• 제목/요약/키워드: radiotherapy response

검색결과 432건 처리시간 0.028초

국소적으로 진행된 자궁경부암에서 방사선과 Cisplatin의 동시병합요법의 치료결과 (Therapeutic Results of Concurrent Chemoradiation in Locally Advanced Uterine Cervical Cancer)

  • 강승희;서현숙;양광모;이응수;박성관
    • Radiation Oncology Journal
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    • 제13권1호
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    • pp.55-61
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    • 1995
  • Purpose : Despite a development of therapeutic machines and advance in modern radiation therapy techniques, locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate, Combination of chemotherapy and radiotherapy demonstrated benefit in improving local control and possibly the overall survival. Our study was performed to evaluate effect of concurrent chemoradiation on locally advanced uterine cervical cancer. Methods and Materials : Twenty six patients with locally advanced stage(FIGO stage IIB with ${\geq}5cm$ in diameter, III, IVA) were treated with combination of radiation therapy and concurrent cisplatinum between May of 1988 and September of 1993 at our hospital. Radiation therapy consisted of external irradiaton and 1-2 sessions of intracavitary irradiation. Cisplatinum was administered in bolus injection of 25mg/$m^2$ at weekly intervals during the course of external radiation therapy. Results : Of the 26 Patients, twenty-five patients were evaluable for estimation of response. Median follow-up period was 25 months with ranges from 3 to 73 months. Stage IIB, III, and IVA were 16, 5, 4 patients, respectively, Twenty patients were squamous cell carcinoma. Response was noted in all 25 patients: complete response(CR) in 17/25($68\%$), Partial response(PR) in 8/25($32\%$). Of the 24 patients except one who died of sepsis at 3 months follow-up, seventeen patients($70.8\%$) maintained local control in the pelvis: 16/17($94.1\%$) in CR, 1/17($14.3\%$) in PR. Fourteen of the 17 patients with CR are alive disease free on the completion of follow-up. Median survival is 28 months for CR and 15 months for PR. Analysis of 5-year survival by stage shows 11/16($59.8\%$) in IIB, 3/5($60.0\%$) in III, and 1/4($25.0\%$) in IVA. Overall 5-year survival rate was $55.2\%$. Ten patients recurred: 4 at locoregional, 3 in distant metastasis and 3 with locoregional and distant site. Toxicity by addition of cisplatinum was not excessive. Conclusion : Although the result of this study was obtained from small number of patients, it is rather encouraging in view of markedly improved response rate compared with the results of historical group.

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생체 내 흡수선량 측정을 위한, 얇은 테프론의 TLD 반응감도에 대한 효과성 (The Effect of Thin Teflon on TLD Response for in vivo Dosimetry of Radiotherapy)

  • Kim, Sookil;Yum, Ha-Young;Jeong, Tae-Sig;Moon, Chang-Woo
    • 한국의학물리학회지:의학물리
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    • 제14권2호
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    • pp.74-80
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    • 2003
  • 본 연구의 목적은 핵의학 분야에서 생체 내 흡수선량의 직접 측정에 사용될 수 있는, 테프론을 씌운 TLD의 수행성을 알아보고, 흡수선량 측정 시 테프론의 영향에 대하여 분석하고자 한다. 테프론 캡슐에 든 LiF TLD-100의 반응감도를 고체 팬텀 내에서의 깊이를 달리 하며 측정하였다 성인 인체모형 팬텀을 이용하여 테프론을 씌운 TLD로써 생체 내 흡수선량을 측정하였다. 테프론을 씌우지 않은 보통의 TLD를 이용하여 구한 PDD, TMR, 그리고 생체흡수선량과 테프론을 씌운 TLD로 구한 값을 비교하였다. 보통의 TLD를 이용하여 구한 반응값과 테프론을 씌운 TLD로 구한 값의 차이는 build-up이상의 깊이에서는 같은 조건하에서 3% 이내였다. 그러나 팬텀 표면 부근에서는 테프론 켑슐의 두께에 기인한 build-up 효과로 인해 큰 차이를 보였다. 본 연구에서 테프론 켑슐로 인하여 수 메가볼트의 방사선에 대한 TLD의 흡수선량 측정에 미치는 변화는 미미한 것으로 나타났다. 따라서 치료 환경 하에서 테프론을 씌운 TLD가 생체 내 선량측정에 매우 적합한 것으로 사료된다.

