• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6585-6590
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• 2013

Background: Although FOLFOX (infusional fluorouracil/leucovorin plus oxaliplatin) is established as a standard chemotherapeutic regimen, the long term efficacy of adjuvant XELOX (oral capecitabine plus intravenous oxaliplatin) in Asian colorectal cancer (CRC) patients remains anecdotal. Moreover, uncertainties persist as to whether pharmacogenetic differences in Asian populations preclude equally tolerable and effective administration of these drugs. Method: One hundred consecutive patients with resected colorectal cancer received adjuvant XELOX (oxaliplatin 130 $mg/m^2$ on day 1 plus capecitabine 900 $mg/m^2$ twice daily on day 1 to 14 every 3 weeks for 8 cycles) at Queen Mary Hospital, Hong Kong. Endpoints monitored during follow-up were disease-free survival (DFS) and disease recurrence, overall survival (OS) and adverse events (AEs). Results: The median patient age was 56 years, 56% were diagnosed with rectal cancer and 44% with colonic cancer. After a median follow-up of 4.3 years (95% confidence interval, 3.2-4.7), 24 recurrences were confirmed including 13 patients who died due to progressive disease. Four-year DFS was 81% in colon cancer patients and 67% in rectal cancer patients (p=0.06 by log-rank test). For the cohort as a whole, OS was 90% at 3 years and 84% at 5 years. Treatment-related AEs led to early withdrawal in four patients. The commonest non-hematological AEs were neuropathy (91%), hand-foot syndrome (49%) and diarrhea (46%), while the commonest grade 3/4 AEs were neutropenia (11%) and diarrhea (10%). Conclusion: These results confirm the favourable long term survival benefit with good tolerability in using adjuvant XELOX in treating East Asian colorectal cancer patients.

• 한국환경성돌연변이발암원학회:학술대회논문집
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• 한국환경성돌연변이발암원학회 2004년도 춘계학술대회
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• pp.107-107
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• 2004

• 성인간호학회지
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• 제28권3호
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• pp.343-353
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• 2016

Purpose: This study aimed to identify the levels of oxaliplatin-induced peripheral neuropathy (OXLIPN) and the quality of life (QOL) related to OXLIPN in patients with digestive system cancer. Methods: A total of 83 patients with chemotherapy-induced peripheral neuropathy (CIPN)-related symptoms participated in this study. Data were collected through self-reported questionnaire which were constructed to include general and clinical characteristics, EORTC QLQ-C30, Patient Neurotoxicity Questionnaire (PNQ), and EORTC QLQ-CIPN20. Results: The average scores of OXLIPN upper and lower extremity scale were 30.01 and 29.16, respectively. The average scores of PNQ sensory and motor scale were 2.11 and 1.70, respectively. The mean score of the QLQ-C30 global health status was 54.85, and the range of mean score of the functional and symptom subdomains was 34.85~73.29 and 17.67~53.54, respectively. The CIPN-related symptoms positively correlated with the global health status scale and all subdomains of functional scale, respectively and negatively correlated with fatigue, pain, dyspnea, insomnia, and financial problem subdomains of the symptom scale, respectively. Conclusion: Oncology nurses should pay attention and provide remedies for CIPN symptoms reported by their patients. Nursing interventions should be developed for patients with digestive system cancer to alleviate CIPN and enhance their QOL.

• Tuberculosis and Respiratory Diseases
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• 제75권3호
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• pp.111-115
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• 2013

Although the relationship between malignancy risk with systemic sclerosis (SSc) has been inconclusive, there are some previous studies for a positive correlation. Most patients with SSc have some degree of lung parenchymal involvement in the form of interstitial thickening and fibrosis. Interstitial lung disease is the most common pulmonary manifestation of SSc. Interstitial lung disease following chemotherapy (5-fluorouracil, leucovorin, and oxaliplatin [FOLFOX]) is an uncommon life-threatening complication and it is induced by oxaliplatin. We report a case of multiple cancers in a patient with SSc and aggravated interstitial lung disease by chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2191-2194
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• 2014

Background: Fluorouracil-based regimens have been widely accepted and recommended in the guidelines for treating patients with early or advanced staged colon cancer, although results are controversial. Here we performed a systemic analysis to evaluate the impact of S-1 based regimens on response and survival of patients with colon cancer. Methods: Clinical studies evaluating the impact of S-1 based regimens on response and survival of patients with colon cancer were identified using a predefined search strategy. Summary response rates (RRs) to treatment were calculated. Results: Six clinical studies which including 227 patients with advanced colorectal cancer were considered eligible for inclusion. Two studies were conducted using combination of S-1 and Oxaliplatin, and four studies featured S-1 and irinotecan. Systemic analysis showed that, in all patients, pooled RRs was 43.17%. Major adverse effects were hematological toxicities, gastrointestinal disturbance, neurosensory toxicity. No treatment related death occurred. Conclusion: This systemic analysis suggests that S-1 based regimens, both with oxaliplatin or irinotean are associated with acceptable response and toxicity in patients with colon cancer.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.60-63
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• 2011

Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.

