• Title/Summary/Keyword: Chemotherapy alone

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Long-term results of ipsilateral radiotherapy for tonsil cancer

  • Koo, Tae Ryool;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.66-71
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    • 2013
  • Purpose: We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. Materials and Methods: From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. Results: The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Conclusion: Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.

Extended Field Radiotherapy With or Without Chemotherapy in Patients with Cervical Cancer and Positive Para-Aortic Lymph Nodes: a Single Institution Retrospective Review

  • Ng, Boon Huat;Rozita, AM;Adlinda, A;Lee, Wei Ching;Zamaniah, WI Wan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3827-3833
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    • 2015
  • Background: Positive para-aortic lymph node (PALN) at diagnosis in cervical cancer patients confers an unfavorable prognosis. This study reviewed the outcomes of extended field radiotherapy (EFRT) and concurrent chemotherapy with extended field RT (CCEFRT) in patients with positive PALN at diagnosis. Materials and Methods: Medical records of 407 cervical cancer patients between 1st January 2002 to 31st December 2012 were reviewed. Some 32 cases with positive PALN were identified to have received definitive extended field radiotherapy with or without chemotherapy. Treatment outcomes, clinicopathological factors affecting survival and radiotherapy related acute and late effects were analyzed. Results: Totals of 13 and 19 patients underwent EFRT and CCEFRT respectively during the period of review. The median follow-up was 70 months. The 5-year overall survival (OS) was 40% for patients who underwent CCEFRT as compared to 18% for patients who had EFRT alone, with median survival sof 29 months and 13 months, respectively. The 5-years progression free survival (PFS) for patients who underwent CCEFRT was 32% and 18% for those who had EFRT. Median PFS were 18 months and 12 months, respectively. Overall treatment time (OTT) less than 8 weeks reduced risk of death by 81% (HR=0.19). Acute side effects were documented in 69.7% and 89.5% of patients who underwent EFRT and CCEFRT, respectively. Four patients (12.5%) developed radiotherapy late toxicity and there was no treatment-related death observed. Conclusions: CCEFRT is associated with higher 5-years OS and median OS compared to EFRT and with tolerable level of acute and late toxicities in selected patients with cervical cancer and PALN metastasis.

Metformin Addition to Chemotherapy in Stage IV Non-Small Cell Lung Cancer: an Open Label Randomized Controlled Study

  • Sayed, Rana;Saad, Amr S;El Wakeel, Lamia;Elkholy, Engi;Badary, Osama
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6621-6626
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    • 2015
  • Purpose: To evaluate effects of metformin on clinical outcome of non-diabetic patients with stage IV NSCLC. Materials and Methods: A prospective, randomized, open-label, controlled pilot study was conducted on patients with stage IV NSCLC with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-2, excluding patients with diabetes and lactic acidosis. Thirty chemo-$na\ddot{i}ve$, non-diabetic patients with stage IV NSCLC were enrolled. Fifteen patients received intravenous gemcitabine/cisplatin regimen alone (arm B) while fifteen patients received the same regimen plus daily oral metformin 500mg (arm A). The effect of metformin on chemotherapy-response rates, survival, and adverse events in these patients was evaluated. Results: Objective response rate (ORR) and median overall survival (OS) in arms A and B were 46.7% versus 13.3% respectively, p=0.109 and 12 months versus 6.5 months, respectively, p=0.119. Median progression free survival (PFS) in arms A and B was 5.5 months versus 5 months, p=0.062. No significant increase in toxicity was observed in arm A versus arm B. Percentage of patients who experienced nausea was significantly lower in arm A versus arm B, at 26.7% versus 66.7% respectively, p=0.028. Conclusions: Metformin administration reduced occurrence of chemotherapy induced-nausea. Non-statistically significant improvements in the ORR or OS were observed. Metformin had no effect on PFS.

