• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2793-2796
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• 2014

Background: Glioblastoma multiform (GBM) is a highly aggressive tumor with median survival of approximately 14 months. Management consists of maximal surgical resection followed by post-operative chemoradiation with concurrent then adjuvant temozolamide. The standard radiotherapy dose is 60Gy in 2-Gy fractions recommended by the radiation therapy oncology group (RTOG). With the vast majority of tumor recurrences occurring within the previous irradiation field and the poor outcome associated with standard therapy, regimens designed to deliver higher radiation doses to improve local control and enhance survival are needed. In this study, we report a single institutional experience in treatment of 68 consecutive patients with GBM, treated with resection, and given post-operative radiotherapy followed by concurrent and/or adjuvant chemotherapy. Results: Of the 80 patients who entered this study, 68 completed the treatment course; 45 (66.2%) males and 23 (33.8%) females with a mean age at diagnosis of $49.0{\pm}12.9$ (21-75) years. At a median follow up of 19 months, 39 (57.3%) patients had evidence of tumor progression and 36 (52.9%) had died. The median over all survival for all patients was 16 months and progression free survival for all patients was 6.02 months. All potential prognostic factors were analyzed to evaluate their effects on overall survival. Age ${\leq}50$ year, concurrent and adjuvant chemotherapy and extent of surgery had significant p values. We found lower progression rate among patients who received higher doses of radiotherapy (>60Gy). Higher radiation doses improved progression free survival (p=0.03). Despite increasing overall survival, this elevation was not significant. Conclusions: This study emphasize that higher radiation doses of (>60Gy) can improve local control and potentially survival, so we strongly advise prospective multi centric studies to evaluate the role of higher doses of radiotherapy on GBM patient outcome.

• Radiation Oncology Journal
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• v.8 no.2
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• pp.261-267
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• 1990

Twenty patients with biopsy-proven Waldeyer's ring lymphoma were treated with radiotherpy between 1984 and 1990 at the Department of Radiation Therapy, Inje University Paik Hospital and seventeen evaluable patients were analysed retrospectively. Dose of radiation ranged from 35 to 50 Gy to Waldeyer's ring structure with an additional 5 and 10 Gy boost dose to the primary site. The lower cervical nodes received 35 to 60 Gy. The median follow-up period was 24 months (range;9 to 80 months). The 5-year overall survival rate was $50.2{\%}$ and 5-year disease free survival rate was $47.1{\%}$. The final local control rate was $82.4{\%}$. The relapse developed average 10 months after treatment. Most of relapses were systemic ($87.5{\%}$). The patients with stage I disease fared better than advance stage. The favorable histology of lymphoma showed better prognosis than unfavorable histology. There was no significant difference in survival rate between radiotherapy alone and combination of chemotherapy and radiotherapy in early stage lymphomas. But of the patients with advanced stage, those who received chemotherapy and radiotherapy had better prognosis than those treated with radiotherapy alone.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4133-4136
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• 2012

Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.215-219
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• 1991

To evaluate the effect of MVP chemotherapy and hyperfractionated radiotherapy in Stage III unresectable non small cell lung cancer (NSCLC), authors have conducted a prospective randomized study since January 1991, Stage IIIa or IIIb unresectable NSCLC patients were treated with hyperfractionated radiotherapy (120 cGy/fx BID) up to 6500 cGy following 3 cycles of induction MVP (Mitomycin C 6 mg/$m^2$, Vinblastine 6 mg/$m^2$, Cisplatin 60 mg/$m^2$) and randomized for either observation or 3 cycles of maintenance MVP chemotherapy. Until August 1991, 18 patients were registered to this study. 4 cases were stage IIIa and 14 were stage IIIb. Among 18 cases 2 were lost after 2 cycles of chemotherapy, and 46 were analyzed for this preliminary report. The response rate of induction chemotherapy was $62.5\%$ : partial response, $50\%$ and minimal response, $12.5\%$. Residual tumor of the one partial responder was completely disappeared after radiotherapy. Among 6 cases who were progressed during induction chemotherapy, 4 of them were also progressed after radiotherapy. All patients were tolerated BID radiotherapy without definite increase of acute complications, compared with conventional radiotherapy group. But at the time of this report, one patient expired in two month after the completion of the radiotherapy because of treatment related complication. Although the longer follow up is needed, authors are encouraged with higher response rate and acceptable toxicity of this treatment. Authors believe that this study is worthwhile to continue.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.305-312
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• 2018

