• Title, Summary, Keyword: maintenance therapy

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Update on the Evidence Regarding Maintenance Therapy

  • Lee, Jeong Eun;Chung, Chae-Uk
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.1
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    • pp.1-7
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    • 2014
  • Maintenance therapy has emerged as a novel therapeutic paradigm for advanced non-small-cell lung cancer (NSCLC). Maintenance therapy that aims to sustain a clinically favorable state after first-line chemotherapy has two strategies. Switch maintenance therapy entails switching to a new and non-cross-resistant agent in an alternating or sequential manner, on completion of first-line chemotherapy. Continuous maintenance therapy keeps ongoing administration of a component of the current regimen after four to six cycles of chemotherapy, if there is a stable disease, or better response. Both maintenance therapies can be continued, until disease progression. The potential evidence regarding maintenance therapy includes providing the opportunity to receive additional treatment, through sustaining tumor shrinkage, and delayed emergence of tumor-related symptom. Thus far, debates over the parameters used to predict the effectiveness of maintenance therapy, financial burden, and uncertainty of improving the quality of life exist. Despite many debates, maintenance therapy, which is currently recommended, has been disclosed to be beneficial.

The comparison of clinical changes during maintenance phase after non-surgical or surgical therapy of chronic periodontitis (만성 치주염에서 비외과적 또는 외과적 치주치료 후 유지관리기 동안 임상적 변화의 비교)

  • Kim, Jee-Hyun;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.69-84
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    • 2006
  • Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.

Long-term evaluations of teeth and dental implants during dental maintenance period

  • Yoon, Da-Le;Kim, Yong-Gun;Cho, Jin-Hyun;Lee, Jae-Mok;Lee, Sang-Kyu
    • The Journal of Advanced Prosthodontics
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    • v.9 no.3
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    • pp.224-231
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    • 2017
  • PURPOSE. This study was designed to evaluate the teeth and dental implants during dental maintenance therapy over 3 years in different conditions after periodontal and dental prosthetic treatment. MATERIALS AND METHODS. 166 patients received maintenance therapy. 59 patients were treated with 2% minocycline-HCl ointment as local drug delivery (LDD) (L group) and 107 patients were treated without LDD (NL group). Clinical data was collected in maintenance period for evaluation. Patients were classified into groups depending on the application of LDD with maintenance therapy, the type of dental treatment before maintenance period (Pre-Tx), the frequency (F-MT), and regularity (R-MT) of maintenance therapy. RESULTS. The numbers of lost teeth (N-teeth, P=.003) and newly placed dental implants (N-implants, P=.022) are significantly different according to Pre-Tx. F-MT among patients who received surgical dental treatment before maintenance period showed statistical differences in N-teeth (P=.041), but not in N-implants (P=.564). All of the patients in L group showed high F-MT (F-MT1). In NL group, there were no statistical differences in N-teeth or N-implants according to F-MT or R-MT. In F-MT1 group, application of LDD made N-teeth significantly different from both Pre-Tx groups while no significant difference could be found in N-implant. Independent t-test and one-way ANOVA were selected for statistical analysis. CONCLUSION. The regular maintenance therapy and LDD can be effective for teeth during maintenance period. It is not only pharmacological efficacy in decreasing bacterial species that makes LDD a useful adjunct. Application of LDD also motivates patients to take adequate check-ups in the aspects of both frequency and regularity.

The importance of SPT(Supportive Periodontal Therapy) for prevention of peri-implant disease (임상가를 위한 특집 1 - Peri-implant disease를 방지하기 위한 Supportive Periodontal Therapy(SPT)의 중요성)

  • Park, Su Jung
    • The journal of the Korean dental association
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    • v.51 no.12
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    • pp.630-636
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    • 2013
  • During the past decade, the use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has become highly predictable and successful. SPT(Supportive Periodontal Therapy) identified as regular visits to the therapist for periodontal control and maintenance in a well-organized scheme, the number of appointments per year following a pre-designed subject-tooth/implant-site risk assessment method. Peri-implant disease was a frequent finding in subjects having natural healthy dentition and in subjects without periodontitis. Supportive periodontal program were found to be strongly related to implant survival. This study demonstrates that regular maintenance reduces the risk for peri-implant inflammation significantly as compared with irregular maintenance. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications. It is highly recommended to maintain implant patients under a strict supportive periodontal treatment protocol that might contribute to implant survival, and regular maintenance reduces the risk for periimplant inflammation significantly as compared with irregular maintenance. Ideally, patients may be informed on the beneficial effect of a regular patient-related post-therapy care before implant insertion.

