• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4693-4697
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• 2016

Aim: The objective of this study is to investigate prognostic factors affecting survival of patients undergoing concurrent or sequential chemoradiotherapy (CRT) for stage III non-small-cell lung cancer (NSCL). Methods and materials: We retrospectively reviewed the clinical records of 148 patients with advanced, inoperable stage III NSCLC, who were treated between 2007 and 2015. Results: The median survival was found to be 19 months and 3-year overall survival was 27%. Age (<65 vs ${\geq}65years$, p=0.026), stage (IIIA vs IIIB, p=0.033), dose of radiotherapy (RT) (<60 vs ${\geq}60Gy$, p=0.024) and treatment method (sequential chemotherapy+RT vs concurrent CRT, p=0.023) were found to be factors affecting survival in univariate analyses. Gender, histological subtype, weight loss during CRT, performance status, induction/consolidation chemotherapy and presence of comorbidities did not affect survival (p>0.050). Conclusion: Young age, stage IIIA, radiotherapy dose and concurrent chemoradiotherapy may positively affect survival in stage III NSCL cases.

• Radiation Oncology Journal
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• 제18권4호
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• pp.257-264
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• 2000

목적 : 조기 비소세포성 폐암의 경우 수술이 최선의 치료법으로 생각 되고있다. 환자가 내과적인 질환으로 수술이 불가능한 경우, 혹은 수술을 거부한 경우 방사선치료가 수술의 대체적 치료로 사용 가능하다. 근치적방사선치료를 시행 받은 환자에서의 치료성적 및 이에 영향을 미치는 요인의 분석을 통하여 향후 치료에 도움을 얻고자 본 연구를 시행하였다. 대상 및 방법 : 서울대학교병원 치료방사선과에서 1987년 6월부터 1997년 6월 사이에 치료를 시행 받은 조직학적으로 진단된 조기 비소세포성 폐암 환자 32명을 대상으로 하였다. 수술이 불가능했던 이유로는 폐질환이 21명으로 가장 많았다. 대상환자의 중간 연령은 68세였으며, 조직학적으로는 편평상피암이 24명으로 가장 많았다. 임상 병기는 T1, T2, T3가 각각 5명, 25명, 2명이었으며, 진단시의 종양의 크기는 3$\~$5 cm가 13명으로 가장 많았다. 방사선치료는 6 MV또는 10 MV 선형가속기를 이용하여, 종양부위에 54.0$\~$68.8 Gy (중앙값; 61.2 Gy)를 조사하였고 12명의 환자에서는 동시분할조사를 시행하였다. 추적관찰기간은 2개월에서 93개월 (중앙값; 23개월)이었고, 생존기간은 치료개시일을 기준으로 산정하였다. 결과 : 전체생존률은 코년, 5년이 각각 44.6$\%$, 24.5$\%$이었으며, 무병생존률은 38.9$\%$, 28.3$\%$, 중앙생존기간은 23개월이었다. 전체환자 32명중 최종 추적관찰 시 25명이 사망하였으며, 이중 7명이 페암이외의 질환으로 사망하였다. 단변량분석 상 종양의 크기는 전체생존률과 무병생존률에 통계적으로 유의한 영향을 주는 요인으로 판정되었고 (p=0.0015, p=0.0022), T 병기는 전체생존률에 의미있는 요인으로 판정되었다(p=0.0395). 다변량분석 상 종양의 크기는 무병생존률에 통계적으로 의미있는 요인으로 판정되었으며(p=0.0317), 전체생존률에 영향을 주는 경향을 보였다 (p=0.0649). 종격동의 방사선조사 여부는 생존률에 영향을 주지 않았다. 결론 : 근치적방사선치료는 조기 비소세포성 폐암 환자로 내과적인 질환으로 수술 불가능한 경우나 환자가 수술을 거부한 경우, 특히 T1 또는 3 cm 이하의 종양에서는 수술적치료를 대치할 수 있는 치료법이다. 그러나 종양의 크기가 5 cm를 넘는 경우에는 방사선치료만으로는 장기생존자가 거의 없었으며, 따라서 이러한 환자의 치료에 있어 과분할조사나 기관지내 추가조사, 방사선감작제의 사용, 입체조형방사선치료, 강도변조방사선치료 등의 이용을 고려해야 할 것이다.

