ABSTRACT
PURPOSE: To evaluate the efficacy of hydromorphone-OROS (HM-OROS) in reducing sleep disturbance and relieving cancer pain. MATERIALS AND METHODS: One hundred twenty cancer patients with pain (numeric rating scale [NRS] > or = 4) and sleep disturbance (NRS > or = 4) were evaluated. The initial HM-OROS dosing was based on previous opioid dose (HM-OROS:oral morphine=1:5). Dose adjustment of the study drug was permitted at the investigator\'s discretion. Pain intensity, number of breakthrough pain episodes, and quality of sleep were evaluated. RESULTS: A total of 120 patients received at least one dose of HM-OROS; 74 of them completed the final assessment. Compared to the previous opioids, HM-OROS reduced the average pain NRS from 5.3 to 4.1 (p < 0.01), worst pain NRS from 6.7 to 5.4 (p < 0.01), sleep disturbance NRS from 5.9 to 4.1 (p < 0.01), incidence of breakthrough pain at night from 2.63 to 1.53 times (p < 0.001), and immediate-release opioids use for the management of breakthrough pain from 0.83 to 0.39 times per night (p = 0.001). Of the 74 patients who completed the treatment, 83.7% indicated that they preferred HM-OROS to the previous medication. The adverse events (AEs) were somnolence, asthenia, constipation, dizziness, and nausea. CONCLUSION: HM-OROS was efficacious in reducing cancer pain and associated sleep disturbances. The AEs were manageable.
Subject(s)
Humans , Analgesics, Opioid , Asthenia , Breakthrough Pain , Constipation , Dizziness , Incidence , Nausea , Prospective StudiesABSTRACT
BACKGROUND: Autologous peripheral blood stem cell transplantation (PBSCT) has been used as a major treatment strateg for malignant lymphoproliferative disorder. The number of CD34 positive cells in the harvested product is a very important factor for achieving successful transplantation. We studied the factors that can predict the number of CD34 positive cells in the harvested product of multiple myeloma (MM) and Non-Hodgkin's lymphoma (NHL) patients after mobilizing them with chemotherapy plus G-CSF. METHODS: A total of 69 patients (MM 25 patients, NHL 44 patients) with malignant lymphoproliferative disorder had been mobilizedwith chemotherapy and granulocyte colony-stimulating growth factor from January, 2003 to July, 2008. We analyzed the clinical characteristics, the peripheral blood (PB) parameters and the number of CD34 positve cells in the PB and their correlation with the yield of PBPCs collected from the mobilized patients. RESULTS: The total number of leukapheresis sessions was 134 (mean: 1.94 session per patient), and the mean number of harvested CD34 positive cell per patient was 12.47x10(6)/kg. The number of harvested CD34 positive cells was correlated with the patient's height, the number of peripheral blood hematopoietic progenitor cells (HPC) and the number of PB CD34 positive cells at the harvest (P or =23.7/microliter) at the harvest might be the predictor of harvesting more than 3x10(6)/kg CD34 positive cell for autologous PBSCT in patients with malignant lymphoproliferative disorder.
