• 제목/요약/키워드: Cancer, Pancreatic

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췌장암 MRgART시 복부가스용적 변화에 의한 선량전달오류 원인 분석 (Analysis of the cause of dose delivery errors due to changes in abdominal gas volume during MRgART pancreatic cancer)

  • 하민용;손상준;김찬용;이제희
    • 대한방사선치료학회지
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    • 제32권
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    • pp.73-83
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    • 2020
  • 목 적: 본 연구에서는 췌장암 환자 MRgART(Magnetic Resonance-guided Adaptive Radiation Therapy)시 복부가스용적변화로 인하여 Image fusion 과정에서 생길 수 있는 조직과 가스의 전자밀도 매칭오류를 확인하고 그에 따른 선량 변화와 치료시간에 미치는 영향을 확인해 보고자 한다. 대상 및 방법: 본원에서 ViewRay MRIdian System (Viewray, USA)를 이용하여 MRgART를 시행한 췌장암 환자 중 최초 simulation시와 비교하여 복부가스용적감소가 발생한 환자를 대상으로 Initial plan과 복부가스 전자밀도를 수정한 AGC(Abdominal gas correction) plan의 PTV와 OAR선량을 비교하였고, 총4회 Adaptive 치료에서 환자의 Beam ON(%)을 확인하여 복부가스용적이 치료시간에 미치는 영향을 확인해 보았다. 결 과: Initial plan에서의 Mean, Minimum, Maximum 선량과 AGC plan의 Mean, Minimum, Maximum 선량평균값을 비교하였을 시 OAR에서는 -7~0.1%의 선량차이를 보였으며 평균 0.16% 감소하였고, PTV에서는 4.5~5.5%의 선량이 감소하였으며 평균 5.1%의 선량이 감소하였다. Adaptive치료 시 복부가스용적이 증가할수록 Beam ON(%)이 감소하였다. 결 론: Initial plan과 Adaptive plan간 복부가스용적 변화는 Adaptive plan시 전자밀도매칭 오류로 이어질 수 있으며 이는 PTV와 주변OAR의 선량분포를 변화시키므로 Adaptive plan시 영상 fusion 과정에서 가스용적을 보정한 정확한 전자밀도매칭은 필수적인 요소이다. 또한 복부가스용적이 커질수록 Beam ON(%)이 감소하여 환자의 Motion error로 인한 치료시간이 증가될 수 있다. 따라서 MRgART시에는 전자밀도매칭을 확인하고 복부가스의 가변성을 최소화 하여야 한다.

지주막하강내 약물투여에 의한 말기암 환자의 통증관리 -증례 보고- (Pain Management of Terminal Cancer Patients by Intrathecal Injection of Local Anesthetics, Opioid and Adjuvants -A report of two cases-)

  • 이선화;김종일;이상곤;반종석;민병우
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.259-262
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    • 2000
  • There are many difficulties in the management of terminal cancer pain. We often encounter difficulties when nerve blocks or epidural injection of drugs do not produce good results. Local anesthetics, opioids and adjunctives, were administered to two patients intrathecally. The results were very satisfactory. It has complications such as hypotension or infection due to intrathecal route. In the first case, the pancreatic cancer patient complicated with severe epigastic pain but unfortunately no management was effective in pain control. Intrathecal injection of bupivacaine and morphine mixture was successful even if syncope which was relieved by bed rest. In the second case, the patient complicated with lower abdominal pain due to ovarian cancer who very well controlled by epidural injection of morphine and clonidine mixture but morphine demand was greatly increased. Intrathecal injection of morphine and ketamine were tried. The patient had comportable analgesic effect. CSF leakage to subcutaneous occurred but resolved by change of the catheter position or retunnelling. There were no significant complications reported in two cases.

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녹혈의 화학요법 항암제 부작용 억제 효능 (Effect of Deer Blood on Reduction of the Side Effects of Chemotherapeutic Drugs)

  • 김한섭;홍순복;성현제;문근아;윤유식
    • 생약학회지
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    • 제34권2호통권133호
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    • pp.145-149
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    • 2003
  • Many chemotherapeutic drugs were developed and contributed to the increase of cure rate of cancer, however severe side effect of these drugs is a major cause of poor quality of life of cancer patients. Effect of deer blood on cancer therapy was investigated in mouse tumor model. Deer blood itself was shown to have mild antitumor activity. However it has significant effect on the reduction of the side effects of chemotherapy. Deer blood recovered the reduction of WBC and platelet (myelotoxicity) during fluorouracil chemotherapy. Deer blood also recovered the increase of serum blood urea nitrogen (BUN; indicator of renal toxicity) and increase of serum amylase activity (AMY; indicator of pancreatic toxicity) almost to the control level during cisplatin chemotherapy. Fluorouracil and cisplatin are major chemotherapeutic drugs which are currently used in clinical cancer therapy, and the results strongly suggest that deer blood can be used for reducing the side effects and improving the quality of life during chemotherapy of cancer patients.