We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3253-3258
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• 2012

Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.647-652
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• 2015

Background: Lung cancer was one of the most common cancers in both men and women all over the world. In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods: We enrolled 186 patients with stage IV NSCLC after long term chemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age, gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastatic sites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multiple therapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) were selected. For consideration of factors influencing survival and response for patients with advanced NSCLC, logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening module for patients with elevated survival after long term chemotherapy become possible. Results: Of the total of 186 patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3 years (long-term group). For logistic regression analysis, the short-term group was taken as control group and the long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lung and liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronic bronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Cox regression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g. targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastatic site (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC. Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associated with long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logistic regression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associated with long-term survival. Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLC who had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. more than third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.71-95
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• 1995

To be helpful to the treatment of pulmonary cancer with oriental medicine, we got clinical reports together and analyzed the data. The results were obtained as follows: 1. The treating methods could be summarized as three methods that were reinforcing vital energy, eliminating harmful Qi, and reinforcing vital energy with eliminating harmful Qi. The methods of reinforcing vital energy were supplementing Qi & Yin, increasing pahological heat & reinforcing kidney, augmenting Qi & blood, supplementing vital energy and strengthening fundermental energy, reinforcing spleen and increasing Qi, lubricate Yin and lung, and the other methods of eliminating harmful Qi were transforming pathological fluid and softening, clarifying heat and eliminating poison, dipersing lung and softening, toxicding and softening, guiding Qi and activating blood, clarifying heat and dispersing lung, guiding Qi and counteracting stress etc., and the methods of supplementing vital energy with eliminating poison were reinforcing spleen and transforming pathological fluid, increasing Qi and activating blood, supplementing Yin and clarifying heat, reinforcing spleen and dry the dampness, lubricating lung and transforming patholigical fluid and supplementing Qi and activating blood. 2. The oriental prescriptions used for pulmonary cancer were Chunkeum-Weekyungtang & Sohamhwingtang, Jinhayookgunjatang, Hyulboochukeotang, Bokbangkyogonamtang was reported to be effective in the treatment of metastasis. 3. Bokbangshinjingtang and haewool were applied for the complications of pulmonary cancer, Soshihotang for fever, hangamryung for tumor pain. Prunus ansu Komarov, Eriobotrya japonica Lirdley, Pyrrosiae lingua Farwel, Steomon japonica Miguel, Maximowiczia chinensis Ruprecht var, Morus bombycis Koidzumi for cough, Panax Pseudo-ginseng Wall. var, Bletilla striata Reichenbach f., Acacia catechu(兒茶) for hemoptysis, Lonicerae flos, Aspongopus chinensis(九香蟲) for chest pain, Cypsum Fibrosum, Gazella gutturosa, Scutellaria baicalensis Georgi, Gypsophila oldhamiana Miquel for fever, Lepidii semen descurainiae semen, Belamcanda chinensis D.C, Gnaphalium affine(佛耳草) for asthma. 4. For the reduction of side effect by chemotherapy and radiotherapy it was known that supplementing Qi was used chiefly for side effect of chemotherapy and augmenting Yin applied to side effect of radiotherapy. 5. The oriental presciptions were suggested for the side effect by chemotherapy and radiotherapy ; Sammaekaek(參麥液), Whaebokwontang(化瘀復元湯), Hwangjungomitang(黃精五味湯), Yukmijihwangtang(六味地黃湯), Hyangsayukgunjatang(香砂六君子湯), Samlyeekulsan for side effect by chemotherapy while Geumgweisingiwhan, Hwanglyentang(黃連湯), Hwanglyenhaedoktang(黃連解毒湯), Yangyeunchungpeitang(養陰淸肺湯), Idongtang(二冬湯), Jayeunkanghwatang(滋陰降火湯) for side effect by radiotherapy.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.161-168
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• 1997

