• 제목/요약/키워드: subacute toxicities

검색결과 28건 처리시간 0.023초

Radiosurgery for Recurrent Brain Metastases after Whole-Brain Radiotherapy : Factors Affecting Radiation-Induced Neurological Dysfunction

  • Gwak, Ho-Shin;Yoo, Hyung-Jun;Youn, Sang-Min;Lee, Dong-Han;Kim, Mi-Sook;Rhee, Chang-Hun
    • Journal of Korean Neurosurgical Society
    • /
    • 제45권5호
    • /
    • pp.275-283
    • /
    • 2009
  • Objective : We retrospectively analyzed survival, local control rate, and incidence of radiation toxicities after radiosurgery for recurrent metastatic brain lesions whose initial metastases were treated with whole-brain radiotherapy. Various radiotherapeutical indices were examined to suggest predictors of radiation-related neurological dysfunction. Methods : In 46 patients, total 100 of recurrent metastases (mean 2.2, ranged 1-10) were treated by CyberKnife radiosurgery at average dose of 23.1 Gy in 1 to 3 fractions. The median prior radiation dose was 32.7 Gy, the median time since radiation was 5.0 months, and the mean tumor volume was $12.4cm^3$. Side effects were expressed in terms of radiation therapy oncology group (RTOG) neurotoxicity criteria. Results : Mass reduction was observed in 30 patients (65%) on MRI. After the salvage treatment, one-year progression-free survival rate was 57% and median survival was 10 months. Age(<60 years) and tumor volume affected survival rate(p=0.03, each). Acute (${\leq}$1 month) toxicity was observed in 22% of patients, subacute and chronic (>6 months) toxicity occurred in 21 %, respectively. Less acute toxicity was observed with small tumors (<$10cm^3$. p=0.03), and less chronic toxicity occurred at lower cumulative doses (<100 Gy, p=0.004). "Radiation toxicity factor" (cumulative dose times tumor volume of <1,000 Gy${\times}cm^3$) was a significant predictor of both acute and chronic CNS toxicities. Conclusion: Salvage CyberKnife radiosurgery is effective for recurrent brain metastases in previously irradiated patients, but careful evaluation is advised in patients with large tumors and high cumulative radiation doses to avoid toxicity.

S-Bioallethrin의 독성에 미치는 N-Octyl bicycloheptene dicarboximide의 영향 (Effect of N-Octyl bicycloheptene dicarboximide on the Toxicity of S-Bioallethrin in Rats)

  • 홍사욱;장준식
    • Environmental Analysis Health and Toxicology
    • /
    • 제8권1_2호
    • /
    • pp.37-58
    • /
    • 1993
  • In order to investigate the toxicities of S-bioallethrin (5-biol) and its combination treatment with N-octyl bicycloheptene dicarboximide (MGK-264), the acute and subacute toxicity, and enzyme activity test were performed. $LD_{50}$ levels of S-biol and MGK-264 in rats are 640 mg/kg and 3, 280 mg/kg respectively. However, when rats were treated with the mixture of S-biol and MGK-264 (1 : 5 ratio), the $LD_{50}$ was decreased to 545 mg/kg. In serological analysis, ALT and LDH were increased in animals treated with the mixture. Also glucose level was significantly increased after 5 weeks in animals treated with both S-biol and the mixture. Other biochemical parameters such as cytochrome P-450 and NADPH-cytochrome c reductase in the liver and kidney were shown to be not significantly changed. Levels of total ATPase and $mg^{2+}$ ATPase were significantly decreased in the liver of animals treated with the mixture after 4-5 weeks. In addition, S-biol can alone decrease total ATPase activity. Total ATPase activity was also significantly decreased in the kidney after 5 week treatment with the mixture. Similarily, glucose-6-phosphatase activity was significantly decreased in animals treated with the mixture. When either S-biol or MGK-264 was administered, cholinesterase and carboxyesterase activities were slightly decreased but they were significantly decreased when the mixture was administered.

