The majority of non-small cell lung cancer patients present with locally advanced disease that may not be resectable. A single modality treatment such as thoracic radiotherapy often results in an inferior outcome when compared to combined modality treatment. Various combinations of radiotherapy, chemotherapy, and surgery have been tested in patients with locally advanced non-small-celllung cancer with promising results. The favorable results of the combined modality treatment are accompanied by a corresponding increase in treatment related morbidity. In this article, the results of the application of combined modality treatments in the management of locally advanced non-small cell lung cancer are reviewed.
Carcinoma, Non-Small-Cell Lung* ; Combined Modality Therapy* ; Drug Therapy ; Humans ; Radiotherapy

No abstract available.
Chemoradiotherapy* ; Chemotherapy, Adjuvant* ; Humans ; Nasopharyngeal Neoplasms*

PURPOSE: Letrozole showed efficacy and generally favorable toxicities, along with the convenience of oral administration in postmenopausal patients with hormone receptor (HR)–positive metastatic breast cancer (MBC). To the best of our knowledge, there have been no reports of the clinical outcomes in Korean patients, although letrozole is widely used in practice. Therefore, this studywas conducted to affirm the efficacy and toxicities of letrozole in Korean patients. MATERIALS AND METHODS: This study retrospectively analyzed 84 HR-positive MBC patients who had been treated with letrozole from January 2001 to December 2012. Clinicopathological characteristics and treatment history were extracted from medicalrecords. All patients received 2.5 mg letrozole once a day until there were disease progressions or unacceptable toxicity. Progression-free survival (PFS) was the primary endpoint, and secondary endpoints were overall survival (OS), objective response rate (ORR), and toxicity. RESULTS: The median age of the subjects was 59.3 years. Letrozole treatment resulted in a median PFS of 16.8 months (95% confidence interval [CI], 9.8 to 23.8) and a median OS of 56.4 months (95% CI, 38.1 to 74.7). The ORR was 36.9% for the 84 patients with measurable lesions. Multivariate analysis revealed symptomatic visceral disease (hazard ratio, 3.437; 95% CI, 1.576 to 7.495; p=0.002) and a disease-free interval ≤ 2 years (hazard ratio, 2.697; 95% CI, 1.262 to 5.762; p=0.010) were independently associated with shorter PFS. However, sensitivity to adjuvant hormone treatment was not related to PFS. Letrozole was generally well tolerated. CONCLUSION: Letrozole showed considerable efficacy and tolerability as a first-line treatment in postmenopausal patients with HR-positive MBC.
Administration, Oral ; Breast Neoplasms* ; Breast* ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Korea* ; Multivariate Analysis ; Retrospective Studies

The symposium on “Oncology Leadership in Asia” was held as part of the official program of the 42nd Annual Meeting of the Korean Cancer Association with International Cancer Conference. Given the increasing incidence of cancer in all countries and regions of Asia, regardless of developmental stage, and also in light of the recognized need for Asian countries to enhance collaboration in cancer prevention, research, treatment and follow-up, the symposium was held with the aim of bringing together oncology specialists from eight countries and regions in Asia to present the status in their own national context and discuss the key challenges and requirements in order to establish a greater Asian presence in the area of cancer control and research. The task of bringing together diverse countries and regions is made all the more urgent in that while Asia now accounts for more than half of all new cancer cases globally, clinical guidelines are based predominantly on practices adopted in Western countries, which may not be optimized for unique ethnic, pharmacogenomic and cultural characteristics in Asia. Recognizing the need for Asia to better gather information and data for the compilation of Asia-specific clinical guidelines, the participants discussed the current status in Asia in the national and regional contexts and identified future steps towards integrated and collaborative initiatives in Asia. A key outcome of the symposium was a proposal to combine and integrate the activities of existing pan-Asian societies, including the Asian Pacific Federation of Organizations for Cancer Research and Control (APFOCC) and Asian Clinical Oncology Society (ACOS). Further proposals included the expansion of pan-Asian society membership to include individuals and the essential need to encourage the participation of young researchers in order to ensure self-sustainability of cancer control efforts in the future.
Asia ; Asian Continental Ancestry Group ; Cooperative Behavior ; Cultural Characteristics ; Follow-Up Studies ; Humans ; Incidence ; Leadership* ; Medical Oncology ; Specialization

