• Title/Summary/Keyword: dose response

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A Formulated Korean Red Ginseng Extract Inhibited Nitric Oxide Production through Akt- and Mitogen Activated Protein Kinase-dependent Heme Oxygenase-1 Upregulation in Lipoteichoic Acid-stimulated Microglial Cells (홍삼추출액은 lipoteichoic acid로 자극된 소교세포에서 Akt 및 MAPK 의존적으로 heme oxygenase-1 발현을 유도함으로써 NO 생성을 억제함)

  • Shin, Ji Eun;Lee, Kyungmin;Kim, Ji-Hee;Madhi, Iskander;Kim, YoungHee
    • Journal of Life Science
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    • v.29 no.4
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    • pp.402-409
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    • 2019
  • Korean red ginseng made from steaming and drying fresh ginseng has long been used as a traditional herbal medicine due to its effects on the immune, endocrine, and central nerve systems and its anti-inflammatory activity. In this study, we investigated the molecular mechanism responsible for the anti-inflammatory effects of a formulated Korean red ginseng extract (RGE) in response to lipoteichoic acid (LTA), a cell wall component of gram-positive bacteria. RGE inhibited LTA-induced nitric oxide (NO) secretion and inducible nitric oxide synthase (iNOS) expression in BV-2 microglial cells, without affecting cell viability. RGE also inhibited nuclear translocation of nuclear factor kappa B ($NF-{\kappa}B$) p65 and degradation of $I{\kappa}B-{\alpha}$. In addition, RGE increased the expression of heme oxygenase-1 (HO-1) in a dose-dependent manner, and the inhibitory effect of RGE on iNOS expression was abrogated by small interfering RNA-mediated knockdown of HO-1. Moreover, RGE induced nuclear translocation of nuclear factor E2-related factor 2 (Nrf2), a transcription factor that regulates HO-1 expression. Furthermore, the phosphoinositide-3-kinase (PI-3K) inhibitor and mitogen-activated protein kinase (MAPK) inhibitors suppressed RGE-mediated expression of HO-1, and RGE enhanced the phosphorylation of Akt, extracellular signal-regulated kinases (ERKs), p38, and c-JUN N-terminal kinases (JNKs). These results suggested that RGE suppressed the production of NO, a proinflammatory mediator, by inducing HO-1 expression via PI-3K/Akt- and MAPK-dependent signaling in LTA-stimulated microglia. The findings indicate that RGE could be used for the treatment of neuroinflammation induced by grampositive bacteria and that it may have therapeutic potential for various neuroinflammation-associated disorders.

Pathophysiological Regulation of Vascular Smooth Muscle Cells by Prostaglandin F2α-dependent Activation of Phospholipase C-β3 (Prostaglandin F2α 의존적 phospholipase C-β3 활성화에 의한 혈관평활근세포의 병태생리 조절 연구)

  • Kang, Ki Ung;Oh, Jun Young;Lee, Yun Ha;Lee, Hye Sun;Jin, Seo Yeon;Bae, Sun Sik
    • Journal of Life Science
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    • v.28 no.12
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    • pp.1516-1522
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    • 2018
  • Atherosclerosis is an obstructive vessel disease mainly caused by chronic arterial inflammation to which the proliferation and migration of vascular smooth muscle cells (VSMCs) is the main pathological response. In the present study, the primary responsible inflammatory cytokine and its signaling pathway was investigated. The proliferation and migration of VSMCs was significantly enhanced by the prostaglandin $F_{2{\alpha}}$ ($PGF_{2{\alpha}}$), while neither was affected by tumor necrosis factor ${\alpha}$. Prostacyclin $I_2$ was seen to enhance the proliferation of VSMCs while simultaneously suppressing their migration. Both prostaglandin $D_2$ and prostaglandin $E_2$ significantly enhanced the migration of VSMCs, however, proliferation was not affected by either of them. The proliferation and migration of VSMCs stimulated by $PGF_{2{\alpha}}$ progressed in a dose-dependent manner; the $EC_{50}$ value of both proliferation and migration was $0.1{\mu}M$. VSMCs highly expressed the phospholipase isoform $C-{\beta}3$ ($PLC-{\beta}3$) while others such as $PLC-{\beta}1$, $PLC-{\beta}2$, and $PLC-{\beta}4$ were not expressed. Inhibition of the PLCs by U73122 completely blocked the $PGF_{2{\alpha}}$-induced migration of VSMCs, and, in addition, silencing $PLC-{\beta}3$ significantly diminished the $PGF_{2{\alpha}}$-induced proliferation and migration of VSMCs. Given these results, we suggest that $PGF_{2{\alpha}}$ plays a crucial role in the proliferation and migration of VSMCs, and activation of $PLC-{\beta}3$ could be involved in their $PGF_{2{\alpha}}$-dependent migration.

