• 대한한의학회지
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• 제42권1호
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• pp.119-128
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• 2021

비소세포성폐암 3기B 진단을 받고, 표준치료인 동시항암방사선치료를 시행했으나 별무효과였던 40대 남자에게, 한양방통합치료를 장기간 집중적으로 시행한 결과, 3개월만에 완전 관해에 도달하고, 5년 생존에 성공함으로써 한양방통합치료의 가능성을 보여 주었기에, 이에 증례를 보고한다.

• Journal of Chest Surgery
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• 제45권1호
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• pp.40-44
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• 2012

Background: The experience of a single-institution regarding surgery for small cell lung cancer (SCLC) was reviewed to evaluate the surgical outcomes and prognoses. Materials and Methods: From July 1990 to December 2009, thirty-four patients (28 male) underwent major pulmonary resection and lymph node dissection for SCLC. Lobectomy was performed in 24 patients, pneumonectomy in eight, bilobectomy in one, and segmentectomy in one. Surgical complications, mortality, the disease-free survival (DFS) rate, and the overall survival rate were analyzed retrospectively. Results: The median follow-up period was 26 months (range, 4 to 241 months), and there was one surgical mortality (2.9%). Six patients (17.6%) experienced recurrence, all of which were systemic. Eight patients died during follow-up; four died of disease progression and the other four died of pneumonia or of another non-cancerous cause. The three-year DFS rate was $79.2{\pm}2.6%$ and the overall survival rate was $66.4{\pm}10.5%$. Recurrence or death was significantly prevalent in the patients with lymph node metastasis (p=0.001) as well as in those who did not undergo adjuvant chemotherapy (p=0.008). The three-year survival rate was significantly greater in the patients with pathologic stage I/II cancer than in those with stage III cancer (84% vs. 13%, p=0.001). Conclusion: Major pulmonary resection for small cell lung cancer is feasible in selected patients. Patients with pathologic stage I or II disease showed an excellent survival rate after surgery and adjuvant treatment. Prospective randomized studies will be needed to define the role of surgery in early-stage small cell lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.731-736
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• 2014

Objective: To observe the short-term efficacy, long-term survival time and adverse responses with nedaplatin (NDP) or cisplatin (DDP) concomitant with other chemotherapy in treating non-small cell lung cancer. Materials and Methods: A retrospective, randomized, control study was conducted, in which 619 NSCLC patients in phases III and IV who were initially treated and re-treated were randomly divided into an NDP group (n=294) and a DDP group (n=325), the latter being regarded as controls. Chemotherapeutic protocols (CP/DP/GP/NP/TP) containing NDP or DDP were given to both groups. Patients in both groups were further divided to evaluate the clinical efficacies according to initial and re-treatment stage, pathological pattern, type of combined chemotherapeutic protocols, tumor stage and surgery. Results: The overall response rate (ORR) and disease control rate (DCR) in the NDP group were 48.6% and 95.2%, significantly higher than in the DDP group at 35.1% and 89.2%, respectively (P<0.01). In NSCLC patients with initial treatment, squamous carcinoma and phase III, there were significant differences in ORR and DCR between the groups (P<0.05), while ORR was significant in patients with adenocarcinoma, GP/TP and in phase IIIa (P<0.05). There was also a significant difference in DCR in patients in phase IIIb (P<0.05). According to the statistical analysis of survival time of all patients and of those in clinical phase III, the NDP group survived significantly longer than the DDP group (P<0.01). The rates of decreased hemoglobin and increased creatinine, nausea and vomiting in the NDP group were evidently lower than in DDP group (P<0.05). Conclusion: NDP concomitant with other chemotherapy is effective for treating NSCLC, with higher clinical efficacy than DDP concomitant with chemotherapy, with advantages in prolonging survival time and reducing toxic and adverse responses.

