• Journal of Gastric Cancer
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• v.19 no.2
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• pp.148-156
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• 2019

Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.

• Biomedical Science Letters
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• v.5 no.2
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• pp.181-190
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• 1999

To evaluate the usefulness of transforming growth factor-$\beta$1 (TGF-$\beta$1) as a new tumor marker, we determined the plasma TGF-$\beta$1 levels using sandwich ELISA assay in cancer patients. Patients with three most common adult cancers in Korea (stomach, liver and breast cancer) and children's cancers (leukemia and two kinds of solid tumor) were enrolled for the study. Furthermore, 39 individuals were subjected to age and sex-stratified plasma TGF-$\beta$1 analysis. No statistical difference was demonstrated with respect to age or sex. The mean plasma TGF-$\beta$1 level (16.0 ng/ ml) of stomach cancer patients was significantly higher than that (8.3 ng/ml) of controls. However, there was no difference among the mean plasma TGF-$\beta$1 levels of liver, breast cancer patients and controls. Seven of 16 patients (43.7%) with stomach cancer, one of 8 (12.5%) with liver cancer, and one of 7 (14.3%) with breast cancer showed higher TGF-$\beta$1 levels compared to controls. Plasma TGF-$\beta$1 concentrations of five leukemic children remained in the normal range regardless of the remission state. In contrast, initial high TGF-$\beta$1 levels from two children with solid tumors returned to normal range on surgical resection of tumors. From the above results, we could conclude that plasma TGF-$\beta$1 levels of apparently healthy individuals seem to be rather constant irrespective of difference in age or sex, and the plasma TGF-$\beta$1 has the limited value as a screening test for the diagnosis of aforementioned adult cancers because of its low sensitivity. Finally, additional studies need to be pursed for the large number of stomach cancer and pediatric solid tumor patients in order to reach a secure conclusion on the usefulness of plasma TGF-$\beta$1 as a tumor marker in these patients.

• Journal of Korean Traditional Oncology
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• v.20 no.2
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• pp.37-49
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• 2015

Objectives : Retroperitoneal liposarcoma (RPS) is a rare solid tumor and has a high recurrence rate after surgery. New complementary and alternative medicine is required to manage symptoms of RPS and side effects of surgery, chemotherapy and radiation therapy. The purpose of this case report is to report two cases of reduction of side effects of surgery and radiation therapy in RPS treated with Wheel Balanced Therapy (WBT) which is a traditional Korean medicine treatment program for patients with cancer. Methods : Two patients with RPS were treated with WBT. Each of patients received personalized WBT schedule including acupuncture. The changes in clinical and laboratory findings were evaluated. Results : The symptoms of patients were improved after about 2 weeks hospitalization. Conclusions : This case report suggests that WBT has a potential to treat side effects of surgery and radiation therapy in patients with RPS. Further rigorous studies are necessary to investigate the therapeutic effects of WBT on RPS.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2523-2526
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• 2012

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge. Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes. Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ${\leq}50$. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/$mm^3$, 34 (26%) one between 100-300 cells/$mm^3$ and 40 (31%) an ANC greater than 300 cells/$mm^3$. Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC <100 cells/$mm^3$ were more likely to die than patients with ANC >300 cells/$mm^3$ by a factor of 4.3. Similarly patients >50 years of age were 2.7 times more likely to die than younger patients. Conclusion: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup.

• Journal of Sensor Science and Technology
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• v.20 no.5
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• pp.300-304
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• 2011

Exhaled breath gases include gases generated in the body. When there is disease in the body, exhalation can include gas components from the disease. If we can find these specific elements through analysis of the exhalation gases, this can be an effective way to diagnose the disease. The lung has a close relationship with exhalation. Lung cancer refers to malignant tumors which originate in the lungs. Exhalation from the lung causes direct jets of gas to be ejected through the mouth and nose, so by analyzing these jets it may be possible to diagnose lung cancer. In our study we attempt to diagnose lung cancer from patient's exhaled gases. Exhalation of lung cancer patients was analyzed using gas chromatography-mass spectroscopy(GC-MS) and the expiratory gas was also measured using a sensor system. The system was designed to use a metal oxide sensor and solid phase micro extraction(SPME) fiber. The GC-MS analysis of the healthy subject's and cancer patient's exhalation gases both showed the presence of decane in the breath of patients with lung cancer. In addition, the results from the sensor system showed significant difference between the lung cancer patients and the healthy subjects.

• Korean Journal of Clinical Pharmacy
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• v.18 no.2
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• pp.75-83
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• 2008

