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Concurrent Chemoradiotherapy in Locally Advanced Carcinoma of the Uterine Cervix Preliminary Results of Phases III Prospective Randomized Trial
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Young Seok Kim, Eun Kyung Choi, Jong Hoon Kim, Seung Do Ahn, Sang Wook Lee, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Jung Eun Mok, Joo Hyun Nam
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Cancer Res Treat. 2002;34(3):191-197. Published online June 30, 2002
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DOI: https://doi.org/10.4143/crt.2002.34.3.191
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 Abstract
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- PURPOSE
A prospective, randomized phase III, clinical trial was performed to assess treatment related acute toxicity, early response and survival difference, between a monthly 5-FU cisplatin, and a weekly cisplatin group alone, for concurrent chemoradiotherapy in the locally advanced uterine cervical carcinoma patients.
MATERIALS AND METGODS: Between March 1998 and March 2000, 35 patients, with locally advanced (FIGO stage IIB to IVA) cervical carcinoma, were studied, but 5 patients were excluded inform the analysis due to their refusal of treatment. The patients were randomly assigned to 'monthly 5-FU cisplatin' (arm I), or 'weekly cisplatin' (arm II), groups. The patients of arm I received 5-FU cisplatin (5-FU 1,000 mg/m2/day cisplatin 20 mg/m2/day, IV continuous infusion, for 5 days, 3 cycles with 4-week intervals) with radiation therapy. Those of arm II received only cisplatin (cisplatin 30 mg/m2/day, IV bolus, 6 cycles with 1-week intervals) with radiation therapy. The radiation therapy consisted of external beam irradiation of 41.4~50.4 Gy/23~28 fractions, and high dose rate intracavitary treatments, delivering a dose of 30~35 Gy to point A in 6~7 fractions.
During intracavitary radiation, a parametrial boost was delivered for a point B dose of 60 Gy in the non-thickened side, and 65 Gy in the thickened side. Treatment related acute toxicities were assessed using Radiation Therapy Oncology Group (RTOG) acute morbidity scoring criteria. The response to treatment, and survival, were analyzed. The median follow-up period was 19 months.
RESULTS
The FIGO stage distributions of arm I (n=16) and arm II (n=14) were as follows; IIB 10, IIIA 1, IIIB 4, IVA 1 in arm I, 12, 0, 1 and 1 in arm II respectively. The compliance of both arms were 80.0% and 93.3%, respectively (p=0.37). During radiation therapy, the incidences of leukopenia, greater than RTOG grade 2, were 25.0%, 14.3%, respectively. There were no patients with gastrointestinal or genitourinary toxicity greater than RTOG grade 2. The complete response rates at 3 months, following radiation therapy, were 87.5% and 92.9% respectively. Two-year disease free survival rates were 81.3%, 85.7%, respectively, for each arms.
CONCLUSION
There was no significant difference in response to treatment, or patterns of failure, between the monthly FP and weekly cisplatin arms. Although there were no statistically significant differences, the patients of the weekly cisplatin arm had better compliance. More patients, and a longer follow up, are needed for improved evaluation of the regimen.
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Bcl-2 Expression in Endometrial Hyperplasia and Carcinoma
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Jong Hyeok Kim, Chang Won Koh, Joor Yung Huh, Bong Hee Kim, Hun Sik Kong, Jun Hee Na, Yong Nam Kim, Young Tak Kim, Joo Hyun Nam
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J Korean Cancer Assoc. 1998;30(6):1207-1218.
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Abstract
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- PURPOSE
To speculate the role of bcl-2 protooncogene in endometrial carcinogenesis by determination of the expression of bcl-2 in endometrial hyperplasia and carcinoma.
MATERIALS AND METHODS
We studied bcl-2 expression by an immunohistochemical method in the paraffin-embedded blocks of 78 patients with endometrial hyperplasia, 64 with simple hyperpasia, 9 with complex hyperplasia and 5 with atypical hyperplasia respectively, and 33 endometrial carcinoma treated at Asan Medical Center from June, 1989 to May, 1997.
Intensity of bcl-2 staining was scored on a scale of 0 to 4, calibrated by comparison with stromal lymphocytes, which always received a score of 4.
RESULTS
The results of this study showed that bcl-2 was relatively highly expressed in simple (n= 64), complex (n=9) and atypical hyperplasias (n=5) with mean staining scores of 2.95+/-1.09 (Mean+Standard Deviation), 2.78+/-1.20 and 3.60+/-0.89 respectively, which showed no difference among histologic types. In endometrial carcinoma, the expression of bcl-2 was significantly down regulated (mean score=1.76+/-1.35) compared with that of hyperplasia, and did not conelate with FIGO surgical stage. However, grade III tumor showed significantly lower expression that grade I or II tumor.
CONCLUSION
Bcl-2 expression is down regulated in endometrial carcinoma than endo- metrial hyperplasia, and correlates with tumor grade, which suggest that bcl-2 expression might be the result of carcinogenesis or bcl-2 plays only an adjunctive role in the endometrial carcinogenesis.
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Everamplification of GER-2/neu Oncogene Detected by Differential PCR and its Prognostic Significance in Advanced Epithelial Ovarian Cancer
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Sang Soo Lee, Jong Hyok Kim, Chang Won Ko, Joon Hee Na, Yong Man Kim, Young Tak Kim, Joo Hyun Nam, Jung Eun Mok
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J Korean Cancer Assoc. 1998;30(4):752-761.
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Abstract
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- PURPOSE
S: The objectives of this study were to investigate the prevalence of HER-2/neu oncogene amplification by differential polymerase chain reaction and to examine whether HER-2/neu oncogene overamplification has any prognostic significance in advanced epithelial ovarial cancer patients.
MATERIALS AND METHODS
The study population comprised thirty patients with stage III or IV epithelial ovarian cancer who were managed at Asan Medical Center between January 1994 and December 1996. Fresh frozen tumor samples of primary lesion were analysed by differential polymerase chain reaction to assess amplification of HER-2/neu oncogene. The correlation between HER-2/neu oncogene overamplification and histologic subtype or tumor grade or serum CA 125 level after second chemotherapy were evaluated using chi-square test, and for survival analysis, Kaplan-Meier curves were plotted and the differences between the curves were tested for significance using Log-rank test.
RESULTS
HER-2/neu oncogene was amplified in all of the cases (100% 30/30), but significant overamplification [gene copy number > or =1.5 a.u.(arbitrary unit)] was observed in 46.7% (14/30). There was no significant correlation between HER-2/neu oncogene overamplification and histologic subtype or tumor grade or serum CA 125 level after second chemotherapy and there was no correlation between HER-2/neu oncogene overamplification and overall survival.
CONCLUSION
The prevalence of HER-2/neu oncogene overamplification is 46.7%, but it may not be a significant prognostic factor in advanced epithelial ovarian cancers.
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Urinary Gonadotropin Fragment ( UGF ) Measurements , Its Efficacy in Patients with Gynecologic and Various Malignancies
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Joo Hyun Nam, Jong Hyeok Kim, Sang Yoong Park, Roger Walker, Laurence A Cole
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J Korean Cancer Assoc. 1998;30(3):561-572.
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Abstract
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- No abstract available.
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