• Title/Summary/Keyword: Adjuvant treatment

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Minimally Invasive Option Using Percutaneous Pedicle Screw for Instability of Metastasis Involving Thoracolumbar and Lumbar Spine : A Case Series in a Single Center

  • Park, Ho-Young;Lee, Sun-Ho;Park, Se-Jun;Kim, Eun-Sang;Lee, Chong-Suh;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.100-107
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    • 2015
  • Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

  • Stankevica, Jekaterina;Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5237-5240
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    • 2012
  • Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.

A new aspect of an old friend: the beneficial effect of metformin on anti-tumor immunity

  • Kim, KyeongJin;Yang, Wen-Hao;Jung, Youn-Sang;Cha, Jong-ho
    • BMB Reports
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    • v.53 no.10
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    • pp.512-520
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    • 2020
  • T-cell-based cancer immunotherapies, such as immune checkpoint blockers (ICBs) and chimeric antigen receptor (CAR)-T-cells, have significant anti-tumor effects against certain types of cancer, providing a new paradigm for cancer treatment. However, the activity of tumor infiltrating T-cells (TILs) can be effectively neutralized in the tumor microenvironment (TME) of most solid tumors, rich in various immunosuppressive factors and cells. Therefore, to improve the clinical outcomes of established T-cell-based immunotherapy, adjuvants that can comprehensively relieve multiple immunosuppressive mechanisms of TME are needed. In this regard, recent studies have revealed that metformin has several beneficial effects on anti-tumor immunity. In this mini-review, we understand the immunosuppressive properties of TME and how metformin comprehensively enhances anti-tumor immunity. Finally, we will discuss this old friend's potential as an adjuvant for cancer immunotherapy.

Surgical Management of Metastatic Lung cancer (전이성 폐암의 외과적 고찰)

  • Kim, Gil-Dong;Jeong, Gyeong-Yeong
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.281-286
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    • 1994
  • From 1973 through June 1993, 25 patients underwent pulmonary resection for pulmonary metastases from carcinoma or sarcoma at our institution. There were 11 carcinomas and 14 sarcomas. 24 patients[96% complete] could follow-up and the median follow-up time was 20 months with a range of 4 months to 271 months and total follow-up period was 1105 months-patients. In our patients, actuarial 5-year survival rate was 49%, mean survival time was 66.6$\pm$12.6 months and median survival time was 84 months. Patients with sarcoma, more than 24 months of the tumor-free interval, postoperative adjuvant therapy had a better survival than did those with carcinoma, less than 24 months of the tumor-free interval, no postoperative adjuvant therapy. But there were no statistical differences between two groups[P>0.05]. This results recommend more aggressive surgical treatment for pulmonary metastases.

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Intradural Retroclival Chordoma

  • Choo, Yeon-Soo;Joo, Sang-Wook;Noh, Seung-Jin;Lee, Sun-Il
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.152-155
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    • 2009
  • A 43-year-old woman presented with dizziness, ataxia and right hearing difficulty. Her magnetic resonance images demonstrated an inhomogeneously contrast-enhanced large tumor growing into right cavernous sinus and Meckel's cave located totally within intradural retroclival region. She underwent retromastoid suboccipital craniotomy to resect the tumor mass and adjuvant gamma knife radiosurgery for remnant tumor at 1 month after operation. Adjuvant radiosurgery after surgical excision seems to be effective for the treatment of intradural extraosseous chordomas.

Juvenile Pilomyxoid Astrocytoma in the Opticohypothalamus

  • Kim, Sung-Hyun;Kang, Sam-Suk;Jung, Tae-Young;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.445-447
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    • 2010
  • Pilomyxoid astrocytoma (PMA) is a newly recognized variant of a pilocytic astrocytoma. This report describes a case of a pilomyxoid astrocytoma that occurred in the opticohypothalamus. The patient was a 18-year-old girl who complained decreased visual acuity and visual field over a period of two years. Magnetic resonance imaging (MRI) showed an irregular lobulated tumor with heterogeneous enhancement at the suprasellar region involving the hypothalamus. The mass was partially removed via the subfrontal approach. Its pathology was confirmed to be PMA. Adjuvant chemotherapy with cisplatin and vincristine was started following tumor resection. After four cycles, the mass showed a partial response to the chemotherapy. Although long-term outcome is yet to be determined, the administration of combined cisplatin and vincristine treatment seems to be an effective regimen for a pilomyxoid astrocytoma.

Anti-inflammatory Activity of Detoxified Bacterial Strains in Wistar Rats

  • Sur, Tapas Kumar;Auddy, Biswajit;Mitra, Susil Kumar;Sarkar, Dipak Kumar;Bhattacharyya, Dipankar
    • Natural Product Sciences
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    • v.16 no.3
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    • pp.159-163
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    • 2010
  • A mixture of several detoxified bacterial strains ($Sterodin^{(R)}$) has been studied for anti-inflammatory effect in Wistar rats on carrageenin, dextran and prostaglandin $E_1$ ($PGE_1$) induced edema in acute model and cotton pellet and carrageenin induced sub-acute model, while, Freund's adjuvant induced chronic model. The bacterial strains showed strong inhibitory activity in acute, sub-acute and chronic models of inflammation. Further, it reduced ${\alpha}1$ acid glycoprotein and ${\alpha}2$ macroglobulin levels in serum and prostaglandin $E_2$ in inflamed paw. These results indicated that the bacterial strains probably act through prostaglandin mediatory pathways and may be useful in treatment of inflammation.

A treatment of drug resistant denture stomatitis by microbiological analysis and adjuvant therapy: a case report (미생물학적 분석과 보조요법을 이용한 내성을 가진 의치성구내염 치료)

  • Song, Young-Gyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.2
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    • pp.120-126
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    • 2022
  • In severe cases of denture stomatitis, antifungal drugs are sometimes ineffective. This case is a 72-year-old patient who was prescribed fluconazole for five months but had no improvement in symptoms. After re-diagnosis, medication was performed, and temporary dentures were fabricated for oral rehabilitation. This report describes that microbiological analysis and adjuvant therapy can be helpful, in case does not improve symptoms even with continuous medication of antifungal agent.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

  • Song, Sanghyuk;Chie, Eui Kyu;Kim, Kyubo;Lee, Hyuk-Joon;Yang, Han-Kwang;Han, Sae-Won;Oh, Do-Youn;Im, Seock-Ah;Bang, Yung-Jue;Ha, Sung W.
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.213-217
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    • 2012
  • Purpose: To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Materials and Methods: Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). Results: The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Locoregional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Conclusion: Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.