Purpose: Currently lung cancer ranks second in cancer for incidence rate and is a disease that ranks first for a death rate by cancerous growth because it is already advanced at the time of diagnosis. The purpose of this paper was to analyze the factors that affect the effectiveness of and rash occurrence by Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR TKI) in patients with non-small cell lung cancer. Methods: A retrospective chart review of 100 patients, who took EGFR TKI (erlotinib, gefitinib) among patients who were diagnosed with non-small cell lung cancer in a Hospital in Korea between May 2005 and February 2008, was conducted. The drug effectiveness was evaluated by Response Evaluation Criteria In Solid Tumor. Results: EGFR mutation was the only factor associated with drug response (complete response and partial response). When stable disease was added to drug response as the evaluation parameter, ECOG and rash as well as EGFR mutation were found to be important factors. Survival, however, was not affected by EGFR mutation. The factors influenced on survival were older age (${\geq}65$), low ECOG ($1{\sim}2$), adenocarcinoma and rash. In the case of rash, group with EGFR mutation or low ECOG showed significantly higher chance of occurrence. There was no significant difference in rash occurrence between gefitinib and erlotinib groups. Conclusions: Based on the results, EGFR mutation positive and low ECOG ($1{\sim}2$) were significantly important factors for both effectiveness of EGFR TKI and rash occurrence. Also, rash itself was found to be an independently significant factor for the disease control and survival. Therefore, while administering EGFR TKI, patients who have the factors associated with rash occurrence should be closely monitored for effective and safe drug therapy.

• Journal of Gastric Cancer
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• v.8 no.2
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• pp.65-69
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• 2008

Surgery is the only curative modality for the treatment of gastric cancer. There has been no drastic improvement in the treatment of gastric cancer with chemotherapy. Clinical trials have attempted to demonstrate the benefit of the preoperative chemotherapy for gastric cancer. The benefit of the use of preoperative chemotherapy or chemoradiotherapy has been demonstrated for other solid cancers such as breast cancer, esophageal cancer and rectal cancer. Despite the rationale of the use of preoperative chemotherapy for patients with gastric cancer, the evidence of positive results with the use of preoperative chemotherapy has not been clear. Recently the British Medical Research Council Adjuvant Gastric Cancer Infusional Chemotherapy (MAGIC) study demonstrated the survival benefit of preoperative and postoperative chemotherapy. However, this study had several problems with the use of a heterogeneous population of patients, the method of surgery and the use of perioperative chemotherapy. Further studies with new drugs are warranted to determine the role of pre-operative chemotherapy for patients with gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4205-4208
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• 2013

Objective: The aim of this study was to explore change and significance of serum carcino-embryonic antigen (CEA) before and after gefitinib therapy in patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty patients with advanced NSCLCs in III~IV stages were selected as study objects given gefitinib therapy combined with routine local radiotherapy until tumor progression or intolerable toxicity. After treatment, all patients were divided into control and non-control groups according to the results of evaluation based on RECIST 1.1 (Response Evaluation Criteria in Solid Tumors in 2009). Peripheral fasting blood from all patients was collected in the early morning and serum CEA was assessed by electro-chemiluminescence immunoassay (ECLIA) before and after treatment. Before treatment, patients were divided into high CEA group (CEA level > 50 ng/mL) and low CEA group (CEA level ${\leq}$ 50 ng/mL). Adverse reactions were noted and progression-free survival (PFS) in both groups was recorded after long-term follow-up that ended in December, 2012. Results: There was no difference between control and non-control groups in CEA level before treatment (P>0.05), whereas serum CEA decreased more markedly lower in the control group after treatment (P<0.01). All patients were divided into high CEA group (26) and low CEA group (14) according to serum CEA level. There was no statistically significant difference between two groups in adverse reactions (P>0.05) but the rate in former group was lower. Additionally, survival rates at 9 and 12 months in high CEA group were clearly higher than in the low CEA group (P<0.01). Conclusions: Serum CEA level can serve as a biochemical index to evaluate the prognosis with gefitinib treatment for NSCLC.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.51-57
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• 2011

Background: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. Material and Methods: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. Results: Mean age at operation was $66.0{\pm}12.4$ years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of $28.0{\pm}17.8$ months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (${\geq}$95%), or in small solid lesions (${\leq}$2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of $31.7{\pm}11.6$ months, no patient developed recurrence. Conclusion: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2879-2882
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• 2014

Background: Breast cancer (BC) is the most common form of cancer in Iranian women, and it remains a major health problem. An increasing number of young women are being diagnosed with BC, and therefore, there is an increasing likelihood that more women will survive breast cancer for many years. Many opine that self-disclosure of BC diagnosis is important because talking about cancer helps people to make sense of their experiences; in fact, self-disclosure appears to play an important role in many health outcomes. However, this has not yet been studied in BC patients in Iran. Therefore, this study aimed to explore the status of self-disclosure of BC diagnosis by Iranian women to friends and colleagues. Materials and Methods: All BC records for 2001-2011 of employed women were studied at five hospitals in Mashhad. Data about the self-disclosure of BC diagnosis were gathered through telephone interviews, and the participants filled out a questionnaire about their status of self-disclosure of BC diagnosis to various groups of people. Results: The mean age of employed women at the time of diagnosis was $44.3{\pm}6.7$ years. Over 60% self-disclosed to work colleagues and over 90% to bosses/managers. Seventy per cent reported that they had support from their family and husband's family, while 95% reported that they had support from parents, siblings, children and friends. Conclusions: Most employed women self-disclosed freely to family, friends, colleagues and bosses/managers. Apparently, self-disclosure of breast cancer diagnosis may have negative effects at work. About half of patients reported that they had support from family, managers and colleagues; however, for nearly 28% of employed women, disclosure had less positive effects. In particular, it altered their perception of others, produced difficulties with work and family and diminished closeness with the people who were told. However, the stigma of BC is far less than it once was.