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Outcomes of Treatment for Malignant Peripheral Nerve Sheath Tumors: Different Clinical Features Associated with Neurofibromatosis Type 1
In Kyung Hwang, Seung Min Hahn, Hyo Sun Kim, Sang Kyum Kim, Hyo Song Kim, Kyoo‑Ho Shin, Chang Ok Suh, Chuhl Joo Lyu, Jung Woo Han
Cancer Res Treat. 2017;49(3):717-726.   Published online December 1, 2016
DOI: https://doi.org/10.4143/crt.2016.271
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Malignant peripheral nerve sheath tumors (MPNSTs) are a rare subtype of sarcoma that occur spontaneously or in association with neurofibromatosis type 1 (NF-1). This study aimed to clinically differentiate these types of MPNSTs.
Materials and Methods
The study reviewed 95 patients diagnosed with and treated for MPNST at Yonsei University Health System, Seoul, Korea over a 27-year period. The clinical characteristics, prognostic factors, and treatment outcomes of sporadic MPNST (sMPNST) and NF-1 associated MPNST (NF-MPNST) cases were compared.
Results
Patients with NF-MPNST had a significantly lower median age (32 years vs. 45 years for sMPNST, p=0.012), significantly larger median tumor size (8.2 cm vs. 5.0 cm for sMPNST, p < 0.001), and significantly larger numbers of imaging studies and surgeries (p=0.004 and p < 0.001, respectively). The 10-year overall survival (OS) rate of the patients with MPNST was 52±6%. Among the patients with localized MPNST, patients with NF-MPNST had a significantly lower 10-year OS rate (45±11% vs. 60±8% for sMPNST, p=0.046). Univariate analysis revealed the resection margin, pathology grade, and metastasis to be significant factors affecting the OS (p=0.001, p=0.020, and p < 0.001, respectively). Multivariate analysis of the patients with localized MPNST identified R2 resection and G1 as significant prognostic factors for OS.
Conclusion
NF-MPNST has different clinical features from sMPNST and requires more careful management. Further study will be needed to develop specific management plans for NF-MPNST.

Citations

Citations to this article as recorded by  
  • Survival outcomes of malignant peripheral nerve sheath tumors (MPNSTs) with and without neurofibromatosis type I (NF1): a meta-analysis
    Zhixue Lim, Tian Yuan Gu, Bee Choo Tai, Mark Edward Puhaindran
    World Journal of Surgical Oncology.2024;[Epub]     CrossRef
  • Malignant Peripheral Nerve Sheath Tumor, a Heterogeneous, Aggressive Cancer with Diverse Biomarkers and No Targeted Standard of Care: Review of the Literature and Ongoing Investigational Agents
    Neeta Somaiah, Bishnuhari Paudyal, Robert E. Winkler, Brian A. Van Tine, Angela C. Hirbe
    Targeted Oncology.2024; 19(5): 665.     CrossRef
  • Hemoperitoneo secundario a tumor maligno de la vaina del nervio periférico en hígado
    Siomara Aransuzú Chávez-Sánchez, Álvaro Bellido-Caparó, Guido Saúl Gallegos-Serruto, Víctor Manuel Vásquez Morales, Mercedes Del Pilar Bravo-Taxa, Carlos Aurelio García-Encinas
    Revista de Gastroenterología del Perú.2024;[Epub]     CrossRef
  • Unraveling neuronal and metabolic alterations in neurofibromatosis type 1
    Valentina Botero, Seth M. Tomchik
    Journal of Neurodevelopmental Disorders.2024;[Epub]     CrossRef
  • The Multimodality Management of Malignant Peripheral Nerve Sheath Tumours
    Remus Seres, Hassan Hameed, Martin G. McCabe, David Russell, Alexander T. J. Lee
    Cancers.2024; 16(19): 3266.     CrossRef
  • Malignant peripheral nerve sheath tumor mimicking carotid body tumor, a rare case report and review of literature
    Pezhman Kharazm, Soheil Noruzi, Alireza Aghili, Ali Zarbakhsh, Ramin Azarhoosh, Fereshteh Maghsudloo
    International Journal of Surgery Case Reports.2024; 124: 110406.     CrossRef
  • Perioperative Observations and Outcome in Surgical Treatment of Malignant Peripheral Nerve Sheath Tumors
    Julian Zipfel, Jonas Tellermann, Kevin Paul Ferraris, Florian Grimm, Antje Bornemann, Benjamin Bender, Helmut Dittmann, Jürgen Schäfer, Konstantin Nikolaou, Ruth Ladurner, Volker Steger, Marcos Tatagiba, Martin U. Schuhmann, Isabel Gugel
    Cancers.2024; 16(22): 3757.     CrossRef
  • Malignant peripheral nerve sheath tumor in children: A clinicopathologic and molecular study with parallels to the adult counterpart
    Narasimhan P. Agaram, Leonard H. Wexler, Ping Chi, Cristina R. Antonescu
    Genes, Chromosomes and Cancer.2023; 62(3): 131.     CrossRef
  • Results of surgical treatment of patients with malignant peripheral nerve sheath tumors: a retrospective and prospective study
    Adil T. Abdulzhaliev, Evgeny A. Sushentsov, Irena V. Boulytcheva, Anastasia I. Senderovich, Maxim P. Nikulin, Denis I. Sofronov, Vladislav E. Bugaev
    Journal of Modern Oncology.2023; 24(4): 446.     CrossRef
  • Modeling human cancer predisposition syndromes using CRISPR/Cas9 in human cell line models
    Garrett M. Draper, Daniel J. Panken, David A. Largaespada
    Genes, Chromosomes and Cancer.2023; 62(9): 493.     CrossRef
  • Survival analysis of malignant peripheral nerve sheath tumor: Experience of a tertiary center in Taiwan
    Yu-Wei Chang, Wen-Chieh Liao
    Journal of the Chinese Medical Association.2023; 86(6): 584.     CrossRef
  • Management of Central and Peripheral Nervous System Tumors in Patients with Neurofibromatosis
    Rebecca Brown
    Current Oncology Reports.2023; 25(12): 1409.     CrossRef
  • Benign Retroperitoneal Schwannoma with Liver Metastasis: An Unusual Presentation
    Meraj Ahmed, B. G. Vageesh, Anil K. Agarwal, Manish Sharma
    International Journal of Advanced Medical and Health Research.2023; 10(2): 115.     CrossRef
  • An isolated colonic neurofibroma: A rare colonic neoplasm. Case report with clinicopathologic features and review of literature
    Mukund Tinguria
    Human Pathology Reports.2022; 28: 300650.     CrossRef
  • Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck
    Carlos Suárez, Fernando López, Juan P. Rodrigo, William M. Mendenhall, Remco de Bree, Antti A. Mäkitie, Vincent Vander Poorten, Robert P. Takes, Stefano Bondi, Luiz P. Kowalski, Ashok R. Shaha, Veronica Fernández-Alvarez, Julio C. Gutiérrez, Nina Zidar, C
    Advances in Therapy.2022; 39(8): 3449.     CrossRef
  • Solitary and complicated neurofibroma of small Bowel: A case report
    Hassane Ait Ali, Brahim Zeriouh, Usman Egyir Ebo, Badr Serji, Tijani Elharroudi
    International Journal of Surgery Case Reports.2021; 78: 126.     CrossRef
  • Management of sarcomas in children, adolescents and adults: Interactions in two different age groups under the umbrellas of GSF-GETO and SFCE, with the support of the NETSARC+ network
    Emmanuelle Bompas, Valentine Martin, Fatima Meniai, Maud Toulmonde, Perrine Marec-Berard, Line Claude, Françoise Ducimetiere, Cyrus Chargari, Véronique Minard-Colin, Nadège Corradini, Valérie Laurence, Sophie Piperno-Neumann, Anne-Sophie Defachelles, Valé