• Radiation Oncology Journal
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• 제32권2호
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• pp.70-76
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• 2014

Purpose: To review the results of postoperative radiation therapy (PORT) for residual non-small cell lung cancer (NSCLC) following surgical resection and evaluate multiple clinicopathologic prognostic factors. Materials and Methods: A total of 58 patients, who completed scheduled PORT for positive resection margin, among 658 patients treated with PORT from January 2001 to November 2011 were retrospectively analyzed. Radiation therapy was started at 4 to 6 weeks after surgery. Chemotherapy was also administered to 35 patients, either sequentially or concurrently with PORT. Results: The median age of patients was 63 years (range, 40 to 82 years). The postoperative pathological stage I NSCLC was diagnosed in 10 (17.2%), stage II in 18 (31.0%), and stage III in 30 patients (51.7%). Squamous cell carcinoma was identified in 43, adenocarcinoma in 10, large cell in 1, others in 4 patients. Microscopic residual disease (R1) was diagnosed in 55 patients (94.8%), and the remaining three patients were diagnosed with gross residual disease (R2). The median dose of PORT was 59.4 Gy (range, 50.0 to 64.8 Gy). Chemotherapy was administered to 35 patients (60%), and the median follow-up time was 22.0 months (range, 6.0 to 84.0 months). The 3-year locoregional relapse-free survival and distant metastasis-free survival rates were 82.1% and 52.9%, respectively. The median overall survival was 23.8 months (range, 6.0 to 84.1 months), and the 3-year overall survival rate was 58.2%. Chemotherapy did not influence the failure pattern or survival outcome. Conclusion: PORT is an effective modality for improving local tumor control in incompletely resected NSCLC patients. Major failure pattern was distant metastasis despite chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.815-822
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• 2015

Purpose: In this study, we aimed to evaluate the effects of sex-based non-small cell lung cancer (NSCLC) varieties on survival rates. Materials and Methods: A retrospective study was performed in patients with NSCLC who were diagnosed by histological methods between the years 2000 and 2010. A chi-square test was used to compare variables. Overall survival (OS) was estimated by the Kaplan-Meier method. Results: Of the 844 patients, 117 (13.9%) were women and 727 (86.1%) were men. Adenocarcinoma was more common in women than in men (p<0.0001). There were more women non-smokers than men (p<0.0001). There was no statistically significant difference in ECOG PS, weight loss>10%, stage, LDH, albumin and treatment between women and men. Women younger than 65 years (17.0 vs 12.0 months; p=0.03), who had adenocarcinoma histology (15.0 vs 10.0 months; p=0.006) and who had a hemoglobin level ${\geq}12g/dL$ (18.0 vs 12.0 months; p=0.01) were found to have a better median OS rate than men. Median OS rates were found to be 13.0 months in females and 12.0 months in males (p=0.14). Among metastatic patients, the median OS was 11.0 months in females and 8.0 months in males (p=0.005). Among stage IIIB and stage IV patients who had first line platinum-based chemotherapy, the median OS was 17.0 months in women and 11.0 months in men (p=0.002). The response rate of chemotherapy was higher in women than in men (p=0.03). Conclusions: In our study, we found that survival duration is longer and chemotherapy response is better in women with NSCLC who do not have anemia or comorbidities and who are mostly non-smokers with adenocarcinomas. Further studies regarding the causes of these differences may provide clarity on this subject.

• 대한두경부종양학회지
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• 제24권2호
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• pp.162-168
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• 2008

Purpose：To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials：From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range：40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median：70.8Gy). Results：Median follow-up time was 39.4 months(range：8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion：Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.

