To get a better understanding of the location, pathophysiology, etiology and prognosis of multiple malignant tumors (MPMT), we evaluated the medical records of 22 patients with MPMT. Our results suggested that radiotherapy and chemotherapy might play an important role in the pathogenesis of MPMT and follow-up is important in detecting a secondary primary malignant tumor (PMT) at an early stage. Surgical removal of tumors is the first-choice therapy for MPMT.
Adenocarcinoma ; drug therapy ; radiotherapy ; surgery ; Adult ; Aged ; Breast Neoplasms ; drug therapy ; radiotherapy ; surgery ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; surgery ; Colonic Neoplasms ; drug therapy ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; drug therapy ; radiotherapy ; surgery ; Male ; Middle Aged ; Neoplasms, Second Primary ; drug therapy ; radiotherapy ; surgery ; Prognosis ; Stomach Neoplasms ; drug therapy ; radiotherapy ; surgery

Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

In hepatocellular carcinoma (HCC), sorafenib is the only approved systemic chemotherapy, and has been applied for those with advanced HCC especially with systemic metastasis. However, the treatment results are suboptimal leaving many cases with disease progression despite the use of optimum dose. There is no established guideline for those that fail to respond to sorafenib treatment. In this case, a 46-years-old male with metastatic lung cancer from HCC experienced progression despite sorafenib treatment. Then, the patient received surgical resection of the metastatic lung mass followed by radiation therapy and achieved complete remission for 10 months after the surgical treatment and radiation therapy. Alpha-fetoprotein level was normalized and complete remission has been maintained.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Disease Progression ; Drug Therapy ; Humans ; Lung Neoplasms ; Lung* ; Male ; Neoplasm Metastasis* ; Radiotherapy

Primary malignant lesions of the vagina represent less than 2% of all gynecologic malignancies. Primary vaginal sarcoma accounts for about 2% of all malignant vaginal lesions and the leiomyosarcoma is the most common vaginal sarcoma found in adult women. The treatment is wide resection of lesion and radiotherapy or chemotherapy, but the progress is not hopeful. We report a case of primary vaginal sarcoma metastasized to the lung. Although the primary lesion was 1.8 cm, but the patient died of metastatic lung cancer.
Adult ; Drug Therapy ; Female ; Hope ; Humans ; Leiomyosarcoma* ; Lung Neoplasms ; Lung* ; Radiotherapy ; Sarcoma ; Vagina

BACKGROUND: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer MATERIAL AND METHOD: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. RESULT: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) CONCLUSION: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.
Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Mortality ; Neoplasm Staging ; Pathology ; Radiotherapy ; Retrospective Studies ; Survival Rate

With the introduction of X-rays of higher energy that have higher penetrability, it has become possible to treat the deep-seated tumor with increased local control rate. But at the same time it has incrased the damage to the deep seated organs, especially to the lung which is known to be the less radiotolerable tissue in the body. This study analyses the 66 patients who were exposed to the irradiation of the lung, and examines the development of radiation pneumonitis and its related factors. The results of the study are summarized as folows : 1. The 66 patients were consisted of 40 cases of lung cancer, 15 cases of breast cancer and 11 cases of mediastinal tumors. There were 37 males and 29 females with the male to female ratio 1.3 : 1. A male to female ratio in the lung cancer was 3 : 1. 2. Among 66 patients, 26 patients (39%) developed the radiographical changes of acute radiation pneumonitis and 13 out of 26 patients (50%) showed the clinical features of acute radiation pneumonitis. 3. The onest of acute radiation pneumonitis ranged from 10 days to 6 months after the completion of radiotherapy. 4. There was a statistically significant close relationship between the development of radiation pneumonitis and the radiation dose. 5. As the irradiated lung volume increased, the development of radiation pneumonitis increased. But the statistical significance was not strong. 6. The increased incidence of radiation pneumonitis was observed when the chemotherapy was given before or concomittantly with radiotherapy. 7. There was no significant correlation between the development of radiation pneumonitis and the age, smoking and the presence of underlying lung disease.
Breast Neoplasms ; Drug Therapy ; Female ; Humans ; Incidence ; Lung ; Lung Diseases ; Lung Neoplasms ; Male ; Radiation Pneumonitis* ; Radiotherapy ; Smoke ; Smoking