    Bulletin du Cancer.2021; 108(2): 163.     CrossRef
  • Malignant Peripheral Nerve Sheath Tumor Presenting as Horner′s Syndrome
    Mohamed Azharudeen, Jayachandran Selvaraj, Vivekanandan Pillai, Jeyakumar Meyyappan, Vamsidhar Veeranki
    Cureus.2021;[Epub]     CrossRef
  • Survival and NF1 Analysis in a Cohort of Orthopedics Patients with Malignant Peripheral Nerve Sheath Tumors
    Daniel K. Knewitz, Colin J. Anderson, William T. Presley, MaryBeth Horodyski, Mark T. Scarborough, Margaret R. Wallace, Kanya Honoki
    Sarcoma.2021; 2021: 1.     CrossRef
  • The impact of host immune cells on the development of neurofibromatosis type 1: The abnormal immune system provides an immune microenvironment for tumorigenesis
    Cheng-Jiang Wei, Shu-Chen Gu, Jie-Yi Ren, Yi-Hui Gu, Xiang-Wen Xu, Xin Chou, Xiang Lian, Xin Huang, Hai-Zhou Li, Ya-Shan Gao, Bin Gu, Tao Zan, Zhi-Chao Wang, Qing-Feng Li
    Neuro-Oncology Advances.2020; 2(Supplement): i33.     CrossRef
  • Establishment and characterization of patient-derived cancer models of malignant peripheral nerve sheath tumors
    Rieko Oyama, Fusako Kito, Mami Takahashi, Emi Hattori, Rei Noguchi, Yoko Takai, Marimu Sakumoto, Zhiwei Qiao, Shunichi Toki, Masato Sugawara, Yoshikazu Tanzawa, Eisuke Kobayashi, Fumihiko Nakatani, Shintaro Iwata, Akihiko Yoshida, Akira Kawai, Tadashi Kon
    Cancer Cell International.2020;[Epub]     CrossRef
  • Sporadic neurofibroma of transverse colon in a patient without neurofibromatosis type 1: A case report
    Toru Imagami, Saburo Sugita, Takaya Nagasaki, Masahiro Kimura, Keisuke Ito, Shingo Inaguma
    International Journal of Surgery Case Reports.2020; 71: 19.     CrossRef
  • Isolated colonic neurofibroma, a rare tumor: A case report and review of literature
    Sara Ghoneim, Sonia Sandhu, Dalbir Sandhu
    World Journal of Clinical Cases.2020; 8(10): 1932.     CrossRef
  • Diagnosis and management of malignant peripheral nerve sheath tumors: Current practice and future perspectives
    Bethany C Prudner, Tyler Ball, Richa Rathore, Angela C Hirbe
    Neuro-Oncology Advances.2020; 2(Supplement): i40.     CrossRef
  • Computed Tomography–Based Differentiation of Benign and Malignant Craniofacial Lesions in Neurofibromatosis Type I Patients: A Machine Learning Approach
    Cheng-Jiang Wei, Cheng Yan, Yan Tang, Wei Wang, Yi-Hui Gu, Jie-Yi Ren, Xi-Wei Cui, Xiang Lian, Jin Liu, Hui-Jing Wang, Bin Gu, Tao Zan, Qing-Feng Li, Zhi-Chao Wang
    Frontiers in Oncology.2020;[Epub]     CrossRef
  • Prognosis and risk factors for malignant peripheral nerve sheath tumor: a systematic review and meta-analysis
    Zhenyu Cai, Xiaodong Tang, Haijie Liang, Rongli Yang, Taiqiang Yan, Wei Guo
    World Journal of Surgical Oncology.2020;[Epub]     CrossRef
  • RABL6A Is an Essential Driver of MPNSTs that Negatively Regulates the RB1 Pathway and Sensitizes Tumor Cells to CDK4/6 Inhibitors
    Jordan L. Kohlmeyer, Courtney A. Kaemmer, Casey Pulliam, Chandra K. Maharjan, Allison Moreno Samayoa, Heather J. Major, Kendall E. Cornick, Vickie Knepper-Adrian, Rajesh Khanna, Jessica C. Sieren, Mariah R. Leidinger, David K. Meyerholz, K.D. Zamba, Jill
    Clinical Cancer Research.2020; 26(12): 2997.     CrossRef
  • Treatment and survival differences across tumor sites in malignant peripheral nerve sheath tumors: a SEER database analysis and review of the literature
    Enrico Martin, Ivo S Muskens, J H Coert, Timothy R Smith, Marike L D Broekman
    Neuro-Oncology Practice.2019; 6(2): 134.     CrossRef
  • Superficial malignant peripheral nerve sheath tumor from recurrent neurofibroma in the abdominal wall of a patient without neurofibromatosis type 1
    Chang Yeon Jung, Jung Min Bae, Joon Hyuk Choi, Ki Hoon Jung
    Yeungnam University Journal of Medicine.2019; 36(1): 63.     CrossRef
  • How Effective Are Noninvasive Tests for Diagnosing Malignant Peripheral Nerve Sheath Tumors in Patients with Neurofibromatosis Type 1? Diagnosing MPNST in NF1 Patients
    Maria Schwabe, Stanislav Spiridonov, Elizabeth L. Yanik, Jack W. Jennings, Travis Hillen, Maria Ponisio, Douglas J. McDonald, Farrokh Dehdashti, Cara A. Cipriano
    Sarcoma.2019; 2019: 1.     CrossRef
  • Malignant peripheral nerve‑sheath tumors in an adolescent patient with mosaic localized NF1: A case report
    Hiroki Hagizawa, Shigenori Nagata, Toru Wakamatsu, Yoshinori Imura, Takaaki Tanaka, Hidetatsu Outani, Eiichi Konishi, Norifumi Naka, Hironari Tamiya
    Molecular and Clinical Oncology.2019;[Epub]     CrossRef
  • Racial/ethnic disparities and incidence of malignant peripheral nerve sheath tumors: results from the Surveillance, Epidemiology, and End Results Program, 2000–2014
    Erin C. Peckham-Gregory, Roberto E. Montenegro, David A. Stevenson, David H. Viskochil, Michael E. Scheurer, Philip J. Lupo, Joshua D. Schiffman
    Journal of Neuro-Oncology.2018; 139(1): 69.     CrossRef
  • Retroperitoneal malignant schwannoma in a child
    Jun Wang, Mingming Yu, Haobo Zhu, Liqu Huang, Xiaojiang Zhu, Chenjun Chen, Yaqi Shi, Geng Ma, Yunfei Guo, Zhongqin Yu
    Journal of International Medical Research.2018; 46(10): 4315.     CrossRef
  • Spectrum of gastrointestinal lesions of neurofibromatosis type 1: a pictorial review
    Nada Garrouche, Amel Ben Abdallah, Nadia Arifa, Ibtissem Hasni, Yasser Ben Cheikh, Waad Ben Farhat, Sana Ben Amor, Hela Jemni
    Insights into Imaging.2018; 9(5): 661.     CrossRef
  • Malignant peripheral nerve sheath tumor in children: A single-institute retrospective analysis
    Hong Yul An, Kyung Taek Hong, Hyoung Jin Kang, Jung Yoon Choi, CheRy Hong, Hyun-young Kim, Tae Hyun Choi, Chang Hyun Kang, Han-Soo Kim, Jung-Eun Cheon, Sung-Hye Park, June Dong Park, Kyung Duk Park, Hee Young Shin
    Pediatric Hematology and Oncology.2017; 34(8): 468.     CrossRef
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Efficacy of Postoperative Concurrent Chemoradiation for Resectable Rectal Cancer: A Single Institute Experience
Joong Bae Ahn, Hee Chul Chung, Nae Choon Yoo, Jae Kyung Roh, Nam Kyu Kim, Chang Ok Suh, Gwi Eon Kim, Jin Sil Seong, Woong Ho Shim, Hyun Cheol Chung
Cancer Res Treat. 2004;36(4):228-234.   Published online August 31, 2004
DOI: https://doi.org/10.4143/crt.2004.36.4.228
AbstractAbstract PDFPubReaderePub
Purpose

For patients with Dukes' stage B and C rectal cancer, surgery followed by adjuvant chemoradiotherapy is considered to be the standard treatment. However, the drugs used in combination with 5-fluorouracil (5-FU), the method of administration, duration of adjuvant therapy and the frequencies of administration presently remain controversial topics. We investigated (1) the efficacy and safety of adjuvant radiotherapy and 5-FU/leucovorin (LV) chemotherapy for patients who had undergone curative resection and (2) the effect of dose related factors of 5-FU on survival.

