• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.785-789
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• 2012

Background and Purpose: Cisplatin is the most common chemotherapeutic agent for loco-regionally advanced nasopharyngeal carcinoma (NPC); however, toxicity is a limiting factor for some patients. We retrospectively compared the efficacy and toxicity of weekly docetaxel-based and cisplatin-based concurrent chemoradiotherapy in loco-regionally advanced NPC. Methods and Materials: Eighty-four patients with Stage III and IVA-B NPCs, treated between 2007 and 2008, were retrospectively analyzed. Thirty received weekly docetaxel-based concurrent chemotherapy, and 43 were given weekly cisplatin-based concurrent chemotherapy. Radiotherapy was administered using a conventional technique (seven weeks, 2.0 Gy per fraction, total dose 70-74 Gy) with 6-8 Gy boosts for some patients with locally advanced disease. Results: Median follow-up time was 42.3 months (range, 8.6-50.8 months). There were no significant differences in the 3-year loco-regional failure-free survival (85.6% vs. 92.3%; p=0.264), distant failure-free survival (87.0% vs. 92.5%; p=0.171), progression-free survival (85.7% vs. 88.4%; p=0.411) or overall survival (86.5% vs. 92.5%, p=0.298) of patients treated concurrently with docetaxel or cisplatin. Severe toxicity was not common in either group. Conclusions: Weekly docetaxel-based concurrent chemoradiotherapy is potentially effective and has a tolerable toxicity; however, further investigations are required to determine if docetaxel is superior to cisplatin for advanced stage NPC.

• Radiation Oncology Journal
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• 제33권4호
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• pp.294-300
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• 2015

Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent. Materials and Methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months). Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS. Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

• Radiation Oncology Journal
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• 제27권2호
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• pp.71-77
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• 2009

목 적: 동시적 항암화학방사선치료를 받은 식도암 환자의 치료성적과 예후인자를 분석하였다. 대상 및 방법: 1994년 1월부터 2007년 7월까지 식도암으로 방사선치료를 받은 환자 246명 중 근치적 목적으로 45Gy이상의 방사선치료와 함께 동시적 항암화학요법을 받았으며 생존확인이 가능하였던 78명을 대상으로 후향적 분석을 시행하였다. AJCC 병기 IIA~IVB까지의 환자를 대상으로 하였는데, IVB는 상부식도암이 아닌 환자에서 쇄골상부림프절 전이가 있거나 하부식도암이 아닌 환자에서 복강림프절 전이가 있는 경우만을 포함시켰다. 방사선치료는 중앙값 54 Gy를 조사하였고, 항암화학요법은 대부분의 환자(88%)에서 5-FU와 cisplatin (FP) 병합요법으로 시행되었다. 추적관찰기간은 2~117개월(중앙값 14개월)이었다. 결 과: 흉부단층촬영이나 식도내시경을 통해 치료에 대한 반응을 확인할 수 있었던 54명의 환자중 완전관해가 17명, 부분관해가 18명이었다. 완전관해를 보인 환자에서 재발할 때까지의 기간은 중앙값 20개월이었고 첫 재발부위로 국소재발이 3명, 원격전이가 7명이었다. 1년, 2년, 5년 전체 생존률은 각각 58.9%, 21.7%, 12.2%이었고 중앙 생존기간은 14개월이었다. 전체 생존률에 대한 단변량분석에서 치료에 대한 반응과 FP병합요법의 횟수가 통계적인 유의성을 보여주었다. 환자의 숫자가 적었으나 방사선감작제로 일단위 혹은 주단위의 cisplatin이 FP 병합요법보다 좋은 결과를 보였다. 결 론: 원격장기로의 전이가 없는 국소진행성 식도암 환자에서 동시적 항암화학방사선치료는 기존의 연구와 유사한 결과를 보여주었다. 일단위 혹은 주단위의 cisplatin이 전신상태가 FP 병합요법에 적절하지 않은 환자에서 대안으로 사용될 수 있을 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3139-3144
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• 2014

