Cancer Research and Treatment

Original Articles

Lung cancer

Real-World Experience of Nivolumab in Non-small Cell Lung Cancer in Korea: Sun Min Lim, Sang-We Kim, Byoung Chul Cho, Jin Hyung Kang, Myung-Ju Ahn, Dong-Wan Kim, Young-Chul Kim, Jin Soo Lee, Jong-Seok Lee, Sung Yong Lee, Keon Uk Park, Ho Jung An, Eun Kyung Cho, Tae Won Jang, Bong-Seog Kim, Joo-Hang Kim, Sung Sook Lee, Im-II Na, Seung Soo Yoo, Ki Hyeong Lee; Cancer Res Treat. 2020;52(4):1112-1119. Published online May 15, 2020; DOI: https://doi.org/10.4143/crt.2020.245

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Purpose
The introduction of immune checkpoint inhibitors represents a major advance in the treatment of lung cancer, allowing sustained recovery in a significant proportion of patients. Nivolumab is a monoclonal anti–programmed death cell protein 1 antibody licensed for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after prior chemotherapy. In this study, we describe the demographic and clinical outcomes of patients with advanced NSCLC treated with nivolumab in the Korean expanded access program.
Materials and Methods
Previously treated patients with advanced non-squamous and squamous NSCLC patients received nivolumab at 3 mg/kg every 2 weeks up to 36 months. Efficacy data including investigator-assessed tumor response, progression data, survival, and safety data were collected.
Results
Two hundred ninety-nine patients were treated across 36 Korean centers. The objective response rate and disease control rate were 18% and 49%, respectively; the median progression-free survival was 2.1 months (95% confidence interval [CI], 1.87 to 3.45), and the overall survival (OS) was 13.2 months (95% CI, 10.6 to 18.9). Patients with smoking history and patients who experienced immune-related adverse events showed a prolonged OS. Cox regression analysis identified smoking history, presence of immune-related adverse events as positive factors associated with OS, while liver metastasis was a negative factor associated with OS. The safety profile was generally comparable to previously reported data.
Conclusion
This real-world analysis supports the use of nivolumab for pretreated NSCLC patients, including those with an older age.

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Advances in reprogramming of energy metabolism in tumor T cells
Liu Xuekai, Song Yan, Chu Jian, Song Yifei, Wu Xinyue, Zhang Wenyuan, Han Shuwen, Yang Xi
Frontiers in Immunology.2024;[Epub] CrossRef
Effectiveness and Safety of PD-1 Inhibitors’ Treatment for Patients with Non-Small-Cell Lung Cancer in China: A Real-World Study
Ning Wan, Yongbang Chen, Liqing Lu, Bing Wang, Liuliu He, Hongyi Liang, Fei Xie, Xiaoshun Jian, Bo Ji, Jianping Zhang, Hammoda Abu-Odah
European Journal of Cancer Care.2024; 2024: 1. CrossRef
Optimization of treatment strategies for elderly patients with advanced non-small cell lung cancer
Qiang Chen, Shuo Ying, Jianwen Qin, Li Zhang
Frontiers in Oncology.2024;[Epub] CrossRef
Real-World Data on Pembrolizumab for Pretreated Non-Small-Cell Lung Cancer: Clinical Outcome and Relevance of the Lung Immune Prognostic Index
Ana Ortega-Franco, Clare Hodgson, Haseem Raja, Mathew Carter, Colin Lindsay, Sarah Hughes, Laura Cove-Smith, Paul Taylor, Yvonne Summers, Fiona Blackhall, Raffaele Califano
Targeted Oncology.2022; 17(4): 453. CrossRef
Liver metastases and the efficacy of immune checkpoint inhibitors in advanced lung cancer: A systematic review and meta-analysis
Handai Xia, Wengang Zhang, Yuqing Zhang, Xiaoling Shang, Yanguo Liu, Xiuwen Wang
Frontiers in Oncology.2022;[Epub] CrossRef
Immune-Related Adverse Events Predict the Efficacy of Immune Checkpoint Inhibitors in Lung Cancer Patients: A Meta-Analysis
Donghui Wang, Cen Chen, Yanli Gu, Wanjun Lu, Ping Zhan, Hongbing Liu, Tangfeng Lv, Yong Song, Fang Zhang
Frontiers in Oncology.2021;[Epub] CrossRef
Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer
Min Jung Geum, Chungsoo Kim, Ji Eun Kang, Jae Hee Choi, Jae Song Kim, Eun Sun Son, Sun Min Lim, Sandy Jeong Rhie
Pharmaceuticals.2021; 14(5): 445. CrossRef
Nivolumab