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국소성 소세포 폐암에 대한 복합화학요법 및 방사선 병용치료의 효과 (The Result of Combined Modality Treatment for Limited Stage Small Cell Lung Cancer)

  • 김재철;장양숙;류삼열;박인규
    • Radiation Oncology Journal
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    • 제7권2호
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    • pp.205-211
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    • 1989
  • 1984년 7월부터 1988년 9월까지 경북대학교병원 치료방사선과에서 소세포 폐암으로 진단되어 복합화학요법 및 방사선 병용치료를 받은 27명을 대상으로 치료성적을 분석하였다. 완전관해율은 $70\%$, 부분관해율은 $22\%$, 무반응은 $8\%$였다. 여자, 수행상태 HO, 방사선량 4500cGy이상, 화학요법 4회 이상, 그리고 혈청 enolase수치 30ng/m1 이하 등에서 완전관해율이 높게 나타났으나 통계적 의의는 없었다. 중앙생존기간은 10개월이었고 1년생존율과 2년 생존율은 각각 $40.7\%$$12.2\%$였다. 생존율을 높이는 인자로는 수험상태 HO (p<005), 완전관해 (p<0.05), 하학요법 4회 이상(p<005), 방사선량 4500 cGy이상 등으로 나타났으며, 성별과 예방적 전뇌조사는 영향을 미치지 않았다.

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진행성 위암 환자에서 Heptaplatin과 5-Fluorouracil 복합요법의 임상효과 (Clinical Effects of the Combination Chemotherapy of Heptaplatin and 5-Fluorouracil in Advanced Gastric Cancer)

  • 신가실;오정미
    • 한국임상약학회지
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    • 제14권2호
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    • pp.61-70
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    • 2004
  • Heptaplatin is a new platinum derivative with antitumor activity against gastric cancer. Preclinical studies showed that it is less toxic than other platinum analogues. The purpose of this study is to evaluate the efficacy and toxicity of the combination therapy of heptaplatin and 5-fluorouracil in Korean advanced gastric cancer patients. This study was investigated retrospectively. The patients group consisted of 65 advanced gastric cancer patients with no prior radiotherapy. All patients received heptaplatin $400\;mg/m^2$ by 2-3 hour infusion on Day 1 and 5-FU $1000\;mg/m^2by 12-24 hour continuous infusion for 5 days. After the first cycle, subsequent doses were adjusted according to the toxicity. Courses were repeated every 28 days. As results, objective response occurred in 16 patients $(24.6\%)$. Two were complete and 14 were partial response. Median progression free survival was 32 weeks with $29\%$ of patients progression free at 1 year. The most common hematologic toxicity was anemia. Grade 3 or 4 anemia was seen at $2.7\%$ of treatment cycles. Grade 3 or higher leucopenia was seen at $1.2\%$ of cycles. Grade 3 or 4 neutropenia and thrombocytopenia occurred at $6.1\%\;and\;1.5\%$ of cycles, respectively. The most common nonhematologic toxicity was proteinuria. Though no patients experienced grade 3 or 4 proteinuria, proteinuria was a considerable factor for this chemotherapy. Grade 3 or higher gastrointestinal toxicities were nausea and vomiting ($4.6\%$ of patients) and diarrhea ($1.5\%$ of patients). Grade 2 renal toxicity with elevation of serum creatinine was seen in $0.3\%$ of cycles, which is less than that of other platinum analogues. This study showed that combination therapy of heptaplatin and 5-FU have modest antitumor activity against advanced gastric cancer without severe renal toxicity.

