherapy and satisfaction between colon cancer patients treated with FOLFOX4 and XELOX. Methods: The study was conducted in 26 patients with stage III colon cancer. Patients were received FOLFOX4 (n=17) or XELOX (n=9). QoL, convenience, and satisfaction were assessed using the Quality of Life Questionnaire-C30 (QLQ-C30), Quality of Life Questionnaire-Chemotherapy Induced Peripheral neuropathy (QLQ-CIPN) and Functional Assessment of Chronic Illness Therapy Chemotherapy Convenience and Satisfaction Questionnaire (FACIT-CCSQ), respectively. Patients completed questionnaires at baseline, at cycle 4 (C4) and cycle 8 (C8) (FOLFOX4) or at cycle 3 (C3) and cycle 6 (C6) visits (XELOX) and at their final visit. Results: In the QLQ-C30, at the final visit, XELOX patients had better functional scores than FOLFOX4 patients (physical: 85.7 vs.60.4, p=0.03; role: 83.3 vs. 57.5, p=0.04) as well as better symptom scores (constipation: 9.5 vs. 40.4, p=0.01). In CIPN, at the C6/C8 visit, XELOX patients had lower motor scale scores than FOLFOX4 patients (3.8 vs. 21.6, p=0.02). Moreover, at the C6/C8 visit, XELOX was more convenient than FOLFOX4 in FACIT-CCSQ (79.7 vs. 55.5, p=0.04). Male patients were especially likely to consider XELOX to be more convenient (90.0 vs. 55.0, p=0.01) and satisfactory (55.4 vs. 26.2, p=0.03) and fewer concern (91.0 vs. 65.0, p=0.03) than FOLFOX4. XELOX patients spent fewer days on hospital visits at C3/C4, C6/C8 and final visit (2.8 vs. 4.2, p=0.01; 2.7 vs. 4.1, p=0.01; 3.0 vs. 4.5, p=0.01). Conclusion: XELOX may be a better adjuvant chemotherapy choice for patients with colon cancer than FOLFOX4 in terms of QoL, convenience, and satisfaction.