• Title/Summary/Keyword: unresectable

Search Result 159, Processing Time 0.035 seconds

Phase II Study of Concurrent Chemotherapy with Etoposide and Cisplatin (EP) and Radiation Therapy for Unresectable Stage III Non-small Cell Lung Cancer (수술이 불가능한 제 III기 비소세포폐암에서 Cisplatin 및 Etoposide(EP)의 화학요법과 방사선요법의 병행요법(2상 임상연구))

  • Hur, Nam-Hyun;Lee, Choon-Taek;Kim, Jae-Hag;Jang, Jae-Jin;Nam, Seung-Mo;Park, Yeon-Hee;Ryoo, Baek-Yeol;Kim, Tae-You;Im, Young-Hyuck;Kang, Yoon-Koo;Kim, Mi-Sook;Yoo, Seong-Yul;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.4
    • /
    • pp.776-784
    • /
    • 1997
  • Background : Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC). however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, and survival of concurrent chemotherapy with etoposide and cisplatin(EP) and radiation therapy for unresectable stage III NSCLC. Method : Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide and cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. Results : Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient. The median survival was 12.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia($\geq$ grade 3, 46%). Thrombocytopenia over grade 3 was found in 11%. Radiation pneumonitis occurred in 13 patients(46%). Conclusion : Concurrent chemotherapy(EP) plus radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.

  • PDF

Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma

  • Jung, Da Hoon;Kim, Mi-Sook;Cho, Chul Koo;Yoo, Hyung Jun;Jang, Won Il;Seo, Young Seok;Paik, Eun Kyung;Kim, Kum Bae;Han, Chul Ju;Kim, Sang Bum
    • Radiation Oncology Journal
    • /
    • v.32 no.3
    • /
    • pp.163-169
    • /
    • 2014
  • Purpose: To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma. Materials and Methods: From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL). Results: The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. ${\geq}50mL$), and pre-SBRT CEA level (<5 vs. ${\geq}5ng/mL$) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with ${\leq}12$ months (p = 0.026). Six patients (10%) experienced ${\geq}$grade 3 complications. Conclusion: SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.

palliative intubation for advanced esophageal cancer (진행성 식도암의 고식적 식도삽관술)

  • 공현우
    • Journal of Chest Surgery
    • /
    • v.22 no.1
    • /
    • pp.146-150
    • /
    • 1989
  • Dysphagia is common in patients with cancer of the esophagus. The rate of resectability of the lesion is low, and the majority of the patients require palliation to relieve the dysphagia. Celestin tube intubation was performed in patients with unresectable carcinoma of the esophagus, of one with malignant bronchoesophageal fistula. Dysphagia and respiratory symptoms were relieved and the patients became able to eat semi-solid food and fully ambulatory.

  • PDF

Therapeutic Effect of OK-432 for Lymphangioma in Children (OK-432를 사용한 소아 림프관종 치료효과)

  • Jung, Sung-Eun;Kim, Dae-Yeon;Shim, In-Bo;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
    • /
    • v.4 no.2
    • /
    • pp.131-136
    • /
    • 1998
  • Lymphangioma is a congenital malformation of the lymphatic system that expands into the surrounding tissues in a manner similar to a malignant tumor. Surgical excision has been the treatment of choice, but the results are often unsatisfactory due to incomplete resection, fluid collection and recurrences. Intralesional injection of OK-432(lyophilized incubation mixture of Group A Streptococcus pyogenes of human origin) was employed in treating 24 patients with lymphangiomas between 1992 and 1997. The method was used in 21 patients as a primary therapy, and in 3 patients for unresectable or recurrent cases as a secondary treatment. The results were excellent in 8 patients (33.3%), good in 7 patients (21.8 %) and poor in 7 patients (21.8 %). The side effects were fever under $39^{\circ}C$ and local inflammation. However these symptoms subsided in a few days without serious sequelae. These results suggest that intralesional injection of OK-432 is safe and effective treatment for primary lymphangioma as well as a secondary therapy for unresectable or recurrent cases.

