• Title/Summary/Keyword: pathological response

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Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: preliminary results of a randomized controlled trial

  • Aghili, Mahdi;Khalili, Nastaran;Khalili, Neda;Babaei, Mohammad;Farhan, Farshid;Haddad, Peiman;Salarvand, Samaneh;Keshvari, Amir;Fazeli, Mohammad Sadegh;Mohammadi, Negin;Ghalehtaki, Reza
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.119-128
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    • 2020
  • Purpose: Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients. Materials and Methods: In this clinical trial we recruited patients with rectal adenocarcinoma located from 5 cm to 15 cm above the anal verge. Patients in group I (short-course) received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/㎡ from day 1-5 twice daily and oxaliplatin 50 mg/㎡ on day 1 once daily). Patients in group II (long-course) received a total dose of 50-50.4 Gy/25-28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/㎡ twice daily. Both groups underwent consolidation chemotherapy followed by delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade. Results: In this preliminary report on complications and pathological response, 66 patients were randomized into two study groups. Mean duration of radiotherapy in the group II (long-course) was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the shortcourse and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group except one grade 4 hematologic toxicity that was seen in group II. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333). Conclusion: For patients with rectal cancer located at least 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.

Treatment outcomes of neoadjuvant concurrent chemoradiotherapy followed by esophagectomy for patients with esophageal cancer

  • Kim, Yong-Hyub;Song, Sang-Yun;Shim, Hyun-Jeong;Chung, Woong-Ki;Ahn, Sung-Ja;Yoon, Mee Sun;Jeong, Jae-Uk;Song, Ju-Young;Nam, Taek-Keun
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.12-20
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    • 2015
  • Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

Study of Korean Medicine's Pathological Symptoms and Health-Related Quality of Life among Normal, Overweight, and Obese Groups from Multi-Center Case Report (다기관 증례 수집을 통한 정상, 과체중, 비만군에서의 한의 병증 및 건강과 관련된 삶의 질에 대한 연구)

  • Lee, Jaechul;Dong, Sang Oak;Lee, Siwoo
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.1
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    • pp.10-16
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    • 2013
  • Objectives: This work aimed to investigate differentiations of Korean medicine's pathological symptoms and SF-12 sub scales among normal, overweight and obese subjects from multi-center case report. Methods: From 2009 to 2011 survey were carried out to 1,589 subjects who took treatment or were hospitalized in 7 Korean medicine hospitals and 3 Korean medicine clinic. Survey include Korean medicine's pathological symptoms and SF-12. Whole survey were obtained from subjects with interviewers. Obesity degree was divided into three groups by body mass index: Normal group is from 18.5 below 23, overweight from 23 below 25 and obese group is over 25. Chi-square test was performed to reveal differentiation response rate of pathologic symptoms among obesity groups. ANOVA test was carried out for compare each group's SF-12 sub scales. Results: Patients of overweight or obesity have more symptoms such as skin itching, swelling, weakness in lower legs, and feverish with swollen joints. Contrary, normal weight group responded symptoms of dry skin more than those of obese group. As a fatigue, obese group have more fatigue feeling at afternoon and evening, compared to high frequency response of normal weight groups' morning fatigue. Obese groups shows low physical scores of health related quality of life, in contrast, high mental scores of that. Conclusions: This is first work of pathologic symptoms shown by obese groups. This would contribute to standardization of Korean medicine's pattern identification as suggestion of classification point for obese groups.

Significance of ABO-Rh Blood Groups in Response and Prognosis in Breast Cancer Patients Treated with Radiotherapy and Chemotherapy

  • Cihan, Yasemin Benderli
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.4055-4060
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    • 2014
  • Background: To evaluate whether ABO-Rh blood groups have significance in the treatment response and prognosis in patients with non-metastatic breast cancer. Materials and Methods: We retrospectively evaluated files of 335 patients with breast cancer who were treated between 2005 and 2010. Demographic data, clinic-pathological findings, treatments employed, treatment response, and overall and disease-free survivals were reviewed. Relationships between clinic-pathological findings and blood groups were evaluated. Results: 329 women and 6 men were included to the study. Mean age at diagnosis was 55.2 years (range: 26-86). Of the cases, 95% received chemotherapy while 70% were given radiotherapy and 60.9% adjuvant hormone therapy after surgery. Some 63.0% were A blood group, 17.6% O, 14.3% B and 5.1% AB. In addition, 82.0% of the cases were Rh-positive. Mean follow-up was 24.5 months. Median overall and progression-free survival times were 83.9 and 79.5 months, respectively. Overall and disease-free survival times were found to be higher in patients with A and O blood groups (p<0.05). However rates did not differ with the Rh-positive group (p=0.226). In univariate and multivariate analyses, ABO blood groups were identified as factors that had significant effects on overall and disease-survival times (p=0.011 and p=0.002). Conclusions: It was seen that overall and disease-free survival times were higher in breast cancer patients with A and O blood groups when compared to those with other blood groups. It was seen that A and O blood groups had good prognostic value in patients with breast cancer.

Immunosignature: Serum Antibody Profiling for Cancer Diagnostics

  • Chapoval, Andrei I;Legutki, J Bart;Stafford, Philip;Trebukhov, Andrey V;Johnston, Stephen A;Shoikhet, Yakov N;Lazarev, Alexander F
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4833-4837
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    • 2015
  • Biomarkers for preclinical diagnosis of cancer are valuable tools for detection of malignant tumors at early stages in groups at risk and screening healthy people, as well as monitoring disease recurrence after treatment of cancer. However the complexity of the body's response to the pathological processes makes it virtually impossible to evaluate this response to the development of the disease using a single biomarker that is present in the serum at low concentrations. An alternative approach to standard biomarker analysis is called immunosignature. Instead of going after biomarkers themselves this approach rely on the analysis of the humoral immune response to molecular changes associated with the development of pathological processes. It is known that antibodies are produced in response to proteins expressed during cancer development. Accordingly, the changes in antibody repertoire associated with tumor growth can serve as biomarkers of cancer. Immunosignature is a highly sensitive method for antibody repertoire analysis utilizing high density peptide microarrays. In the present review we discuss modern methods for antibody detection, as well as describe the principles and applications of immunosignature in research and clinical practice.