To develop a more appropriate therapeutic strategy for treatment of nonpulmonary visceral metastatic testicular seminoma based on the International Germ Cell Consensus Classification, we reviewed the medical records of patients with nonpulmonary visceral metastatic testicular seminoma who were treated over a 20-year period. Only 15 (2.2%) of the 686 cases of testicular seminoma were nonpulmonary visceral metastatic seminoma. The median age of patients was 38 years (range, 22-53 years). Ten (67%) of the patients had an initial diagnosis of supradiaphragmatic or visceral metastatic disease. In addition to nonpulmonary visceral metastasis, all patients had lymph node metastasis as well, the majority of which involved the retroperitoneal lymph nodes. The median and mean progression-free survival durations after chemotherapy for advanced disease were 19 months and 63.7 months, respectively. Six patients (40%) survived, five relapsed after radiation therapy and four died of chemorefractory disease not dependent on the specific regimen. Although the number of cases reviewed in this study was small, we conclude that the choice of chemotherapeutic regimen among the current treatments for nonpulmonary visceral metastatic seminoma of testis primary does not present a different outcome. Therefore, multimodality therapies using new strategies or new agents are well indicated.
Adult ; Antineoplastic Agents, Combined/administration & dosage* ; Bone Neoplasms/secondary ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/drug therapy ; Combined Modality Therapy ; Human ; Lung Neoplasms/secondary ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/drug therapy ; Lymphatic Metastasis ; Male ; Middle Age ; Retroperitoneal Neoplasms/secondary* ; Retroperitoneal Neoplasms/radiotherapy ; Retroperitoneal Neoplasms/drug therapy* ; Retrospective Studies ; Seminoma/secondary* ; Seminoma/radiotherapy ; Seminoma/drug therapy* ; Testicular Neoplasms/pathology*

PURPOSE: To review the treatment outcomes of patients with limited-stage small-cell lung cancer (LS-SCLC) receiving daily thoracic irradiation (RT) to > or = 60 Gy. Materials and M ethods: The records of patients treated with RT for LS-SCLC between 1990 and 2002 at Pusan National University Hospital were retrospectively reviewed. Fifty-six patients were identified who had received once-daily 1.8~2 Gy fractions from 40 Gy to 63 Gy. All patients received sequential chemotherapy and then RT. These patients were arbitrary divided two groups according to thoracic radiation dose, <60 Gy and > or =60 Gy. The time to death was assessed using actuarial method. RESULTS: Two- and 5-year overall survival rates for <60 Gy and > or =60 Gy group was 32% and 41% and 14% and 21%, respectively (p=1.6). Median overall survival for <60 Gy group and > or =60 Gy group was 17 and 20 months, respectively. Two case of acute Grade 3 esophagitis and one case of acute Grade 4 pneumonitis developed in > or =60 Gy group. The first relapse sites of chest for <60 Gy group and > or =60 Gy group were 9/15 (60%) and 3/8 (38%), respectively (p=0.4). CONCLUSION: > or =60 Gy once-daily thoracic radiotherapy was generally well tolerated and moderately improves local control compared to <60 Gy in patients with LS_ SCLC who are treated with combination chemotherapy
Busan ; Chemoradiotherapy ; Drug Therapy ; Drug Therapy, Combination ; Esophagitis ; Humans ; Lung Neoplasms* ; Lung* ; Pneumonia ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Thorax

BACKGROUND AND OBJECTIVEThe efficacy of complete resection of the cancer for patients with stage IIIa non-small cell lung cancer (NSCLC) is limited. Synthetic therapy is taken the lead in advocating at present. However, the value of post-operative radiotherapy is not still clear. The aim of this study is to evaluate the survival time and side effects of postoperative chemotherapy or chemoradiotherapy in the treatment of stage IIIa NSCLC.

