Background. Lymphoma of the vocal fold is extremely rare due to low lymphoid content in the larynx. To date, fewer than 100 cases of laryngeal lymphoma have been reported; however, none of these literatures are concerned about exclusive laryngeal involvement of recurred lymphoma which initially appeared in other body sites. Specific consensus about management for these patients yet to exist, due to its rare occurrence; however, the main modality of treatment is chemotherapy alone or in combination with radiation therapy. Case. Herein, we report a case of a 51-year-old female patient who had recurrent T-cell lymphoma developing in bilateral vocal folds. The patient was originally diagnosed of T-cell lymphoma in right colic flexure 10 years ago, and was cured by chemotherapy. Immunohistochemical stain revealed the histologic type of recurred tumor in the vocal folds that are identical to the previously cured lymphoma. Conclusion. To the best of our knowledge, this was the first case that recurrent lymphoma occurred solely in the vocal folds. Despite its rarity, lymphoma should be put in the index of suspicion among those patients with decreased vocal fold mucosal wave without definite vocal fold mass who had a history of cured lymphoma.
Park, Jeong-Jae;Kang, Jong-Sool;Lee, Hyun-Sung;Lee, Jong-Soo;Lee, Young-Ha;Youm, Jin-Young
Journal of Korean Neurosurgical Society
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제38권5호
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pp.366-374
/
2005
Objective : Nitric oxide[NO] is implicated in a wide range of biological processes in tumors and is produced in glioma. To investigate the role of NO and its interaction with the tumoricidal effects of anticancer drugs, we study the antitumor activities of NO donors, with or without anticancer drugs, in human glioma cell lines. Methods : U87MG and U373MG cells were treated with the NO donors sodium nitroprusside[SNP] and S-nitroso-N-acetylpenicillamine[SNAP], alone or in combination with the anticancer drugs 1,3-bis[2-chloroethyl]-1-nitrosourea[BCNU] and cisplatin. Cell viability, cell proliferation, DNA fragmentation, nitrite level, and the expression of Bcl-2 and Bax were determined. Results : NO was markedly increased after treatment with SNP or SNAP; however, the addition of the anticancer drugs did not significantly affect NO production NO donors or anticancer drugs reduced glioma cell viability and, in combination, acted synergistically to further decrease cell viability in a dose- and time-dependent manner. Cell proliferation was inhibited and apoptosis were enhanced by combined treatment. Bax expression was increased by combined treatment, whereas Bcl-2 expression was reduced. The antitumor cytotoxicity of NO donors and anticancer drugs differed according to cell type. Conclusion : BCNU or cisplatin can inhibit cell viability and proliferation of glioma cells and can induce apoptosis. These effects are further enhanced by the addition of a NO donor which modulates the antitumor cytotoxicity of chemotherapy depending on cell type. Further biological, chemical, and toxicological studies of NO are required to clarify its mechanism of action in glioma.
Thymic tumors are the most common tumors in the anterior mediastinum. Total resection is the main treatment and predictor of longer survival. Adjuvant radiotherapy alone or in combination with chemotherapy is recommended with incomplete excision or advanced disease. Thirty seven patients with thymic tumors were included in this retrospective study from January 2001 till December 2012. They were studied regarding age, sex, performance status, tumor size and invasion, stage, pathology, treatment given, overall and progression free survival. Myasthenia gravis was present in 18.1% of the patients. Masaoka stage III was diagnosed in 40.5% of the cases followed by stage II in 24.3% and the other stages with lower percentages. Pathology type B3 was the most frequent followed by B2 and B1 with percentages of 27, 24.3 and 21.7 respectively. Complete resection was conducted in 11 cases (29.75%). Partial resection or debulking was done in 15 (40.5%) and a biopsy was taken in 11 cases (29.8%) Adjuvant chemotherapy was given to 14 patients (37.8%) and neoadjuvant to 13 (35.2%). Adjuvant radiotherapy was given to 17 patients (46%) and neoadjuvant to 14 (37.8%). The 5-year overall survival by was 83% for stage I, 71% for stage II, 60% for stage III, and 44% for stage IV (p=0.0426). Five year progression free survival was 71% for stage I, 62% stage II, 42% stage III, and 37% for stage IV (p=0.0532). In conclusion with the rare thymic tumors early stage and complete resection have the highest impact on overall and progression free survival.
