• Title/Summary/Keyword: Tumor therapy

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Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: searching the evidence to guide the decision

  • Oh, In-Jae;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.16-24
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    • 2017
  • Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article.

Radiation Therapy of Suprasellar Germ Cell Tumors (뇌하수체상부 배아세포종의 방사선치료 성적)

  • Park Woo Yoon;Choi Doo Ho;Choi Eun Kyung;Kim Il Han;Ha Sung Whan;Park Charn Il
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.169-176
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    • 1988
  • A retrospective study was performed on 15 patients with suprasellar germ cell tumors treated by megavoltage external beam irradiation between Feb. 1979 and Dec. 1985. Follow-up period of survivors was 30 to 91 months. Histologic diagnosis was obtained before radiation therapy in 10patients (9 germinomas and 1 mixed). Five patients were treated without histologic verification. In 9 patients with biopsy-proven germinomas radiation therapy was delivered to the craniospinal axis in 6, to the whole brain in 3. In 5 patients with mixed germ cell tumor or elevated tumor marker, irradiation was delievered to the craniospinal axis in 2, to the whole brain in 2, and to the primary site only in 1. Total doses ranged from 5,000 to 5,500 cGy to the primary site, 3,000 to 4,400 cGy to the whole brain, and 1,300 to 3,000 cGy to the spine. In these 14, local tumor was controlled and primary or spinal failure was not observed. One patient without elevated tumor marker was treated to the whole brain. The tumor was not controlled and he had spinal recurrence. Overall survival and disease-free survival rates were $86\%$ at 5 year. It is proven that radiation therapy is an effective treatment for suprasellar germ cell tumors. The neuroendocrinologic presentation, tumor marker status, early response to radiation measured on CT seem to be useful means for selecting patients for radiation therapy when tissue diagnosis is not available.

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Computed Tomography-Aided Diagnosis of Nasal Adenocarcinoma Treated with Rhinotomy and Radiation Therapy in a Dog (CT 진단 후 비절개술 및 방사선요법으로 치료한 개의 비강 선암의 발생례)

  • 홍성혁;김명철
    • Journal of Veterinary Clinics
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    • v.19 no.2
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    • pp.256-259
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    • 2002
  • A 39 kg, 7-year-old male Labrador Retriever dog with a 3-month history of epistaxis, sneezing, and nasal discharge was referred to the Veterinary Medical Center of the Tokyo University. On the plain X-ray and computed tomography (CT) of the head showed increased density of the soft tissue in the left nasal cavity and the tumor infiltrated to nasal septum. The tumor mass removed by rhinotomy. Histopathological examination of the mass revealed adenocarcinoma. Four weeks after the surgery, the radiation therapy was performed twice a week for f weeks. 4 months after surgery, the dog had a recurrence in nasal cavity and administered carboplatin 300 mg/$m^2$ twice. However, the tumor had no response to chemotherapy, additional surgery and additional radiation therapy, and the dog was euthanized at the owner's request. At necropsy, metastatic proliferation was confirmed in the lung, lymph nodes and nasal cavity.

Radiopharmaceuticals for Imaging of Cellular Proliferation (세포 증식 영상용 방사성의약품)

  • Oh, Seung-Jun
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.209-223
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    • 2002
  • By considering the biological properties of a tumor, it should be possible to realize better results in cancer therapy. PET imaging offers the opportunity to measure tumor growth non-invasively and repeatedly as an early assessment of response to cancer therapy. Measuring cellular growth instead of energy metabolism showed offer significant advantages in evaluating therapy. Thymidine and its derivative nucleoside compounds can be changed to mono, di- and tri- phosphate compounds by thymidine kinase and then be incorporated into DNA. Their bindings are increased in highly proliferating cells due to the high DNA synthesis rate. To evaluate cell proliferation, many kinds of thymidine and uridine derivatives have been labeled with positron emitter and radioactive iodine. Compared to radiopharmaceuticals which have radioisotope labeled base ring such as pyirmidine, the radiopharmacuticals which have radioisotope labeled sugar ring are more stable in vivo and have metabolic resistance. The biological properties such as DNA incorporation ratios are highly dependent on their chemical structures and metabolic processes. This overview describes synthesis of radiopharmaceuticals and their biological properties for imaging of tumor cell proliferation.

