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Chemotherapy for Lung Cancer in the Era of Personalized Medicine

  • Lee, Seung Hyeun
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.3
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    • pp.179-189
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    • 2019
  • Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.

Understanding on Chemotherapy and Self-Care in Cancer Patients after an Individual Education (항암화학요법 개별교육을 받는 암 환자의 교육이해도와 자가간호수행 정도)

  • Kim, Eun-Mi;Kim, Hee-Jin;Kim, Soo-Jin;Kim, Bo-Kyung
    • Asian Oncology Nursing
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    • v.10 no.2
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    • pp.163-170
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    • 2010
  • Purpose: This study was conducted to examine understanding of chemotherapy of cancer patients after they received individual education on it and their execution of self-care for symptoms. Methods: Thirty-two participants who received individual education on chemotherapy from nurses specializing in education for cancer patients when they started to take chemotherapy were asked to complete the questionnaire on their understanding in education and execution of self-care. Results: Understanding on chemotherapy education of the participants recorded 4.30 on a scale of one to five with five the highest. Regarding self-care for symptoms, all participants carried out one or more methods of self-care except for one person each for vomiting, diarrhea, and constipation. Conclusion: This study showed that cancer patients who received individual education on chemotherapy performed self-care for their symptoms.

Treatment Outcome of Palliative Chemotherapy in Inoperable Cholangiocarcinoma in Thailand

  • Butthongkomvong, Kritiya;Sirachainan, Ekaphop;Jhankumpha, Supattra;Kumdang, Surang;Sukhontharot, On-Usa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3565-3568
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    • 2013
  • Background: Cholangiocarcinoma is the most common cancer in males in Thailand. The outcome is poor although systemic chemotherapy has been used in attempts to improve disease control, quality of life and prolong survival in patient with unresectable and advanced disease. Materials and Methods: In this retrospective study the medical records of all patients diagnosed as having unresectable and metastatic cholangiocarcinoma and receiving systemic chemotherapy at Udonthani Cancer Hospital during January 2007 to December 2010 were reviewed. Results: Among the total of 105 patients, 21 received gemcitabine-based chemotherapy and 84 5FU-based chemotherapy. Most received platinum doublet regimens. 5FU-based regimens yielded an overall response rate (tumor control) of 23.8% and a median survival of 7.2 months while gemcitabine-based regimens yielded an overall response rate (tumor control) 19.1% and a median survival of 10.0 months. Conclusions: Tumor control and survival of patient with advanced cholangiocarcinoma treated with gemcitabine-based and 5FU-based chemotherapy do not markedly differ.

Update of Adjuvant Chemotherapy for Resected Gastric Cancer

  • Oh, Sang-Cheul
    • Journal of Gastric Cancer
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    • v.12 no.1
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    • pp.3-6
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    • 2012
  • Gastric cancer is the second cause of cancer that is related to death and the fourth most common cancer, worldwide. Complete resection of cancer is the only curative treatment for gastric cancer. However, even if complete resection is possible, recurrence is frequently observed in Gastric patients. Therefore, adjuvant treatment modality for resectable gastric cancer is needed to increase the survival of patients. This study wants to describe the role of adjuvant chemotherapy for resectable gastric cancer, with updated data of recent studies. Several meta-analysis studies demonstrated a benefit of adjuvant chemotherapy for resectable gastric cancer. Due to the heterogeneity of the population and regimens, there is no consensus regarding the adjuvant chemotherapy. Recently published, well designed phase III studies demonstrated the statistically significance of adjuvant chemotherapy for the resectable gastric cancer, with the extended lymph node dissection. Further phase III trials, to determine the best regimen and schedule of adjuvant chemotherapy, was suggested to use the fluoropyrimidine based regimen as control group.

