Ki Yong-Kan;Kwon Byung-Hyun;Kim Won-Taek;Nam Ji-Ho;Yun Man-Su;Lee Hyung-Sik;Kim Dong-Won
Radiation Oncology Journal
/
v.24
no.2
/
pp.110-115
/
2006
Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.
Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE), combined with portal vein embolization (PVE), and high intensity focused ultrasound (HIFU) sequential therapy in treating patients with hepatocellular carcinoma (HCC). Methods: Patients with inoperative HCC were treated by two methods: in the study group with TACE first, then PVE a week later, and then TACE+PVE every two months as a cycle, after 2~3 cycles finally HIFU was given; in the control group only TACE+PVE was given. Response (CR+PR), and disease control rate (CR+PR+SD), side effects, overall survival and time to progress were calculated. Results: Main side effects of both groups were nausea and vomiting. No treatment related death occurred. In the study group, 32 patients received TACE for overall 67 times, PVE 64 times, and HIFU 99 times; on average 2.1, 2 and 3.1 times for each patient, respectively. In the control group, 36 patients were given TACE 78 times and PVE 74 times, averaging 2.2 and 2.1 times per patient. Effective rate: 25.0% in study group and 8.3% in control group (p>0.05). Disease control rates were 71.9% and 44.4%, respectively (p<0.05). In patients with portal vein tumor thrombus, the rate reduced over 1/2 after treatment was 69.2%(9/13) in the study and 21.4%(3/14) in the control group (p<0.05). Rate of AFP reversion or decrease over 1/2 was 66.7%(16/24) in study and 37%(10/27) (p<0.05) in control group. Median survival time: 16 months in study and 10 months in control group. PFS was 7months in study and 3 months in control group. Log-rank test suggested that statistically significant difference exists between two groups (p=0.024). 1-, 2- and 3-year survival rates were 56.3%, 18.8% and 9.3% in study, while 30.6%, 5.6% and 0 in control group, respectively, with statistically significant difference between two groups (by Log-rank, p = 0.014). Conclusions: The treatment of TACE+PVE+HIFU sequential therapy for HCC increases response rate, prolong survival, and could thus be a safe and effective treatment for advanced cases.
Kim, Seok;Park, Ki-Sung;Kum, Yoon-Seup;Lee, Sub;Bae, Chi-Hoon;Hyun, Dae-Sung
Journal of Chest Surgery
/
v.42
no.5
/
pp.610-614
/
2009
Background: Several trials have reported on whether adjuvant chemotherapy for resected stage IB non-small cell lung cancer is needed. The aim of our study was to investigate prognostic factors for recurrence to help identify patients who should receive adjuvant chemotherapy. Material and Method: We reviewed the cases of 48 stage IB non-small cell lung cancer patients between 1997 and 2006. Disease-free survival and overall survival rates were calculated by the Kaplan-Meier method. Univariate analysis was performed with the log rank test and multivariate analysis was done using Cox's proportional hazard model. Result: The median follow-up time was 48 months. The overall survival rate was 55.9%, and the disease-free survival rate was 48.6%. Of 8 variables, two factors, visceral pleural invasion and Iymphovascular invasion, were prognostic factors of disease-free survival (univariate analysis). Visceral pleural invasion was a significant prognostic factor in multivariate analysis, and overall survival in com-pared one or more variable such as visceral pleural invasion or, and lymphovascular invasion with the other variables. Conclusion: Visceral pleural invasion was identified as a poor prognostic factor and it may help select which patients will benefit from adjuvant chemotherapy in addition to more comprehensive follow-up.
Jo, Kyung Il;Im, Young-Hyuck;Kong, Doo Sik;Seol, Ho Jun;Nam, Do-Hyun;Lee, Jung-Il
Journal of Korean Neurosurgical Society
/
v.54
no.5
/
pp.399-404
/
2013
Objective : The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods : Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan- Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results : Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) ${\geq}70$ (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were $89.5{\pm}4.5%$ and $70.5{\pm}6.9%$ at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (${\leq}3$) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion : The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery.
Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease. The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59-0.72), 0.60 (0.54-0.65), and 0.63 (0.56-0.69), respectively. Conclusions: Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.
Jang, Sun Woo;Jeon, Myeon Ho;Choi, Minha;Kim, Tae-Woong
KSCE Journal of Civil and Environmental Engineering Research
/
v.30
no.5B
/
pp.487-495
/
2010
Soil moisture is a crucial factor in hydrological system which influences runoff, energy balance, evaporation, and atmosphere. United States National Aeronautic and Space Administration (NASA) and Department of Agriculture (USDA) have established Soil Moisture Experiment (SMEX) since 2002 for the global observations. SMEX provides useful data for the hydrological science including soil moisture and hydrometeorological variables. The purpose of this study is to investigate the relationship between remotely sensed soil moisture data from aircraft and satellite and ground based experiment. C-band of Polarimetric Scanning Radiometer (PSR) that observed the brightness temperature provides soil moisture data using a retrieval algorithm. It was compared with the In-situ data for 2-30 cm depth at four sites. The most significant depth is 2-10 cm from the correlation analysis. Most of the sites, two data are similar to the mean of data at 10 cm and the median at 7 cm and 10 cm at the 10% significant level using the Rank Sum test and t-test. In general, soil moisture data using the C-band of the PSR was established to fit the Normal, Log-normal and Gumbel distribution. Soil moisture data using the aircraft and satellites will be used in hydrological science as fundamental data. Especially, the C-band of PSR will be used to prove soil moisture at 7-10 cm depths.
Hye Jung Choo;Sun Joo Lee;Dong Wook Kim;Yoo Jin Lee;Jin Wook Baek;Ji-yeon Han;Young Jin Heo
Korean Journal of Radiology
/
v.22
no.8
/
pp.1341-1351
/
2021
Objective: To compare the quality of various polychromatic and monochromatic images with or without using an iterative metal artifact reduction algorithm (iMAR) obtained from a dual-energy computed tomography (CT) to evaluate total knee arthroplasty. Materials and Methods: We included 58 patients (28 male and 30 female; mean age [range], 71.4 [61-83] years) who underwent 74 knee examinations after total knee arthroplasty using dual-energy CT. CT image sets consisted of polychromatic image sets that linearly blended 80 kVp and tin-filtered 140 kVp using weighting factors of 0.4, 0, and -0.3, and monochromatic images at 130, 150, 170, and 190 keV. These image sets were obtained with and without applying iMAR, creating a total of 14 image sets. Two readers qualitatively ranked the image quality (1 [lowest quality] through 14 [highest quality]). Volumes of high- and low-density artifacts and contrast-to-noise ratios (CNRs) between the bone and fat tissue were quantitatively measured in a subset of 25 knees unaffected by metal artifacts. Results: iMAR-applied, polychromatic images using weighting factors of -0.3 and 0.0 (P-0.3i and P0.0i, respectively) showed the highest image-quality rank scores (median of 14 for both by one reader and 13 and 14, respectively, by the other reader; p < 0.001). All iMAR-applied image series showed higher rank scores than the iMAR-unapplied ones. The smallest volumes of low-density artifacts were found in P-0.3i, P0.0i, and iMAR-applied monochromatic images at 130 keV. The smallest volumes of high-density artifacts were noted in P-0.3i. The CNRs were best in polychromatic images using a weighting factor of 0.4 with or without iMAR application, followed by polychromatic images using a weighting factor of 0.0 with or without iMAR application. Conclusion: Polychromatic images combined with iMAR application, P-0.3i and P0.0i, provided better image qualities and substantial metal artifact reduction compared with other image sets.
Bello, Marcelo Adeodato;de Menezes, Raquel Ferreira;de Sousa Silva, Brunna;da Silva, Rafael de Carvalho;Cavalcanti, Rousiane Silva;da Costa Moraes, Thayane de Fatima;Tonellotto, Fabiana;de Aguiar, Suzana Sales;Martucci, Renata Brum;Bergmann, Anke;Thuler, Luiz Claudio Santos
Asian Pacific Journal of Cancer Prevention
/
v.17
no.10
/
pp.4769-4774
/
2016
Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.