Reactions Weekly.2021; 1855(1): 269. CrossRef
Immune-Related Adverse Events Associated With Outcomes in Patients With NSCLC Treated With Anti-PD-1 Inhibitors: A Systematic Review and Meta-Analysis
Zhe Zhao, Xinfeng Wang, Jinghan Qu, Wei Zuo, Yan Tang, Huijuan Zhu, Xiaoguang Chen
Frontiers in Oncology.2021;[Epub] CrossRef

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High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity: Ji Hyun Hong, Yeon-Sil Kim, Sea-Won Lee, So Jung Lee, Jin Hyung Kang, Suk Hee Hong, Ju-Young Hong, GeumSeong Cheon; Cancer Res Treat. 2019;51(3):1156-1166. Published online November 29, 2018; DOI: https://doi.org/10.4143/crt.2018.472

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Purpose
Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy.
Materials and Methods
Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy₁₀ (range, 51.75 to 150 Gy₁₀), and the median re-RT dose was 68.8 Gy₁₀ (range, 43.2 to 132 Gy₁₀).
Results
Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED₁₀) doses were the most significant prognostic factors. Cumulative BED₁₀≥145 Gy₁₀ and re-RT BED₁₀≥68.7 Gy₁₀ were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred.
Conclusion
Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

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ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy
Steven J. Frank, Indra J. Das, Charles B. Simone, Brian J. Davis, Curtiland Deville, Zhongxing Liao, Simon S. Lo, Susan L. McGovern, Rahul R. Parikh, Michael Reilly, William Small, Naomi R. Schechter
International Journal of Particle Therapy.2024; 13: 100021. CrossRef
Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer
Konstantinos Filippatos, Ioannis M. Koukourakis, Stavros Anevlavis, Axiotis Giaktzidis, Michael I. Koukourakis
Cancers.2023; 15(20): 5083. CrossRef
Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review
Dorota Gabrys, Roland Kulik, Agnieszka Namysł-Kaletka
The British Journal of Radiology.2022;[Epub] CrossRef
High Dose Thoracic Re-Irradiation and Chemo-Immunotherapy for Centrally Recurrent NSCLC
Brane Grambozov, Markus Stana, Bernhard Kaiser, Josef Karner, Sabine Gerum, Elvis Ruznic, Barbara Zellinger, Raphaela Moosbrugger, Michael Studnicka, Gerd Fastner, Felix Sedlmayer, Franz Zehentmayr
Cancers.2022; 14(3): 573. CrossRef
Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
Life.2022; 12(2): 292. CrossRef
Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef
Thoracic re-irradiation with 3D-conformal or more advanced techniques: A systematic review of treatment safety by the Re-irradiation Study Group of the Italian Association of Radiation and Oncology AIRO
Marta Maddalo, Elisa D’Angelo, Francesco Fiorica, Angela Argenone, Melissa Scricciolo, Salvatore Cozzi, Alessia Nardangeli, Francesco Dionisi, Gianluca Costantino, Stefano Vagge, Antonio Pontoriero, Vittorio Donato, Mariangela Massaccesi
Critical Reviews in Oncology/Hematology.2021; 167: 103500. CrossRef
Radiotherapy for head and neck tumours using an oral fixation and parameter acquisition device and TOMO technology: a randomised controlled study
Xiaofang Zhang, Tianlu Wang, Xinyan Xiao, Xia Li, Chen Yu Wang, Bo Huang, Lei He, Yingqiu Song
BMJ Open.2021; 11(11): e052542. CrossRef
The Medical Physics Management of Reirradiation Patients
Kelly C. Paradis, Martha M. Matuszak
Seminars in Radiation Oncology.2020; 30(3): 204. CrossRef
Reirradiation at local relapse of non-small cell lung cancer
D.V. Gogolin, I.A. Gulidov, Y.S. Mardynsky, T.Y. Antonenko, A.Y. Buksha
Onkologiya. Zhurnal imeni P.A.Gertsena.2020; 9(3): 48. CrossRef

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255 Download
8 Web of Science
10 Crossref

Ipilimumab Real-World Efficacy and Safety in Korean Melanoma Patients from the Korean Named-Patient Program Cohort: Minkyu Jung, Jeeyun Lee, Tae Min Kim, Dae Ho Lee, Jin Hyung Kang, Sung Young Oh, Soo Jung Lee, Sang Joon Shin; Cancer Res Treat. 2017;49(1):44-53. Published online April 27, 2016; DOI: https://doi.org/10.4143/crt.2016.024

