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Journal of the Korean Cancer Association

1966  to  Present  ISSN: 0496-6872

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Permanent Genotypic and Phenotypic Change of Prostate Cancer Cell Line LNCaP through Cellular Interactions with Prostate or Bone Fibroblasts in vitro or in vivo.

Hong Woo RHEE ; Sung Hak KANG ; Tae Kon HWANG ; Leland W K CHUNG

Journal of the Korean Cancer Association.2001;33(2):168-177.

PURPOSE: Cell-cell interactions determine normal prostate development and subsequent neoplastic transfor mation. The progression of prostate cancer from androgen-dependent to androgen-independent states involves multiple steps of genetic changes mediated by tumor-microenvironment interactions. To understand the epigenetic factors that lead to progression, we studied if 1) androgen-dependent and non-metastatic LNCaP may interact with prostate or bone fibroblasts under microgravity-simulated conditions in vitro. 2) LNCaP may interact with prostate fibroblasts in vivo, and acquire androgen-independence and metastatic potential. MATERIALS AND METHODS: The LNCaP sublines were generated as follows. 1) LNCaP cells were grown in vitro either alone or with prostate or bone fibroblasts under microgravity-simulated conditions. 2) LNCaP cells were grown in vivo as chimeric tumors with prostate fibroblasts. The LNCaP sublines were characterized by studies of chromosomal analysis, comparative genomic hybridization and, in vivo tumorigenicity and metastatic potential. RESULTS: In comparison to the parental LNCaP cells, the LNCaP sublines underwent permanent genotypic and phenotypic changes manifested in androgen-independence and metastatic potential. CONCLUSION: These results emphasize the importance of cell-cell interaction as a critical determinant that could "induce" or "select" progenies favoring enhanced prostate cancer growth and progression. This concept favors the development of toxic gene therapy targeting both prostate cancer epithelium and supporting bone stroma for an effective eradication and prevention of prostate cancer bone metastasis.
Cell Line* ; Comparative Genomic Hybridization ; Epigenomics ; Epithelium ; Fibroblasts* ; Genetic Therapy ; Humans ; Neoplasm Metastasis ; Parents ; Prostate* ; Prostatic Neoplasms*

Cell Line* ; Comparative Genomic Hybridization ; Epigenomics ; Epithelium ; Fibroblasts* ; Genetic Therapy ; Humans ; Neoplasm Metastasis ; Parents ; Prostate* ; Prostatic Neoplasms*

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Combination Chemotherapy with Vinorelbine and Ifosfamide in Patients with Advanced Non-Small Cell Lung Cancer.

Seong Geun KIM ; Sung Hyun KIM ; Hyuk Chan KWON ; Kee Hyun LEE ; Jae Seok KIM ; Hyo Jin KIM

Journal of the Korean Cancer Association.2001;33(2):163-167.

PURPOSE: We conducted a phase II study of vinorelbine and ifosfamide combination chemotherapy in patients with advanced or recurrent non-small cell lung cancer (NSCLC) to evaluate response rate, response duration, and toxicities of this regimen. MATERIALS AND METHODS: From June 1998 to March 2000, twenty seven patients with advanced or recurrent non- small cell lung cancer (stage IIIB and IV) who had no prior systemic chemotherapy were enrolled in this study. All patients were treated with vinorelbine and ifosfamide combination chemotherapy (vinorelbine 25 mg/m2 i.v. days 1 & 8, and ifosfamide 2 g/m2 i.v. days 1~3 with Mesna 1600 mg/m2). Each cycle was repeated every 21 days. RESULTS: All twenty seven patients were eligible and assessable. Age ranged from 41 to 72 (median 57 years). 14 patients were male and 13 were female. Overall response rate was 33.3%. One complete response (3.7%) and 8 partial responses (29.6%) were observed. Stable disease was 15 (55.6%) and progressive disease was 3 (11.1%). Overall median survival duration was 7.8 months. The median progression-free and response durations were 6.6 months and 3.5 months respectively. World Health Organization grade 3 to 4 neutropenia occurred in 6.5%. Nonhematologic toxicities including nausea/vomiting, nephropathy and hepatopathy were generally grade 1 or 2. CONCLUSION: The combination chemotherapy with vinorelbine and ifosfamide in the patients with advanced or recurrent non-small cell lung cancer can be considered as an effective and safe treatment.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Ifosfamide* ; Male ; Mesna ; Neutropenia ; Small Cell Lung Carcinoma ; World Health Organization

Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Ifosfamide* ; Male ; Mesna ; Neutropenia ; Small Cell Lung Carcinoma ; World Health Organization

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Expression of P53, Bcl-2, Bax, and P-glycoprotein in Relation to Chemotherapeutic Response in Patients with Advanced Non-Small-Cell Lung Cance.

Suk Young PARK ; Eun Hee LEE ; Kee Won KIM ; Chul Seung KAY ; Seok Chan KIM ; Ji Won SUHR ; Kyung Shick LEE

Journal of the Korean Cancer Association.2001;33(2):158-162.

PURPOSE: To evaluate the relationship between the expressions of p53, bcl-2, bax, and p-glycoprotein and the chemotherapeutic response seen in patients with advanced NSCLC. MATERIALS AND METHODS: Forty-four patients pathologically proven as NSCLC were reviewed. They had undergone at least two cycles of the same chemotherapeutic agents (cisplatin 60 mg/m2 day 1+ vinorelbine 25 mg/m2 day 1, 8, 21-day cycle) and the clinical response was evaluated by WHO criteria. The expressions of p53, bcl-2, bax, and p-glycoprotein were determined by immunohistochemistry. RESULTS: Patients recorded as CR (2/44) and PR (20/44) were classified as the responder group (22/44) and stable (17/44) and progression (5/44) as the non-responder group (22/44). Positive expression of p53, bcl-2, bax, and p-glycoprotein were 84.1%, 65.9%, 88.6%, and 61.4% respectively. The expression score of p53 was significantly higher in the non-responder group than that seen in the responder group (8.59+/-1.89 vs 5.32+/-2.15, p<0.05). However, the expression scores of bcl-2, bax, and p-glycoprotein were not significantly correlated with the clinical response. CONCLUSION: This study suggests that p53 gene mutation plays an important role in the clinical response to chemotherapy including cisplatin and vinorelbine. In future investigations, the correlation with the survival time will be studied.
Cisplatin ; Drug Therapy ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Lung* ; P-Glycoprotein*

Cisplatin ; Drug Therapy ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Lung* ; P-Glycoprotein*

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Effect of p53 and p16 Protein Expression in Relation to Body Mass Index for Breast Cancer Risk.

Mi Kyung KIM ; Jung Yeon KIM ; Gyung yub GONG ; Sei Hyun AHN

Journal of the Korean Cancer Association.2001;33(2):149-157.

PURPOSE: This study was conducted to investigate whether breast cancer with p53 protein overexpression (p53+) and loss of p16 protein expression (p16-) shows different body size indicator (height, weight, body mass index) associations as compared with breast tumors without p53 protein overexpression and the loss of p16 expression (p53-, p16+). MATERIALS AND METHODS: A hospital based case-control study was conducted among 92 women patients and 122 control subjects. The p53 protein overexpression and loss of p16 protein expression in the tissue sections of patients with breast cancer were determined using immunohistochemistry. RESULTS: A total of 26 tumors (28%) demonstrated p53 overexpression and 35 tumors (46%) showed abnormal p16 expression. The heaviest women had a higher risk with p53- and p16+ breast tumors. The odds ratios (OR) adjusted for age, menopausal status, smoking, and drinking revealed a significant gradient of increasing risk of breast cancer with increasing BMI in p53- and p16+ breast cancer. The adjusted ORs for the highest quintile of BMI was 8.51 with p53+ tumors and 14.2 with p53- tumors, and 55.6 with p16+ tumors and 3.72 with p16- tumors. p53 protein overexpression and the loss of p16 expression did not significantly correlate with nodal status, tumor size, estrogen or progesterone receptor status. CONCLUSION: The study concluded that a strong association between p53-/p16+ tumors and BMI suggests the occurrence of p53-/p16+ tumors is related with obesity as compared to p53-/p16+ tumors.
Body Mass Index* ; Body Size ; Body Weight ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Drinking ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Obesity ; Odds Ratio ; Receptors, Progesterone ; Smoke ; Smoking

