• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7811-7816
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• 2014

Background: Despite advances in radiotherapy, overall survival of glioblastoma multiforme (GBM) patients is still poor. Moreover dosimetrical analyses with these newer treatment methods are insufficient. The current study is aimed to compare intensity modulated radiation therapy (IMRT) linear accelerator (linac) and helical tomotherapy (HT) treatment plans for patients with prognostic aggressive brain tumors. Material and Methods: A total of 20 GBM patient plans were prospectively evaluated in both linac and HT planning systems. Plans are compared with respect to homogenity index, conformity index and organs at risk (OAR) sparing effects of the treatments. Results: Both treatment plans provided good results that can be applied to GBM patients but it was concluded that if the critical organs with relatively lower dose constraints are closer to the target region, HT for radiotherapeutical application could be preferred. Conclusion: Tomotherapy plans were superior to linear accelerator plans from the aspect of OAR sparing with slightly broader low dose ranges over the healthy tissues. In case a clinic has both of these IMRT systems, employment of HT is recommended based on the observed results and future re-irradiation strategies must be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1235-1239
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• 2015

Background: Fragile histidine triad (FHIT) gene is a tumor suppressor gene which involved in breast cancer pathogenesis. Epigenetics alterations in FHIT contributes to tumorigenesis of breast cancer. Objective: Our objective was to study FHIT promoter region hypermethylation in Egyptian breast cancer patients and its association with clinicopathological features. Materials and Methods: Methylation-specific polymerase chain reaction was performed to study the hypermethylation of FHIT promoter region in 20 benign breast tissues and 30 breast cancer tissues. Results: The frequency of hypermethylation of FHIT promoter region was significantly increased in breast cancer patients compared to bengin breast disease patients. The Odd's ratio (95%CI) of development of breast cancer in individuals with FHIT promoter hypermethylation (MM) was 11.0 (1.22-250.8). There were also significant associations between FHIT promoter hypermethylation and estrogen, progesterone receptors negativity, tumor stage and nodal involvment in breast cancer pateints. Conclusions: Our results support an association between FHIT promotor hypermethylation and development of breast cancer in Egyptian breast cancer patients. FHIT promoter hypermethylation is associated with some poor prognostic features of breast cancer.

• Radiation Oncology Journal
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• 제36권4호
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• pp.317-324
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• 2018

Purpose: This study aimed to evaluate the long-term survival outcomes and prognostic factors that affect the clinical outcomes of patients who underwent surgery and postoperative radiotherapy for major salivary gland mucoepidermoid carcinoma (MEC). Materials and Methods: We retrospectively reviewed the clinical data of 44 patients who underwent surgery followed by radiotherapy for primary MEC of the major salivary glands between 1991 and 2014. The median follow-up period was 9.8 years (range, 0.8 to 23.8 years). Results: The overall outcomes at 5 and 10 years were 81.5% and 78.0% for overall survival (OS), 86.2% and 83.4% for disease-free survival, 90.6% and 87.6% for locoregional recurrence-free survival, and both 90.5% for distant metastasis-free survival (DMFS). Histologic grade was the only independent predictor of OS (low vs. intermediate vs. high; hazard ratio = 3.699; p = 0.041) in multivariate analysis. A poorer survival was observed among patients with high-grade tumors compared with those with non-high-grade tumors (5-year OS, 37.5% vs. 91.7%, p < 0.001; 5-year DMFS, 46.9% vs. 100%, p < 0.001). Conclusion: Surgery and postoperative radiotherapy resulted in excellent survival outcomes for patients with major salivary gland MEC. However, high-grade tumors contributed to poor DMFS and OS. Additional aggressive strategies for improving survival outcomes should be developed for high-grade MEC.

• International journal of thyroidology
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• 제11권2호
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• pp.143-151
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• 2018

Background and Objectives: Sirtuins (SIRTs) play important roles in cellular and organismal homeostasis. They have distinct gene expression patterns in various cancers; however, the relationship between SIRT expression and the progression of thyroid cancer is unclear. We investigated the expression of SIRTs in patients with papillary thyroid carcinoma (PTC) and their role as biomarkers for predicting the aggressiveness of this disease. Materials and Methods: We used immunohistochemical staining to evaluate the expression of SIRT1 and SIRT3 in tumor specimens from 270 patients with PTC. We also evaluated the potential association between SIRT expression and diverse clinicopathological features. Results: High SIRT1 expression was negatively correlated with lymphovascular invasion, central lymph node metastasis, and lateral lymph node metastasis. Multivariate analyses revealed that high SIRT1 expression was a negative independent risk factor for lateral lymph node metastasis. By contrast, high SIRT3 expression was positively correlated with locoregional recurrence. Interestingly, when patients were grouped by tumor SIRT expression patterns, the group with low SIRT1 expression and high SIRT3 expression was correlated with more aggressive cancer phenotypes including central lymph node metastasis and lateral lymph node metastasis. Conclusion: Our results suggest that SIRTs play dual roles in tumor progression, and the combination of decreased SIRT1 expression and increased SIRT3 expression is significantly associated with a poor prognosis in patients with PTC.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1553-1558
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• 2015

