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Original Articles
Definitive Chemoradiotherapy Versus Surgery Followed by Adjuvant Radiotherapy in Resectable Stage III/IV Hypopharyngeal Cancer
Jun Won Kim, Mi Sun Kim, Se-Heon Kim, Joo Hang Kim, Chang Geol Lee, Gwi Eon Kim, Ki Chang Keum
Cancer Res Treat. 2016;48(1):45-53.   Published online March 13, 2015
DOI: https://doi.org/10.4143/crt.2014.340
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this study is to compare the treatment outcomes for locally advanced resectable hypopharyngeal cancer between organ-preserving chemoradiotherapy (CRT) and surgery followed by radiotherapy (SRT).
Materials and Methods
We reviewed 91 patients with stage III/IV hypopharyngeal squamous cell carcinoma treated with radiotherapy (RT). In the CRT group (n=34), 18 patients were treated with concurrent CRT and 16 patients with induction chemotherapy plus concurrent CRT. In the SRT group (n=57), six patients were treated with total laryngopharyngectomy, 34 patients with total laryngectomy (TL) and partial pharyngectomy (PP), and 17 patients with PP, which were followed by adjuvant radiotherapy (n=41) or CRT (n=16). The median RT dose was 70 Gy for CRT and 59.4 Gy for SRT.
Results
Five-year local control (84.1% vs. 90.9%), and disease-free survival (DFS, 51.0% vs. 52.7%) and overall survival (OS, 58.6% vs. 56.6%) showed no significant difference between the CRT and SRT groups. The functional larynx-preservation rate was higher in the CRT group (88.2% vs. 29.8%). Treatment-related toxicity, requiring surgical intervention, occurred more frequently in the SRT group (37% vs. 12%). In the SRT group, TL resulted in a significantly higher DFS than larynx-sparing surgery (63.9% vs. 26.5%, p=0.027). Treatment outcome of the SRT group improved when only patients with TL were considered (n=40); however, 5-year OS (67.1% vs. 58.6%, p=0.830) and DFS (63.9% vs. 51.0%, p=0.490) did not improve significantly when compared to the CRT group.
Conclusion
Organ preserving CRT provided a treatment outcome that is comparable to SRT for locally advanced hypopharyngeal cancer, while offering an opportunity for functional larynx-preservation and reduced treatment-related toxicity.

Citations

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  • Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment
    Donghyeok Kim, Nalee Kim, Sungmin Koh, Man Ki Chung, Young-Ik Son, Dongryul Oh, Han-Sin Jeong, Yong Chan Ahn
    Cancer Research and Treatment.2022; 54(1): 84.     CrossRef
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    Jialing Wu, Kaiyun You, Changlong Chen, Huimin Zhong, Yanhui Jiang, Huaqian Mo, Juanjuan Song, Xingsheng Qiu, Yimin Liu
    Frontiers in Oncology.2021;[Epub]     CrossRef
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    Jun-Ook Park, Young Min Park, Woo-Jin Jeong, Yoo Seob Shin, Yong Tae Hong, Ik Joon Choi, Ji Won Kim, Seung Hoon Woo, Yeon Soo Kim, Jae Won Chang, Min-Sik Kim, Kwang-Yoon Jung, Soon-Hyun Ahn, Chul-Ho Kim, Ki Hwan Hong, Phil-Sang Chung, Young-Mo Kim, Se-Heo
    Clinical and Experimental Otorhinolaryngology.2021; 14(2): 225.     CrossRef
  • Prognostic significance of human papillomavirus status and treatment modality in hypopharyngeal cancer
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  • Initial surgical versus non-surgical treatments for advanced hypopharyngeal cancer: A meta-analysis with trial sequential analysis
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    Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics.2020; 28(3): 311.     CrossRef
  • Pacientes con carcinoma localmente avanzado de hipofaringe. Resultados a lo largo de un periodo de 30 años
    Xavier León, Montserrat López, Jacinto García, Carlota Rovira, María Casasayas, Miquel Quer
    Acta Otorrinolaringológica Española.2019; 70(6): 315.     CrossRef
  • A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study
    Manigreeva Krishnatreya, Amal Chandra Kataki, Jagannath Dev Sharma, Nizara Baishya, Tashnin Rahman, Mouchumee Bhattcharyya, Ashok Kumar Das, Manoj Kalita
    Indian Journal of Otolaryngology and Head & Neck Surgery.2019; 71(S1): 798.     CrossRef