Computed tomography offers many advantages over routine radiographs in screening for lung cancer, and it is clear that low-dose spiral CT screening can more frequently find considerably smaller lung cancers than previous detection tools. Recently, investigators have performed low-dose spiral CT scanning for screening of lung cancer, and have suggested that CT screening can depict lung cancers at smaller sizes and at earlier stages. With technological advances in spiral CT scanners, the detection rate of small noncalcified pulmonary nodules has markedly increased, with higher rates noted with thinner collimation of CT scanning. Unfortunately, the majority of these have proved to be benign, i.e. false positive results. If, even in part, CT features could be found to predict benign nodules without follow-up, the false-positive rate would be reduced, and consequently, the cost, emotional stress, radiation dose, morbidity and mortality associated with interventional procedures would also be reduced. There have been several studies trying to establish reliable CT features for benign lesions in small pulmonary nodules and to determine their outcome. Although these efforts have not completely resolved the issue of false positive results, it is expected that lessons will be learnt on how to manage these small nodules through experience with screening in the near future. Because pulmonary nodules on CT are much more common in Korea than in western countries, the management algorithm for screening CT-detected nodules should be modified according to different circumstances, with consensus among related physicians and radiologists. In addition, to enhance patient care and avoid misunderstanding of inherent limitation of CT screening by the screening subjects, physicians, hospital managers as well as radiologists should provide proper information regarding CT screening to the screenees.
Consensus ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Mass Screening* ; Mortality ; Patient Care ; Research Personnel ; Stress, Psychological ; Thorax* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed*

No abstract available.
Cyclooxygenase 2* ; Humans*

PURPOSE: In order to elucidate the antitumor effect of photodynamic therapy (PDT), using a derivative of the photosensitizing agent hematoporphyrin (Photogem) and a diode laser, the cell death of uterine cancer cell lines (CaSki, HT3, HeLa, and SKOV-3), and mice transplanted with TC-1 lung cancer cells, were evaluated. MATERIALS AND METHODS: The morphological changes, MTT assay, flow cytometry, cytotoxicity and tumor growth inhibition study were evaluated at various time intervals after the PDT. RESULTS: The results showed that the survival rates of each cell line decreased with time and dose response after performing the PDT. Also, the PDT-induced damage of cancer cells was almost entirely confined to necrosis of the tumor cells in the early time courses. The irradiation of CaSki cells in the presence of Photogem induced plasma membrane disruption and cell shrinkage, indicating the plasma membrane as the main target for Photogem. In the in vivo experiment, significantly longer survival and a significantly smaller tumor size were seen over the time courses of the Photogem with irradiation compared to the untreated control groups; resorption of the tumor was also observed after the PDT treatment. CONCLUSION: Collectively, our results indicated that Photogem possesses anti-tumor effects, and necrosis-like death, with plasma membrane damage, was postulated to be the principal mechanism of the antitumor effect of the PDT using Photogem.
Animals ; Cell Death ; Cell Line* ; Cell Membrane ; Flow Cytometry ; Hematoporphyrins ; Lasers, Semiconductor ; Lung Neoplasms ; Mice ; Necrosis* ; Photochemotherapy ; Survival Rate ; Uterine Cervical Neoplasms* ; Uterine Neoplasms

PURPOSE: Speculoscopy, or magnified chemiluminescent examination (MCE), is a new visual method for the detection of cervical neoplasia. It utilizes low magnification and a special "blue-white" chemiluminescent light. The purpose of this study was to evaluate the screening effectiveness of speculoscopy combined with the conventional Papanicolaou smear, as compared with the latter alone, through a clinical trial in Korea. MATERIALS AND METHODS: This prospective, randomized, university hospital-based clinical study was performed in the outpatient clinic of the Department of Obstetrics and Gynecology at Dankook University Medical Center from December 1, 2001 to June 30, 2002. Of the 113 patients aged 19~74 years who had undergone both conventional Papanicolaou cervical cytologic test and speculoscopy, 38 cases underwent histologic diagnoses by colposcopy- directed biopsy. RESULTS: Of the 113 patients, there were 87 (77.0%) spe-culoscopy diagnoses of negative, 9 (8.0%) of suspicious, and 17 (15.0%) of positive. Of the 38 histologic diagnoses, there were 19 (50.0%) diagnoses of negative, 7 (18.4%) of LSIL, 1 (2.6%) of HSIL, 10 (26.3%) of SCC, and 1 (2.6%) of ACC. Pap smear showed sensitivity of 77.8% and specificity of 81.3%, whereas speculoscopy showed 94.1% and 100.0%, respectively, and Pap smear combined with speculoscopy showed 100.0% and 81.3%, respectively. CONCLUSION: Speculoscopy showed a higher sensitivity rate than Pap smear as a screening test, although the sample size was small. Speculoscopy combined with Pap smear is thought to be a very effective method for detecting cervical neoplasia.
Academic Medical Centers ; Ambulatory Care Facilities ; Biopsy ; Diagnosis ; Gynecology ; Humans ; Korea ; Mass Screening ; Obstetrics ; Papanicolaou Test ; Prospective Studies ; Sample Size ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

