• 제목/요약/키워드: therapy response

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Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • 제37권4호
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

봉독침자극(蜂毒鍼刺戟)이 생쥐의 면역기능(免疫機能)에 미치는 영향(影響) (Effect of Api-Toxin Therapy on Depression of Immune Response in Mice)

  • 강승범;고형균;김창환
    • 대한한의학회지
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    • 제17권1호
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    • pp.234-246
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    • 1996
  • In order to investigate the effects of api-toxin therapy on depression of immune response, mice were exposed to cold stress $(-20^{\circ}C)$) in 30 minutes twice a day and api-toxin(Bee Venom from Korea and U.S.A) therapy was treated to the Kihae $(CV_6)$ locus of human body every two days with 4 sessions of treatment for 8 days. The mice were sensitized i.v. with $5{\times}10^8$ sheep red blood cells (SRBC) on the 4th day and challenged i.d. with $2{\times}10^9$ SRBC 4 days later. Immune Response for delayed type hypersensitivity (DTH), lympocyte transformation(LTT), hemolysin titer(HL), plaque forming cells (PFC) were measured.

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골격성 III급 부정교합환자의 이모장치에 대한 반응성 및 치료효과에 관한 연구 (THE RETROSPECTIVE STUDY ON THE RESPONSE TO THE CHINCAP THERAPY IN SKELETAL CLASS III CHILDREN)

  • 김병호;양원식
    • 대한치과교정학회지
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    • 제24권4호
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    • pp.799-817
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    • 1994
  • The purpose of this study was to evaluate the initial skeletal pattern and growth change of whom had responsed well to chincap therapy. 93 patients seleted for this study were in mixed dentition and treated with chincap for more than 2 years. And 54 subjects were selected from these total samples and classified into two groups by the improvement of four measurements : ANB difference, APDI, Wits appraisal, and AF-BF. One was good response group which consisted of 26 children and the other was poor response group with 19 patients. Various measures of the craniofacial structure in the initial lateral cephalograms and the annual increments were calculated and analyzed by comparing two groups with t-test. The results were as follows : 1. Good response group had more horizontal growth pattern in initial stage of treatment than poor response group, and the contributing factors of this result were anterior posterior facial height ratio, gonial angle, lower genial angle and SN-mandibular plane angle. 2. The maxilla was positioned more anteriorly in good response group. 3. The amounts of vertical growth of maxilla was smaller but the horizontal growth of maxilla was larger in good response group. 4. The mandible rotated more infero-posteriorly in good response group. 5. The good response group had more vertical growth pattern of mandibular condyle.

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Watsu 치료가 뇌졸중 이후 성인 편부전마비환자의 근긴장도에 미치는 영향 (The Effect of Watsu Therapy on Muscle Tone in Adult Hemiparesis Patient After Stroke)

  • 천승철
    • 대한물리치료과학회지
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    • 제11권2호
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    • pp.46-56
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    • 2004
  • The purpose of this study was to investigate the effect of watsu therapy on muscle tone in adult hemiparesis patient after stroke. The subject was a 66 year old patient with left hemiparesis whose self gait was independent with minimal assist. The subject was ambulatory with some degree of limitation and demonstrated a little tremor and asymmetry in the body. A multiple treatment design(A-B-C-B) for a single-subject research was used for this study. The watsu therapy consisted of basic moves, head cradle, underfar leg, near leg cradle in watsu I (transition flow), for 25 minutes, which lasted 12 sessions for a total 21 sessions. A baseline was conducted for a first time and a general ROM exercise was conducted after the first watsu therapy. Tone assessment scale was tested : 1. posturing at rest 2. response to passive movement 3. associated reaction Comparing to the baseline and general ROM exercise, The results showed that the watsu therapy had some positive effects on improvement of three tests and there was a more positive effects of both response to passive movement and associated reaction.

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웃음요법이 군병원 요통환자의 스트레스 반응과 통증에 미치는 영향 (Effects of Laughter Therapy on Stress Response and Pain of Military Personnel with Low Back Pain in Hospital)

  • 유정아;김금순
    • 근관절건강학회지
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    • 제16권1호
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    • pp.36-45
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    • 2009
  • Purpose: This study was to determine the effects of laughter therapy on stress response and pain of military patients with low back pain. Method: The subjects in the experimental group received 3-sessions of laughter therapy on 3 consecutive days. The primary outcome measures were state anxiety, depression, blood pressure, pulse rate and pain. Result: After 3 sessions of laughter therapy, the scores of state anxiety(p=.046), depression(p=.028) and pulse rate(p=.003) were significantly lower and diastolic blood pressure(p=.038) was significantly higher in the experimental group than those in the control group. The level of pain(p=.711) was not different significantly between two groups. Conclusion: Laughter therapy could be an effective strategic intervention for military patients with low back pain to reduce the level of anxiety and depression. Further studies are needed to determine long-term effects of laughter therapy and its effects on cardiovascular system and pain.