Materials and Methods

130 rectal cancer patients with Dukes' B or C stage disease who were treated with curative resection were evaluated. The adjuvant therapy consisted of two cycles of 5-FU/LV chemotherapy followed by pelvic radiotherapy with chemotherapy, and then 4~10 more cycles of the same chemotherapy regimen were delivered based on the disease stage. The cumulative dose of 5-FU per body square meter (BSA), actual dose intensity and relative dose intensity were obtained. The patients were divided into two groups according to the median value of each factor, and the patients' survival rates were compared.

Results

With a median follow-up duration of 52 months, the 5-year disease-free survival and overall survival rates of 130 patients were 57% and 73%, respectively. Locoregional failure occurred in 17 (13%) of the 130 patients, and the distant failure rate was 27% (35/130). The chemotherapy related morbidity was minimal, and there was no mortality for these patients. The cumulative dose of 5-FU/BSA had a significant effect on the 5-year overall survival for Dukes' C rectal cancer patients (p=0.03). Multivariate analysis demonstrated that only the performance status affected the 5-year overall survival (p=0.003).

Conclusion

An adjuvant therapy of radiotherapy and 5-FU/LV chemotherapy is effective and tolerable for Dukes' B and C rectal cancer patients. A prospective, multicenter, randomized study to evaluate the effects of the cumulative dose of 5-FU/BSA on survival is required.

Citations

Citations to this article as recorded by  
  • Seven low-mass ions in pretreatment serum as potential predictive markers of the chemoradiotherapy response of rectal cancer
    Kangsan Roh, Seung-Gu Yeo, Byong Chul Yoo, Kyung-Hee Kim, Sun Young Kim, Min-Jeong Kim
    Anti-Cancer Drugs.2016; 27(8): 787.     CrossRef
  • A 19-Gene expression signature as a predictor of survival in colorectal cancer
    Nurul Ainin Abdul Aziz, Norfilza M. Mokhtar, Roslan Harun, Md Manir Hossain Mollah, Isa Mohamed Rose, Ismail Sagap, Azmi Mohd Tamil, Wan Zurinah Wan Ngah, Rahman Jamal
    BMC Medical Genomics.2016;[Epub]     CrossRef
  • Safety of Early Chemotherapy after a Laparoscopic Colorectal Cancer Resection: A Case-Control Study
    Seung Ho Shin, Sun-Il Lee, Dong-Jin Choi, Si-Uk Woo, Jin Kim, Byung-Wook Min, Hong-Young Moon, Seon Hahn Kim
    Journal of the Korean Society of Coloproctology.2009; 25(6): 429.     CrossRef
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Paclitaxel and Cisplatin Combination Chemotherapy in Pretreated Breast Cancer
Joo Hyuk Sohn, Yong Tai Kim, Sun Young Rha, Nae Choon Yoo, Jae Kyung Roh, Byung Soo Kim, Chang Ok Suh, Gwi Eon Kim, Woo Ick Jang, Hyun Cheol Chung
Cancer Res Treat. 2003;35(3):267-273.   Published online June 30, 2003
DOI: https://doi.org/10.4143/crt.2003.35.3.267
AbstractAbstract PDF
PURPOSE
A single institute trial of combination chemotherapy, with paclitaxel and cisplatin, in patients with metastatic breast cancer, having failed previous combination chemotherapy, was performed. MATERIALS AND METHODS: Patients were only eligible for this study if there disease had progressed, following treatment with previous chemotherapy, in either an adjuvant or a metastatic setting. Paclitaxel 175 mg/m2 was administered as a 3-hour continuous infusion on day 1, and cisplatin 80 mg/m2 was administered for 2 hours on day 2, with adequate hydration. This was repeated every 3 weeks, and continued until one of the following events occurred: disease progression, unacceptable adverse effect or treatment refusal by the patient. Intercurrent palliative radiotherapy, or concurrent hormonal therapy, was permitted, depending on each patient's status. All the endpoints were evaluated under the principle of intention to treat analysis. RESULTS: A total of 24 patients entered the study, and 18 had at least one measurable lesion, but 6 did not. The objective response rate of the 18 patients was 50%(9/18). Two were complete responses and seven showed partial responses. The median response duration, progression free and overall survival were 5.3 months (range, 4~18), 6 months (95% CI, 5~7) and 12 months (95% CI, 7~17), respectively. 67% of the planned dose was administered. Out of a total 135 cycles administered, about 20% of cycles showed grade 3 or 4 leukopenia and 7% showed grade 3 thrombocytopenia. Two patients suffered from pneumonia, and one experienced neutropenic fever. Mucositis, greater than grade 3, existed in three cases. No treatment related deaths were reported. CONCLUSION: The combination chemotherapy, with paclitaxel and cisplatin, was active in the treatment of metastatic breast cancer patients having failed previous chemotherapy.

Citations

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  • Cisplatin in Ovarian Cancer Treatment—Known Limitations in Therapy Force New Solutions
    Aleksandra Zoń, Ilona Bednarek
    International Journal of Molecular Sciences.2023; 24(8): 7585.     CrossRef
  • Fever and breast cancer: A critical review of the literature and possible underlying mechanisms
    Shiva Mehran, Afshin Taravati, Esfandiar Baljani, Yousef Rasmi, Zafar Gholinejad
    Breast Disease.2021; 40(3): 117.     CrossRef
  • 3D Collagen Vascular Tumor-on-a-Chip Mimetics for Dynamic Combinatorial Drug Screening
    Li Wan, Jun Yin, John Skoko, Russell Schwartz, Mei Zhang, Philip R. LeDuc, Carola A. Neumann
    Molecular Cancer Therapeutics.2021; 20(6): 1210.     CrossRef
  • A New and Integral Approach to the Etiopathogenesis and Treatment of Breast Cancer Based upon Its Hydrogen Ion Dynamics
    Salvador Harguindey, Khalid Alfarouk, Julián Polo Orozco, Kévin Hardonnière, Daniel Stanciu, Stefano Fais, Jesús Devesa
    International Journal of Molecular Sciences.2020; 21(3): 1110.     CrossRef
  • Towards an Integral Therapeutic Protocol for Breast Cancer Based upon the New H+-Centered Anticancer Paradigm of the Late Post-Warburg Era
    Salvador Harguindey, Khalid Alfarouk, Julián Polo Orozco, Stefano Fais, Jesús Devesa
    International Journal of Molecular Sciences.2020; 21(20): 7475.     CrossRef
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Results of Definitive Radiation Therapy in Adenosquamous Cell Carcinoma of the Uterine Cervix
Sang Wook Lee, Chang Ok Suh, Eun Ji Chung, Gwi Eon Kim, Kyung Ran Park, Kang Kyoo Lee, Ik Jae Lee, Tchan Kyu Park, Jaewook Kim, Jong Taek Park, Jae Uk Shim, Joon Oh Park
J Korean Cancer Assoc. 2001;33(1):21-26.
AbstractAbstract PDF
PURPOSE
To define the clinical features and pattern of failure and to evaluate the results of radiation treatment in of adenosquamous cell carcinoma of the uterine cervix.
