• Title/Summary/Keyword: median line

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Docetaxel and Cisplatin in First Line Treatment of Patients with Unknown Primary Cancer: A Multicenter Study of the Anatolian Society of Medical Oncology

  • Demirci, Umut;Coskun, Ugur;Karaca, Halit;Dane, Faysal;Ozdemir, Nuriye Yildirim;Ulas, Arife;Baykara, Meltem;Benekli, Mustafa;Ozkan, Metin;Buyukberber, Suleyman
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1581-1584
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    • 2014
  • Background: The overall prognosis for cancers of unknown primary (CUP) is poor, median overall survival (OS) being 6-12 months. We evaluated our multicentric retrospective experience for CUP administered docetaxel and cisplatin combination therapy. Materials and Methods: A total of 29 patients that were pathologically confirmed subtypes of CUP were included in the study. The combination of docetaxel ($75mg/m^2$, day 1) and cisplatin ($75mg/m^2$, day 1) was performed as a first line regimen every 21 days. Results: The median age was 51 (range: 27-68). Some 17 patients had multimetastatic disease on the inital diagnosis. Histopathological diagnoses were well-moderate differentiated adenocarcinoma (51.7%), undifferentiated carcinoma (27.6%), squamous cell cancer (13.8%), mucoepidermoid carcinoma (3.4%) and neuroendocrine differentiated carcinoma (3.4%). Median number of cycles was 3 (range: 1-6). Objective response rate was 37.9% and clinical benefit was 58.6%. Median progression free survival (PFS) and overall survival (OS) were 6 months (range: 4.3-7.7 months) and 16 months (range: 8.1-30.9 months), respectively. Fourteen patients (60.8%) were treated in a second line setting. There was no treatment related death. Most common toxicities were nausia-vomiting (44.6%) and fatigue (34.7%), serious cases (grade 3/4) suffering nausia-vomiting (10.3%), neutropenia (13.8%) and febrile neutropenia (n=1). Conclusion: The combination of cisplatin and docetaxel is an effective regimen for selected patients with CUP.

Efficacy and Toxicity of Gemcitabine Plus Docetaxel Combination as a Second Line Therapy for Patients with Advanced Stage Soft Tissue Sarcoma

  • Ali Osman, Kaya;Suleyman, Buyukberber;Metin, Ozkan;Necati, Alkis;Alper, Sevinc;Nuriye Yildirim, Ozdemir;Suleyman, Alici;Onur, Esbah;Veli, Berk;Celalettin, Camci;Arife, Ulas;Ugur, Coskun;Mustafa, Benekli
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.463-467
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    • 2012
  • Purpose: To assess the safety and efficacy of a gemcitabine plus docetaxel regimen as a second line therapy for patients with advanced soft tissue sarcoma (STS) resistant to doxorubicin and ifosfamide-based therapy. Patients and Methods: Medical records of 64 patients with advanced STS who received gemcitabine plus docetaxel regimen as a second line treatment between May 2006 and June 2011 were examined. All patients had been previously treated with doxorubicin plus ifosfamide-based regimen at first line setting. Patients received gemcitabine 900 $mg/m^2$ on days one and eight intravenously over 90 minutes, followed by docetaxel 75 $mg/m^2$ on day eight intravenously over one hour. Cycles were repeated every 3 weeks. Results: The male-to-female ratio was 37/27 and the median age was 44 years (range; 19-67 years). Objective responses were observed in 13 (20.3 %) patients (2 CR, 11 PR) and stable disease in 21 (32.8 %). Total clinical benefit (CR+PR+SD) was observed in 34 (53.1 %). Median overall survival (OS) was 18 months (95% confidence interval (CI):12.1-23.9) and Median time to progression (TTP) was 4.8 months (95% CI: 3.6-6). A total of 243 cycles of chemotherapy were administered. The median number of cycle was 3 (range;1-11). The most common grade 3-4 hematologic toxicity was neutropenia (35.9 %). The most common nonhematologic toxicities consisted of nausea/vomiting (37.5 %), mucositis (32.8 %), peripheral neuropathy (29.7%), and fatigue (26 %). There was no toxicity-related death. Conclusion: The combination of gemcitabine plus docetaxel is an active and tolerable regimen as a second line therapy for patients with advanced soft tissue sarcoma who have failed doxorubicin and ifosfamide-based therapy.