PURPOSE: The cDNA microarray has become a useful tool for observing the expression of thousands of genes simultaneously. However, obtaining good quality microarray data is not easy due to the inherent noise at various stages of the experiment. Therefore, it is essential to understand the source of the variation in the microarray experiment and its size as an initial step of the data analyses. MATERIALS AND METHODS: The total RNA extracted from HT-1080 fibrosarcoma and normal rat tissues were hybridized to the cDNA microarrays with 0.5 K human and 5 K rat genes, respectively. A homotypic reaction and dye swap experiments were used to identify the sources of the variation. RESULTS: The relative fluorescent intensities of the microarray, if unnormalized, have a large variation, particularly in the lower intensity region. The distribution of the log intensity ratios also exhibit some departure from a band around zero, which is the distribution pattern expected when the majority of genes in the microarray are not regulated. Normalization of the log ratios is usually required as a means of preprocessing the data. We claim that a within-print tip group, an intensity-dependent normalization through a loess fit adjustment will be useful for this purpose, particularly in the initial stages of the microarray experiment. CONCLUSION: For proper data analysis, an understanding the source of the variation and preprocessing of data with a suitable normalization method will be important. It is important to have an interactive cooperation between a researcher and a statistician from the early stages of the study design and to the final stages of data analysis.
Animals ; DNA, Complementary* ; Fibrosarcoma ; Humans ; Noise ; Oligonucleotide Array Sequence Analysis* ; Rats ; RNA ; Statistics as Topic

PURPOSE: The pattern of radioprotection by the combined use of low dose amifostine plus IL-1beta was investigated in mice exposed to an acute whole-body radiation dose of 10 Gy. MATERIALS AND METHODS: Male ICR mice were divided into the control group, the irradiation-only group, the high dose amifostine (400 mg/kg i.p. 30 min before irradiation) group, and the low dose amifostine (200 mg/kg i.p. 30 min before irradiation) plus IL-1beta (5 microgram/kg i.p. 20 h before irradiation) group. The radioprotective effects were evaluated using TUNEL assay and microcolony survival assay at jejunal crypt, bone marrow cell count and CBC in peripheral blood, and survival analysis up to 30 days following irradiation. RESULTS: The apoptotic index (p=0.987), surviving crypt number (p=0.484), and the number of WBCs (p=0.226), RBCs (p=0.544), and platelets (p=0.157) were not significantly different between the high dose amifostine group and the low dose amifostine plus IL-1beta group, although the bone marrow cell count was higher in the combination group. The irradiation-only group was dead within 15 days. However, the survival rate at 30 days in the high dose amifostine and the low dose amifostine plus IL-1beta pretreatments were 61% and 66%, respectively. Moreover, the differences between the two groups were insignificant for both 10 days (p=0.9461) and 30 days (p=0.8030). CONCLUSION: These results indicate that the low dose amifostine plus IL-1beta may be applied as a non-toxic radioprotector, while the high dose amifostine, known as the strongest radioprotector, however, had toxic side effects.
Amifostine* ; Animals ; Bone Marrow Cells ; Humans ; In Situ Nick-End Labeling ; Interleukin-1* ; Interleukin-1beta* ; Interleukins* ; Male ; Mice ; Mice, Inbred ICR ; Radiation Protection ; Survival Analysis ; Whole-Body Irradiation