BACKGROUND/AIMS: The risk of venous thromboembolism (VTE), which encompasses deep vein thrombosis and pulmonary embolism (PE), increases in patients with cancer. Anticancer treatment is also associated with an increased risk for VTE. We conducted this study to investigate the clinical characteristics of patients with cancer and PE related to anticancer treatment in a tertiary care hospital in Korea. METHODS: We retrospectively reviewed the clinical data of patients with an underlying malignancy who were diagnosed with PE by chest computed tomography (CT) with or without lower extremity CT angiography between January 2006 and December 2007 at Seoul National University Hospital. RESULTS: Overall, 95 patients with malignancies among 168 with PE were analyzed. The median age was 64 years. The median time interval from the malignancy diagnosis to the PE diagnosis was 5.5 months. Lung cancer was the most common malignancy (23.0%), followed by pancreatobiliary cancer, stomach cancer, gynecological cancer, breast cancer, and hepatocellular carcinoma. Platinum-containing and pyrimidine analog-containing chemotherapeutic regimens were common. CONCLUSIONS: PE was diagnosed within 1 year after the cancer diagnosis in almost 70% of patients. Lung cancer was the most common underlying malignancy.
Adult ; Aged ; Aged, 80 and over ; Angiography ; Antineoplastic Agents/*therapeutic use ; Biliary Tract Neoplasms/drug therapy/epidemiology/radiotherapy ; Female ; Humans ; Lung Neoplasms/drug therapy/epidemiology/radiotherapy ; Male ; Middle Aged ; *Neoplasms/drug therapy/epidemiology/radiotherapy ; Pancreatic Neoplasms/drug therapy/epidemiology/radiotherapy ; Pulmonary Embolism/*epidemiology/radiography ; *Radiotherapy ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/drug therapy/epidemiology/radiotherapy ; Tomography, X-Ray Computed

OBJECTIVETo compare the surgery complications and laryngeal function sparing rate after preoperative concurrent chemoradiotherapy and preoperative radiotherapy of pyriform sinus cancer.

METHODSForty-six patients with squamous cell carcinoma of pyriform sinus from March 2002 to March 2009 were retrospectively analyzed. Concurrent chemotherapy with radiotherapy (CRT + S group) was conducted in twenty-three patients. Cisplatin (50 mg/weekly) was mostly applied. Twenty-three patients were treated with radiation only (RT + S group). Surgery was conducted after a break-time of 21 - 44 days (median, 31 d) and 17 - 40 days (median, 28 d), respectively.

RESULTSThe complication rate of CRT + S group and RT + S group were 30.4% and 39.1% respectively, no significant differences was found (χ(2) = 0.099, P < 0.05). The one-year laryngeal function sparing rate of the two groups were 52.2% and 17.4% respectively, with significant differences (χ(2) = 6.133, P < 0.05). The one-year local regional control rate and disease free survival rate for the CRT + S group were 89.9%, 71.1%, and for RT + S group were 56.3%, 47.1%, P level were 0.018 and 0.037, respectively. There was significant differences in one year local regional control rate and disease free survival rate between the two groups.

CONCLUSIONThe addition of concurrent chemotherapy to preoperative radiotherapy in patients with pyriform sinus cancer does not increase the incidence of surgery complications. Chemotherapy improves the remission rate and appears to increase the laryngeal function sparing rate. Preoperative concurrent chemoradiotherapy can improve the local and regional control, and certainly, more investigations will be needed.

Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; therapy ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Hypopharyngeal Neoplasms ; drug therapy ; radiotherapy ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To analyze the nutritional status and nosocomial infection of nasopharyngeal carcinoma patients before and after the chemoradiotherapy treatment. METHOD: An analysis was made for the nutritional and nosocomial infection status of 82 cases before and after chemoradiotherapy treatment. RESULT: Statistically significant differences were revealed between indexes related with nutritional status such as body mass, hemoglobin, serum albumin before and after the treatment. Sixty-three patients occurred nosocomial infection. The infection rate was 76.83%. The main risk factor was oropharynx mucosal lesion and the rate is 92.68%. Isolates of 39 bacteria were found, of which Gram-negative organisms were 58.97%, Fungi were 30.77%, Gram-positive ones were 7.69%, Herpes zoster were 2.56%. CONCLUSION Chemoradiotherapy has negative influence on nutritional status of patients. Medical personnel should pay attention to patients' nutritional status and do a good job of nutritional status monitoring, nutrition support, dieting guidance, reducing side effects, in order to improve the patient's tolerability and quality of life. The nosocomial infection rate of Gram-negative bacteria of oropharyngeal mucosal is the highest in patients with advanced nasopharyngeal cancer during chemoradiotherapy. It is very important for us to prevent and control nosocomial infection.
Adult ; Aged ; Carcinoma ; Combined Modality Therapy ; Cross Infection ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; microbiology ; radiotherapy ; Nutritional Status ; Risk Factors