  • PDF

Surgical Treatment of Stage III Carcinoma of the Lung after Preoperative Chemotherapy and Radiation Therapy - 8 case report - (폐암의 항암약물및 방사선치료후 절제수술;8례 보고)

  • 이두연
    • Journal of Chest Surgery
    • /
    • v.25 no.9
    • /
    • pp.962-967
    • /
    • 1992
  • Eight patients with proven clinical stage Ill lung carcinoma of which six were epidermoid cell carcinoma and two were small cell carcinoma underwent concomitant radiation therapy and chemotherapy before surgical resection from March 1990 to February 1992 at the thoracic surgical department, Yongdong Severance Hospital, Yonsei University College Medicine The therapy consisted of more than one cycle of chemotherapy every 4 weeks and concomitant irradiation. Three to four weeks after chemotherapy and radiation therapy, the patient were reevaluated for thoracotomy and pulmonary resection. Two patients were found to have unresectable lesions and, radiosotopes were implanted to the remaining tumors. Three patients had complete pneumonectomies and two patients had pericardial penumonectomyo. Only one patient had complete pneumonectomy & concomitant resection of ribs attached to tumors with reconstruction of chest wall with Marlex mesh. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 2 patients, without operative mortality. The median survival of all patients was eight months, but the median survival of survivors which lung tumor were completely resected completely and whose pathologic reports showed stage I or 0, was about 18 months to now. The overall result indicates some benefit from this preoperative chemotherapy and radiation therapeutic regimen in patients with advanced unresectable lung cancer.

  • PDF

Advances in the Management of Unresectable or Metastatic Pancreatic Neuroendocrine Tumors: Chemotherapy, Targeted Therapy, Hormonal Treatment, and Future Directions

  • Bilici, Ahmet
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.6
    • /
    • pp.2151-2159
    • /
    • 2015
  • Pancreatic neuroendocrine tumors (pNETs) are rare and heterogenous tumors and surgery to remove the primary tumor is the mainstay of treatment for resectable disease. However, curative surgery is often not feasible, because half of patients with pNET have metastases at the time of diagnosis. Palliative dubulking surgery and liver-directed therapies are appropriate options for these patients. Streptozocin-based regimens are standard, although temozolamide-based treatments are rapidly gaining wide clinical application. Somatostatin analogs are mainly indicated in hormonally active tumors to ameliorate symptoms. In addition, anti-tumoral activity has been proven in well-differentiated NETs. Recently, there has been tremendous progress in the molecular biology of pNETs; thereby, the efficacy of sunitinib and everolimus in the treatment of patients with metastatic pNETs has been proven by large placebo-controlled phase III trials. Currently, there are no definitively proven predictive biomarkers to evaluate response to medical therapies in patients with pNET. Therefore, further studies are needed to individualize and optimize their management. This article reviews systemic chemotherapy, targeted therapies, and anti-secretory treatments for the management of patients with unresectable or metastatic pNETs, summarized in the light of recent advances.

The Result of Reconstruction of the Lower Esophagus With Jejunum for Carcinoma of the Lower Esophagus and the Cardia (공장을 대용식도로 이용한 하부식도암의 수술성적)

  • 김근호
    • Journal of Chest Surgery
    • /
    • v.14 no.3
    • /
    • pp.195-201
    • /
    • 1981
  • The results of reconstruction of the lower esophagus with jejunum in a total of 24 cases of primary carcinoma of the lower third esophagus and gastroesophageal carcinoma were presented, and clinical values of substitution for the esophagus with jejunum were also discussed. They were operated in the department of thoracic and cardiovascular surgery, Hanyang University Hospital during the period of 9 years from 1972 to 1981. Surgical managements to lower esophageal reconstruction with jejunum were carded out with not the same procedure in all cases studied, but with three different procedure mentioned below/ In 13 cases of lower third esophagectomy with or without partial `8astrectomy of a total of 24 cases, interposition of jejunum between the esophagus and the stomach were performed after the fashion to esophagojejunostomy with mobilized jejunal loops and 8astro-JeJunostomy with side to side anastomosis. In 7 cases of lower third esophagectomy and total gastrectomy, the continuity of the esophagus were performed the fashion to esophagojejunostomy with mobilized jejunum. In 4 cases of unresectable gastro-esophageal carcinoma, bypass operation of the lower esophagus and the stomach were performed after the fashion to esophagojejunostomy with side to and anastomosis. After the bypass operation, it was observed that oral feeding to the patients was excellent. Following these consecutive series of 20 cases of radical operation for lower esophageal carcinomas and 4 cases of bypass operation for unresectable gastroesophageal carcinomas, no complication such as postoperative leakage and stenosis from anastomotic site or Infection In operating area and operative death were observed.