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Purpose
Ipilimumab improves survival in advanced melanoma patients. However, the efficacy and safety of ipilimumab has not been evaluated in Asian melanoma patients with a high frequency of mucosal and acral melanoma subtypes.
Materials and Methods
Advanced melanoma patients treated with 3 mg/kg ipilimumab in a Korean multicenter named-patient program (NPP) were evaluated between September 2014 and July 2015. Baseline characteristics and blood parameters including neutrophil to lymphocyte ratio (NLR) were assessed, and outcome and adverse events were evaluated according to subtypes.
Results
A total of 104 advanced melanoma patients were treated. The primary sites were acral (31.7%), mucosal (26%), cutaneous (26%), uveal (9.6%), and unknown (6.7%). Sixty-eight patients (65.4%) experienced adverse events, and the most common toxicity was skin rash (22.1%), 10 patients (9.6%) experienced adverse events of grade 3 or higher. The median progression-free survival (PFS) was 2.73 months (95% confidence interval, 2.67 to 2.85), and there was no difference in PFS according to subtypes. Poor performance status, liver metastasis, and NLR (≥5) were independent poor prognostic factors by multivariate analysis.
Conclusion
In the Korean NPP cohort, ipilimumab showed similar efficacy and tolerability compared to Western patients, regardless of subtypes. All subtypes should benefit from ipilimumab with consideration of performance status, liver metastasis, and NLR.

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Baseline neutrophil-to- ratio combined with the change during treatment provides risk stratification for metastatic malignant melanoma patients treated with PD-1 inhibitors in a Chinese population
Chen Wang, Shengyan Liu, Xin Li, Kang Cui, Weijie Zhang, Yabing Du
Frontiers in Oncology.2023;[Epub] CrossRef
Effect of liver metastasis on the efficacy of immune checkpoint inhibitors in cancer patients: a systemic review and meta-analysis
Bao-Wen Tian, Cheng-Long Han, Han-Chao Wang, Lun-Jie Yan, Zi-Niu Ding, Hui Liu, Xin-Cheng Mao, Jin-Cheng Tian, Jun-Shuai Xue, Long-Shan Yang, Si-Yu Tan, Zhao-Ru Dong, Yu-Chuan Yan, Dong-Xu Wang, Tao Li
Clinical & Experimental Metastasis.2023; 40(4): 255. CrossRef
MelRisk: Using neutrophil-to-lymphocyte ratio to improve risk prediction models for metastatic cutaneous melanoma in the sentinel lymph node
Ryckie G. Wade, Samuel Bailey, Alyss V. Robinson, Michelle C.I. Lo, Howard Peach, Marc D.S. Moncrieff, James Martin
Journal of Plastic, Reconstructive & Aesthetic Surgery.2022; 75(5): 1653. CrossRef
The Prognostic Significance of Baseline Neutrophil-to-Lymphocyte Ratio in Melanoma Patients Receiving Immunotherapy
Yayun Li, Yu Meng, Huiyan Sun, Lin Ye, Furong Zeng, Xiang Chen, Guangtong Deng
Journal of Immunotherapy.2022; 45(1): 43. CrossRef
The pharmacotherapeutic management of nail unit and acral melanomas
Julianne M. Falotico, Shari R. Lipner
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Prognostic value of neutrophil-lymphocyte ratio and lactate dehydrogenase in melanoma patients treated with immune checkpoint inhibitors: A systematic review and meta-analysis
Yongchao Zhang, Bozhi Liu, Sergei Kotenko, Wei Li
Medicine.2022; 101(32): e29536. CrossRef
Real‐world, population‐based cohort study of toxicity and resource utilization of second‐line ipilimumab for metastatic melanoma in Ontario, Canada
Wei Fang Dai, Jaclyn Beca, Ruth Croxford, Wanrudee Isaranuwatchai, Ines B. Menjak, Teresa M. Petrella, Nicole Mittmann, Craig C. Earle, Scott Gavura, Rebecca E. Mercer, Timothy P. Hanna, Kelvin K. W. Chan
International Journal of Cancer.2021; 148(8): 1910. CrossRef
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Náthali Felícia Mineiro dos Santos Garrett, Ana Cristina Carvalho da Costa, Elaine Barros Ferreira, Giovanni Damiani, Paula Elaine Diniz dos Reis, Christiane Inocêncio Vasques, Gayle E. Woloschak
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Malgorzata Gajdzis, Radoslaw Kaczmarek, Pawel Gajdzis
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Anja Wessely, Theresa Steeb, Michael Erdmann, Lucie Heinzerling, Julio Vera, Max Schlaak, Carola Berking, Markus Vincent Heppt
International Journal of Molecular Sciences.2020; 21(3): 879. CrossRef
Neutrophil diversity and plasticity in tumour progression and therapy
Sebastien Jaillon, Andrea Ponzetta, Diletta Di Mitri, Angela Santoni, Raffaella Bonecchi, Alberto Mantovani
Nature Reviews Cancer.2020; 20(9): 485. CrossRef
Ipilimumab-Induced Enterocolitis: A Systematic Review and Meta-Analysis
Kelcie Witges, Leigh Anne Shafer, Ryan Zarychanski, Ahmed M. Abou-Setta, Rasheda Rabbani, Orvie Dingwall, Charles N. Bernstein
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Prognostic and predictive role of elevated lactate dehydrogenase in patients with melanoma treated with immunotherapy and BRAF inhibitors: a systematic review and meta-analysis
Fausto Petrelli, Raffaele Ardito, Barbara Merelli, Veronica Lonati, Mary Cabiddu, Silvia Seghezzi, Sandro Barni, Antonio Ghidini
Melanoma Research.2019; 29(1): 1. CrossRef
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Wungki Park, Gilberto Lopes
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Ocular Oncology and Pathology.2019; 5(5): 323. CrossRef
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Yingguo Ding, Shan Zhang, Jianjun Qiao
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Tony Ibrahim, Christine Mateus, Maria Baz, Caroline Robert
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Qiaoyun Tan, Shuxia Liu, Caixia Liang, Xiaohong Han, Yuankai Shi
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Clinical Drug Investigation.2018; 38(10): 967. CrossRef
A high neutrophil to lymphocyte ratio prior to BRAF inhibitor treatment is a predictor of poor progression-free survival in patients with metastatic melanoma
Antoine Finon, Julia Zaragoza, Hervé Maillard, Nathalie Beneton, Guido Bens, Mahtab Samimi, Agnès Caille, Laurent Machet
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Frontiers in Oncology.2017;[Epub] CrossRef

