• Title/Summary/Keyword: Treatment Efficacy

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Patients with HER2-positive Early Breast Cancer Receiving Adjuvant Trastuzumab: Clinicopathological Features, Efficacy, and Factors Affecting Survival

  • Ulas, Arife;Kos, Tugba;Avci, Nilufer;Cubukcu, Erdem;Olmez, Omer Fatih;Bulut, Nilufer;Degirmenci, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1643-1649
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    • 2015
  • Background: The aim of the present study was to evaluate clinicopathological characteristics of our early stage breast cancer patients who are epidermal growth factor receptor 2 (HER2) overexpressed/amplified (HER2+), the efficacy of trastuzumab treatment and survival results. Materials and Methods: Patients with HER2-positive early stage breast cancer receiving adjuvant trastuzumab were investigated retrospectively. Clinicopathological features of 210 patients and treatment outcome were analysed. To evaluate survival rates, the Kaplan-Meier method was used. Univariate and multivariate analyses were conducted with the Cox regression model. Results: Mean age of the patients was 51.8, 71.9% being postmenopausal. Some 37.6% of patients were node negative, and 31% had T1 tumor size and 52.4% were positive for estrogen receptor. Of 210 patients, 89.5% completed planned 52 weeks adjuvant trastuzumab treatment. The median follow up was 27.5 months (6.0-86.0). Relapse free survival (RFS) was 68.0 months (95% CI: 62.1-74.0) and overall survival (OS) was 74.8 months (95% CI: 69.5-80.1). The 3 year OS for all patients was 92.0% and RFS was 79.6%. During follow up, relapse was detected at the rate of 14.3%. Trastuzumab associated cardiotoxicity was found at the rate of 3.3%. In univariate analyses, larger tumor size and grade III were significantly associated (p<0.05) with RFS. Multivariate analyses of covariates displaying p<0.05 identified grade III as an independent prognostic factor. Conclusions: In the present study, it was established that trastuzumab had a satisfactory safety profile and treatment efficacy as in other clinical studies and that among clinicopathological factors evaluated, only being grade 3 had a significant effect on RFS. The occurrence of relapse with adjuvant trastuzumab makes it necessary to identify molecular predictors, which will define this group better and help explain resistance to anti HER2 based therapies.

The Efficacy on the Immunotherapy with Patient Lymphocytes in Unexplained Infertility (원인불명의 불임환자에서 림파구 정맥주입에 의한 면역 치료의 효능에 관한 연구)

  • Jung, Byeong-Jun;Lee, Sang-Hoon;Hur, Min
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.3
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    • pp.293-300
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    • 1997
  • The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

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The Comparison Study on the Efficacy of Bucillamine Monotherapy and Bucillamine plus Methotrexate Combination Therapy in the Treatment of Rheumatoid Arthritis (류마티스 관절염 환자에서 Bucillamine 단독요법과 Bucillamine과 Methotrexate 병용요법의 치료효과에 대한 비교연구)

  • Lee, Young Ran;Suh, Okkyung;Jung, Sung Soo;Jun, Jae Bum;Yoo, Dae Hyun;Lee, Suk Hyang;Shin, Hyun Taek;Kim, Seong Yoon
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.1-12
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    • 1998
  • Rheumatoid arthritis (RA) is a common systemic inflammatory disease which DMARDS have been widely used as a treatment modality both as monotherapy and combination therapy Bucillamine, one of newer DMARDS, has recently proven its efficacy as monotherapy in the treatment of RA. The objective of this study was to compare the efficacy and the safety of bucillamine monotherapy and bucillamine plus methotrexate combination therapy in the treatment of rheumatoid arthritis. Forty-nine mild RA patients were enrolled in this prospective, open-trial and were assigned to receive bucillamine 200 mg/day (n=18) or bucillamine 200 mg/day and methotrexate 7.5-15 mg/week (n=31) orally for 16 weeks. Concomitant use of NSAID and prednisolone <5 mg/day or equivalent dose of steroid were allowed. Both monotherapy group and combination therapy group have shown significant improvement in disease activities (Ritchie index, painful joints, swollen joints, morning stiffness, grip strength, ESR, RF, CRP, patient's self assessment of pain, physician's global assessment of disease activity) from the baseline. However, there was no statistically significant difference between two groups. The adverse effects were more frequently shown in combination therapy group than monotherapy group. In conclusion, in patients with mild RA monotherapy has shown to be equally efficacious as combination therapy with less side effects.