MATERIALS AND METHODS
From Jun. 1981 to Dec. 1997, 43 patients with adenosquamous cell carcinoma of the uterine cervix were retrospectively analyzed external radiation treatment and HDR-ICR from Yonsei cancer center and Wonju cristian hospital. The median age was 51. Stage distribution according to FIGO were stage 1b in 10, 2a in 5, 2b in 18, 3b in 9, 4a in 1. Median follow-up period was 41 months.
RESULTS
Overall survival rate and disease free survival rate were 57.2% and 60.2%. Complete response rate was 86.0%. Locoregional failure was observed in seven patients.
CONCLUSION
Major pattern of failure was locoregional failure. Adenosquamous cell carcinoma was not more aggressive than other pathologic types.
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Clinical Significance of Apoptosis and p53 Protein Expression in Stage IIB Squamous Cell Carcinoma of the Cervix Treated with Radiotherapy Alone
Eun Ji Chung, Gwi Eon Kim, Jinsil Seong, Woo Ick Yang, Young Tae Kim, Chang Ok Suh
J Korean Cancer Assoc. 2000;32(3):638-646.
AbstractAbstract PDF
PURPOSE
The purpose was to investigate the spontaneous apoptotic index (SAI) and p53 protein expression and to identify the role of SAI and p53 protein positivity.
MATERIALS AND METHODS
Forty six patients with squamous cell carcinoma of the cervix, FIGO stage IIB, treated with curative radiotherapy alone between 1990 and 1993 were included in this study. Definitive radiotherapy including external beam and high-dose-rate brachytherapy was given. Pretreatment paraffin-embedded biopsy specimens of those patients were scored for apoptosis and p53 protein expression using mouse mondegrees Clonal antibody (DO-7) by immuno staining. Clinicopathologic characteristics were also studied in relation to SAI and p53 protein expression, and as prognostic factors for clinical outcome.
RESULTS
SAI and p53 were not related to any clinical characteristics. The range of the SAI was 0.2~4.7% (median 1.1%, mean 1.5%). The rate of p53 protein expression was 65.2% (30/46). Patients whose tumors had high SAI and low p53 protein positivity had better treatment outcome than those with lower SAI. There was also a significant correlation between the SAI and p53 protein expression.
CONCLUSION
The pretreatment SAI and p53 oncoprotein expression are clinically useful in predicting the clinical outcome of FIGO stage IIB squamous cell carcinoma of the uterine cervix patients treated with definitive radiotherapy.
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Efficacy of Local Radiotherapy as a Salvage Modality for Hepatocellular Carcinoma Which is Refractory to TACE ( Transcatheter Arterial Chemoembolization )
Hee Chul Park, Jinsil Seong, John Jihoon Lim, Gwi Eon Kim, Kwang Hyub Han, Chae Yoon Chon, Young Myoung Moon, Do Yun Lee, Jong Tae Lee, Chang Ok Suh
J Korean Cancer Assoc. 2000;32(1):220-228.
AbstractAbstract
PURPOSE
Transcatheter arterial chemoembolization (TACE) has been actively performed for the treatment of unresectable or inoperable hepatocellular carcinoma. However, for the patients with treatment failure after TACE, few options are available for salvage. The purpose of this study was to investigate the efficacy of local radiotherapy as a salvage moda- lity for treatment failure after TACE.
MATERIALS AND METHODS
From January 1993 to December 1997, 27 patients were included in this study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Childs class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Mean tumor size was 7.2+/- 2.9 cm. Liver cirrhosis was associated in 10 patients. Portal vein thrombosis was presented in 5 patients. Serum alpha-fetoprotein was positive in 8 patients. According to VICC staging, the number of patients in III and IVA were 17 and 10, respectively. Treatment failure to TACE was evaluated by CT scan and angiography. Radiotherapy was given to the field including tumor with generous margin using 10-MV X-ray. Mean tumor dose was 51.8+-7.9 Gy in daily 1.8 Gy fractions. Tumor response was based on CT scans 4~6 weeks following completion of treatment.
RESULTS
An objective response was observed in 16 of 24 patients who were possible to be evaluated, giving a response rate of 66.7%. Survival rates after salvage radiotherapy at 1, 2, 3 years were 55.9%, 35.7%, and 21.4%, respectively. The median survival was 14 months. Six patients among responders are surviving at present. Acute toxicity included G1 elevation of AST/ALT in 4 patients, G2 thrombocytopenia in 2, G2 hyperbilirubinemia in 5, and G2 hypoalbuminemia in 3. During follow-up, 4 patients developed ascites. At 6 months after treatment, gastric ulcers and duodenal ulcer were developed in 2 and 1 patient, respectively.
CONCLUSION
Local radiotherapy for treatment failure after TACE in hepatocellular carci- noma appears to be a feasible and effective salvage modality. It gives a 66.7% response rate with a median survival of 14 months. Acute toxicity was self-limiting and manageable. Gastric and duodenal ulcer were significant toxicities after treatment. Further studies are required to find optimal methods of radiotherapy to minimize toxicity.
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Strain - Specific Differences in Radiation - Induced Apoptosis in Murine Tissues
Jinsil Seong, Sung Hee Kim, Won Jae Lee, Chang Ok Suh, Jin Sik Min
J Korean Cancer Assoc. 1998;30(6):1259-1268.
AbstractAbstract PDF
PURPOSE
To characterize strain-specific differences in radiation response in murine tissues with different radiosensitivity.
MATERIALS AND METHODS
Six-week old male mice of 2 strains, C57Bl/6J and C3H/HeJ, were given whole body gamma-radiation with a single dose of 10 or 25 Gy. At different times after irradiation, mice were killed and tissues with different radiosensitivity, thymus and liver, were collected. Each tissue sample was stained with hematoxylin and eosin and apoptotic cells were scored. Expression of p53, Bcl-2, Bcl-x, and Bax was analysed by western blotting and densitometry.
RESULTS
Radiation induced massive apoptosis in thymus with a peak level at 8 h after radiation. With 10 Gy irradiation, apoptotic indices in C57Bl/6J and C3H/HeJ were 81.0 2.5% and 59.4 4.0%, respectively (p<0.05). Radiation upregulated the expression of p53, Bcl-x, and Bax, but not Bcl-2; p53 with a peak level of 2.5 fold (C57Bl/6J) and 1.4 fold (C3H/HeJ) at 4 h, Bax with a peak level of 2.6 fold (C57Bl/6J) and 1.3 fold (C3H/HeJ) at 8 h, and Bcl-x with a peak level of 11.1 fold (C57Bl/6J) and 8.2 fold (C3H/HeJ) at 8 h after radiation. In liver, however, radiation-induced apoptosis was minimal (peak apoptotic index of 2.1% in C57Bl/6J and 1.7% in C3H/HeJ). None of p53, Bcl-2, Bcl-x, and Bax was significantly increased.
CONCLUSIONS
Induction of apoptosis and regulation of related genes by radiation were tissue specific. Strain difference of radiation-induced apoptosis was well coupled with theinduction of related genes in thymus, a radiosensitive tissue. This study shows that quantitative difference of radiation induced apoptosis by strain is regulated at the gene level with the involvement of multiple genes.
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Brain Metastasis and Leptomeningeal Carcinomatosis in Breast Cancer
Yoon Soo Chang, Jeong Hun Seo, Ruth Lee, Joong Bae Ahn, Kwang Yong Shim, Soo Jung Gong, Hwa Young Lee, Sun Young Rha, Nae Choon Yoo, Chang Ok Suh, Joo Hang Kim, Jae Kyung Rho, Kyong Sik Lee, Jin Sik Min, Byung Soo Kim, Hyun Cheol Chung
J Korean Cancer Assoc. 1998;30(3):464-474.