The Effect of Therapy Oriented CT in Radiation Therapy Planning (치료 계획용 전산화 단층촬영이 방사선 치료계획에 미치는 효과)

  • Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.149-155
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    • 1987
  • The success of radioation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (plannng CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients $(28\%)$. Treatment planning was changed in $47\%$ of head and neck tumor, $79\%$ of intrathoracic tumor and $63\%$ of abdmonial tumor. in breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was $10\%$ in intrathoracic and intra-abdominal tumors but $20\%$ in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT Planning is very helpful in radiotherapy Planning.

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Enriching CCL3 in the Tumor Microenvironment Facilitates T cell Responses and Improves the Efficacy of Anti-PD-1 Therapy

  • Tae Gun Kang;Hyo Jin Park;Jihyun Moon;June Hyung Lee;Sang-Jun Ha
    • IMMUNE NETWORK
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    • v.21 no.3
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    • pp.23.1-23.16
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    • 2021
  • Chemokines are key factors that influence the migration and maintenance of relevant immune cells into an infected tissue or a tumor microenvironment. Therefore, it is believed that the controlled administration of chemokines in the tumor microenvironment may be an effective immunotherapy against cancer. Previous studies have shown that CCL3, also known as macrophage inflammatory protein 1-alpha, facilitates the recruitment of dendritic cells (DCs) for the presentation of tumor Ags and promotes T cell activation. Here, we investigated the role of CCL3 in regulating the tumor microenvironment using a syngeneic mouse tumor model. We observed that MC38 tumors overexpressing CCL3 (CCL3-OE) showed rapid regression compared with the wild type MC38 tumors. Additionally, these CCL3-OE tumors showed an increase in the proliferative and functional tumor-infiltrating T cells. Furthermore, PD-1 immune checkpoint blockade accelerated tumor regression in the CCL3-OE tumor microenvironment. Next, we generated a modified CCL3 protein for pre-clinical use by fusing recombinant CCL3 (rCCL3) with a non-cytolytic hybrid Fc (HyFc). Administering a controlled dose of rCCL3-HyFc via subcutaneous injections near tumors was effective in tumor regression and improved survival along with activated myeloid cells and augmented T cell responses. Furthermore, combination therapy of rCCL3-HyFc with PD-1 blockade exhibited prominent effect to tumor regression. Collectively, our findings demonstrate that appropriate concentrations of CCL3 in the tumor microenvironment would be an effective adjuvant to promote anti-tumor immune responses, and suggest that administering a long-lasting form of CCL3 in combination with PD-1 blockers can have clinical applications in cancer immunotherapy.

Antitumor Effects of Sigbunhwan and Bigihwan on Tumor Cells derived from Leukemia and Lymphoma Patients (식분환(息賁丸) 및 비기환(?氣丸)이 백혈병(白血病) 임파종(淋巴腫) 환자(患者)에서 추출(抽出)한 암세포(癌細胞)에 미치는 항암(抗癌) 효과(效果))