Background: COX-2 has been shown to play an important role in the development of breast cancer and increased expression has been mooted as a poor prognostic factor. The purpose of this study was to investigate the relationship between COX-2 immunohistochemical expression and known predictive and prognostic factors in breast cancer in a routine diagnostic histopathology setting. Materials and Methods: Formalin-fixed paraffin-embedded tumour tissue of 144 no special type (NST) invasive breast carcinomas histologically diagnosed between January 2009 and December 2012 in Hospital Sultanah Bahiyah, Alor Setar, Kedah were immunostained with COX-2 antibody. COX-2 overexpression was analysed against demographic data, hormone receptor status, HER2-neu overexpression, histological grade, tumour size and lymph node status. Results: COX-2 was overexpressed in 108/144 (75%) tumours and was significantly more prevalent (87%) in hormone receptor-positive tumours. There was no correlation between COX-2 overexpression and HER2/neu status. Triple negative cancers had the lowest prevalence (46%) (p<0.05). A rising trend of COX-2 overexpression with increasing age was observed. There was a significant inverse relationship with tumour grade (p<0.05), prevalences being 94%, 83% and 66% in grades 1, 2 and 3 tumours, respectively. A higher prevalence of COX-2 overexpression in smaller size tumours was observed but this did not reach statistical significance. There was no relationship between COX-2 expression and lymph node status. Conclusions: This study did not support the generally held notion that COX-2 overexpression is linked to poor prognosis, rather supporting a role in tumorigenesis. Larger scale studies with outcome data and basic studies on cancer pathogenetic pathways will be required to cast further light on whether COX-2 inhibitors would have clinical utility in cancer prevention or blockage of cancer progression. In either setting, the pathological assessment for COX-2 overexpression in breast cancers would have an important role in the selection of cancer patients for personalized therapy with COX-2 inhibitors.

• 한방안이비인후피부과학회지
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• 제32권4호
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• pp.13-28
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• 2019

Objectives : The purpose of this study is to report the effectiveness of Korean medical treatment on 222 patients with alopecia areata. Methods : The subjects of this study were 222 patients who had received Korean medical treatment among the patients who visited the Balmer's Korean Medicine Clinic from January 1, 2016 to December 31, 2017. The extent of the alopecia areata was measured every month to determine the improvement. We analyzed the relationship between the types of alopecia areata, the extent of hair loss, duration of illness, age at first visit, and the treatment of alopecia areata. Results : 1. There were 100 males(45.0%) and 122 females(55.0%). The mean age of patients was 35.3 years old. 2. Of the 222 patients, 142(64%) were "cured". 31(14%) showed "good", 21(9.5%) showed "fair", 28(12.6%) showed "poor" improvement. 3. According to clinical records, of the 64 patients with alopecia areata(AA), 48(75.0%) were cured. Of the 100 patients with alopecia areata multiplex(AAM), 68 patients (68.0%), 12(50.0%) out of 24 patients with ophiasis, 5(55.6%) out of 9 with alopecia semi-totalis(AST), 3(50.0%) out of 6 patients with alopecia totalis(AT), 6(31.6%) out of 19 patients with alopecia universalis(AU) were cured. 4. Patients with the wider hair loss extent and with more severe type of alopecia areata required longer treatment period to cure, and the cure rate was lowered(p<0.05). 5. The shorter duration of the disease was related to the higher cure rate(p<0.05). If the treatment was started after six months of the duration, the cure rate was lowered. Therefore, beginning treatment within six months of the onset is recommended. 6. The period until terminal hair showed was 1.5 months for AA, 1.7 months for AAM, 1.6 months for ophiasis, 1.9 months for AST, 2.3 months for AT, 3.2 months for AU. 7. The treatment period to cure was 4.9 months for AA, 7.3 months for AAM, 7.7 months for ophiasis, 6.8 months for AST, 7.7 months for AT, 16.3 months for AU. 8. The major prognostic factors were extent and type of alopecia, duration of the disease and relapse. Conclusions : We analyzed the effectiveness of Korean medical treatment through cure rate according to the prognostic factors. This study will provide useful data for the treatment of alopecia areata.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.13-19
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• 2024

Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.