AbstractAbstract PDF
PURPOSE
Brain metastasis is estimated to occur in 20 to 40% of cancer patients, and meningeal involvement has been reported in 5% to 8% of cancer patients. Even if the prognosis is grave, standard treatment modality of brain metastasis or leptomeningeal carcinomatosis has not been established. We evaluated the prognosis and the clinical features of the brain and leptomeningeal metastasis of the breast cancer.
MATERIALS AND METHODS
The 43 patients who was diagnosed as brain parenchymal metastasis or leptomeningeal carcinomatosis clinically, radiologically and/or cytologically were included in this study. The median age was 44(range: 27-61) years.
RESULTS
The median duration from brain metastasis to death was 181 days(range: 8~1599), and the median duration from leptomeningeal carcinomatosis to death was 39 days(range: 25~152). Age(p=0.7174) and number of brain metastatic lesion(p=0.4097) did not influence the survival, but the presence of other systemic metastatic lesion affected the survival(p 0.0224). When we compared the survival rates of patients according to treatment modality, the patients with systemic chemotherapy versus patients without systemic chemotherapy showed differences(p= 0.0009). Patients treated with whole brain radiation only versus patients with whole brain radiation and other systemic management also showed different survival rate(p=0.0009). But intrathecal chemotherapy had no effect on survival. Well differentiated, solitary lesions were treated by operation and/or gamma-knife surgery, and their effects were good.
CONCLUSION
Prolongation of survival was suggested with whole brain radiotherapy combined with systemic treatment in brain or leptomeningeal metastasis. Further study is expected to confirm this finding.
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Parasternal Recurrence after Curative Resection of Breast Cancer
Eun Ji Chung, Chang Ok Suh, Won Park, Hy Do Lee, Kyung Shik Lee, Gwi Eon Kim
J Korean Cancer Assoc. 1998;30(2):253-261.
AbstractAbstract PDF
PURPOSE
We tried to find the patients characteristics of parasternal recunence, to classify the parasternal recunence according to the radiological and clinical features, and to evaluate the efficacy of local radiotherapy.
MATERIALS AND METHODS
Between August 1987 and April 1997, twenty one patients with parastemal recurrence of breast cancer after surgery with or without adjuvant chemotherapy were treated with radiotherapy. Age distribution at initial operation was ranged from 31 to 79 years(median 48 years). Sixteen(76.2%) cancers were in the right breast and five(23.8%) were in the left. The pathologic types were infiltrative ductal carcinoma in 18 patients and medullary carcinoma in 3 patients. Eight patients had stage I, three had stage IIa, six had stage IIb, one had stage IIIa diseases and we had no information about the initial stage of the other 3 patients. Parasternal recurrence were diagnosed by biopsy in 7 patients, and the other 14 recurrences were diagnosed by clinical and radiologic findings such as chest CT, whole body bone scan. All the patients were treated with radiation for the parasternal recurrent tumors. In addition, five patients also received chemotherapy(FAC or Taxol based protocol) and one patient also received partial resection before radiotherapy. Radiotherapy was delivered with Co-60 gamma-ray or 4~6 MV X-ray or electron beam to both supraclavicular lymph nodes and parasternal areas with total doses of 3000~6480 cGy(median 6100 cGy).
RESULTS
The range of interval between curative resection and parasternal recurrence were 4~110 months(median 34 months). The main symptoms of the parasternal recurrence were a painless mass(n=10). The duration of symptom before diagnosis ranged from one to 36 months(median 7 months). Among 21, five patients(23.8%) presented distant metastses at the diagnosis of parasternal recurrences. The parasternal recurrences were classified into three groups according to radiologic and clinical findings; the recurrent tumors originated from sternum and invaded into adjacent tissues(Group 1, n=5), tumors originated from intemal mammary lymph nodes and invaded into sternum or parasternal tissues(Group 2, n=6), tumors originated from medial chest wall and invaded into sternum or parasternal tissues(Group 3, n=10). In nineteen patients(19/21; 90.5%) there was complete response of parasternal recurrence following radiotherapy. Although the follow up period was relatively short(3~78 montbs, median 14 months), there were no local recurrence in radiation field in 19 patients with complete response. Among the 16 patients without distant metastases at diagnosis of parasternal recurrence, nine patients were alive without any evidence of disease.
CONCLUSION
Chest CT scan is necessary and effective in patients with parastemal discomfort, pain, swelling or palpable mass after mastectomy. And we found that radiotherapy was very effective for the local treatment of parasternal recunence in terms of symptom palliation and local control of tumor. Although we classified the parasternal recurrence into three groups, we could not reach any conclusive results because of short follow up duration and insufficient patients number.
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Management of rocoregional recurrent breast cancer
Kyung Ran Park, Jong Young Lee, Chang Geol Lee, Chang Ok Suh, John Kyu Loh Juhn, Gwi Eon Kim, Soo Gon Kim, Won Yong Oh, Eun Hee Koh, Byung Soo Kim
J Korean Cancer Assoc. 1992;24(5):684-694.
AbstractAbstract PDF
No abstract available.
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Radiotherapy in Hodgkin's disease
Young Hwan Park, Chang Ok Suh, Gwi Eon Kim, John Kyu Loh Juhn
J Korean Cancer Assoc. 1992;24(2):277-287.
AbstractAbstract PDF
No abstract available.
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The results of multimodality treatment in neuroblastoma
Chuhl Joo Lyu, Chang Ok Suh, Eui Ho Hwang, Seung Kang Choi, Woo Hee Jung, Sung Nok Hong, Byung Soo Kim
J Korean Cancer Assoc. 1991;23(2):337-342.
AbstractAbstract PDF
No abstract available.
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Effectiveness of postoperative adjuvant treatment between radiation alone and chemotherapy plus radiation in locally advanced breast cancer
Kyung Ran Park, John Kyu Loh Juhn, Chang Ok Suh, Gwi Eon Kim, Eun Hee Koh, Byung Soo Kim, Kyung Sik Lee
J Korean Cancer Assoc. 1991;23(1):107-119.
AbstractAbstract PDF
No abstract available.
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The Effect of Adjuvant Chemotherapy with Cyclophosphamide , Methotrexate , and 5 - Fluorouracil ( CMF ) following Radical Mastectomy in Fem
Eun Hee Koh, Joo Hang Kim, Byung Soo Kim, Cheong Soo Park, Jin Sik Min, Kyung Shik Lee, Choon Kyu Kim, Kwan Ho Cho, Chang Ok Suh, Gwi Eon Kim
J Korean Cancer Assoc. 1985;17(1):16-25.
AbstractAbstract PDF
The forty-one female patients of breast cancer were treated with adjuvant chemotherapy following radical mastectomy were retrospectively analyaed with compared to aixty patienr.s treated with postoperative radiotherapy. The chemotherapy consisted of 12 monthly cycles of cyclophosphamide, methotrexate and 5-fluorouracil. After 45 months of study, the comparative relapse-free survival rate at three years waa significantly higher in chemotherapy group(chemotherapy group 78.0%, radiocherapy group 41. 1%: P(0.01). At three years 92.3% of patients given chemotherapy and 72, 5% of radio- therapy group remained alive. This difference was not significant. The patients with four or more positive axillary nodes had a higher per cent of relapses than those with fewer nodes. Three-year relapse-free suvival rate of chemotherapy group was aignificantly improved compared to radiotherapy group irrespective of the number of the axillary lymph nodes affected. The three-year relapse-free survival rates in hoth premenopausal women(chemotherapy group 76.5%, radiotherapy group 46.3%) and postmenopausal group(chemotherapy group 73.3%, radiotherapy group 42.0%) were increased in chemotherapy group than radiotherapy group, but statistically significant difference couldn't obtain in postmenopausal women. Five of 41 patients(12. 2i.) in chemotherapy group and 23 of 60 Patients(38.3%) in radio- therapy group had experienced reeurrence. The sites of the initial recurrence of all six patients in chemotherapy group were local-regional area, while 21 of 23 patients in radiothe- rapy group had distant metastases. These results showed postoperative adjuvant radiotherapy alone couldn't prevent distant metastasis at all. The side effects and hematologic toxicities attributable to chemotherapy were moderate and acceptable. Above short-term follow up result represented the encouragement for postoperative adju- vant chemotherapy in female breast cancer, but this study would continue to prove a real decrease rather than postoponement of relapse.
