• Title/Summary/Keyword: Cancer chemotherapy

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Assessment of Appropriateness of Criteria for Insurance Coverage on Systemic Therapy used in Renal Cell Carcinoma (신세포암에 사용되는 전신 항암요법의 요양급여기준에 관한 고찰)

  • Kim, Jeong-Yeon;Park, Eun-Ji;Bae, Min-Kyung;Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.319-331
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    • 2011
  • Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

Effects of Hand Reflexology on Physiological.Emotional Responses and Immunity in the Patients with Chronic illness; Chronic renal failure patients and Cancer patients (손 반사요법이 만성질환자의 생리.정서적 반응과 면역 반응에 미치는 효과 : 만성신부전증과 암 환자 중심으로)

  • 이정희;오세영;박옥순;권인각;정미아;이은아
    • Journal of Korean Academy of Nursing
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    • v.32 no.5
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    • pp.716-726
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    • 2002
  • The purpose of this study was to explore the effects of hand reflexology on the physiological.emotional responses and immunity of the patients with chronic illness. This study looked specifically at patients with chronic renal failure(CRF) and cancer patients. Method: This study was designed as a quasi-experimental nonequivalent control group pre and post test. Subjects were 54 patients who received dialysis and chemotherapy in one hospital. Thirty-one patients were assigned to the experimental group and 23 to the control group. The hand reflexology was applied to both hands of the experiment group for ten minutes each time, 5 times during three days. For data collection, physiological lab levels, immune cells of blood and questionnaires for emotional responses were measured before and after the program. Result: BT of the experiment group was decreased significantly on both of the 1st and the 5th application. PR & BP were decreased significantly on the 1st times, but not 5th times. Hb levels of the experimental group were significantly increased. And emotional responses, vigor and mood scores of the experiment group were significantly increased. B cell & CD19 were increased significantly on the experiment group. Suppressor T cell and NK cell showed significant decrease after the program, but no significant differences between the groups. Conclusion: We have found that the hand reflexology helps the chronic patients to improve physiological.emotional responses and the immune reaction. Through this result, the hand reflexology is effective as a intervention of psychoneuroimmunologic function.

Detection of Colorectal Cancer with Spine Metastasis During Conservative Treatment for Lumbar Disc Herniation:A Case Report (요추 추간판 탈출증 치료 중 척추 전이가 발생한 대장암 환자 1예)

  • Kwon, Yong-Su;Bae, Jun-Hyo;Yu, Jae-eun;Kim, Hyo-Jun;Park, Joon;Kim, Gook-Beom;Lee, Hee-Won;Kim, Min-Kyun;Hong, Jung-soo
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.187-194
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    • 2020
  • The objective of this study is to report an accidental detection of colorectal cancer (CRC) metastasis to spine during conservative treatment for lumbar disc herniation. We treated a 65-year-old female who was diagnosed with lumbar disc herniation on September 2019 by acupuncture, pharmacopuncture, cupping treatment, chuna manual therapy, herbal medicine treatment, medicine treatment and physical therapy. After that we analyzed medical record from December 12, 2019 to February 11, 2020. The patient was diagnosed with CRC and received tumor resection in 2014. After 2 times of chemotherapy, she arbitrarily interrupted the treatment. Since she stated that CRC treatment was terminated, we had difficulty in finding connection between symptom and CRC. During the treatment period, compression fracture at L3 body was found, which was caused by CRC metastasis. Rigorous question, appropriate radiological and clinical tests are required to patients who have history of malignant tumor.

A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer

  • Jeong, Chaiho;Lee, Jinhee;Ryu, Seongyul;Lee, Hwa Young;Shin, Ah Young;Kim, Ju Sang;Ahn, Joong Hyun;Kang, Hye Seon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.436-439
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    • 2015
  • Small cell lung cancer (SCLC), which originated from neuroendocrine tissue, can develop into paraneoplastic endocrine syndromes, such as Cushing syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone (ACTH). This paraneoplastic syndrome is known to be a poor prognostic factor in SCLC. The reason for poor survival may be because of a higher risk of infection associated with hypercortisolemia. Therefore, early detection and appropriate treatment for this syndrome is necessary. But the diagnosis is challenging and the source of ACTH production can be difficult to identify. We report a 69-year-old male patient who had severe hypokalemia, metabolic alkalosis, and hypertension as manifestations of an ACTH-secreting small cell carcinoma of the lung. He was treated with ketoconazole and spironolactone to control the ACTH dependent Cushing syndrome. He survived for 15 months after chemotherapy, which is unusual considering the poor outcome of the ectopic ATH syndrome associated with SCLC.

