• Radiation Oncology Journal
• /
• 제30권4호
• /
• pp.213-217
• /
• 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.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권10호
• /
• pp.4153-4158
• /
• 2014

Background: This study was aimed to establish a novel method to simultaneously detect expression of four genes, ribonucleotide reductase subunit M1(RRM1), X-ray repair cross-complementing gene 1 (XRCC1), thymidylate synthase (TS) and class III ${\beta}$-tubulin (TUBB3), and to assess their application in the clinic for prediction of response of non-small cell lung cancer (NSCLC) to chemoradiotherapy. Materials and Methods: We have designed four gene molecular beacon (MB) probes for multiplex quantitative real-time polymerase chain reactions to examine RRM1, XRCC1, TUBB3 and TS mRNA expression in paraffin-embedded specimens from 50 patients with advanced or metastatic carcinomas. Twenty one NSCLC patients receiving cisplatin-based first-line treatment were analyzed. Results: These molecular beacon probes could specially bind to their target genes in homogeneous solutions. Patients with low RRM1 and XRCC1 mRNA levels were found to have apparently higher response rates to chemoradiotherapy compared with those with high levels of RRM1 and XRCC1 expression (p<0.05). The TS gene expression level was not significantly associated with chemotherapy response (p>0.05). Conclusions: A method of simultaneously detecting four molecular markers was successfully established and applied for evaluation of chemoradiotherapy response. It may be a useful tool in personalized cancer therapy.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권21호
• /
• pp.9225-9232
• /
• 2014

Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ethnicity [${\beta}=1.3$; 95% confidence interval (CI): 0.21, 2.43; p value=0.020], being female [${\beta}=1.8$; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [${\beta}=0.08$; 95%CI: 0.06, 1.46; p value=0.035], presence of nausea or vomiting [${\beta}=2.3$; 95%CI: 1.12, 3.48; p value <0.001] and other side effects [${\beta}=1.45$; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our local population. Attention should be given to non-Malay males and patients having nausea, vomiting or other side effects. Sufficient information, proactive assessment and appropriate management of side effects would improve patient satisfaction and thus create motivation to adhere to treatment plans.

• Journal of Chest Surgery
• /
• 제34권7호
• /
• pp.539-546
• /
• 2001

배경: 면역저하 환자에게 발생하는 폐 합병증은 흔히 치명적이다. 폐생검술과 같은 침습적인 진단 술기의 위험도 때문에 일반적으로 임상 양상과 방사선 영상 소견에 근거하여 경험적인 치료가 적용된다. 그러나 최근 수술 술기와 수술 전후의 환자 관리의 발전으로 인해 술기와 연관된 위험도는 줄어든 실정이다. 이에 폐합병증을 동반한 심한 면역저하 환자에서 시행된 폐생검술의 위험성 및 유효성에 대하여 전향적으로 분석하였다. 대상 및 방법: 1996년 6월부터 1999년 12월까지 폐합병증을 동반한 면역저하 환자 42명에서 43례의 폐생검술을 실시하였다. 면역저하는 다음과 같이 정의하였고(1, 혈액학적인 질환으로 인해 화학요법이나 다른 치료를 동반하여 받은 경우, 2. 이식 수술 후 면역 억제제를 복용하는 경우, 3. 1 개월 이상의 스테로이드 복용, 4. 원발성 면역결핍 질환), 이상의 면역저하 환자에서 새로운 폐합병증을 동반하고 1 주간의 경험적 치료에 호전이 없거나 급속하게 진행되는 경우를 대상으로 하였다 기저 질환은 혈액학적 질환(31명), 이식 수술 환자(3명), 고형암으로 인한 화학요법(2명)등이었으며 수술은 개흉술이나 video-aided thoracoscopic surgery (VATS)를 통하여 이루어 졌다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권14호
• /
• pp.6149-6154
• /
• 2015

