• Title/Summary/Keyword: Adjuvant treatment

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Phase II Study of Compliance and Morbidity with 4 Cycles of Taxotere Followed by 4 of Doxorubicin-Cyclophosphamide for Adjuvant Treatment of Operable Breast Cancer Patients

  • Yaghan, Rami Jalal;Dagher, Nawaf Mahmood
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4031-4035
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    • 2016
  • Background: In the adjuvant treatment of breast cancer, anthracycline and taxane based regimens can be used concomitantly or sequentially. The best order in the sequential regimens has yet to be well established. This study evaluated the feasibility of 4 cycles of adjuvant taxotere ($100mg/m^2$) every 3 weeks followed by 4 cycles of doxorubicin ($60mg/m^2$) and cyclophosphamide ($600mg/m^2$) every 3 weeks. The primary outcome was the safety profile. Secondary outcomes were disease free survival (DFS) and overall survival (OS). Materials and Methods: This non-randomize prospective phase II stud was performed at Jordan University of Science and Technology and its affiliated King Abdulla Teaching Hospital between July 2009 and August 2010. Data collection was closed on May $31^{th}$, 2015 giving a median follow up period of 62 months. The study was approved by the institutional review board and a written informed consent was obtained for each patient. Results: Fifty patients were enrolled. The median age was 53.1 years (range 34-76). One patient (2%) had stage I disease, 17 (34%) stage II, and 32 (64.0%) stage III. Forty-six patients were evaluable for efficacy analysis. The completion rate was 95.7%. No dose modifications were needed. The incidences of grade 3-4 neutropenia and febrile neutropenia were 14 % and 10%. No grade 3-4 non-hematological adverse events were encountered. At a median follow up time of 62 months the OS and the DFS rates were 76.1% and 56.5%. Those for stages I and II combined were 100% and 75%. Conclusions: Taxotere first followed by doxorubicin-cyclophosphamide appears a feasible regimen as evidenced by an acceptable completion rate, a satisfactory safety profile, and an OS and DFS rates comparable to other studies.

Progress and Challenges in Chemotherapy for Loco-Regionally Advanced Nasopharyngeal Carcinoma

  • Liang, Zhong-Guo;Chen, Ze-Tan;Li, Ling;Qu, Song;Zhu, Xiao-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4825-4832
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    • 2015
  • Incidence rates of nasopharyngeal carcinoma are high in Indonesia, Singapore and South-Eastern China. Chemoradiotherapy has been the standard regimen for locally advanced nasopharyngeal carcinoma according to guidelines from the National Comprehensive Cancer Network. Recently, advances in the management of nasopharyngeal carcinoma have transferred into better treatment outcomes. Most phase III clinical trials support the addition of concurrent chemotherapy to radiotherapy for the initial treatment of these patients. Studies evaluating effects and toxicity of concurrent chemotherapy with different regimens have been reported. However, the status of adding adjuvant chemotherapy or induction chemotherapy remains controversial. Recent studies have shown that adjuvant chemotherapy with two or three cycles may improve survival for nasopharyngeal carcinoma with stage N2-3 disease or with persistently detectable plasma EBV DNA after radiotherapy. This review examines the pertinent issues and latest studies concerning the management of loco-regionally advanced NPC, regarding concurrent chemotherapy, adjuvant chemotherapy, and induction chemotherapy in decades.

Articular Cartilage Protective Effects of Kangwhaldoche-tang(Qianghuodaozhi-tang) Aqueous Extracts on the Adjuvant-induced Rat Rheumatoid Arthritis (강활도체탕(羌活導滯湯) 물 추출물의 Adjuvant 유발 류마티스 관절염 랫트에 대한 관절연골 보호효과)