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271 Download
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Interstitial Lung Change in Pre-radiation Therapy Computed Tomography Is a Risk Factor for Severe Radiation Pneumonitis: Yun Hee Lee, Yeon Sil Kim, Sang Nam Lee, Hyo Chun Lee, Se Jin Oh, Seoung Joon Kim, Young Kyoon Kim, Dae Hee Han, Ie Ryung Yoo, Jin Hyung Kang, Suk Hee Hong; Cancer Res Treat. 2015;47(4):676-686. Published online February 13, 2015; DOI: https://doi.org/10.4143/crt.2014.180

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Purpose
We examined clinical and dosimetric factors as predictors of symptomatic radiation pneumonitis (RP) in lung cancer patients and evaluated the relationship between interstitial lung changes in the pre-radiotherapy (RT) computed tomography (CT) and symptomatic RP. Materials and Methods Medical records and dose volume histogram data of 60 lung cancer patients from August 2005 to July 2006 were analyzed. All patients were treated with three dimensional (3D) conformal RT of median 56.9 Gy. We assessed the association of symptomatic RP with clinical and dosimetric factors.
Results
With a median follow-up of 15.5 months (range, 6.1 to 40.9 months), Radiation Therapy Oncology Group grade ≥ 2 RP was observed in 14 patients (23.3%). Five patients (8.3%) died from RP. The interstitial changes in the pre-RT chest CT, mean lung dose (MLD), and V30 significantly predicted RP in multivariable analysis (p=0.009, p < 0.001, and p < 0.001, respectively). MLD, V20, V30, and normal tissue complication probability normal tissue complication probability (NTCP) were associated with the RP grade but less so for grade 5 RP. The risk of RP grade ≥ 2, ≥ 3, or ≥ 4 was higher in the patients with interstitial lung change (grade 2, 15.6% to 46.7%, p=0.03; grade 3, 4.4% to 40%, p=0.002; grade 4, 4.4% to 33.3%, p=0.008). Four of the grade 5 RP patients had diffuse interstitial change in pre-RT CT and received chemoradiotherapy. Conclusion Our study identified diffuse interstitial disease as a significant clinical risk for RP, particularly fatal RP. We showed the usefulness of MLD, V20, V30, and NTCP in predicting the incidence and severity of RP.

