• Journal of Chest Surgery
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• 제33권2호
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• pp.173-178
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• 2000

Background: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer Material and method: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. Result: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) Conclsion: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1127-1130
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• 2013

Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

• Radiation Oncology Journal
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• 제7권2호
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• pp.235-245
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• 1989

Rhabdomyosarcoma is a highly malignant soft tissue sarcoma that can arise in any site of the body containing striated muscle or its mesenchymal analgae. It is the most common childhood sarcoma with two peak age frequencies, one at ages 2 to 6, and one in the adolescence. The site, stage and extent of disease, and pathologic characteristics of the tumor contribute to prognostic factors that influence therapeutic decisions. The results of treatment of 52 patients with rhabdomyosarcoma, who were treated at Department of Radiation Oncology, Yonsei University College of Medicine, Yosei Cancer Center from 1976 to 1987 were retrospectively analyzed. The most frequent clinical group and primary sites were IRS group III (57.7%) and head and neck (42.3%) including orbit (11.5%) and parameningeal region(13.5%). The overall and disease free 5 year survival rate of eligible 41 patients were 31.7%, 29.3%, respectively. The complete remission (CR) rate was 50% in clinical group III and 0% in IV. Primary tumors of the orbit, clinical group 1 and embryonal subtype had the best prognosis. The Survival rate was improved by additiion of chemotherapy to operation and radiation therapy.

• Clinical Endoscopy
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• 제56권1호
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• pp.38-49
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• 2023

Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I²=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I²=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I²=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.29-41
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• 2018

Lung cancer is one of the most commonly diagnosed cancers and the leading cause of cancer-related deaths worldwide. Although progress in the treatment of advanced non-small cell lung cancer (NSCLC) has been made over the past decade, the 5-year survival rate in patients with lung cancer remains only 10%-20%. Obviously, new therapeutic options are required for patients with advanced NSCLC and unmet medical needs. Cancer immunotherapy is an evolving treatment modality that uses a patient's own immune systems to fight cancer. Theoretically, cancer immunotherapy can result in long-term cancer remission and may not cause the same side effects as chemotherapy and radiation. Immunooncology has become an important focus of basic research as well as clinical trials for the treatment of NSCLC. Immune checkpoint inhibitors are the most promising approach for cancer immunotherapy and they have become the standard of care for patients with advanced NSCLC. This review summarizes basic tumor immunology and the relevant clinical data on immunotherapeutic approaches, especially immune checkpoint inhibitors in NSCLC.

• Journal of Yeungnam Medical Science
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• 제7권2호
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• pp.109-114
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• 1990

저자들은 두경부암의 포괄적인 치료의 일부로서 외부 방사선 조사와 고선량율 경관조사를 시행하여 12명중 9명에서 완전 관해를 얻었으며, 치료중이나 치료후 경관조사와 직접 관련된 급성 부작용이나 합병중의 발생이 없었다. 그러나 대상환자가 적고 추적기간이 짧은관계로 생존율의 향상은 추측하기 어려우나 완전 관해를 얻은 환자는 장기간 무병 상태로 추적되고 있어서 외부방사선 조사와 경관 조사는 두경부암 치료에 큰 역할을 하리라 기대된다.

• Radiation Oncology Journal
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• 제20권4호
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• pp.328-333
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• 2002

목적 : 절제 불가능한 췌장암은 예후가 불량하여 효과적인 치료법의 개발이 요망되고 있다. 본 연구에서는 Gemcitabine 또는 Paclitaxel과 5-Fluorouracil (5-FU)을 이용한 동시항암화학방사선요법을 시행하여 치료효과를 분석하고자 하였다. 대상 및 방법: 임상적으로 혹은 개복수술 소견 상 절제 불가능한 췌장암으로 진단받은 환자를 대상으로 Gemcitabine 또는 Paclitaxel과 5-FU을 이용한 동시항암화학방사선요법을 시행하였다. 방사선 치료는 원발병소와 주위 림프절을 포함하여 5주 동안 45 Gy를 조사하였다. 이 기간동안 Gemcitabine $1,000\;mg/m^2$ 또는 Paclitaxel $50\;mg/m^2$의 매주 1회 주사 및 5-FU의 매일 경구 투여를 시행하였다. 추적관찰기간은 6개월에서 36개월이었으며, 생존율은 Kaplan-Meier법을 이용하여 분석하였다. 결과 : 1999년 1월부터 2001년 11월까지 본 치료법이 시행된 경우는 54예였으며, 이중 계획된 치료를 종료한 42예를 분석하였다. 남녀 비는 30 : 12였고 중앙 연령은 60세였다. 총 54예 중 치료 중 원격전이나 암종증(carcinomatosis) 등으로의 진행 6명$(50\%)$, 시작시 불량한 전신수행 상태 4명$(33.3\%)$, 병변과 무관한 병발질환 1명$(8.3\%)$, 치료 거부 1명$(8.3\%)$ 등으로 총 12예에서 치료가 중단되었다. 42명의 환자 중 40예에서 반응 평가가 가능하였으며 완전 관해 1예, 부분 관해 24예로 관해율은 $59\%$로 나타났다. 중앙 생존값은 12개월, 1년 생존율은 $46.7\%$, 2년 생존율은 $17.0\%$였다. Grade III 이상의 치료독성으로는 혈액학적 독성이 8예$(19\%)$, 오심, 구토 등의 비혈액학적 독성이 9예$(20\%)$이었다. 이중 2명은 치료독성에 의한 상부 소화기 출혈로 사망하였다. 결론 : 절제 불가능한 췌장암에서 Gemcitabine 또는 Paclitaxel를 이용한 동시항암화학방사선요법은 관해율과 생존율에 있어서 효과적인 치료로 생각된다. 그러나 독성감소를 위한 연구가 또한 병행되어야 할 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.567-574
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• 2001