Body Mass Index* ; Body Size ; Body Weight ; Breast Neoplasms* ; Breast* ; Case-Control Studies ; Drinking ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Obesity ; Odds Ratio ; Receptors, Progesterone ; Smoke ; Smoking

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Cancer Incidence in Daegu in 1997~98: The First Results of the Daegu Cancer Registry.

Choong Won LEE ; Mi Young LEE ; Hyun Sook LIM ; Soo Sang SOHN ; Jae Kyu JEON

Journal of the Korean Cancer Association.2001;33(2):136-148.

PURPOSE: A population-based cancer registry was set up in January 1, 1997 to estimate the incidence of cancer in Daegu, South Korea. MATERIALS AND METHODS: Data sources for case-finding and abstracting were hospital inpatients, other sources in hospitals other than inpatients, and private pathology laboratories. The registered cases were matched against two external databases, the death certificate and medical insurance claims. RESULTS: A total of 7,837 cases (4,203 males, 3,634 females) were registered in 1997~98 excluding 2,718 cases of DCN. The crude incidence rates of all cancers combined were 170.7/100,000 (ASR 255.0) in males and 149.8 (ASR 154.4) in females. In males, the most common cancer was stomach (47.3, ASR 69.0), followed by liver (28.0, ASR 37.6), lung (26.0, ASR 44.1), colorectum (14.9, ASR 23.3),urinary bladder (4.5, ASR 7.0) and prostate (3.5, ASR 7.0). The most common cancer in females was stomach (25.8, ASR 26.9), followed by breast (21.7, ASR 20.4), cervix uteri (21.1, ASR 20.4), colorectum (14.9, ASR 16.0), lung (9.9, ASR 11.0), liver (9.3, ASR 10.1), and thyroid (6.1, ASR 5.7). The overall percentage of microscopically verified and the DCN% were 80.3%, 27.7% in males and 88.7%, 20.7% in females, respectively. CONCLUSION: These results show that the incidence level of all cancers combined in both sexes in Daegu is approaching that of other industrialized regions in Asia as well as in the world.
Abstracting and Indexing as Topic ; Asia ; Breast ; Cervix Uteri ; Daegu* ; Information Storage and Retrieval ; Death Certificates ; Female ; Humans ; Incidence* ; Inpatients ; Insurance ; Korea ; Liver ; Lung ; Male ; Pathology ; Prostate ; Stomach ; Thyroid Gland ; Urinary Bladder

Abstracting and Indexing as Topic ; Asia ; Breast ; Cervix Uteri ; Daegu* ; Information Storage and Retrieval ; Death Certificates ; Female ; Humans ; Incidence* ; Inpatients ; Insurance ; Korea ; Liver ; Lung ; Male ; Pathology ; Prostate ; Stomach ; Thyroid Gland ; Urinary Bladder

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Prognostic Significance of Lymph Node Micrometastasis in pT2N0 Gastric Cancer.

Hyeon Kook LEE ; Sam Je CHO ; Yoon Ho KIM ; Hye Seung LEE ; Woo Ho KIM ; Kuhn Uk LEE ; Kuk Jin CHOE ; Jin Pok KIM ; Han Kwang YANG

Journal of the Korean Cancer Association.2001;33(2):130-135.

