• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.65-73
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• 2022

A breakthrough in immunotherapy has changed the outlook for metastatic colorectal cancer (mCRC) treatment as the immune surveillance evasion mechanism of tumor cells has been continuously elucidated. Immune checkpoint inhibitors (ICI), such as pembrolizumab, nivolumab, and ipilimumab, which block immune checkpoint receptors or ligands have been approved for the treatment of mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) mCRC based on numerous clinical studies. However, 50% of dMMR/MSI-H mCRC and most mismatch repair proficient/microsatellite stable mCRC remained unresponsive to current immunotherapy. Clinical trials on combination therapy that adds various treatments, such as target agents, chemotherapy, or radiation therapy to ICI, have been actively conducted to overcome this immunotherapy limitation. Further studies on safety and efficacy are needed although several trials presented promising data. Additionally, dMMR/MSI-H, tumor mutation burden, and programmed cell death ligand-1 expression have been studied as biomarkers for predicting the treatment response to immunotherapy, but the discovery and validation of more sensitively predictable biomarkers remained necessary. Thus, this study aimed to review recent studies on immunotherapy in mCRC, summarize the efficacy and limitation of immunotherapy, and describe the biomarkers that predict treatment response.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.562-577
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• 2023

Objectives: This is a five-year survival and complete response (CR) report on pancreatic cancer treated with western medicine and Korean traditional medicine. Method: A 59-year-old woman diagnosed with pancreatic cancer visited ○○ Korean traditional medicine hospital after neoadjuvant chemotherapy and pylorus-preserving pancreaticoduodenectomy. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from March 2018 to September 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years and three months of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on October 26, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for pancreatic cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for pancreatic cancer.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.404-407
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• 2009

A 43-yr-old patient visited our department with intermittent chest pain he had suffered with for the past 2 months. Chest CT showed an egg shaped mass in the left chest wall. Local resection was performed for distinguishing the mass from a neurogenic tumor. The diagnosis was periosteal Ewing sarcoma of the rib. Since there was no evidence of metastasis based on the PET-CT, a 2nd operation was done with wide resection and thoracoplasty. The patient was then treated with combined chemotherapy. There has been no local recurrence for the fast 1 year. The patient's age and tumor origin were distinct from the usual characteristics of Ewing's sarcoma. Periosteal Ewing's sarcoma of the rib has rarely been reported. We report here on a case of periosteal Ewing's sarcoma of the rib along with a review of the relevant medical literature.

• The Korean Journal of Nuclear Medicine
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• v.37 no.5
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• pp.331-335
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• 2003

Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose $(^{18}FFDG)PET$ uptake diminished more rapidly fellowing therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT, It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with lymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on $^{18}FFDGPET$ while CT showed persistent destructive bone lesion. Thus, $^{18}FFDGPET$ study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.84-90
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• 1995

To evaluate the role of radiation and chemotherapy after limb-saving operation in the management of soft tissue sarcoma, the authors analysed retrospectively 33 patients treated in department of Orthoaepdic Surgery and Radiation Therapy, Catholic University Medical College, in terms of survival rate, local recurrence rate and prognostic factors. There were 16 males and 17 females. The age distribution ranged from 16 to 81 years with mean age of 48. The follow-up period ranged from 2 to 10 years with average of 5.5 years. The histologic diagnoses were 9 liposarcoma(27.2%), 8 malignant fibrohistiocytoma(24.2%), 7 unclassifiable(21.2%), 3 rhabdomyosarcoma(9.1%), 2 malignant schwannoma, 2 synovral sarcoma, and 2 fibrosarcoma(6.1%) in orders. While marginal and intralesional margins were gained in 24 patients(72.7%), wide and radical margins were obtained only in 9 patients(27.3%). On postoperative 3 weeks, local irradiation of 5000-7000 cGy was delivered to all patients by shrinking field technique for 5-8 weeks. Of 33 patients, 16(45.5%) patients were received adjuvant chemotherapy in combination of adriamycin, cyclophosphamide & vicristine, or VP16 & ifosfamide based on histologic type and obtained surgical margin. The survival rates by direct method at 2 years and 5 years were 58% and 37% respectively. Local recurrences occured in 15 patients(45.5%) at average 16 months after operation. Survival rates at 2 years and 5 years were 37% and 22% in case of intralesional and manginal excision, 75% and 47% in case of wide and radical excision respectively with statistical significance(p<0.05). They were 25% and 17% in the presence of local recurrence, 67% and 42% in the absence of local recurrence respectively with statistical significance(p<0.05). Even though there was no statistical correlation between survival rate and tumor size(p>0.05), the authors considered tumor size as a significant prognostic factors as well as surgical margin and the presence of local recurrence.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.81-88
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• 2018