Clinical study in 320 cases for cancer patients on the effect Hangamdan(抗癌丹) (항암단(抗癌丹)을 투여(投與)한 각종(各種) 암환자(癌患者) 320례(例)에 대(對)한 고찰(考察))

  • Cho, Jung-hyo;Yoo, Hwa-seung;Lee, Yeon-weol;Son, Chang-kyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.12 no.2
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    • pp.157-175
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    • 2004
  • The purpose of this study was to investigate the effects of Hangamdan(抗癌丹). The clinical study was carried out 320 cases of patients with cancer treated by Hangamdan(抗癌丹) from May 1st 1998 to September 1st 1999. The results were summarized as follows; 1. The effects of improvement in the symptoms with traditional oriental cancer therapy(47.6%) were higher than combined treatment of western and oriental therapy(37.4%). 2. In the analysis of hematology, maintenance and increasing of WBC(86.2%), Hgb(87.2%), P1atelet(97.6%) RBC(81.1%) were observed. In the analyses of tumor marker, maintenance and decreasing of CEA(76%), CA19-9(88.8%), AFP(69.2%) were observed. 3. In the analysis of safety, maintenance and decreasing of AST(93.1%), ALT(95%), BUN(92.2%), Creatinine(93.6%) were observed. 4. In the analysis of QOL attached by cancer, combined treatment of western and oriental therapy(maintenance and improvement; 91.8%) was higher than traditional oriental cancer therapy(maintenance and improvement; 79.3%) 5. In the analysis of survival in patients with terminal cancer, above 6 months(46.3%), 12 months(19.2%). 6. In the analysis of antitumor effects, combined treatment of western and oriental therapy(maintenance 71.6% improvement 12.8%) was higher than traditional oriental therapy (maintenance 66.7% improvement 9.5%). 7. In the analysis of curative evaluation, combined treatment of western and oriental therapy(maintenance 40.4% improvement 41.8%) was higher than traditional oriental therapy (maintenance 23.8% improvement 46.1%). 8. In the analysis of IL-12 and IFN-$\gamma$ attached by cancer, increasing of IL-12(32.3%), IFN-$\gamma$(41.5%) were observed. From the above results, it is suggested that Hangamdan has significant effects of antitumor and immune activity, also could be usefully applied for cancer patients by combination with western therapy or alone.

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The Clinical study in 83 cases for colorectal cancer patients on the effects by Hangamdan(抗癌丹) (항암단(抗癌丹)을 투여(投與)한 대장암(大腸癌) 환자(患者) 83례(例)에 대한 임상보고(臨床報告))

  • Lee, Yong-Yeon;Seo, Sang-Hoon;Yoo, Hwa-Seung;Choi, Woo-Jin;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Kyu;Cho, Chong-Kwan
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.6 no.1
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    • pp.165-180
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    • 2000
  • Clinical studies were carried out 83 cases of patients with colorectal cancer treated by Hangamdan(抗癌丹) from January 1th 1998 to September 30th 2000. The results were summarized as follows; 1. Distribution of those attached by colorectal cancer, by sex, showed that Male is more then Female, by age, showed that the number of fifties is majority. 2. Distribution of diagnostic stage, in descending order; stage III(53%, top), stage IV(45.8%). 3. The effects of maintenance and improvement in the symptoms with traditional oriental therapy(83.3%) and combined treatment of western and oriental therapy(92.1%) were observed. The effects of the symptoms were as follows: diarrhea(37.3%), abdominal pain (25.3%), general body weakness(22.9%), nausea(20.5%) and etc. in orders. 4. Analysis of hematology attached by colorectal cancer, maintenance and increasing of WBC(89.9%), RBC(74.7%), Hgb(81.1%), Platelet(92.4%) were observed. After taken Hangamdan, the safety of the liver and kidney were as follows; maintenance and decreasing of AST(85.9%), ALT(94.8%), GTP(87.5%), Creatinine(90.9%) were observed. 5. of IL-12 and $IFN-\gammer$ attached by colorectal cancer, increasing of IL-12(53.3%), IFN-{\gammer}(80%)$) were observed. 6. Analysis of QOL attached by colorectal cancer, maintenance and improvement of combined treatment of western and oriental therapy(89.6%), traditional oriental therapy(83.3%) were observed. 7. Analysis of survival in patients with IV stage of colorectal cancer, above 7 months(18.4%), 12 months(65.8%). 8. Analysis of antitumor effects, maintenance of traditional oriental therapy(83.3%) and maintenance and improvement of combined treatment of western and oriental therapy(80.5%) were observed. Analysis of tumor marker attached by colorectal cancer, maintenance and decreasing of CEA(78.8%) were observed. 9. Analysis of curative valuation, maintenance and improvement of traditional oriental therapy(83.3%), combined treatment of western and oriental therapy(72.7%) were observed. From the above results, it is suggested that Hangamdan has significant effects of antitumor and immune activity, also could be usefully applied for colorectal cancer patients by combination with western therapy or alone.