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Tairo Kashihara, Yuko Nakayama, Kimiteru Ito, Yuko Kubo, Kae Okuma, Satoshi Shima, Satoshi Nakamura, Kana Takahashi, Koji Inaba, Naoya Murakami, Hiroshi Igaki, Yuichiro Ohe, Masahiko Kusumoto, Jun Itami
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Görkem Türkkan, Yves Willems, Lizza E.L. Hendriks, Rémy Mostard, Lennart Conemans, Hester A Gietema, Cristina Mitea, Stéphanie Peeters, Dirk De Ruysscher
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Marisol Arroyo-Hernández, Federico Maldonado, Francisco Lozano-Ruiz, Wendy Muñoz-Montaño, Mónica Nuñez-Baez, Oscar Arrieta
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Clinical and Dosimetric Predictors of Radiation Pneumonitis in Patients With Non-Small Cell Lung Cancer Undergoing Postoperative Radiation Therapy
Annemarie F. Shepherd, Michelle Iocolano, Jonathan Leeman, Brandon S. Imber, Aaron T. Wild, Michael Offin, Jamie E. Chaft, James Huang, Andreas Rimner, Abraham J. Wu, Daphna Y. Gelblum, Narek Shaverdian, Charles B. Simone, Daniel R. Gomez, Ellen D. Yorke,
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Fangjuan Li, Hui Liu, Hongyu Wu, Shixiong Liang, Yaping Xu
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Clinical Pharmacokinetics of Tegafur Administered with Epirubicin and Cisplatin in Patients with Advanced Gastric Cancer: Jin Hyung Kang, Yoo Lim Kim, Hea Kyoung Cho, Eun Sook Lee, Soo Jin Cha, Young Sun Hong, Kyung Shik Lee, Hyo Jeong Kuh; Cancer Res Treat. 2003;35(3):224-231. Published online June 30, 2003; DOI: https://doi.org/10.4143/crt.2003.35.3.224

Abstract PDF: PURPOSE
Tegafur, an oral prodrug of 5-fluorouracil (5-FU), has been used in the treatment of gastric cancers. UFT (tegafur + uracil) has been developed to enhance the efficacy of tegafur. This study was conducted to assess the pharmacokinetics (PK) of tegafur in gastric cancer patients given the ECU-E regimen (epirubicin, cisplatin, UFT-E, an enteric-coated formula of UFT). A preliminary evaluation of antitumor efficacy and toxicity of ECU-E regimen was also performed. MATERIALS AND METHODS: Of the 32 gastric cancer patients registered for the ECU-E regimen, 8 participated in the PK study. The plasma concentration of tegafur was determined using HPLC. RESULTS: Seven out of the 8 patients were evaluable for response after 2 cycles, and showed 3 partial responses, 1 stable disease and 3 progressive diseases. No major toxicities were observed. Plasma profiles of the tegafur after the first dose showed significant differences in the amount and rate of absorption, i.e., rapid absorption group vs. slow absorption group. The level of C(max) in the rapid absorption group was 1.8 fold higher, and the AUC(0-5h) 4 fold greater, than those in the slow absorption group, nonetheless, the steady state concentrations showed no significant difference. These data indicate that the different absorption rates may not affect the overall exposure to tegafur. The patients with low Cp(ss, peak) showed poor efficacy compared to those with high Cp(ss, peak), suggesting that the concentration of tegafur may be one of the pharmacodynamic determinants in patients administered with ECU-E. CONCLUSION: This study evaluated the pharmacokinetics of tegafur in gastric patients given the ECU-E regimen, and provides preliminary data on the relationship between the plasma tegafur level and the efficacy, which warrants further evaluation.

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Effect of Vinorelbine, Ifosfamide and Cisplatin Combination Chemotherapy in Stage III-IV Non-Small-Cell Lung Cancer: Young Chul Kim, So Young Lee, Hong Joo Cho, Jung A Kim, So Hyang Song, Chi Hong Kim, Hoon Kyo Kim, Meyung Im Ahn, Jin Young You, Sung Whan Kim, Deng Gon Cho, Kyu Do Cho, Jin Hyung Kang; Cancer Res Treat. 2002;34(5):352-356. Published online October 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.5.352

