• Title/Summary/Keyword: adjuvant Korean therapy

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Clinical outcome of patients with refractory Kawasaki disease based on treatment modalities

  • Kim, Hyun Jung;Lee, Hyo Eun;Yu, Jae Won;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.328-334
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    • 2016
  • Purpose: Although a significant number of reports on new therapeutic options for refractory Kawasaki disease (KD) such as steroid, infliximab, or repeated intravenous immunoglobulin (IVIG) are available, their effectiveness in reducing the prevalence of coronary artery lesions (CAL) remains controversial. This study aimed to define the clinical characteristics of patients with refractory KD and to assess the effects of adjuvant therapy on patient outcomes. Methods: We performed a retrospective study of 38 refractory KD patients from January 2012 to March 2015. We divided these patients into 2 groups: group 1 received more than 3 IVIG administration+steroid therapy, (n=7, 18.4%), and group 2 patients were unresponsive to initial IVIG and required steroid therapy or second IVIG (n=31, 81.6%). We compared the clinical manifestations, laboratory results, and echocardiographic findings between the groups and examined the clinical utility of additional therapies in both groups. Results: A significant difference was found in the total duration of fever between the groups ($13.0{\pm}4.04days$ in group 1 vs. $8.87{\pm}2.30days$ in group 2; P=0.035). At the end of the follow-up, all cases in group 1 showed suppressed CAL. In group 2, coronary artery aneurysm occurred in 2 patients (6.4%). All the patients treated with intravenous corticosteroids without additional IVIG developed CALs including coronary artery aneurysms. Conclusion: No statistical difference was found in the development of CAL between the groups. Prospective, randomized, clinical studies are needed to elucidate the effects of adjunctive therapy in refractory KD patients.

The Efficacy of Moxibustion for Female Stress Urinary Incontinence: a Systematic Review (여성 복압성 요실금에 대한 뜸 치료의 효과 : 체계적 문헌 고찰)

  • Park, Hye-Rin;Jo, Hee-Geun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.4
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    • pp.1-22
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    • 2020
  • Objectives: The purpose of this review is to evaluate the efficacy of moxibustion for stress urinary incontinence (SUI) in women. Methods: For relevant randomized controlled trials (RCTs), we searched the following databases from their inception to September 1, 2020: The Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database (CNKI), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), and National Digital Science Library (NDSL). The key search terms were 'stress urinary incontinence' and 'moxibustion'. Data extraction and assessment of risk of bias were conducted by two authors independently. Results: A total of 11 RCTs were finally included in this systematic review. In all studies, moxibustion treatment was applied as an adjuvant therapy to the conventional treatment, and the most common conventional treatment was pelvic floor muscle training (PFMT). The treatment group (conventional treatment plus moxibustion) showed statistically more significant effect than the control group (conventional treatment only) in various evaluation indicators including urinary incontinence frequency, 1 hour urine pad test, quality of life, the clinical efficacy rate, and pelvic muscle strength. Conclusions: In this study, we investigated the efficacy of moxibustion as an adjuvant therapy for female SUI patients. Further studies are needed to supplement the safety of moxibustion and the evaluation of moxibustion dose.

Treatment and Results of Olfactory Neuroblastoma (후각신경아세포종의 치료 및 결과)

  • Wu Hong-Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.177-181
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    • 2000
  • Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

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Large Cell Neuroendocrine Carcinoma of the Thymus: A Two-Case Report

  • Yoon, Yong-Han;Kim, Jae-Ho;Kim, Kwang-Ho;Baek, Wan-Ki;Lee, Hyun-Kyu;Lee, Moon-Hee;Lee, Kyung-Hee;Kim, Lucia
    • Journal of Chest Surgery
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    • v.45 no.1
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    • pp.60-64
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    • 2012
  • A large cell neuroendocrine carcinoma (LCNEC) of the thymus is a very rare malignant tumor that has a very poor prognosis. The detailed clinical features of LCNEC are still unknown, including the long term prognoses and the definitive modalities of the treatment for LCNEC of the thymus. We are reporting 2 cases of an enlarged LCNEC of the thymus, both of which were diagnosed and treated by surgical resection followed by postoperative adjuvant chemoradiation therapy. Although recurrences and metastases of the LCNEC were noticed 1 and 4 years postoperatively for each case, aggressive surgical resection and adjuvant chemoradiation therapy may be helpful for a patient's long term survival.

Clinical Course and Side Effects of Imatinib in Recurrent Patient after Surgical Resection of GIST - A Case and Literature Review (위장관 간질종양의 수술 후 재발한 환자에서 발생한 Imatinib의 부작용과 효능 - 증례와 문헌고찰)

  • Jung Ho Bae;Gwang Ha Kim;Dong Uk Kim;Bong Eun Lee;Geun Am Song
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.100-103
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    • 2013
  • A 79-year-old man was diagnosed with gastrointestinal stromal tumor (GIST) of the gastric cardia. We performed proximal subtotal gastrectomy and started imatinib therapy as adjuvant treatment after surgery. Whole body skin rash with urticaria was onset on 10 days after imatinib treatment, and the patient decided to stop imatinib because of side effect. After 3 months, PET CT revealed GIST was recurred at spleen and abdominal lymph nodes, abdominal wall. The patient was then restarted on imatinib therapy. On follow-up imaging studies, the tumor almost disappeared, but both pleural effusion and pericardial effusion were found. In this paper, we describe a case of clinical course and side effects in recurred GIST after adjuvant imatinib mesylate treatment.

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Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue

  • Sharma, Kanika;Ahlawat, Parveen;Gairola, Munish;Tandon, Sarthak;Sachdeva, Nishtha;Sharief, Muhammed Ismail
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.73-81
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    • 2019
  • Purpose: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. Materials and Methods: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. Results: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. Conclusion: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.

Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea

  • Chang, Ah Ram;Park, Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.25-31
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    • 2017
  • Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

Merkel cell carcinoma: A series of seven cases

  • Lee, Yong Woo;Bae, Yong Chan;Nam, Su Bong;Bae, Seong Hwan;Kim, Hoon-Soo
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.441-448
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    • 2019
  • Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

The Present State of Cancer Therapy in China - In Journal of Integrated Traditional Chinese and Western Medicine - (중국의 암치료 현황 - '중의중서의결합잡지'를 중심으로 -)

  • Yoon, Seoung-Woo;Park, Jae-Woo
    • Journal of Korean Traditional Oncology
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    • v.11 no.1
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    • pp.65-73
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    • 2006
  • For discovering a new trend of cancer therapy in east and west medicine, we have investigated the journal of integrated traditional chinese and western medicine(ITCWM) from Jan. 2000 to Jun. 2006. The main treatment of cancer therapy in ITCWM was western treatments(chemotherapy, radiotherapy, surgery etc.). Traditional chinese medicine(TCM) was adjuvant treatments. But, it is said that TCM has some important roles in treating cancer at this journal.

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