OBJECTIVE: This study was performed to evaluate the overall survival and the change in treatment modalities in patients with uterine endometrial cancer in Korea. METHODS: From January 1990 to March 2005, medical records of 740 patients with endometrial cancer in nine hospitals were reviewed. The overall survival was determined supported by the death statistics of Korea National Statistical Office. RESULTS: The mean age of patients was 51.5 years (range: 21-82 years). The mean gravidity and parity were 3.3 and 2.1 (range: 0-18, 0-9), respectively. The most common stage, grade and histological type at diagnosis were FIGO stage I, grade 1 and endometrioid adenocarcinoma (76.5%, 56.4% and 87.2%), respectively. The main treatment modalities was surgery on stage I (59.8%), surgery-adjuvant radiotherapy on stage II (55.1%), surgery-adjuvant radiotherapy or surgery-adjuvant chemoradiation on stage III (38.3%) and surgery-adjuvant chemotherapy on stage IV (55.6%). The preferred treatment modality was surgery only on grade 1 (69.0%) and surgery-adjuvant radiotherapy on grade 2-3 (43.4% and 53.2%). Surgery had been the most common method of therapy before 1998 but its prevalence gradually decreased. As a result, surgery-adjuvant radiotherapy and surgery-adjuvant chemotherapy were most widely performed in 2004-2005 and surgery-adjuvant chemoradiation also increased more than a twofold. The overall 5 years survival rate (5YSR) for all 740 patients was 81.3%. The overall 5YSR of stage I was 89.0%. The overall 5YSR of grade 1, grade 2, grade 3 were 96.0%, 92.0%, 80.0%. Before 1998, the survival rate was 77.0%. Since then it increased to 83-88% and in 2000-2001 it increased to 88.0%, and it was the highest survival rate. CONCLUSION: The survival rate of endometrial cancer has been improving for the past 15 years and the method of treatment is also being changed currently. In order to improve the survival rate of endometrial cancer, a close investigation including genetic and environmental factors of the pathophysiology of endometrial cancer along with the epidemiology of risk factors, should be carried out.
Carcinoma, Endometrioid ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms* ; Epidemiology ; Female ; Gravidity ; Humans ; Korea* ; Medical Records ; Parity ; Prevalence ; Radiotherapy ; Risk Factors ; Survival Rate

PURPOSE: Cardiotoxicity following cancer chemotherapy or radiotherapy is an emerging issue for breast cancer patients. The purpose of this study was to analyze the current domestic research trends for exercise intervention for Korean breast cancer patients under chemotherapy or radiotherapy, focused on cardiovascular indices as study outcome measures and to make suggestions for future nursing studies. METHODS: A literature search was done using PubMed, CINAHL and two Korean databases to identify experimental studies reported in Korean or English between 2,000 and 2015. We identified five studies independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed by RoBANS criteria. RESULTS: Tai-chi exercise was used in three studies and aerobic exercise programs or yoga and walking exercise in the remaining studies. Two studies evaluated cardiovascular outcomes and showed positive findings for breast cancer patients. For cardiovascular indices, heart rate and blood pressure were used. CONCLUSION: This study showed the need for conducting well-designed experimental studies including clinical cardiovascular outcomes to generate evidence on exercise intervention for cancer therapy-induced cardiotoxicity prevention. Additional studies are warranted to accelerate the potential use of exercise as a nursing intervention for cancer patients under chemotherapy or radiotherapy.
Bias (Epidemiology) ; Blood Pressure ; Breast Neoplasms* ; Breast* ; Cardiovascular System ; Drug Therapy* ; Exercise ; Heart Rate ; Humans ; Nursing ; Outcome Assessment (Health Care) ; Radiotherapy* ; Walking ; Yoga

This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors.
Adolescent ; Antineoplastic Agents/therapeutic use ; Central Nervous System Neoplasms/diagnosis/drug therapy/radiotherapy ; Child ; Child, Preschool ; Disease-Free Survival ; Hospitals ; Humans ; Infant ; Leukemia, Myeloid, Acute/diagnosis/epidemiology/mortality/therapy ; Myelodysplastic Syndromes/diagnosis/epidemiology/mortality/therapy ; Neoplasms, Second Primary/*diagnosis/epidemiology/mortality/therapy ; Osteosarcoma/diagnosis/epidemiology ; Retrospective Studies ; Stem Cell Transplantation ; Survival Rate ; Transplantation, Autologous ; Young Adult

This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors.
Adolescent ; Antineoplastic Agents/therapeutic use ; Central Nervous System Neoplasms/diagnosis/drug therapy/radiotherapy ; Child ; Child, Preschool ; Disease-Free Survival ; Hospitals ; Humans ; Infant ; Leukemia, Myeloid, Acute/diagnosis/epidemiology/mortality/therapy ; Myelodysplastic Syndromes/diagnosis/epidemiology/mortality/therapy ; Neoplasms, Second Primary/*diagnosis/epidemiology/mortality/therapy ; Osteosarcoma/diagnosis/epidemiology ; Retrospective Studies ; Stem Cell Transplantation ; Survival Rate ; Transplantation, Autologous ; Young Adult

OBJECTIVETo study the effect of Qingre Liyan Decoction (QRLYD) in the prevention and treatment of acute radiative oral mucositis (AROM), and to explore the mechanism of QRLYD by detecting epidermal growth factor (EGF) and T lymphocytes (CD3, CD4, and CD8).