  • Kang, Dae-Geun;Kang, Byung-Ki
    • The Journal of Internal Korean Medicine
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    • v.12 no.2
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    • pp.96-112
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    • 1991
  • Attempts were made to see the antitumor effects of Sigbunhwan widely used in Oh-jug(五積) employing tumor cells Lines such as K562 derived from erythroleukemia, Raji from lympoma and MO-4 from blastogenic tumor. Different concentrations of Sigbunhwan and combined therapy of Sigbunhwan and Bigihwan were treated to those tumor cells lines and then live cells were counted by Trypan blue assay and $^{3}H-Thymidine$ uptake assay. The results obtained were as follows. 1. $^{3}H-Thymidine$ uptake of various tumor cells lines when treated with high concentrations of Sigbunhwan for 48hours showed that the rate of DNA synthesis decreased 76% to 90% by the treatment of 1% Sigbunhwan but this inhibition was rather decreased when Sigbunhwan concentration was increased to 10, 15 and 20%.(Fig 3) 2. When Sigbunhwan was combined with Bigihwan which was also an antitumor drug, the effectiveness of tumor cells dealth was somewhat inceased showing a generally similar pattern to that of Bigihwan alone used.(Fig 4) This combination therapy also showed that higher concentrations of antitumor agent were no more·effective or rather harmful according to the tumor cells lines having different growth rate.(Fig 5,6) 3. The antitumor effects of combined Sigbunhwan and Bigihwan was decreased if the concentrations of this combination therapy was increased to 10 times showing relatively sluggish decrease in K562 and MO-4 but a sharp inhibitory effect in Raji which grows slowly.(Fig 7). 4. When Sigbunhwan was treated at low concentrations, K562 was more inhibited by 0.75% to 1.0% of Sigbunhwan while Raji was more inhibited by 0.25% to 0.5% of that.(Fig 8) 5. When Sigbunhwan was treated together with Bigihwan at low concentrations, the tumor cells death rate was 75% to 89% in Baji, 31% to 95% in MO-4 and 41 to 89% in K562, showing this combination therapy was more effect to Raji derived from lymphoma.(Fig 9) 6. The number of live tumor cells was correlated with optical density of MTT assay when measured with 2% Sigbunhwan treatment to tumor cells lines for 24 hours.(Fig 10) 7. 7 days treatment of 0.25% Sigbunhwan was compared with one day treatment of 1% suggesting long term treatment more effective.(Fig 11)

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Successful Endoscopic Resection of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Unresponsive to Helicobacter pylori Eradication Therapy

  • Jeongmin Choi
    • Clinical Endoscopy
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    • v.55 no.1
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    • pp.136-140
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    • 2022
  • Eradication of Helicobacter pylori is the first-line treatment for gastric mucosa-associated lymphoid tissue (MALT) lymphomas; however, lesions may persist in 20% of patients after initial treatment, thereby necessitating the use of an additional therapeutic approach. Other treatment options include radiation therapy, chemotherapy, endoscopic resection, rituximab therapy, or watchful waiting. We present a case of localized gastric MALT lymphoma that did not respond to H. pylori eradication therapy. The patient waited for 12 months but the tumor showed no signs of regression endoscopically. Histologic examination revealed residual MALT lymphoma. The tumor was then successfully treated using endoscopic submucosal dissection and the patient remained disease-free for 4 years. To our knowledge, this is the first case in which a gastric MALT lymphoma was treated with endoscopic submucosal dissection. In conclusion, endoscopic resection may be recommended as second-line therapy for properly selected patients with gastric MALT lymphoma as it is effective and minimally invasive.

CT of Late Complication of Central Nervous System after Radiation Therapy of Brain Tumors (뇌종양의 방사선치료후 발생한 만성변화의 CT소견)

  • Hong, Seong-Eon;Cho, Chong-Hee;Ahn, Chi-Yul
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.287-297
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    • 1984
  • The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways, and the damage to nerve tissue may be slow in making its appearance, and once damage has occured the patient recovers slowly and incompletly. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination o( rnorphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, progression, persistence, or recurrence of tumor or radiation-induced edema or necrosis, The authors are obtained as following results ; 1. The field size(whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the tatal tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2, The histopathologic diagnosis of 9cases were glioblastoma multiforme(3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases) , radiation necrosis(2), tumor recurrence with or without calcification (2), radiation·induced infarction (1). 3. The recurrent symptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.

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