Intraneural Venous Malformations of the Median Nerve

  • Porto, Sara Alicia Gonzalez;Rodriguez, Alba Gonzalez;Miguez, Jose Midon
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.371-373
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    • 2016
  • Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

Characteristics of Median Frequency According to the Load During Fatiguing Isometric Exercise (등척성 운동시 운동강도에 따른 중앙주파수의 특성)

  • Lee, Su-Young;Shin, Hwa-Kyung;Cho, Sang-Hyun
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.141-149
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    • 2003
  • Median frequency can be regarded as a valid indicator of local muscle fatigue. As local muscle fatigue develops, the muscle fiber conduction velocity decreases, the fast twitch fibers are recruited less, and consequently the median frequency shifts toward the lower frequency area. The aim of this study was to test the characteristics of the median frequency according to exercise load (30% and 60% of MVC on the biceps brachii, 40% and 80% of MVC on the vastus lateralis) during the fatiguing isometric exercise. Thirteen healthy male volunteer students of Yonsei University were recruited. After the testing maximal voluntary isometric contraction, three variables (initial median frequency, regression slope, fatigue index) from the regression line of MDF data were measured in each exercise load. The results showed that the regression slope and fatigue index were significantly different for the biceps brachii, but not for the vastus lateralis initial MDF was not significant difference according to the exercise load on both muscles. The regression slope and fatigue index could monitor physiologic muscle change during fatiguing isometric exercise. The results showed that two MDF variables reflect the local muscle fatigue according to the exercise load.

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Metastatic Pancreatic Carcinoma and Experience with FOLFIRINOX - a Cross Sectional Analysis From a Developing Country

  • Zahir, Muhammad Nauman;Jabbar, Adnan Abdul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6001-6006
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    • 2015
  • Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

Cisplatin Plus Gemcitabine for Treatment of Breast Cancer Patients with Brain Metastases: a Preferential Option for Triple Negative Patients?

  • Erten, Cigdem;Demir, Lutfiye;Somali, Isil;Alacacioglu, Ahmet;Kucukzeybek, Yuksel;Akyol, Murat;Can, Alper;Dirican, Ahmet;Bayoglu, Vedat;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3711-3717
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    • 2013
  • Background: To assess the efficacy and tolerability of Cisplatin plus Gemcitabine combination in patients with brain metastases (BM) from breast cancer (BC). Materials and Methods: Eighteen BC patients with BM who were treated with Cisplatin plus Gemcitabine regimen between 2003-2011 were evaluated. Results: A median of 6 cycles of this regimen were received, in fifteen patients (83.3%) as first-line chemotherapy, in 2 as second-line and in 1 as third-line after diagnosis of BM. Dose reduction was performed in 11 (61.1%) patients; major reasons were neutropenia and leukopenia. Grade III neutropenia and Grade II trombocytopenia rates were 33.3% and 16.7% respectively. Overall response rate (ORR; complete+partial response rate) was 33.4% (n=6) for the entire study population; triple negative patients achieved an 66.6% ORR while hormone receptor (HR) positive patients had 25% and HER2 positive patients 12.5%. Median progression-free survival was 5.6 months (2.4-8.8 months, 95%CI) and longer in patients with triple negative breast cancer (TNBC) (median 7.4 months, 95%CI, 2.4-12.3 months) than the patients with other subtypes (median 5 months for HER2 positive and 3.6 months for HR positive patients). Median PFS of the patients with TNBC who received this regimen as first-line was 9.2 months (5.2-13.2 months, 95%CI). Conclusions: Cisplatin plus Gemcitabine may be a treatment option for patients with BM from breast cancer. Longer PFS and higher response rates are results that support the usage of this regimen especially for the triple negative subtype. However, further prospective and randomized trials are clearly required to provide more exact information.