Concurrent Cisplatin and Radiotherapy in Refractory Patients to Induction Chemotherapy and Recurrent Head and Neck Cancer (유도항암요법에 반응치 않는 환자와 재발한 두경부암환자에서 Cisplatin과 방사선 동시치료)

  • Kim Hoon-Kyo;Kang Jin-Hyoung;Lee Kyung-Sik;Kim Dong-Jip;Chang Hong-Suk;Yoon Sei-Chul;Cho Seung-Ho;Sub Byung-Do
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.21-24
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    • 1992
  • In patients with locally advanced head and neck cancers who do not respond to induction chemotherapy and who have locoregional recurrence after local treatment subsequent radiotherapy alone does not have any additative effect. The theoretical rationale and promising clinical response of concurrent chemoradiotherapy in patients with the head and neck cancers have been recently conducted Ten patients(9 stage IV, q stage III) were treated with concurrent chemoradiotherapy(radiotherapy start from day 1 of chemotherapy; cisplatin $100mg/m^2$ intravenously every 3 weeks for $3{\sim}4$ cycles on day 1.22 and 43..). Four patients achieved complete response(CR) and overall response rate was 80% (8/10). The major toxicities we re leukopenia (90%), nausea/vomiting(80%), stomatitis(80%) and peripheral neuropathy(30%). Most of these side effects were mild to moderate and reversible.

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Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer

  • Supaadirek, Chunsri;Pesee, Montien;Thamronganantasakul, Komsan;Thalangsri, Pimsiree;Krusun, Srichai;Supakalin, Narudom
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3511-3514
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    • 2016
  • Purpose: To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMT-RT) without surgery. Materials and Methods: A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January $1^{st}$, 2003 and December $31^{st}$, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMT-RT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5-fluorouracil short infusion plus leucovorin and/or capecitabine or 5-fluorouracil infusion alone. All patients received pelvic irradiation. Results: There were 5 patients (10.4%) with a complete pathological response. The 3 year-overall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (p<0.01). The respective 5 year-overall survival rates were 70.3% and 0% (p<0.01). The 5 year-overall survival rates in Gr.I for patients who received surgery within 56 days after complete CCRT as compared to more than 56 days were 69.5% and 65.1% (p=0.91). Preoperative CCRT used for 12 of 30 patients in Gr.I (40%) with lower rectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. Conclusions: The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.

Experimental Studies on the Pulmonary Toxicity of Combined Bleomycin and Cyclophosphamide Administration in Rats (Bleomycin 과 Cyclophosphamide 의 병용투여가 흰쥐의 폐독성에 미치는 영향)

  • Na, Seok-Ju;Gwak, Mun-Seop
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.914-920
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    • 1989
  • Bleomycin and cyclophosphamide are widely used and effective anti-cancer agents for treatment of various forms of cancer. Bleomycin has no myelotoxicity, but because of potential risk of pulmonary complications including interstitial pneumonitis and idiopathic interstitial pulmonary fibrosis, it has been limited in use. Some investigator has also suggested that cyclophosphamide can induce pulmonary toxicity like bleomycin. Recently, The combination chemotherapy including bleomycin and cyclophosphamide has been adopted effectively in some types of cancer. But there are no available literatures for synergistic effect of pulmonary toxicity in combination chemotherapy including these two drugs. We tried this study to observe synergism of pulmonary toxicity using these two drugs in rats. The animals were divided into five groups: group 1 received intra-peritoneal injection of saline, group 2-a received only bleomycin 0.1 mg [0.4 mg/kg] by intra-peritoneal injection twice a week, group 2-b received only bleomycin 0.5 mg [2 mg/kg] by intra-peritoneal injection twice a week, group 3-a received bleomycin 0.1 mg [0.4 mg/kg] twice a week +cyclophosphamide 5 mg [20 mg/kg] two weeks interval by intra-peritoneal injection, group 3-b received bleomycin 0.5 mg [2 mg/kg] twice a week + cyclophosphamide 5 mg[20 mg/kg] two weeks interval by intra-peritoneal injection. The animals were sacrificed at 2 and 4 weeks later. Lung tissues were obtained and observed by light microscope. The results are as follows: 1. The pathologic findings of group 1 were normal without change. 2. There was no difference between group 2-a and group 3-a at 2 weeks later, group 3-a, however, revealed more severe change in lung tissue at 4 weeks later compared with group 2-a. 3. In group 3-b there was more severe pulmonary injury compared with group 2-b at 2 and 4 weeks later. We conclude that the combined administration of bleomycin and cyclophosphamide induce more severe pulmonary toxic effect than bleomycin administration alone and the combination chemotherapy including these two drugs will be require special attention to selection of the dose of each drug.