A Case of Chemotherapy for Transmissible Venereal Tumor in a Dog (화학요법을 이용한 개 전파성 생식기 육종 피료 1례)

  • 김종민;양현국;신태영;권오경;남치주
    • Journal of Veterinary Clinics
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    • v.13 no.2
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    • pp.212-215
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    • 1996
  • Chemotherapy of transmissible venereal tumor (TVT) in a dog has been tried, using vincritstine, cyclophosphamide, and methotrexate. The dog was hiven an combination chemotherapy and underwent complete regression of the tumors with on recurrence. The result of our clinical trial indicates that combination chemotherapy is an effective modality for dogs with TVT.

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Comparison of Efficacy and Toxicity of First Line Chemotherapy with or without Epirubicin for Patients with Advanced Stage Soft Tissue Sarcoma

  • Cao, Jie;Huang, Xin-En;Liu, Jin;Wu, Xue-Yan;Lu, Yan-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7171-7177
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    • 2013
  • Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.

Treating Adults with Hodgkin Lymphoma in the Developing World: a Hospital-Based Cohort Study from Armenia

  • Avagyan, Armen;Danielyan, Samvel;Voskanyan, Astghik;Sargsyan, Lilit;Hakobyan, Lusine;Zohrabyan, Davit;Safaryan, Liana;Harutyunyan, Lilit;Bardakchyan, Samvel;Iskanyan, Samvel;Arakelyan, Samvel;Tamamyan, Gevorg
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.101-104
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    • 2016
  • Background: With advances in diagnostics and treatment approaches, patients with Hodgkin's lymphoma (HL) in developed countries can nowadays expect to have excellent outcomes. However, information about the characteristics and outcomes in the developing world is very scarce, and this is important given the fact that there are several reports about differences of disease characteristics depending on geographic location and the development level of the country. Materials and Methods: In this retrospective study we assessed the features of 36 adult (${\geq}18$ years old) patients with HL and their diagnosis and treatment and outcomes in the Clinic of Chemotherapy of Muratsan University Hospital of Yerevan State Medical University, Armenia, between 2008-2014. Results: All patients had classic HL and among them 19 (53%) had nodular sclerosis subtype, 8 (22%) mixed cellularity and 9 (25%) lymphocyte-rich. 16 (44.5%) patients were at stage II, 13 (36%) stage III and 7 (19.5%) stage IV. Median follow-up time was 24.5 months (range 1-71 months) and during the whole follow-up period only two relapses (early) were documented and there were no deaths. Twenty-three (64%) patients received a BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) regimen, and 13 (36%) ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) regimen. A total of 25 (69.5%) patients received radiation in addition to chemotherapy. Conclusions: Although the number of patients involved in the study is small and the median follow-up time was just two years, this retrospective study shows that treatment of HL can be successfully organized in a resource-limited setting.

Long-Term Survival Analysis of Intraperitoneal versus Intravenous Chemotherapy for Primary Ovarian Cancer and Comparison between Carboplatin- and Cisplatin-based Intraperitoneal Chemotherapy

  • Eoh, Kyung Jin;Lee, Jung-Yun;Nam, Eun Ji;Kim, Sunghoon;Kim, Young Tae;Kim, Sang Wun
    • Journal of Korean Medical Science
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    • v.32 no.12
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    • pp.2021-2028
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    • 2017
  • In epithelial ovarian cancer (EOC), intraperitoneal (IP) administration of chemotherapy is an effective first-line treatment and may improve outcomes, compared with intravenous (IV) chemotherapy. We used Kaplan-Meier survival analysis to compare long-term survival between propensity score-matched patients with advanced EOC receiving IP (n = 34) vs. IV (n = 68) chemotherapy. Additionally, clinical features associated with carboplatin-based (n = 21) and cisplatin-based (n = 16) IP chemotherapy were analyzed and compared with those associated with IV chemotherapy. The IP and IV chemotherapy groups had a median follow-up duration of 67 (range, 3-131) and 62 (range, 0-126) months, respectively, with no significant difference in progression-free survival (PFS) (P = 0.735) and overall survival (OS) (P = 0.776). A significantly higher proportion of patients in the IV (91.2%) than in the IP (67.6%) chemotherapy group (P = 0.004) received ${\geq}6$ cycles. However, the frequency of toxic events (anemia, granulocytopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) was significantly higher in the IP than in the IV group. Within the IP group, no significant differences were observed in PFS (P = 0.533) and OS (P = 0.210) between the cisplatin-based and carboplatin-based chemotherapy subgroups. The 10-year OS was 28.6% and 49.2% in carboplatin-based and cisplatin-based IP chemotherapy groups, respectively. Toxic events (granulocytopenia, leukopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) were significantly more common in the cisplatin-based subgroup. In patients with EOC, cisplatin-based IP chemotherapy may be an acceptable alternative to IV chemotherapy regarding long-term survival, but toxicity must be addressed.