• Journal of Gastric Cancer
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• 제23권2호
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• pp.315-327
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• 2023

Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. Materials and Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020). Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2355-2359
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• 2015

Background: Combination chemotherapy of 5 fluorouracil (5-FU) and leucovorin (LV) with oxaliplatin, mainly FOLFOX regimens, has shown considerable antitumor activity and a tolerable toxicity profile in gastric cancer. The goal of this study was to retrospectively compare the efficacy and toxicity of modified FOLFOX-6 (mFOLFOX6) regimen in advanced gastric cancer (AGC) patients with good and poor performance status (PS). Materials and Methods: AGC patients receiving the mFOLFOX6 regimen including oxaliplatin $85mg/m^2$, bolus of 5-FU $400mg/m^2$ and LV $400mg/m^2$ on the first day, followed by $2400mg/m^2$ of 5- FU as a continious infusion over 46 hour for first-line treatment were eligible for the study. Results: A total 58 patients with a median age of 59.5 (32-81) were included. The median follow up of the study was 9.2 months. Thirty patients (51.7%) with an ECOG PS 0-1 were assigned to the good PS arm, while 28 patients (48.3%) with ECOG PS 2 were in the poor PS arm. Overall response rates were 36.6 and 28.8%, respectively (p=0.91). Median PFS was 6.7 and 6.3 months in good PS and poor PS arms (p=0.50) and median OS was 9.6 and 10.4 months (p=0.55). As compared with good PS arm, poor PS arm was associated with more grade 3-4 neutropenia and anemia. Dose reduction and dose delays were also significantly higher. Conclusions: In this study, mFOLFOX6 was similarly effective in both arms. Although hematologic toxicity was significantly higher in patients with poor PS, it remained manageable. Our results suggest that this regimen may be an effective treatment option for AGC patients with poor PS.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.160-166
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• 2007

목적: 진행성위암의 경우 근치적 수술 후 보조항암요법에도 불구하고 5년 생존율이 그리 높지 않은 것으로 보고되고 있다. 이에 항암제 감수성 검사를 기초로 한 항암요법은 최소한 환자들에게 효과가 없는 약제 투여를 막을 수 있는 기회를 제공할 수 있다는 측면에서는 고무적이라 할 수 있다. 본 연구에서는 보조항암요법의 효과를 높이기 위한 유효약제 선정을 위하여 항암제 감수성검사를 실시하였으며 그 결과를 분석하여 항암제 선택에 이용하고자 임상병리학적 요인에 따른 항암제 감수성을 비교하였다. 대상 및 방법: 2005년 8월부터 2006년 8월까지 영남대학교 병원 외과에서 위절제술을 받은 위암환자 81명의 위암절제조직을 이용하여 항암제 감수성 검사를 실시하였다. 검사방법은 ATP (Adenosine Triphosphate) based chemotherapy response assay였다. 항암제 감수성과 임상병리학적 요인과의 상관관계를 보기 위하여 성별, 연령, 종양표지자(CEA 치, CA19-9 치), 암의 위치, 진행암 형태, 조직학적 형태, 분화 유무, 침윤도, Lauren 분류, Ming 분류, 림프관 침윤 유무, 맥관 침윤 유무, 신경 침윤 유무, 림프절 전이 유무, 병리학적 병기를 선정 비교하였다. 결과: 위암 환자를 대상으로 한 항암제 감수성 순위를 보면 5-FU, Epirubicin, Irinotecan, Oxaliplatin 순이었으며 통계학적으로 유의했다(P=0.000). 성별, 연령, 종양표지자(CEA 치, CA19-9치), 암의 위치, 진행암 형태, 조직학적 형태, 분화 유무, 침윤도, Lauren 분류, Ming 분류, 림프관 침윤 유무, 맥관 침윤 유무, 신경 침윤 유무, 림프절 전이 유무, 병리학적 병기 모두에서 유의하게 감수성의 차이를 보였다. 결론: 위암절제조직에서 시행한 항암제 감수성 순위는 5-FU, Epirubicin, Irinotecan, Oxaliplatin의 순이었으며 위절제술을 받은 위암환자의 절제조직을 이용 항암제 감수성검사를 시행한 결과 약제별 임상병리학적 인자에 따라 감수성의 차이가 있으므로 획일적인 항암화학요법을 실시하는 것보다 항암제 감수성 검사를 통하여 감수성 높은 약제들을 조합하여 사용하는 것이 바람직할 것으로 보인다.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.408-416
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• 2019

Purpose: To study the efficacy of capecitabine or S-1 plus oxaliplatin (CAPOX or SOX) for treating thymidine phosphorylase (TP)- or dihydropyrimidine dehydrogenase (DPD)-positive advanced gastric cancer. Materials and Methods: Eighty-six patients with stage IIIC to IV gastric cancer were assessed for TP and DPD expression by immunohistochemistry. The association between CAPOX or SOX efficacy and TP/DPD expression was retrospectively analyzed. Results: There were no significant differences in the objective remission rate (ORR, 52.27% vs. 47.62%; P>0.05), disease control rate (72.73% vs. 73.81%, P>0.05), progression-free survival (hazard ratio [HR], 1.119; 95% confidence interval [CI], 0.739-1.741; P=0.586), and overall survival (OS; HR, 0.855; 95% CI, 0.481-1.511; P=0.588) between CAPOX and SOX. A higher number of stage IV patients showed TP positivity, while DPD-positive patients predominantly showed intestinal type of gastric cancer. In TP-positive patients, the ORRs associated with CAPOX and SOX treatments were 57.14% and 38.10%, respectively; OS was better with CAPOX than with SOX (HR, 0.447; 95% CI, 0.179-0.978; P=0.046). Among DPD-positive patients, the SOX treatment-associated ORR (60.87%) was significantly higher than the CAPOX treatment-associated ORR (43.48%). Furthermore, SOX treatment resulted in better OS than did CAPOX treatment (HR, 2.020; 95% CI, 1.019-4.837; P=0.049). Conclusions: No significant difference in clinical efficacy was found between CAPOX and SOX. TP-positive patients might respond better to CAPOX while DPD-positive patients may respond better to SOX. Our findings might serve as a guide for personalized chemotherapy for gastric cancer.