• Title/Summary/Keyword: radiotherapy response

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Update of Research on Drug Resistance in Small Cell Lung Cancer Chemotherapy

  • Chen, Yi-Tian;Feng, Bing;Chen, Long-Bang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3577-3581
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    • 2012
  • Small cell lung cancer (SCLC) is characterized by a short cell doubling time, rapid progression and early occurrence of blood-borne and lymph metastasis. The malignancy is the highest of all lung cancer types. Although SCLC has a relatively good initial response to chemotherapy as well as radiotherapy, relapse or disease progression may occur quickly after the initial treatment. Drug resistance, especially multi-drug resistance, is the most important cause of failure of SCLC chemotherapy. This article provides a brief update of research on mechanisms of drug resistance in SCLC and reversal strategies.

Clinical Application of $^{18}F$-FDG PET in Multiple Myeloma (다발성 골수종에서의 $^{18}F$-FDG PET의 임상이용)

  • Lee, Su-Jin;Choi, Joon-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.509-512
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    • 2009
  • This review focuses on the clinical use of $^{18}F$-FDG PET to evaluate multiple myeloma. $^{18}F$-FDG PET is useful for diagnosis, staging of multiple myeloma and differential diagnosis of myeloma related disease such as monoclonal gammopathy of undetermined significance or plasmacytoma. For therapy response, $^{18}F$-FDG PET may be effective after chemotherapy for multiple myeloma and radiotherapy for plasmacytoma.

Delayed Radionecrosis of the Larynx (지연성 후두방사선괴사에 대한 고찰)

  • 홍기환;김연우;전희석;양윤수
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.75-80
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    • 2002
  • Radiation therapy is an effective treatment modality for malignant disease of the head and neck, but it is not without risk and complication. Response of the larynx to radiotherapy varies from mild erythema to severe inflammation with edema and induration. possibly leading to necrosis of cartilage. These changes are due to an inflammatory reaction characterized by infiltration of polymorphonuclear leukocytes, vascular thrombosis, and obliteration of lymphatic channels. Late changes consist of telangiectasia of the skin, alopecia, loss of subcutaneous fat, degenerative changes in the connective tissues. But, radiation necrosis of laryngeal cartilage is an uncommon complication and it is a devastating process for which further necessitates surgical treatment. It is generally agreed that the only treatment for patient not responding to conservative measures is a total laryngectomy. We experienced 4 cases of delayed radionecrosis of the larynx who underwent radiation therapy for glottic cancer and hypopharyngeal cancer. We report these cases with review of literature.

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P53 OVEREXPRESSION AND OUTCOME OF RADIOTHERAPY IN HEAD & NECK CANCERS

  • Kim, In-Ah;Choi, Ihl-Bhong;Kang, Ki-Mun;Choi, Byung-Ok;Kim, Kyung-Mi;Park, Kyung-Shin;Cho, Seong-Ho;Kim, Hyung-Tae;Kim, Young-Shin;Kang, Chang-Suk
    • Proceedings of the Korean Biophysical Society Conference
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    • 1999.06a
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    • pp.70-70
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    • 1999
  • Experimental studies have implicated the wild type p53 in cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancers.(omitted)

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Huge Immature Teratoma of Mediastinum - A case report - (종격동에 발생한 거대 미성숙기형종 -1례 보고-)

  • 강재걸
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.867-872
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    • 1989
  • Primary mediastinal immature teratoma is a rare germinal tumor which includes various elements of mature teratoma, choriocarcinoma, yolk sac carcinoma, embryonal carcinoma, and seminoma in some proportions. The tumor is virtually restricted to young man and the response to surgery and radiotherapy are poor. Recently, we experienced a case of primary mediastinal immature teratoma with elevated serum [-HCG and [-fetoprotein in 18 years old man. The well-encapsulated mass, weighing 4.5 kg, was completely resected and then adjuvant combination chemotherapy was tried with Vincristine, Bleomycin, and Cisplatin. Radical excision of tumor and adjuvant chemotherapy would appear to produce better result than have been reported in other cases. The postoperative course was uneventful and the tumor markers were returned to normal range.