PURPOSE: The prognostic significance of lymph node (LN) micrometastasis in gastric cancer remains contro versial. We therefore investigated the clinicopathologic factors related to LN micrometastasis and evaluated the clinical relevance of micrometastasis with regard to urrence. MATERIALS AND METHODS: A total of 1083 LNs from 39 patients with pT2N0 gastric cancer and who underwent curative resection in 1993 were further immunohistochemically stained using an anti-cytokeratin Ab cocktail (AE1-AE3). RESULTS: Micrometastases were found in 3.9% (42/1083) of the resected LNs and 53.8% (21/39) of the patients with pT2N0 gastric cancer. LN micrometastasis was found to be significantly related with histologic differentiation. The recurrence rate of gastric cancer was higher in patients with LN micrometastasis (31.6%) than in those without (6.3%), with a borderline significance (p=0.074). In uni variate analysis, patients with LN micrometastasis had a shorter 5-year disease-free survival (65%) than those without LN micrometastasis (87%) (p=0.075). In multivariate analysis, multiple LN micrometastasis was associated with a poor prognosis, but with a borderline significance (p=0.069, Risk ratio 4.815) CONCLUSION: We were able to identify LN micrometastases missed on routine H-E staining, using an immuno histochemical technique. Our results suggest that LN micrometastasis is associated with the recurrence of pT2N0 gastric cancer.
Disease-Free Survival ; Humans ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Micrometastasis* ; Odds Ratio ; Prognosis ; Recurrence ; Stomach Neoplasms*

Disease-Free Survival ; Humans ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Micrometastasis* ; Odds Ratio ; Prognosis ; Recurrence ; Stomach Neoplasms*

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The Expression of Insulin-like Growth Factor (IGF), IGF- Binding Protein (IGFBP) and the Role of IGFBP-3 in the Korean Gastric Cancer Cell Lines.

Dae Yeol LEE ; Ho Keun YI ; Doo Hyun YANG ; Pyung Han HWANG

Journal of the Korean Cancer Association.2001;33(2):121-129.

PURPOSE: Insulin-like growth factor (IGF)-I and II are potent mitogens, postulated to exert autocrine and paracrine effects on growth regulation in human gastric cancer. In this study, we evaluated the expression of IGF-I, -II and IGFBPs in a panel of human gastric cancer cell lines. We also evaluated whether high expression of IGFBP-3 in human gastric cancer cells may increase the sensitivity to the anti-proliferative agents. MATERIALS AND METHODS: 10 human korean gastric cancer ceIl lines and 1 Caucacian gastric adenocarcinoma cell line were used for this study. IGF and IGFBP expressions were evaluated by RT-PCR. IGFBP proteins in conditioned media were detected by Western Ligand Blot. Cell survival after treatment of anti-proliferative agents was assessed by MTT assay. RESULTS: IGF-I and II were expressed in all gastric cancer cell lines. In addition, IGF-I and II stimulated the proliferation of gastric cancer cells. The expression of IGFBP-2 was found in all gastric cancer cell lines. IGFBP-4 was expressed in the most of cell lines. IGFBP-3, -4 and -6 were expressed in about 50% of cell lines. The growth inhibition of IGFBP-3 expressing cells by anti- proliferative agents was more significant than that of IGFBP-3 nonexpressing cells. Cell growth inhibition with treatment of these agents was accompanied by increased IGFBP-3 mRNA level. CONCLUSION: These data confirm that IGF-I, -II, and certain IGFBPs were expressed in gastric cancer cells, and gastric cancer cells show the differential growth inhibition by anti-proliferative agents. The differential growth inhibitory effect of anti-proliferative agents is, at least in part, mediated through up-regulation of IGFBP-3 expression.
Adenocarcinoma ; Carrier Proteins* ; Cell Line* ; Cell Survival ; Culture Media, Conditioned ; Humans ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Mitogens ; RNA, Messenger ; Stomach Neoplasms* ; Up-Regulation

Adenocarcinoma ; Carrier Proteins* ; Cell Line* ; Cell Survival ; Culture Media, Conditioned ; Humans ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Mitogens ; RNA, Messenger ; Stomach Neoplasms* ; Up-Regulation

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The Inhibitory Effect of Amiloride on the Growth of Human Gastric Carcinoma Cells in Vitro.

Seung Su KANG ; Duck Kyung KONG ; Chee Whan NO ; Byung Joo CHOI ; Moo In PARK ; Seun Ja PARK ; Keun Young PARK ; Ja Young KOO

Journal of the Korean Cancer Association.2001;33(2):113-120.

