• Title/Summary/Keyword: Treatment Efficacy

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Comparison of WHO and RECIST Criteria for Evaluation of Clinical Response to Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Chaudhry, Naseer Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3213-3218
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    • 2012
  • When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran

  • Ghahremani, Leila;Mousavi, Zakiyeh;Kaveh, Mohammad Hossein;Ghaem, Haleh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5133-5138
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    • 2016
  • Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran.This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group's mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women's health and reduce deaths due to breast cancer.

Inhibition of Tumor Growth in Vitro by a Combination of Extracts from Rosa Roxburghii Tratt and Fagopyrum Cymosum

  • Liu, Wei;Li, Su-Yi;Huang, Xin-En;Cui, Jiu-Jie;Zhao, Ting;Zhang, Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2409-2414
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    • 2012
  • Objective: Traditional Chinese herbal medicines have a very long history. Rosa roxburghii Tratt and Fagopyrum cymosum are two examples of plants which are reputed to have benefits in improving immune responses, enhancing digestive ability and demonstrating anti-aging effects. Some evidence indicates that herbal medicine soups containing extracts from the two in combination have efficacy in treating malignant tumors. However, the underlying mechanisms are far from well understood. The present study was therefore undertaken to evaluate anticancer effects and explore molecular mechanisms in vitro. Methods: Proliferation and apoptosis were assessed with three carcinoma cell lines (human esophageal squamous carcinoma CaEs-17, human gastric carcinoma SGC-7901 and pulmonary carcinoma A549) by MTT assay and flow cytometry, respectively, after exposure to extract from Rosa roxburghii Tratt (CL) and extract from Fagopyrum cymosum (FR). $IC_{30}$ of CL and FR were obtained by MTT assay. Tumor cells were divided into four groups : control with no exposure to CL or FR; CL with $IC_{30}$ CL; FR with $IC_{30}$ FR; CL+FR group with 1/2 ($IC_{30}$ CL + $IC_{30}$ FR). RT-PCR and Western blot analysis were used to detect the expression of Ki-67, Bax and Bcl-2 at mRNA and protein levels. Results: Compared with the CL or FR groups, the combination of CL+FR showed significant inhibition of cell growth and increase in apoptosis; the mRNA and protein expression levels of Ki-67 and Bcl-2 in CL+FR group were all greatly decreased, while the expression of Bax was markedly increased. Conclusions: These results indicate that the synergistic antitumor effects of combination of CL and FR are related to inhibition of proliferation and induction of apoptosis.

Repeat Colonoscopy Every 10 Years or Single Colonoscopy for Colorectal Neoplasm Screening in Average-risk Chinese: A Cost-effectiveness Analysis

  • Wang, Zhen-Hua;Gao, Qin-Yan;Fang, Jing-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1761-1766
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    • 2012
  • Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

PLGA-Based Nanoparticles as Cancer Drug Delivery Systems

  • Tabatabaei Mirakabad, Fatemeh Sadat;Nejati-Koshki, Kazem;Akbarzadeh, Abolfazl;Yamchi, Mohammad Rahmati;Milani, Mortaza;Zarghami, Nosratollah;Zeighamian, Vahideh;Rahimzadeh, Amirbahman;Alimohammadi, Somayeh;Hanifehpour, Younes;Joo, Sang Woo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.517-535
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    • 2014
  • Poly (lactic-co-glycolic acid) (PLGA) is one of the most effective biodegradable polymeric nanoparticles (NPs). It has been approved by the US FDA to use in drug delivery systems due to controlled and sustained-release properties, low toxicity, and biocompatibility with tissue and cells. In the present review, the structure and properties of PLGA copolymers synthesized by ring-opening polymerization of DL-lactide and glicolide were characterized using 1H nuclear magnetic resonance spectroscopy, gel permeation chromatography, Fourier transform infrared spectroscopy and differential scanning calorimetry. Methods of preparation and characterization, various surface modifications, encapsulation of diverse anticancer drugs, active or passive tumor targeting and different release mechanisms of PLGA nanoparticles are discussed. Increasing experience in the application of PLGA nanoparticles has provided a promising future for use of these nanoparticles in cancer treatment, with high efficacy and few side effects.