운동중재에 관한 국내 간호학 논문 분석 (The Analysis of Exercise Therapy in Nursing Research)

  • 전점이
    • 대한간호학회지
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    • 제30권2호
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    • pp.319-330
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    • 2000
  • This study is aimed at analyzing the trend of research on the use of exercise in nursing research, through suggesting directions for future research and implementation of the various exercise therapies. Research studies were taken from dissertations and theses selected from the Academic Society Journals of nursing science, Journals from universities, medical and nursing schools, research institutes in various universities, the Central Journal of Medicine, and the New Medical Journal. The research published between 1970 and 1997 in Korea were analyzed, 51 research were selected. The research are analyzed according to: published time, source of the research, research design, subjects, sample size, dependant variables, exercise therapy, and effect of exercise therapy. The results were as follows: 1. Research on exercise therapy increased rapidly in the 1990's. At this time, 88.2% of research was published. 2. Research areas included: 54.9% non- degree research, 27.5% Doctoral theses, and 17.6% Master's theses. 3. The experimental design included: 66.7% non- equivalent control group pre-test/ post-test design and 29.4% one group pre-test/post- test design. 4. Out of the Subjects: 52.9% were patients with various health problems, and 47.1% were healthy individuals. 5. Sample size included: 52.9% with above 31 subjects, 11.8% with 11~15 and 26~30. 6. Exercise therapy was analyzed by type, intensity, frequency, duration, and period. 1) The Types: Aerobic exercise at 60.8% was the most common, active exercise for muscle strengthening and building made up 21.6%. 2) Exercise with 40~65% intensity comprised 25.5%, 70~85% with 7.8%, and no description of the intensity was 66.7%. 3) Frequency of 3~5 per week was the most common at 78.4%. 4) Duration: 15~60 minutes was the most common length of time at 76.5%. 5) Periods: More than 5 weeks at 82.3% were the most common in their categories. 7. Dependant variables: Psychological response was measured as a dependant variable in 92.2%, Cardio-pulmonary function 88.2%, Body Composition was 86.3%, Physical Response was 60.8%, Lipid Metabolism was 58.8%, Physical Strength was 49.0%, Glucose Metabolism was 25.5%, Activities of Daily Living was 17.6% and others added to be 3.9%. 8. The effect of Exercise Therapy was categorized into 'positive', 'partially positive', and 'no effect' according to dependant variables: Having a positive effect - Glucose Metabolism (93.3%), Physical Response (85.0%), Activities of Daily Living (81.8%), Psychological Response (71.6%), Lipid Metabolism (67.6%), Cardio- pulmonary Function (63.6%), Physical Strength (68.1%), and Body Composition (56.4%). The following suggestions can be made on the above findings: 1. Research findings on Exercise Therapy as a Nursing Intervention need to be described by their elements of type, intensity, frequency, duration and period. 2. Toproperly study the positive effects of Exercise Therapy, there needs to be ⑴ appropriate research design, ⑵ selection criteria for the subjects ⑶ contents of exercise prescription to individuals or groups ⑷ measurement criterion for the dependent variables. 3. Meta-analysis on exercise therapy also needs to be done to analyze and integrate the various results.

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Third-line Hormonal Therapy to Treat Prostate Cancer Relapse after Initial and Second-line Hormonal Therapy: Report of 52 Cases and Literature Review