Objective : Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted. Methods : From April 2010 to March 2016, data from spondylitis patients were collected retrospectively. In total, 69 patients (51 with pyogenic spondylitis and 18 with tuberculous spondylitis) were included. Clinical data, laboratory findings including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, measurements of Cobb angles at the initial and final follow-up, and radiologic features on magnetic resonance imaging (MRI) scans were evaluated. To test differences between the pyogenic and tuberculous groups, numerical data were compared using the student's t-test and Mann-Whitney U test, and categorical data were compared using the chi-square test and Fisher's exact test. Results : The patients' mean age was 60.0 years. Male sex was slightly predominant (56.5%). There was no difference in mean age and sex between the two groups. The pyogenic group had a relatively higher proportion of immunocompromised patients. The peak CRP value was higher in the pyogenic group than in the tuberculous group (14.08 mg/dL and 8.50 mg/dL, respectively, p=0.009), whereas the ESR was not significantly different between the groups (81.5 mm/h and 75.6 mm/h, respectively, p=0.442). Radiologically, the presence of disc space sparing and vertebral body collapse differed between the groups. In the tuberculous group, the disc was more commonly preserved on contrast-enhanced MRI (50% and 23.5%, respectively, p=0.044), and vertebral body collapse was more common (66.6% and 15.7%, respectively, p<0.001). The mean length of hospitalization was longer in the pyogenic group (56.5 days and 41.2 days, respectively, p=0.001). Four mortality cases were observed only in the pyogenic group. The most commonly isolated microorganism in the pyogenic group was Staphylococcus aureus(S. aureus) (methicillin susceptible S. aureus and methicillin resistant S. aureus [MRSA] in 8 and 4 cases, respectively). Conclusion : The clinical and radiological manifestations of spontaneous spondylitis differ based on the causative organism. Pyogenic spondylitis patients tend to have a higher CRP level and a more severe clinical course, whereas tuberculous spondylitis patients present with destruction of the vertebral body with disc sparing more frequently. The presence of MRSA is increasing in community-acquired spondylitis cases.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.172-176
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• 2000

Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1313-1320
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• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

• Journal of Gastric Cancer
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• v.9 no.3
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• pp.128-135
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• 2009

Purpose: The aim of this study was to compare synchronous and metachronous hepatic metastases in patients with gastric cancer to determine clinicopathologic features and differences in prognosis as a function of the timing of the metastasis and the treatment modality rendered. Materials and Methods: Sixty-seven patients who were diagnosed with gastric cancer metastatic to the liver and treated at the Hanyang University Hospital between June 1992 and December 2006 were retrospectively analyzed to study the pertinent clinicopathologic features and effect of treatment methods. Results: There was a significant difference with respect to lymphatic (P=0.041) and vascular invasion (P=0.036) in comparing the clinicopathologic features between the patients with synchronous and metachronous hepatic metastases. The 1-year survival rate and median survival time of patients with gastric cancer and liver metastases were 38.9% and 9.2 months in the entire patient cohort, 30.9% and 9.2 months in the synchronous group, and 44.5% and 9.7 months in the metachronus group, respectively (P=0.436). The group of patients undergoing local treatment (such as surgery and radiologic intervention) followed by systemic chemotherapy, the group of patients receiving systemic chemotherapy only, and the untreated group of patients were compared, and there was no difference between the synchronous and metachronous groups. The synchronous and metachronous groups had high survival rates with local treatment. Conclusion: In patients with gastric cancer and liver metastases, there was no difference in prognosis based on the timing of the hepatic metastases. Independent of the timing of hepatic metastasis, aggressive treatment, such as surgery and radiologic intervention, may help improve the prognosis.

• The Journal of Internal Korean Medicine
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• v.37 no.1
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• pp.77-89
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• 2016

Objectives: The aim of this study was to develop a standard instrument of pattern identification and evaluation for chemotherapy-induced peripheral neuropathy (CIPN).Methods: The advisory committee for this study was organized by 12 professors of traditional Korean medicine from the Korean Association of Traditional Oncology. The items and structure of the instrument were designed based on a review of previous publications. We revised the instrument in consultation with the advisory committee and received additional advice via email.Results: We divided the symptoms and signs of CIPN into four pattern identifications: wind arthralgia (風痺), cold arthralgia (寒痺), dampness arthralgia (濕痺), and arthralgia of the deficiency type (虛痺). We obtained the mean weights to reflect the standard deviations from each symptom of the four pattern identifications, which were scored on a 5-point scale by the advisor committee. After we obtained the answers to discrimination between variable symptoms (變症) and ordinary symptoms (素症) from the 12 experts, we gained the final weight from the combination of the ratio of pattern identification to the number of total answers of the advisory committee and the mean weight.Conclusions: The Instrument on Pattern Identification and Evaluation for CIPN was developed through a discussion between 12 experts. There was a limitation that the validity and reliability of this instrument have not been proven. However, the significance of this study was that it is the first Instrument on Pattern Identification and Evaluation aimed at assessing CIPN in traditional Korean medicine.