Yoon M.,Proton Therapy |
Shin D.H.,Proton Therapy |
Kim J.,Samsung |
Kim J.W.,Proton Therapy |
And 7 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2011
Purpose: To evaluate the dosimetric benefits of advanced radiotherapy techniques for craniospinal irradiation in cancer in children. Methods and Materials: Craniospinal irradiation (CSI) using three-dimensional conformal radiotherapy (3D-CRT), tomotherapy (TOMO), and proton beam treatment (PBT) in the scattering mode was planned for each of 10 patients at our institution. Dosimetric benefits and organ-specific radiation-induced cancer risks were based on comparisons of dose-volume histograms (DVHs) and on the application of organ equivalent doses (OEDs), respectively. Results: When we analyzed the organ-at-risk volumes that received 30%, 60%, and 90% of the prescribed dose (PD), we found that PBT was superior to TOMO and 3D-CRT. On average, the doses delivered by PBT to the esophagus, stomach, liver, lung, pancreas, and kidney were 19.4 Gy, 0.6 Gy, 0.3 Gy, 2.5 Gy, 0.2 Gy, and 2.2 Gy for the PD of 36 Gy, respectively, which were significantly lower than the doses delivered by TOMO (22.9 Gy, 4.5 Gy, 6.1 Gy, 4.0 Gy, 13.3 Gy, and 4.9 Gy, respectively) and 3D-CRT (34.6 Gy, 3.6 Gy, 8.0 Gy, 4.6 Gy, 22.9 Gy, and 4.3 Gy, respectively). Although the average doses delivered by PBT to the chest and abdomen were significantly lower than those of 3D-CRT or TOMO, these differences were reduced in the head-and-neck region. OED calculations showed that the risk of secondary cancers in organs such as the stomach, lungs, thyroid, and pancreas was much higher when 3D-CRT or TOMO was used than when PBT was used. Conclusions: Compared with photon techniques, PBT showed improvements in most dosimetric parameters for CSI patients, with lower OEDs to organs at risk. © 2011 Elsevier Inc.
Park H.J.,Center for Pediatric Oncology |
Park E.-H.,National Cancer Center |
Jung K.-W.,National Cancer Center |
Kong H.-J.,National Cancer Center |
And 7 more authors.
Korean Journal of Hematology | Year: 2012
Background The nationwide statistical analysis of hematologic malignancies in Korea has not been reported yet. Methods The Korea Central Cancer Registry and the Korean Society of Hematology jointly investigated domestic incidence rates and prevalence of hematologic malignancies occurred between 1999 and 2008, and analyzed survival rates of patients who were diagnosed between 1993 and 2008. Data of hematologic malignancies from 1993 to 2008 were obtained from the Korean National Cancer Incidence Data base. The crude incidence rates, age-specific incidence rates, age-standardized incidence rates, annual percentage change of incidence, and prevalence from 1999-2008 were calculated. Survival rates for patients diagnosed in 1993-2008 were estimated. Results In 2008, a total of 8,006 cases of hematologic malignancies were occurred, which comprised 4.5% of all malignancies. In all genders, non-Hodgkin lymphoma, myeloid leukemia, and multiple myeloma were most frequent diseases. In terms of age, ages between 60 and 69 were most prevalent. From 1999 to 2008, the age-standardized incidence rates increased from 10.2 to 13.7, and the annual percentage change was 3.9%. The 5-year survival rate increased from 38.2% during 1993-1995 to 55.2% during 2004-2008. As of January 2009, number of patients with 10-year prevalence was 33,130, and with 5- to 10-year prevalence was 10,515. Conclusion This is the first nationwide statistical report of hematologic malignancies in Korea. It could be used as the basic information to help investigate epidemiologic characteristics, evaluate progress during the past years, and establish future strategies for hematologic malignancies. Periodic statistical analysis of hematologic malignancies in Korea should be continued. © 2012 Korean Society of Hematology.