Subject(s)
Humans , Granulocytes , Hematopoietic Stem Cells , Leukapheresis , Linear Models , Lymphoma, Non-Hodgkin , Lymphoproliferative Disorders , Multiple Myeloma , Peripheral Blood Stem Cell Transplantation , ROC Curve , TransplantsABSTRACT
BACKGROUND/AIMS: To date, an effective salvage chemotherapy regimen for the treatment of refractory or relapsing non-Hodgkin's lymphoma (NHL) has not been discovered. This study was conducted to evaluate the efficacy and safety of gemcitabine, etoposide, cisplatin, and dexamethasone in relapsed or refractory NHL patients. METHODS: All patients had histologically proven relapsed or refractory NHL. Treatments consisted of gemcitabine 700 mg/m2 by continuous i.v. on days 1 and 8; etoposide 40 mg/m2 by i.v. on days 1-4; cisplatin 60 mg/m2 by i.v. on day 1; or dexamethasone 40 mg by i.v. on days 1-4 (GEPD) every 21 days. The primary end point was the patient response rate following two cycles of treatment. After two cycles, stem cells were harvested using mobilizing regimens (ESHAP or GEPD plus filgrastim), and this was followed by autologous stem cell transplantation or four additional cycles of GEPD. RESULTS: Between January 2005 and January 2006, 20 patients (13 males and 7 females) were enrolled in the study. The median age was 53 (range 16-75) years. The most common histology was diffuse large B-cell lymphoma (n=10). The median follow-up duration was 5.2 (range 1.0-16.0) months. After two cycles, the overall response rate was 50.0% (10/20), including two complete responses and eight partial responses. The doselimiting toxicity was myelosuppression. Grade IV neutropenia and thrombocytopenia occurred in 13 (65.0%) and 6 patients (30.0%), respectively. The median number of CD34-positive cells collected was 6.0 (range, 2.8-11.6)x10(6)/kg. Of the 17 patients < 66 years of age, 4 (23.5%) proceeded to autologous stem cell transplantation. CONCLUSIONS: GEPD chemotherapy in patients with refractory or relapsed NHL was effective as a salvage therapy and helpful for stem cell harvest followed by autologous transplantation.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biopsy , Cisplatin/administration & dosage , Deoxycytidine/administration & dosage , Dexamethasone/administration & dosage , Etoposide/administration & dosage , Follow-Up Studies , Glucocorticoids/administration & dosage , Immunosuppressive Agents/administration & dosage , Lymphoma, Large B-Cell, Diffuse/drug therapy , Neoplasm Recurrence, Local/drug therapy , Prospective Studies , Stem Cell Transplantation/methods , Treatment OutcomeABSTRACT
PURPOSE: Heptaplatin (Sunpla) is a cisplatin derivative. A phase IIb trial using heptaplatin resulted in a 34% response rate with mild nephrotoxicity. We conducted a randomized phase III trial of heptaplatin plus 5-FU compared with cisplatin plus 5-FU in patients with advanced gastric cancer. MATERIALS AND METHODS: One hundred seventy-four patients (heptaplatin, n=88; cisplatin, n=86) from 13 centers were enrolled. The eligibility criteria were as follows: patients with pathologically-proven adenocarcinoma, chemonaive patients, or patients who had received only single adjuvant chemotherapy, and who had a measurable or evaluable lesion. On day 1, heptaplatin (400 mg/m2) or cisplatin (60 mg/m2) was given over 1 hour with 5-FU (1 gm/m2) on days 1~5 every 4 weeks. RESULTS: At the time of survival analysis, the median overall survival was 7.3 months in the 5-FU + heptaplatin (FH) arm and 7.9 months in the 5-FU + cisplatin (FP) arm (p=0.24). Of the FH patients, 34.2% (complete response [CR], 1.3%; partial response [PR], 32.9%) experienced a confirmed objective response compared with 35.9% (CR 0%, PR 35.9%) of FP patients (p=0.78). The median-time-to-progression was 2.5 months in the FH arm and 2.3 months in the FP arm. The incidence of neutropenia was higher with FP (28%) than with FH (16%; p=0.06); grade 3~4 nausea and vomiting were more frequent in the FP than in the FH arm (p=0.01 and p=0.05, respectively). The incidence of increased proteinuria and creatininemia was higher with FH than with FP; however, there was no statistical difference. There were no treatment-related deaths. CONCLUSION: Heptaplatin showed similar effects to cisplatin when combined with 5-FU in advanced gastric cancer patients with tolerable toxicities.