Kim, Doo-Jin;Kim, Eun-Jin;Lee, Tae-Young;Won, Ji-Na;Sung, Moon-Hee;Poo, Haryoung
Journal of Microbiology and Biotechnology
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제23권9호
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pp.1339-1346
/
2013
Conventional chemotherapeutic regimens often accompany severe side effects and fail to induce complete regression of chemoresistant or relapsing metastatic cancers. The need for establishing more efficacious anticancer strategies led to the development of a combined modality treatment of chemotherapy in conjunction with immunotherapy or radiotherapy. It has been reported that poly-gamma-glutamate (${\gamma}$-PGA), a natural polymer composed of glutamic acids, increases antitumor activity by activating antigen-presenting cells and natural killer (NK) cells. Here, we investigated the antitumor effect of ${\gamma}$-PGA in combination with cyclophosphamide in a murine melanoma model. Whereas cyclophosphamide alone directly triggered apoptosis of tumor cells in vitro, ${\gamma}$-PGA did not show cytotoxicity in tumor cells. Instead, it activated macrophages, as reflected by the upregulation of surface activation markers and the secretion of proinflammatory factors, such as nitric oxide and tumor necrosis factor ${\alpha}$. When the antitumor effects were examined in a mouse model, combined treatment with cyclophosphamide and ${\gamma}$-PGA markedly suppressed tumor growth and metastasis. Notably, ${\gamma}$-PGA treatment dramatically increased the NK cell population in lung tissues, coinciding with decreased metastasis and increased survival. These data collectively suggest that ${\gamma}$-PGA can act as an immunotherapeutic agent that exhibits a synergistic antitumor effect in combination with conventional chemotherapy.
With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.
Yu, Hong-Sheng;Wang, Xin;Song, Ai-Qin;Liu, Ning;Zhang, Wei;Yu, Li
Asian Pacific Journal of Cancer Prevention
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제13권8호
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pp.3961-3965
/
2012
Objective: To compare the clinical effects of concurrent radiochemotherapy with those of radiotherapy in treating locally advanced nasopharyngeal carcinoma (Stage III~IVa). Methods: A total of 95 patients suffering from nasopharyngeal carcinoma (Stage III~IVa) were divided into two groups: concurrent radiochemotherapy (Group CCRT, n=49) and radiotherapy (Group RT, n=46). The two groups were both delivered conventional fractionated radiotherapy, while Group CCRT also received three cycles of PF (DDP+5-Fu) or PLF (DDP+5-Fu+CF) chemotherapy. Results: The complete remission rate and total remission rate of Group CCRT were higher than those of Group RT ($X^2$=4.72~7.19, P<0.05). The one-year overall survival (OS) rate calculated by the life table method, was also higher than that of Group RT ($X^2$=4.24, P<0.05) as well as the 3-year OS rate, nasopharyngeal control rate and cervical lymph nodes' control rate ($X^2$=4.28~4.40, P<0.05). In addition, the 5-year OS and metastasis-free rates of Group CCRT were higher than those of Group RT and the differences were of statistical importance ($X^2$=3.96~8.26, P<0.05). However, acute toxicity was also obviously higher, the difference in gastrointestinal reactions being statistically significant ($X^2$=11.70, P<0.05). Conclusion: This study demonstrated that concurrent radiochemotherapy could improve the remission rate, overall survival rate and locally control rate. The toxicity of concurrent radiochemotherapy could be tolerated by the patients.
Effects of ionizing radiation alone and combined with chemotherapy on tumor growth and it's clonal specificity monitored by changes in distribution of chromosome number were studies in A549 ceil line originated from human adenocarcinoma of the lung. Radiation (300 rad, 600 rad and 900 rad) were delivered with or without 5-FU. Forty eight hours later, 57.5% of growth inhibition of cell w8s seen in cells treated with 5-FU concentration of $0.4{\mu}g/ml$ for 24hr exposure. Cell survival curves after radiation with and without 5-FU were made. Chromosomal analysis of cells in metaphase in control, and in cells treated with 300 rad of radiation, or $0.4{\mu}g/ml$ of 5-FU treatment, and combined treatment of both were done to examine the changes in ploidy and number of chromosome. Radiation combined with S-FU enhanced growth inhibition of A549 cells. However, no evidence of synergegic effects in growth. inhibition was observed in the cells treated with the combination therapy. Pattern of chromosomal distribution of survived cells were shifted from hyperploidy to hypoploidy by single dose of radiation (300 rad). As radiation dose increased a large number of hypoploidy cells were observed. Following treatment of cells with 5-FU, chomosomal distribution of survived cells were also shifted to hypodiploidy which were seen in cells treated with radiation, The ceil treated with 5-FU and fellowed by radiation within 24 hrs had cell with increased number of hypodiploidy cells. Almost same type of chromosomal changes were reproduced in cells treated with combined treatment with radiation and 5-FU. Minor differences were that cells with fewer number of chromosome were more frequent in cells treated with combined therapy. Further increase in cells of hypoploidy (93%) having 1-10 chromosome were induced by additional radiation. Therefore, the enhanced therapeutic effect of 5-FU combined with radiation of A549 cells appeared to be additive rather than synergistic.
