• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4255-4259
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• 2013

Background: Soft tissue sarcomas (STS) are a heterogeneous group of tumors, and approximately 40-50% of patients with STS develop metastatic disease. The median overall survival of those patients was 12 months and their 5-year survival rate was 8%. Therefore, study on more effective treatment, especially the targeting therapies, is urgently needed. Objective: To evaluate the efficacy and safety of Endostar$^{(R)}$ combined with chemotherapy in patients with advanced STS. Methods: A retrospective case-series study was conducted in Cancer Institute of PLA, Xinqiao Hospital. A total of 71 patients suffering from advanced STS (IIB - IV) were included, of whom 49 cases treated with chemotherapy alone were defined as the control group and the rest 22 cases treated with the traditional chemotherapy combined with Endostar$^{(R)}$ were defined as the test group. The short-term therapeutic effects including objective response rate (ORR), disease control rate (DCR) and safety were evaluated in the two groups. In the follow-up, progression-free survival (PFS) and overall survival (OS) were also observed. Results: In the test and control groups, the ORR was 18.2% and 12.2%, respectively (P=0.767), and the DCR was 86.4% and 61.2%, respectively (P=0.034). The median time to progression in the test and control groups was 120 days and 70 days with significant difference (P = 0.017), while the median overall survival was 452 days and 286 days without significant difference (P=0.503). The one-year survival rate in the test group and control group was 56.2% and 35.4%, respectively, while the two-year survival rate was 30.2% and 26.5%, respectively. No significant difference in the side effects was found between the two groups. Conclusions: Endostar$^{(R)}$ combined with chemotherapy resulted in a higher DCR and longer PFS in the patients with advanced STS, and the toxicity was tolerable.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.133-137
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• 2013

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

• Radiation Oncology Journal
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• v.29 no.1
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• pp.20-27
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• 2011

Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.428-434
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• 2007

Background: Recent studies have suggested that UFT may be an effective adjuvant therapy for completely resected IB (pT2N0) non-small cell lung cancer (NSCLC). We designed this study to clarify the feasibility of performing adjuvant chemotherapy with UFT for completely resected IB nor-small cell lung cancer, Material and Method: We randomly assigned patients suffering with completely resected IB non-small cell lung cancer to receive either UFT 3g for 2 year or they received no treatment. All patients had to be followed until death or the cut-off date (December 31 2006). Result: From June 2002 through December 2004, 64 patients were enrolled. Thirty five patients were assigned to receive UFT (the UFT group) and 29 patients were assigned to observation (the control group). A follow-up surrey on the 3 year survival rate was successfully completed for all the patients. The median follow-up time for all the patients was 32.8 months. In the UFT group, the median time of administration was 98 weeks (range: $2{\sim}129$ weeks). The rate of compliance was 88.2% at 6 months, 87.5% at 12 months, 80.6% at 18 month and 66.7% at 24 months. Seven recurrences (24.1%) occurred in the control group and six (17.1%) occurred in the UFT group (p=0,489). The three-year disease free survival rate was 71.3% for the control group and 82.0% for the UFT group (p=0.331). On the subgroup analysis, the three-year disease free survival rate for the patients with adenocacinoma was 45.0% for the control group and 75.2% for the UFT group (p=0.121). The three-year disease free survival rate for the patients with non-adenocarcinoma was 88.1% for the control group and 88.9% for the UFT group (p=0.964), Conclusion: Postoperative oral administration of UFT was well-tolerated. Adjuvant chemotherapy with UFT for completely resected pT2N0 adenocarcinoma of the lung could be expected to improve the disease free survival, but this failed to achieve statistical significance. A prospective randomized study for a large number of patients will be necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1101-1106
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• 2013