Subject(s)
Humans , Adenocarcinoma , Arm , Chemotherapy, Adjuvant , Cisplatin , Drug Therapy, Combination , Fluorouracil , Incidence , Malonates , Nausea , Neutropenia , Organoplatinum Compounds , Proteinuria , Stomach Neoplasms , VomitingABSTRACT
Primary isolated bone marrow disease as a presenting feature of diffuse large B-cell lymphoma is very rare. We describe the first Korean case of isolated bone marrow diffuse large B-cell lymphoma with hemolytic anemia as the first manifestation. A32-year-old man was admitted to our hospital presenting with fever and hematuria. He had severe anemia and high lactate dehydrogenase activity. His peripheral blood smear and laboratory findings were suggestive of intravascular hemolytic anemia. The bone marrow biopsy revealed involvement with diffuse large B-cell lymphoma. A computed tomographic scan showed splenomegaly, but no lymphadenopathy. Our case shared some clinical features with the Asian variant of intravascular B-cell lymphoma, but there was infrequent involvement of the sinusoids of lymphoma cells and no hemophagocytosis. Our patient was treated with R-CHOP regimen for six cycles and he is in remission after autologous peripheral blood stem cell transplantation.
Subject(s)
Humans , Anemia , Anemia, Hemolytic , Asian People , B-Lymphocytes , Biopsy , Bone Marrow , Bone Marrow Diseases , Fever , Hematuria , L-Lactate Dehydrogenase , Lymphatic Diseases , Lymphoma , Lymphoma, B-Cell , Peripheral Blood Stem Cell Transplantation , SplenomegalyABSTRACT
The objective of the current study was to investigate the treatment outcomes for the use of cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP) chemotherapy in adult patients with hemophagocytic lymphohistiocytosis (HLH). Seventeen HLH patients older than 18 yr of age were treated with CHOP chemotherapy. A response evaluation was conducted for every two cycles of chemotherapy. With CHOP chemotherapy, complete response was achieved for 7/17 patients (41.2%), a partial response for 3/17 patients (17.6%), and the overall response rate was 58.8%. The median response duration (RD) was not reached and the 2-yr RD rate was 68.6%, with a median follow-up of 100 weeks. Median overall survival (OS) was 18 weeks (95% CI, 6-30 weeks) and the 2-yr OS rate was 43.9%. Reported grade 3 or 4 non-hematological toxicities were increased serum liver enzyme levels and stomatitis. Grade 3 or 4 hematological toxicities were leukopenia (50.8%), anemia (20%), and thrombocytopenia (33.9%). Neutropenic fever was observed in 21.6% of patients (14/65 cycles), and most of the cases were resolved with supportive care including treatment with broad-spectrum antibiotics. CHOP chemotherapy seems to be effective in adult HLH patients and the toxicities are manageable.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Follow-Up Studies , L-Lactate Dehydrogenase/blood , Lymphohistiocytosis, Hemophagocytic/drug therapy , Prednisone/administration & dosage , Remission Induction , Survival Rate , Treatment Outcome , Vincristine/administration & dosageABSTRACT
BACKGROUND: The CHOP regimen has been the standard therapy for non-Hodgkin's lymphoma (NHL) for the past 30 years, but its effect on complete response and long-term survival rates were unsatisfactory. Therefore, more effective chemotherapeutic regimens are required. We attempted to treat non-Hodgkin's lymphoma with a newly developed cyclophosphamide, adriamycin, etoposide, prednisolone (CHEP) combination chemotherapy which substitutes etoposide for vincristine in a preexisting cyclophosphamide, adriamycin, prednisolone, vincristine (CHOP) regimen. METHODS: Between March 1997 and April 2003, 36 patients with a histologically confirmed NHL were enrolled in the study. All patients received CHEP chemotherapy as a first-line treatment. Tratment courses were repeated every 34 weeks for at least 4 cycles, pending response to the treatment. RESULTS: The overall response rate achieved was 86.1% for all of the patients. The complete response (CR) and partial response (PR) rates were 72.2% and 13.9%, respectively. The CR rate was significantly higher in patients with stage III disease, and a PS score of 02 (p<0.0001, p=0.017, respectively). The three year overall (OS) and failure-free survival (FFS) rates were 61.2%, 58.2%, respectively. Stage, extranodal involvement, and the attainment of CR influenced OS significantly (p=0.027, p=0.047, p=0.0001, respectively) as determined by univariate analysis. Stage, serum LDH level, extranodal involvement, the international prognostic index (IPI), and the attainment of CR influenced FFS significantly (p=0.0013, p=0.048, p=0.020, p=0.018, p=0.0001, respectively) as determined by univariate analysis. The dose-limiting toxicity was due to myelosuppression. Nno neurologic side effects were seen, which frequently occur after using vincristine. CONCLUSIONS: The CHEP regimen in patients with aggressive NHL is effective as a first-line therapy, and possesses an acceptable toxicity profile. We suggest a trial that adds rituximab to the CHEP regimen as afirst-line therapy for aggressive NHL in the future.
