Effects of ionizing radiation alone and combined with chemotherapy on tumor growth and it's clonal specificity monitored by changes in distribution of chromosome number were studies in A549 ceil line originated from human adenocarcinoma of the lung. Radiation (300 rad, 600 rad and 900 rad) were delivered with or without 5-FU. Forty eight hours later, 57.5% of growth inhibition of cell w8s seen in cells treated with 5-FU concentration of $0.4{\mu}g/ml$ for 24hr exposure. Cell survival curves after radiation with and without 5-FU were made. Chromosomal analysis of cells in metaphase in control, and in cells treated with 300 rad of radiation, or $0.4{\mu}g/ml$ of 5-FU treatment, and combined treatment of both were done to examine the changes in ploidy and number of chromosome. Radiation combined with S-FU enhanced growth inhibition of A549 cells. However, no evidence of synergegic effects in growth. inhibition was observed in the cells treated with the combination therapy. Pattern of chromosomal distribution of survived cells were shifted from hyperploidy to hypoploidy by single dose of radiation (300 rad). As radiation dose increased a large number of hypoploidy cells were observed. Following treatment of cells with 5-FU, chomosomal distribution of survived cells were also shifted to hypodiploidy which were seen in cells treated with radiation, The ceil treated with 5-FU and fellowed by radiation within 24 hrs had cell with increased number of hypodiploidy cells. Almost same type of chromosomal changes were reproduced in cells treated with combined treatment with radiation and 5-FU. Minor differences were that cells with fewer number of chromosome were more frequent in cells treated with combined therapy. Further increase in cells of hypoploidy (93%) having 1-10 chromosome were induced by additional radiation. Therefore, the enhanced therapeutic effect of 5-FU combined with radiation of A549 cells appeared to be additive rather than synergistic.
Background: There is no suggested molecular indicator for the determination of which patients will benefit from anti-angiogenetic treatment in metastatic colorectal cancers. Materials and Methods: In this study, VEGF and $HIF-1{\alpha}$ expression and their clinical significance were studied in tumor tissues of patients with colorectal cancer receiving bevacizumab-based treatment. VEGF and $HIF-1{\alpha}$ were assessed by immunohistochemistry in the primary tumors of 53 metastatic colorectal cancer patients receiving chemotherapy in combination with first line bevacizumab. Results: The clinical benefit rate in the low-VEGF expression group was 38%, while it was 62% in the high expression group. While the median progression-free survival (PFS) was 10 months in the high-VEGF expression group, it was 8 months in the low-VEGF expression group (p = 0.009). The median overall survival (OS) was found to be 26 months vs 15 months. Thus, when VEGF was strongly expressed it was in favor of that group and the difference was statistically significant (p = 0.03). High VEGF expression rate was an independent factor that correlated with OS or PFS (p=0.016 and 0.009, respectively). Conclusions: The data showed that VEGF may have predictive value for determining the treatment of CRC.
Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric age group. All patients with RMS regardless of their initial stage or group receive combination chemotherapy as 'standard therapy' consisting of vincristine, actinomycin-D and cyclophosphamide. Actinomycin-D was not readily available in Turkey at one time. Carboplatin was used instead in order to prevent delays in treatment. The aim of this report is to present the results of patients with rhabdomyosarcoma receiving carboplatin or actinomycin-D therapy. Materials and Methods: Twenty four patients with rhabdomyosarcoma treated between December 2000 and June 2011 were included in this retrospective study. The patients were treated according to International Rhabdomyosarcoma Study Group guidelines. Eleven patients were treated with actinomycin-D and 13 with carboplatin ($250mg/m^2/dose$ for 2 days). The two groups were then compared in terms of 2- and 5-year overall survival (OS) and hematological and non-hematological toxicities. Results: Age, sex, stage and the mean duration of follow-up were similar in both groups (p>0.05). Two- and five-year OS levels were 68.2% in the carboplatin group and 78.0% and 40.0%, respectively, in the actinomycin-D group. There was no statistical difference in the number of febrile episodes (p=0.86) and no other hematological and non-hematological adverse effects were recorded in both groups. Conclusions: The findings show that carboplatin can be used as an alternative drug in the primary treatment of rhabdomyosarcoma in the event that actinomycin-D is unavailable or not tolerated.
