Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival. Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM. Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of $40{\pm}20$ years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%). Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.
Objective : We compared the survival time between patients with multiple gamma knife radiosurgery (GKRS) and patients with a single GKRS plus whole brain radiation therapy (WBRT), in patients with multiple metachronous brain metastases from lung cancer. Methods : From May 2006 to July 2010, we analyzed 31 patients out of 112 patients who showed multiple metachronous brain metastases. 20 out of 31 patients underwent multiple GKRS (group A) and 11 patients underwent a single GKRS plus WBRT (group B). We compared the survival time between group A and B. Kaplan-Meier method and Cox proportional hazards were used to analyze relationship between survival and 1) the number of lesions in each patient, 2) the average volume of lesions in each patient, 3) the number of repeated GKRS, and 4) the interval of development of new lesions, respectively. Results : Median survival time was 18 months (range 6-50 months) in group A and 6 months (range 3-18 months) in group B. Only the average volume of individual lesion (over 10 cc) was negatively related with survival time according to Kaplan-Meier method. Cox-proportional hazard ratio of each variable was 1.1559 for the number of lesions, 1.0005 for the average volume of lesions, 0.0894 for the numbers of repeated GKRS, and 0.5970 for the interval of development of new lesions. Conclusion : This study showed extended survival time in group A compared with group B. Our result supports that multiple GKRS is of value in extending the survival time in patients with multiple metachronous brain metastases, and that the number of the lesions and the frequency of development of new lesions are not an obstacle in treating patients with GKRS.
Purpose: Unresectable rectal cancer has a grave prognosis. regardless of the therapy used and median survival is less than 1 rear. Also, it is reported by many authors that $50-80\%$ of unresectable lesions were rendered resectable by radiation therapy and the median survival time for the completely resected patients were better than that of the unresected patients. So we analyzed retrospectively our data for the better treatment outcome in these patients. Materials and MEthods:From 1980 to 1992, 45 patients with initially unresectable tumors in the rectum were treated with radiation therapy with/without surgery in Department of Radiation Oncology, Yonsei Cancer Center 10 MV radiation and multiple field technique (box or AP/PA) were used. The total dose was 28-70 Gy and median dose was 48 Gy. We evaluated the lesion status at 45-50 Gy for operability. If the lesions appeared to be resectable, the Patients were operated on 4-6 weeks after radiation therapy. But if the lesions were still fixed, the radiation dose was increased to 60-65 Gy. Results: For all patients, the 2-year actuarial survival was $13.3\%$ and median survival was 9.5 months. Of 6 patients who had received less than 45 Gy, only $17\%$ of patients responded, but in the patients who had received more than 45 Gy, $60\%$ of response rate was achieved Six of the 24 patients$(25\%)$ underwent surgical resections following RT. For patients undergoing curative resection. the two-rear survival was $50\%,$ but that of the patients without resection was $9.5\%$ (p<0.01). Survival of patients with complete response following RT was $50\%$ at 2 years. Survival of patients with partial response, stable disease and progressive disease after RT was $13.4\%,\;15.4\%,\;0\%$ respectively (P<0.05). Conclision: Our data suffests that the efforts which can increase the response rate and aggressive surgical approach are needed to achieve the better local control and survival in unresectable rectal cancers.
Background: We aimed to investigate the relationship between blood groups and pancreatic cancer in a Turkish population in Western Blacksea region. Methods: This is a retrospective study. Zonguldak Karaelmas University outpatient oncology clinic records were screened for the period between 2004 and 2011. Results: The median age of patients were 56 (${\pm}16$) and 132 of 633 study population had pancreatic cancer. Pancreatic cancer patients had significantly higher rates of blood group A compared to controls (OR 1.8, 95%CI, p 0.005). Rates of blood group AB was significantly lower than the control group (OR 0.37, 95% CI, p 0.04). The median survival (IR) time in subjects having the blood groups A, B, AB and O were 7.0 (1-28), 7.0 (2-38), 10 (2-36) and 9.0 (2-48) months respectively; the blood group 0 had significantly higher overall survival (OS) compared to the non-0 groups (p 0.04). Conclusions: Pancreatic cancer patients had more common blood group A in our population. Moreover, blood group AB appeared to be a protective factor against pancreatic cancer in our population. Blood group 0 had a significantly longer survival compared to non-0, regardless of prognostic factors.
Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.