Subject(s)
Humans , Cyclophosphamide , Doxorubicin , Drug Therapy , Drug Therapy, Combination , Etoposide , Lymphoma , Lymphoma, Non-Hodgkin , Prednisolone , Survival Rate , Vincristine , RituximabABSTRACT
PURPOSE: Although concurrent chemoradiotherapy (CCRT) has been considered as a standard treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN), this treament is associated with increased toxicities such as mucositis and dermatitis. As a result, the dose intensity can be reduced and interruptions of radiotherapy are more common for CCRT than for sequential treatment, especially for the elderly patients. This prospective study was performed to assess the efficacy and safety profiles of the induction chemotherapy of docetaxel and cisplatin for elderly patients with locally advanced SCCHN. MATERIALS AND METHODS: Patients over 65 years of age with locally advanced SCCHN were treated with docetaxel (70 mg/m(2)) and cisplatin (75 mg/m(2)) every 21 days. The chemotherapy consisted of two cycles with a third cycle that was administered to the responding patients. Patients who did not respond to initial chemotherapy underwent radiotherapy as a definitive local treatment. RESULTS: Fifty patients were enrolled in this study and 44 patients were assessable for response and toxicity. The overall response rate was 88%, 16 patients (36%) achieved a complete response and 23 patients (52%) achieved a partial response. After a median follow-up of 24 months (range: 9~38 months) the median disease free period and overall survival period had not yet been reached. The one year and two year survival rates were 89% and 70%, respectively. The most common grade 3/4 adverse event was neutropenia, which occurred in 33 patients (75%) and 4 patients had febrile neutropenia. CONCLUSION: Combination chemotherapy of docetaxel and cisplatin is an effective regimen with an acceptable safety profile as the induction treatment for elderly patients suffering with SCCHN.
Subject(s)
Aged , Humans , Carcinoma, Squamous Cell , Chemoradiotherapy , Cisplatin , Dermatitis , Drug Therapy , Drug Therapy, Combination , Febrile Neutropenia , Follow-Up Studies , Head and Neck Neoplasms , Head , Induction Chemotherapy , Mucositis , Neck , Neutropenia , Prospective Studies , Radiotherapy , Survival RateABSTRACT
Gastrointestinal tract (GIT) lymphomas usually originate from B-lymphocytes but rarely from T-lymphocytes. The stomach is the most common site for extranodal GIT lymphoma but the esophagus is a rare site. In addition, a primary esophageal T-cell lymphoma is an uncommon disorder. We encountered a case of a primary esophageal T-cell lymphoma in a 60-year-old man, who had swallowing difficulties and multiple ulcers in the upper and lower esophageal mucosa on gastroscopy. Immunohistochemical staining for the biopsy material from the multiple esophageal ulcers tested positive for LCA and CD45RO (pan T-cell marker) and negative for cytokeratin and CD20 reactivity, respectively. No other abnormal lesions were observed on a computed tomography scan of the neck, chest, abdomen and pelvis. After six cycles of combination chemotherapy with cyclophosphamide, adriamycin, vincristin, prednisolone, etoposide and gemcitabine, the multiple esophageal ulcers had completely disappeared suggesting a complete clinical response. We report this case with a review of the relevant literature.
