• Title/Summary/Keyword: Treatment Efficacy

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Adjuvant Chemotherapy and Prognostic Factors in Stage II Colon Cancer - Izmir Oncology Group Study

  • Kucukzeybek, Yuksel;Dirican, Ahmet;Demir, Lutfiye;Yildirim, Serkan;Akyol, Murat;Yildiz, Yasar;Bayoglu, Ibrahim Vedat;Alacacioglu, Ahmet;Varol, Umut;Salman, Tarik;Yildiz, Ibrahim;Can, Huseyin;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2413-2418
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    • 2015
  • Background: Although adjuvant chemotherapy is a standard treatment in stage III colon cancer, its benefit is not as clear for stage II patients. In this retrospective analysis, we aimed to evaluate the survival of patients with low-risk stage II colon cancer, the efficacy of adjuvant chemotherapy in high-risk stage II colon cancer patients, and prognostic factors in stage II disease. Materials and Methods: One hundred and seventeen patients who were diagnosed with stage II colon cancer between January 2006 and December 2011 were included in the study. Patients were stratified into two groups as being low-risk and high-risk according to risk factors for stage II disease. Adjuvant 5-fluorouracil-based chemotherapy were administered to the patients with risk factors. Results: Ninety-four patients were treated with adjuvant chemotherapy due to high risk factors and 23 were monitored without treatment. Median follow-up time was 43 months. In terms of disease free survival and overall survival, adjuvant chemotherapy did not provide a statistically significant difference. Univariate analysis demonstrated that bowel obstruction was the major risk factor for shortened disease-free survival, while bowel perforation and perineural invasion were both negative prognostic factors for overall survival. Conclusions: The recommendation of adjuvant chemotherapy for stage II colon cancer is not clear. In our study, it was found that adjuvant chemotherapy did not contribute to survival in high-risk stage II patients. Due to the fact that prognosis of stage II patients is good, many more patients will be needed for statistically significant differences in survival. Adjuvant chemotherapy containing 5 fluorouracil is being used to high-risk stage II patients although it is not a standard treatment approach.

XELOX Plus Bevacizumab vs. FOLFIRI Plus Bevacizumab Treatment for First-line Chemotherapy in Metastatic Colon Cancer: a Retrospective Study of the Anatolian Society of Medical Oncology

  • Duran, Ayse Ocak;Karaca, Halit;Besiroglu, Mehmet;Bayoglu, Ibrahim Vedat;Menekse, Serkan;Yapici, Heves Surmeli;Yazilitas, Dogan;Bahceci, Aykut;Uysal, Mukremin;Sevinc, Alper;Hacibekiroglu, Ilhan;Aksoy, Asude;Tanriverdi, Ozgur;Arpaci, Erkan;Inanc, Mevlude;Dane, Faysal;Ozkan, Metin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10375-10379
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    • 2015
  • Background: XELOX plus bevacizumab (XELOX-Bev) and FOLFIRI plus Bevacizumab (FOLFIRI - Bev) treatments are an effective strategies patients with metastatic colorectal cancer (mCRC).The aim of this study was to compare efficacy of first-line XELOX-Bev treatment vs FOLFIRI-Bev treatment for mCRC. Materials and Methods: A total of 409 patients with mCRC who received chemotherapy were included and divided into 2 groups. Group 1 (n=298) received XELOX-Bev and Group 2 (n=111) FOLFIRI-Bev. Comparisons were made in terms of overall (OS) and progression-free (PFS) survival, response rate (RR), and grade 3-4 toxicity. Results: Median follow-up was 11 months in Group 1 and 15 months for Group 2. Complete remission was observed in 29 (9.7%) and 2 (1.8%) patients, partial remission in 139 (46.6%) and 27 (24.5%), stable disease in 88 (29.5%) and 49 (44.1%) and progressive disease in 42 (14.1%) and 33 (30.0%) patients in Group 1 and 2, respectively. Median OS was 25 months (range 2-57 months, 95%CI; 22.2-27.7) for Group 1 and 20 months (range 1-67 months, 95%CI; 16.8-23.1) for Group 2 (p=0.036). Median PFS was 9.6 months (range 2-36 months, 95%CI; 8.8-10.4) for Group 1 and 9 months (range 1-44 months, 95%CI; 7.4-10.5) for Group 2 (p=0.019). Objective RR was 56.4% in Group 1 and 26.1% in Group 2 (p<0.001). Conclusions: First-line XELOX-Bev is more effective with a better response rate, prolongation of median PFS/OS, and a superior safety profile compared with FOLFIRI-Bev.