  • Kwon, O-Gon;An, Hee-Duk
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.49-61
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    • 2013
  • Objectives : This study was conducted to determine whether or not Kangwhaldoche-tang(Qianghuodaozhi-tang) (KDT) aqueous extracts can protect articular cartilage losses on the Freund's complete adjuvant(FCA)-induced rat rheumatoid arthritis. Methods : 520, 260 or 130 mg/kg of KDT were orally administered once a day for 14 days from 14 days after FCA treatments, and 15 mg/kg of dexamethasone was intraperitoneally administered as reference drug in this experiment. Changes on the body weight, knee circumferences, gross arthritis score, inflammatory tissue prostaglandin(PG) $E_2$ levels were monitored with cartilage collagen components and glucosaminoglycans(GAGs) compositions - chondroitin sulphate, heparin sulphate and hyaluronic acid in the present study. Results : As results of FCA treatment, classic rheumatoid arthritis featuring dramatic decreases of the body weights, cartilage collagen and GAGs contents with increases of the knee circumferences, gross arthritis scores and inflammatory tissue $PGE_2$ levels, were demonstrated in the present study. However, these changes from FCA - induced rheumatoid arthritis were clearly inhibited by treatment of dexamethasone and all three different dosages of KDT. Although overall anti-inflammatory effects of KDT 520 mg/kg were lowered than those of dexamethasone 15 mg/kg treated rats, KDT 520 mg/kg showed more favorable preserve effects on the cartilage GAGs and KDT 260 mg/kg treated rats showed similar preserve effects as compared with dexamethasone 15 mg/kg in this experiment. Conclusions : The present results supported that over 75 mg/kg of KDT showed favorable anti-arthritic effects on the FCA-induced arthritis mediated by suppression of $PGE_2$, representative inflammatory mediator, and may help improve rheumatoid arthritis.

Update on Current Role of Perioperative Chemotherapy in Upper Tract Urothelial Carcinoma (상부 요로상피암에서 신보조 항암요법 및 보조 항암요법의 최신 지견)

  • Jeon, Byeong Jo;Tae, Bum Sik;Park, Jae Young
    • The Korean Journal of Urological Oncology
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    • v.16 no.3
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    • pp.89-96
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    • 2018
  • Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.

Evaluating the Immunological Adjuvant Activities of Carrageenan and Degraded Carrageenan (Carrageenan과 degraded carrageenan의 면역 보강제로서의 효능 평가)

  • Park, Ji-Hun;Choi, Tae-Saeng
    • Journal of Life Science
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    • v.28 no.9
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    • pp.1076-1080
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    • 2018
  • Carrageenan (CGN) has been used as a safe food additive for several decades. CGN has also been widely used to induce inflammation in various animal models. Likewise, degraded CGN (dCGN), which is produced by subjecting CGN to acid hydrolysis, also induces inflammation and does so more effectively than CGN. One of the most important characteristics of an immunological adjuvant is its ability to activate innate immunity. The immune-adjuvant effects of CGN and dCGN have not yet been studied in detail. The purpose of this study was to evaluate the immunological adjuvant activities of both CGN and dCGN, which was done by comparing the levels of an ovalbumin (OVA)-specific antibody after treatment with OVA in the absence or presence of CGN or dCGN in plasma from immunized mice. CGN and dCGN showed similar levels of adjuvant activity, as evidenced by increased antibody titer. Specifically, both CGN and dCGN significantly increased the levels of OVA-specific IgG, IgG1, and IgG2a antibodies in the plasma as compared with OVA alone (the control). However, compared to the positive control (Freund's adjuvant), both CGN and dCGN caused greater increases in IgG1 than in IgG2a. These results suggest that CGN and dCGN have similar adjuvant activities and produce more IgG1 antibodies than IgG2a.