METHODSSixty patients conforming with the standard were randomly assigned to two groups, 30 patients in each group. Patients in the trial group were treated with QRLYD, and those in the control group were treated with Dobell's solution, both groups receiving conventional radiation treatment. The treatment course for both groups was 6 weeks on average. Blood routine test, CD3, CD4, and CD8 in the peripheral blood and EGF in the saliva were detected one day before and on the 14th and 28th day of radio-therapy.

RESULTSPatients in the trial group were in good condition with normal spirits and intake of food and drinks. The incidence of AROM is lower and the effect in preventing AROM is higher in the trial group than those in the control group (P<0.05). The EGF in saliva, and CD4 and CD8 in the blood of patients in the trial group were higher than those in the control group (P<0.05).

CONCLUSIONQRLYD can cure and prevent AROM. The mechanism may be related with its effects in enhancing body immunity and promoting salivary EGF.

Acute Disease ; Adult ; Carcinoma ; radiotherapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Epidermal Growth Factor ; blood ; Female ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Incidence ; Leukocyte Count ; Male ; Middle Aged ; Phytotherapy ; adverse effects ; Platelet Count ; Radiation Injuries ; drug therapy ; prevention & control ; Stomatitis ; drug therapy ; epidemiology ; etiology ; prevention & control ; T-Lymphocyte Subsets ; drug effects ; Treatment Outcome

BACKGROUND: The National Health Insurance Service (NHIS) established a healthcare claim database for all Korean citizens. This study aimed to analyze the NHIS data and investigate the patterns of breast cancer treatments. METHODS: We constructed a retrospective female breast cancer cohort by analyzing annual incident cases. The annual number of newly diagnosed female breast cancer was compared between the NHIS data and Korea National Cancer Incidence Database (KNCIDB). The annual treatment patterns including surgery, chemotherapy, radiation therapy, endocrine therapy and targeted therapy were analyzed. RESULTS: A total of 148,322 women with newly diagnosed invasive breast cancer during 2006–2014 was identified. The numbers of newly diagnosed invasive breast cancer cases were similar between the NHIS data and KNCIDB, which demonstrated a strong correlation (r = 0.995; P < 0.001). The age distribution of the breast cancer cases in the NHIS data and KNCIDB also showed a strong correlation (r = 1.000; P < 0.001). About 85% of newly diagnosed breast cancer patients underwent operations. Although the proportions of chemotherapy use have not changed during 2006–2014, the total number of chemotherapy prescriptions sharply increased during this period. The proportions of radiotherapy and anti-hormonal therapy increased. Among the anti-hormonal agents, tamoxifen was the most frequently prescribed medication, and letrozole was the most preferred endocrine treatment in patients aged ≥ 50 years. CONCLUSION: Along with the increased breast cancer incidence in Korea, the frequencies of breast cancer treatments have increased. The NHIS data can be a feasible data source for future research.
Age Distribution ; Breast Neoplasms* ; Breast* ; Cohort Studies ; Delivery of Health Care ; Drug Therapy ; Epidemiology ; Female ; Humans ; Incidence ; Information Storage and Retrieval ; Korea ; National Health Programs* ; Prescriptions ; Radiotherapy ; Retrospective Studies ; Survivors* ; Tamoxifen

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.
Adenocarcinoma/radiotherapy ; Adenocarcinoma/mortality ; Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use+ACo- ; Antineoplastic Agents, Combined/adverse effects ; Carboplatin/administration +ACY- dosage ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/drug therapy ; Cervix Neoplasms/radiotherapy+ACo- ; Cervix Neoplasms/mortality ; Cervix Neoplasms/drug therapy ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration +ACY- dosage ; Combined Modality Therapy ; Comparative Study ; Cyclophosphamide/administration +ACY- dosage ; Doxorubicin/administration +ACY- dosage ; Female ; Fluorouracil/administration +ACY- dosage ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/epidemiology ; Hematologic Diseases/etiology ; Hematologic Diseases/epidemiology ; Hepatitis, Toxic/etiology ; Hepatitis, Toxic/epidemiology ; Human ; Kidney Diseases/epidemiology ; Kidney Diseases/chemically induced ; Korea/epidemiology ; Life Tables ; Lymphatic Metastasis ; Middle Age ; Particle Accelerators ; Radiotherapy, High-Energy+ACo-/adverse effects ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome