2.Evolving Cancer Classification in the Era of Personalized Medicine: A Primer for Radiologists.
Ailbhe C O'NEILL ; Jyothi P JAGANNATHAN ; Nikhil H RAMAIYA
Korean Journal of Radiology 2017;18(1):6-17
Traditionally tumors were classified based on anatomic location but now specific genetic mutations in cancers are leading to treatment of tumors with molecular targeted therapies. This has led to a paradigm shift in the classification and treatment of cancer. Tumors treated with molecular targeted therapies often show morphological changes rather than change in size and are associated with class specific and drug specific toxicities, different from those encountered with conventional chemotherapeutic agents. It is important for the radiologists to be familiar with the new cancer classification and the various treatment strategies employed, in order to effectively communicate and participate in the multi-disciplinary care. In this paper we will focus on lung cancer as a prototype of the new molecular classification.
Adenocarcinoma
;
Classification*
;
Humans
;
Lung Neoplasms
;
Molecular Targeted Therapy
;
Precision Medicine*
3.Long-Term Survival in Stage IV Esophageal Adenocarcinoma with Chemoradiation and Serial Endoscopic Cryoablation.
Zachary SPIRITOS ; Parit MEKAROONKAMOL ; Bassel F EL-RAYES ; Seth D FORCE ; Steven A KEILIN ; Qiang CAI ; Field F WILLINGHAM
Clinical Endoscopy 2017;50(5):491-494
Esophageal cancer has a poor overall prognosis and is frequently diagnosed at a late stage. Conventional treatment for metastatic esophageal cancer involves chemotherapy and radiation. Local disease control plays a significant role in improving survival. Endoscopic spray cryotherapy is a novel modality that involves freezing and thawing to produce local ablation of malignant tissue via ischemic mechanisms. Spray cryotherapy has been shown to be effective, particularly for early T-stage, superficial esophageal adenocarcinomas. We present the case of a 72-year-old-male with locally recurrent stage IV esophageal adenocarcinoma and long-term survival of 7 years to date, with concurrent chemoradiation and serial cryoablation. He remains asymptomatic and continues to undergo chemotherapy and sequential cryoablation. The findings highlight the long-term safety and efficacy of cryotherapy in combination with chemoradiation, and suggest that cryoablation may have an additive role in the treatment of advanced stage esophageal adenocarcinoma.
Adenocarcinoma*
;
Cryosurgery*
;
Cryotherapy
;
Drug Therapy
;
Esophageal Neoplasms
;
Freezing
;
Prognosis
4.Single agent chemotherapy with cyclophosphamide in patients with advanced prostatic cancer.
Korean Journal of Urology 1993;34(4):626-630
Eleven patients with advanced prostatic cancer who had received single agent chemotherapy with cyclophosphamide were evaluated. All patients had pathologically confirmed prostatic adenocarcinoma and were unresponsive to or in relapse after hormonal therapy. They were treated intravenously with 200mg/m2 cyclophosphamide daily for four days every four weeks. The National prostatic Cancer Project(NPCP) response criteria were used. so objective response included patients with complete or partial response as well as objectively stable disease as defined by NPCP response criteria. The response rate was 54.6 %. with three partial response(27.3 8 ) and three objectively stable disease(27.3) of the eleven patients. All the six patients with partial response and objectively stable disease lived longer than 4 year, whereas for the five patients with objective progression. only two patient lived longer than 1 year. Toxicity was mild and tolerable. Mild and asymptomatic cyclophosphamide-induced hyponatremia was observed in two patients and hemorrhagic cystitis of mild degree was observed in one patient Severe hematologic and gastrointestinal toxicities were not observed.
Adenocarcinoma
;
Cyclophosphamide*
;
Cystitis
;
Drug Therapy*
;
Humans
;
Hyponatremia
;
Prostatic Neoplasms*
;
Recurrence
5.A network meta-analysis of the short-term efficacy of five chemotherapy regimens based on cisplatin and fluorouracil for esophagogastric junctional adenocarcinoma.