Subject(s)
Humans , Middle Aged , Abdomen , B-Lymphocytes , Biopsy , Cyclophosphamide , Deglutition , Doxorubicin , Drug Therapy, Combination , Esophagus , Etoposide , Gastrointestinal Tract , Gastroscopy , Keratins , Lymphoma , Lymphoma, T-Cell , Mucous Membrane , Neck , Pelvis , Prednisolone , Stomach , T-Lymphocytes , Thorax , UlcerABSTRACT
Invasive aspergillosis (IA) of the paranasal sinuses is a rare infectious complication associated with allogeneic hematopoietic stem cell transplantation (HSCT). However, immunocompromised patients are particularly at risk of fulminant IA. The high risk of an invasive fungal infection (IFI) following allogeneic HSCT is due to several factors, including neutropenia before engraftment, disruption of mucosal barriers by various preparative regimens and the use of broad-spectrum antimicrobial agents, as well as the immunosuppressive effects of prophylaxis and treatment of GVHD. As the therapy for an IFI following allogeneic HSCT is often unsuccessful, the mortality rate is increased by 95%. Therefore, early diagnosis is important to overcome the high mortality of this destructive disease. In previous studies, high risks for the early onset of IA were demonstrated in patients with severe aplastic anemia (SAA), independent of the day of engraftment. Here, we report a case of invasive aspergillosis of the maxillary sinuses and orbit in a 50 years old man with SAA, who underwent an allogeneic HSCT from a HLA-matched sibling conditioned with Cytoxan/Fludara/ATG.
Subject(s)
Humans , Middle Aged , Anemia, Aplastic , Anti-Infective Agents , Aspergillosis , Early Diagnosis , Hematopoietic Stem Cell Transplantation , Immunocompromised Host , Maxillary Sinus , Mortality , Neutropenia , Orbit , Paranasal Sinuses , Siblings , Stem Cell Transplantation , Stem CellsABSTRACT
BACKGROUND: CHOP (cyclophosphamide, adriamycin, prednisolone, vincristine) regimen is still the standard therapy for non-Hodgkin's lymphoma, but its complete response rate & long-term survival rate are 45~55% and 30%, respectively. New chemotherapy regimen will be required for enhancing response rate and duration of survival. We tried to treat non-Hodgkin's lymphoma with newly developing CHEP-OB (cyclophosphamide, adriamycin, etoposide, prednisolone, vincristine, bleomycin) combination chemotherapy which include etoposide, bleomycin in preexisting CHOP regimen. METHODS: 51 patients with non-Hodgkin's lymphoma who admitted to Busan Paik Hospital Inje University between January 1996 and August 2002 were selected. They were treated with CHEP-OB combination chemotherapy given every 3~4 weeks for total 6 cycles. RESULTS: Objective response was achieved in 82.4% of the patients. Complete response (CR) and partial response (PR) rates were 66.7% and 15.7%, respectively. CR rate was significantly lower in patients with T cell immmunophenotype. Five year overall (OS) and failure-free survival (FFS) rate were 61.9%, 54.7%, respectively. Multivariate analysis showed that sex, stage and attainment of CR were factors independently predictive for OS and that stage and attainment of CR were factors independently predictive for FFS. Major side effect was myelotoxicity. CONCLUSION: CHEP-OB combination chemotherapy might be useful as a treatment strategy in non-Hodgkin's lymphoma considering similar response and survival rate, lower toxicity when it is compared with 3rd generation combination chemotherapy. But more effective chemotherapeutic regimen needs to be explored.