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Effecacy of Induction chomotherapy in Squamous Cell Carcinoma of the Head and Neck
Joo Hang Kim, Byung Soo Kim, Eun Hee Koh, Yi Hyeong Lee, Gwi Eon Kim, Chang Ok Suh, Won Yong Oh, Kwan Ho Cho, Jin Sil Seong, Won Pyo Hong, Myung Hyun Chung, Won Sang Lee, Cheong Soo Park, Choong Koo
J Korean Cancer Assoc. 1985;17(1):28-34.
AbstractAbstract PDF
A clinical study was carried out to investigate the effectiveness and feasjbility of one course of induction chemotherapy with cis-platinum, vincriatine, and bleomycin in 40 patients with squamous cell carcinoma of the head and neck. Twenty three patients(57.5%) had an objective responses; there were 1 complete response (2.5%) and 22 partial responses(55.0%). Responses to chemotherapy was not significantly influenced by disease stage and there were insufficient numbers for a site-by-site comparison. Drug toxicity was tolerable with no life threatening side effects and no added risks to surgery or radiotherapy were encountered. We concluded the effectiveness and feasibility of induction chemotherapy were estabilished.
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Result of Definitive Irradiation for Regional Stage 4 Carcinoma of the Nasopharynx : An Analysis of the Patterns of Failure
Kwan Ho Cho, Soo Kon Kim, Kyung Ran Park, Mi Son Chun, Chang Ok Suh, Gwi Eon Kim, John J. K. Loh, Joo Hang Kim, Byung Soo Kim, Eun Hee Koh
J Korean Cancer Assoc. 1985;17(2):229-237.
AbstractAbstract PDF
Between January 1, 1971 and December 31, 1983, sixty three patients received radiotherapy for advanced (Stage IV) carcinoma of the nasopharynx confined to the head and neck at Yonsei University College of Medicine, Yonsei Cancer Center. Fifty seven of those 63 patients received at least 6,000 cGy. The 5 and 10 year actuarial survival rates were 21.8 and 13.1% and those median survival was 24 months. The actuarial survivals (median survival months) for Group 1 (16 who had sufficiently advanced primary tumor to qualify for Stage IV : T4 N0orl), Group 2 (34 who had sufficiently advanced adenopathy to qualify for Stage IV: T1-3N2or 3) and Group 3 ( 13 who had advanced both of primary and adenopathy: T4 N 2 or 3) were 9.7(19), 32.9(44) and 0%(9) respectively. The survival of the patients in Group 2 was better than that of those in either Group 1(p<0.005) or Group 3(p<0.001). Local persistence or recurrence of tumor in the nasopharynx was the primary cause of failure and occurred in 39.1%(18/46) of evaluable patents. Distant metastases was the next and occurred in 28.3%(13/46). There was a definite correlation between recurrence at primary site and T-stage; 61.5%(8/13) of evaluable Group 1 and 61.9%(13/21) of T 4 patients (Group 3 included) had local failure. Similary, failure in the neck (regional failure) correlated with N-stage, being 24%(9/25) for evaluable Group 2. The incidence of distant failure had no correlation with T-stage but correlated with N-stage; 40%(10/25) of Group 2 developed distant metastases. Treatment failure occured in 95%(36/38) of the patients by 2 years after therapy.
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Intraoperative Radiaton Therapy ( IORT ) - Preliminary Clinical Experience of Yonsei Cancer Center -
John J. K. Loh, Sung Sil Chu, Gwi Eon Kim, Chang Ok Suh, Byung Soo Kim, Hung Kun Oh, Wyun Kon Park, Coong Bai Kim, Kyung Shik Lee
J Korean Cancer Assoc. 1986;18(1):49-59.
AbstractAbstract PDF
Intraoperative Radiation Therapy(IORT) is a cancer treatment modality in which resect- able masses or organs are removed surgically and residual cancer cells are sterilized by irradiation with a single massive dose during operation while patient is still anesthesized. Because it is possible that the tumor mass can be visualized directly at the time of surgical exploration, tumor volume can be determined more precisely and at the same time sensitive adjacent structures can be pulled aside from the irradiation. With these theoretical advantages as compare to conventional external irradiation, IORT can improve the thera- peutic ratio of tumor control to narmal tissue injury. Yonsei Cancer Center initiated a pilot study of multidisciplinary IORT program in February of 1986 for the first attempt in Korea. IORT was performed in 7 patients with stomach cancer by using existing NEC 18 MeV Linear Accelera.tor treatment room as a surgical suite. 10RT t am included department of surgery, department of anesthesiology, department of clinical pathology, operating room nursing personnel and department of radiation ancology. Although duration of foliow up is too short to lead conclusion, our preliminary clinical experience of IORT for stomach cancer is presented along with its historical review, general rationale, cquipments. techniques and practical problems encountered.
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The Treatment Results of Non - Metastatic Wilms'tumor by Multimodality Approach
Jin Sil Seong, John J. K. Loh, Chang Ok Suh, Gwi Eon Kim, H. J. Chung, I. J. Choi, Byung Soo Kim
J Korean Cancer Assoc. 1988;20(1):59-67.
AbstractAbstract PDF
Forty-two cases of non-metastatic Wilms tumor, treated at Dept. of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, between January 1970 and September 1984 were retrospectively analysed. With the introduction of well-planned multimodality concept, 26 patients were treated in this manner (group A), and multimodality treatment consist of surgery, radiotherapy, and chemotherapy and details of treatment regimen are described. Prior to introduction of multimodality concept, 16 patients were treated by rather individual basis with diversities of multimodalities which was not well-planned (group B). Two year relapse free survival rate of group A and group B was 88% and 31%, respectively (p< 0.05). By stage in group A, 2 yr. RFS for stage I, II, and III showed 92%, 88%, and 80%, respectively. The most significant prognostic factor was histologic subtype, i.e., favorable vs, unfavorable histology (p<0.005). Other prognostic factors included weight of tumor mass and status of lymph node involvement (p<0.05). From this study it can be concluded that; 1. well-planned multimodality approach to Wilms tumor can produce far superior survival relative to that of not well planned, 2. similar good results can also applied to even in the advanced stage, 3. significant prognostic factors are histologic subtype, weight of tumor mass, and status of lymph node involvement.
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Effect of Radiofrequency Hyperthermia on Hepatocellular Carcinoma - Preliminary report -
Chang Ok Suh, John J. K. Loh, Jin Sil Seong, Jae Kyung Roh, Byung Soo Kim, In Suh Park, Heung Jae Choi
J Korean Cancer Assoc. 1988;20(2):117-126.
AbstractAbstract PDF
Effectiveness of hyperthermia in the treatment of hepatocellular carcinoma was evaluated by the restrospective analysis of 31 patients who received radiofrequency hyperthermia at Department of Radiation Oncology, Yonsei Cancer Center, Yonsei Univ. College of Medicine between May 1985 and March 198B. All patients had advanced unresectable tumors, either unsuitable or re,fractory to conventional treatment modalities. B MHz radiofrequency capacitive type of hyperthermia was used either alone (1 case) or combined with other treatment modalities; i.e. 16 cases with external radiation, 7 cases with chemotherapy, 4 cases with l-131 Lipoidol and 3 cases with external radiation+ chemotherapy. Hyperthermia was given once or twice a week, usually 30 minutes after radiotherapy or chemotherapy. External radiotherapy was given with an average dose of 2,500-3000 cGy in 3 weeks. Response rate (CR! PR+ MR) was 32.3% (10/31); CR was achieved in one patient, PRa in 2 cases, PRb in 4 cases, and MR in 3 cases. All responders except for one received external radiotherapy with hyperthermia. Response rate of the patients who received combined radiotherapy and hyperth- ermia was 47.4% (9/19). On the other hand, only one of tweleve patients who received combination of hyperthermia and chemotherapy or I-131-Lipiodol showed partial response. As a result, hyperthermia was more effective when combined with external radiation than when combining with chemotherapy or other modality. In conclusion, hyperthermia, combined with external radiotherapy, is promising treatment method in the management of unresectable hepatocelluar carcinomas.
