• Title/Summary/Keyword: Definitive

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Feasibility and Efficacy of Concurrent Chemoradiotherapy in Elderly Patients with Esophageal Squamous Cell Carcinoma: a Respective Study of 116 Cases from a Single Institution

  • Li, Xue;Zhao, Lu-Jun;Liu, Ning-Bo;Zhang, Wen-Cheng;Pang, Qing-Song;Wang, Ping;Yuan, Zhi-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1463-1469
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    • 2015
  • Background: To evaluate the safety and efficacy of combined chemoradiotherapy or radiotherapy alone in elderly patients with esophageal carcinoma to identify the best method of treatment. Materials and Methods: One hundred and sixteen patients with esophageal carcinoma aged 70 and older who received definitive radiotherapy or chemoradiotherapy entered the study. Overall survival (OS), disease-free survival (DFS) and treatment-related toxicities were assessed. Results: The median OS of the overall population was 17.9 months. For patients treated with cCRT, sCRT and radiotherapy alone, the median OS was 22.3 months, 18.0 months and 12.4 months respectively(P=0.044). Median OS for patients treated with radiotherapy dose ${\geq}60Gy$ and <60Gy was 20.2 months and 10.9 months respectively (p=0.017). By univariate analysis, Chemoradiotherapy (include cCRT and sCRT) and radiotherapy dose ${\geq}60Gy$ were found to achieve higher survival rates compared with radiotherapy alone and radiotherapy dose <60Gy (P=0.015, P=0.017). By multivariate analysis, chemoradiotherapy (HR=1.645, P=0.022) and radiotherapy dose ${\geq}60Gy$ (HR=1.642, P=0.025) were identified as independent prognostic factors of OS. Conclusions: Definitive concurrent chemoradiotherapy could be considered as a feasible and effective treatment in esophageal carcinoma patients aged 70 and older. Radiotherapy dose 60Gy is an effective treatment option compared with standard dose radiotherapy, while higher doses are not beneficial to improve survival.

Definitive Radiotherapy of Non-Small Cell Lung Cancer (비소세포 폐암의 근치적 방사선치료)

  • Lee, Jong-Young;Park, Kyung-Ran
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.303-309
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    • 1995
  • Purpose : The effect of dose escalation of up to 6500 cGy on local control and survial was investigated in locally advanced non-small cell lung cancer. Materials and Methods: Ninety eight patients with biopsy-proven unresec-table non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radio-therapy alone. Group A was treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy; and group B was treated with 6500 cGy of same daily fractions. Results : The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B). Conclusion : Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered.

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Full Mouth Rehabilitation in a Patient with Limited Restorable Space (수복 공간이 부족한 환자에서의 완전구강회복)

  • Lim, Kwang-Gil;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.145-156
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    • 2010
  • Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

An Evaluation Study on the Cardiovascular Risk Factors in a Rural Adult Population (농촌지역 주민의 심혈관 질환 위험요인 평가)

  • Na, Baek-Ju;Park, Kyung-Soo;Lim, Jung-Su;Sun, Byeong-Hwan;Nam, He-Sung;Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.193-204
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    • 1998
  • Cardiovascular diseases are the leading cause of death and disability in Korea. Their risk factors can be classified as either modifiable or nonmodifiable and among modifiable factors are high bood pressure, elevated blood cholesterol, obesity and cigarette smoking. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in a rural community and to get basic data for the development of a community-based rick reduction intervention program. Evaluation involved population-based, cross-sectional samples of adult residents in a rurual community. We measured blood pressure, body fat percent by bioelectric impedance fatness analyzer and serum cholesterol and interviewed adult residents over 20-year-old age. Blood pressure was checked twice and hypertension was classified by the sixth report of the Joint National Committee on Detection. Evaluation, and Treatment of High Blood Pressure. The Cutpoints for high blood cholesterol was used National Cholesterol Treatment Guidelines and those for obesity was 25% in male. 30% in female. The results were as follows: 1. Prevalence of definitive hypertension was 59.7% in males and 54.4% in female. 2. Prevalence of hypercholesterolemia was 14.3% in male and 18.2% in female. 3. Prevalence of obese was 10.7% in male and 41.1% in female. 4. Among definitive hypertension, hypercholesterolemia, and obesity 52.1% possessed one risk factor, 12.6% two risk factors and 2.5% three risk factors in males. In females 41.4% possessed one risk factor and 27.6%. 5.7% respectively. 5. The smoking rate was 65.8% in males and 5.2% in females. Our results are used effectively for the community-based intervention towards cardiovascukr diseases risk reduction. However, because of limitations in our study design, further datas are needed including other risk factors and in-person clinical datas.