Cervical cancer (CxCa) is the most common cancer in women and a prominent cause of cancer mortality worldwide. The primary cause of CxCa is human papillomavirus (HPV). Radiation therapy and chemotherapy have been used as standard treatments, but they have undesirable side effects for patients. It was reported that gallic acid has antioxidant, antimicrobial, and anticancer activities. Gold nanoparticles are currently being used in medicine as biosensors and drug delivery agents. This study aimed to develop a drug delivery agent using gold nanoparticles conjugated with gallic acid. The study was performed in uninfected (C33A) cervical cancer cells, cervical cancer cells infected with HPV type 16 (CaSki) or 18 (HeLa), and normal Vero kidney cells. The results showed that GA inhibited the proliferation of cancer cells by inducing apoptosis. To enhance the efficacy of this anticancer activity, 15-nm spherical gold nanoparticles (GNPs) were used to deliver GA to cancer cells. The GNPs-GA complex had a reduced ability compared to unmodified GA to inhibit the growth of CxCa cells. It was interesting that high-concentration ($150{\mu}M$) GNPs-GA was not toxic to normal cells, whereas GA alone was cytotoxic. In conclusion, GNPs-GA could inhibit CxCa cell proliferation less efficiently than GA, but it was not cytotoxic to normal cells. Thus, gold nanoparticles have the potential to be used as phytochemical delivery agents for alternative cancer treatment to reduce the side effects of radiotherapy and chemotherapy.
Background: Elderly patients with acute myeloid leukemia (AML) have a poor outcome because of co-morbidities, poor tolerance to intensive chemotherapy and inherently more resistant disease. Clofarabine is a second generation nucleoside analogue which has shown promising activity in elderly patients with AML. This study was conducted to review the outcome of treatment with clofarabine in a group of such patients. Methods: The records of 5 elderly patients who were diagnosed to have AML and treated with clofarabine over a 12 month period were reviewed retrospectively. Results: There were 2 female and 3 male patients with a median age of 68 years (range 65-82). At the time of treatment, 2 patients had newly diagnosed AML not considered suitable for intensive therapy, while 3 patients had partial or no response to conventional chemotherapy. The overall response rate was 100%, all patients achieving a complete remission. Induction and consolidation were well tolerated. All patients developed neutropenia with a median duration of 20 days (range 17-42). One patient developed hand and foot syndrome and a generalized rash but recovered. There was no mortality and all patients remained in remission after a median follow-up of 5.2 months (Range 3-10). Conclusion: Clofarabine (alone or in combination) is active in elderly AML patients with an acceptable safety profile and should be considered a potential option in this group.
From Jan.1982 to Dec.1990, 77 patients with rectal cancer were treated with curative surgical resection followed by postoperative adjuvant irradiation alone or combined with chemotherapy at the Department of Radiation Oncology, Korea University Hospital (KUH). Fifty-four (54/77, $70.1{\%}$) patients underwent abdominoperineal resection , 20 (20/77, $26{\%}$) patients underwent low anterior resection, and 3 (3/77, $3.9{\%}$,) patients had wide excision only. Thirty-nine (39/77, $50.5{\%}$) received sequential chemotherapy (2 cycles to 12 cycles). The 5-year survival rate for the entire group was $43{\%}:\;78.2{\%}$ in B2+B3, $39.4{\%}$ in stage C1+C2+C3. Survival rates decreased with increasing penetration of the bowel wall by tumor and the presence of regional lymph node metastasis. Those patients survival who underwent an abdominoperineal resection also experienced a significant decrease in compared to low anterior resection ($23.1{\%}$ vs. $63.8{\%}$ in 5-year survival, p <0.05). Local failure occurred in 15 ($19.5{\%}$) out of the 77 patients overall, 1($5.3{\%}$) of 19 in stage B2+B3, and 14 ($24.1{\%}$,) of 58 in stage C1+C2+C3. Presacral area was most common site of local failufre (8/17, $47.1{\%}$). Distant failure occurred in 13 ($16.9{\%}$) of 77 patients. The most frequent site of distant failure was the lung followed by the liver, the bone, and the brain. Combined locoregional and distant failure occurred in 2 ($2.6{\%}$) of 77 patients. Pathological confirmation of perirectal fat and/or regional lymph node involvement resulted in a singificant decrease in survival and local control.
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