Abstract PDF: PURPOSE
To evaluate the response rates, toxicitiesy, and survival rates, to vinorelbine (Navelbine(R)), cisplatin and ifosfamide combination chemotherapy, of the patients with inoperable NSCLC (stage III and IV), who received vinorelbine (Navelbine(R)), cisplatin, ifosfamide combinationthe mentioned chemotherapy every 4 weeks.
MATERIALS AND METHODS
This study included 26 patients with inoperable NSCLC (stage III and IV), who attended St. Vincent's Hospital Bbetween April 1999 and December 2001, 26 patients were included at St.Vincent's Hospital. The chemotherapy regimen consisted of vinorelbine (25 mg/m2 on days 1 and 8), ifosfamide (1,500 mg/m2 on days 1- and 2 with mesna), and cisplatin (30 mg/m2 on days 1- to 3). The cycles were administered every 4 weeks. A 25% reduction in the doses reduction was applied into subsequent courses if there werewas grade 3~4 neutropenia.
RESULTS
The median age was 63 (range, 44~73) years and the male : to female ratio was 19 : 7. One patient had stage IIIa, 6 had stage IIIb and 19 had stage IV. Twenty two patients had an ECOG performance status of 0 or 1, andwith 4 hadhave one of 2. Eighteen of the patients had adenocarcinoma, 7 had squamous cell carcinomas, and 1 had an undifferentiated NSCLC. Two patients were innot able to be evaluatedble due to follow-up loss. Among Of the 24 patients able to be evaluatedble patients, 1 patient had a complete response and 9 patients hada partial responses, and thewith an overall response rate wasof 41.7%. During a total of 104 cycles, grade 3 neutropenia occurred in 29%, grade 4 neutropenia in 12%, grade 3~4 thrombocytopenia in 4%, grade 3 anemia in 11%, and grade 3~4 mucositis in 2%. The mean time to progression was 6.4 months (range 1~13) and the median overall survival was 10 months (range 1.5~32).
CONCLUSION
The combination of vinorelbine, ifosfamide and cisplatin, in the dose and schedule employed in this study, shows an response rate of 41.7%, but, because grade 3- or 4 neutropenia occurred in 41%, a careful investigation is needed.

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Chemotherapy induced severe neutropenia: Ji Yun Han, Yoo Bae Ahn, Jin Hyung Kang, Han Rim Moon, Young Sun Hong, Hoon Kyo Kim, Kyung Sik Lee, Dong Jib Kim, He Sook Shin, Hye Sun Cha; J Korean Cancer Assoc. 1993;25(4):601-606.

Abstract PDF: No abstract available.

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Pericardial effusion in malignant cancer patients: Chan Soo Moon, Hae Uk Jung, Ho Chul Song, Jin Hyung Kang, Jang Sung Chae, Hoon Kyo Kim, Kyoo Bo Choi, Kyung Sik Lee, Dong Jib Kim; J Korean Cancer Assoc. 1993;25(4):595-600.

Abstract PDF: No abstract available.

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Pain Control in the Termial Cancer Patients at Hospice - ward: Ji Youn Han, Jae You Kim, Jin Hyung Kang, Han Lim Moon, Young Sun Hong, hoon Kyo Kim, Kyung Shick Lee, Dong Jip Kim, Gi Soon Yeoun, Yeong Ok Kim, In Ok Seo, You Suk chong, Young Yi Cho, Suk Kyng Choe; J Korean Cancer Assoc. 1996;28(2):295-301.

Abstract PDF: Pain is one of the most frequent and troublesome symptoms in cancer patients and its prevalence is estimated highest in the terminally ill patients as about 60-80%. For the patient, pain represents a major source of physical limitation, social disability, and emotional distress. For the physician, it represents a difficult diagnostic and therapeutic problem. We retrospectively reviewed 39 advanced cancer patients who had been admitted to the Hospice-ward at Kangnam St. Mary's Hospital with pain as the chief complaints to assess the cause and the severity of pain, and to rate the degree of pain-control by 'principles of pain-control'. The results were as follows: 1) Among 39 patients, 28(72%) had more than severe pain at admission and the most common cause of pain was bone metastases(51%). 2) Morphine sulfate was used in 36 patients and 35 of all 39 patients had experienced major degree of pain-control: 25(64.1%) had 100% pain-control, and 10(25.6% ) had more than 75% pain-control. 3) The side effects of morphine were constipation, nausea and vomiting, confusion, respiratory depression and sedation but no drug tolerance or addiction. Increasing the dose or changing the route of administratian of morphine through periodic and regular reassessment of pain are important to improve the pain management and to increase the level of information available to physician and patients regarding appropriate approach to pain-control.

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