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Effects of Rituximab Including Long-term Maintenance Therapy in Children with Nephrotic Syndrome in a Single Center of Korea

  • Kim, Seong Heon;Lim, Taek Jin;Song, Ji Yeon;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.22 no.1
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    • pp.1-6
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    • 2018
  • Rituximab (RTX) is a chimeric monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation. Several studies have examined its use in intractable nephrotic syndrome (NS) with some positive results. However, those studies examined such effects for a short-term period of 1 year, and some patients continued to relapse after a lapse in RTX treatment. Our use of RTX as a maintenance therapy (RTX injection when the CD19 cell count exceeded $100-200/{\mu}L$ before relapse) showed some noticeable efficacy. We used RTX in 19 patients with steroid-dependent NS (SDNS). In 12 patients treated with RTX maintenance therapy, only one relapse occurred. The mean treatment period was $23.4{\pm}12.7months$, and the mean number of RTX administrations was $3.9{\pm}1.6$. The relapse rates were decreased (from 2.68/year to 0.04/year), and the drug-free period also increased (from 22.5 days/year to 357.1 days/year) during maintenance therapy. The other seven patients were treated with one cycle of RTX or additional cycles in case of relapse (non-maintenance therapy). Relapse rates were significantly decreased after RTX treatment (from 1.76/year to 0.96/year, P=0.017). The relapse-free period was $15.55{\pm}7.38$ (range, 5.3-30.7) months. No severe side effects of RTX were found except for a hypersensitivity reaction such as fever and chills during its infusion. In conclusion, RTX is considered an effective and safe option to reduce the relapse rate by a single- or maintenance-interval therapy in SDNS.

The Clinical study in 62 cases for lung cancer patients on the effects by Hangamdan(抗癌丹) (항암단(抗癌丹)을 투여(投與)한 폐암(肺癌) 환자(患者) 62례(例)에 대한 임상보고(臨床報告))

  • Choi, Byung-lyul;Son, Chang-kyu
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.121-131
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    • 2001
  • Clinical studies were carried out 62 cases of patients with lung cancer treated by Hangamdan(抗癌丹) from January 1th 1998 to September 30th 2000. The results were summarized as follows; 1. Distribution of those attached by lung cancer, by sex, showed that Male is more then Female, by age, showed that the number of sixties is majority. 2. Distribution of diagnostic stage, in descending order; stage IV(43.6%,top), stage III(35.5%), stage II(17.7%), stage I(3.2%). 3. The effects of maintenance and improvement in the symptoms with traditional oriental therapy(83.3%) and combined treatment of western and oriental therapy(84.0%) were observed. The effects of the symptoms were as follows; cough(50.0%), anorexia(48.4%), chest discomfort(31.0%), sputum(24.2%), general body weakness(11.3%), hemoptysis(9.7%) and etc. in orders. 4. Analysis of hematology attached by lung cancer, maintenance and increasing of WBC(98.4%), RBC(74.2%), Hgb(71.0%), Platelet(96.7%) were observed. After taken Hangamdan, the safety of the liver and kidney were as follows; maintenance and decreasing of AST(91.5%), ALT(93.2%), ${\gamma}-GTP$(95.0%), BUN(82.7%), Creatinine(93.3%) were observed. 5. Analysis of IL-12 and $IFN-{\gamma}$ attached by lung cancer, increasing of IL-12(31.3%), $IFN-{\gamma}$(72.7%) were observed. 6. Analysis of QOL attached by lung cancer, maintenance and improvement of combined treatment of western and oriental therapy(94.0%), traditional oriental therapy(91.7%) were observed. 7. Analysis of survival in patients with IV stage of lung cancer, above 7 months(22.2%), 12 months(70.4%). 8. Analysis of antitumor effects, maintenance of traditional oriental therapy(50.0%) and maintenance and improvement of combined treatment of western and oriental therapy(80.0%) were observed. 9. Analysis of curative valuation, maintenance and improvement of traditional oriental therapy(50.0%), combined treatment of western and oriental therapy(60.0%) were observed. From the above results, it is suggested that Hangamdan has significant effects of antitumor and immune activity, also could be usefully applied for lung cancer patients by combination with western therapy or alone.