Background: Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Carboplatin, a platinum-derived agent, is used as neoadjuvant chemotherapy for pediatric osteosarcoma because of its anti-tumor activity and had low toxicity as compared to cisplatin. Objective: To determine demographic data, prognostic factors and outcome of childhood osteosarcoma treated with a carboplatin-based chemotherapeutic protocol at Chiang Mai University. Method: A retrospective analysis was conducted on 34 osteosarcoma patients aged less than 18 years and treated between 2003 and 2011. Results: Overall limb-salvage and amputation rates were 23.5% and 70.6%, respectively. With the mean follow-up time of 29.5 months (1.5-108.9), the Kaplan-Meier analysis for 3-year disease-free survival (DFS) and 3-year overall survival (OS) were $20.2{\pm}7.7%$ and $47.1{\pm}9.5%$ respectively. Patients who had initial pulmonary metastasis were at significantly greater risk for developing recurrence (p=0.02, OR=7; 1.2-40.1) and had a tendency to have lower 3-year OS compared to those without initial pulmonary metastasis ($28.1{\pm}13%$, $63.1{\pm}12.3%$, respectively, p=0.202). On univariate analysis, age at diagnosis >14 years and patients who were declined surgery were significantly associated with lower 3-year OS (p=0.008 and <0.05, respectively). However, age at diagnosis, sex, tumor size and histological subtypes were not found to significantly affect recurrence or survival. Conclusions: In our study, the survival rate was far lower than those reported from developed countries. These might indicate the ineffectiveness of carboplatin in combination with doxorubicin as frontline treatment of pediatric osteosarcoma, especially in those with initial pulmonary metastasis. Refinement in risk and treatment stratification and dose intensification for pediatric osteosarcoma constitutes a future challenge to improve outcomes, especially in metastatic patients who may need a more intensive regimen.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.148-154
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• 2019

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.103-109
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• 1991

Radiotherapy result of 162 patients with stage I, II intermediate grade non-Hodgkin's Iymphoma was analyzed to clarify the role and limit of radiotherapy. Of 68 initial failures, 38.2% occurred in field and 61.8% occurred out of field. Proportion of in-field and out-of-field failures in stage I was 30.0% and 70.0%, respectively with involved field treatment and was 43.8% and 56.2% with extended field treatment, respectively; in stage ll , was 16.7% and 83.3%, 41.7% and 58.3%, respectively. The disease free suwival rate at S years was 48.1% for all patients and was 50.3% and 40.4% for patients with stage I and II, respectively. The survival was significantly different by stage. Bulky tumors (${\geq}10$ cm) and B symptoms didn't influence prognosis significantly. The 5 year disease free suwival with extended or wide field was better than that with involved field especially in stage I. Overall survival rates for all patients, patients with stage 1, and ll disease were 57.7%, 65.3% and 52.2% , respectively, after survival gain of the salvage chemotherapy was combined. But the overall survival of stage I disease was not better than that of stage II disease. Thus, extended field was required to achieve better disease free survival and relapsed cases might gain with chemotherapy.

• Radiation Oncology Journal
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• v.33 no.4
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• pp.294-300
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• 2015

Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent. Materials and Methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months). Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS. Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

• Radiation Oncology Journal
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• v.35 no.4
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• pp.332-339
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• 2017

Purpose: This study aimed to evaluate the prognostic effects of lymphovascular invasion (LVI) in triple-negative breast cancer (TNBC) patients who underwent surgical resection. Materials and Methods: A total of 63 non-metastatic TNBC patients who underwent surgical resection were retrospectively investigated from 2007 to 2016 in Inje University Busan Paik Hospital. Pathological tests revealed that 12 patients (19.0%) had LVI. Approximately 61.9% (n = 39) of the patients' samples stained positive for p53. Additional chemotherapy and radiotherapy (RT) were performed in 53 (84.1%) and 47 (74.6%) patients, respectively. Results: The median follow-up period was 39.5 months (range, 5.9 to 123.0 months). The pathological T stage (p = 0.008), N stage (p = 0.014), and p53 positivity (p = 0.044) were associated with LVI. Overall, the 3-year disease-free survival (DFS) rate and overall survival (OS) rate were 85.4% and 90.2%, respectively. Ten patients (15.9%) experienced relapse. LVI (n = 12) was associated with relapses (p = 0.016). p53 positivity was correlated with poor DFS (p = 0.048). Furthermore, LVI was related to poor DFS (p = 0.011) and OS (p = 0.001) and considered as an independent prognostic factor for DFS (p = 0.039). The 3-year DFS of patients with LVI (n = 12) was only 58.3%. Adjuvant RT minimized the negative prognostic effect of LVI on DFS (p = 0.068 [with RT] vs. p = 0.011 [without RT]). Conclusion: LVI was related to the detrimental effects of disease progression and survival of TNBC patients. Thus, a more effective treatment strategy is needed for TNBC patients with LVI.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1105-1109
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• 2012

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.