• Asian Pacific Journal of Cancer Prevention
• /
• 제14권3호
• /
• pp.2009-2012
• /
• 2013

Objective: To investigate the efficacy and safety of Yadanzi$^{(R)}$ (Javanica oil emulsion injection) combined with chemotherapy for treatment of patients with advanced gastric cancer. Methods: From January 2011 to December 2012, we recruited 75 patients with advanced gastric cancer, who received javanica oil emulsion injection together with chemotherapy. After two cycles of treatment, efficacy and safety of the combined therapies were evaluated. Results: Overall response rate of 75 patients after treatment was 85.3% (CR+PR+SD). Treatment related side effects were recorded. No treatment related death occurred. Conclusions: Javanica oil emulsion injection combined with chemotherapy could be considered as a safe and effective regimen in treating patients with advanced gastric cancer. Further randomized clinical trials should be conducted to confirm whether the addition of Yadanzi$^{(R)}$ to chemotheraphy could be associated with reduced toxicity, enhanced tolerability and improved quality of life for patients with advanced gastric cancer.

• Journal of Gastric Cancer
• /
• 제23권2호
• /
• pp.328-339
• /
• 2023

Purpose: This study aimed to evaluate the efficacy and safety of neoadjuvant programmed cell death-1 (PD-1) inhibitors plus apatinib and chemotherapy (PAC) in patients with locally advanced gastric cancer (LAGC). Materials and Methods: Seventy-three patients with resectable LAGC were enrolled and named the PAC group (n=39) or apatinib plus chemotherapy (AC) group (n=34) based on the treatment they chose. Neoadjuvant therapy was administered in a 21-day cycle for 3 consecutive cycles, after which surgery was performed. Results: The PAC group exhibited a higher objective response rate than the AC group (74.4% vs. 58.8%, P=0.159). Moreover, the PAC group showed a numerically better response profile than the AC group (P=0.081). Strikingly, progression-free survival (PFS) (P=0.019) and overall survival (OS) (P=0.049) were prolonged, whereas disease-free survival (DFS) tended to be longer in the PAC group than in the AC group (P=0.056). Briefly, the 3-year PFS, DFS, and OS rates were 76.1%, 76.1%, and 86.7% in the PAC group and 46.9%, 49.9%, and 70.3% in the AC group, respectively. Furthermore, PAC (vs. AC) treatment (hazard ratio=0.286, P=0.034) was independently associated with prolonged PFS in multivariate Cox regression analyses. The incidence of adverse events did not differ between the two groups (all P>0.05), where leukopenia, anemia, hypertension, and other adverse events were commonly observed in the PAC group. Conclusions: Neoadjuvant PAC therapy may achieve a preferable pathological response, delayed progression, and prolonged survival compared to AC therapy with a similar safety profile in patients with LAGC; however, further validation is warranted.

• Journal of Hospice and Palliative Care
• /
• 제4권2호
• /
• pp.130-136
• /
• 2001

Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

• 대한골관절종양학회지
• /
• 제3권1호
• /
• pp.1-8
• /
• 1997

Osteosarcoma is the most common primary bony malignancy and its survivorship has been progressed markedly through refined chemotherapy and surgery. But still there are many non-responders and analysis of prognostic factors may be helpful for them. Two hundred and sixty-six patients were enlisted between Mar, 1985 and Sep. 1994. Among them our inclusion criteria were: 1)primary, nonmetastatic classical osteosarcoma 2)extremity in location 3)no prior treatment at other institute and completed neoadjuvant chemotherapy and surgery according to our protocol. One hundred and eleven cases were eligible. Analyzed factors were:age, sex, location, tumor size, and pathologic response. Statistical methods were log-rank test for univariate and Cox's test for multivariate analysis. Male to female ratio was 69:42 with an average age of 17.2 years. Locations of tumor were distal femur 59, proximal tibia 29, and proximal humerus 8. Tumor size were measured by its maximal diameter and 48 cases were above 10cm and 47 cases were below 10cm. For pathologic response, 57 cases showed more than 90% and 54 cases were less than that. Limb salvage procedure was 101 cases and amputation was 10 cases and their local recurrence rate were 3.6%. Average follow-up period was 24(9-78.2) months and their final status was CDF 86, AWD 8, NED 5, and DOD 12 cases. In univariate study: type of operation(p=0.005), tumor size(p=0.005), and pathologic response(p=0.02) were significant variables. Pathologic response(p=0.03) and type of operation(p=0.01) were meaningful prognostic factors on multivariate analysis. But the latter result was interpreted as a bias, so pathologic response remained as a sole meaningful prognostic factor. More aggressive chemotherapy will be needed to improve the survival.