  • PDF

랫드에서 cis-Malonato[(4R,5R)-4,5-bis(aminomethyl)-2-isopropyl-1,3-dioxolane]platinum(II)(SKI 2053R)의 아급성독성시험에 관한 연구 (Subacute Toxicity of cis-Malonato[(4R,5R)-4,5-bis(aminomethyl)-2-isopropyl-1,3-dioxolane]platinum(II)(SKI 2053R) in rats)

  • 김형욱;강경선;신동진;조재진;김배환;서광원;남기환;이영순
    • Toxicological Research
    • /
    • 제8권2호
    • /
    • pp.217-233
    • /
    • 1992
  • This study was performed to determine the toxic effects of graded dose levels of SKI 2053R after repeated administration. Three groups of Sprague-Dawley rats(10M and 10F per group) were given a total of 25 i.v. injections of SKI 2053R (1.50,3.75,9.38mg/kg/day). In order to compare the toxic effects of SKI 2053R with those of cisplatin, one group of Sprague-Dawley rats (10M and 10F per group) were given a total of 25 i.v.injections of cisplatin (1.70mg/kg/day). The dosing schedule was divided into five courses of 5 consecutive days with 16-day dose-free intervals between each course. No drug-related toxicity occurred in low dose level group (1.50mg/kg/day) of SKI2053R. From the results of hematological examination, peripheral WBC counts, RBC counts and hemoglobin of high dose level group(9.38mg/kg/day)of SKI 2053R were significantly lower than those of no-treated group. Other toxicities including reduced final body weight, proteinuria and hematuria were observed in high dose level group of SKI 2053R. But, no change was detected in serum biochemical values of SKI 2053R treated groups. All of the rats in cisplatin treated group were died between 3 and 13 weeks, while rats treated with SKI2053R survived to the end except one rat of middle dose level group(3.75mg/kg/day). In histopathological examinations, rats that received cisplatin manifested severe tubular damage in kidney and hemosiderosis in spleen, but no critical pathological lesion was observed in rats of other groups. Considering the results of this study, it was concluded that non-toxic dose of SKI 2053R in this treatment schedule was estimated to be 3.75 mg/kg/day and the maximum tolerated dose was to be higher than 9.38mg/kg/day. The toxic profiles fo SKI 2053R were different from those of cisplatin, and its toxicity was considerably lower than that of cisplatin.

  • PDF

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

  • Aghili, Mahdi;Sotoudeh, Sarvazad;Ghalehtaki, Reza;Babaei, Mohammad;Farazmand, Borna;Fazeli, Mohammad-Sadegh;Keshvari, Amir;Haddad, Peiman;Farhan, Farshid
    • Radiation Oncology Journal
    • /
    • 제36권1호
    • /
    • pp.17-24
    • /
    • 2018
  • Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.

속단(續斷) 추출물의 C57BL/6 마우스를 이용한 2주 경구투여 독성시험 (Two-weeks Oral Dose Toxicity Study of Dipsacus asperoides Extracts in C57BL/6 Mice)

  • 허혜윤;신동호;이지혜;서윤수;김용범;신인식;강소희;손미경;김중선
    • 대한본초학회지
    • /
    • 제36권5호
    • /
    • pp.101-108
    • /
    • 2021
  • Objectives : A root of Dipsacus asperoides C. Y. Cheng et T. M. Ai (D. asperoides) has been traditionally used as a medicinal resource in several Asian countries, including Korean and traditional Chinese medicine that has been traditionally used for treating several medical conditions including pain, arthritis, and bone fractures in Korea. In the present study, we investigated potential subacute toxicities of D. asperoides extract. Methods : C57BL/6 mice (male, 7weeks) were randomly divided into 4 groups of 5 mice. Except for the control group, the mice were orally administrated D. asperoides extract at doses of 50, 150, or 450 mg/kg/day for 2 weeks. At the end of the treatment period, all mice were euthanized, and the following parameters were examined: mortality, body weight, clinical signs, gross findings, hematology, serum biochemistry, organ weight, and histopathology. Results : There were no abnormalities in mortality, clinical signs, body weight, gross findings, or organ weight after repeated administration of D. asperoides extract for 2 weeks, compared with the control group. In addition, there were no significant changes in hematological, serum biochemical, and histopathological parameters between the control group and D. asperoides extract administrated groups with doses of up to 450 mg/kg/day. Conclusion : In this study, D. asperoides extract showed no significant toxicities at a dose of up to 450 mg/kg/day in mice. Although we could not confirm the toxic dose of D. asperoides extract, it can be considered safe for further pharmacological use.