Effects of Herba Taraxaci Herbal-Acupuncture on Adjuvant Arthritis in Rats (포공영(蒲公英) 약침(藥鍼)이 Rat의 Adjuvant 관절염(關節炎)에 미치는 영향(影響))

  • Ha, Ji-Yong
    • Journal of Pharmacopuncture
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    • v.2 no.1 s.2
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    • pp.135-152
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    • 1999
  • To investigate effects of Taraxaci herbal-acupuncture on Adjuvant Arthritis in rats, the edema rate, the number of WBC, the quantity of total protein, albumin and globulin in the blood serum and histological test of the muscular tissue were measured in the arthritis part. 1. After elicitating arthritis of Sprague Dawely(SD) rats by injection of Freund's complets adjuvant for 2 weeks, saline was injected for the Exp. I group and Taraxaci herbal-acupuncture was injected for the Exp. II group during 30days. Selected point was $ST_{35}$ in both the groups. And then the volume of the paw were checked. The volume of paw was $0.84{\pm}0.14mm$ in the Exp. I group and $0.38{\pm}0.17mm$ in the Exp. II group, the swelling of the paw was restricted significantly in the Exp. II group(p<0.05) 2. The number of WBC was $10.34{\pm}0.14(10^3/ml)$ in the normal group and $37.47{\pm}5.46(10^3/ml)$ in the Exp. I group. It was $20.39{\pm}4.23(10^3/ml)$ in the Exp. II group. This fact showed that the group Exp. II was more effective than the Exp. I group in the treatment of arthritis(p<0.05) 3. The content of the total protein in the blood serum was $6.14{\pm}0.43g/dl$ in the normal group, $7.95{\pm}0.94g/dl$ in the Exp. I group, and $6.38{\pm}1.75g/dl$ in the Exp. II group. This fact showed that the group Exp. II was more effective than the Exp. I group in the treatment of arthritis(p<0.05) 4. The contents of albumin in the blood serum was $2.94{\pm}0.13g/dl$ in the normal group, $2.01{\pm}0.48g/dl$ in the Exp. I group. and $2.71{\pm}0.34g/dl$ in the Exp. II group. This fact showed that the group Exp. II was more effective than the Exp. I group in the treatment of arthritis(p<0.05) 5. The contents of globulin in the blood serum was $3.19{\pm}0.48g/dl$ in the normal group, $4.70{\pm}1.26g/dl$ in the Exp. I group. and $3.67{\pm}0.56g/dl$ in the Exp. II group. There was no significance in the serum globulin between Exp. II group and Exp. I group from the stastical analysis 6. In histological finding, because of severe inflammatory reaction, remarkably irregular tissue and large amount of inflammatory cells were found in the Exp. I group. But the Exp. II group showed small amount of inflammatory cells, the refrained inflammatory state and even recovering state. From these results, it is showed Taraxaci herbal-acupuncture refrain inflammatory reaction and muscular tissue necrosis in SD rats paw were induced by Freund's complete adjuvant

Surgical Treatment of Thymoma (흉선종의 외과적 치료)

  • Jo, Gyu-Cheol;Jo, Gyu-Seok;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.303-307
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    • 1995
  • We experenced 18 patients with surgically treated thymoma from January 1986 to December 1993. There were 13 male and 5 female ranged from 23 to 69 years of age. Among them Myasthenia gravis was present in 8 patients (44%) The predominant cell type was lymphocytic(11 patients), followed by epithelial (3) and mixed (4), and had no value in predicting prognosis. Treatment consisted of complete resection in 15 patients, partial resection in 2 patients and 1 patient was performed biopsy. Only, and then adjuvant radiation therapy was done in 7 patients and 3 patients needed adjuvant chemotherapy. Invasion of the adjacent tissue in thymoma was the most improtant prognostic value. There were 6 non-invasive tumors and 12 invasive tumors. Two patients with invasive thymomas resulted in death and one of 6 patients with non-invasive thymomas died during follow up ranged from 25 day to 60 months. The causes of death were myasthenic crisis in 1 patient, C. N. S. problem in 1 patient and pulmonary & mediastinal metastasis in 1 patient.