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Microwave Cavity with Controllable Temperature for In Vitro Hyperthermia Investigations

  • Kiourti, Asimina;Sun, Mingrui;He, Xiaoming;Volakis, John L.
    • Journal of electromagnetic engineering and science
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    • v.14 no.3
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    • pp.267-272
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    • 2014
  • Hyperthermia is a form of cancer treatment in which affected human tissue is exposed to $>40^{\circ}C$ temperature. In this paper, our goal is to assess the efficacy of fullerene agents to reduce heating time for cancer treatment. Such agents can accelerate heating of cancer cells and improve hyperthermia treatment efficacy. Typically, in vitro testing involves cancer cell culturing, heating cell cultures in accordance to specifications, and recording cancer cell viability after hyperthermia. To heat cell cultures, we design and evaluate a 2.4-GHz microwave cavity with controllable temperature. The cavity is comprised of a polystyrene cell culture dish (diameter = 54 mm, height = 13.5 mm) and a printed monopole antenna placed within the cavity for microwave heating. The culture temperature can be controlled through the intensity and duration of the antenna's microwave radiation. Heating experiments were carried out to validate the cavity's performance for F-12K culture medium (Kaighn's F-12K medium, ATCC). Importantly, fullerene agents were shown to reduce heating time and improve hyperthermia treatment efficacy. The culture medium temperature increased, on average, from $24.0^{\circ}C$ to $50.9^{\circ}C$ (without fullerene) and from $24.0^{\circ}C$ to $56.8^{\circ}C$ (with 3 mg/mL fullerene) within 15 minutes.

Evaluation of the Biocontrol Potential of Some Medicinal Plant Materials Alone and in Combination with Trichoderma harzianum Against Rhizoctonia solani AG 2-1

  • Lee, Hye-Min;Khan, Zakaullah;Kim, Sang-Gyu;Baek, Nam-In;Kim, Young-Ho
    • The Plant Pathology Journal
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    • v.27 no.1
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    • pp.68-77
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    • 2011
  • Fifty five species of medicinal plant materials were tested for their antifungal activity in vitro against Rhizoctonia solani AG 2-1 and Trichoderma harzianum to select plant species that can be used to improve the biocontrol efficacy of T. harzianum. Six species were effective against R. solani AG 2-1 but were also antagonistic to T. harzianum, except for Cinnamomum loureirii stem bark (CSB). CSB inhibited mycelial growth of R. solani AG 2-1 by 73.7% but showed an inhibitory effect on mycelial growth of T. harzianum by only 2.2%. Scanning electron microscophs showed that the CSB treatment resulted in deformed R. solani AG 2-1 hyphal cells, and transmission electron microscophs revealed degenerated cell structures such as degenerated cytoplasm and disentangled cell wall and the accumulation of electron-dense inclusions (asterisks) in the CSB treatment. The biocontrol efficacy of radish damping-off increased greatly following the combined treatments of T. harzianum and CSB and the combined treatment increased efficacy from 6.4-23.1% to 37.1-87.3% compared with either treatment alone. CSB did not affect T. harzianum population growth, as it was almost the same in rice-bran peat medium (culture) amended with 0.1% and 1.0% CSB powder as in non-amended medium. The formulation of T. harzianum in rice-bran peat medium amended with CSB powder reduced the severity of radish damping-off by 80.6%, suggesting that T. harzianum and CSB can be formulated as a biocontrol product for the control of R. solani AG 2-1.

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms

  • Choi, Jae Young;Choi, Chang Hwa;Ko, Jun Kyeung;Lee, Jae Il;Huh, Chae Wook;Lee, Tae Hong
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.208-218
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    • 2019
  • Background: The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms. Methods: From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed. Results: Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only 3 aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, 5 (6.9%) remnant neck, and 1 (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of 8 asymptomatic and 2 symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included 1 major and 3 minor recanalizations. Conclusion: Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

A Pilot Clinical Study of the Efficacy and Safety of Phellinus Linteus (Sanghuang) Extract Treatment for Knee Osteoarthritis