THE APPLICATION OF NECK DISSECTION IN THE TREATMENT OF ORAL CANCER (구강암 치료에 있어 경부곽청술의 응용)

  • Kim, Chin-Soo;Kim, Sung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.97-104
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    • 1992
  • This is a report of three cancer patients treated with the different methods of neck dissection considering the state of the each patient. 1. A 76-year old femals patient who showed $T2_N0_M0$ squamous cell carcinoma received the regional neck dissection with resection of primary lesion. The postoperative result was uneventful without recurrence for 3.6 years. 2. A 52-year old male patient who was diagosed $_T3_N1_M0$ squamous cell carcinoma was treated with the bilateral neck dissection and radical resection of primary lesion. Metastasis was noticed on the right scapular area 8 months postoperatively. We treated him with radiation and chemotherapy, but he died 13 months postoperatively. 3. A 55-year old male patient who showed $_T2_N1_M0$ squamous cell cvarcinoma was treated with the classical neck dissection and the radical resection of primary lesion. The postoperative result was good with no recurrence for 4 years.

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Simultaneous Inhibition of CXCR4 and VLA-4 Exhibits Combinatorial Effect in Overcoming Stroma-Mediated Chemotherapy Resistance in Mantle Cell Lymphoma Cells

  • Kim, Yu-Ri;Eom, Ki-Seong
    • IMMUNE NETWORK
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    • v.14 no.6
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    • pp.296-306
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    • 2014
  • There is growing evidence that crosstalk between mantle cell lymphoma (MCL) cells and stromal microenvironments, such as bone marrow and secondary lymphoid tissues, promotes tumor progression by enhancing survival and growth as well as drug resistance of MCL cells. Recent advances in the understanding of lymphoma microenvironment have led to the identification of crucial factors involved in the crosstalk and subsequent generation of their targeted agents. In the present study, we evaluated the combinatory effect of blocking antibodies (Ab) targeting CXCR4 and VLA-4, both of which were known to play significant roles in the induction of environment-mediated drug resistance (EMDR) in MCL cell line, Jeko-1. Simultaneous treatment with anti-CXCR4 and anti-VLA-4 Ab not only reduced the migration of Jeko-1 cells into the protective stromal cells, but also enhanced sensitivity of Jeko-1 to a chemotherapeutic agent to a greater degree than with either Ab alone. These combinatorial effects were associated with decreased phosphorylation of ERK1/2, AKT and NF-${\kappa}B$. Importantly, drug resistance could not be overcome once the adhesion of Jeko-1 to the stromal occurred despite the combined use of Abs, suggesting that the efforts to mitigate migration of MCLs should be attempted as much as possible. Our results provide a basis for a future development of therapeutic strategies targeting both CXCR4 and VLA-4, such as Ab combinations or bispecific antibodies, to improve treatment outcomes of MCL with grave prognosis.

A Case of Amylase Producing Small Cell Lung Cancer (아밀라제를 생성하는 소세포성 폐암 1예)

  • Lee, Han-Min;Song, Young-Gu;Park, Tae-Byung;Hwang, Sung-Chul;Lee, Yi-Hyeong;Hahn, Myung-Ho;Yim, Hyun-Ee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.661-668
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    • 1997
  • The majority of lung cancers associated with hyperamylasemia are adenocarcinomas. Here we report an unusual case of a 54-year-old male patient who complained of dyspnea, anterior chest wall discomfort and facial edema for one month, presenting with a huge mediastinal mass and hyperamylasemia complicated by pericardial effusion. Histological evaluation of mediastinal mass revealed small cell carcinoma and pericardium showed nonspecific inflammation with fibrosis. The serum amylase had an electrophoretic mobility similar to that of salivary gland enzyme. There were no evidence of a salivary or pancreatic causes of hyperamylasemia. After chemotherapy, parenchymal lung lesions improved and hyperamylasemia disappeared. For the management of pericardial effusion, a pericardial window was formed. We concluded that the striking increase in serum amylase was due to the ectopic production of this enzyme by the tumor.

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Treatment Results of Rhabdomyosarcoma (악성 횡문근 육종의 방사선 치료)

  • Lee Youn Goo;Ahn Ki Jung;Suh Chang Ok;Kim Gwi Eon;Lohn John J.K.;Ahn Hee Jung;Choi In Joon;Kim Byung Soo
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.235-245
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    • 1989
  • Rhabdomyosarcoma is a highly malignant soft tissue sarcoma that can arise in any site of the body containing striated muscle or its mesenchymal analgae. It is the most common childhood sarcoma with two peak age frequencies, one at ages 2 to 6, and one in the adolescence. The site, stage and extent of disease, and pathologic characteristics of the tumor contribute to prognostic factors that influence therapeutic decisions. The results of treatment of 52 patients with rhabdomyosarcoma, who were treated at Department of Radiation Oncology, Yonsei University College of Medicine, Yosei Cancer Center from 1976 to 1987 were retrospectively analyzed. The most frequent clinical group and primary sites were IRS group III (57.7%) and head and neck (42.3%) including orbit (11.5%) and parameningeal region(13.5%). The overall and disease free 5 year survival rate of eligible 41 patients were 31.7%, 29.3%, respectively. The complete remission (CR) rate was 50% in clinical group III and 0% in IV. Primary tumors of the orbit, clinical group 1 and embryonal subtype had the best prognosis. The Survival rate was improved by additiion of chemotherapy to operation and radiation therapy.