PURPOSE: In the present study the effects of amiloride on the growth of human gastric adenocarcinoma cell line, AGS cells were examined with or without the addition of 5-fluorouracil (5-FU) in vitro. MATERIALS AND METHODS: The growth of AGS cells was examined by counting number of cells on two and four days post-treatment with 50 micrometer, 100 micrometer, 200 micrometer, 400 micrometer, 800 micrometer, amiloride, and 0.1 microgram/ml, 0.3 microgram/ml 5-FU, after plating AGS cells into 6 well plates at a density of 10 x 10(4) cells/well. The reversibility of the effects of amiloride was examined on two to eight days post-treatment with 400 micrometer amiloride after seeding 2 x 10(4) cells/dish. Cell cycle analysis was performed after four day-treatment with 400 micrometer amiloride. RESULTS: Amiloride (50~800 micrometer) significantly inhibited the growth of AGS in a dose-dependent fashion (p<0.05). The inhibitory effect of amiloride on growth of AGS was reversible since removal of amiloride after 24 hours treatment led to resumption of rapid growth up to control levels. Amiloride combined with 5-FU markedly inhibited the growth of AGS in a dose-dependent fashion compared to that of amiloride or 5-FU alone (p<0.05). The fraction of S phase, G0-G1 phase and G2-M phase was 19.3%, 55.7%, 18.8%, in the amioride group (400 micrometer) and 43.9%, 37.4%, 25.1% in the control group, respectively, showing significantly higher G1 fraction in amiloride group compared to control. CONCLUSION: This is the first paper which reported that amiloride inhibited in vitro growth of human gastric adenocarcinoma cells and that its effect of growth inhibition may be synergistic with 5-FU. Amiloride given with or without 5-FU may be useful agent in the treatment of gastric carcinomas. The inhibitory effects of amiloride on the growth of AGS may be mediated in part by blocking G1-S transition of cell cycle.
Adenocarcinoma ; Amiloride* ; Cell Cycle ; Cell Line ; Fluorouracil ; Humans* ; S Phase

Adenocarcinoma ; Amiloride* ; Cell Cycle ; Cell Line ; Fluorouracil ; Humans* ; S Phase

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Significance of p53 Immunoreactivity in Squamous Cell Carcinoma of the Cervix Treated with Radiotherapy Alone.

Sung Ja AHN ; Ho Sun CHOI ; Chan CHOI ; Byung Sik NAH ; Woong Ki CHUNG ; Taek Keun NAM

Journal of the Korean Cancer Association.2001;33(2):106-112.

PURPOSE: We undertook this study to evaluate the significance of p53 immunoreactivity in squamous cell carcinoma of the cervix, treated with radiotherapy alone. MATERIALS AND METHODS: Immunohistochemical staining of p53 proteins were performed in eighty patients with squamous cell carcinoma of the cervix, and who completed curative radiotherapy between Jan. 1996 and Apr. 1998 at the Department of Therapeutic Radiology, Chonnam National University Hospital. External- beam radiotherapy was combined with intracavitary brachytherapy. Results were analyzed for the end points of pelvic tumor control and distant failure rates. The follow-up time ranged from 7 to 58 months with a median of 40 months. RESULTS: p53 positive and negative groups involved 45 and 35 patients, respectively, and the positive p53 immunoreactivity rate was 56% (45/80). p53 immunoreactivity showed no significant correlation with age, tumor size, serum tumor marker (SCC), or HPV18 expression, while there was a statistically marginally significant correlation with HPV16 expression. The pelvic tumor control rate of the p53 positive group was 87% and that of p53 negative group was 83% (0.05). The other parameters influencing negatively to the pelvic tumor control and with statistical significance were tumor ulceration and barrel type. Multivariate analysis also showed that p53 immunoreactivity had no prognostic value for pelvic tumor control of the disease, and that the statistically significant factor was tumor ulceration. The treatment failure rate of the p53 positive group was 23% and that of the negative group was 26% (p>0.05). CONCLUSION: p53 immunoreactivity in the cervix cancer stage IB, II patients seems to have no value as a predictor of tumor behavior after curative radiotherapy.
Brachytherapy ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Multivariate Analysis ; Radiation Oncology ; Radiotherapy* ; Treatment Failure ; Ulcer ; Uterine Cervical Neoplasms

