• Title/Summary/Keyword: second-line treatment

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Resistant Gestational Trophoblastic Neoplasia Patients Treated with 5-Fluouracil plus Actinomycin D

  • Manopunya, Manatsawee;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.387-390
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    • 2012
  • A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonly administered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second line of treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear. To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patients resistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen between August 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases who met the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12. The median number of cycles for each patient was two and only one case achieved remission while four of the cases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicated myelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting with manageable toxicity.

A Pooled Analysis on Crizotinib in Treating Chinese Patients with EML4-ALK Positive Non-small-cell Lung Cancer

  • Li, Yang;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4797-4800
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    • 2015
  • Background: This analysis was conducted to evaluate the efficacy and safety of crizotinib based regimens in treating Chinese patients with EML4-ALK positive non-small-cell lung cancer. Materials and Methods: Clinical studies evaluating the efficacy and safety of crizotinib based regimens on response and safety for Chinese patients with EML4-ALK positive non-small-cell lung cancer were identified by using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. Results: In crizotinib based regimens, 3 clinical studies which including 128 Chinese patients with EML4-ALK positive non-small-cell lung cancer and treated with crizotinib based regimen were considered eligible for inclusion. Pooled analysis suggested that, in all patients, the pooled RR was 59.3% (76/128) in crizotinib based regimens. ALT/AST mild visual disturbances, nausea, and vomiting were the main side effects. No treatment related death occurred in these crizotinib based treatments. Conclusions: This pooled analysis suggests that crizotinib based regimens are associated with good response rate and accepted toxicities in treating Chinese patients with EML4-ALK positive non-small-cell lung cancer.

Prediction of Turbidity in Treated Water and the Estimation of the Optimum Feed Concentration of Coagulants in Rapid Mixing Process using an Artificial Neural Network Model (인공신경망 모형을 이용한 급속혼화공정에서 적정 응집제 주입농도 결정 및 응집처리후 탁도의 예측)

  • Jeong, Dong-Hwan;Park, Kyoohong
    • Journal of Korean Society on Water Environment
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    • v.21 no.1
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    • pp.21-28
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    • 2005
  • The training and prediction modeling using an artificial neural network was implemented to predict the turbidity of treated water as well as to estimate the optimized feed concentration of polyaluminium chloride (PACl) in a water treatment plant. The parameters used in the input layers were pH, temperature, turbidity and alkalinity, while those in output layers were PACl and turbidity of treated water. Levenberg-Marquadt method of feedforward back-propagation perceptron in the neural network toolbox of MATLAB program was used in this study. Correlation coefficients of the training data with the measured data were 0.9997 for PACl and 0.6850 for turbidity and those of the testing data with measured data were 0.9140 for PACl and 0.3828 for turbidity, when four parameters at input layer, 12-12 nodes each at both the first and the second hidden layers, and two parameters(PACl and turbidity) at output layer were used. Although the predictability of PACl was improved, compared to that of the previous studies to use the only coagulant dose as output layer, turbidity in treated water could not be predicted well. Acquisition of more data through several years obtained with the advanced on-line measuring system could make the artificial neural network useful and practical in actual water treatment plants.

Safety and efficacy of pemetrexed for the treatment of lung adenocarcinoma in patients with various stages of chronic kidney disease

  • Yang, Jieun;park, Ji Eun;Jo, Jaemin;Kim, Young Ree;Chang, Jee Won;Han, Sang Hoon;Han, Chi Wha
    • Journal of Medicine and Life Science
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    • v.19 no.1
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    • pp.14-19
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    • 2022
  • We investigated the safety and efficacy of pemetrexed monotherapy in patients with lung adenocarcinoma and various renal conditions, including chronic kidney disease. We also analyzed whether baseline renal function affected progression-free survival (PFS). We retrospectively analyzed 71 patients who received maintenance-and second-line pemetrexed monotherapy. Patients were divided into two groups according to estimated glomerular filtration rate (eGFR): fair eGFR (>60 mL/min/1.73 m2) and lower eGFR (59 mL/min/1.73 m2 or less). The safety and efficacy were evaluated for each group. Median ages were 73.2 years in the lower eGFR group (n=28) and 64.5 years in the fair eGFR group (n=43). Patients with a lower eGFR achieved a median PFS of 4.7 months, while the median PFS for patients with a fair eGFR was 2.7 months. The difference between the two groups was not statistically significant (P=0.075). Both groups showed treatment-related low-grade hematological and non-hematological adverse events. Pemetrexed monotherapy is safe and effective in patients with lung adenocarcinoma with a lower eGFR.

