• Title/Summary/Keyword: palliative chemotherapy

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Relapsed Wilms' tumor with multiple brain metastasis

  • Akakin, Akin;Yilmaz, Baran;Eksi, Murat Sakir;Yapicier, Ozlem;Kilic, Turker
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.96-98
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    • 2016
  • Wilms' tumor is the most common malignant renal tumor in childhood. The brain metastasis of a Wilms' tumor with anaplastic histopathology is rare. We present the case of an 8-year-old girl with Wilms' tumor, who presented with multiple brain metastases 5 years after her primary diagnosis. The brain masses were diagnosed after a generalized tonic-clonic seizure attack. The big solid mass in the cerebellum was resected, and whole-brain radiotherapy was performed, after which, she succumbed to her disease. In the case of clinical suspicion, cranial surveillance should be included in the routine clinical work-up for Wilms' tumor. Combined aggressive therapy (surgery+radiotherapy+chemotherapy) should be applied whenever possible, for both better survival and palliative aspects.

Surgical Management of Esophageal Carcinoma after Esophageal Prosthesis (인공 식도를 삽입한 식도암 환자의 수술치험 4례)

  • 박승훈
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.90-95
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    • 1995
  • Effective relief of dysphagia in unresectable esophageal cancer patients not only prolong survival but also is prerequisite for other treatment modalities.We tried surgical resection in 4 patients who had unresectable esophageal cancer,managed initially with esophageal prosthesis then followed by chemotherapy with good response. Curative resection was possible in 2 patients and palliative resection in one and exploration only in one case.Curatively resected patients are alive without recurrence for 57 months,8 months,each.Other non-curatively resected patients died after 10 months,7 months. Above results suggest that initial esophageal prosthesis to relieve dysphagia followed by chemotherapy in unresectable esophageal cancer may provide another chances for curative resection that promise better survival and need more clinical experience and trial.

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Current and Future Role of the Gastroenterologist in GI Cancer Management

  • John M. Carethers
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.78-81
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    • 2013
  • With advances in technology, advances in the understanding of biology of cancer, and the advent of improved and novel therapies, the role of the gastroenterologist has been modified greatly over the past 2 decades, and continues to be shaped by the knowledge, skill, and opportunity to capitalize on the unique position that gastroenterologists hold in the patient care continuum. The gastroenterologist is evolving from a "pure" diagnostician to an endoscopic surgeon, a geneticist, a nutritionist, an immunologist and chemotherapist, and palliative care physician.

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A Case of Hepatic and Pulmonary Metastatic Colorectal Cancer Patient Treated by Traditional Korean Therapy and XELOX Chemotherapy (한방치료와 XELOX 요법을 병행하여 호전된 간, 폐 전이 대장암 환자 1례)

  • Im, Chang-Rak;Kwon, Kang;Sur, Young-Chan;Bang, Sun-Hwi;Kim, Sung-Su;Seong, Shin
    • Journal of Korean Traditional Oncology
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    • v.17 no.1
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    • pp.17-25
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    • 2012
  • Objective : This report is aimed to investigate the effectiveness of traditional korean therapy including intravenous Cultivated Wild Ginseng Pharmacopuncture (CWGP) and Soram immunopharmacopuncture with XELOX chemotherapy in treating metastatic colorectal cancer patient. Methods : A 47-year-old woman who was diagnosed as metastatic colorectal cancer on Oct 2011 was concurrently treated with traditional Korean therapy (TKT) and XELOX (capecitabine plus oxaliplatin) for 7 months. TKT includes intravenous CWGP, Soram immuno-pharmacopuncture, acupuncture, moxibustion, and herbal medicine. The effectiveness of therapies was evaluated with computed tomography and tumor marker levels such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). And pain on the lateral abdomen was recorded with Visual Analogue Scale (VAS). Results : The tumor mass size of metastatic liver was decreased from 10 cm to 4.3 cm. The tumor marker levels such as CEA and CA19-9 are also decreased. From these results, this case report suggests that the TKT with palliative chemotherapy may be a useful method to treat unresectable metastatic colorectal cancer.

Advances in the Management of Unresectable or Metastatic Pancreatic Neuroendocrine Tumors: Chemotherapy, Targeted Therapy, Hormonal Treatment, and Future Directions

  • Bilici, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2151-2159
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    • 2015
  • Pancreatic neuroendocrine tumors (pNETs) are rare and heterogenous tumors and surgery to remove the primary tumor is the mainstay of treatment for resectable disease. However, curative surgery is often not feasible, because half of patients with pNET have metastases at the time of diagnosis. Palliative dubulking surgery and liver-directed therapies are appropriate options for these patients. Streptozocin-based regimens are standard, although temozolamide-based treatments are rapidly gaining wide clinical application. Somatostatin analogs are mainly indicated in hormonally active tumors to ameliorate symptoms. In addition, anti-tumoral activity has been proven in well-differentiated NETs. Recently, there has been tremendous progress in the molecular biology of pNETs; thereby, the efficacy of sunitinib and everolimus in the treatment of patients with metastatic pNETs has been proven by large placebo-controlled phase III trials. Currently, there are no definitively proven predictive biomarkers to evaluate response to medical therapies in patients with pNET. Therefore, further studies are needed to individualize and optimize their management. This article reviews systemic chemotherapy, targeted therapies, and anti-secretory treatments for the management of patients with unresectable or metastatic pNETs, summarized in the light of recent advances.

Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist's Perspective

  • Sehhoon Park
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.67-74
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    • 2023
  • Perioperative treatment with conventional cytotoxic chemotherapy for resectable non-small cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now become an essential component of treatment, even as neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery ICB applications have proven clinical efficacy in preventing disease recurrence. In addition, neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy alone. To confirm this, an early signal of OS benefit has been shown in a selected population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment options increases, the variables to be considered for making treatment decisions become more complex. Thus, the role of a multidisciplinary team-based treatment approach has not been fully emphasized. This review presents up-to-date pivotal data that lead to practical changes in managing resectable NSCLC. From the medical oncologist's perspective, it is time to dance with surgeons to decide on the sequence of systemic treatment, particularly the ICB-based approach, accompanying surgery for operable NSCLC.

Development and Evaluation of "Hospice Smart Patient" Service Program ("호스피스 스마트 환자" 서비스 프로그램 개발 및 평가)

  • Park, Chai-Soon;Yoo, Yang-Sook;Choi, Dong-Won;Park, Hyun-Jeong;Kim, Ji-In
    • Journal of Korean Academy of Nursing
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    • v.41 no.1
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    • pp.9-17
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    • 2011
  • Purpose: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. Methods: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. Results: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. Conclusion: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

Extrapulmonary Small Cell Carcinoma - a Case Series of Oropharyngeal and Esophageal Primary Sites Treated with Chemo-Radiotherapy

  • Sahai, Puja;Baghmar, Saphalta;Nath, Devajit;Arora, Saurabh;Bhasker, Suman;Gogia, Ajay;Sikka, Kapil;Kumar, Rakesh;Chander, Subhash
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7025-7029
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    • 2015
  • Background: The optimal sequence and extent of multimodality therapy remains to be defined for extrapulmonary small cell carcinoma because of its rarity. The purpose of our study was to assess the response to neoadjuvant chemotherapy followed by chemoradiation/radiation in patients with extrapulmonary small cell carcinoma. Materials and Methods: Four consecutively diagnosed patients were included in this study. The primary tumor site was oropharynx in three patients and esophagus in one. The patients with the limited disease were treated with chemotherapy followed by concurrent chemoradiation (n=2) or radiotherapy (n=1). The patient with the extensive disease with the primary site in vallecula was treated with chemotherapy and palliative radiotherapy to the metastatic site. Results: The median follow-up was 22.5 months (range, 8-24 months). Three patients with the limited disease (base of tongue, n=2; esophagus, n=1) were in complete remission. The patient with the extensive disease died of loco-regional tumor progression at 8 months from the time of diagnosis. Conclusions: The combination of chemotherapy and radiotherapy is the preferred therapeutic approach for patients with extrapulmonary small cell carcinoma. Induction chemotherapy followed by concurrent chemoradiation or radiation provides a good loco-regional control in patients with limited disease.

Prognostic Factors in First-Line Chemotherapy Treated Metastatic Gastric Cancer Patients: A Retrospective Study

  • Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Guven, Mehmet;Nas, Necip;Yunce, Muharrem;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3869-3872
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    • 2012
  • Background: The majority of patients with gastric cancer in developing countries present with advanced disease. Systemic chemotherapy therefore has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyze prognostic factors for survival in advanced gastric cancer patients undergoing first-line palliative chemotherapy. Methods: We retrospectively reviewed 107 locally advanced or metastatic gastric cancer patients who were treated with docetaxel and cisplatin plus fluorouracil (DCF) as first-line treatment between June 2007 and August 2011. Twenty-eight potential prognostic variables were chosen for univariate and multivariate analyses. Results: Among the 28 variables of univariate analysis, nine variables were identified to have prognostic significance: performance status, histology, location of primary tumor, lung metastasis, peritoneum metastasis, ascites, hemoglobin, albumin, weight loss and bone metastasis. Multivariate analysis by Cox proportional hazard model, including nine prognostic significance factors evident in univariate analysis, revealed weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level to be independent variables. Conclusion: Performance status, weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level were identified as important prognostic factors in advanced gastric cancer patients. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

A Case of Long Term Survival of Gastric Cancer on Trastuzumab Based Treatment (Trastuzumab으로 장기 생존한 진행성 위암 증례 1예)

  • Jihye Park;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.39-41
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    • 2015
  • We report a case of long term survival on trastuzumab based treatment. A 51-year-old man with dyspepsia received esophagogastroduodenoscopy on another hospital and was transferred for further evaluation under the impression of advanced gastric cancer, Borrmann type III, antrum, lesser curvature. After further studies in our hospital, the patient was diagnosed with advanced gastric cancer, adenocarcinoma, moderately differentiated with pancreas invasion and lymph node metastasis. Though he was recommended with chemotherapy, he refused and left for oriental herbal medicine. After 4 months, the patient was admitted through emergency room for hematemesis. Diagnosed with gastric outlet obstruction due to gastric cancer in the antrum, he underwent the placement of pyloric metal stent insertion. Immunohistochemical staining showed HER2-positive finding, and he was treated with palliative chemotherapy of trastuzumab, capecitabine, and cisplatin, 16 times during 11 months. The patient showed neutropenia after the therapy, so cisplatin was left out, and he received combination chemotherapy of trastuzumab and capecitabine, 34 times during 25 months. Response evaluation showed no remarkable change in extent of primary stomach cancer, lymph node metastasis, and regression of metastasis site, and the patient is continuing chemotherapy.

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