Effects of 2-methoxy-1,4-naphthoquinone (MQ) on MCP-1 Induced THP-1 Migration (MCP-1에 의해 유도된 THP-1 유주에 미치는 2-methoxy-1,4-naphthoquinone (MQ)의 영향)

  • Kim, Si Hyun;Park, Bo Bin;Hong, Sung Eun;Ryu, Sung Ryul;Lee, Jang Ho;Kim, Sa Hyun;Lee, Pyeongjae;Cho, Eun-Kyung;Moon, Cheol
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.245-251
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    • 2019
  • This study examined the effects of 2-methoxy-1,4-naphthoquinone (MQ) on the monocyte chemoattractant protein-1 (MCP-1)-induced migration of monocytes, which is an important phenomenon for the body defense and immune response. MQ is a major component extracted from Impatiens balsamina leaves, which have been used for many years in Asian medicine for the treatment of a range of diseases and pain. The cytotoxicity of MQ began to appear at a concentration of $10{\mu}M$, and approximately 50% cytotoxicity was confirmed at $100{\mu}M$. The MCP-1 induced migration of the THP-1 monocyte cell line increased after MQ treatment in a dose dependent manner and the largest increase was observed at $0.1{\mu}M$. The level of cAMP expression decreased after a treatment with $0.1{\mu}M$ MQ. The phosphorylation of extracellular signal-regulated kinases 1/2 (Erk1/2), a key signaling protein involved in the signaling pathway of C-C motif chemokine receptor 2 (CCR2), a receptor for MCP-1, was increased by the simultaneous treatment of $0.1{\mu}M$ MQ. These results show that MQ increases the MCP-1-induced migration of THP-1, decreases the level of cAMP expression, and increases the level of Erk1/2 phosphorylation.

Inhibitory Effect of Protaetiamycine 9 Derived from Protaetia brevitarsis seulensis Larvae on LPS-mediated Inflammation in RAW264.7 Cells (LPS로 자극한 RAW264.7 대식세포에서 흰점박이꽃무지 유충 유래 Protaetiamycine 9의 항염증 효과)

  • Choi, Ra-Yeong;Seo, Minchul;Lee, Joon Ha;Kim, In-Woo;Kim, Mi-Ae;Hwang, Jae-Sam
    • Journal of Life Science
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    • v.31 no.11
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    • pp.987-994
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    • 2021
  • Our previous studies have reported that antimicrobial peptides (AMPs) derived from the larvae of white-spotted flower chafer (Protaetia brevitarsis seulensis) exert anti-inflammatory and neuroprotective activities. This study explored the anti-inflammatory effects of protaetiamycine 9 (CVLKKAYFLTNLKLRG-NH2), a novel AMP, derived from P. b. seulensis against lipopolysaccharide (LPS)-mediated inflammatory response in RAW264.7 macrophage cells. Protaetiamycine 9 (25, 50, 75, and 100 ㎍/ml) did not cause cytotoxic effects against RAW264.7 cells. The RAW264.7 cells were pre-treated with various concentrations of protaetiamycine 9 (25-100 ㎍/ml) for 1 hr and then exposed to LPS (100 ng/ml) for 24 hr. Protaetiamycine 9 treatments decreased the LPS-induced secretion of inflammatory mediators, such as nitric oxide (NO), in a dose-dependent manner. Protaetiamycine 9 (25-100 ㎍/ml) effectively downregulated the LPS-induced increase in mRNA and the protein expression of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2), which are involved in the production of inflammatory mediators. Protaetiamycine 9 also suppressed the production and gene expression of pro-inflammatory cytokines, including interleukin (IL)-6 and IL-1β, compared to the presence of LPS alone. Furthermore, protaetiamycine 9 inhibited the degradation of inhibitory kappa B alpha (IκB-α) and the phosphorylation of mitogen-activated protein kinases (MAPKs), such as extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38. In conclusion, these results suggest that protaetiamycine 9 exhibits LPS-mediated inflammatory responses by blocking IκB-α degradation and MAPK phosphorylation.