Reconfiguration of occlusal plane by Esthetic mounting(OP1) : a case report (Esthetic mounting (OP1)을 사용하여 교합면 재구성을 시행한 증례)

  • Cho, Sang-Ho
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.1
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    • pp.4-15
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    • 2014
  • A face-bow and an articulator have been used as crucial devices in a prosthodontic reconstruction of a collapsed occlusal plane. In order to avoid inaccuracy of median line in maxilla and the canted occlusal plane both of which may result from using a facebow with ear rods, a facebow that locate a patient's facial median line as reference line has been under development. A mounting technique that tries to bring a center of patient's face into line with the center of the articulator, called esthetic mounting, is currently employed to overcome the imprecision resulted from mounting with ear-bow transfer. We would like to study a case that used OP finder 1, one of the esthetic mounting techniques.

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study

  • Jung, Hyun yeb;Lee, Eun Mi
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.124-132
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    • 2022
  • Background: Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer. Methods: We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020. Results: Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57-62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5-8.6 months) and 4.5 months (95% CI, 2.7-6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS. Conclusion: The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

Analyses of Multiple Factors for Determination of "Selected Patients" Who Should Receive Rechallenge Treatment in Metastatic Colorectal Cancer: a Retrospective Study from Turkey

  • Ozaslan, Ersin;Duran, Ayse Ocak;Bozkurt, Oktay;Inanc, Mevlude;Ucar, Mahmut;Berk, Veli;Karaca, Halit;Elmali, Ferhan;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2833-2838
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    • 2015
  • Background: Repeating a prior chemotherapy (rechallenge therapy) is an option for selected patients with metastatic colorectal cancer, but there is very little evidence in the literature for this approach. Thus, we reviewed our registry to evaluate prognostic factors and survival of patients who received irinotecan and oxaliplatin-based regimens as rechallenge third and fourth-line therapy. Materials and Methods: Patients who received irinotecan-based or oxaliplatin-base regimen as first-line had been rechallenged with third-line or fourth-line therapy. These patients were selected from the database of Turkish mCRC registry archives between October 2006 and June 2013 and evaluated retrospectively for factors effecting progression free survival (PFS) and overall survival (OS) by the Kaplan-Meire and Cox-regression methods. Results: Thirty-nine patients were enrolled. The median duration of follow-up was 36 months (14-68 months). Thirty-one patients (76%) died during follow-up. In terms of rechallenge treatments, 29 patients had received third-line and 10 patients had received fourth-line. Response rate (RR) was found to be 12.9%, with stable disease in 19 (48.7%) patients. The median PFS was 6 months (95%CI=4.64-7.35 months) and the median OS was 11 months (95%CI=8.31-13.68 months). The factors effecting survival (PFS and OS) were only being PFS after first-line chemotherapy ${\geq}12months$ (p=0.007, 95% CI=1.75-35.22 and p=0.004, 95%CI=1.44-7.11), both in univariate and multivariate analyses. Conclusions: This study indicates that rechallenge treatment could be a good option as a third or later line therapy in patients who had ${\geq}12months$ PFS onreceiving first line therapy.

A Study of the effective approach method for median control chart of non-normally distributed process (비정규분포공정에서 계량치관리를 위한 메디안 특수 관리도의 모형설계와 그 적용에 관한 실용에 연구)

  • 신용백
    • Journal of the Korean Professional Engineers Association
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    • v.21 no.4
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    • pp.19-32
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    • 1988
  • Whereas is non-symmetrical distribution manufacturing process the traditional X-chart by Shewhart is not plotted relatively on the central line but plotted on the skew of upper-hand side or lower-hand side. That is to say, for the purpose of producing either upper-specification-oriented items or lower-specification-oriented items, and when we carry out tighter control so as to have them pass only its specifications, the distribution shape naturally has a non-normal distribution. In the Shewhart X-chart, which is the most widely used one in Korea, such skewed distributions make tile plots to be inclined below or above the central line or outside the control limits although no assignable causes can be found. To overcome such short comings is non-normally distributed processes, a distribution-free type of confidence interval can be used, which should be haled on order statistics. This thesis is concerned with the design of control chart based on a sample median which is easy to use in practical situation and therefore properties for non-normal distributions, such as Gamma, Beta, Lognormal, Weibull, Pareto, and Truncated-normal distributions, may be easily analyzed. To enhance this improvement, I proved the property of practical applications of control chart method by comparing and analyzing the case studies of practical application of special purpose control chart method, and also by introducing the new designed median control chart.

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