Yun T.,Center for Specific Organs Cancer |
Eom H.-S.,Center for Specific Organs Cancer
BMC Cancer | Year: 2010
Background: Non-Hodgkin lymphoma (NHL) is a hematologic malignancy for which good diagnostic markers are lacking. Despite continued improvement in our understanding of NHL, efforts to identify diagnostic markers have yielded dismal results. Here, we translated low-mass-ion information in urine samples from patients with NHL into a diagnostic marker.Methods: To minimize experimental error, we tested variable parameters before MALDI-TOF analysis of low-mass ions in urine. Urine from 30 controls and 30 NHL patients was analyzed as a training set for NHL prediction. All individual peak areas were normalized to total area up to 1000 m/z. The training set analysis was repeated four times. Low-mass peaks that were not affected by changes in experimental conditions were collected using MarkerView™ software. Human Metabolome Database (HMDB) searches and ESI LC-MS/MS analyses were used to identify low-mass ions that exhibited differential patterns in control and NHL urines. Identified low-mass ions were validated in a blinded fashion in 95 controls and 66 NHL urines to determine their ability to discriminate NHL patients from controls.Results: The 30 highest-ranking low-mass-ion peaks were selected from the 60-urine training set, and three low-mass-ion peaks with high intensity were selected for identification. Of these, a 137.08-m/z ion showed lower mass-peak intensity in urines of NHL patients, a result that was validated in a 161-urine blind validation set (95 controls and 66 NHL urines). The 130.08-m/z ion was identified from HMDB searches and ESI LC-MS/MS analyses as hypoxanthine (HX). The HX concentration in urines of NHL patients was significantly decreased (P < 0.001) and was correlated with the mass-peak area of the 137.08-m/z ion. At an HX concentration cutoff of 17.4 μM, sensitivity and specificity were 79.2% and 78.4%, respectively.Conclusions: The present study represents a good example of low-mass-ion profiling in the setting of disease screening using urine. This technique can be a powerful non-invasive diagnostic tool with high sensitivity and specificity for NHL screening. Furthermore, HX identified in the study may be a useful single urine marker for NHL screening. © 2010 Yoo et al; licensee BioMed Central Ltd.
Yoo H.,Center for Specific Organs Cancer |
Sohn S.,Center for Specific Organs Cancer |
Nam B.H.,National Cancer Center |
Min H.S.,National Cancer Center |
And 4 more authors.
International Journal of Molecular Medicine | Year: 2010
Hypoxia in the tumor microenvironment triggers a variety of genetic and adoptive responses that regulate tumor growth. Tumor hypoxia is often associated with a malignant phenotype, resistance to therapy, and poor survival. The objectives of this study were to evaluate the expressions of carbonic anhydrase 9 (CA9) and vascular endothelial growth factor (VEGF) in astrocytic gliomas and to relate patterns of expression with prognosis, that is with histological grade and survival. We investigated 78 World Health Organization (WHO) grade II, III, and IV astrocytic gliomas. CA9 expression was examined in paraffin-embedded sections by immunohistochemistry. Fourteen tumors were grade II, 30 were grade III, and 34 were grade IV. It was found that CA9 expression was significantly associated with a higher-grade histology (p<0.001). There were 3 CA9 positive tumors in grade II (21.4%), 10 in grade III (33.3%), and 27 in grade IV (79.4%). For all tumors and WHO grade II, overall survival was found to be significantly dependent on CA9 expression (p=0.004, p=0.01). Furthermore, VEGF expression was found to be significantly related to tumor grade (p=0.02) and tended to be related to overall survival (p=0.1). However, no relation was found between the expression of CA9 and VEGF (p=0.17). Nevertheless, the expressions of CA9 and VEGF were found to be associated with tumor grade and possibly with survival. Further studies on a larger patient population are needed to determine the correlation between the expressions of CA9, and VEGF in astrocytic gliomas and clinical outcome.
Kim S.J.,Sungkyunkwan University |
Yang D.-H.,Chonnam National University |
Kim J.S.,Yonsei University |
Kwak J.-Y.,Chonbuk National University |
And 11 more authors.