Establishment of Test Conditions and Interlaboratory Comparison Study of Neuro-2a Assay for Saxitoxin Detection (Saxitoxin 검출을 위한 Neuro-2a 시험법 조건 확립 및 실험실 간 변동성 비교 연구)

  • Youngjin Kim;Jooree Seo;Jun Kim;Jeong-In Park;Jong Hee Kim;Hyun Park;Young-Seok Han;Youn-Jung Kim
    • Journal of Marine Life Science
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    • v.9 no.1
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    • pp.9-21
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    • 2024
  • Paralytic shellfish poisoning (PSP) including Saxitoxin (STX) is caused by harmful algae, and poisoning occurs when the contaminated seafood is consumed. The mouse bioassay (MBA), a standard test method for detecting PSP, is being sanctioned in many countries due to its low detection limit and the animal concerns. An alternative to the MBA is the Neuro-2a cell-based assay. This study aimed to establish various test conditions for Neuro-2a assay, including cell density, culture conditions, and STX treatment conditions, to suit the domestic laboratory environment. As a result, the initial cell density was set to 40,000 cells/well and the incubation time to 24 hours. Additionally, the concentration of Ouabain and Veratridine (O/V) was set to 500/50 μM, at which most cells died. In this study, we identified eight concentrations of STX, ranging from 368 to 47,056 fg/μl, which produced an S-shaped dose-response curve when treated with O/V. Through inter-laboratory variability comparison of the Neuro-2a assay, we established five Quality Control Criteria to verify the appropriateness of the experiments and six Data Criteria (Top and Bottom OD, EC50, EC20, Hill slop, and R2 of graph) to determine the reliability of the experimental data. The Neuro-2a assay conducted under the established conditions showed an EC50 value of approximately 1,800~3,500 fg/μl. The intra- & inter-lab variability comparison results showed that the coefficients of variation (CVs) for the Quality Control and Data values ranged from 1.98% to 29.15%, confirming the reproducibility of the experiments. This study presented Quality Control Criteria and Data Criteria to assess the appropriateness of the experiments and confirmed the excellent repeatability and reproducibility of the Neuro-2a assay. To apply the Neuro-2a assay as an alternative method for detecting PSP in domestic seafood, it is essential to establish a toxin extraction method from seafood and toxin quantification methods, and perform correlation analysis with MBA and instrumental analysis methods.

Patterns in the Use and Perception of Digital Breast Tomosynthesis: A Survey of Korean Breast Radiologists (디지털 유방 토모신테시스에 대한 국내 사용 현황과 인식에 관한 설문조사 연구)

  • Eun Young Chae;Joo Hee Cha;Hee Jung Shin;Woo Jung Choi;Jihye Kim;Sun Mi Kim;Hak Hee Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1327-1341
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    • 2022
  • Purpose To evaluate the pattern of use and the perception of digital breast tomosynthesis (DBT) among Korean breast radiologists. Materials and Methods From March 22 to 29, 2021, an online survey comprising 27 questions was sent to members of the Korean Society of Breast Imaging. Questions related to practice characteristics, utilization and perception of DBT, and research interests. Results were analyzed based on factors using logistic regression. Results Overall, 120 of 257 members responded to the survey (response rate, 46.7%), 67 (55.8%) of whom reported using DBT. The overall satisfaction with DBT was 3.31 (1-5 scale). The most-cited DBT advantages were decreased recall rate (55.8%), increased lesion conspicuity (48.3%), and increased cancer detection (45.8%). The most-cited DBT disadvantages were extra cost for patients (46.7%), insufficient calcification characterization (43.3%), insufficient improvement in diagnostic performance (39.2%), and radiation dose (35.8%). Radiologists reported increased storage requirements and interpretation time for barriers to implementing DBT. Conclusion Further improvement of DBT techniques reflecting feedback from the user's perspective will help increase the acceptance of DBT in Korea.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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The relationships between lead exposure indicies and urinary δ-ALA by HPLC and colorimetric method in lead exposure workers (연노출근로자에 있어서 흡광광도법과 HPLC법에 의한 요중 δ-ALA 배설량과 연노출지표들 간의 관련성)