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Comparison of Metabolic Profiles of Normal and Cancer Cells in Response to Cytotoxic Agents

  • Lee, Sujin;Kang, Sunmi;Park, Sunghyouk
    • 한국자기공명학회논문지
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    • 제21권1호
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    • pp.31-43
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    • 2017
  • Together with radiotherapy, chemotherapy using cytotoxic agents is one of the most common therapies in cancer. Metabolic changes in cancer cells are drawing much attention recently, but the metabolic alterations by anticancer agents have not been much studied. Here, we investigated the effects of commonly used cytotoxic agents on lung normal cell MRC5 and lung cancer cell A549. We employed cis-plastin, doxorubicin, and 5-Fluorouracil and compared their effects on the viability and metabolism of the normal and cancer cell lines. We first established the concentration of the cytotoxic reagents that give differences in the viabilities of normal and cancer cell lines. In those conditions, the viability of A549 decreased significantly, whereas that of MRC5 remained unchanged. To study the metabolic alterations implicated in the viability differences, we obtained the metabolic profiles using $^1H$-NMR spectrometry. The $^1H$-NMR data showed that the metabolic changes of A549 cells are more remarkable than that of MRC5 cells and the effect of 5-FU on the A549 cells is the most distinct compared to other treatments. Heat map analysis showed that metabolic alterations under treatment of cytotoxic agents are totally different between normal and cancer cells. Multivariate analysis and weighted correlation network analysis (WGCNA) revealed a distinctive metabolite signature and hub metabolites. Two different analysis tools revealed that the changes of cell metabolism in response to cytotoxic agents were highly correlated with the Warburg effect and Reductive lipogenesis, two pathways having important effects on the cell survival. Taken together, our study addressed the correlation between the viability and metabolic profiles of MRC5 and A549 cells upon the treatment of cytotoxic anticancer agents.

두경부 악성 임파종에 대한 병용치료의 결과 (The Result of Combined Modality Treatment for Non-Hodgkin's Lymphoma of Head and Neck)

  • 김재철;김상보;류삼열;박인규
    • Radiation Oncology Journal
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    • 제8권2호
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    • pp.255-260
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    • 1990
  • 1985년 4월부터 1989년 9월까지 경북대학교병원 치료방사선과에서 두경부 악성 임파종으로 진단되어 복합화학요법 및 방사선 병용치료를 받은 26명을 대상으로 치료성적을 분석하였다. 완전관해율은 $88{\%}$, 부분관해율은 $12{\%}$였고 관해율에 영향을 미치는 예후인자는 없었다. 3년 생존율 및 3년무병생존율은 각각 $62.4{\%}$$65.2{\%}$였다. 생존율이 높았던 군은 편측성 임파절침범(p<0.05), 방사선량 5000 cGy 이상 (p<0.01), 화학요법 6회 이상 (p=0.06)등이었다. 26예 중 8예 (부분관해 3예 포함)에서 재발을 했으며 재발 양상은 국소재발 1예, 원격 전이 1예, 인접조직에 재발 1예, 국소 재발 및 원격전이 2예 등이었다.

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Temozolomide during and after Radiotherapy for Newly Diagnosed Glioblastomas : A Prospective Multicenter Study of Korean Patients

  • Joo, Jin-Deok;Chang, Jong-Hee;Kim, Jeong-Hoon;Hong, Yong-Kil;Kim, Young-Hoon;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • 제52권2호
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    • pp.92-97
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    • 2012
  • Objective : This study was performed to determine the safety and outcome of concurrent chemoradiotherapy (CCRT) and adjuvant chemotherapy with temozolomide for Korean patients with a newly diagnosed glioblastoma. Methods : Patients were recruited from four institutions between 2004 and 2007. The patients received fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks and daily temozolomide, followed by 6 cycles of adjuvant temozolomide. The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS), response, and safety. Results : A total of 103 patients were enrolled in this study. Ninety-six patients (93%) completed the CCRT and 54 patients (52%) received 6 cycles of adjuvant temozolomide. The response rate was 73% (53/73) and the tumor control rate was 92% (67/73). Of the 96 patients who completed the CCRT, the median OS was 18.0 months and the 1- and 2-year OS rates were 74 and 38%, respectively. The median PFS was 10.0 months and the 1- and 2-year PFS rates were 33 and 16%, respectively. The only significant prognostic factor of survival was the extent of surgical resection (p<0.05). CCRT resulted in grade 3 or 4 hematologic toxic effects in 8% of patients. No opportunistic infections were noted. Conclusion : This study is the first prospective multi-institutional report of CCRT and adjuvant chemotherapy with temozolomide for patients with a newly diagnosed glioblastoma in Korea. The current protocol may prolong the survival of Korean patients with a glioblastoma and may be tolerable in terms of toxicity.