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Treatment Results of Non - operative Treatment Modality in Esophageal Cancer
John Juhn Kyu Loh, Kyung Ran Park, Chang Ok Suh, Chang Ok Suh, Seung Nok Hong, Byung Soo Kim
J Korean Cancer Assoc. 1988;20(2):143-153.
AbstractAbstract PDF
This report is a retrospective study of 99 patients with squamous cell carcinoma of the esophagus, treated with non-operative treatment modality (radiation therapy alone or chemotherapy and radiation therapy) or esophagectomy and radiation therapy+chemotherapy between January 1980 and December 1986. Of 99 patients, fifty three patients received definitive treatment as a curative intent and forty six patients received palliative treatment. Two year survival rate of definitive and palliative group was 24% (median survival of 11.3 months) and 1.5% (median survival of 4.4 months) respectively. Of 53 patients with definitive group, 33 patients were treated by radiation alone, 10 patients were treated by chemotherapy and radiation, and 10 patients were treated by esophagectomy and radiation+chemotherapy. Two year survival rate of radiation alone, chemother- apy and radaition, and esophagectomy and radiation+chemotherapy was 20/i, 33.6%, and 23% respectively. There wasno statistical significance in 2 year survival rate between non-operative and surgical group. Of 46 patients with palliative group, 33 patients (72%) showed symptomatic relief. In conclusion, it is our feeling that surgical intervention may not be necessary in definitive management of esophageal cancer on basis of this study although it is difficult to draw definite conclusion because this report is the retrospective study and the number of patients population is small.
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Combined Radiotherapy and Hyperthermia for Locally Advanced Cervical Carcinoma
John Juhn Kyu Loh, Jin Sil Seong, Chang Ok Suh, Gwi Eon Kim, Byung Soo Kim, Jae Wook Kim, Tchan Kyu Park
J Korean Cancer Assoc. 1988;20(2):172-180.
AbstractAbstract PDF
Twenty-one patients with locally advanced cervical carcinoma, who all thought to refractory to conventional treatment modality, i.e., mass size above 5 cm in shortest diameter and/or had poor response to radiotherapy at the dose of 3000 cGy/3 wk, treated with combined radiotherapy and hyperthermia between May 1985 and December 1987, at the Dept. of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, were retrospectively analysed. 8 MHz radiofrequency capacitive type of hyperthermia was combined with radiotherapy in 21 patients. Extemal radiothcrapy with a total dose of 4500-6000 cGy/4-6 wk and high dose rate ICR with a total dose 3000-390(l cGy in 10-13 fractions/4 wks were given. Hyperthermia was given twice a week with a total of 4 10 treatment sessions. In all cases hyperthermia was given within 30 minutes after radiotherapy. Temperature was measured by inserting thermocouple through the vaginal fornix and an attempt was made to maintain 40C or above for at least 30 minutes. As a result, CR was achived in 15 patients(17%), and PR in 6 patients. The overall response rate was 100%. Side effects were 1 case of pelvic abscess, 2 second degree burn, and 4 fat necrosis, and prognostic factors associated with tumor response.
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Combined Hyperthermia and Radiation Therapy on Primary Hepatocellular Carcinoma
Jin Sil Seong, Yun Ku Lee, Chang Ok Suh, John Juhn Kyu Loh, Hyung Sik Yoo, Jae Kyung Roh, Byung Soo Kim, Kwang Hyub Hahn, Sang In Lee, Heung Jae Choi
J Korean Cancer Assoc. 1989;21(1):117-129.
AbstractAbstract PDF
Thirty patients with unresectable hepatocellular carcinoma due to either locally advanced lesion or association with liver cirrhosis, treated with combined hyperthermia and radiotherapy between April 1988 and July 1988, at Dept. of Radiation Oncology, Yonsei University College of Medicine, were prospectively ananlysed. External radiotherapy of a total dose of 3060 cGy/3.5 wks was given. Hyperthermia was given twice a week with a total of 6 treatment sessions using 8 MHz radiofrequency capacitive type heating device, i.e., Thermotron RF-8 and Cancermia. In all cases hyperthermia was given within 30 minutes after radiotherapy. Temperature was measured by inserting thermocouple into the tumor mass under the ultrasonographic guidance in all patients except for those who had bleeding tendency. As a result, PR was achieved in 12 patients (40%) and symptomatic improvement was observed in 22 patients (78. 6%) among 2S patients who had suffered from abdominal pain. The most significant factor affecting tumor responae rate was the type of tumor (single massive; 10/14, 71.4%, diffuse infiltrative; 2/10, 20%, multinodular; 0/6, 0%, P< 0.005>. There were not any significant side effects relating to combined treatment. Hepatic failure was the leading cause of death (5/11, 45.5%) and distant metastases were observed in 5 patients (one to brain, four to lung). In conclusion, combined hyperthermia and radiotherapy can be considered as an effective treatment modality in management of primary hepatocellular carcinoma.
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A Report of Two Cases of Leptomeningeal Carcinomatosis on Stomach Cancer
Dong Lip Kim, Jae Kyung Roh, Jin Hyuk Choi, Hyun Cheol Chung, Yong Jun Park, Won Ho Kim, Seung Min Kim, Jin Sik Min, Kwang Hwa Park, Chang Ok Suh, Jun Kyu Loh, Byung Soo Kim
J Korean Cancer Assoc. 1989;21(1):141-150.
AbstractAbstract PDF
Meningeal carcinomatosis is an important neurologic complication. It is increasingly being recog- nized as a cause of neurologic disability in life. But stomach cancer has rarely been reported to be a cause of meningeal carcinomatosis. We reported two cases of 46-year-old male and 56-year-oldfemale who were diagnosed gastric cancer by biopsy under fiberoptic gastroscopy. These two cases of stomach cancer with meningeal invasion revealed malignant cells in their cerebrospinal fluid by repeated lumbar puncture. After diagnosis, they were treated radiation therapy in whole brain field. And, now, we have the plan of intrathecal chemotherapy.
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Recurrent Wilms' Tumor Following Primary Treatment
Jin Sil Seong, Chang Ok Suh, Gwi Eon Kim, Byung Soo Kim, John Juhn Kyu Loh
J Korean Cancer Assoc. 1989;21(2):424-431.
AbstractAbstract PDF
Fourteen cases of recurrent Wilms' tumor following primary treatment, treated at Dept. of Radiation Oncology, Yonsei Vniversity College of Medicine, Yonsei Cancer Center between 1970 and 1984 were retrospectively analysed. All the patients relapsed within 2 years and the most frequently involved site appeared the lung followed by the primary site and the liver. Among 7 patients to whom salvage treatment was attempted, 3 were successfully salvaged to long term survival over 3 years. From this study it can be concluded that the close follow up to detect any recurrent disease as soon as possible should be done, salvage treatment should be tried with more refined treatment regimen, and new attempts, although experimental, should also be done to the patients who show poor response to conventional salvage treatment.
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The Treatment Results of Combination of Radiotherapy and chemotherapy in Limited Stage Small Cell Lyug Cancer
Chang Ok Suh, Jun Kyu Loh, Kyung Ran Park, Chang Ok Suh, Gwi Eon Kim, Jae Kyung Roh, Seong Kyu Kim, Byung Soo Kim
J Korean Cancer Assoc. 1990;22(1):131-144.