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ECTOPIC ERUPT10N OF TRANSPOSED MANDIBULAR PERMANENT LATERAL INCISOR (이소 맹출한 하악 측절치의 교정적 치험례)

  • Lim, Hyun-Hwa;Kim, Yong-Soo;Jang, Ki-Taek;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.438-443
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    • 2000
  • Ectopic eruption should be understood as a change in the course of the normal eruption path of a dental bud at any moment its origin. An example of this alteration is the dental transposition, a rare and more specific dental anomaly that may be defined as a change of position between two teeth. This case shows ectopic eruption of transposed mandibular lateral incisor beneath primary first molar at the first transitional period of the mixed dentition The crown of the lateral incisor has tipped distally, compelling root resorption and exfoliation of the adjacent primary cuspid and primary first molar. The reason for such eruption is not clearly understood, but it may involve; (1)trauma history, (2)prolonged retention of the deciduous teeth, (3)premature exfoliation of the deciduous teeth, and (4)genetic factor. Treatment is divided into interceptive and definitive treatment. Ectopically erupting mandibular incisor tends to become transposed with the adjacent cuspid and thus seems to warrant early orthodontic intervention. Early treatment may obviate later extraction or transposition of the incisor and canine in the permanent dentition. Timing is an important factor to be considered regarding in the correction of the lateral incisor transposition. This case advocates treatment with an active orthodontic therapy at the early stage of the mixed dentiton, before the eruption of the permanent cuspid.

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Minimally Invasive Laser-Assisted Biopsy of the Oral Lesions for Oral Graft-Versus-Host Disease after Hematopoietic Stem-Cell Transplantation (조혈줄기세포이식후 발생한 이식편대숙주병의 구강병소에 대한 최소침습적 레이저조직생검 증례)

  • Kim, Yun-Mi;Yun, Hee-Jung;Kim, Hyun-Sil;Kim, Kee-Deog;Jung, Bock-Young;Pang, Nan-Sim;Park, Won-Se
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.147-154
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    • 2012
  • Hematopoietic stem-cell transplantation (HSCT) is a treatment for immune deficiency, autoimmune diseases, and hematopoietic malignancies. The main complication of allogenic HSCT is graft-versus-host disease (GVHD). Oral mucosal biopsy is needed for a definitive diagnosis and treatment planning of GVHD, but this procedure causes bleeding and bacteremia in a poor general condition. We evaluated the efficacy of laser-assisted biopsy as a minimally invasive treatment. Three cases were described in this article. All patients' medical records, clinical photographs, and histopathologic findings were reviewed. All patients felt comfortable and no severe complications occurred. The quality of the obtained biopsy material was adequate for a definitive diagnosis of GVHD. Laser-assisted, minimally invasive biopsy of the oral mucosa does not cause bleeding, and it reduces the chances of infection, bacteremia, and postoperative scarring compared to the usual histopathologic biopsy procedure. It would thus be advantageous to use this procedure to biopsy GVHD patients.