Annals of Hematology | Year: 2014
We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of l-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40–44 Gy of radiotherapy with weekly administration of 30 mg/m2 of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m2), ifosfamide (1,200 mg/m2), and dexamethasone (40 mg) from days 1 to 3, and l-asparaginase (4,000 IU/m2) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and l-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by l-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL. © 2014, Springer-Verlag Berlin Heidelberg.
Han K.S.,Urologic |
Choi H.J.,University of Ulsan |
Jung D.C.,Center for Specific Organs Cancer |
Park S.,National Cancer Center |
And 5 more authors.
Clinical Radiology | Year: 2011
Aim: To evaluate the diagnostic accuracy of conventional cystography for the detection of urine leakage at the vesicourethral anastomosis (VUA) site after radical prostatectomy based on computed tomography (CT) cystography. Materials and methods: Patients who underwent radical prostatectomies at a single tertiary cancer centre were prospectively enrolled. Conventional cystography was routinely performed on postoperative day 7. Non-enhanced pelvic CT images were obtained after retrograde instillation of the same contrast material for a reference standard of urine leakage at the VUA site. Urine leakage was classified as follows: none; a plication abnormality; mild; moderate; and excessive. Results: One hundred and twenty consecutive patients were enrolled. Conventional cystography detected 14 urine leakages, but CT cystography detected 40 urine leakages, which consisted of 28 mild and 12 moderate urine leakages. When using CT cystography as the standard measurement, conventional cystography showed a diagnostic accuracy of 17.8% (5/28) for mild urine leakage and 75% (9/12) for moderate leakage. Of nine patients diagnosed with mild leakage on conventional cystography, four (44.4%) had complicated moderate urine leakages based on CT cystography, requiring prolonged catheterization. The sensitivity, specificity, positive and negative predictive values, and accuracy of conventional cystography were 35, 100, 100, 75.4, and 78.3%, respectively. Conclusions: Conventional cystography is less accurate than CT cystography for diagnosing urine leakage at the VUA site after a radical prostatectomy. The present results suggest that CT cystography is a good choice for diagnostic imaging of urine leakage after radical prostatectomy. © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Mishra S.K.,Gachon University |
Mishra S.K.,Dr Hari Singh Gour University |
Kang J.-H.,National Cancer Center |
Kang J.-H.,Chung - Ang University |
And 5 more authors.
Molecules and Cells | Year: 2013
Midazolam is a widely used anesthetic of the benzodiazepine class that has shown cytotoxicity and apoptosisinducing activity in neuronal cells and lymphocytes. This study aims to evaluate the effect of midazolam on growth of K562 human leukemia cells and HT29 colon cancer cells. The in vivo effect of midazolam was investigated in BALB/c-nu mice bearing K562 and HT29 cells human tumor xenografts. The results show that midazolam decreased the viability of K562 and HT29 cells by inducing apoptosis and S phase cell-cycle arrest in a concentration-dependent manner. Midazolam activated caspase-9, capspase-3 and PARP indicating induction of the mitochondrial intrinsic pathway of apoptosis. Midazolam lowered mitochondrial membrane potential and increased apoptotic DNA fragmentation. Midazolam showed reactive oxygen species (ROS) scavenging activity through inhibition of NADPH oxidase 2 (Nox2) enzyme activity in K562 cells. Midazolam caused inhibition of pERK1/2 signaling which led to inhibition of the anti-apoptotic proteins Bcl-XL and XIAP and phosphorylation activation of the pro-apoptotic protein Bid. Midazolam inhibited growth of HT29 tumors in xenograft mice. Collectively our results demonstrate that midazolam caused growth inhibition of cancer cells via activation of the mitochondrial intrinsic pathway of apoptosis and inhibited HT29 tumor growth in xenograft mice. The mechanism underlying these effects of midazolam might be suppression of ROS production leading to modulation of apoptosis and growth regulatory proteins. These findings present possible clinical implications of midazolam as an anesthetic to relieve pain during in vivo anticancer drug delivery and to enhance anticancer efficacy through its ROS-scavenging and pro-apoptotic properties. © The Korean Society for Molecular and Cellular Biology. All rights reserved.