Arthroscopic Bankart Repair using Suture Anchors (봉합나사를 이용한 Bankart 병변의 관절경적 봉합술)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Shin, Sang-Howa;Kwak, Jong-Ill
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.173-177
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    • 2006
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint. Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 90 cases and evaluated the results with the functional grading system of Rows and Zarins after patients were followed up for more than 24 months. Results: Combined pathologies identified under arthroscopy were Hill-sachs lesion in 46 cases, SLAP lesion in 12 cases, Rotate cuff lesion in 7 cases. The results were excellent or good in 82(91.1%) cases and redislocation was happened only 3 cases. Conclusion: We concluded that arthroscopic Bankart repair with suture anchors is one of the reliable and effective method for recurrent shoulder dislocation with Bankart lesion.

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Arthroscopic Treatment for Meniscal Cyst (관절경을 이용한 반월상연골 낭종의 치료)

  • Min, Byoung-Hyun;Lee, Weon Ik;Choi, Seung Joon;Kang, Shin Young
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.141-146
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    • 1998
  • Recent studies suggest that most meniscal cysts can be treated surgically by arthroscopic management of the meniscal tear and arthroscopic cyst evacuation. But arthroscopic cyst decompression may sacrifice a substantial amount of meniscal tissue that is not torn in order to expose the "stalk" of the cyst. Nowadays, the trend is changing as preserving the involved meniscus to prevent from inevitable degenerative changes after meniscectomy. The purpose of this report is to describe a new surgical technique that minimizes loss of meniscal tissue in hopes of maximizing residual meniscal function. We experienced 10 patients with meniscal cysts that were consisted of four lateral cysts and six medial cysts. Menisci were torn in all cases. Arthroscopic partial meniscectomy and decompression of cysts were performed in 9 cases, and arthroscopic partial meniscectomy and open cystectomy in 1 case. The procedures were consisted of injection of the methylene blue into the cyst, partial meniscectomy of the meniscal tear until the dye was seen in orifice of the cyst, and decompression of cyst through cystic opening. This article serves to confirm the relationship between torn menisci and cysts, to re-evaluate the occurrence ratio of the meniscal cyst on the medial to lateral meniscus, and to assess the efficacy of arthroscopic partial meniscectomy and decompression of cyst as a potentially meniscal sparing procedure.

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Antiviral Activity of Seaweed Extracts against Feline Calicivirus

  • Kim, Kyoung-Lan;Lee, Dae-Sung;Park, Mi-Sun;Eom, Sung-Hwan;Lim, Keun-Sik;Kim, Jong-Soon;Lee, Dong-Ho;Kang, Chang-Keun;Kim, Young-Mog;Lee, Myung-Suk
    • Fisheries and Aquatic Sciences
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    • v.13 no.2
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    • pp.96-101
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    • 2010
  • Norovirus, which causes gastroenteritis in humans, is an important food-borne pathogen worldwide. In an effort to discover an antiviral substance against norovirus, extracts from several seaweeds were evaluated for antiviral activity against feline calicivirus (FCV), which was used as a surrogate. The methanolic extract of Undaria pinnatifida exhibited the most significant antiviral activity and virucidal efficacy against FCV. The concentrations of the extract that reduced viral replication by 50% ($EC_{50}$) and resulted in the death of 50% of the host cells ($CC_{50}$) were 0.05 mg/mL and 1.02 mg/mL, respectively. The selectivity index, calculated from the ratio of the $CC_{50}$ and $EC_{50}$ was 20.4. No FCV infection of host cells occurred following a 1-h incubation in the presence of 12.50 mg/mL U. pinnatifida extract, indicating that the virus was completely inactivated by the extract treatment. The results obtained in this study will contribute to the development of a natural antiviral substance that will prevent food-borne disease caused by norovirus.