  • Matsumoto, Kazuhiro;Hagiwara, Masayuki;Hayakawa, Nozomi;Tanaka, Nobuyuki;Ito, Yujiro;Maeda, Takahiro;Ninomiya, Akiharu;Nagata, Hirohiko;Nakamura, So
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3645-3649
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    • 2014
  • The aim of this study was to evaluate the efficacy of third-line combined androgen blockade (CAB) therapy for castration-resistant prostate cancer that relapsed after primary and second-line CAB. We retrospectively reviewed the medical records of 52 patients who received first-, second-, and third-line CAB therapy (medical or surgical castration, plus steroidal antiandrogen of chlormadinone acetate, or nonsteroidal antiandrogen of flutamide or bicalutamide). For cumulative analysis, we searched the PubMed database and identified a total of 50 cases published in English. Including our cases, this provided a total of 102 cases for analysis. In our study cohort, 11 cases (21.2%) achieved more than 50% reduction of serum prostate-specific antigen (PSA) on initiation of third-line CAB. We found that third-line CAB with nonsteroidal antiandrogen after second-line CAB with steroidal antiandrogen exhibited favorable results, with a positive response in six of 13 patients (46.2%). Cumulative analysis findings were comparable. Regarding the timing of third-line CAB administration, 15 patients had started at a PSA equal to or less than 4.0 ng/ml, and eight of them (53.3%) showed a positive response to treatment, compared to only three of 37 patients (8.1%) whose PSA at the initiation of third-line therapy was higher than 4.0 ng/ml (p<0.001). We conclude that third-line CAB with nonsteroidal antiandrogen would be particularly useful for patients whose cancer progressed after second-line CAB with steroidal antiandrogen. The timing of treatment seems to be important because the higher the PSA at the start of third-line therapy, the lower the PSA response rate.

악성 폐쇄성 황달 환자에 있어서 간문에 대한 방사선치료의 역할 (The Role of Porta Hepatis Irradiation in Relieving Malignant Obstructive Jaundice)

  • 양광모;서현숙
    • Radiation Oncology Journal
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    • 제8권1호
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    • pp.79-84
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    • 1990
  • 1984년부터 1988년까지 인제대학교 의과대학 치료방사선과에서 전이성 암에의해 발생한 악성 폐쇄성 황달환자 13명을 대상으로 간문을 포함하는 국소방사선치료를 시행하였다. 총 3명의 환자중 추적가능한 7명은 표준 방사선 조사야에 2.6주에서 6주 동안에 걸쳐 $2600\~5480$cGy의 방사선 조사를 받았으며 이중 5명은 완전관해, 1명은 부분 관해를 보여주었다. 전체 13명의 환자에서의 평균 생존기간은 3개월 이었으며 7명의 추적가능한 환자에서는 10.5개월이었다. 완전 관해를 보인 환자 5명중 2명은 황달의 재발없이 1년 이상의 생존기간을 보여주었다. 따라서 간문의 전이성 암으로 인해 발생한 악성 폐쇄성 황달 환자에 있어서 간문을 포함하는 조사야의 국소적 방사선 치료는 황달 해소와 증상완화에 많은 도움을 줄 수 있는 것으로 생각된다.

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Relationship between Functional Fitness and Break Response in Elderly Drivers: Comparison with Young Driver

  • Kim, Ga Eun;Choi, Ye Eun;Yang, Su Seong;Kim, Sun A;Bae, Young Sook
    • The Journal of Korean Physical Therapy
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    • 제30권5호
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    • pp.187-192
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    • 2018
  • Purpose: This study compared the functional fitness and brake response of elderly and young drivers to confirm the correlation between the functional fitness and brake response. Methods: This study was a cross sectional observational design. Older drivers (>65age, n=21) and young adult drivers (20-40aged, n=20) were enrolled as subjects. The functional fitness of the subjects was measured using a senior fitness test consisting of a back scratch (BS), chair sit and reach (CSR), arm curl (AC), chair stand up (CSU), foot up and go (8-FUG), and 2-minute step (2-MS). The brake response used the virtual driving simulator to measure the brake reaction time (BRT) and braking distance (BD) according to the pedestrian protection and traffic signal compliance. Results: The older drivers had a lower BS (p<0.000), CSU (p=0.040), and 8-FUG (p=0.011) than the young adult drivers. BS and 8-FUG showed a significant positive correlation with the BRT and BD of pedestrian protection and traffic signal compliance. CSU showed a significant negative correlation with the BRT of pedestrian protection and traffic signal compliance. Conclusion: These findings suggest that the flexibility of the upper extremity, lower extremity strength, and agility are strongly correlated with the driving performance of elderly drivers.

The response of thrombosis in the portal vein or hepatic vein in hepatocellular carcinoma to radiation therapy

  • Bae, Bong Kyung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • 제34권3호
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    • pp.168-176
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    • 2016
  • Purpose: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results: The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion: RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.