Knowledge and Learning Needs Related to Cancer Treatment in Gynecological Cancer Patients (부인암환자의 항암치료에 대한 지식정도 및 교육요구도)

  • Seo, Mi-Sook;Choi, Euy-Soon
    • Journal of Korean Academy of Nursing
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    • v.36 no.6
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    • pp.942-949
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    • 2006
  • Purpose: This study was to investigate the knowledge and learning needs of chemotherapy in gynecological cancer patients. Method: The subjects consisted of 103 gynecological cancer patients receiving chemotherapy from April 2005 to August 2005. Data was collected using a questionnaire about knowledge and learning needs of chemotherapy. The data was analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using SAS. Result: Average scores of knowledge and learning needs of general treatment and care were 2.74, and 3.30 respectively. Average score of knowledge and learning needs of chemotherapy were 2.54 and 3.23 respectively. Learning needs of general treatment and care and of chemotherapy were significantly different in relation to marital status, educational level, family support, the operation, and the amount of chemotherapy received. Items with the highest level of learning needs were the symptoms of recurring illness of general treatment, and minimizing side effects of chemotherapy. There were a negative correlation between knowledge and learning needs on general treatment and a positive correlation between knowledge and learning needs on chemothearpy but there were not significant statistically. Conclusion: The level of learning needs related to cancer treatment was high, whereas, that of knowledge was low. Therefore, when designing an educational program for gynecological cancer patients, understanding of learning needs is necessary. Also, consideration of a patient's characteristics, and a systematic and detailed educational program should be provided.

Energy Intake and Fatigue in Patients Receiving Chemotherapy (항암화학요법을 받는 암환자의 에너지섭취량과 피로)

  • Byun, Mi Suk;Kim, Na Hyun
    • Journal of Korean Biological Nursing Science
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    • v.14 no.4
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    • pp.258-267
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    • 2012
  • Purpose: The purpose of this study was to identify the relationship between energy intake and fatigue in cancer patients receiving chemotherapy. Methods: A total of 106 subjects had participated in this study. Data were collected at a university hospital in D city from September 1st to November 10th, 2010. Energy intake including carbohydrates, protein and fat was measured by scale and analyzed using Can Pro 3.0 program. Fatigue level was measured by the Revised Piper Fatigue Scale. Data were analyzed using descriptive analysis, t-test, ANOVA and Pearson correlation coefficient with SPSS/WIN 15.0. Results: The mean calorie intake during chemotherapy was $906.53{\pm}201.28Kcal/day$ which was 45.3% of the recommended daily calorie intake. The mean of protein intake level was $43.62{\pm}11.13g/day$, and it was low compared to the recommended daily protein intake. Calories, carbohydrates, and protein levels on 3rd day after chemotherapy were significantly lower than those of 2nd day after chemotherapy (p<.001). The fatigue level during chemotherapy was $5.77{\pm}0.77$ which was moderate level of fatigue. There was a significant negative interrelation between energy intake and fatigue. Conclusion: Theses results suggested that nursing approaches to encourage dietary intake may be helpful to reduce fatigue for cancer patients receiving chemotherapy.