• Radiation Oncology Journal
• /
• 제9권1호
• /
• pp.59-63
• /
• 1991

1983년에서 1989년까지 가톨릭의대 부속 성모병원 방사선치료실에서 비인강종양으로 확진되어 치료를 시행한 환자 31명중 치료가 불완전했던 환자 8명을 제외한 23명의 치료성적으로 후향조사 하였다. 이들 중 11명의 환자에 있어서는 방사선 단독요법을 시행하였으며, 12명의 환자에소는 cispiatin+5-fluorouracil 혹은 cisplatin-bleomycin-vincristine을 이용하여 1회 내지 3회에 걸친 유도 화학요법후 방사선치료를 시행하였다. 방사선 단독요법으로 치료된 11명의 환자에서 완전 관해율은 55%(6/11), 부분관해율은 45%(5/11)였다. 유도화학요법을 시행한 12명의 환자중 약물 치료후 완전관해율은 25%(3/12)였으며, 부분관해율은 75%(9/12)였고, 연속적으로 시행된 방사선 치료후에는 완전 관해율이 83%(10/12)로 증가되었으며, 부분 관해율은 17%(2/12)였다. 유도 항암요법에 부분관해를 보였던 환자중 stage 111 환자 1명과 stage IV 환자 6명이 추가 방사선 치료후 완전 관해를 보였다. 방사선 단독요법군에서는 4명에 국소재발이 발생했으며,-약물요법과 방사선치료를 병행했던 군에서는 국소재발 3명과 폐로의 원격전이가 1명에서 발생되었다. 방사선단독으로 치료한 환자군과 유도화학요법과 방사선 치료를 병행한 환자군에서의 생존율의 차이가 통계적으로 유의하지 않았다. $28.55{\pm}15$ and $M{\pm}SD=28.588{\pm}25.39$, p>0.05) 치료환자군의 수가 적은 이유로 통계분석 결과 큰 의의를 발견할 수 없었다.

• Journal of Korean Neurosurgical Society
• /
• 제58권1호
• /
• pp.1-8
• /
• 2015

Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

• Radiation Oncology Journal
• /
• 제18권4호
• /
• pp.309-313
• /
• 2000

자궁 평활근육종의 경부림프절로의 전이는 지금까지 보고되지 않았으며 타 부위로의 전이 시에도 방사선치료는 드물게 이용되어왔다. 저자들은 자궁 평활근육종 환자에서 수술과 골반부 방사선치료를 시행 받고 10개월 후에 경부림프절 전이가 발생하여 인접한 후두주위공간, 척추골, 척추관을 함께 침습하였기에 방사선치료와 화학요법의 경험과 함께 보고하는 바이다. 전이된 종양은 수술이 불가능하여 방사선치료가 의뢰되었으며 총 6,000 Gy의 경부 방사선치료와 taxol과 carboplatin으로 화학요법을 시행하였다. 전이 암은 점차로 크기가 감소하여서 거의 만져지지 않을 정도로 되었다. 환자는 경부 방사선치료와 화학요법을 시행 받은 후 8개월간 척수압박증상을 발생하지 않았고, 연하곤란은 회복되어서 좋은 상태를 유지하였다. 광범위한 경부전이 암이 고선량 경부방사선치료와 화학요법에 좋은국소 반응을 보였기에 수술이 불가능한 전이성 평활근육종 환자에서 이 두 가지 치료법이 고려될 수도 있겠다.