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Exploiting the Fanconi Anemia Pathway for Targeted Anti-Cancer Therapy

  • Jo, Ukhyun;Kim, Hyungjin
    • Molecules and Cells
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    • v.38 no.8
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    • pp.669-676
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    • 2015
  • Genome instability, primarily caused by faulty DNA repair mechanisms, drives tumorigenesis. Therapeutic interventions that exploit deregulated DNA repair in cancer have made considerable progress by targeting tumor-specific alterations of DNA repair factors, which either induces synthetic lethality or augments the efficacy of conventional chemotherapy and radiotherapy. The study of Fanconianemia (FA), a rare inherited blood disorder and cancer predisposition syndrome, has been instrumental in understanding the extent to which DNA repair defects contribute to tumorigenesis. The FA pathway functions to resolve blocked replication forks in response to DNA interstrand cross-links (ICLs), and accumulating knowledge of its activation by the ubiquitin-mediated signaling pathway has provided promising therapeutic opportunities for cancer treatment. Here, we discuss recent advances in our understanding of FA pathway regulation and its potential application for designing tailored therapeutics that take advantage of deregulated DNA ICL repair in cancer.

Combined Chemotherapy and Radiotherapy versus Radiotherapy alone in the Management of Localized Angiocentric Lymphoma of the Head and Neck (국한성 두경부 혈관 중심위 림프종에서 화학방사선 병용치료법과 방사선치료 단독요법의 비교)

  • Chang Sei Kyung;Kim Gwi Eon;Lee Sang-Wook;Park Hee Chul;Pyo Hong Ryull;Kim Joo Hang;Moon Sun Rock;Lee Hyeong Sik;Choi Eun Chang;Kim Kwang Moon
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.17-23
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    • 2002
  • Purpose : To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. Materials and Methods : Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20~70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1~6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. Results : Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.

KFDA TLD Dose Quality Audit and Measurement Uncertainty (식품의약품안전청의 치료방사선 선량보증과 측정불확도)

  • Jeong, Hee-Kyo;Lee, Hyun-Ku;Kim, Gwe-Ya;Yang, Hyun-Kyu;Lim, Chun-Il
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.153-156
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    • 2004
  • Korea Food and Drug Administration(KFDA) has peformed the calibration of therapy level dosimeters for Co-60 radiation since 1979. The reference standard ionization chamber has been calibrated at BIPM in France. The uncertainty on the KFDA calibration coefficients is 0.9 %(k=2) for air kerma and absorbed dose to water. Since 1999 a national quality audit program for ensuring dosimetry accuracy in Korea radiotherapy centers has been performed by the KFDA. The uncertainty associated with the determination of the absorbed dose to water from the TLD readings for high energy x-ray is 1.6 %(k=1). The correction factors for energy, non-linearity dose response, and TLD holder are used in the dose determination. Agreement between the user stated dose and KFDA measured dose within ${\pm}$ 5 % is considered acceptable. KFDA TLD postal dose quality audit program was peformed for 71 beam qualities of 53 domestic radiotherapy centers in 2003. The results for quality assurance showed that 63 out of 71 beam qualifies (89 %) satisfied the acceptance limit. The second audit was carried out for the centers outside the limit and ail of them have been corrected.