  • Long-term oncological and functional outcomes of induction chemotherapy followed by (chemo)radiotherapy vs definitive chemoradiotherapy vs surgery-based therapy in locally advanced stage III/IV hypopharyngeal cancer: Multicenter review of 266 cases
    Eun-Jae Chung, Woo-Jin Jeong, Young Ho Jung, Seong Keun Kwon, Tack-Kyun Kwon, Soon-Hyun Ahn, Myung-Whun Sung, Bhumsuk Keam, Dae-Seog Heo, Jin Ho Kim, Hong-Gyun Wu, Keun-Wook Lee, Keun-Yong Eom, Young-Soo Rho
    Oral Oncology.2019; 89: 84.     CrossRef
  • Surgery is not the only determinant of an outcome in patients with hypopharyngeal carcinoma
    Robert Smee, Janet R. Williams, Damian P. Kotevski
    Head & Neck.2019; 41(5): 1165.     CrossRef
  • Open-neck organ preservation surgery for hypopharyngeal cancer: indications, techniques, limits, and outcomes
    Patrick J. Bradley, Liangfa Liu
    Current Opinion in Otolaryngology & Head & Neck Surgery.2019; 27(2): 123.     CrossRef
  • Oncologic and Functional Outcomes After Primary and Salvage Laryngopharyngoesophagectomy With Gastric Pull-Up Reconstruction for Locally Advanced Hypopharyngeal Squamous Cell Carcinoma
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    Frontiers in Oncology.2019;[Epub]     CrossRef
  • Patients With Locally Advanced Hypopharyngeal Carcinoma. Results Over a 30-year Period
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    Acta Otorrinolaringologica (English Edition).2019; 70(6): 315.     CrossRef
  • Clinical value of ultrasonic imaging in diagnosis of hypopharyngeal cancer with cervical lymph node metastasis
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    Oncology Letters.2019;[Epub]     CrossRef
  • Management of advanced hypopharyngeal carcinoma: systematic review of survival following surgical and non-surgical treatments
    A Habib
    The Journal of Laryngology & Otology.2018; 132(5): 385.     CrossRef
  • Surgery vs. radiotherapy for locally advanced hypopharyngeal cancer in the contemporary era: A population‐based study
    Yi‐Jun Kim, Rena Lee
    Cancer Medicine.2018; 7(12): 5889.     CrossRef
  • The impact of surgical margin status on the outcomes of locally advanced hypopharyngeal squamous cell carcinoma treated by primary surgery
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    Acta Oto-Laryngologica.2018; 138(12): 1136.     CrossRef
  • The diagnostic role of diffusion-weighted magnetic resonance imaging in hypopharyngeal carcinoma
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  • Matched-pair analysis of patients with advanced hypopharyngeal cancer: surgery versus concomitant chemoradiotherapy
    Shigemichi Iwae, Masato Fujii, Ryuichi Hayashi, Yasuhisa Hasegawa, Takashi Fujii, Kenji Okami, Akihiro Homma, Tetsuro Onitsuka, Takakuni Kato, Takenori Ogawa, Kyoichi Terao, Nobuya Monden, Naoki Otsuki, Hiroshi Nishino, Ichiro Ota, Yasushi Fujimoto, Kazut
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  • Survival benefit of surgical approach for advanced oropharyngeal and hypopharyngeal cancer: A retrospective analysis
    Chih-Tao Cheng, Ching-Yuan Lin, Skye Hung-Chun Cheng, Yi-Ping Lin, Lay-Chin Lim, Nicolas Pennarun, Zhen-Ying Liu, Shyuang-Der Terng
    Head & Neck.2017; 39(10): 2104.     CrossRef
  • When is definitive radiotherapy the preferred treatment for head and neck squamous cell carcinoma?
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    European Archives of Oto-Rhino-Laryngology.2015; 272(10): 2583.     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

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  • 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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Editorial
Does the Addition of Adjuvant Chemotherapy to Concurrent Chemoradiotherapy Improve the Survival of Patients with Locally Advanced Nasopharyngeal Cancer?
Gwi Eon Kim
Cancer Res Treat. 2003;35(5):369-372.   Published online October 31, 2003
DOI: https://doi.org/10.4143/crt.2003.35.5.369
AbstractAbstract PDF
No abstract available.
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Original Articles
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.