  • Ahn, Kyu-Dong;Lee, Sung-Soo;Hwangbo, Young;Lee, Gab-Soo;Yeon, You-Yong;Kim, Yong-Bae;Lee, Byung-Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.6 no.1
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    • pp.77-87
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    • 1996
  • In order to compare the difference of the measurement of delta aminolevulinic acid(${\delta}$-ALA) in urine between HPLC method(HALA) and colorimetric method(CALA), and also to provide useful information for the new diagnostic criteria of ${\delta}$-ALA in urine in lead poisoning, if at all possible in the future, authors studied 234 male lead workers who were selected from 7 storage battery factories, 3 secondary smelting industries, and 2 litharge making industries. Study subjects were selected on the basis of blood Zinc protoporphyrin(ZPP) level from low to high concentration to cover wide range of lead exposure. Study variables for this study were ${\delta}$-ALA measured by two different methods, blood lead(PbB), and blood ZPP. The results were as follows: 1. There was very high correlation between ${\delta}$-ALA measured by two method(r = 0.989 : HALA = -0.8194 + 0.8110 ${\times}$ CALA), but the value of CALA was measured about 2mg/L greater than HALA. 2. While the correlations of ${\delta}$-ALA by two method with blood lead and blood ZPP were 0.46 and 0.37 respectively, they were increased to 0.63 and 0.57 if ${\delta}$-ALA values were log-transformed. 3. Simple linear regression of ${\delta}$-ALA measured by two method on ZPP were as follows: CALA = 2.0421 + 0.0341 ${\times}$ ZPP ($R^2=0.1385$ p = 0.0001) HALA = 0.8006 + 0.0280 ${\times}$ ZPP ($R^2=0.1389$ p = 0.0001) 4. Simple linear regression of ${\delta}$-ALA measured by two method on PbB were as follows: CALA = - 0.4134 + 0.1545 ${\times}$ PbB ($R^2=0.2085$ p = 0.0001) HALA = -1.2893 + 0.1287 PbB ($R^2=0.2154$ p = 0.0001), 5. Simple linear regression of log-transformed ${\delta}$-ALA by two method on ZPP and PbB were as follows: logHALA = 0.3078 + 0.0060 ZPP ($R^2=0.3329$ p = 0.0001) logCALA = 1.0189 + 0.0044 ZPP ($R^2=0.3290$ p = 0.0001) logHALA = -0.0221 + 0.0246 PbB ($R^2=0.4046$ p = 0.0001) logCALA = 0.7662 + 0.0184 PbB ($R^2=0.4108$ p = 0.0001) 6. The cumulative percent of colorimetric method to detect lead workers whose value of PbS and ZPP were over screening level such as $40{\mu}/dl$ and $100{\mu}/dl$ respectively was higher than HPLC method if cut-off level of ${\delta}$-ALA for screening of lead poisoning was 5 mg/L. But if cut-off level of ${\delta}$-ALA measured by HPLC was reduced to 3 mg/L which is compatible to 5 mg/L of ${\delta}$-ALA measured by colorimetric method, there were good agreement between two methods and showed dose-response relationship with other lead exposure indices such as PbB and ZPP.

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Herbicidal Phytotoxicity under Adverse Environments and Countermeasures (불량환경하(不良環境下)에서의 제초제(除草劑) 약해(藥害)와 경감기술(輕減技術))