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Dosimetric and Clinical Predictors of Acute Esophagitis in Lung Cancer Patients in Turkey Treated with Radiotherapy

  • Etiz, Durmus;Bayman, Evrim;Akcay, Melek;Sahin, Bilgehan;Bal, Cengiz
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4223-4228
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    • 2013
  • Background: The purpose of this study was to determine the clinical and dosimetric factors associated with acute esophagitis (AE) in lung cancer patients treated with conformal radiotherapy (RT) in Turkey. Materials and Methods: In this retrospective review 104 lung cancer patients were examined. Esophagitis grades were verified weekly during treatment, and at 1 week, and 1 and 2 months afterwards. The clinical parameters included patient age, gender, tumor pathology, number of chemotherapy treatments before RT, concurrent chemotherapy, radiation dose, tumor response to RT, tumor localization, interruption of RT, weight loss, tumor and nodal stage and tumor volume. The following dosimetric parameters were analyzed for correlation of AE: The maximum ($D_{max}$) and mean ($D_{mean}$) doses delivered to the esophagus, the percentage of esophagus volume receiving ${\geq}10$ Gy ($V_{10}$), ${\geq}20$ Gy ($V_{20}$), ${\geq}30$ Gy ($V_{30}$), ${\geq}35$ Gy ($V_{35}$), ${\geq}40$ Gy ($V_{40}$), ${\geq}45$ Gy ($V_{45}$), ${\geq}50$ Gy ($V_{50}$) and ${\geq}60$ Gy ($V_{60}$). Results: Fifty-five patients (52.9%) developed AE. Maximum grades of AE were recorded: Grade 1 in 51 patients (49%), and Grade 2 in 4 patients (3.8%). Clinical factors had no statistically significant influence on the incidence of AE. In terms of dosimetric findings, correlation analyses demonstrated a significant association between AE and $D_{max}$ (>5117 cGy), $D_{mean}$ (>1487 cGy) and $V_{10-60}$ (percentage of volume receiving >10 to 60 Gy). The most significant relationship between RT and esophagitis were in $D_{max}$ (>5117 cGy) (p=0.002) and percentage of esophageal volume receiving >30 Gy ($V_{30}$ >31%) (p=0.008) in the logistic regression analysis. Conclusions: The maximum dose esophagus greater than 5117 cGy and approximately one third (31%) of the esophageal volume receiving >30 Gy was the most statistically significant predictive factor associated with esophagitis due to RT.

"Sandwich" Chemotherapy (CT) with Radiotherapy (RT) Improves Outcomes in Patients with Stage IE/IIE Extranodal Natural Killer (NK)/T-cell Lymphomas

  • Zhang, Jing;Zhu, Meng-Yuan;Wang, Liang;Wang, Hua;Wang, Wei-Da;Geng, Qi-Rong;Lu, Yue
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4061-4066
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    • 2013
  • The extranodal natural killer/T-cell lymphoma (ENKTL) shows high local or systemic failure rates when radiotherapy (RT) is taken as the primary treatment, suggesting a role for chemotherapy (CT) added to RT for this disease. However, the appropriate mode of combined modality therapy (CMT) has not been fully defined. A total of one hundred and twenty-one patients with ENKTL receiving sandwich CT with RT were reviewed between January 2003 and August 2012. The primary endpoints were the response rate, progression-free survival (PFS), overall survival (OS), and the relapse rate. After the initial CT, there were 84 (69.4%) patients in CR, 22 (18.2%) patients in PR, 9 (7.4%) patients in SD, and 6 (5%) patients in PD, respectively. At the end of RT, the CR, PR, SD, and PD rates for all patients were 90.9% (n=110), 1.7% (n=2), 4.1% (n=5), and 3.3% (n=4), respectively. After a median follow-up of 42.3 months (3.5~112.3 months), the 5-year PFS was 74.7% (95% CI 70.4%~79.0%), and 5-year OS was 77.3% (95% CI 67.9%~86.7%). Disease progression was documented in 25 (20.7%) patients. The rates of systemic failure, local failure, and regional failure were 18.2%, 5.8%, 1.7%, respectively. Twenty death events (16.5%) were observed for the entire group of patients (18 deaths related to PD). Furthermore, CR to the initial CT and low Korean Prognostic Index (KPI) can independently predict long PFS and OS. The sandwich CMT achieved an excellent outcome for localized ENKTL with acceptable toxicity. We recommend it can be applied as the optimal choice for localized ENKTL.