Background: Medical treatment for eliminating the side effects of cancer therapy may not always be efficacious. Acupuncture is one of the most widely accepted alternative and complementary therapies in use today. In this study, we investigated the efficacy of acupuncture in patients experiencing cancer treatment side effects, including nausea, vomiting, pain, poor sleep quality and anxiety. Materials and Methods: A total of 45 inpatients who underwent chemotherapy between February and April 2013 in the Oncology Department of Numune Hospital were included in our study. Acupuncture was administered to the patients one day prior to chemotherapy, on the day of chemotherapy and one day after chemotherapy. The patients were evaluated on nausea, vomiting, pain, sleep quality and anxiety before the chemotherapy and on the $4^{th}$ day of chemotherapy. Results: Of the 45 patients included in the study, 18 (40%) were female and 27 (60%) were male. A total of 25 (55.6%) had an elementary school education; 32 patients (71%) had stage 4 cancer and were treated with palliative chemotherapy (the patient characteristics are shown in Table 1). Statistically significant decreases (p<0.001) in pain, nausea, vomiting, insomnia and anxiety scores were observed after the acupuncture treatment compared to baseline. There were no differences in the age, gender, education level, stage or metastasis levels between the patient groups whose symptoms improved or were unchanged. Conclusions: Our study showed that acupuncture has positive effects in cancer treatment patients who experience nausea, vomiting, pain, poor sleep quality and anxiety as side effects of chemotherapy. Chemotherapy-related side effects in cancer patients could be decreased by the concurrent use of acupuncture.

• Radiation Oncology Journal
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• 제34권1호
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• pp.59-63
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• 2016

Purpose: To evaluate the clinical outcomes of symptomatic bone lesions in patients with multiple myeloma (MM) who received local radiotherapy (LRT). Materials and Methods: Fifty-one patients with 87 symptomatic bone lesions treated via LRT were analyzed. LRT was delivered at a median total dose of 21 Gy (range, 12 to 40 Gy) in a median of 7 fractions (range, 4 to 20 fractions). The clinical outcomes of LRT and the factors affecting treatment response were assessed. Results: After a median follow-up time of 66.7 weeks, symptom relief was achieved for 85 of 87 lesions (97.7%). The median time to symptom relief was 7 days from the start of LRT (range, 1 to 67 days). The duration of in-field failure-free survival ranged from 1.1 to 450.9 weeks (median, 66.7 weeks). The radiation dose or use of previous and concurrent chemotherapy was not significantly associated with in-field failure for LRT (p = 0.354, 0.758, and 0.758, respectively). Conclusion: Symptomatic bone lesions in patients with MM can be successfully treated with LRT. A higher radiation dose or the use of concurrent chemotherapy may not influence the in-field disease control. A relatively low radiation dose could achieve remission of symptoms in patients with MM.

• 대한한의학회지
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• 제39권4호
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• pp.171-176
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• 2018

Background: Small cell lung cancer (SCLC) tends to grow more rapidly and spread much faster than non-small cell lung cancer (NSCLC). A concurrent combination of chemotherapy and thoracic radiotherapy is suggested as the standard conventional treatment, but it is more challenging for elderly patients having pulmonary and cardiovascular comorbidities. Case presentation: Here we present a case of an 80-year-old male, current smoker diagnosed with SCLC in limited stage T3N0M0 (36mm right upper lobe, satellite nodule) in Dec, 2015. The standard concurrent chemoradiotherapy was not available for his comorbidities, which included chronic obstructive pulmonary disease (COPD) and angina pectoris. Furthermore, he and his family refused the recommended chemotherapy or radiotherapy exclusively. Alternatively, he received various non-conventional treatments including local radiofrequency hyperthermia, mistletoe, and Traditional Korean medicine including acupuncture, moxibustion and herbs since Jan. 2016. Despite the progression in primary tumor size, there have been no other distant relapse so far, and the patient has been in stable condition ever since. Conclusion: We suggest that a combination of various alternative treatments could be a candidate for elderly patients intolerable to conventional cytotoxic treatments.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.70-72
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• 2017

A 41-year old woman with dysphagia visited, which was aggravated after eating. On physical examination, there was a palpable mass on the left supraclavicular area. Endoscopic examination revealed a mass on the distal esophagus with irregular mucosa, erythema and a whitish plaque with luminal narrowing. The patient was diagnosed with unresectable esophageal cancer (squamous cell carcinoma, T3N2M1, Stage IV). The patient received CCRT (total 63 Gy) with cisplatin and 5-fluorouracil (5-FU). After CCRT, the patient took an additionally 2 cycles of chemotherapy for consolidation (cisplatin and 5-FU every 4 weeks). After additional chemotherapy, endoscopic examination showed no residual tumor, a chest CT scan revealed that the mass in the distal esophagus had decreased and there was no enlargement of the lymph nodes around the left supraclavicular area. The patient has been in complete remission for 5 years.