Locally Advanced Breast Cancer in Jamaica: Prevalence, Disease Characteristics and Response to Preoperative Therapy

  • Chin, Sheray Nicole;Green, Cheryl May Antoinette;Gordon-Strachan, Georgiana Marie;Wharfe, Gilian Helen Frances
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3323-3326
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    • 2014
  • Breast cancer is the most common cancer in Jamaican women. Locally advanced breast cancer (LABC) is associated with aggressive biology and poor prognosis, and has a predilection for African-American women. In this retrospective review, we assessed the prevalence of LABC as a breast cancer presentation in a population of mainly Afro-centric ethnicity, and determined disease characteristics and response to pre-operative chemotherapy. LABC was prevalent (20%), and had a low pathological response rate to pre-operative chemotherapy, with a high risk of disease recurrence. Increased utilization of breast cancer screening may help detect cancer at less advanced stages, and optimizing pre-operative chemotherapy is recommended to improve response rates and ultimately survival.

Changes in Automated Mammographic Breast Density Can Predict Pathological Response After Neoadjuvant Chemotherapy in Breast Cancer

  • Jee Hyun Ahn;Jieon Go;Suk Jun Lee;Jee Ye Kim;Hyung Seok Park;Seung Il Kim;Byeong-Woo Park;Vivian Youngjean Park;Jung Hyun Yoon;Min Jung Kim;Seho Park
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.384-394
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    • 2023
  • Objective: Mammographic density is an independent risk factor for breast cancer that can change after neoadjuvant chemotherapy (NCT). This study aimed to evaluate percent changes in volumetric breast density (ΔVbd%) before and after NCT measured automatically and determine its value as a predictive marker of pathological response to NCT. Materials and Methods: A total of 357 patients with breast cancer treated between January 2014 and December 2016 were included. An automated volumetric breast density (Vbd) measurement method was used to calculate Vbd on mammography before and after NCT. Patients were divided into three groups according to ΔVbd%, calculated as follows: Vbd (post-NCT - pre-NCT)/pre-NCT Vbd × 100 (%). The stable, decreased, and increased groups were defined as -20% ≤ ΔVbd% ≤ 20%, ΔVbd% < -20%, and ΔVbd% > 20%, respectively. Pathological complete response (pCR) was considered to be achieved after NCT if there was no evidence of invasive carcinoma in the breast or metastatic tumors in the axillary and regional lymph nodes on surgical pathology. The association between ΔVbd% grouping and pCR was analyzed using univariable and multivariable logistic regression analyses. Results: The interval between the pre-NCT and post-NCT mammograms ranged from 79 to 250 days (median, 170 days). In the multivariable analysis, ΔVbd% grouping (odds ratio for pCR of 0.420 [95% confidence interval, 0.195-0.905; P = 0.027] for the decreased group compared with the stable group), N stage at diagnosis, histologic grade, and breast cancer subtype were significantly associated with pCR. This tendency was more evident in the luminal B-like and triple-negative subtypes. Conclusion: ΔVbd% was associated with pCR in breast cancer after NCT, with the decreased group showing a lower rate of pCR than the stable group. Automated measurement of ΔVbd% may help predict the NCT response and prognosis in breast cancer.

Feasibility Study for the Development of a Device for Detecting Pathological Tissues (병리학적 조직 진단장치 개발에 대한 타당성 분석 연구)

  • Ko, Chea-Ok;Park, Min-Young;Pack, Jeong-Ki
    • Proceedings of the Korea Electromagnetic Engineering Society Conference
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    • 2005.11a
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    • pp.421-424
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    • 2005
  • X-ray is currently most effective method in detecting small malignant breast tumors but has the several problems due to suppressing breast, ionizing radiation and not detecting small cancer. In this paper, a new method is proposed by using dielectric characteristics of pathological tissues and time delay of backscattered response. We have developed a detection algorithm and verified it by numerical simulation and measurement for a prototype system. For a prototype system, we have fabricated experimental model(artificial breast with a cancer) and UWB(ultra-wideband) antenna. The results of the measurement simulation show an excellent detection capability of a cancer tissue. It is found that a good UWB antenna is a key element of such detection system. Further study is ongoing to develop a commercial system.

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Classification of Pathological Voice from ARS using Neural Network (신경회로망을 이용한 ARS 장애음성의 식별에 관한 연구)

  • Jo, C.W.;Kim, K.I.;Kim, D.H.;Kwon, S.B.;Kim, K.R.;Kim, Y.J.;Jun, K.R.;Wang, S.G.
    • Speech Sciences
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    • v.8 no.2
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    • pp.61-71
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    • 2001
  • Speech material, which is collected from ARS(Automatic Response System), was analyzed and classified into disease and non-disease state. The material include 11 different kinds of diseases. Along with ARS speech, DAT(Digital Audio Tape) speech is collected in parallel to give the bench mark. To analyze speech material, analysis tools, which is developed local laboratory, are used to provide an improved and robust performance to the obtained parameters. To classify speech into disease and non-disease class, multi-layered neural network was used. Three different combinations of 3, 6, 12 parameters are tested to obtain the proper network size and to find the best performance. From the experiment, the classification rate of 92.5% was obtained.

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