Brachytherapy ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Multivariate Analysis ; Radiation Oncology ; Radiotherapy* ; Treatment Failure ; Ulcer ; Uterine Cervical Neoplasms

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A Phase II Study of Oxaliplatin, 5-Fluorouracil, and Leucovorin in 5- Fluorouracil-Pretreated Metastatic Colorectal Cancer.

Keun Seok LEE ; Won Sup LEE ; Hark Kyun KIM ; Joo Young JEONG ; Dae Seog HEO ; Yung Jue BANG ; Noe Kyeong KIM

Journal of the Korean Cancer Association.2001;33(2):99-105.

PURPOSE: To evaluate antitumor response, time to progression, and toxicities of oxaliplatin, 5- fluorouracil (5-FU), and leucovorin (LV) continuous infusion in patients with metastatic colorectal cancer who progressed during or after treatment with a 5-FU-containing regimen. MATERIALS AND METHODS: Forty-eight patients with metastatic colorectal cancer, who progressed while receiving or after discontinuing palliative chemotherapy with 5- FU-based regimen, were enrolled in this study. Treatment consisted of oxaliplatin (85 mg/m2 on day 1) as a 2-hour infusion followed by bolus 5-FU (400 mg/m2 on day 1), and 5-FU 48-hour infusion 2.4~3 g/m2 concurrently with LV 48-hour infusion 150 mg/m2, without mixing. Cycles were repeated at 2-week intervals. The dose of 5-FU was modified, depending on the hematologic toxicity profile. RESULTS: The objective response rate was 28% for 43 assessable patients (95% confidence interval, 14% to 42%), including one complete remission (2%). Seventeen additional patients (39%) had stable disease, and fourteen (33%) progressed. The median time to progression was 5.9 months and the median overall survival was 13.2 months from the start of the chemotherapy. From the 297 cycles analyzed, hematologic toxicities per course were: leukopenia; grade I 26.6%, grade II 3.4%, and grade III 0.3%, thrombocytopenia; grade I 10.8%, grade II 3.0%, grade III 1.0%, and grade IV 0.3%. The most frequent nonhematologic adverse reactions were nausea/vomiting and peripheral neuropathy, which were rated as WHO grade II in 13 patients (49%) and 11 patients (22%), respectively. CONCLUSION: This phase II study of oxaliplatin, 5-FU, and LV continuous infusion showed enhanced antitumor activity in patients with 5-FU-pretreated metastatic colorectal cancer. Overall toxicity was acceptable; neurotoxicity and bone marrow suppression constituted the dose-limiting side effects.
Bone Marrow ; Colorectal Neoplasms* ; Drug Therapy ; Fluorouracil* ; Humans ; Leucovorin* ; Leukopenia ; Peripheral Nervous System Diseases ; Thrombocytopenia

Bone Marrow ; Colorectal Neoplasms* ; Drug Therapy ; Fluorouracil* ; Humans ; Leucovorin* ; Leukopenia ; Peripheral Nervous System Diseases ; Thrombocytopenia

Country

Republic of Korea

Publisher

Korean CancerAssociation

ElectronicLinks

http://koreamed.org/JournalVolume.php?id=36

Editor-in-chief

E-mail

Abbreviation

Journal of the Korean Cancer Association

Vernacular Journal Title

대한암학회지

ISSN

0496-6872

EISSN

Year Approved

2007

Current Indexing Status

Currently Indexed

Start Year

1966

Description

Discontinued and the name of the journal changed to Cancer Research and Treatment: 2001 (v33 n3) to Present pISSN 1598-2998 eISSN 2005-9256

Current Title

Cancer Research and Treatment

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