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    Breast Disease.2021; 40(3): 117.     CrossRef
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    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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A Phase II Study of Gemcitabine Monotherapy in Breast Cancer Patients Refractory to Anthracycline and Taxane
Jun Yong Park, Chul Kim, Joo Hyuk Sohn, Yong Tae Kim, Sun Young Rha, Woo Ick Jang, Gwi Eon Kim, Hyun Cheol Chung
Cancer Res Treat. 2002;34(4):274-279.   Published online August 31, 2002
DOI: https://doi.org/10.4143/crt.2002.34.4.274
AbstractAbstract PDF
We performed a phase II trial to evaluate the efficacy and the safety of gemcitabine monotherapy, a pyrimidine antimetabolite, in patients, who had previously failed anthracycline and taxane-based chemotherapy for the treatment of metastatic breast cancer.
MATERIALS AND METHODS
Twenty-one patients with metastatic breast cancer, which was unresponsive to previous chemotherapy, were entered into this study. Gemcitabine was administered at 850 mg/m2, as a 60- minute intravenous infusion on days 1, 8 and 15. This regimen was repeated every 28 days with G-CSF support, but without dose reduction.
RESULTS
Objective responses were seen in 6 of the 20 patients who were able to be evaluated (1 complete response and 5 partial responses), with an objective response rate of 30%. The median time to progression was 5 (1~20) months, and the median overall survival duration was 11 (2~21) months. The actual dose intensity was 566.7 mg/m2/wk (range; 340~637.5 mg/m2/wk) and the relative dose intensity was 0.89 (range; 0.40~1.00). Toxicity was mainly hematological. Toxicities included: grade 3 neutropenia in 20% and anemia in 5%. Grades 3 and 4 thrombocytopenia occurred in 15% of the patients.
CONCLUSION
Gemcitabine monotherapy is an effective and safe treatment for refractory breast cancer patients heavily treated with the anthracycline and taxane- based regimen.

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  • A phase II study of tipifarnib and gemcitabine in metastatic breast cancer
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  • Gemcitabine Single or Combination Chemotherapy in Post Anthracycline and Taxane Salvage Treatment of Metastatic Breast Cancer: Retrospective Analysis of 124 Patients
    Min Kyoung Kim, Sung-Bae Kim, Jin Hee Ahn, Soon Im Lee, Sei-Hyun Ahn, Byung Ho Son, Gyungyub Gong, Hak-Hee Kim, Jung-Shin Lee, Yoon-Koo Kang, Woo Kun Kim
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  • Gemcitabine monotherapy as salvage chemotherapy in heavily pretreated metastatic breast cancer
    Sun Young Rha, Yong Hwa Moon, Hei Chul Jeung, Yong Tae Kim, Joo Hyuk Sohn, Woo Ick Yang, Chang Ok Suh, Gwi Eon Kim, Jae Kyung Roh, Hyun Cheol Chung
    Breast Cancer Research and Treatment.2005; 90(3): 215.     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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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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Esophageal squamous cell carcinoma-comparison of radiotherapy alone to chemo-radiotherapy combination with or without surgery-
Hyung Sik Lee, Won Joo Huh, Gwi Eon Kim, Chang Ok Seo, Joon Kyoo Roh, Jae Kyung Roh, Byung Soo Kim
J Korean Cancer Assoc. 1993;25(1):59-66.
AbstractAbstract PDF
No abstract available.
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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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A case report of extraocular sebaceous gland carcinoma with lung metastasis
Dong Lip Kim, Hyun Cheol Chung, Ho Young Lim, Eun Hee Koh, Joo Hang Kim, Jae Kyung Roh, Joon Chang, Jung Soo Park, Eun Kyung Han, Gwi Eon Kim, Byung Soo Kim, Jin Ju Kim
J Korean Cancer Assoc. 1992;24(1):174-179.
AbstractAbstract PDF
No abstract available.
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A phase II trial of combined sequential FP (5-FU+cisplatin) chemotheraphy and radiotherapy in locally advanced unresectable esophageal cancer
Jong Won Ha, Hyun Cheol Chung, Dong Lip Kim, Jin Hyuk Choi, Nae Choon Yoo, Eun Hee Koh, Joo Hang Kim, Jae Kyung Roh, Gwi Eon Kim, John Kyu Loh Juhn, Byung Soo Kim
J Korean Cancer Assoc. 1991;23(2):307-314.
AbstractAbstract PDF
No abstract available.