Background: Elderly patients with acute myeloid leukemia (AML) have a poor outcome because of co-morbidities, poor tolerance to intensive chemotherapy and inherently more resistant disease. Clofarabine is a second generation nucleoside analogue which has shown promising activity in elderly patients with AML. This study was conducted to review the outcome of treatment with clofarabine in a group of such patients. Methods: The records of 5 elderly patients who were diagnosed to have AML and treated with clofarabine over a 12 month period were reviewed retrospectively. Results: There were 2 female and 3 male patients with a median age of 68 years (range 65-82). At the time of treatment, 2 patients had newly diagnosed AML not considered suitable for intensive therapy, while 3 patients had partial or no response to conventional chemotherapy. The overall response rate was 100%, all patients achieving a complete remission. Induction and consolidation were well tolerated. All patients developed neutropenia with a median duration of 20 days (range 17-42). One patient developed hand and foot syndrome and a generalized rash but recovered. There was no mortality and all patients remained in remission after a median follow-up of 5.2 months (Range 3-10). Conclusion: Clofarabine (alone or in combination) is active in elderly AML patients with an acceptable safety profile and should be considered a potential option in this group.
Kim, Nyeon Cheon;Kim, Seung Soo;Seo, Won Suk;Park, Kyeong Bae;Park, Joon Soo;Shin, Sang Mann;Cho, Hyun Deuk
Clinical and Experimental Pediatrics
/
v.48
no.2
/
pp.208-211
/
2005
Primary lung cancer is unusual in children; the squamous cell variant is extremely rare. Lung cancer is classified by histologic types into small-cell lung cancer, non-small cell lung caner, carcinoid, mucoepidermoid carcinoma, and adenoid cystic carcinoma. Furthermore, non-small cell lung cancer is subclassified into adenocarcinoma, large-cell carcinoma, and squamous cell carcinoma. The incidence of lung cancer is influenced by smoking, especially in squamous cell carcinoma, and large cell carcinoma. The present treatments for these tumors are chemotherapy, radiation therapy, and surgical resection depending on their histologic types or stages, but yield very poor survival rates. In this article, we report a case of basaloid squamous cell lung carcinoma in an 11-year-old boy who had symptoms of both leg weakness and back pain radiating to both legs. We confirmed the primary lung carcinoma cells by percutaneous transthoracic needle biopsy. The metastatic carcinoma cells were identified at the bone marrow and lumbar spine. We treated with a combination chemotherapy and radiation therapy. However, he expired 4 months after the onset of disease.
Shin Hyun Soo;Seong Jinsil;Oh Won Yong;Kim Gwi Eon
Radiation Oncology Journal
/
v.11
no.1
/
pp.119-126
/
1993
From 1988 to 1991, nineteen patients with unresectable localized pancreatic carcinoma were treated with radiotherapy and/or hyperthermia or in combination with chemotherapy. Radiation dose of 4500-5000 cGy with or without additional 500-1000 cGy was administered over 5 to 6 weeks to the pancreatic tumor area using 10 MV linear accelerator. Five of 19 patients were given chemotherapy, either neoadjuvant or maintenance setting with FAM regimen (5-FU, adriamycin and mitomycin C), which was repeated every 4 weeks for one year or until progression. Symptomatic palliation was achieved in 17 among 19 patients ($89{\%}$) and objective response (complete or partial response in CT finding) was achieved in 5 among 11 patients ($45{\%}$). The median survival time was 9 months and one-year survival rate, $32{\%}$. Local-regional failure was documented in 10 among 13 patients ($77{\%}$) and distant failures were found in the liver (3 patients) and carcinomatosis (2 patients). Prognostic significance of various factors such as age, sex, performance status, tumor location, stage, etc. were assessed. Any factors did not have the prognostic significance in univariate analysis. Treatment was well tolerated in most of the patients with only mild to moderate toxicity.
Park Yoon-Kyu;Kim Chang-Soo;Yoo Bong-Ok;Chung Eul-Sam;Seel David J.
Korean Journal of Head & Neck Oncology
/
v.2
no.1
/
pp.23-31
/
1986
During the past 14years 267 patients presented with a lump in the neck proven to be metastatic cancer histologically. In most cases the primary site was discovered by thorough physical examination, E.U.A.(examination under anesthesia) and radiodiagnostic studies. However in 31 cases complete diagnostic evaluation failed to reveal the primary site. This paper discusses the characteristics of this group of patients in terms of the frequency of the ultimately discovered primary sites, policies for diagnosis, methods of management, and the ultimate prognosis for such cases in Korea. The male: female ratio was 6.8:1 and 84 % of all cases occurred in the $51{\sim)70$ age group. The majority of these cancers were epidermoid carcinomas(67.7%) and 22 of the 31(71 %) were Stage IV lesinos(17 N3A lesions and 5 N3B lesions). Surgical management was employed in 7 cases only, and in 5 cases this was combined with rediotherapy, chemotherapy, or both. Nevertheless, the only patients who survived disease-free for two years or more (one for over 5 years) were two patients in this management group. None of the patients treated by radiotherapy or chemotherapy of a combination of these two modalities survived. Occult primary sites were eventually discovered in 5 of the 31 cases, two in the nasopharynx, and one each in the base of tongue, pyrifrom sinus, middle ear. Of the 21 cases with epidermoid carcinoma which presented in the neck, 2 are free of disease for 3years or more. Of those who underwent radical surgery two of five survived. This study thus confirms the principle enunciated by MacComb in 1972 that surgical treatment in the form of radical neck dissection is the cornerstone of management whenever feasible.