Treatment for Metastatic Pancreatic Cancer (전이성 췌장암의 치료)

  • Bo Young Lee;Sang Myung Woo
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.64-68
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    • 2018
  • Pancreatic ductal adenocarcinoma is a dismal prognosis and 5th leading cause of cancer related death in Korea. A large proportion of patients are diagnosed at advanced or metastatic stage. Therefore systemic chemotherapy has become the mainstay of treatment for pancreatic cancer. For most patients advanced or metastatic pancreatic cancer that has a good Eastern Cooperative Oncology Group performance status (ECOG PS) 0 or 1, we can recommend for FOLFIRINOX (leucovorin, 5-fluorouracil [5-FU], irinotecan and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel). Currently, steps towards improved therapeutic efficacy of palliative chemotherapy have been made by introducing these regimens. For patients with an ECOG PS of 2, gemcitabine monotherapy or S1 alone is recommended. The second-line therapy for patients initially treated with gemcitabine-based chemotherapy includes provide FOLFOX (leucovorin, 5-FU, and oxaliplatin), capecitabine plus oxaliplatin, and 5-FU plus liposomal irinotecan. The gemcitabine-based chemotherapy is a reasonable choice for patients treated with FOLFIRINOX. Currently, studies on selecting patients for biomarkers related to molecular biologic features of tumors are underway for the realization of precise medicine, and the development and verification of preclinical models for the development of new therapeutic agents are being carried out continuously.

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Comparison of marginal bone loss and patient satisfaction in single and double-implant assisted mandibular overdenture by immediate loading

  • Tavakolizadeh, Sara;Vafaee, Fariborz;Khoshhal, Masume;Ebrahimzadeh, Zahra
    • The Journal of Advanced Prosthodontics
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    • v.7 no.3
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    • pp.191-198
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    • 2015
  • PURPOSE. The purpose of this study was to compare the coronal bone level and patient satisfaction in 1-implant and 2-implant assisted mandibular overdentures. MATERIALS AND METHODS. Twenty patients who had maladaptive mandibular dentures were treated in this study. Patients were randomly divided into two groups. The first group received 1 implant (Simple line II, Implantium, South Korea) in their mandibular midline and the second group received 2 implants in their B and D regions (according to Misch's category). If the primary stability of each implant was at least 60 ISQ, ball attachment was placed and denture relined with soft liner. After 6 weeks, retentive cap incorporated with hard acrylic resin. In the 6 and 12 months recalls, periapical digital radiograph were made and visual analogue scale questionnaires were used to record patient satisfaction. The Friedman test was done for comparing the presurgical and postsurgical parameters in each group and the U-Mann Whitney test (P<.05) was done for comparison of post-treatment results between the two groups. RESULTS. All implants achieved sufficient primary stability to be immediately loaded. Patient satisfaction was high, and there were no significant differences between two groups (P>.05). In addition, mean marginal bone loss was $0.6{\pm}0.67$ mm in the first group and $0.6{\pm}0.51$ mm in the second group, after 12 month. Mean marginal bone loss showed no significant differences between two groups. CONCLUSION. This preliminary one-year result indicated that mandibular overdentures anchored to a single implant can be a safe and cost-effective method as a starting step for implant-overdenture treatment.