The Toxicity and Anti-cancer Activity of the Hexane Layer of Melia azedarach L. var. japonica Makino's Bark Extract

  • Kim, Hyun-Woo;Kang, Se-Chan
    • Toxicological Research
    • /
    • 제28권1호
    • /
    • pp.57-65
    • /
    • 2012
  • In this study, the 4-week oral toxicity and anti-cancer activity of the hexane layer of Melia azedarach L. var. japonica Makino's bark extract were investigated. We carried out a hollow fiber (HF) assay and 28-day repeated toxicity study to confirm the anti-cancer effect and safety of the hexane layer. The HF assay was carried out using an A549 human adenocarcinoma cell via intraperitoneal (IP) site with or without cisplatin. In the result, the 200 mg/kg b.w of hexane layer with 4 mg/kg b.w of cisplatin treated group, showed the highest cytotoxicity aginst A549 carcinoma cells. For the 28-day repeated toxicity study, 6 groups of 10 male and female mice were given by gavage 200, 100, or 50 mg/kg b.w hexane layer with or without 4 mg/kg b.w of cisplatin against body weight, and were then sacrificed for blood and tissue sampling. The subacute oral toxicity study in mice with doses of 200, 100, and 50 mg/kg b.w hexane layer showed no significant changes in body weight gain and general behavior. The cisplatin-treated group significantly decreased in body weight compared to the control group but regained weight with 100 and 200 mg/kg b.w of hexane layer. The biochemical analysis showed significant increase in several parameters (ALT, total billirubin, AST, creatinine, and BUN) in cisplatin-treated groups. However, in the group given a co-treatment of hexane layer (200 mg/kg b.w), levels of these parameters decreased. In hematological analysis, cisplatin induced the reduction of WBCs and neutrophils but co-treatment with hexane layer (100 and 200 mg/kg b.w) improved these toxicities caused by cisplatin. The histological profile of the livers showed eosinophilic cell foci in central vein and portal triad in cisplatin treated mice. These results show that hexane layer might have an anti-cancer activity and could improve the toxicity of cisplatin.

파라벤류의 독성과 내분비계장애 효과 (Toxicity and Endocrine Disrupting Effect of Parabens)

  • 안혜선;나원흠;이재은;오영석;계명찬
    • 환경생물
    • /
    • 제27권4호
    • /
    • pp.323-333
    • /
    • 2009
  • 파라벤은 p-하이드록시 벤조산(p-hydroxybenzoic acid)의 알킬에스테르로, 비교적 빠르게 흡수, 대사 및 배설되는 살균성 보존제로 식품, 화장품, 약품 등에 널리 사용되고 있다. 실제 인체는 파라벤 복합물에 노출된다. 파라벤의 안전성에 관한 연구결과들에 대한 고찰 결과 파라벤 종류에 따라 다양한 독성종말점을 대상으로 파라벤의 급성, 아급성 및 만성독성 영향은 비교적 적은 것으로 나타났다. 파라벤은 에스트로젠 유사활성을 가지며 화장품을 통한 경피흡수를 통해 유방암과의 상관성이 보고되었으나, 이와 상반된 견해도 있다. 파라벤의 항안드로젠성은 남성생식기계의 장애를 유발할 수 있으나 이와 상반된 견해도 있다. 파라벤은 정자의 미토콘드리아 기능 및 남성호르몬 생성을 저해할 수 있으나 이와 상반된 견해도 있다. 배아발달에는 독성이 없는 것으로 나타났다. 세포독성으로는 세포용혈, 미토콘드리아 막투과성 변화, 세포사멸 등을 유발할 수 있다. 수환경에서 파라벤은 환경에스트로젠으로 작동하여 어류에서 내분비장애 효과를 발휘한다. 결론적으로 파라벤은 저독성물질로 분류할 수 있으나, 인체 및 수생동물들에서 파라벤의 노출경로 및 농도, 사용기간 등에 따른 독성과 내분비계장애 효과에 대하여는 다양한 종말점을 대상으로 좀 더 구체적인 독성자료들이 요구된다.