Neuroblastoma is the most common extracranial solid tumor of childhood which presents various clinical symptoms depending on the primary and metastatic sites. However, it has been rarely reported that sudden onset of blindness was the chief complaint of neuroblastoma. A four years old boy was admitted to the Yeungnam University Hospital with the chief complaint of a sudden onset of blindness due to a distant metastasis of abdominal neuroblastoma to the sphenoid sinus. On admission, both side pupils were dilated without light reflex, fundoscopy showed pale optic disk, electroretinogram was subnormal and visual evoked potential showed no response. The liver was palpable in $3{\frac{1}{2}}$ finger breadth from the right costal margin and adult fist sized mass was palpable in the right flank. Skull X-ray showed destructed sphenoid bone and clinoid process and brain CT scan showed tumor mass in the sphenoid sinus and left orbit. Ultrasonogram and CT scan of the abdomen showed large tumor masses around the right kidney and para-aortic and retropancreatic lymph node. IVP showed displaced right calyceal system with preserved contour. Left supraclavicular lymph node which appeared after admission was biopsied and it showed poorly differentiated neuroblasts. He was treated according to the multiagent chemotherapy schedule for stage IV neuroblastoma patient of children's cancer study group. Abdominal tumor masses and sphenoid sinus mass were markedly reduced after 2 courses of the combination chemotherapy of cyclophosphamide, vincristine, DTIC, adriamycin and VM-26. Eventhough the blindness was not improved, the patient has been in good clinical condition.
Standard combination chemotherapy including isoniazid, rifampin, pyrazinamide, and ethambutol is very effective against tuberculosis. But, these medicines can cause hepatotoxicity which is the main reason for treatment interruption or change in drug regimen. In order to identify risk factors associated with hepatotoxcity in Koreans and assess elevated baseline LFTs' contributions to hepatotoxicity, a retrospective case control study was performed. The medical records of 277 patients who diagnosed with tuberculosis at a community hospital from January 1st, 2007 to June 30th, 2010 were reviewed. Patients were categorized into 3 groups (non toxic group, patients without increase in LFT levels; mild to moderate hepatotoxic group and severe hepatotoxic group). And the correlation between risk factors and hepatotoxicity was analyzed by using SPSS program. The overall incidence of hepatotoxicity was 18% and 8.7% of patients developed severe toxicity. Patients in the severe toxic group had the longest treatment period among the three groups. In 75% of severe toxic group, hepatotoxicity occurred within 18.3 days after starting medication. Hypoalbuminemia (serum albumin <3 g/dl) was a significant risk factor for development of severe toxicity. Elevated baseline transaminase (except ALT), total bilirubin, and preexisting hepatitis were also risk factors which were more than twice as likely to increase risk of severe hepatotoxicity (p>0.05). In conclusion, hypoalbuminemia (serum albumin level <3 g/dl) was a significant risk factor for anti-tuberculosis druginduced severe toxicity. Therefore, before starting antituberculosis chemotherapy, serum albumin level should be assessed at baseline. In high-risk patients (hypoalbuminemia, elevated LFTs) for hepatotoxicty, liver function should be closely monitored up to at least 21 days after taking medication.
Acute promyelocytic leukemia(APL) is not just the poor grades of treating a type of blood cancer hayeoteul combination with chemotherapy despite concurrent radiation therapy are known to exhibit a greater effect and also works on normal cells to result in side effects. In this study, when after treatment with gamma rays, such as $TNF-{\alpha}$ in order to reduce these side effects was confirmed how affected the cell death of normal cells and cancer cells. HL-60 cells were used as the APL cell line HL-60 cells were differentiated with DMSO for treatment are shown the properties of normal granulocytes was used as a control group. As a result, HL-60 cells treated with $TNF-{\alpha}$ and gamma rays with only showed a cytotoxic effect by inducing the apoptosis cells were put to death. Consequently, $TNF-{\alpha}$ is thought to active substances that can increase the efficiency of cancer treatment to increase the removal of cancer cells when used with low-density gamma-ray treatment in order to eliminate the side effects of chemotherapy.
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