속발성 간암으로 인한 협통(脇痛) 치험(治驗) 1례(例) (One Case on Hypochondriae Pain developed by Metastatic Liver Cancer)

  • 정광식;감철우;박동일;전종철
    • 대한한방내과학회지
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    • 제22권4호
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    • pp.717-722
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    • 2001
  • This study was performed on the basis of clinical consideration about patient who has hepatocholangiocarcinoma, and pancreatic cancer. Cancer has gradually increased morbidity and mortality all over the world including Korea. Western medicine has treated with surgical therapy, chemotherapy, radiotherapy and immunotherapy, but has not obtained outstanding results and has a difficulty due to side effects by those therapies. In this study, we recognized that symptom including hypochondriac pain by cancer are rapidly decreased with herbal medication treatment and acupuncture therapy. Oriental medicine treatment is applied throughly on the basis of the oriental medicine principle and the prescriptions were used Naeso-oksultang(內消沃雪湯). According to the above results, we can know this patient has improvement of patient's symptom on administration of oriental medicine treatment, it is helpful in decresing symptoms of patient and in improving quality of life.

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One Case of BRCA2 Germline Mutation Ovarian Cancer Mother and Carrier Daughter found by Genetic Counseling

  • Lee, Eun Jung;Jeong, Hee Jeong;Kim, Min Kyu
    • Journal of Genetic Medicine
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    • 제10권2호
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    • pp.124-127
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    • 2013
  • Among cause of carcinogenesis, heredity is believed to take about 10 percent in ovarian cancer. BRCA1 or BRCA2 account for largest portion of Hereditary Breast and Ovary Cancer (HBOC). Frequency of BRCA1/2 germ line mutations varies according to region and ethnicity from 1.1-39.7 percent. The identification of ovarian cancers with a BRCA mutation is will be more and important due to the possibility to offer a genetic counseling and also due to potential beneficial treatment effects with a poly-ADP-ribose polymerase inhibitor in some individuals. We report the case of a 41 year old woman with a stage Ic mucinous ovarian adenocarcinoma and carrier daughter found on family genetic counseling. We indentified other family members with a history of breast cancer of 1st degree and pancreatic cancer of 2nd degree relative. After a screening with immunohistochemistry, the absence of nuclear expression for BRCA1 and BRCA2 was revealed. The gene sequencing confirmed heterozygous mutations of BRCA2 gene. The daughter of the case subject consented for a test. This test was shown the daughter is positive for BRCA2 mutation. Regular surveillance, chemoprophylaxis with oral contraceptive and prophylactic surgery after childbearing were offered to her.

간암환자(肝癌患者) 1례(例)에 대한 증례보고(證例報告) (Case study on one case of hepatoma)

  • 김태식;고성규
    • 대한한방내과학회지
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    • 제19권1호
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    • pp.73-81
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    • 1998
  • This study was performed on the basis of clinical consideration about patient who has hepatoma, cholangiocarcinoma and pancreatic cancer. Cancer has gradually increased morbidity and mortality all over the world including Korea. Western medicine has treated with surgical therapy, chemotherapy, radiotherapy and immunotherapy, but has not obtained outstanding results and has a difficulty due to side effects by those therapies. In this study, we recognized that symptom including pain by cancer are rapidly decreased with oriental medicine treatment. Oriental medicine treatment is applied throughly on the basis of the oriental medicine principle and the prescrptions were used Bulwhankumjunggisan(不換金正氣散), Sojukbaekchulsan(消積白朮散) Banhabackchulchunmatang(半夏白朮天麻湯). The communitial effect of those prescriptions are invigorating the spreen and benefiting vital energy(健脾益氣), supporting healthy energy to eliminate evils(扶正祛邪) and those treatments are corresponed with traditional oriental treatment principle. Also we can know this patient has a little improvement in the general test including biochemistry, blood test, urine analysis and etc. in spite of outstanding improvement of patient's symptom on administration of oriental medicine. According to the above results, though we has not got satisfaction in getting rid of cancer completely on administration of oriental medicine, it is helpful in decreasing symptoms including pain by cancer and in improving quality of life of patient and in improving quality of patient life.

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Patterns of initial failure after resection for gallbladder cancer: implications for adjuvant radiotherapy

  • Kim, Tae Gyu
    • Radiation Oncology Journal
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    • 제35권4호
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    • pp.359-367
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    • 2017
  • Purpose: This study sought to identify potential candidates for adjuvant radiotherapy and patterns of regional failure in patients who underwent curative-intent surgery for gallbladder cancer. Materials and Methods: Records for 70 patients with gallbladder cancer who underwent curative resection at a single institution between 2000 and 2016 were analysed retrospectively. No patients received adjuvant radiotherapy. Initial patterns of failure were evaluated. Regional recurrence was categorized according to the definitions of lymph node stations suggested by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Results: Median follow-up was 23 months. Locoregional recurrence as any component of first failure occurred in 29 patients (41.4%), with isolated locoregional recurrence in 13 (18.6%). Regional recurrence occurred in 23 patients, and 77 regional recurrences were identified. Commonly involved regional stations were #13, #12a2, #12p2, #12b2, #16a2, #16b1, #9, and #8. Independent prognostic factors for locoregional recurrence were ${\geq}pT2$ disease (hazard ratio [HR], 5.510; 95% confidence interval [CI], 1.260-24.094; p = 0.023) and R1 resection (HR, 6.981; 95% CI, 2.378-20.491; p < 0.001). Conclusion: Patients with pT2 disease or R1 resection after curative surgery for gallbladder cancer may benefit from adjuvant radiotherapy. Our findings on regional recurrence may help physicians construct a target volume for adjuvant radiotherapy.

Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

  • Wen, Ru-Min;Zhang, Yi-Jing;Ma, Sha;Xu, Ying-Li;Chen, Yan-Su;Li, Hai-Long;Bai, Jin;Zheng, Jun-Nian
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3703-3708
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    • 2015
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whether preoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materials and Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluated retrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. The predictive value of NLR for non-metastatic RCC was analyzed. Results: The NLR of 327 patients was $2.72{\pm}2.25$. NLR <1.7 and NLR ${\geq}1.7$ were classified as low and high NLR groups, respectively. Chi-square test showed that the preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histological subtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. To evaluate the independent prognostic significance of NLR, multivariate COX regression models were applied and identified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019). Conclusions: Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker of poor OS and DFS in patients with non-metastatic RCC.

Physical Activity and its Relation to Cancer Risk: Updating the Evidence

  • Kruk, Joanna;Czerniak, Urszula
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.3993-4003
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    • 2013
  • Scientific evidence for the primary prevention of cancer caused by physical activity of regular moderate-intensity or greater is rapidly accumulating in this field. About 300 epidemiologic studies on the association between physical activity and cancer risk have been conducted worldwide. The objectives of this paper were three-fold: (i) to describe briefly the components of physical activity and its quantification; (ii) to summarize the most important conclusions available from comprehensive reports, and reviews of the epidemiologic individual and intervention studies on a role physical activity in cancer prevention; (iii) to present proposed biological mechanisms accounting for effects of activity on cancer risk. The evidence of causal linked physical activity and cancer risk is found to be strong for colon cancer - convincing; weaker for postmenopausal breast and endometrium cancers - probable; and limited suggestive for premenopausal breast, lung, prostate, ovary, gastric and pancreatic cancers. The average risk reductions were reported to be 20-30%. The protective effects of physical activity on cancer risk are hypothesized to be through multiple interrelated pathways: decrease in adiposity, decrease in sexual and metabolic hormones, changes in biomarkers and insulin resistance, improvement of immune function, and reduction of inflammation. As there are several gaps in the literature for associations between activity and cancer risk, additional studies are needed. Future research should include studies dealing with limitations in precise estimates of physical activity and of a lack of consensus on what defines sedentary behavior of individuals and those linked with the proposed biomarkers to cancer risk and controlled exercise intervention trials.

Effect of Resveratrol on Oral Cancer Cell Invasion Induced by Lysophosphatidic Acid

  • Kim, Jin Young;Cho, Kyung Hwa;Lee, Hoi Young
    • 치위생과학회지
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    • 제18권3호
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    • pp.188-193
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    • 2018
  • The aim of the current study was to demonstrate the potential therapeutic efficacy of resveratrol in oral cancer patients. Lysophosphatidic acid (LPA) intensifies cancer cell invasion and metastasis, whereas resveratrol, a natural polyphenolic compound, possesses antitumor activity, suppressing cell proliferation and progression in various cancer cell lines (ovarian, gastric, oral, pancreatic, colon, and prostate cancer cells). In addition, resveratrol has been identified as an inhibitor of LPA-induced proteolytic enzyme expression and ovarian cancer invasion. Furthermore, resveratrol was shown to inhibit oral cancer cell invasion by downregulating hypoxia-inducible factor $1{\alpha}$ and vascular endothelial growth factor expression. Recently, we demonstrated that LPA is important for the expression of transcription factors TWIST and SLUG during epithelial-mesenchymal transition (EMT) in oral squamous carcinoma cells. In this study, we treated serum-starved cultures of oral squamous carcinoma cell line YD-10B with resveratrol for 24 hours prior to stimulation with LPA. To identify an optimal resveratrol concentration that does not induce apoptosis in oral squamous carcinoma cells, we determined the toxicity of resveratrol in YD-10B cells by assessing their viability using the MTT assay. Another assay was performed using Matrigel-coated cell culture inserts to detect oral cancer cell invasion activity. Immunoblotting was applied for analyzing protein expression of SLUG, TWIST1, E-cadherin, and GAPDH. We demonstrated that resveratrol efficiently inhibited LPA-induced oral cancer cell EMT and invasion by downregulating SLUG and TWIST1 expression. Therefore, resveratrol may potentially reduce oral squamous carcinoma cell invasion and metastasis in oral cancer patients, improving their survival outcomes. In summary, we identified new targets for the development of therapies against oral cancer progression and characterized the therapeutic potential of resveratrol for the treatment of oral cancer patients.