• 한국방사선학회논문지
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• 제9권6호
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• pp.393-401
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• 2015

폐암에 대한 방사선치료는 단독치료 또는 병용치료 시에 효과적인 치료이다. 연구에 의하면 최적의 방사선치료 이용률은 61%에서 74% 범위로 추정되고 있으나, 우리나라의 방사선치료 이용률은 낮은 것으로 조사되어 이에 대한 연구가 필요하다. 본 연구는 부산, 경남 지역에서 폐암환자의 방사선치료 이용률을 조사하여 방사선 이용의 적절성을 평가하고 방사선치료 이용관련 인자를 밝히고자 하는 것이다. 본 연구는 폐암으로 진단된 부산, 경남 지역 인구를 대상으로 하였다. 연구를 위하여 2개의 병원에 등록된 환자 1,036명의 환자 자료를 수집하여 최종적으로 연구에 적합한 897명을 대상으로 연구를 수행하였다. 연구는 적정 이용비율과 실제 방사선치료 비율을 비교하였고, 방사선치료 이용의 적정성과 관련인자를 확인하고자 하였다. 연구대상자 897명 중에서 503명(56%)은 내과적 치료가 시행되었고, 394명 (44%)는 방사선치료가 시행되었다. 전체 폐암환자의 방사선치료 이용률은 42%이었다. 조직학적 분류에 의한 비소세포 폐암의 비율은 33%이었고, 소세포 폐암은 90%이었다. 폐암의 방사선치료 이용과 관련 인자는 연령, 조직학적 유형, 임상병기, 의뢰의사, 임상검사이었다. 부위(site)별 방사선치료 이용률을 비교했을 때 근치적 흉부치료는 42%이었고, 완화적 치료는 26%이었다. 조직학적 유형의 비교에서 소세포 폐암의 이용률은 낮았고 특히 병기 III기에서 이용률은 가장 낮았다. 부산, 경남지역에서 방사선치료의 이용률은 적정한 이용률 보다 낮게 나타났다. 이용률 차이는 환자요인, 종양요인, 의료 서비스 요인으로 설명할 수 있었다. 이용률 개선을 위해서는 아웃리치 서비스(outreach service) 프로그램의 개발과 다 학제적 팀의 활성화가 필요하다.

• Journal of Chest Surgery
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• 제27권3호
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• pp.209-214
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• 1994

Lung cancer is one of the most disastrous of all the current cancers in Korea. In 1990 it was projected that there would be 5, 500 new lung cancer patients in Korea and that 5, 000 would die of their disease. This is a mortality rate of 91 percent. We reviewed the surgically treated 153 bronchogenic cancer patients from January 1987 to December 1991 in St. Mary`s Hospital of Catholic University Medical College. There were 121 men and 32 women ranging in age from 18 to 83 years, with a mean of 56 years. Of the 153 patients, resection was possible in 138 patients and the resectability was 90.1 percent. Squamous cell carcinoma was present in 48 percent of patients, adenocarcinoma in 29 percent, adenosquamous carcinoma in 7 percent, large cell carcinoma in 6 percent, salivary gland tumor in 5 percent, and small cell carcinoma and carcinoid in 3 percent respectively. Postoperative cancer staging was grouped stage I 33 percent, stage II 21 percent, stage IIIa 35 percent, and stage IIIb 10 percent. Lobectomy was performed in 70 percent, pneumonectomy in 17 percent, and segmentectomy in 14 percent. Three and 5-year postoperative survival in resectable 138 patients were 47 and 29 percent respectively.

• Journal of Chest Surgery
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• 제32권2호
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• pp.151-157
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• 1999

배경: 많은 실험적인 연구에서 종양 조직 내의 아포프토시스와 미세 혈관의 생성은 서로 반비례한다고 보고된다. 비소세포 폐암 조직내에서 두 수치의 관계를 조사하여 보았다. 대상 및 방법:조직내의 아포프토시스의 정도는 deoxynucleotidyl trasferase방법으로(Apop Tag In Situ Apoptosis Detection Kit, ONCOR) 측정하였고, 종양내 미세 혈관 밀도는 항 CD 31 항체를 이용하였다. 결과:아포프토시스 지수와 종양내 미세 혈관 밀도 사이에는 통계적으로 유의하게 역 상관관계가 있었다(p = 0.047). 결론: 비소세포 폐암종에서 아포프토시스와 미세 혈관 생성의 정도는 서로 연관이 있다고에 할 수있다. 그리고 종양내의 신생 혈관의 생성이 종양내 아포프토시스의 억제에 기여한다고 유추 할 수 있다.