Efficacy of Antiepileptic Drug on the Benign Childhood Epilepsy with Centro-Temporal Spikes (중심-측두엽 극파를 보이는 양성 소아 간질 환자에서 항경련제 투여의 유효성)

  • Oh, Mee Hye;Kim, Soo Young;Seo, Won Hee;Pee, Dae Hun;Choi, Byung Min;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.893-897
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    • 2003
  • Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.

Gamma Knife Radiosurgery for Metastatic Brain Tumors with Exophytic Hemorrhage

  • Park, Eun Suk;Lee, Eun Jung;Yun, Jung-Ho;Cho, Young Hyun;Kim, Jeong Hoon;Kwon, Do Hoon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.592-599
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    • 2018
  • Objective : Metastatic brain tumors (MBTs) often present with intracerebral hemorrhage. Although Gamma Knife surgery (GKS) is a valid treatment option for hemorrhagic MBTs, its efficacy is unclear. To achieve oncologic control and reduce radiation toxicity, we used a radiosurgical targeting technique that confines the tumor core within the hematoma when performing GKS in patients with such tumors. We reviewed our experience in this endeavor, focusing on local tumor control and treatment-associated morbidities. Methods : From 2007 to 2014, 13 patients with hemorrhagic MBTs were treated via GKS using our targeting technique. The median marginal dose prescribed was 23 Gy (range, 20-25). GKS was performed approximately 2 weeks after tumor bleeding to allow the patient's condition to stabilize. Results : The primary sites of the MBTs included the liver (n=7), lung (n=2), kidney (n=1), and stomach (n=1); in two cases, the primary tumor was a melanoma. The mean tumor volume was $4.00cm^3$ (range, 0.74-11.0). The mean overall survival duration after GKS was 12.5 months (range, 3-29), and three patients are still alive at the time of the review. The local tumor control rate was 92% (tumor disappearance 23%, tumor regression 46%, and stable disease 23%). There was one (8%) instance of local recurrence, which occurred 11 months after GKS in the solid portion of the tumor. No GKS-related complications were observed. Conclusion : Our experience shows that GKS performed in conjunction with our targeting technique safely and effectively treats hemorrhagic MBTs. The success of this technique may reflect the presence of scattered metastatic tumor cells in the hematoma that do not proliferate owing to the inadequate microenvironment of the hematoma. We suggest that GKS can be a useful treatment option for patients with hemorrhagic MBTs that are not amenable to surgery.

Insecticidal Activities of Polymers and Surfactants Against Sweet Potato Whitefly, Bemisia tabaci (Hemiptera: Aleyrodidae) (담배가루이에 대한 폴리머와 전착제의 살충효과)

  • Yoon, Chang-Mann;Cho, Sun-Ran;Moon, Sang-Rae;Shin, Youn-Ho;Kim, Gil-Hah
    • The Korean Journal of Pesticide Science
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    • v.15 no.2
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    • pp.177-187
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    • 2011
  • This study was performed to evaluate the polymers and surfactants as the potential control agents of sweet potato whitefly Bemisia tabaci, which is causing problems in ornamental garden and greenhouse. Polymers have an insecticidal activity to knock down and to be lethal to small winged insects by its viscosity. Among five polymers tested at 0.2% concentration, polinol P-24 showed the highest insecticidal activity as 59.4% against B. tabaci adult in cylindrical chamber, and followed by polinol P-20 (insecticidal activity, 57.1%). When treated at 0.1 % or 0.3% concentrations, Polinol P-24 also showed the highest insecticidal activity with 43.3% and 54.5%, respectively. Among eight surfactants tested, insecticidal activity was the highest in 0.0005% NP10 treatment (70.0%), and followed by 0.001% NP7 (67.4%). The synergistic effect between polinol P-24 and eight surfactants was evaluated. After bioassays, the 0.2% polinol P-24 plus 0.005% NP10 was selected as a candidate control agent for controlling of B. tabaci adults. Polinol P-24/NP10 was showed the highest control efficacy against B. tabaci adults applied three times at three day-intervals in square rearing cage. In the greenhouse, the mixture treatment showed good control value over 70% seven days after treatment.