• Restorative Dentistry and Endodontics
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• 제38권1호
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• pp.11-20
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• 2013

Objectives: In most retrospective studies, the clinical performance of restorations had not been considered in survival analysis. This study investigated the effect of including the clinically unacceptable cases according to modified United States Public Health Service (USPHS) criteria into the failed data on the survival analysis of direct restorations as to the longevity and prognostic variables. Materials and Methods: Nine hundred and sixty-seven direct restorations were evaluated. The data of 204 retreated restorations were collected from the records, and clinical performance of 763 restorations in function was evaluated according to modified USPHS criteria by two observers. The longevity and prognostic variables of the restorations were compared with a factor of involving clinically unacceptable cases into the failures using Kaplan-Meier survival analysis and Cox proportional hazard model. Results: The median survival times of amalgam, composite resin and glass ionomer were 11.8, 11.0 and 6.8 years, respectively. Glass ionomer showed significantly lower longevity than composite resin and amalgam. When clinically unacceptable restorations were included into the failure, the median survival times of them decreased to 8.9, 9.7 and 6.4 years, respectively. Conclusions: After considering the clinical performance, composite resin was the only material that showed a difference in the longevity (p < 0.05) and the significantly higher relative risk of student group than professor group disappeared in operator groups. Even in the design of retrospective study, clinical evaluation needs to be included.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6919-6922
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• 2015

Background: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality. Materials and Methods: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time. Results: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of $352{\pm}281.7$ days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of $112{\pm}144.0$ days. Conclusions: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5735-5739
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• 2012

Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival. Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM. Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of $40{\pm}20$ years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%). Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9687-9692
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• 2014

Background: Biliary tract cancers are rare, and surgical resection is the standard treatment at early stages. However, reports on the benefits of adjuvant treatment following surgical resection are conflicting. This study aimed to evaluate the factors affecting survival and adjuvant treatments in patients with surgically treated biliary tract cancers. Materials and Methods: Patient clinical features, adjuvant treatments, and efficacy and prognostic factor data were evaluated. Survival analyses were performed using SPSS 15.0. Results: The median overall survival was 30.7 months (95% confidence interval [CI], 18.4-42.9 months). Median survival was 19 months (95% CI, 6-33) for patients treated with fluorouracil based chemotherapy and 53 months (95% CI, 33.2-78.8) with gemcitabine based chemotherapy(p=0.033). On univariate analysis, poor prognostic factors for survival were galbladder localization, perineural invasion, hepatic invasion, a lack of adjuvant chemoradiotherapy treatment, and a lack of lymph node dissection. On multivariate analysis, perineural invasion was a poor prognostic factor (p=0.008). Conclusions: Biliary tract cancers generally have poor prognoses. The main factors affecting survival are tumour localization, perineural invasion, hepatic invasion, adjuvant chemoradiotherapy, and lymph node dissection. Gemcitabine-based adjuvant chemotherapy is more effective than 5-fluorouracil-based chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1449-1452
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• 2016

Background: Adult rhabdomyosarcoma (RMS) is a rare and aggressive disease with limited data compared with pediatric RMS. The goal of this study was to determine the treatment outcome and identify factors related to survival outcome in Thailand. Materials and Methods: Adult patients (${\geq}15$ years old) with the pathological diagnosis of RMS between 1985 and 2010 were reviewed. The data were retrospectively reviewed from the pathological results and medical records from Srinagarind Hospital, Khon Kaen University. Results: A total of 34 patients were identified in the study. The median age at diagnosis was 35.5 years and the most common primary sites were extremity and the head and neck region. The incidence of pleomorphic RMS increased with age and none was found in those aged younger than 20 years old. The median survival time was 9.33 months (95%CI: 5.6-13.1). The 1- and 5- year survival rates were 38.2% (22.3-54.0) and 20.6% (9.1-35.3). On multivariate analysis, age and size of tumor did not predict better outcome while chemotherapy and surgery were significantly associated with longer survival. Conclusions: Outcome of adult RMS was poor. Surgery and chemotherapy are strongly associated with better prognosis and multimodality treatment should be incorporated in the clinic.