Ryu J.,Center for Specific Organs Cancer |
Park W.S.,Research Institute and Hospital |
Jung Y.-S.,Center for Specific Organs Cancer
Clinical and Experimental Otorhinolaryngology | Year: 2013
Low grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is an extremely rare variant of nasopharyngeal cancer, which exhibits distinct clinicopathological characteristics. Surgical resection has been regarded as the principal treatment. For this, transpalatal or transfacial approach has been classically used for exposure of the field. Up for now, there has been no report on applying endoscopic approach for this disease, which could be an effective alternative to minimize possible morbidities of palatotomy or maxillotomy. Endoscopic approach can be justified considering narrow extent and indolent behavior of LGNPPA. We report a patient with LGNPPA, which was successfully resected exclusively by endoscopic visualization. Our case exhibited narrow-based exophytic features with compatible immunopathologic profiles of LGNPPA. Exclusive endoscopic resection can be effective and less-morbid modality for this rare disease as in this case. © 2013 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.
The different roles of molecular classification according to upfront autologous stem cell transplantation in advanced-stage diffuse large B cell lymphoma patients with elevated serum lactate dehydrogenase
PubMed | Center for Specific Organs Cancer, Korea University, Chonnam National University, Hallym University and 4 more.
Type: Journal Article | Journal: Annals of hematology | Year: 2016
The non-germinal center B cell (non-GCB) subtype of diffuse large B cell lymphoma (DLBCL) is more related to poor prognosis than the GCB subtype. To investigate the role of molecular classification according to upfront autologous hematopoietic stem cell transplantation (ASCT), we retrospectively evaluated 219 newly diagnosed high-risk DLBCL patients. Eighty-one patients were in the ASCT group, and 138 patients were in the non-ASCT group. The ASCT group yielded significantly better overall survival (OS) and progression-free survival (PFS) than the non-ASCT group (p=0.038 and p=0.007), and patients with the non-GCB subtype were more related to inferior PFS than those with the GCB subtype (p=0.020). After performing age-matching by using propensity scores, upfront ASCT continued to show better OS and PFS than non-ASCT (p=0.046 and p=0.026). In the non-ASCT group, the non-GCB subtype showed worse OS and PFS than the GCB subtype (p=0.039 and p=0.007). Patients who achieved complete response showed differences in OS and PFS according to molecular subtype (p=0.007 and p=0.002). In the ASCT group, there were no significant differences in OS and PFS according to molecular classification (p=0.277 and p=0.892). In conclusion, non-GCB subtype DLBCL patients showed poor OS and PFS in the non-ASCT group while they did not show clinical significance in the ASCT group. This suggests the possibility that upfront ASCT may improve the poor prognosis of non-GCB subtype in high-risk DLBCL.
PubMed | Soonchunhyang University, Center for Specific Organs Cancer, University of Ulsan, Catholic University of Daegu and 10 more.
Type: Clinical Trial | Journal: American journal of hematology | Year: 2015
The effects of imatinib plus chemotherapy were assessed in 87 patients with newly diagnosed Philadelphia chromosome-positive (Ph(+) ) acute lymphoblastic leukemia (ALL). Imatinib was administered continuously, starting from the eighth day of remission induction chemotherapy, then through five courses of consolidation or until allogeneic hematopoietic cell transplantation (HCT). Patients who were not transplanted were maintained on imatinib for 2 years. Eighty-two patients (94.3%) achieved complete remission (CR). Among these 82 CR patients, 40 experienced recurrence of leukemia. The 5-year relapse free survival (RFS) rate and overall survival (OS) rates were 39.0% and 33.4%, respectively. In total, 56 patients underwent allogeneic HCT in first CR. The 5-year cumulative incidence of relapse and OS rate of them were 59.1% and 52.6%, respectively. Six of seven patients who were maintained on imatinib after completion of consolidation relapsed and the median time of RFS was 40.7 months. In total patient, cumulative molecular CR rate was 88.5% and median time of molecular CR duration was 13 months. Initial imatinib dose intensity was significantly associated with median CR duration (P < 0.0001), and overall survival (P = 0.002). During the initial phase of treatment of patients with Ph(+) ALL, it is important to maintain imatinib dose intensity.