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Phase II trial of sequential VP-16, cisplatin combination chemotherapy and radiotherapy for locally advanced (stage III) non-small cell lung cancer
Hyun Cheol Chung, Jin Hyuk Choi, Yoon Seok Chung, Dong Jip Kim, Young Sik Lee, Joon Chang, Eun Hee Koh, Joo Hang Kim, Jae Kyung Roh, Sung Kyu Kim, Won Young Lee, Gwi Eon Kim
J Korean Cancer Assoc. 1991;23(1):131-139.
AbstractAbstract PDF
No abstract available.
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Phase II trial of 5-FU, etoposide, cisplatin (FEP) combination chemotherapy in unresectable non-small cell lung cancer
Jin Hyuk Choi, Hyun Cheol Chung, Dong Jip Kim, Je Yol Oh, Joon Chang, Eun Hee Koh, Joo Hang Kim, Jae Kyung Rho, Sung Kyu Kim, Won Young Lee, Gwi Eon Kim, John Kyu Loh Juhn
J Korean Cancer Assoc. 1991;23(1):120-130.
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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Radiotherapy Results of Testicular Pure Seminoma
Soo Kon Kim, Kwan Ho Cho, Mi Soo Hwang, Gwi Eon Kim, Chang Yun Park
J Korean Cancer Assoc. 1986;18(1):41-49.
AbstractAbstract PDF
Between 1971 and 1983, 26 Patients with testicular pure seminoma treated at the Yonsei Cancer Center with radiotherapy are analyzed. The stage distribution was: stage I 46%(12/26), stage B 42%(11/26), and stage III 12% (3/26). Tumor histological subtypes were typical seminoma in 8 patients, anaplastic seminoma in 4 patients, and unknown subtypes in 14 patients. Three-year actuarial disease free survival rate was: overall 76%, stage I 91%', stage II 80%, stage III 0%, Treatment failure were analyzed to determine their apparent causes and the implication of such failures to the future management of the testicular pure seminoma.
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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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Thermal Distribution and Development of RF Hyperthermia for Cancer Treatment
Sung Sil Chu, Gwi Eon Kim, John J. K. Loh, Byung Soo Kim, Min Yong Park, Sung Wha Yang, Dong Kun Jung
J Korean Cancer Assoc. 1986;18(2):183-194.
AbstractAbstract PDF
The biological effects for the use of hyperthermia to treat malignant tumors has been well studied and encouraging clinical results have been reported. However, the engineering and technical aspects of hyperthermia for the deep-seated tumors has not been satisfactory. We have developed the RF capacitive hyperthermia device (Greenytherm-GY 8) by coopera- tion with Yonsei Cancer Center and Green Cross Medical Corporation. It was composed with 8-10 MHz RF generator, capacitive electrode, matching system, cooling system, tem- perature measuring thermocouples and control PC computer. We have measured the tempe- rature and thermal distribution in agar phantom, animals and human tumors. This RF hyperthermia device could be applied for clinical trials as result of following studies. 1) The generating power could be varied to 700-1500 W 2) The Radio-frequency for capacitive heating could be produced to 8-10 MHz 3) It was possible to contral the depth heating from skin by regulation the cooling tem- perature of bolus and choosing properly size electrodes. 4) Deep seated tumors (5-10 cm depth) might be heated to therapeutic temperature 40- 43' C. 5) Side effects and hot feeling on skin could be significantly reduced by cooling bolus and electric matching.
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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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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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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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Malignant Fibrous Histiocytoma of the Mediastinum - Report of two cases -
Young Jin Kim, Hyun Cheol Chung, Wha Young Lee, Hyung Jung Kim, Jae Kyung Roh, Doo Yun Lee, Jong Doo Lee, Gwi Eon Kim, Jun Kyu Loh, Nam Hoon Cho, In Joon Choi, Byung Soo Kim
J Korean Cancer Assoc. 1989;21(2):440-448.
AbstractAbstract PDF
Malignant fibrus histiocytoma (MFH) is a deep seated plemorphic sarcoma of older adults, which occurs most frequently in the deep fascia and skeletal muscle of the extremities and trunk. A rare tumor initially described in 1964 by OBriend and Stout, who considered it to have a histiocytic origin, it has been increasingly recognized as a discrete entity. There are only few descriptions of the intrathoracic occurrence of the MFI-l. Here, we report two cases of MFH originated from the mediastium which is a very unusual site. Radiation appeared to be a useful adjuvant treatment to surgical therapy in one case. Clinical features of the other reported cases of the intrathoracic MFH were also reviewed.
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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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