Background: There is no suggested molecular indicator for the determination of which patients will benefit from anti-angiogenetic treatment in metastatic colorectal cancers. Materials and Methods: In this study, VEGF and $HIF-1{\alpha}$ expression and their clinical significance were studied in tumor tissues of patients with colorectal cancer receiving bevacizumab-based treatment. VEGF and $HIF-1{\alpha}$ were assessed by immunohistochemistry in the primary tumors of 53 metastatic colorectal cancer patients receiving chemotherapy in combination with first line bevacizumab. Results: The clinical benefit rate in the low-VEGF expression group was 38%, while it was 62% in the high expression group. While the median progression-free survival (PFS) was 10 months in the high-VEGF expression group, it was 8 months in the low-VEGF expression group (p = 0.009). The median overall survival (OS) was found to be 26 months vs 15 months. Thus, when VEGF was strongly expressed it was in favor of that group and the difference was statistically significant (p = 0.03). High VEGF expression rate was an independent factor that correlated with OS or PFS (p=0.016 and 0.009, respectively). Conclusions: The data showed that VEGF may have predictive value for determining the treatment of CRC.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권7호
• /
• pp.3213-3218
• /
• 2012

When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

• 성인간호학회지
• /
• 제28권2호
• /
• pp.202-212
• /
• 2016

Purpose: The purpose of this study was to assess the relationship between cognitive function impairment and quality of life (QoL) among patients with breast cancer. Specifically, the intention was to verify the mediating effects for promoting behaviors leading to better health and QoL. Methods: A purposive sample of 152 patients undergoing chemotherapy was recruited. A cross-sectional survey design was used. Data were collected using four instruments: Everyday Cognition Scale, Korean Mini-Mental State Examination, Functional Assessment of Cancer Therapy-Breast Cancer Version 4, and Health Promoting Lifestyle Profile. Results: The mean score for subjective cognitive decline was 65.84; the health promotion behavior was 95.89, and 83.34 for QoL. Health promotion behavior was directly affected by cognitive decline ($R^2=6.0%$) as was QoL ($R^2=43%$). Subjective cognitive decline (${\beta}=-.57$ p<.001) and health promotion behavior (${\beta}=.37$, p<.001) were seen as predicting factors in QoL and explained 56% ($R^2=56%$). Health promotion behavior had a partial mediating effect in the relationship between self-reported cognitive decline and QoL (Sobel test: Z=-3.37, p<.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline and promoting health promotion behavior are highly recommended to improve QoL in cancer patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권3호
• /
• pp.937-940
• /
• 2012

Due to lack of sufficient data on characteristics of breast cancer patients and risk factors for developing metastasis in Iran this study was designed to understand clinical aspects impacting on survival. A cross-sectional study on breast cancer patients was conducted in an oncology clinic of the university hospital between 1995 and 2010. Data were retrieved from medical records and included age, menopausal status, tumor diameter, number of involved nodes, histopathological type, estrogen and progesterone receptor expression, c-erbB-2, primary and secondary metastasis sites, overall survival, disease free interval and type of chemotherapy protocol. The results were analyzed with SPSS 13 software. The mean age of the patients was 49.2 (27-89) years. The primary tumors were mainly ER positive (48%) and PR negative (49.3%). The status of lymph nodes dissected and examined in these patients was unknown in 19 patients (25.3%) while 18 patients (24%) had positive lymph nodes with no report on the number of involved nodes. All of the patients had received antracyclin based chemotherapy in an adjuvant or metastatic setting. Adjuvant hormonal therapy was administered to receptor positive patients. In average, overall survival after recurrence was 30 months (95%CI 24.605-35.325) for non-skeletal versus 42 months (95%CI 31.211-52.789) for skeletal metastasis (P= 0.002). The median survival was also greater for receptor positive patients; 39 months (95%CI 33.716-44.284) for PR+ versus 26 months (95%CI 19.210-32.790) for PR- (P=0.047) and 38 months (95%CI 32.908-43.092) for ER+ versus 27 months (95%CI 18.780-35.220) for ER- patients (P=0.016). No relation was found between site of first metastasis and hormone receptor, age, tumor diameter, DFI and menopausal status. Sites of metastasis were independent of age, size of the tumor, menopausal and hormone receptor status in this study. Overall survival provided significant relations with respect to receptor status and bone metastasis.