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

PURPOSE: We examined whether intratumoral (i.t.) administration of dendritic cells (DCs) into a treated tumor could induce local and systemic antitumor effects in a mouse tumor model. METHODS AND MATERIALS: C57BL/6 mice were inoculated s.c. in the right and left thighs with MCA-102 fibrosarcoma cells on day 0 and on day 7, respectively. On day 7, the tumors (usually 6 mm in diameter) on the right thigh were heated by immersing the tumor-bearing leg in a circulating water bath at 43 degrees C for 30 min; thereafter, the immature DCs were i.t administered to the right thigh tumors. This immunization procedure was repeated on days 7, 14 and 21. The tumors in both the right and left thighs were measured every 7 days and the average sizes were determined by applying the following formula, tumor size=0.5 x (length+width). Cytotoxicity assay was done to determine tumor-specific cytotoxic T-lymphocyte activity. RESULTS: Hyperthermia induced apoptosis and heat shock proteins (HSPs) in tumor occurred maximally after 6 hr. For the local treated tumor, hyperthermia (HT) alone inhibited tumor growth compared with the untreated tumors (p<0.05), and furthermore, the i.t. administered DCs combined with hyperthermia (HT+DCs) additively inhibited tumor growth compared with HT alone (p<0.05). On the distant untreated tumor, HT alone significantly inhibited tumor growth (p<0.05), and also HT+DCs potently inhibited tumor growth (p<0.001); however, compared with HT alone, the difference was not statistically significant. In addition, HT+DCs induced strong cytotoxicity of the splenocytes against tumor cells compared to DCs or HT alone. CONCLUSION: HT+DCs induced apoptosis and increased the expression of HSPs, and so this induced a potent local and systemic antitumor response in tumor-bearing mice. This regimen may be beneficial for the treatment of human cancers.
Animals ; Apoptosis ; Baths ; Dendritic Cells* ; Fever* ; Fibrosarcoma ; Heat-Shock Proteins ; Hot Temperature ; Humans ; Immunization ; Leg ; Methods ; Mice ; T-Lymphocytes, Cytotoxic ; Thigh ; Water

PURPOSE: This study was performed to examine the neck failure patterns after a complete response (CR) to definitive radiotherapy for advanced head and neck cancer patients, as well as evaluate the clinical significance of the results of this study. MATERIALS AND METHODS: Between 1987 and 2008, the clinical data of patients who had been treated with radical radiotherapy for primary squamous cell carcinomas and enlarged cervical lymph nodes was analyzed retrospectively. Ultimately, the cases that showed CR of the cervical lymph node lesions to full-dose radiotherapy were included in this study. The recurrent rate and sites in the cervical lymphatic area were evaluated periodically by radiologic imaging studies, along with some factors which might have affected the rate of recurrence. RESULTS: A total of 73 patients who achieved CR in neck area after radiotherapy were included in this study. The rate of subsequent neck failure among those patients was 19.2%. There was only a 5.5% failure rate in the 55 patients who underwent radiotherapy in their primary site. Eighty percent of the recurrent cases were found within 3 years (median follow-up, 68 months). The majority of neck recurrent cases (47%) were accompanied with the failure of the primary lesions. The initial response of the primary site and the method of radiotherapy simulation were significant prognostic factors associated with the nodal recurrence rate. CONCLUSION: The recurrence rate of cervical nodes in patients with CR to radiotherapy in the primary site and neck area was about 5%. These patients could be followed up with close observation without a planned neck dissection.
Carcinoma, Squamous Cell ; Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies

PURPOSE: Many studies have shown that the completion of adjuvant chemotherapy improves the survival rate. Recently, laparoscopic surgery has been used to treat patients with colon cancer. We analyzed the relationship between the completion of adjuvant chemotherapy and the operation method. METHODS: We retrospectively analyzed the medical records of 147 patients diagnosed with colon cancer from January 1, 2009, to May 31, 2012. The numbers of patients who underwent laparoscopic and open surgery were 91 and 56, respectively. We analyzed the relationship between the operation method and various factors such as the completion rate of chemotherapy, the patient's age, gender, and physical activity, the postoperative hospital stay, the start time of chemotherapy, and the patient's body mass index (BMI), TNM stage, and type of health insurance. RESULTS: In the laparoscopic surgery group, the postoperative hospital stay (13.5 +/- 14.82 days vs. 19.6 +/- 11.38 days, P = 0.001) and start time of chemotherapy (17.7 +/- 17.48 days vs. 23.0 +/- 15.00 days, P = 0.044) were shorter, but the percent complete of chemotherapy (71/91 [78.0%] vs. 38/56 [67.8%], P = 0.121), and survival rate (88/91 [96.7%], 47/56 [83.9%], P = 0.007) were higher than they were in the open surgery group. Patients who were elderly, had a low BMI, and a high American Society of Anesthesiologists score were less likely to complete adjuvant chemotherapy than other patients were. CONCLUSION: Laparoscopic surgery shows a shorter postoperative hospital stay, a shorter start time of chemotherapy, and a higher survival rate. Laparoscopic surgery may be expected to increase compliance of chemotherapy and to improve survival rate.
Aged ; Body Mass Index ; Chemotherapy, Adjuvant* ; Colonic Neoplasms* ; Compliance* ; Drug Therapy ; Humans ; Insurance, Health ; Laparoscopy ; Length of Stay ; Medical Records ; Motor Activity ; Retrospective Studies ; Survival Rate