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Primary Synovial Sarcoma of Lung

  • Cabuk, Devrim;Ustuner, Berna;Akgul, Asli Gul;Acikgoz, Ozgur;Yaprak, Busra;Uygun, Kazim;Topcu, Salih;Muezzinoglu, Bahar
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.306-309
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    • 2014
  • Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcomas. Primary SS arising from the lung is extremely rare, and the prognosis is poor. We report a case of pulmonary SS presenting with a mass lesion invading the right upper and middle lobes, extending to the mediastinum and the chest wall. After tru-cut biopsy, surgical resection was performed. The final diagnosis was SS (biphasic type) based on histological and immunohistochemical findings. There are no guidelines for optimal treatment due to the rarity of these tumors. Current treatment includes surgery and adjuvant chemotherapy and/or radiotherapy.

Suppressing Effects of Sowhalrack-dan(Xiǎohuóluò-dān) on Freund's Complete Adjuvant Induced Arthritic Rats (Adjuvant 유발(誘發) 류마티스 관절염(關節炎)에 대한 소활락단(小活絡丹)의 억제(抑制) 효과(效果))

  • Yun, Sun-Mo;Jeong, Man-Jin;Kwon, O-Gon;Woo, Chang-Hoon;An, Hee-Duk
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.1
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    • pp.97-114
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    • 2011
  • Objectives : The object of this study is to observe the favorable anti arthritic effects of Sowhalrack-dan($Xi\check{a}ohu\acute{o}lu\grave{o}-d\bar{a}n$)(SWRD), which has been traditionally used in Korean medicine to treat rheumatoid arthritis on Freund's complete adjuvant(FCA) induced arthritic Wistar rats. Methods : Rheumatoid arthritis was induced by intradermal injection of FCA(10 mg in 1 ml paraffin oil 0.1 ml/rats). Each of 8 rats showing regular ankle circumferences per group were selected in 14 days after FCA treatment to confirm the induction of rheumatoid arthritis. 300, 150 or 75 mg/kg of SWRD was orally administered once a day for 14 days from 14 days after FCA treatments. Dexamethasone was intraperitoneally administered 15 mg/kg, once a day for 14 days from 14 days after FCA treatments. Rats were sacrificed after 14 days of continuous oral treatment of SWRD or intraperitoneal administration of dexamethasone, and changes were observed; the body weight, knee circumferences, gross arthritis score, inflammatory tissue $prostaglandin(PG)E_2$ levels and cartilage collagen, glucosaminoglycans compositions - chondroitin sulphate, heparin sulphate and hyaluronic acid in the present study. Results : As results of FCA treatment, classic rheumatoid arthritis featuring dramatical decreases on the body weights, cartilage collagen contents and bone glucosaminoglycans - chondroitin sulphate, heparin sulphate and hyaluronic acid contents. Also, it increases the knee circumferences, gross arthritis scores and inflammatory tissue $PGE_2$ levels. However, these changes from FCA induced rheumatoid arthritis were clearly reduced due to the dexamethasone and both two different dosages of SWRD, 300 and 150 mg/kg in the present study. Although FCA induced arthritis were more favorably inhibited by treatment of dexamethasone 15 mg/kg compared to SWRD 300 mg/kg, marked decreases of body weights were detected in dexamethasone 15 mg/kg treated rats. Conclusions : The results obtained in this study suggest that over 150 mg/kg of SWRD showed favorable anti-arthritic effects on the FCA induced arthritis mediated by suppression of $PGE_2$. However, detailed mechanism studies are needed with the screening of the biological active compounds in SWRD. Although FCA induced arthritis were more favorably inhibited by treatment of dexamethasone 15 mg/kg compared to SWRD 300 mg/kg, marked decreases of body weights were detected in dexamethasone 15 mg/kg treated rats, in the present study.

Treatment outcomes after adjuvant radiotherapy following surgery for patients with stage I endometrial cancer

  • Kim, Jiyoung;Lee, Kyung-Ja;Park, Kyung-Ran;Ha, Boram;Kim, Yi-Jun;Jung, Wonguen;Lee, Rena;Kim, Seung Cheol;Moon, Hye Sung;Ju, Woong;Kim, Yun Hwan;Lee, Jihae
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.265-272
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    • 2016
  • Purpose: The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. Materials and Methods: The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0-50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. Results: The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. Conclusion: Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.