Cong WANG ; Dong Jian SONG ; Zhi Li XU ; Shu Ping XIE ; Jun Hong HU
Experimental & Molecular Medicine 2017;49(9):e383-
The primary purpose of this study was to explore the short-term efficacy of different cisplatin and fluorouracil-based chemotherapy regimens in the treatment of patients with esophagogastric junctional adenocarcinoma (EGJA) using a network meta-analysis (NMA). Randomized controlled trials (RCTs) related to chemotherapy regimens based on cisplatin and fluorouracil for EGJA were included from the PubMed, EMBASE and Cochrane Library electronic databases (from inception to June 2016). Direct and indirect evidence were combined to calculate the pooled odds ratio (OR) and its 95% confidence interval (95% CI) as well as to draw the surface under the cumulative ranking (SUCRA) curves. This NMA finally enrolled ten eligible RCTs with the following five regimens: cisplatin plus fluorouracil (cisplatin+fluorouracil), cisplatin+fluorouracil-based chemotherapy (cisplatin+fluorouracil+docetaxel/epirubicin/irinotecan), fluorouracil-based chemotherapy (fluorouracil+docetaxel/doxorubicin/methotrexate/irinotecan), cisplatin-based chemotherapy (cisplatin+docetaxel/epirubicin/irinotecan/capecitabine/s-1) and other drug-based chemotherapy (docetaxel/irinotecan/capecitabine). These results revealed that compared with a cisplatin+ fluorouracil-based chemotherapy regimen, the fluorouracil-based chemotherapy regimen had a lower overall response rate (ORR) and partial response (PR) for EGJA patients (ORR: OR=0.43, 95% CI=0.22–0.86; PR: OR=0.46, 95% CI=0.23–0.91). Cluster analyses suggested that the cisplatin+fluorouracil-based chemotherapy regimen had the best short-term efficacy for EGJA in terms of the complete response (CR), PR, ORR, stable disease (SD) and progression disease (PD). Our results indicated that cisplatin+fluorouracil-based chemotherapy regimens may have the best short-term efficacy in the treatment of EGJA.
Adenocarcinoma*
;
Cisplatin*
;
Drug Therapy*
;
Fluorouracil*
;
Humans
;
Odds Ratio
6.Long Term Complete Response of Unresectable Locally Advanced Pancreatic Cancer after CCRT and Gemcitabine Chemotherapy.
Jaeyun YANG ; Taekyu LIM ; Taegyoon KIM ; Seungmoon HAN ; Sanghee LEE ; Huiseo KIM ; Jiwon LEE ; Seongyeong AHN
Korean Journal of Pancreas and Biliary Tract 2016;21(4):209-215
Locally advanced or metastatic disease accounts for two thirds of total patients with pancreatic cancer. Patients with pancreatic cancer are assessed as resectable, potentially resectable (borderline) or unresectable according to pre-operative examinations. The chances of resectability may be enhanced by using neoadjuvant systemic chemotherapy, radiotherapy or both. This case report presents a locally advanced pancreatic adenocarcinoma that was identified to be unresectable during surgical exploration. After receiving concurrent chemoradiotherapy, the patient was re-evaluated, identified as unresectable and received gemcitabine maintenance chemotherapy. Herein, we report the case of a patient with unresectable locally advanced pancreatic adenocarcinoma who achieved a complete response lasting for more than 32 months after receiving concurrent chmoradiotherapy followed by gemcitabine maintenance chemotherapy.
Adenocarcinoma
;
Chemoradiotherapy
;
Drug Therapy*
;
Humans
;
Maintenance Chemotherapy
;
Pancreatic Neoplasms*
;
Radiotherapy
7.Long Term Complete Response of Unresectable Locally Advanced Pancreatic Cancer after CCRT and Gemcitabine Chemotherapy.
Jaeyun YANG ; Taekyu LIM ; Taegyoon KIM ; Seungmoon HAN ; Sanghee LEE ; Huiseo KIM ; Jiwon LEE ; Seongyeong AHN
Korean Journal of Pancreas and Biliary Tract 2016;21(4):209-215
Locally advanced or metastatic disease accounts for two thirds of total patients with pancreatic cancer. Patients with pancreatic cancer are assessed as resectable, potentially resectable (borderline) or unresectable according to pre-operative examinations. The chances of resectability may be enhanced by using neoadjuvant systemic chemotherapy, radiotherapy or both. This case report presents a locally advanced pancreatic adenocarcinoma that was identified to be unresectable during surgical exploration. After receiving concurrent chemoradiotherapy, the patient was re-evaluated, identified as unresectable and received gemcitabine maintenance chemotherapy. Herein, we report the case of a patient with unresectable locally advanced pancreatic adenocarcinoma who achieved a complete response lasting for more than 32 months after receiving concurrent chmoradiotherapy followed by gemcitabine maintenance chemotherapy.
Adenocarcinoma
;
Chemoradiotherapy
;
Drug Therapy*
;
Humans
;
Maintenance Chemotherapy
;
Pancreatic Neoplasms*
;
Radiotherapy
8.Exclusively Endoscopic Resection of Nasopharyngeal Adenocarcinoma.
Clinical and Experimental Otorhinolaryngology 2013;6(4):263-265
We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.
Adenocarcinoma*
;
Drug Therapy
;
Endoscopes
;
Humans
;
Nasopharyngeal Neoplasms
;
Radiotherapy
;
Recurrence