Outcomes of Metastatic Gestational Trophoblastic Neoplasia: Fourteen Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Siriaree, Sitthicha;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1357-1362
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    • 2016
  • Metastatic gestational trophoblastic neoplasia (GTN) is an uncommon cancer. The principal treatment consists of chemotherapy with or without surgery or radiotherapy. We here retrospectively reviewed the outcomes of metastatic GTN treated at our institute between January, 1999 and December, 2013. Sixty-three patients met the criteria. The median age was 30.0 years and almost 90% were referral cases. Nearly 40% of the studied patients presented with vaginal bleeding while 22.2% were asymptomatic. The most common antecedent pregnancy was hydatidiform mole (57.1%) followed by term pregnancy (20.6%). The median interval time from antecedent pregnancy to the development of GTN was three months and the median pretreatment B-hCG was 58,274 mIU/ml. Stage III (74.6%) was the most common staging followed by stage IV (20.6%) and stage II (4.8%). The most frequent surgery was hysterectomy (31.7%). Thoracotomy and craniotomy were performed in three and two patients, respectively. The most common first line chemotherapy regimen was methotrexate and folinic acid (36.5%) followed by EMA (etoposide, methotrexate, actinomycin D) (34.9%), EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) (17.5%) with the remission rate of 66.7%. Nearly one-third of the patients were given a subsequent chemotherapy regimen after failure with the first line therapy and showed a final response rate of 73.0%. However, in stage IV, the response to first line treatment was only 38.5%. In conclusion, the outcomes of metastatic GTN were poor especially with the higher stages.

Outcome of Daily Cisplatin with Thoracic Chemoradiotherapy in Advanced Non-small Cell Lung Cancer Patients with Comorbid Disorders: a Pilot Study

  • Kiziltan, Huriye Senay;Bayir, Ayse Gunes;Tastekin, Didem;Coban, Ganime;Eris, Ali Hikmet;Aydin, Teoman;Mayadagli, Alparslan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8591-8594
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    • 2014
  • Background: Lung cancer is the most common cancer in males worldwide. The principal mode of treatment in the early stage of non-small cell lung cancer (NSCLC) is surgery. However, five-year survival is only about 15% for all stages. The aim is to investigate the effect of daily low dose cisplatin concurrently with radiation therapy in advanced NSCLC patients with poor performance status. Materials and Methods: Ten patients diagnosed as inoperable Stage IIIB NSCLC with comorbid disease were assessed retrospectively in Bezmialem Vakif University, Faculty of Medicine, Department of Radiation Oncology, between 2011 to 2013. ECOG performance status was between 3 and 4. Cisplatin was administered at $6mg/m^2$ daily, for 5 days a week concurrently with radiotherapy using 160-200 cGy daily fractions, 54 Gy being the lowest and 63 Gy being the highest dose. Results: Complete response at the primary tumour site was obtained in 20% patients. Grade I esophagitis was seen 70 percent of patients, and the grade II haematological toxicity rate was 20 %. Median survival time was 7 months. Conclusions: Median survival time was reasonable, despite the patients ECOG performance status of 3-4, which is similar to groups even without comorbid disorders in comparison to other published papers in the literature. Acceptable toxicity, high response rates and quality of life of patients are the other favourable features.

Breast Lymphoma Treatment Outcomes in a Pakistani Population: 20 Years of Experience at a Single Center

  • Bano, Razia;Zafar, Waleed;Khan, Amina Iqbal;Fiaz, Sohaib Adil;Abid, Mahwish;Chaudhary, Mohammad Zulqarnain;Siddique, Neelam;Khan, Huma Majeed
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3631-3635
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    • 2016
  • Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.