• Radiation Oncology Journal
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• 제25권3호
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• pp.151-159
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• 2007

목적: 국소 진행된 하인두암에서 치료 결과 및 생존율에 영향을 미치는 예후인자를 알아보고자 하였다. 대상 및 방법: 1985년 10월부터 2000년 12월까지 국소 진행된 하인두암 IV기로 근치적 치료를 받은 90명을 대상으로 후향적 분석을 실시하였다. 방사선 단독치료는 12명, 항암화학요법과 병용치료는 65명, 그리고 수술과 수술 후 방사선치료 시행은 13명이었다. 방사선 단독군의 경우 총 방사선 선량은 $59.0{\sim}88.2$ Gy (중앙값 70 Gy)이었다. 항암화학요법은 대부분 5-FU와 cisplatin을 병용하였고, 일부 환자에서는 clsplatin을 기본으로 pepleomycin 또는 vincristin 등을 병용 투여하였다. 추적관찰기간의 중앙값은 15개월이었다. 통계적 방법으로 생존율의 산출은 Kaplan-Meier 법을, 두군의 생존율간의 차이는 Log-rank test를, 그리고 다변량분석에는 Cox prportional hazard model을 각각 이용하였다. 결과: 전체 90명 환자의 3년 및 5년 생존율은 각각 26%, 17%였다. 2년 국소종양제어율은 방사선치료 단독군의 경우 33%, 방사선치료와 항암화학요법을 병용한 군은 32%, 수술 후 방사선치료군 81%로 통계적으로 유의한 차이를 보였다(p=0.006) 생존율에 영향을 미치는 예후인자에 대한 다요인 분석에서 T병기, 동시적 항암화학요법의 유무 및 국소 치료 후 완전 관해 여부가 통계적으로 유의하였다. 방사선치료와 항암화학요법을 병용한 군의 3년 및 5년 후두 보존율은 각각 26%, 22%였다. 이중 동시적 항암항암화학방사선요법이 시행된 11명 환자의 5년 후두 보존율은 52%로 선행화학요법이 시행된 54명의 16%에 비해 통계적으로 유의한 차이를 보였다(p=0.012). 결론: 국소 진행된 하인두암에서 근치적 수술과 방사선치료 병용요법이 방사선치료 단독요법이나 항암화학요법 병용방법에 비하여 더 좋은 결과를 보여주었다. 한편 방사선치료와 동시적 항암화학요법은 후두를 보존할 수 있는 유용한 치료법이 될 수 있음을 시사하였다. 향후 더 많은 환자를 대상으로 전향적 무작위 임상연구가 필요할 것으로 생각된다.

• 대한한방내과학회지
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• 제32권1호
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• pp.129-135
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• 2011

This report documents a case in which the administration of an herbal product, an extract of the lacquer tree, Rhus verniciflua Stokes, as sequential and concurrent treatment with chemotherapy was associated with a long term survival and good quality of life in a patient with metastatic non-small cell lung cancer(NSCLC). A 51-year-old Korean female was referred to the $M{\cdot}{\mu}$ Integrative Cancer Center, East-West Neo Medical centrer, Kyung Hee University for stage IV, metastatic NSCLC. She was treated with aRVS alone for 19 months and then received 1st line paclitaxel/carboplatin combined with aRVS, 2nd line gefitinib, and 3rd line pemetrexed. The number of cycles of pemetrexed administered was seventeen. aRVS was restarted as the 13th pemetrexed was administered. Pemetrexed with aRVS is currently ongoing. This patient has been alive for 41 months, and has been keeping a good performance status so far. We suggest aRVS as sequential and concurrent treatment with chemotherapy is an effective alternative treatment strategy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2993-2998
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• 2015

Background: Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Materials and Methods: Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Results: Patients in the IC group presented with advanced stage (Stage 3=89.2% versus 75.4%) (P=0.02) but a high rate of total mesorectal excision (TME) (100% versus 93.4%) (P=0.01) and sphincter preservation surgery (54.9 % versus 22.9%) (P=0.001). Patients with low rectal cancer who received IC had a significantly low positive CRM rate (9.2% versus 34%) (P=0.002). Actuarial 5 year DFS in IC and no IC groups were 39% and 43% (P=0.9) and 5 year OS were 70% and 47% (P=0.003). Pathological tumor size [HR: 2.2, CI: 1.1-4.5, P=0.01] and nodal involvement [HR: 2, CI: 1.08-4, P=0.02] were independent predictors of relapse while pathological nodal involvement [HR: 2.6, CI: 1.3-4.9, P=0.003] and IC [HR: 0.7, CI: 0.5-0.9, P=0.02] were independent predictors of death. Conclusions: In low rectal cancer, induction chemotherapy before CRT may significantly decrease CRM positivity and improve 5 year overall survival.