MANAGEMENT OF INFRAOCCLUDED MANDIBULAR SECOND PRIMARY MOLARS: CASE REPORT (저위교합된 제 2유구치에 대한 치험례)

  • Kwak, So-Youn;Park, Ki-Tae;Kim, Ji-Yeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.475-480
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    • 2009
  • An infraoccluded tooth is a tooth that has failed to erupt to be in line with adjacent teeth in the vertical plane of occlusion. Multiple complications can occur as a result of an infraoccluded tooth. Tipping of neighboring teeth, loss of space opposing teeth elongation, increased susceptibility to dental caries and abnormal eruption path, impaction and rotation of permanent successor are the consequences of infraocclusion of primary molar. Therefore, early diagnosis and treatment is the key to prevent the complications. Treatment options can be periodic follow-up, temporary restoration or extraction of the infraoccluded tooth depending on the presence of the successor, the extent of infraocclusion and the extent of tilting of the neighboring teeth. The infraoccluded primary molars with permanent successors present tend to exfoliate normally. However, failure to do periodic check up of the infraoccluded teeth may lead to serious complications. In these cases, surgical extractions are often necessary after space regaining and space maintainers should be placed until the eruption of the permanent successors are completed.

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Progression of Subdural Effusion after Surgical Treatment (뇌경막하수종의 수술적 치료에 따른 임상 경과)

  • Kim, Jaehyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1765-1773
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    • 2013
  • The purpose of this study was to contribute to the medical treatment of subdural effusion through clinical sequence analysis of patients who experienced improvement of subdural drainage and had a second operation for subdural drainage or subduroperitoneal shunt. Sixteen cases of the whole patients who have been underwent subdural effusion and subdural drainage were analyzed during the period from 2006 July to 2012 June. The study gave us a result that all of patients, who was taking aspirin, have been under the second operation(p<0.001) and these group have had a subduraoperitoneal shunt(p=0.014)). According to the comparative analysis for the patients group that divided into two; one had subduroperitoneal shunt and the other had no subduroperitoneal shunt, the outcomes of this study were shown as follows. First, their median line deviation was serious in their brain CT. In addition, their subdural effusion increased or did not change with a headache, vomiting, fever and dyspnea. As a result of those symptoms. subduraoperitoneal shunt was carried out(p=0.006). The surgical method for patients who were taken asprin must be cautiously selected and the prevention of sudden disappearance of cerebrospinal fluid and excessive change of intracranial pressure is very important in operation craniectomy.

Cisplatin Plus Gemcitabine for Treatment of Breast Cancer Patients with Brain Metastases: a Preferential Option for Triple Negative Patients?

  • Erten, Cigdem;Demir, Lutfiye;Somali, Isil;Alacacioglu, Ahmet;Kucukzeybek, Yuksel;Akyol, Murat;Can, Alper;Dirican, Ahmet;Bayoglu, Vedat;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3711-3717
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    • 2013
  • Background: To assess the efficacy and tolerability of Cisplatin plus Gemcitabine combination in patients with brain metastases (BM) from breast cancer (BC). Materials and Methods: Eighteen BC patients with BM who were treated with Cisplatin plus Gemcitabine regimen between 2003-2011 were evaluated. Results: A median of 6 cycles of this regimen were received, in fifteen patients (83.3%) as first-line chemotherapy, in 2 as second-line and in 1 as third-line after diagnosis of BM. Dose reduction was performed in 11 (61.1%) patients; major reasons were neutropenia and leukopenia. Grade III neutropenia and Grade II trombocytopenia rates were 33.3% and 16.7% respectively. Overall response rate (ORR; complete+partial response rate) was 33.4% (n=6) for the entire study population; triple negative patients achieved an 66.6% ORR while hormone receptor (HR) positive patients had 25% and HER2 positive patients 12.5%. Median progression-free survival was 5.6 months (2.4-8.8 months, 95%CI) and longer in patients with triple negative breast cancer (TNBC) (median 7.4 months, 95%CI, 2.4-12.3 months) than the patients with other subtypes (median 5 months for HER2 positive and 3.6 months for HR positive patients). Median PFS of the patients with TNBC who received this regimen as first-line was 9.2 months (5.2-13.2 months, 95%CI). Conclusions: Cisplatin plus Gemcitabine may be a treatment option for patients with BM from breast cancer. Longer PFS and higher response rates are results that support the usage of this regimen especially for the triple negative subtype. However, further prospective and randomized trials are clearly required to provide more exact information.

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

  • Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3561-3566
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    • 2014
  • Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.