Surgical Ligation on Significant Patent Ductus Arteriosus in Very Low Birth Weight Infants: Comparison between Early and Late Ligations

  • Lee, Jun Ho;Ro, Sun Kyun;Lee, Hyun Ju;Park, Hyun Kyung;Chung, Won-Sang;Kim, Young Hak;Kang, Jeong Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.444-450
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    • 2014
  • Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.

Re-irradiation of unresectable recurrent head and neck cancer: using Helical Tomotherapy as image-guided intensity-modulated radiotherapy

  • Jeong, Songmi;Yoo, Eun Jung;Kim, Ji Yoon;Han, Chi Wha;Kim, Ki Jun;Kay, Chul Seung
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.206-215
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    • 2013
  • Purpose: Re-irradiation (re-RT) is considered a treatment option for inoperable locoregionally recurrent head and neck cancer (HNC) after prior radiotherapy. We evaluated the efficacy and safety of re-RT using Helical Tomotherapy as image-guided intensity-modulated radiotherapy in recurrent HNC. Materials and Methods: Patients diagnosed with recurrent HNC and received re-RT were retrospectively reviewed. Primary endpoint was overall survival (OS) and secondary endpoints were locoregional control and toxicities. Results: The median follow-up period of total 9 patients was 18.7 months (range, 4.1 to 76 months) and that of 3 alive patients was 49 months (range, 47 to 76 months). Median dose of first radiotherapy and re-RT was 64.8 and 47.5 $Gy_{10}$. Median cumulative dose of the two courses of radiotherapy was 116.3 $Gy_{10}$ (range, 91.8 to 128.9 $Gy_{10}$) while the median interval between the two courses of radiation was 25 months (range, 4 to 137 months). The response rate after re-RT of the evaluated 8 patients was 75% (complete response, 4; partial response, 2). Median locoregional relapse-free survival after re-RT was 11.9 months (range, 3.4 to 75.1 months) and 5 patients eventually presented with treatment failure (in-field failure, 2; in- and out-field failure, 2; out-field failure, 1). Median OS of the 8 patients was 20.3 months (range, 4.1 to 75.1 months). One- and two-year OS rates were 62.5% and 50%, respectively. Grade 3 leucopenia developed in one patient as acute toxicity, and grade 2 osteonecrosis and trismus as chronic toxicity in another patient. Conclusion: Re-RT using Helical Tomotherapy for previously irradiated patients with unresectable locoregionally recurrent HNC may be a feasible treatment option with long-term survival and acceptable toxicities.

Cutting Propagation of Eleutherococcus senticosus MAXIM (가시오가피의 거목번식방법(揷木繁殖方法))

  • Park, Ho-Ki;Park, Moon-Soo;Kim, Tai-Soo;Choi, In-Leok;Jang, Yeong-Sun;Kim, Gue-Seong
    • Korean Journal of Medicinal Crop Science
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    • v.2 no.2
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    • pp.133-139
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    • 1994
  • Eleutherococcus senticocus MAXIM containing compounds for a cordial and lumbago is a native plant in this country. However it is generally difficult to propagate them by seed. This study was carried out to improve propagation efficacy by cutting method using Eleutherococcus senticosus MAXIM collected Mt. Odae for three years$('90{\sim}'92)$. Rooting was delayed by 3 to 12 days but callus formation and rooting percentage was high by 75%, 30% respectively in the treatment of Rooton-F powder, a chemical for rooting promotion, compared with non-treatment. Rooting percentage and rooting characters were not differenced by treatment for remove rooting inhibition compounds and soil-media mixured by 1:1 of vermiculite and perlite was suitable for elevating rooting ratio. A. chiisanensis and A. sieboldianum were rooted well in any time to be cut, while rooting activity of E. senticosus was different by time to be cut. Rooting ratio of E. senticosus was 26%, 36% and 60% when cutten March 20, July 20 and september 20, respectively.

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The Changes of Sedation in the Department of Pediatric Dentistry, Yonsei University Dental Hospital (연세대학교 치과대학병원 소아치과의 진정법의 변화 양상)

  • Lee, Koeun;Song, Je Seon;Kim, Seong-Oh;Lee, Jaeho;Choi, Byungjai;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.154-161
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    • 2018
  • Sedation is a useful behavior management technique for dental patients who may be uncontrollable or have medical problems. The aim of this study is to investigate the changes in patterns of sedative treatments in pediatric dentistry by analyzing the distribution of patients and used sedative agents. Patients and sedative agents were reviewed based on the electronic medical records (EMR) of the department of pediatric dentistry in Yonsei University Dental Hospital from 2011 to 2016. The number of patients who were treated under sedation generally increased. Male received more sedation treatment than female by 2014, and they became similar from 2015. The treatment percentage of patients with systemic disease decreased in 2013, remained constantly afterwards. The ratio of sedative treatment for the age 4 - 5 and age 6 - 10 generally increased, while that of the age 0 - 2 and older than age 11 decreased. The ratio of the age 3 remained steady. Nitrous oxide was the most frequently used sedative agent. The use of benzodiazepine increased while the use of chloral hydrate decreased. Although the use of sedation has expanded, multidimensional approaches for ensuring safety have been less focused. Therefore, it is necessary to explore further studies for the safety and efficacy of the use of sedation.

Evaluation of Peri-procedural Warfarin Therapy Undergoing Cardioversion in Patients with Atrial fibrillation (심방세동 환자의 심율동전환 시행 전·후 warfarin 치료의 적절성 평가)

  • Moon, Jung-Yeon;Kim, Bo-Ram;Jo, Eun-Jung;Cho, Yoon-Sook;Han, Hyun-Joo;Choi, Eue-Keun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.201-206
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    • 2016
  • Objective: Direct current cardioversion for atrial fibrillation could be associated with the risk of thromboembolic events. Anticoagulation therapy with warfarin (INR 2.0-3.0) is recommended 3 weeks before and 4 weeks after cardioversion to reduce the risk of thromboembolism. This study evaluated warfarin therapy in pharmacist-managed anticoagulant services (ACS). Methods: This retrospective study was performed in 106 patients with atrial fibrillation from 2012 to 2013. The primary efficacy endpoint was the composite of stroke, transient ischemic attack, myocardial infarction, and cardiovascular death. The primary safety measure was major bleeding. To evaluate the peri-procedural effects of warfarin treatment, we studied whether target INR was maintained, as well as the maintenance period of the therapeutic range. Quality of treatment was measured by time in therapeutic range (TTR) by using the Rosendaal method. Results: There were no thromboembolic events, but TEE examination at time of cardioversion showed a left atrial thrombus in three patients (2.8%). Bleeding complications after cardioversion occurred in 2 patients (1.9%). The average INR value at the time of cardioversion was $2.59{\pm}0.8$, and was within the therapeutic range in 83 patients (78%). Analysis of the patients in whom the value was within the therapeutic range twice consecutively showed that the ratio of TTR was 80% and the therapeutic range was maintained in 67 patients (63%) for an average of 4.90 weeks prior to cardioversion. Similarly, 76 patients (72%) had a stable INR within the therapeutic range for an average of 5.70 weeks and a mean TTR of 83%. Conclusion: Pharmacists significantly contributed to appropriate warfarin treatment with close monitoring during cardioversion. Likewise, active pharmacist monitoring and systemic management should be considered to reduce thromboembolism and bleeding complications in the peri-cardioversion period.