The 5 year survival rate after surgical resection for stage III non-small cell lung cancer(NSCLC) remains short, only 10-19%. Radiotherapy seems to show some benefit for local control, but it does not reflect to prolongation of survival, as distant metastasis prevails. Vinblastine is one of the most active agent against NSCLC. 5-Fluorouracil(5-FU) and cisplatin are synergistic in anti-cancer activity in adenocarcinoma of gastrointestinal tract and squamous cell cancer of head and neck. We initiated a phase II trial for advanced NSCLC to determine the effect of FVP regimen in response rate, survival and toxicities. The therapy consisted of 5-FU 500mg/m2/12 hours continious IV infusion for 36 hours from day 1, vinblastine 3mg/m2 IV bolus day 1 and 2, cisplatin 75mg/m2 IV infusion over 2 hours day 1 and it was repeated every 3 weeks. Among the 45 patients entered into this study, 40 patients were evaluable for response. The objective response rate was 50%(CR;1/40, 2.5% PRi19/40, 47.5%). The median survival of all the patients was 42.9 weeks(8.4+ - 140.6 weeks); the responding patients survived longer than the non-responders(mediansurvival; 54.4 weeks vs 29.7 weeks, p<0.05). The toxicities of this regimen were acceptable but 1 patient died of pneumonia associated with granulocytopenia. We concluded that the FVP regimen is effective in the treatment of advanced non-small cell lung cancer and a prospective randomized trial and long- term follow up is warranted.
Adenocarcinoma ; Agranulocytosis ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Dronabinol* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Follow-Up Studies ; Gastrointestinal Tract ; Head ; Humans ; Lung ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Pneumonia ; Radiotherapy ; Survival Rate ; Vinblastine

PURPOSE: The aims of this study was to examine the anti-proliferative effect and apoptosis induction by aspirin using SNU-668 human gastric adenocarcinoma cell lines. MATERIALS AND METHODS: After treating SNU-668 cell lines with various concentrations of aspirin, cell growth was quantified by MTT assay. Apoptosis was determined by comparing aspirin treated cell lines by immunofluores cence with control cells after Hoechst 33258 staining. Cell lines were further examined using ELISA. Cell cycle was evaluated by FACS. RESULTS: Inhibition of cellular proliferation occurred when cells were treated with aspirin at concetrations of 1 mM or more. Aspirin also induced apoptosis =in these cell lines. Percentages of induction were 3.0+/- 0.6% , 4.8, +/- 0.6%, 17.5+/-0.8%, and 19.2+/-0.7% at 0, 0.5, 1 and 2 mM concentration of aspirin, respectively. ELISA confirmed apoptosis in these cells. However, cell cycle was not affected. CONCLUSION: These results indicate that induction of apoptotic cell death contribute to the anti-proliferative effect of aspirin on SNU-668 human gastric adenocarcinoma cell lines without affecting cell cycle. These findings suggest aspirin may play an important role in cancer prevention and tumor regression in humans.
Adenocarcinoma* ; Apoptosis* ; Aspirin ; Bisbenzimidazole ; Cell Cycle ; Cell Death ; Cell Line* ; Cell Proliferation* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Stomach Neoplasms