• Radiation Oncology Journal
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• 제15권4호
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• pp.357-367
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• 1997

목적 : 근치적 절제술과 골반림프절 절제술을 시행한 자궁경부암 환자 중에서 치료실패의 위험인자가 있어서 술후 방사선치료를 시행한 환자를 대상으로 치료성적, 예후인자, 실패양상을 알아보기 위하여 후향적 분석을 시행하였다. 대상 및 방법 : FIGO 병기 IB, IIA와 IIB 환자 중에서 근치적 수술과 방사선치료를 시행하고 추적조사가 가능하였던 124명을 대상으로 하였다. 환자들은 1985년 3월부터 1994년 3원까지 수술후 방사선치료를 시행하였으며 최소 추적기간은 24개월이었다. 모든 환자는 4-MV 선형가속기를 이용한 외부방사선치료를 전골반에 50-6OGy를 조사하였고 일부 환자는 코발트를 이용한 고선량율 강내치료를 추가하였다. 결과 : 전체 환자의 5년 생존율과 5년 무병 생존율은 각각 $75.4\%,\;73.5\%$였고, 단변수 분석상 5년 무병 생존율에 영향을 미치는 인자는 림프절 전이 유무, 개수와 위치, 종양의 크기, 자궁체부 침운, 자궁주위조직 침윤, 병기, 자궁경부벽 침윤정도, 질 절제면 양성, 그리고 치료 관계 인자로 방사선량, 강내치료, 항암제 등이 통계상 유의하였으며, 다변량 분석상 림프절 전이와 종양의 크기, 질 절제면 양성이 유의하였다. 치료 실패는 33명이었고 2명은 다른 원인으로 사망하였고 부위별로는 국소재발이 13명, 원격전이 13명 국소-원격 동시 실패가 7명이었고 추적 종료시점까지 5명이 생존하였다. 국소재발은 병기 IB, 림프절 전이 양성 또는 질 절제면 양성 환자에서 많이 발생하였으며 림프절 전이 음성환자에서는 빈도는 낮았으나 원격전이가 상대적으로 더 많았다. 그리고 병기 lIB에서 5년 생존율 은 $56\%$ 였고 22명 중에서 9명이 재발하였다. 결론 : 수술후 방사선치료는 비교적 효과적인 방법이지만 다수의 재발 위험인자들을 가진 환자에게 술후 방사선치료만으로는 재발을 막기가 충분하지 않으므로 방사선감작제의 추가나 동시방사선-항암치료 등의 보다 효과적인 방법이 필요할 것으로 성각되며, 술혹 방사선치료의 효율을 정하기 위하여 무작위 표본 추출에 의한 전향적 연구가 필오하다. 그리고 병기 IIB는 항암치료와 수술후 방사선치료를 시행해도 치료 성적이 나쁘므로 일차적으로 근치적 방사선치료를 시행해야한다.

• Radiation Oncology Journal
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• 제30권4호
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• pp.218-225
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• 2012

Purpose: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. Materials and Methods: Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. Results: The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response ($V2R{\geq}0.4$). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with $V2R{\geq}0.4$ (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). Conclusion: Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5511-5515
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• 2012

Introduction: The nuclear factor ${\kappa}B$ (NF-${\kappa}B$) is a super family of transcription factors which plays important roles in development and progression of cancer. The present investigation concerns NF-${\kappa}B$ /p65 activity in human breast cancers with overexpression of ER, PR, HER-2/neu, as well as the significance of p65 expression with regard to menopausal status, stage, grade, tumor size, nodal status, and NPI of invasive ductal carcinomas in Eastern India. Materials and Methods: In this hospital based study 57 breast cancer patients attending a Breast Clinic of a reputed institute of Eastern India were assessed for p65 protein expression in breast tumor tissue samples by Western blotting. ER, PR and HER-2/neu expression was determined by immunohistochemistry. Results: NF-${\kappa}B$/p65 was significantly associated with advanced stage, large tumor size (${\geq}5$ cm), high grade, negative ER, negative PR, and positive HER-2/neu. High NF-${\kappa}B$/p65 expression was more frequent in patients with a high NPI ($NPI{\geq}5.4$, 84.6%) compared with low NPI (<5.4, 44.4%) and this association was statistically significant (p = 0.002). Conclusion: NF-${\kappa}B$/p65 overexpression was associated with advanced stage, large tumor size, high grade, and high NPI which are poor prognostic factors linked to enhanced aggressiveness of the disease. NF-${\kappa}B$/p65 expression implies aggressive biological behavior of breast cancer and this study validates significant association of NF-${\kappa}B$ /p65 overexpression with negative estrogen and progesterone receptor status and overexpression of HER-2/neu oncoprotein. In our good clinical practice, patients with NF-${\kappa}B$ positive tumors need to be treated aggressively.