Background: Cancers of the maxillary sinuses are not common and are the most difficult head and neck malignancies in which to make an early diagnosis. Objectives: This reports was conducted to evaluated the efficacy of combination therapy and the relationship between the treatment modalities and their outcome of maxillary sinus cancers. Materials and Methods: We retrospectively analyzed a clinical datas of 46 patients who were treated at the department of Otolaryngology-Head and Neck Surgery. The Catholic University of Korea over 10 years between 1987 and 1996. Results: According to AJCC TNM system, 35 patients presented with $T_4$, 10 with $T_3$, one with T1. Two patients were treated with radiotherapy alone, 4 patients with chemotherapy alone, 17 patients with radiotherapy and chemotherapy, 23 patients with combination of surgery, radiotherapy and chemotherapy. The overall 5 years survival rate for combination therapy group were 57%, but 23 patients treated with the other treatment modalities all died within 2 years except two cases with chemotherapy and radiotherapy or radiotherapy alone. There was a statistical trend for better survival and local control in those patients treated with combination therapy than others(p<0.05). Conclusion: The results of this study suggest that it may be possible to acheive better results with aggressive combination treatment including surgery in advanced cases and to avoid orbital excentration in patients with orbital invasion.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2377-2381
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• 2013

A total of 285 patients with stage Ib2 and IIa2 cervical cancer were categorized into three groups, and received preoperative neoadjuvant chemotherapy combined with vaginal intracavitary irradiation, neoadjuvant chemotherapy alone or radiotherapy, respectively. The effective rate of 70.6 % in group 1 was much higher than 41.4% in group 2 (P=0.000) and 46.9 % in group 3 (P=0.000); The percentage of patients receiving postoperative adjuvant therapy was 44.1% in group 1, much lower than 67.8% in group 2 (P=0.001) and 64.6% in group 3 (P=0.004); The percentage of patients with no postoperative risk factor in group 1 was 52.0%, much higher than 32.2% in group 2 (P=0.006) and 35.4% in group 3 (P=0.019); The occurrence rate of surgery-related complications in groups 1, 2 and 3 were 29.4%, 28.7%, and 33.3%, respectively, with no statistical differences among the groups (P=0.981). Regarding preoperative neoadjuvant complications, none were obvious in group 3, while occurrence rates of myelosuppression in groups 1 and 2 were 89.1% and 86.6%, of nausea and vomitting were 78.4% and 78.2%, but without significant differences (all P>0.05). Among 166 patients who received postoperative adjuvant therapy in the three groups, the occurrence rates were: 65.4%, 64.3% and 61.1% respectively for myelosuppression; 42.3%, 38.1%, and 38.9% for nausea and vomiting; 9.6%, 9.5% and 9.7% for urocystitis; and 63.5%, 69.0% and 65.3% enteritis and rectitis. There were no statistically significant differences among them (all P>0.05). The five-year disease-free survival rates (DFS) in groups 1, 2, 3 were 78.3%, 75.1%, 80.9%, respectively; the five-year overall survival rates (OS) were 81.4%, 78.2%, and 81.1%, respectively. The five-year OS of 166 patients receiving postoperative in the three groups were 72.4%, 69.5%, and 71.8%, respectively, with no significant variation (all P>0.05). Although there were no differences among three groups in DFS and OS, preoperative neoadjuvant chemotherapy combined with intracavitary radiotherapy may increase the effective rate and the percentage of patients with no postoperative risk factors and decrease the percentage of patients receiving postoperative adjuvant therapy, thereby decreasing complications indirectly and increasing quality of life.