Objective : As for growth hormone(GH) secreting pituitary adenoma, it's remission should be declared on the basis of satisfactory controlling of the tumor, normalization of hormonal level, and symptomatic improvement of the patient. Several modalities of treatment have been applied and administered, and yet, this disease still remains as inveterate one to be fully treated. The purpose of this study is to evaluate the outcome of gamma knife radiosurgery(GKRS) for GH secreting pituitary adenoma, and to identify various factors affecting the outcome of the treatment. Method : A group of 24 out of 35 patients, treated by Leksell gamma knife unit during the period of March of 1992 through October of 1997, had been observed for more than two years. The mean target volume of microadenoma was $449.3mm^3(range 216-880mm^3)$, and that of macroadenoma was $3183.1mm^3(range 1456-13125mm^3)$. The tumor margin was covered with 50% isodose profile, and mean marginal dose was 25.2Gy(range 15-32.4Gy). The mean number of isocenter was 4.3(range 1-6). The exposed dose to the optic apparatus was less than 8Gy. The mean follow-up period was 37.8months(range 24-102months). Result : No patients showed any increase in the tumor volume during the follow-up period. And definite shrinkage of tumor volume(tumor volume reduction rate, TVRR : more than 50%) was obtained in 10 patients(41.7%). Twenty one patients(87.5%) had reduced hormonal level compared than pre-treatment level. Among them, normalization of the hormonal level was achieved in 12 patients(50%). Clinicoendocrinological remission was seen in 3 patients (12.5%). According to the results of statistical analysis, tumor volume(p=0.016),duration of symptoms(p=0.046), initial GH level(p=0.017), and the invasion of cavernous sinus(p=0.036) were significantly favorable to post-radiosurgical outcome. The TVRR was significantly related to post-radiosurgical reduction of serum GH level. Permanent complication was not seen. Conclusion : The authors concluded that GKRS is a safe and effective treatment modality for acromegaly. To otain the better outcome of GKRS in GH secreting pituitary adenoma, more careful and sophisticated treatment-planning is recommended.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1357-1362
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• 2016

Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Sixty-three patients met the criteria. The median age was 30.0 years and almost 90% were referral cases. Nearly 40% of the studied patients presented with vaginal bleeding while 22.2% were asymptomatic. The most common antecedent pregnancy was hydatidiform mole (57.1%) followed by term pregnancy (20.6%). The median interval time from antecedent pregnancy to the development of GTN was three months and the median pretreatment B-hCG was 58,274 mIU/ml. Stage III (74.6%) was the most common staging followed by stage IV (20.6%) and stage II (4.8%). The most frequent surgery was hysterectomy (31.7%). Thoracotomy and craniotomy were performed in three and two patients, respectively. The most common first line chemotherapy regimen was methotrexate and folinic acid (36.5%) followed by EMA (etoposide, methotrexate, actinomycin D) (34.9%), EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (17.5%) with the remission rate of 66.7%. Nearly one-third of the patients were given a subsequent chemotherapy regimen after failure with the first line therapy and showed a final response rate of 73.0%. However, in stage IV, the response to first line treatment was only 38.5%. In conclusion, the outcomes of metastatic GTN were poor especially with the higher stages.

• 대한후두음성언어의학회지
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• 제28권1호
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• pp.32-37
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• 2017

Background and Objectives : This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. Subjects and Methods : Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. Results : Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. Conclusion : The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.