PURPOSE: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. MATERIALS AND METHODS: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. RESULTS: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). CONCLUSION: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.
Carcinoma, Hepatocellular* ; Humans ; Palliative Care ; Portal Vein* ; Radiotherapy ; Radiotherapy, Conformal* ; Retrospective Studies ; Survival Rate ; Thrombosis*

PURPOSE: The aim of this study is to identify the prognostic factors of distant metastasis (DM) after induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer (HNC). MATERIALS AND METHODS: A total of 321 patients with HNC who underwent IC followed by CRT treated between January 2005 and December 2010 were analyzed retrospectively. IC consisted of three courses of docetaxel (70 mg/m2) and cisplatin (75 mg/m2) every three weeks, followed by radiotherapy of 66-70 Gy/2 Gy per fraction/5 fractions per week concurrent with weekly cisplatin (40 mg/m2). Tumor/nodal stage, primary site, tumor differentiation, lower neck node involvement (level IV, VB, and supraclavicular regions), number of concurrent chemotherapy cycles, overall duration of radiotherapy, and response to IC were assessed as potential prognostic factors influencing DM and survival outcome. RESULTS: The five-year loco-regional recurrence and DM rates were 23.6% and 18.2%. N stage, overall duration of radiotherapy, lower neck node involvement, and response to IC were significant factors for DM. With a median follow-up period of 52 months (range, 4 to 83 months), the 5-year progression-free, DM-free, and overall survival rates were 41.2%, 50.7%, and 55.1%, respectively. Lower neck node involvement (p=0.008) and poor response to IC (p < 0.001) showed an association with significantly inferior DM-free survival. CONCLUSION: Even with the addition of IC, the DM rate and survival outcome were poor when metastatic lower neck lymph nodes were present or when patients failed to respond after receiving IC.
Chemoradiotherapy* ; Cisplatin ; Drug Therapy ; Follow-Up Studies ; Head and Neck Neoplasms* ; Humans ; Induction Chemotherapy* ; Lymph Nodes ; Neck ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: A nationwide survey was conducted of Korean urologists to illustrate physicians' perceptions and real practical patterns regarding Peyronie disease (PD). MATERIALS AND METHODS: A specially designed questionnaire exploring practice characteristics and attitudes regarding PD, as well as patient satisfaction with each treatment modality, was e-mailed to 2,421 randomly selected urologists. RESULTS: Responses were received from 385 practicing urologists (15.9%) with a median time after certification as an urologist of 12 years. Regarding the natural course, 87% of respondents believed that PD is a progressive disease, and 82% replied that spontaneous healing in PD occurred in fewer than 20% of patients. Regarding diagnosis of PD, the methods used were, in order, history taking with physical examination (98%), International Index of Erectile Function questionnaires (40%), intracavernous injection and stimulation (35%), and duplex sonography (28%). Vitamin E was most preferred as an initial medical management (80.2%), followed by phosphodiesterase-5 inhibitors (27.4%) and Potaba (aminobenzoate potassium, 20.1%). For urologists who administered intralesional injection, the injected agent was, in order, corticosteroid (72.2%), verapamil (45.1%), and interferon (3.2%). The most frequently performed surgical procedure was plication (84.1%), followed by excision and graft (42.9%) and penile prosthesis implantation (14.2%). Among the most popular treatments in each modality, the urologists' perceptions regarding the suitability of treatment and patient satisfaction were significantly different, favoring plication surgery. CONCLUSIONS: The practice pattern of urologists depicted in this survey is in line with currently available Western guidelines, which indicates the need for development of further local guidelines based on solid clinical data.
4-Aminobenzoic Acid ; Certification ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Data Collection ; Diagnosis ; Electronic Mail ; Humans ; Injections, Intralesional ; Interferons ; Male ; Patient Satisfaction* ; Penile Implantation ; Penile Induration* ; Physical Examination ; Potassium ; Questionnaires ; Transplants ; Verapamil ; Vitamin E ; Vitamins