Optimal timing for salvage surgery after definitive radiotherapy in hypopharyngeal cancer

  • Chun, Seok-Joo;Keam, Bhumsuk;Heo, Dae Seog;Kim, Kwang Hyun;Sung, Myung-Whun;Chung, Eun-Jae;Kim, Ji-hoon;Jung, Kyeong Cheon;Kim, Jin Ho;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.192-199
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    • 2018
  • Purpose: Use of radiotherapy combined with chemotherapy is increasing in hypopharyngeal cancer. However, many show residual tumor after radiotherapy. Timing for treatment evaluation and salvage therapy is essential. However, optimal timing for salvage surgery has not been suggested. In this study, we tried to evaluate optimal timing for salvage surgery. Methods and Materials: Patients who were diagnosed with hypopharyngeal squamous cell carcinoma between 2006 and 2015 were retrospectively analyzed. All patients received definitive radiotherapy with or without chemotherapy. Response of all treated patients were analyzed at 1, 3, and 6 months after radiotherapy. Any patients with progression before 6 months were excluded. Results: A total of 54 patients were analyzed. Complete remission (CR) rates at 1 month (CR1), 3 months (CR3) and 6 months (CR6) were 66.7%, 81.5%, and 90.7%, respectively. Non-CR at 1 month (NCR1), 3 months (NCR3), and 6 months (NCR6) showed poor locoregional recurrence-free survival rates (1-year rates of 63.7%, 66.7%, and 0.0%, respectively) compared to CR1, CR3, and CR6 (1-year rates 94.3%, 88.0%, and 91.5%, respectively). Particularly significant differences were seen between CR6 and NCR6 (p < 0.001). Of 10 patients with NCR3, 5 showed CR at 6 months (NCR3/CR6). There was no statistical difference in locoregional recurrence-free survival between CR3 and NCR3/CR6 group (p = 0.990). Conclusion: Our data suggest half of patients who did not show CR at 3 months eventually achieved CR at 6 months. Waiting until 6 months after radiotherapy may be appropriate for avoiding additional salvage therapy.

Gene signature for prediction of radiosensitivity in human papillomavirus-negative head and neck squamous cell carcinoma

  • Kim, Su Il;Kang, Jeong Wook;Noh, Joo Kyung;Jung, Hae Rim;Lee, Young Chan;Lee, Jung Woo;Kong, Moonkyoo;Eun, Young-Gyu
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.99-108
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    • 2020
  • Purpose: The probability of recurrence of cancer after adjuvant or definitive radiotherapy in patients with human papillomavirus-negative (HPV(-)) head and neck squamous cell carcinoma (HNSCC) varies for each patient. This study aimed to identify and validate radiation sensitivity signature (RSS) of patients with HPV(-) HNSCC to predict the recurrence of cancer after radiotherapy. Materials and Methods: Clonogenic survival assays were performed to assess radiosensitivity in 14 HNSCC cell lines. We identified genes closely correlated with radiosensitivity and validated them in The Cancer Genome Atlas (TCGA) cohort. The validated RSS were analyzed by ingenuity pathway analysis (IPA) to identify canonical pathways, upstream regulators, diseases and functions, and gene networks related to radiosensitive genes in HPV(-) HNSCC. Results: The survival fraction of 14 HNSCC cell lines after exposure to 2 Gy of radiation ranged from 48% to 72%. Six genes were positively correlated and 35 genes were negatively correlated with radioresistance, respectively. RSS was validated in the HPV(-) TCGA HNSCC cohort (n = 203), and recurrence-free survival (RFS) rate was found to be significantly lower in the radioresistant group than in the radiosensitive group (p = 0.035). Cell death and survival, cell-to-cell signaling, and cellular movement were significantly enriched in RSS, and RSSs were highly correlated with each other. Conclusion: We derived a HPV(-) HNSCC-specific RSS and validated it in an independent cohort. The outcome of adjuvant or definitive radiotherapy in HPV(-) patients with HNSCC can be predicted by analyzing their RSS, which might help in establishing a personalized therapeutic plan.