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Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Versus Placebo as Maintenance Therapy for Advanced Non-small-cell Lung Cancer: A Meta-analysis of Randomized Controlled Trials

  • Alimujiang, S.;Zhang, Tao;Han, Zhi-Gang;Yuan, Shuai-Fei;Wang, Qiang;Yu, Ting-Ting;Shan, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2413-2419
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    • 2013
  • Background: Use of epidermal growth factor receptor inhibitors (EGFR-TKIs ) is now standard for non-small-cell lung cancer (NSCLC). However, the effects of EGFR-TKIs in maintenance therapy for advanced NSCLC patients are still unclear. The preent meta-analysis was performed to examine pooled data of randomized control trials (RCT) where EGFR-TKIs were compared against placebo in maintenance regimens for patients with advanced NCSLC to quantify potential benefits and determine safety. Methods: Several data bases were searched, including PubMed, EMBASE and CENTRAL, and we performed an internet search of conference literature. The endpoints were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS). We performed a meta-analysis of the published data, using Comprehensive Meta Analysis software (Version 2.0). with a fixed effects model and an additional random effects model, when applicable. The results of the meta-analysis are expressed as hazard ratios (HRs) or risk ratios (RRs), with their corresponding 95% confidence intervals (95%CIs). Results: The final analysis included six trials, covering 3,758 patients. Compared with placebo, EGFR-TKIs maintenance therapy improved ORR and PFS for patients with advanced NSCLC, the difference being statistically significant (P<0.05), but proved unable to prolong patients' OS. The main adverse reactions were diarrhea and rashes. Conclusion: EGFR-TKIs demonstrated encouraging efficacy, safety and survival when delivered as maintenance therapy for patients with advanced NSCLC after first-line chemotherapy, especially for the patients who had adenocarcinomas, were female, non-smokers and patients with EGFR gene mutations.

A Study on the Posture Maintenance Performance and Self-Efficacy in accordance with Posture Correction Program (자세교정프로그램에 따른 자세유지 수행과 자기효능감에 관한 연구)

  • Jang, Su-Gyeong
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.459-474
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    • 2000
  • The purpose of this study is to identify the posture correction program as the development of the posture maintenance performance, and search for the more efficient posture correction program. The data analysis was processed by SPSS. The data was analysed with $x^2$-test, t-test, pearson product moment correlation, and stepwise regression analysis. The finding of this study is as follows: There are the homogeneity between two groups was verified on the know ledges CF=.697, df=2, P>.05), self-efficacy(F=.098, df=2, P>.05) about the posture. The developed posture correction program has proved to enhance the posture maintenance performance(knowledge t=1.60, P<.05 ; posture manintenance t=7.69, P<.01). The type of posture correction program showed some significant differences (t=5.62, P<.01) in the accuracy of movement way among the factors of the posture maintenance performance. The posture maintenance performance affected self-efficacy. Therefore, the major conclusion is as follows: The posture correction program was meaningfully effective on developing the posture maintenance, and with practice created accuracy much more on the posture maintenance movement way. The development of the posture maintenance performance affected the increase of self-efficacy about the posture. The self-efficacy has proved so powerful factor to influence on the posture maintenance performance development. So, the posture correction program should be done systematically and continually, and developing the posture maintenance performance should be done with practice. After the education, it should be reinforced through practice, midterm identification and reeducation and motivated with recognizing the accurate posture measurement. And it should be created the correction program to develop the high self-efficacy about the posture. It needs the strategy to educate the correct posture individually, and to spread to the society for healthy life style.

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