  • Ryu, Hwa yeon;Lee, Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.115-121
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    • 2022
  • Background: To evaluate the efficacy and safety of Phellinus linteus (PL) extract for the treatment of knee osteoarthritis (KOA) a pilot clinical study was performed. Methods: There were 24 patients with KOA who enrolled in this double-blind, randomized, controlled, clinical trial. There were 3 groups: PL 1,000 mg/day (PL 1,000), PL 1,500 mg/day (PL 1,500), and dextrin 3,000 mg/day (placebo). Patients took capsules twice a day, 3 capsules at a time, over 8 weeks. Patients were monitored prior to treatment (Visit 1: Week 0), and followed up every 4 weeks (Visit 2: Week 4 and Visit 3: Week 8) where outcome measurements were taken. The primary outcome measure was the score from the Korean version of the Western Ontario and McMasters Universities from baseline to Week 8. The secondary outcomes were measurements from the visual analog scale, quality of life scale, erythrocyte sedimentation, and c-reactive protein. Adverse events were recorded at every visit. Results: The Korean version of the Western Ontario and McMasters Universities score showed the greatest improvement in symptoms of KOA in the PL 1,500 group compared with the placebo group. The erythrocyte sedimentation tended to decrease in the PL 1,500 group compared with the placebo group (which was within the normal range). The visual analog scale score decreased in all groups, with no significant differences between groups. No adverse events related to PL were reported. There were no abnormal hematological or physical findings. Conclusion: This pilot clinical trial was the first step to assess the efficacy and safety of PL used in the treatment of patients with KOA.

The Role of Intensity Modulated Radiotherapy in Cancer Treatment

  • Cheung, Kin-Yin
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.6-8
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    • 2002
  • Intensity modulated radiotherapy (IMRT) is an advanced but expensive form of 3-dimensional conformal radiation therapy technique. While the initial clinical data appear to be promising for some treatment sites, the cost effectiveness of the treatment modality has yet to be justified by long-term clinical outcome. This presentation reviews the potential efficacy and limitation of IMRT in respect of the practicality, dosimetry, and resource aspects. It tries to explore and draw conclusions on the strategies for using this sophisticated and expensive treatment technique from AFOMP perspective.

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An Overview on Severe Acute Respiratory Syndrome(SARS) in WHO Clinical Reports (중증급성호흡기증후군(SARS)의 한약 치료에 관련된 WHO 임상논문 보고에 대한 개관)

  • Jang, In-Soo;Hsing, Li-Chang;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.26 no.2
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    • pp.440-452
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    • 2005
  • Objective: In the winter of 2002, severe acute respiratory syndrome(SARS) began to spread throughout the world. More than 5,000 cases were reported in China, including over 1,700 cases in Hong Kong Special Administrative Region(Hong Kong SAR). The total number of cases reported from Canada and Singapore was more than 200. The total number of SARS cases world-wide reached 8,437 with incidences in 29 counties. Mortality from SARS is estimated at $10{\sim}12%$. When the SARS outbreak occurred in China, the State Administration of Traditional Chinese Medicine of China immediately initiated clinical research projects on the use of integrated herbal medicine and Western medicine for treating SARS. and, in Hong Kong SAR, research on the use of herbal medicine for the prevention and treatment of SARS. Reports were released during convalescence. The objective of this study is to overview twelve clinical SARS reports of WHO on the treatment of SARS with herbal medicine and evaluate the efficacy and safety of treatment of SARS with herbal medicine, and further to share experiences and knowledge of the treatment of SARS. Methods: Twelve clinical reports about SARS from the WHO were selected, overviewed and evaluated for efficacy and safety of treatments of SARS. Results and Conclusion: Twelve clinical reports about SARS showed that the integrated treatment may have advantages, and the advantages are reflected in the following findings: Firstly, herbal medicine is not targeted only at a specific etiology or a certain pathological link, but also at the pathological status of the patients at that particular time. Therefore, comprehensive readjustment was made through various angles, targets and channels to restore the balance of the body. Secondly, there are advantages in the differentiation of the disease and the treatment. Based on the various symptoms, herbal medicine enables the physician to adopt the most suitable principle, provide individual treatment, and to administer medicine in accordance with the actual process and nature of the illness. Thirdly, there are advantages in the results of the treatment; herbal medicine can relieve symptoms, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other Western medicines, and reduce case fatality rate, in addition to lowering the cost of treatment.

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Resistant Gestational Trophoblastic Neoplasia Patients Treated with 5-Fluouracil plus Actinomycin D

  • Manopunya, Manatsawee;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.387-390
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    • 2012
  • A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonly administered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second line of treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear. To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patients resistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen between August 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases who met the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12. The median number of cycles for each patient was two and only one case achieved remission while four of the cases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicated myelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting with manageable toxicity.