• Journal of Gastric Cancer
• /
• 제20권4호
• /
• pp.395-407
• /
• 2020

Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.

• Tuberculosis and Respiratory Diseases
• /
• 제40권4호
• /
• pp.367-377
• /
• 1993

연구배경 : 절제가 불가능한 비소세포 폐암 환자에 대한 복합화학요법의 유용성은 아직도 분명치 않다. 그러나, cisplatin을 주축으로하는 복합화학요법의 반응율은 항암제 단독 투여시의 반응율 보다, 또한 high-dose cisplatin군의 반응율이 low-dose cisplatin군의 반응율보다 높은 것으로 최근 보고되고 있다. 복합화학요법(high VPP), 복합화학요법과 방사선 치료의 병행요법이 진행된 비소세포 폐암에서 생존율을 증가시키는지 알아보기 위해 본 연구를 시작하였다. 방법 : 조직학적으로 비소세포 폐암으로 진단된 stage III이상의 환자 35명을 대상으로 하였다. 이들중, 19명은 VP-16과 high-dose cisplatin(100 $mg/m^2$)으로 구성되는 복합화학요법 그리고 복합화학요법과 방사선 치료를 시행받았으며, 나머지 16명은 치료를 받지 않았다. 두군간의 생존율과 반응율의 차이 및 치료에 다른 부작용을 알아보기 위해 환자의 병록 일지를 검토하였다. 결과: 1) 전체적인 객관적 반응율은 한명의 완전관해를 포함하여 47%(9/19) 였다. 2) 복합화학요법과 방사선 치료를 병행하여 받은 환자군에서의 반응율은 한명의 완전관해를 포함하여 60%(6/10) 였으며, 3개월, 6개월 및 127개월 생존율은 각각 100%, 70% 및 40% 였다. 3) 복합화학요법을 받은 환자군에서의 반응율은 완전관해 없이 33%(3/9) 였으며, 3개월, 6개월 및 12개월 생존율은 각각 78%, 67% 및 33% 였다. 4) 전체적으로 치료군에서 비치료군에 비해 통계적으로 유의하게 (p<0.05) 생존기간이 연장되었다(중앙생간 307일과 95일). 5) 여러 예후인자에 따른 분석에서 운동능력이 좋을수록, stage III에서 그리고 편평상피암에서 좋은 반응율을 보였다. 6) 부작용으로서는 오성과 구토(100%), 탈모증(90%), 빈혈(79%), 백혈구 감소증 (69%), 혈소판 감소증(2%), creatinine의 증가(16%) 그리고 신경독성(5%) 등이 있었다. 결론 : 이상의 결과로 진행된 비소세포 폐암 환자에 대한 hign VPP 복합화학요법은 비치료군에 비해 치료군에서 생존율을 높이는 비교적 좋은 효과가 있으므로 좋은 적응증을 가진 환자들을 선택하여 효과적인 항암치료 및 방사선 치료를 시행하여야 할 것으로 사료된다. 그러나, hign VPP 복합화학요법에 따른 효과 개선은 본 연구 결과에선 뚜렷하지 않으므로 보다 많은 증례에서 추구 연구가 필요하리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권8호
• /
• pp.3159-3162
• /
• 2015

Purpose: This systematic analysis was conducted to evaluate the efficacy and safety of nedaplatin based salvage chemotherapy for treatment of patients with advanced cervical cancer. Methods: Clinical studies evaluating the efficacy and safety of nedaplatin based regimens on response and safety for patients with cervical cancer were identified using a predefined search strategy. Pooled response rates (RRs) were calculated. Results: For nedaplatin based regimens, 5 clinical studies including 264 patients with advanced cervical cancer were considered eligible for inclusion. The analysis showed that, in all patients, pooled RR was 74.6% (197/264). Major adverse effects were leukopenia, thrombocytopenia and nausea/vomiting. No treatment related death occurred with nedaplatin based treatment. Conclusion: This systematic analysis suggests that nedaplatin based regimens are associated with good activity with acceptable tolerability in treating patients with advanced cervical cancer.