No abstract available.
Carcinoma, Mucoepidermoid*

PURPOSE: To evaluate the role of combination therapy of external radiotherapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. METHODS AND MATERIALS: A retrospective review of evaluable 55 esophageal cancer patients referredto the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul. 1983 and Dec.1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group(ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fiffy patients had squamous cell carcinomas. Radiation doses of 2520-6480cGy were delivered over a period of 4-7weeks. using 4MV LIVAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1,2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. RESULTS: Median follow up period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months(20 days-73 months) in B group. The 1,2 YSRs were 26.7%, 8.9% in A group. 12.7%, 4.3% in B group (p>0.05), respectively. The 1,2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose(5000cGy more or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were 43.8%, 25.0%, respectively. Complete response rate of 25.0% in A and 8.3% in B were achieved. The local failure and distant metastsis were 52.4%, 23.8% in A group. 64.3%, 14.3% in B group, respectively. The combination therapy revealed more freguent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to modereate. CONCLUSION: The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.
Aged ; Carcinoma, Squamous Cell ; Drug Therapy ; Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Leukopenia ; Male ; Middle Aged ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer provides anticipated cure rates of 10-65% depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer METHODS AND MATERIALS: From November 1983 to October 1994, 31 patients with Stage II and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone. and 15 patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy(median 7010 cGy). In combined group. 7 patients were treated with cis-platin plus 5-FU, 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. RESULTS: Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient (66.6%) of the RT alone group and 14 patient (93.3%) of the chemoradiation group. There was no statistical difference in CR rate between the two groups. The overall survival rates at 5 years were 23.4% in the radiation alone group. 23.5% in the chemoradiation group. Disease-free survival rates at 3 year were 44.5% in the radiation alone group. 40% in the chemoradiation group. There was no statistical differences in overall survival rates and disease free survival rates between the two groups.Local recurrences occurred in 71.5% of the radiation alone group. 72.7% of the chemoradiation group and distant metastasis occurred in 14.4% of radiation alone group. 9.1% of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity. CONCLUSION: Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-up may be necessary to confirm the present result of combined chemotherapy and radiotherapy.
Carboplatin ; Carcinoma, Squamous Cell* ; Chemoradiotherapy* ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Leucovorin ; Methotrexate ; Neck* ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: Since 1983, authors have conducted a study to evaluate the effect of external radiation therapy an to determine affected factors in management of the patients with malignant obstructive jaundice due to porta hepatis metastasis from stomach cancer. MATERIALS AND METHODS: Thirty two patients with malignant obstructive jaundice due to porta hepatis metstasis from gastric cancer were presented. We have analysed 23 patients who were treated with external radiation therapy of more than 3000 cGy. The radiation dose, disease extent at development of jaundice, total bilirubin levels before radiation therapy, differentiation of histology, combined treatment, intent of primary surgery, initial stage of gastric cancer were analyzed to determine affected factors in radiation therapy. External radiation therapy was delivered with a daily dose of 180-300 cGy. 5 times a week fractionation using 4 MeV linear accelerator. The radiation field included the porta hepatis with tumor mass by the abdominal ultrasonography or CT scan. In twenty three patients received more than 3000 cGy, total irradiation dose was ranged from 3000 cGy to 5480 cGy, median 3770 cGy. Among 23 patients, 13 patients were delivered more than equivalent dose of TDF 65(4140 cGy/23fx). RESULTS: Among 23 patients, complete, partial and no response were observed in 13, 5, 5 patients, respectively. The median survival for all patients was 5 months. He significant prolongation of median survival was observed in complete responders(11 months) as compared to partial and no responders(5 months, 5 months, respectively). Out of 13 patients with complete response, 6 patients lived more than a year. Among 13 patients received more than 4140 cGy equivalent dose, complete, partial and no response were observed in 10, 2 and 1 patients, respectively. The median survival for all these patients was 9.5 months. The median survival for complete responders(10/13) was 11.5 months. Among 10 patients receiving less than 4140 cGy equivalent dose, complete, partial and no response were observed in 3,3,4 patients, respectively. The median survival for al these patients was 4.3 months. Therefore, the radiation dose affected the results of treatment. For the complete response with prolongation of survival duration, at least 4140 cGy equivalent dose should be delivered to porta hepatis. In evaluation of the disease extent, 7 patients of 13 complete responders showed localized disease in porta hepatis or peripancreatic area, but all patients with partial and no response showed wide extensive disease or persistant disease of primary gastric cancer. Therefore, the patients with the localized disease were the higher probability of complete response and long term survival. This study suggested that the radiation dose and the disease extent at development of jaundice affected in radiation dose and the disease extent at development of jaundice affected in radiation therapy for malignant obstructive jaundice. There were no serious complications related to external radiation therapy. CONCLUSION: External radiation therapy only could achieve the palliative affect in the patients with malignant obstructive jaundice due to porta hepatis metastasis from stocach cancer. This study suggested that the prolongation of survival duration could be achieved in complete responders and radiation dose, extent of disease affected the results of treatment of malignant obstructive jaundice.
Bilirubin ; Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis* ; Particle Accelerators ; Stomach Neoplasms* ; Stomach* ; Tomography, X-Ray Computed ; Ultrasonography

Primary malignant tumor of trachea is rare and often extensive at presentation and frequently causes life threatening airway obstruction. Primary extranodal lymphomas comprise about 10% of all malignant lymphomas. However, the primary malignant lymphoma of trachea is extremely rare. We presented here a case of 62-year-old male, was diagnosed as a primary extranodal lymphoma arising in the trachea with review of literature.
Airway Obstruction ; Humans ; Lymphoma* ; Male ; Middle Aged ; Trachea*

PURPOSE: To evaluate the potential advantage for "sandwich" technique radiotherapy compared to postoperative radiotherapy in respectable rectal cancer. METHODS AND MATERIALS: Between January 1989 and May 1994, 60 patients with respectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital.Fifty one patients were available for analysis : 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with postoperative radiotherapy. In sandwich technique radiotherapy(RT), patients were treated with preoperative RT 1500 cGy/5fx. followed by immediate curative resection. Patients staged as Astler-Coller B2, C were considered for postoperative RT with 2500-4500 cGy. In postoperative RT, total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-6weeks was delivered. Patients were followed for median period of 25 months. RESULTS: The overall 5-year survival rates for sandwich technique RT group and postoperative RT group were 60% and 71%, respectively(p>0.05). The 5-year disease free survival rates for each group were 63%. There was no difference in local failure rate between two groups(11% versus 7%). Incidence of distant metastasis was 11%(2/20) in the sandwich technique RT group and 20%(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. CONCLUSION: The sandwich technique radiotherapy group shows local recurrence and survival similar to those of postoperative RT alone group but reduced distant metastasis compared to postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT.Key Words : Rectal cancer, Sandwich technique, Radiotherapy
Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Neoplasm Metastasis ; Radiotherapy* ; Rectal Neoplasms ; Recurrence ; Seoul ; Survival Rate

No abstract available.
Amyloid* ; Arthritis, Rheumatoid* ; Humans ; Multiple Myeloma*

PURPOSE: Carcinomas arising in the gall bladder (GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5- year survival rates are less than 10%. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. MATERIALS AND METHODS: From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy (median 44.25Gy), and three patients received additional intraluminal brachytherapy (range, 25Gy to 30Gy). Twenty-seven patients received a postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. RESULTS: Median follow up period was 8.5 months (range 2-97 months). The overall 2-year and 5-year survival rates in all patients were 29.9% and 13.3% respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were 34.5% and 27.8% respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation (43.8% vs. 20.7%). albeit, statistically insignificant (P>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance (P<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status (P<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were 40.5% and 22.6% respectively. There was no statistical differences in two groups (P>0.05). CONCLUSION: The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy. More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.
Biopsy ; Brachytherapy ; Chemotherapy, Adjuvant ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Gallbladder ; Humans ; Leucovorin ; Mitomycin ; Particle Accelerators ; Prognosis ; Radiotherapy* ; Retrospective Studies* ; Survival Rate ; Urinary Bladder*