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Lymphovascular invasion as a negative prognostic factor for triple-negative breast cancer after surgery

  • Ahn, Ki Jung;Park, Jisun;Choi, Yunseon
    • Radiation Oncology Journal
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    • v.35 no.4
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    • pp.332-339
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    • 2017
  • Purpose: This study aimed to evaluate the prognostic effects of lymphovascular invasion (LVI) in triple-negative breast cancer (TNBC) patients who underwent surgical resection. Materials and Methods: A total of 63 non-metastatic TNBC patients who underwent surgical resection were retrospectively investigated from 2007 to 2016 in Inje University Busan Paik Hospital. Pathological tests revealed that 12 patients (19.0%) had LVI. Approximately 61.9% (n = 39) of the patients' samples stained positive for p53. Additional chemotherapy and radiotherapy (RT) were performed in 53 (84.1%) and 47 (74.6%) patients, respectively. Results: The median follow-up period was 39.5 months (range, 5.9 to 123.0 months). The pathological T stage (p = 0.008), N stage (p = 0.014), and p53 positivity (p = 0.044) were associated with LVI. Overall, the 3-year disease-free survival (DFS) rate and overall survival (OS) rate were 85.4% and 90.2%, respectively. Ten patients (15.9%) experienced relapse. LVI (n = 12) was associated with relapses (p = 0.016). p53 positivity was correlated with poor DFS (p = 0.048). Furthermore, LVI was related to poor DFS (p = 0.011) and OS (p = 0.001) and considered as an independent prognostic factor for DFS (p = 0.039). The 3-year DFS of patients with LVI (n = 12) was only 58.3%. Adjuvant RT minimized the negative prognostic effect of LVI on DFS (p = 0.068 [with RT] vs. p = 0.011 [without RT]). Conclusion: LVI was related to the detrimental effects of disease progression and survival of TNBC patients. Thus, a more effective treatment strategy is needed for TNBC patients with LVI.

Hematological Effect of Water Extracts of Cham-Dang-Gui on Cyclophosphamide Induced Anemic Rat (Cyclophosphamide로 유도된 빈혈 흰쥐에서 참당귀 열수추출물이 혈액학적 빈혈지표에 미치는 영향)

  • 한진아;장기효;강순아;조여원
    • Journal of Nutrition and Health
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    • v.36 no.10
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    • pp.1013-1021
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    • 2003
  • Anemia, the condition of the diminished concentration of hemoglobin per erythrocyte is common in patients with cancer and is a frequent complication of myelosuppressive chemotherapy. Cham-Dang-Gui (Angelicae Gigantis Radix) has been used in traditional Korean medicine to treat hematologic deficiencies. In this study, Cyclophosphamide (CYP), an alkylating agent that has a broad spectrum of anti-cancer activities, was intraperitoneally injected into the experimental animals to suppress the bone marrow thereafter, causing anemia. The hemopoietic effects of Cham-Dang-Gui were examined using anemic rat model. Rats were divided into five groups: CON (control group), ANS (CYP-injected + normal diet), AND (CYP-injected + normal diet + Cham-Dang-Gui), ALS (CYP-injected + low iron diet), and ALD (CYP-injected + low iron diet + Cham- Dang-Gui) groups. CYP (30 mg/kg) was intraperitoneally injected to rats for 3 days to induce anemic condition. Saline or Cham-Dang-Gui was administrated orally during the entire experimental period. CYP injection decreased body weight gain and food consumption in comparison with CON group. Oral administration of Cham-Dang-Gui extract with normal iron diet significantly prevented the lower body weight gain. The blood level of hemoglobin, iron status (serum iron, transferrin, ferritin and TIBC) and blood level of vitamin B-12 in Cham-Dang-Gui treated groups were significantly higher than those of Cham-Dang-Gui untreated groups regardless of amount of iron in the diet. Taken together, it could be concluded that the Cham-Dang-Gui extract could improve anemic condition induced by CYP injection by improving hematological value, iron status and vitamin B12 status in rats.