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The Therapeutic Efficacy of Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 유발 말초신경병증에 대한 침치료의 효과 : 체계적 문헌고찰 및 메타 분석)

  • Kim, Eun Hye;Yoon, Jee-Hyun;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.350-361
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    • 2020
  • Objective: This study aimed to report the therapeutic effect of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The articles were sourced from databases including PubMed, EMBASE, Cochrane Library, CNKI, CiNii, WHO ICTRP, JSOM, KMBASE, KISS, NDSL, and OASIS as of July 2019. The main search keywords were peripheral neuropathy and acupuncture, and only randomized controlled trials using acupuncture for therapeutic purposes were included. Cochrane's risk of bias was used to assess the risk of bias, and the Review Manager 5.3 program was used for meta-analysis. Results: Six studies with a total 394 participants were included. When combined treatment of acupuncture and usual care was compared with usual care alone, quality of life improved more significantly in the combination treatment group (SMD=-2.71, 95% CI: -5.01 to -0.41, P=0.02, I2=97%). The CIPN pain score was lower among the combination treatment group, but not to a significant degree (SMD=-2.55, 95% CI: -5.14 to 0.04, P<0.05, I2=98%). There were no severe side effects in any studies. Conclusion: Acupuncture combined with usual care may be considered to safely relieve CIPN pain and improve quality of life for cancer patients. However, as there are few randomized controlled trials studying the effect of acupuncture on CIPN, further well-designed research is needed.

Mixture of Wild Panax Ginseng and Red-Mold Rice Extracts Activates Macrophages through Protection of Cell Regression and Cytokine Expression in Methotrexate-Treated RAW264.7 Cells

  • Shin, Heung-Mook
    • The Journal of Korean Medicine
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    • v.30 no.6
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    • pp.69-79
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    • 2009
  • Objective: In this study, the immunomodulatory activity of a mixture of wild Panax ginseng and red-mold rice extracts (MPR) on RAW 264.7 macrophage cells in the presence and absence of methotrexate (MTX), an anti-cancer drug, was investigated. Methods and Results: In the cell viability, MPR showed a significant cell proliferation and inhibited cell regression by red-mold rice (RMR) alone or MTX alone. MPR induced moderate increase in nitric oxide (NO) production. NO production and inducible nitric oxide synthase (iNOS) mRNA expression by LPS decreased after MPR treatment. In addition, MPR slightly induced COX-2 mRNA expression, but it did not affect the expression of COX-2 mRNA by LPS treatment. In RT-PCR analyses, MPR induced IL-$1{\alpha}$, IL-$1{\beta}$, IL-6, and TNF-$\alpha$ mRNA expression, but had no effect on IL-10 and TGF-$\beta$, regardless of MTX treatment. Furthermore, MPR did not interfere with the cytotoxicity of MTX against MCF-7 human breast carcinoma cells. Conclusions: MPR is efficacious in protecting against MTX-induced cell regression as a result of macrophage activation, resulting in induction of cytokine expression, implying that MPR could be considered an adjuvant in MTX-chemotherapy.

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Percutaneous Retrogasserian Ethanol Gangliolysis of Management of Maxillary Sinus Cancer Pain (삼차신경절 파괴술을 이용한 상악동암의 통증관리)

  • Chang, Won-Young;Choe, Kun-Chun
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.100-104
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    • 1993
  • Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.

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Dramatic Tumor Response to 2nd-line Pemetrexed/Cisplatin Combination Chemotherapy in Patient with Malignant Pleural Mesothelioma (Pemetrexed/cisplatin 병합 2차 항암화학요법에 극적 반응을 보인 악성 흉막 중피종 1예)

  • Lee, Seung Min;Ko, Soon Young;Seo, Tae Ho;Lee, Jung Hyun;Choi, Seung Oh;Lee, Jeong Geun;Kim, Wan Seop;Lee, Tae Hoon;Yoo, Gwang Ha;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.432-436
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    • 2007
  • Malignant pleural mesothelioma (MPM) is a rare tumor that is difficult to clearly distinguish from an adenocarcinoma but usually has a poor prognosis. Numerous cytotoxic agents have been used in the primary treatment of MPM with limited success. A complete response is unusual and a partial response occurs in less than one-third of patients. Recently, a phase III trial showed that a combination of pemetrexed with cisplatin resulted in a significantly higher response rate and median survival time than with cisplatin alone. We encountered a case of a dramatic tumor response to pemetrexed/cisplatin combination chemotherapy in patients with MPM, which was resistant to the 1st-line gemcitabine/cisplatin therapy. After six cycles of pemetrexed/cisplatin combination chemotherapy, the tumor volume had decreased dramatically with complete symptom relief. There was no chemotherapy-related toxicity or scheduled violation. The patient is under maintenance chemotherapy with the same regimen.