• Journal of Chest Surgery
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• 제54권4호
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• pp.266-278
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• 2021

Lobectomy is the standard treatment for early non-small cell lung cancer. Various surgical techniques for lobectomy have been developed, and minimally invasive thoracic surgery, such as video-assisted thoracic surgery or robot-assisted thoracic surgery, has been considered as an alternative to conventional open thoracotomy. The recently robotic lobectomy technique has developed since the first case series was published in 2002. Several studies have reported that robotic lobectomy has comparable oncologic and perioperative outcomes to those of video-assisted thoracic surgery lobectomy and open lobectomy. However, robotic lobectomy remains a challenge for surgeons because of the steep learning curve, reduced tactile sensation, difficulty in port placement, and challenges in cooperation between the surgeon and assistant. Many studies have reported on robotic lobectomy, but few have presented surgical techniques for robotic lobectomy. In this article, the surgical techniques and optimal performance of robotic lobectomy are described in detail for all 5 types of lobectomy for surgeons beginning with robotic lobectomy.

• Journal of Chest Surgery
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• 제16권3호
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• pp.368-374
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• 1983

Combined type of primary lung cancer is a very rare form in clinical experience, which is 3 histologically different variants of bronchogenic carcinoma. These type had a well differentiated squamous carcinoma forming keratin pearls, well differentiated adenocarcinoma and pleomorphic undifferentiated cell carcinoma, usually small cell carcinoma. The patient, a male, 49-Y-0, was complaint coughing, mild dyspnea, blood tinged sputum and chest pain. Under diagnosis of lung cancer preoperatively, the right total pneumonectomy was performed with very difficulty such as arrhythmia, ventilation impairment during post operation course. The histology of specimen was disclose as 3 different histological type, combined lung cancer as squamoadenoundifferentiated carcinoma. The mediastinal nodes were freed from metastasis but the parietal pleural metastatic loci was found. The radio & chemotherapy were performed post-operatively. The patient had been experienced empyema at post-pneumonectomy space and then open drainage procedure and thoracoplasty had been added for treatment course. The patient is alive recently.

• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.211-216
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• 2019

Background: Docetaxel is one of the standard treatments for advanced non-small cell lung cancer. Docetaxel is usually administered in a 3-week schedule, but there is significant toxicity. In this phase II clinical study, we investigated the efficacy and safety of a 4-weekly schedule of docetaxel monotherapy, as first-line chemotherapy for advanced squamous cell carcinoma in elderly lung cancer patients. Methods: Patients with stage IIIB/ IV lung squamous-cell carcinoma age 70 or older, that had not undergone cytotoxic chemotherapy were enrolled. Patients received docetaxel $25mg/m^2$ on days 1, 8, and 15, every 4 weeks. Primary endpoint was the objective response rate (ORR). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity profiles. Results: A total of 19 patients were enrolled. Among 19 patients, 17 were for evaluated efficacy and safety. In the intent-to-treat population, ORR and disease control rate (DCR) were 11.8% and 47.1%, respectively. In the response evaluable population, ORR was 16.7% and DCR was 66.7%. Median PFS and OS were 3.1 months and 3.3 months, respectively. There were three adverse grade 3/4 events. Grade 1 neutropenia was reported in one patient. Conclusion: Our data failed to demonstrate efficacy of a 4-weekly docetaxel regimen, in elderly patients with a poor performance status. However, incidence of side effects, including neutropenia, was lower than with a 3-week docetaxel regimen, as previously reported.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4689-4693
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• 2012

Lung cancer is the most common type of cancer and one of the leading causes of death in the world. Genetic factors play an important role in its development. PDCD6, the encoding gene for programmed cell death protein 6, may function as a tumor suppressor gene. Non-small cell lung cancer (NSCLC) contributes about 80% to newly histologically diagnosed lung cancer patients. To explore the relationship between PDCD6 and NSCLC, we examined two single nucleotide polymorphisms(rs3756712 G/T andrs4957014 G/T, both in the intron region) of the PDCD6gene.A hospital-based case-control study was carried out including 302 unrelated NSCLC patients and 306 healthy unrelated subjects. Significantly increased NSCLC risk was found to be associated with the T allele of rs4957014 (P=0.027, OR=0.760, 95%CI=0.596-0.970). The genotype and allele frequencies of rs3756712 did not shown any significant difference between NSCLC group and controls (P=0.327, OR=0.879, 95%CI=0.679-1.137). In conclusion, we firstly demonstrated the association between the PDCD6 gene and risk of NSCLC in a Chinese Han population.