  • Kwon, Y.W.;Hwang, H.S.;Kang, B.H.
    • Korean Journal of Weed Science
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    • v.13 no.4
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    • pp.210-233
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    • 1993
  • The herbicide has become indispensable as much as nitrogen fertilizer in Korean agriculture from 1970 onwards. It is estimated that in 1991 more than 40 herbicides were registered for rice crop and treated to an area 1.41 times the rice acreage ; more than 30 herbicides were registered for field crops and treated to 89% of the crop area ; the treatment acreage of 3 non-selective foliar-applied herbicides reached 2,555 thousand hectares. During the last 25 years herbicides have benefited the Korean farmers substantially in labor, cost and time of farming. Any herbicide which causes crop injury in ordinary uses is not allowed to register in most country. Herbicides, however, can cause crop injury more or less when they are misused, abused or used under adverse environments. The herbicide use more than 100% of crop acreage means an increased probability of which herbicides are used wrong or under adverse situation. This is true as evidenced by that about 25% of farmers have experienced the herbicide caused crop injury more than once during last 10 years on authors' nationwide surveys in 1992 and 1993 ; one-half of the injury incidences were with crop yield loss greater than 10%. Crop injury caused by herbicide had not occurred to a serious extent in the 1960s when the herbicides fewer than 5 were used by farmers to the field less than 12% of total acreage. Farmers ascribed about 53% of the herbicidal injury incidences at their fields to their misuses such as overdose, careless or improper application, off-time application or wrong choice of the herbicide, etc. While 47% of the incidences were mainly due to adverse natural conditions. Such misuses can be reduced to a minimum through enhanced education/extension services for right uses and, although undesirable, increased farmers' experiences of phytotoxicity. The most difficult primary problem arises from lack of countermeasures for farmers to cope with various adverse environmental conditions. At present almost all the herbicides have"Do not use!" instructions on label to avoid crop injury under adverse environments. These "Do not use!" situations Include sandy, highly percolating, or infertile soils, cool water gushing paddy, poorly draining paddy, terraced paddy, too wet or dry soils, days of abnormally cool or high air temperature, etc. Meanwhile, the cultivated lands are under poor conditions : the average organic matter content ranges 2.5 to 2.8% in paddy soil and 2.0 to 2.6% in upland soil ; the canon exchange capacity ranges 8 to 12 m.e. ; approximately 43% of paddy and 56% of upland are of sandy to sandy gravel soil ; only 42% of paddy and 16% of upland fields are on flat land. The present situation would mean that about 40 to 50% of soil applied herbicides are used on the field where the label instructs "Do not use!". Yet no positive effort has been made for 25 years long by government or companies to develop countermeasures. It is a really sophisticated social problem. In the 1960s and 1970s a subside program to incoporate hillside red clayish soil into sandy paddy as well as campaign for increased application of compost to the field had been operating. Yet majority of the sandy soils remains sandy and the program and campaign had been stopped. With regard to this sandy soil problem the authors have developed a method of "split application of a herbicide onto sandy soil field". A model case study has been carried out with success and is introduced with key procedure in this paper. Climate is variable in its nature. Among the climatic components sudden fall or rise in temperature is hardly avoidable for a crop plant. Our spring air temperature fluctuates so much ; for example, the daily mean air temperature of Inchon city varied from 6.31 to $16.81^{\circ}C$ on April 20, early seeding time of crops, within${\times}$2Sd range of 30 year records. Seeding early in season means an increased liability to phytotoxicity, and this will be more evident in direct water-seeding of rice. About 20% of farmers depend on the cold underground-water pumped for rice irrigation. If the well is deep over 70m, the fresh water may be about $10^{\circ}C$ cold. The water should be warmed to about $20^{\circ}C$ before irrigation. This is not so practiced well by farmers. In addition to the forementioned adverse conditions there exist many other aspects to be amended. Among them the worst for liquid spray type herbicides is almost total lacking in proper knowledge of nozzle types and concern with even spray by the administrative, rural extension officers, company and farmers. Even not available in the market are the nozzles and sprayers appropriate for herbicides spray. Most people perceive all the pesticide sprayers same and concern much with the speed and easiness of spray, not with correct spray. There exist many points to be improved to minimize herbicidal phytotoxicity in Korea and many ways to achieve the goal. First of all it is suggested that 1) the present evaluation of a new herbicide at standard and double doses in registration trials is to be an evaluation for standard, double and triple doses to exploit the response slope in making decision for approval and recommendation of different dose for different situation on label, 2) the government is to recognize the facts and nature of the present problem to correct the present misperceptions and to develop an appropriate national program for improvement of soil conditions, spray equipment, extention manpower and services, 3) the researchers are to enhance researches on the countermeasures and 4) the herbicide makers/dealers are to correct their misperceptions and policy for sales, to develop database on the detailed use conditions of consumer one by one and to serve the consumers with direct counsel based on the database.

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Combined Chemoradiotherapy vs Radiotherapy Alone for Locally Advanced Squamous Cell Carcinoma of the Head and Neck (국소적으로 진행된 두경부 편평상피세포종양의 방사선- 항암화학 병용요법과 방사선단독치료의 비교)

  • Jeong, Hyeon-Ju;Suh, Hyun-Suk;Kim, Chul-Soo;Kim, Re-Hwe;Kim, Sung-Rok
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.9-15
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    • 1996
  • Purpose: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer Provides anticipated cure rates of $10-65\%$ depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer. Materials and Methods : November 1983 to October 1994. 31 Patients with Stage III and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone, and IS patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy (median 7010 cGy). In combined group, 7 patients were treated with cisplatin plus 5-FU 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. Results : Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient ($66.6\%$) of the RT alone group and 14 patient ($93.3\%$) of the chemoradiation group. There was no statistical difference in CR rate between the two groups The overall survival rates at 5 years were $23.4\%$ in the radiation alone group, $23.5\%$ in the chemoradiation group Disease-free survival rates at 3 years were $44.5\%$ in the radiation alone group, $40\%$ in the chemoradiation group. There was no statistical differences in overall survival rates and disease-free survival rates between the two groups. Local recurrences occurred in $71.5\%$ of the radiation alone group, $72.7\%$ of the chemoradiation group and distant metastasis occurred in $14.4\%$ of radiation alone group, $9.1\%$ of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity Conclusion : Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-un may be necessary to confirm the present result of combined chemotherapy and radiotherapy.

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