절제 불가능한 원발성 간암의 입체조형 방사선치료의 초기 임상 결과 (Preliminary Results of 3-Dimensional Conformal Radiotherapy for Primary Unresectable Hepatocellular Carcinoma)

  • 금기창;박희철;성진실;장세경;한광협;전재윤;문영명;김귀언;서창옥
    • Radiation Oncology Journal
    • /
    • 제20권2호
    • /
    • pp.123-129
    • /
    • 2002
  • 목적 : 수술적 절제가 불가능한 원발성 간암 환자들을 대상으로 삼차원적인 방사선치료계획 시스템을 이용한 입체조형 방사선치료를 전향적으로 실시하고 조기 임상 결과를 분석하였다. 또한, 이를 통해 원발성 간암의 비수술적 치료에서 입체조형 방사선치료의 잠재적인 역할과 가능성을 판단해 보고자 하였다. 대상 및 방법 : 1995년 1월부터 1997년 6월까지 원발성 간암으로 진단 후 입체조형 방사선치료의 기법을 적용하여 치료를 받은 17명의 환자가 본 연구 대상에 포함되었다. 대상 환자의 선정 기준은 방사선치료의 과거력이 없는 경우, 간외 전이가 없는 경우, 간경변증의 정도가 Child-Pugh classification A또는 B군인 경우, 종양이 전체 간 용적의 2/3를 넘지 않는 경우, 전신수행도가 European Cooperative Oncology Group (ECOG) 3기 이상으로 악화되지 않은 경우이었다. 15명의 환자에서 경동맥화학색전술과 입체조형 방사선치료의 병용요법이 시행되었다. 대상 환자는 In-ternational Union Against Cancer (UICC) 병기별로 II기 1명, III기 8명, IVA기 8명이었다. 4명의 환자에서 간문맥 혈전증이 동반되었으며, 종양의 평균 직경은 8 cm이었다. 조사영역은 종양과 주변 1.5 cm이었고 조사선량의 분포는 $36\~60\;Gy$로 중앙값은 59.4 Gy이었다. 종양의 반응은 치료 후 $4\~8$주에 시행한 영상 진단을 기준으로 평가하였다. 추적관찰기간의 중앙값은 15개월이었다. 결과 : 2년 생존율은 $21.2\%$였고 평균 생존 기간은 19개월이었다. 완전 반응과 부분 반응을 포함하여 11명의 환자에서 치료에 대한 반응을 보여 반응률은 $64.7\%$였다. 종양의 진행을 보인 환자는 3명으로 이 중 2명의 환자가 조사영역 밖에서 종양의 진행을 보였다. 추적 기간 중 6명의 환자에서 원격 전이가 나타났고 폐 전이와 뼈 전이가 각각 5명과 1명이었다. 삼차원 입체 조형 치료와 관련된 것으로 판단되는 방사선 간염은 발생하지 않았으며 Grade 2의 위염과 십이지장염이 각각 1명씩 발생했다. 치료로 인해 사망하였던 경우는 없었다. 결론 : 절제 불가능한 원발성 간암의 치료에 입체조형 방사선치료를 적용할 것은 비교적 안전하였고 실제적인 치료 효과를 나타내었다. 향후 원발성 간암의 비수술적 치료에 입체조형 방사선치료의 역할이 기대되며 이 치료법의 우수성을 입증하기 위한 제 3상 연구가 뒤따라야 할 것으로 사료된다.