Objectives : Chemotherapy remains part of the treatment triad that includes surgery and radiotherapy for the management of glioblastomas, but disappointing results of chemotherapy have raised the suggestion that chemotherapy should perhaps be abandoned. In order to determine the chemotherapy effect given in addition to radiotherapy, we performed a randomized clinical study of irradiation alone and combination of irradiation with chemotherapy in the treatment of glioblastomas. Methods : From 1991 to 1999, 204 consecutive patients suffering from supratentorial glioblastomas were treated in our hospital. We compared the survival rates/times of these patients according to the treatment modalities[group I-67 patients treated by surgery with radiotherapy and adjuvant chemotherapy(ACNU, paclitaxel, tamoxifen, and others) ; group II-106 by surgery with radiotherapy ; and group III-31 by surgery only]. Results : The overall median survival time was 12 months, with overall survival rates at 1 and 2 year of 46.7% and 16.6%, respectively. On univariate analysis, median survival and 1- and 2-year survival rates were statistically improved by the use of chemotherapy ; group I-15 months, 75.7%, and 25.9%, group II-11 months, 39.3%, and 15.4%, and group III-3 months, 9.7%, and 6.5%, respectively(p=0.0001). But, on multivariate analysis considering compounding variables, survival was independently associated only with radiotherapy(p=0.0112). Conclusion : These results suggest that the addition of chemotherapy to radiotherapy does not affect the overall survival in glioblastomas. Mainly long-survivor glioblastoma patients might benefit by adjuvant chemotherapy, which probably means patients with initial favorable prognostic factors(young age, minimal residual tumors, good performance status). It is necessary to continue to search for an effective chemotherapy regimen to prolong survival of patients with glioblastomas.
Woradet, Somkiattiyos;Promthet, Supannee;Songserm, Nopparat;Parkin, Donald Maxwell
Asian Pacific Journal of Cancer Prevention
/
v.14
no.3
/
pp.1623-1627
/
2013
Cholangiocarcinoma (CCA) is a major health problem and cause of death among people in Northeastern Thailand. In this prospective study 171 patients newly diagnosed with CCA by physicians in 5 tertiary hospitals in four provinces of northeastern of Thailand between February and July 2011 were followed up to January 2012. The outcome was survival time from diagnosis to death. A total of 758.4 person-months of follow-up were available. The mortality rate was 16.9 per 100 person-months (95%CI: 14.1-20.1). The median survival time among CCA patients was 4.3 months (95%CI: 3.3-5.1). Cox's proportional hazard model was used to study the independent effects of factors affecting survival time among patients. Statistically significant factors included advanced stage at diagnosis (HR: 2.5, 95%CI: 1.7-3.8), presentation with jaundice (HR: 1.7, 95%CI: 1.1-2.4) or ascites (HR: 2.8, 95%CI: 1.8-4.4), and positive serum carcinoembryonic antigen (HR: 2.3, 95%CI: 1.2-4.3). Patients who had received standard treatment had a better prognosis that those who did not (HR: 0.5, 95%CI: 0.3-0.7).
Purpose:To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials:From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range:40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median:70.8Gy). Results:Median follow-up time was 39.4 months(range:8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion:Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.
Objective: To explore the clinical application of recombinant human endostatin (Endostar) in the treatment of patients with non-small cell lung cancer (NSCLC) in Chinese mainland. Materials and Methods: A total of 75 patients diagnosed as NSCLC were randomly divided into control group (37 cases) and treatment group (38 cases). Control group was treated with postoperative complementary chemotherapy containing two-agent platinum protocol on postoperative d21, 3 weeks as a cycle, for totally 4~6 cycles. On this basis, treatment group was added with Endostar $7.5mg/m^2$ on postoperative d8~9, 3~4 h/time, qd, 14 weeks as a cycle, for totally 4 cycles. The interval between every two cycles was 7 d. The 5-year progression-free survival (PFS), 5-year survival time and complications in both groups were observed. Results: Compared with control group, the average PFS increased evidently in treatment group by 9.8 months (41.6 months vs. 31.8 months), and there was significant difference (P<0.05). And the median PFS was 42.5 months in treatment group, obviously longer than that in control group (33.7 months) by 8.8 months (P<0.05). Additionally, the 5-year overall survival rate (OS), average survival time and median survival time (MST) were 47.4%, 50.1 months and 59.3 months in treatment group, significantly higher than the 29.7%, 42.1 months and 43.5 months in control group (P<0.05). Only 1 patient showed poor healing of surgical wound in treatment group, but no surgery-associated complication was found in control group. Moreover, the postoperative complementary therapy-connected complication rates were 63.2% (24/38) and 59.5% (22/37) in treatment group and control group respectively, but there was no significant difference (P>0.05). Conclusions: The application of Endostar combined with sensitive platinum-contained chemotherapeutic agents in the postoperative complementary chemotherapy can be widely used in clinic because it can significantly prolong the long-term survival time of patients with NSCLC.
Kim, Young-Woo;Park, Neung-Hwa;Ji, Sang-Keun;Choi, Hyun-Muck;Lee, Sin-Hwa;Lee, Keum-Hee;Jang, Tae-Won;Jung, Maan-Hong
Tuberculosis and Respiratory Diseases
/
v.42
no.1
/
pp.76-83
/
1995
Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.
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