AbstractAbstract PDF
A total of 72 patients with limited stage small cell lung cancer treated with combination of chemotherapy and radiotherapy at Department of Radiation Oncology, Yonsei University College of Meidcine between Jan. 1975 and Dec. 1986 were retrospectively analysed. 1) Age distribution of patients was between forty and seventy-one with median age fifty-five and male to female ratio was 5:l. 2) Complete response rate by treatment modality was as follows; CV+RT was 33.3%; CAV+RT, 43.59o, MOCA+RT. 28.6% and CAV+VP+RT was 62.5%. CAV+VP+RT group showed best result and this was statistically significant to MOCA+RT group (p=0.02) but insignificant to CV+ RT or CAV+RT grouP (P>0.1). 3) Median survival and 5 year actuarial survival rate by treatment modality were as follows; CVt RT was 15 3 months and 16.2%. CAV+RT, 14months and 16.396; MOCA+RT, 7month and 09; and CAV+ VP+ RT was 24 month and 30.7% respectively. CAV+VP+ RT groulp shawed the best results and these were statistically significant to MOCA+RT group(p<0.05) but insignificant to CV+RT or CAV+RT group (p>0,05). 4l Patterns of failure in complete response group were as follows; local failure was 24%, distant failure, 52% and local and distant failure was 24%. 5) Local control rate by radiation dosage in complete response group was as follows; when total dose of 4500-4900 cGv was given, local control rate was 50%; 5000 cGy, 43% however when total dose was given between 5100-7000 cGy, local control rate was significantly improved to 100%. 6) The incidences of brain metastsis in PCI (prophylactic cranial irradiation) group and control group were 20% and 32% respectively, although this was statistically insignificant (p=0.32). 7) Statistically significant factors affecting prognosis were performance status, TNM stage, initial status of presentation of superior vena cava syndrome and pleural effusion, location of tumor, response status to treatment and whether or not maintenance chemotherapy is added.
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Treatment Results and Prognostic Factors of Radical Radiotherapy in FIGO Stage 3B Cervical Cnacer
Hyung Sik Lee, Sun Rock Moon, Byung Soo Kim, Chang Ok Suh, Gwi Eon Kim, Jun Kyu Loh, Dong Won Kim
J Korean Cancer Assoc. 1990;22(2):298-307.
AbstractAbstract PDF
From January 1979 to December 1981, One hundred and sixty-one patients with stage IIIB car- cinoma of the cervix according to the International Federation of Gynecology and Obstetrics (FIGO) received radical radiation treatment consisting of external irradiation with intracavitary brachytherapy in our institute. Radiation treatment was delivered in a similar fashion in all patients in terms of the dosage and the technique. Complete response rate of 63.9% and overall 5 year survival rate of 49.6% for stage IIIB carcinoma of cervix were obtained in the study. One hundred and sixty one patients were retrospectively analyzed with respect to two variables: the extent of pelvic wall involvement and the presence of hydronephrosis. The extent of pelve wall involvement proved to be a strong prognostic factor, that is, the patients with unilateral involvement had a 5 year survival rate of 58.7% and bilateral ones of 34.3%;, whereas in those with fixation of pelvic wall involvement (frozen pelvis) it was only 23.5% (p= 0.000). The presence of nonfunctioning kidney or hydronephrosis proved to be statistically insignificant factors as far as the survival rates are concerned (p=0.87). We can, therefore, conclude that subsets of the patient with Stage IIIB cervical cancer with bilateral pelvic wall involvement or pelvic wall fixation carries unfavorable prognostic factors as compare to those of unilateral subset and these should be kept in mind when designing treatment plan.
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Efficacy of Combined Modality , Multidisciplinary Treatment ( Neoadjuvant Chemotherapy , Difinite Local Treatment , and Adjuvant Chemotherapy ) in Locally Advanced Head and Neck Squamous Cell Carcinoma
Jae Kyung Roh, Wha Young Lee, Hyun Cheol Chung, Young Joon Park, Hyung Keun Roh, Chang Ok Suh, Gwi Eon Kim, Jun Kyu Loh, Won Pyo Hong, Cheong Soo Park, Byung Soo Kim
J Korean Cancer Assoc. 1990;22(3):518-532.
AbstractAbstract PDF
Between January, 1986 and October, 1989, 40 patients with previously untreated, locally advanced head and neck squamous cell carcinoma enrolled for combined modality treatment (CMT) with neoadjuvant chemotherapy (2 cycles of infusional 5-FU and cis-platin), definite local treatment (DLT) (surgery and/or radiotheray) and adjuvant chemotherapy (3 cycles of infusional 5-FU and cis-platin) to enhance the therpeutic efficacy. Of the 40 enrolled, all the patients were evaluable for tumor responses and treatmen#t related toxicities after neoadjuvant chemotherapy, and 35 patients finished scheduled CMT. Male to female ratio were 33:7, median age 54 year old (34-69), and median ECOG performance grade 1 (0-2). Primary sites were nasopharynx 19, oral cavity 16, larynx 3, hypopharynx 1, and maxillary sinus l. After the 2 cycles of neoadjuvnt therpay, 8/40 (20%), 23/40 (72.5%) achieved compIete remission (CR) and partial remission (PR), respectively with 92.5% over all response rates. After the DLT, 23/ 35 (67.5%) 11/35 (31.4%) achieved CR, and PR respectively with 97.1% over all response rates. Of the 35 patients who finished the DLT, 15 received the 3 cycles of adjuvnat chemotherapy with infusional 5-FU and cis-platin. The median failure-free, and overal survival duration of 35 evaluable patients were 21.7 months and 31.0 months, respectively after the CMT. The median survival duration was significantly prolonged in patients with objective respanses after the neoadjuvant chemotherapy compared to those of non-responders (p<0.05). Of the 35 patients who finished the DLT, patients who received the adjuvant chemotherapy showed trend of prolongation of survival when compared to no adjuvant chemotherapy patients Imedian overall survival duration; adjuvant group 21.7 months, no adjuvant group 17.6 month (p>0.05). This study strongly suggests that CMT can increase the median response duration and survival especially in patients with locally advanced head and neck squamous cell carcinoma who showed responses after the neoadjuvant chemotherapy with infusional 5-FU and cis-platin, but phase III randomized controlled prospective studies are warranted for the verification of this study.
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Preoperative Chemotherapy in Wilms Tumor
Chuhl Joo Lyu, Byung Soo Kim, Woo Hee Jungn, Chang Ok Suh, Seung Kang Choi, Eui Ho Hwang
J Korean Cancer Assoc. 1994;26(4):631-637.
AbstractAbstract PDF
From l988, the use of preoperative chemotherapy for selected Wilms tumor was adopted at Yonsei Cancer Center. Between 1988 and 1992, 10 children has given preoperative chemotherapy. During that period, 21 children with Wilms tumor underwent primary nephrectomy(postop- erative treatment group). The criteria for preoperative chemotherapy were (a) initial surgical removal is excessively hazardous to patient (b) inoperable because of large size or extent of disease (c) patient with vena cava or atrial extension (d) radiologic evidence of extensive local invasion of adjacent or- gans or distant metastasis. After preaperative treatment, the tumor size was markedly(>50%) reduced in five patients. In all patients, nephrectomy was performed safely without rupture of tumor. Except stage IV patients, the dawnstaging may reduced the use of radiotherapy during ad)uvant treatment. The 3-year survival rate for patients with preoperative chemotherapy was 80%. The survival of the preoperative chemotherapy group was similar to that in the postoperative treatment group(2-year survival rate; 80% vs 84%). But there was a higher rate of local recurrence in preoperative chemotherapy group. We conclude that preoperative chemotherapy is the effective method of treatment in the selected cases of Wilms tumor.
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