Molecular genetic characterization of multiple antimicrobial resistant Salmonella spp. isolated from pigs and cattle (소와 돼지유래 다제내성 Salmonella속 균의 분자유전학적 특성)

  • Lee, Woo-Won;Jung, Byeong-Yeal;Lee, Gang-Rok;Lee, Dong-Soo;Kim, Yong-Hwan
    • Korean Journal of Veterinary Service
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    • v.32 no.1
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    • pp.61-76
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    • 2009
  • At the present study, it was aimed to explore the molecular genetic characterization of multiple antimicrobial resistant Salmonella spp. isolates from pigs and cattle. A total of 138 Salmonella Typhimurium (S. Typhimurium) isolates were typed with phage, among them, 83.3% of S. Typhimurium tested could divide into a 10 phage types. Definitive type 193 (DT193) (25.4%) and DT195 (24.6%) were exhibited as the dominant types. DT104 and U302 were found from pigs and cattle. On the other hand, S. Enteritidis had 6 phage types, of them, phage type 21 (PT21) and PT11b were the popular types. In the plasmid profiles, 135 of S. Typhimurium isolates were exhibited 1 to 6 plasmid bands which molecular weight ranged from 90 to 2kb. 35 isolates (25.4%) harbored a 90kb plasmid which is thought to be the serotype specific virulence plasmid. Two of twenty five S. Enteritidis had common plasmids at 2 and 1.5kb. With multiplex polymerase chain reaction, virulence genes (invA and spvC) were detected from all Salmonella spp. from 167 of S. Typhimurium, S. Enteritidis and chloramphenicol resistant S. Schwarzengrund, but some drug resistant genes, such as PSE-1, cml/tetR and flo were not determined but other drug resistant genes, for example TEM and int were found. The detection rates of spvC, TEM and int gene was 35.3%, 29.3% and 72.5%, respectively. The TEM gene was highly popular in S. Typhimurium, which was detected from ampicillin and amoxicillin resistant strains as 95.9%. int gene was able to detect from all the isolates identified as multidrug resistsnt (MDR), particularly DT193 was thought as the most prevalent virulence and multidrug resistance isolate. The major plasmid profile and drug resistance pattern of DT193 were 90, 40, 10.5, 6.3, 3.0kb and ACCbDNaPSSuT, respectively. MDR was commonly found in other phage types, particularly DT104, U302 and DT203.

Apodemus agrarius as a new definitive host for Neodiplostomum seoulense

  • Chai, Jong-Yil;Park, Jae-Hwan;Guk, Sang-Mee;Kim, Jae-Lip;Kim, Hyo-Jin;Kim, Won-Hee;Shin, Eun-Hee;Klein, Terry A.;Kim, Heung-Chul;Chong, Sung-Tae;Song, Jin-Won;Baek, Luck-Ju
    • Parasites, Hosts and Diseases
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    • v.45 no.2 s.142
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    • pp.157-161
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    • 2007
  • A total of 1,496 rodents and insectivores were live-trapped at Yeoncheon-gun (n = 351), Paju-shi (804), and Pocheon-gun (343), Gyeonggi-do (Province), and examined for intestinal helminths, including Neodiplostomum seoulense, seasonally from December 2004 to September 2005. Six species of rodents, including Apodemus agrarius (1,366), Mus musculus (32), Micronytus fortis (28), Eothenomys regulus (9), Micronys minutus (6), and Cricetulus triton (3), and 1 species of insectivores Crocidura lasiura (54) were collected. A total of 321 adult N. seoulense were collected from 19 (1.4%) A. agrarius. The worm burden ranged from 1 to 101 per A. agrarius (mean; 16.9). No N. seoulense was observed in other rodent or insectivore species examined. The infection rate during autumn (4.5%) was higher than those during spring (0.8%), summer (0.8%), and winter (0.5%). The average number of N. seoulense in infected A. agrarius was the highest in spring (66.0 specimens), followed by autumn (15.2), winter (4.5), and summer (3.3). This study first confirms that A. agrarius is a natural definitive host for N. seoulense, and demonstrates that the infection rates and intensities vary seasonally and geographically.