METHODSBetween December 2003 and June 2007, 52 cases that have completed followed-up data with stage IIIa of NSCLC received in the First Affiliated Hospital of Dahan Medical University. Twenty-three patients received postoperative chemoradiotherapy (group A) and 29 patients received postoperative chemotherapy combined with radiotherapy (group B). Group A adopted platinum-based combination chemotherapy for 4-6 cycles. The chemotherapeutics included gemcitabine, vinorelbine and docetaxel. Group B used chemotherapy for 2-4 cycles and then received 3-dimensional conformal radiotherapy (3D-CRT). The prescribe dose of target volume was 50 Gy. The chemotherapy was same as for group A and needed 4 cycles in all. The impact of postoperative adjuvant treatment on survival and toxicity was observed in patients with stage IIIa NSCLC and the reason of disease progression was analyzed.

RESULTSThe median survival was 32.5 months in group A and 31.9 months in group B (P = 0.371). Progression-free survival extended about 6 months (P = 0.044). The survival rate was 87% at 1 year, 0.1% at 2 year, 33% at 3 year for group A compared with 93%, 69%, 45% for group B. The major side effects were hematological and gastrointestinal toxicities, including nausea, vomiting and neutropenia. There was no significant difference in these toxicities between the two groups (P > 0.05). Radioactive esophageal infection occurred in 17.2% of the patients. Acute and late radioactive lung infection occurred in 13.8% and 27.6% of the patients. All these toxicities were below degree 2. Distant metastases were the main reason of disease progression. There was no significant difference in the rates of local recurrence and metastases between the two groups (P > 0.05).

CONCLUSIONCombined modality therapy should be the main therapy of stage IIIa NSCLC. The addition of radiotherapy can effectively prolong progression-free survival and don't highly increase the toxicities.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; radiotherapy ; surgery ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; radiotherapy ; surgery ; Male ; Middle Aged

Non-small cell lung cancer: As most patients with non-small cell lung cancer present with nonsurgically curable diseae, major efforts have been made in the treatment of advanced non-small cell lung cancer (NSCLC) with chemotherapy. Controlled studies of platinum-based chemotherapy vs. supportive care showed statistically significant improvements in survival. During the last several years, the introduction of several new chemotherapeutic agents, such as the taxanes, gemcitabine, vinorelbine, and irinotecan has resulted in improved survival and quality of life for patients with advanced NSCLC. However, the superiority of a regimen in terms of improved survival, quality of life, and toxicity profile has still remained unclear. Newer, targeted therapies hold promise to improve outcome without adding a great deal of additional toxicity. Small cell lung cancer: Small cell lung cancer (SCLC) is characterized by early dissemination and a rapid, aggressive clinical course. The role of combination chemotherapy in patients with SCLC was well established since 1970's; however, no trend toward longer survival has been observed during the last decade. Even if the use of adjunctive radiation therapy does not help in extending survival in extensive-disease, the use of chemotherapy without radiation therapy is to be discouraged in patients with limited-disease, because randomized trials showed a definite survival advantage for combined modality therapy. In terms of the choice of chemotherapy, etoposide/cisplatin or etoposide/carboplatin have emerged as the regimens of choice because they offer a good therapeutic index and can be combined with radiotherapy. Recently, several active agents such as taxanes, topotecan, vinorelbine, and irinotecan have been used in SCLC.
Carcinoma, Non-Small-Cell Lung ; Combined Modality Therapy ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Lung Neoplasms* ; Lung* ; Quality of Life ; Radiotherapy ; Small Cell Lung Carcinoma ; Taxoids ; Topotecan