Effects of KHchunggan-tang on the Nonalcoholic Fatty Liver Disease in Palmitate-induced Cellular Model (Palmitate로 유발된 비알코올성 지방간 모델에 대한 KH청간탕(淸肝湯)의 효과 연구)

  • Han, Chang-Woo;Lee, Jang-Hoon
    • The Journal of Korean Medicine
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    • v.32 no.1
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    • pp.109-120
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    • 2011
  • Objectives: The aim of this investigation was to evaluate the efficacy of KHchunggan-tang aqueous extract on the experimental nonalcoholic fatty liver disease(NAFLD) induced by palmitate. Materials and Methods: To generate a cellular model of NAFLD, we used HepG2 cells, a human hepatoma cell line, treated with 0.5 mM palmitate. By this cellular model, effects of KHchunggan-tang aqueous extract were evaluated. Intracellular lipid accumulation, free radical formation, and apoptosis were detected by Nile red staining, 2',7'-dichloroflourescin diacetate(H2DCF-DA), and 4',6-diamidino-2-phenylindole(DAPI)/propidium iodide(PI) staining, respectively. Some proteins related with NAFLD were determined by western blot. Results: Typical pathological features of NAFLD occurred in the cellular model. Palmitate increased the levels of intracellular lipid vacuoles, decreased cell viability, and increased apoptosis. Palmitate increased free radical formation and lipid peroxidation, too. However, KHchunggan-tang aqueous extract reduced palmitate-induced pathologic features, i.e. steatosis, free radical formation, and apoptosis. In addition, KHchunggan-tang aqueous extract suppressed palmitate-activated c-Jun N-terminal kinase(JNK) signaling, and SP600125, a JNK inhibitor, significantly reversed the palmitate-induced pathologic changes as KHchunggan-tang aqueous extract. It means that the signaling pathway other than JNK can be involved in the KHchunggan-tang mediated cellular protection of palmitate-treated Hep G2 cells. Conclusions: These results suggest that KHchunggan-tang aqueous extract has hepatoprotective effects on NAFLD with combined properties in cellular steatosis, ROS production, and cytoprotection, and thus may have valuable clinical applications for treatment of this chronic liver disease.

Percutaneous Vertebroplasty Following Postural Reduction in Unstable Vertebra Plana; Is it a Contraindication?

  • Kim, Seok-Won;Lee, Seung-Meung;Shin, Ho;Kim, Hyun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.92-95
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    • 2006
  • Objective : Severe vertebral body collapse [vertebra plana] is considered a contraindication to vertebroplasty by most authors. The purpose of this study is to determine the efficacy of vertebroplasty in treating severe compression fracture patients with osteoporosis. Methods : 16 patients underwent 18 vertebroplasties following postural reduction for vertebra plana. The fractures were defined vertebrae that have collapsed to more than 75% of their original height. Imaging and clinical features were analyzed, including involved vertebrae level, vertebral height after postural reduction for 2 days, injected cement volume, clinical outcome and complications. Results : Involved veretebra were located from level T7 to L4. Vertebral body collapse averaged 79% [range $12{\sim}25%$] of the original height. After pillow reduction for 2 days, vertebral body height increased 35% of the original height [range $15{\sim}45%$]. The kyphotic wedge was $12^{\circ}$ before procedure and was decreased $7.0^{\circ}$ after vertebroplasty. The mean injected cement volume was 3.8ml [range $2.0{\sim}4.9ml$]. After the procedure, surgical outcome was excellent in 8 [50%] of 16 patients, good in 7 [42%] and unchanged in one [8%]. The mean pain score [VAS score] prior to vertebroplasty was 8.3 and it changed 3.2 after the procure. Cement leakage to the adjacent disc [5 cases] and paravertebral soft tissues [4 cases] developed but there were no major complications. Conclusion : We propose that vertebra plana due to osteoporosis is not a contraindication to vertebroplasty. Vertebroplasty following postural reduction for severe compression fracture is safe and effective treatment.