Palmela, Carolina;Velho, Sonia;Agostinho, Lisa;Branco, Francisco;Santos, Marta;Santos, Maria Pia Costa;Oliveira, Maria Helena;Strecht, Joao;Maio, Rui;Cravo, Marilia;Baracos, Vickie E.
Journal of Gastric Cancer
/
v.17
no.1
/
pp.74-87
/
2017
Purpose: Neoadjuvant chemotherapy has been shown to improve survival in locally advanced gastric cancer, but it is associated with significant toxicity. Sarcopenia and sarcopenic obesity have been studied in several types of cancers and have been reported to be associated with higher chemotherapy toxicity and morbi-mortality. The aim of this study was to assess the prevalence of sarcopenia/sarcopenic obesity in patients with gastric cancer, as well as its association with chemotherapy toxicity and long-term outcomes. Materials and Methods: A retrospective analysis was performed using an academic cancer center patient cohort diagnosed with locally advanced gastric cancer between January 2012 and December 2014 and treated with neoadjuvant chemotherapy. We analyzed body composition (skeletal muscle and visceral fat index) in axial computed tomography images. Results: A total of 48 patients met the inclusion criteria. The mean age was $68{\pm}10years$, and 33 patients (69%) were men. Dose-limiting toxicity was observed in 22 patients (46%), and treatment was terminated early owing to toxicity in 17 patients (35%). Median follow-up was 17 months. Sarcopenia and sarcopenic obesity were found at diagnosis in 23% and 10% of patients, respectively. We observed an association between termination of chemotherapy and both sarcopenia (P=0.069) and sarcopenic obesity (P=0.004). On multivariate analysis, the odds of treatment termination were higher in patients with sarcopenia (odds ratio=4.23; P=0.050). Patients with sarcopenic obesity showed lower overall survival (median survival of 6 months [95% confidence interval {CI}=3.9-8.5] vs. 25 months [95% CI=20.2-38.2]; log-rank test P=0.000). Conclusions: Sarcopenia and sarcopenic obesity were associated with early termination of neoadjuvant chemotherapy in patients with gastric cancer; additionally, sarcopenic obesity was associated with poor survival.
Purpose: To compare the safety and efficacy of first-line chemotherapy regimen with or without doxorubicin in treating patients with advanced soft tissue sarcoma (STS). Patients and Methods: We retrospectively analyzed a cohort of 56 patients histologically confirmed with STS who were treated at Jiangsu Cancer Hospital and Research Institute from July 2011 to June 2012.The basic element of first line chemotherapy contained epirubicin in group B and lacked epirubicin in group A. Response was assessed using RECIST criteria. The Kaplan-Meier method was used to estimate progress free survival (PFS). Results: According to RECIST criteria, patients in group treated by chemotherapy without epirubicin, the objective response (OR) ratio was 6.5 % (CR0%+PR6.5%). Disease control rate (DCR=CR+PR+SD) was 25.8% with a median follow-up of 14.6 months, including 2 patients achieving a partial response (PR 6.5%) and a stable response (SD 19.4%) in 6. In group B with epirubicin based regimens, no patient had complete response, PR (28 %) was observed in 7 and SD (24 %) in 6. DCR was observed in 13 patients (52%). By Fisher's exact test, the DCR difference between the two groups was statistically significant (p=0.046). In group A, median PFS was 3.0 months (95%CI:2.1-3.8), compared with 4.0 months (95% CI:3.03-4.97) in group B (p=0.0397 by log-rank test). Epirubicin based chemotherapy and ECOG performance status 0-1 were identified as favorable factors for progression in our cohort of patients. Differences of nonhematologic and hematologic toxicities were not statistically significant between the two groups, and the addition of epirobicin was not associated with cardiac toxicity (p=0.446). Conclusion: Our study demonstrates that epirubicin-based chemotherapy is effective and well tolerated, and is superior to chemotherapy without epirubicin regarding efficacy. Therefore it is recommended that epirubicin-based chemotherapy should be considered as first line for patients with advanced STS.
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