  • PDF

Clinical Analysis of Pediatric Thoracic Surgery: Non-Cardiovascular Disease (소아 흉부질환에 대한 임상적 고찰 [비심장혈관계 질환])

  • 안욱수
    • Journal of Chest Surgery
    • /
    • v.14 no.3
    • /
    • pp.202-209
    • /
    • 1981
  • The results of reconstruction of the lower esophagus with jejunum in a total of 24 cases of primary carcinoma of the lower third esophagus and gastroesophageal carcinoma were presented, and clinical values of substitution for the esophagus with jejunum were also discussed. They were operated in the department of thoracic and cardiovascular surgery, Hanyang University Hospital during the period of 9 years from 1972 to 1981. Surgical managements to lower esophageal reconstruction with jejunum were carded out with not the same procedure in all cases studied, but with three different procedure mentioned below/ In 13 cases of lower third esophagectomy with or without partial `8astrectomy of a total of 24 cases, interposition of jejunum between the esophagus and the stomach were performed after the fashion to esophagojejunostomy with mobilized jejunal loops and 8astro-JeJunostomy with side to side anastomosis. In 7 cases of lower third esophagectomy and total gastrectomy, the continuity of the esophagus were performed the fashion to esophagojejunostomy with mobilized jejunum. In 4 cases of unresectable gastro-esophageal carcinoma, bypass operation of the lower esophagus and the stomach were performed after the fashion to esophagojejunostomy with side to and anastomosis. After the bypass operation, it was observed that oral feeding to the patients was excellent. Following these consecutive series of 20 cases of radical operation for lower esophageal carcinomas and 4 cases of bypass operation for unresectable gastroesophageal carcinomas, no complication such as postoperative leakage and stenosis from anastomotic site or Infection In operating area and operative death were observed.

  • PDF

A Case Report of Unresectable Pancreatic Carcinoma Patient for Relieving Cancer Related Pain and Improving Quality of Life by Korean Medical Treatment (한방치료를 통해 수술이 불가능한 췌장암 환자에서 통증개선 및 삶의 질을 회복한 증례)

  • Yun, Hoyoung;Cho, Chongkwan;Yoo, Hwaseung;Bang, Sunhwi
    • Journal of Korean Traditional Oncology
    • /
    • v.18 no.1
    • /
    • pp.9-15
    • /
    • 2013
  • Objectives : The purpose of this study is to report the effect of Korean medicine on the pancreatic carcinoma patient. Method : A patient was diagnosed as unresectable pancreatic carcinoma. She complained insomnia, abdominal pain, dyspepsia and sleep disturbance. She was treated by Korean medicine composed of acupuncture, herbal medication and wild ginseng pharmacopuncture. Results : All symptoms took a favorable turn after Korean medicine treatment. As treatment was performed, as intensity of pain, insomnia, dyspepsia and fatigue were decreased. Conclusion : This study suggests that Korean medicine treatment has effectiveness for improvement of cancer related symptoms of a pancreatic carcinoma patient. Consequently, the treatment is helpful in improving quality of life.

Two Cases of Unresectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgical Resection

  • Huh, Gunn;Chun, Jung Won;You, Min Su;Paik, Woo Hyun;Lee, Sang Hyub;Kim, Yong-Tae;Ryu, Ji Kon
    • Journal of Digestive Cancer Reports
    • /
    • v.7 no.2
    • /
    • pp.61-64
    • /
    • 2019
  • We report two cases of patients with unresectable pancreatic cancer treated with neoadjuvant chemotherapy and surgical resection. In the first case, main mass was located at the neck of the pancreas, encasing superior mesenteric artery and peritoneal seeding was suspected. In the second case, main mass was located at the body of pancreas and superior mesenteric artery was encased. Both patients received FOLFIRINOX chemotherapy regimen, consisting of 5-FU, folinic acid, irinotecan and oxaliplatin. In both cases, tumor size decreased and vascular involvement regressed in response to chemotherapy. After subsequent chemoradiation therapy, both patients underwent surgical resection with negative resection margin. The pathological stages were ypT1cN0 and ypT1aN0, respectively. Both patients received postoperative adjuvant chemotherapy with 6 cycles of 5-FU/folinic acid and remained without evidence of disease for more than 6 months after the surgery.