Subject(s)
Humans , Bleomycin , Doxorubicin , Drug Therapy , Drug Therapy, Combination , Etoposide , Lymphoma, Non-Hodgkin , Multivariate Analysis , Prednisolone , Survival Rate , VincristineABSTRACT
Low-grade B cell mucosa-associated lymphoid tissue (MALT) lymphoma makes up 8% of non-Hodgkin's lymphomas. It has been characterized by a prolonged clinical course and persistent disease at the site of origin. Most patients with low-grade B cell MALT lymphoma occur in the stomach, orbit, intestine, lung, thyroid, salivary gland, skin, soft tissues, bladder, kidney, and central nervous system. The diagnosis of MALT lymphoma can be established by a characteristic finding of infiltration of small lymphocytes that are monoclonal B cell and CD5 negative. Bone marrow involvement seems uncommom but has been developed. Waldenstr m's macroglobulinemia (WM) is usually defined as bone marrow infiltration of lymphoplasmacytoid lymphocytes with a high level of circulating macroglobulin IgM. Lymphadenopathy and splenomegaly occurs in 20~40% of WM. It is very hard work to do differential diagnosis between disseminated low-grade B cell MALT lymphoma and WM with organ involvement by a bone marrow examination. We reprot one case of low grade mediastinal MALT lymphoma with bone marrow involvement and a high level of serum monoclonal IgM with clinical appearance of WM.
Subject(s)
Humans , Bone Marrow , Bone Marrow Examination , Central Nervous System , Diagnosis , Diagnosis, Differential , Immunoglobulin M , Intestines , Kidney , Lung , Lymphatic Diseases , Lymphocytes , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell, Marginal Zone , Lymphoma, Non-Hodgkin , Mediastinum , Orbit , Salivary Glands , Skin , Splenomegaly , Stomach , Thyroid Gland , Urinary Bladder , Waldenstrom MacroglobulinemiaABSTRACT
BACKGROUND: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by a progressive course outlined by the transition from the chronic phase (CP) to blastic crisis (BC). The course of CML-BC is still fatal, and in spite of various efforts in treatment, median survival remains short. The aim of the present study was to analyze the prognostic factors having an impact on response to treatment and survival in patients with CML-BC. We also investigated prognostic influence on survival in myeloid BC according to FAB classification. METHODS: All patients (N=35) with CML with onset of CML-BC between January 1992 and May 2002 were reviewed. RESULTS: The median survival for all patients after onset of CML-BC was 7 weeks, and probable survival rate at 24 months was 5.9%. The adverse prognostic factors for survival of CML-BC were high and intermediate risk of Hasford score at diagnosis of CML (P=0.05), normal serum LDH (P=0.016), bone marrow blasts > or =60% (P=0.092), no treatment at CML-BC (P=0.0056), platelet count <20x10(9)/L (P=0.13). Clonal evolution at diagnosis of CML-BC was associated with a shorter survival. Especially in our study, FAB subtype M4-7 (median survival, 4 weeks; 95% CI, 2~6) had shorter survival duration than M0-2 (median survival, 16 weeks; 95% CI, 5~27) in patients with myeloid CML-BC. CONCLUSION: The management of patients with CML-BC remains highly unsatisfactory. Once blast crisis has occurred, there are useful parameters to assess the prognosis for the individual patient and these may be of interest in planning therapy. Our experience suggests that FAB classification M4-7 are poor prognostic factor in patients with myeloid CML-BC.
Subject(s)
Humans , Blast Crisis , Bone Marrow , Classification , Clonal Evolution , Diagnosis , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Myeloproliferative Disorders , Platelet Count , Prognosis , Retrospective Studies , Survival RateABSTRACT
PURPOSE: A retrospective study was performed o define the clninical significance of p53, P-glycoprotein (Pgp), and Glutathione S transferase-pi (GST-pi) immunohistochemical (IHC) expression in advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: We reviewed fifty seven patients with advanced NSCLC who had undergone surgical resection or bronchoscopic biopsy between March 1997 and March 1999. IHC staining for p53, GST-pi, and Pgp was performed using formalin-fixed, paraffin-embedded specimens of the fifty seven patients. RESULTS: The IHC expression rate was 63% for p53, 28% for Pgp, and 53% for GST-pi, respectively. The median survival of the fifty seven patients was 45 weeks and the response rate was 38.6% (partial response, 22/57). The chemotherapy response and median survival of the p53 negative group (57% and 61 weeks) were better than those demonstrated by the p53 positive group (28% and 21 weeks) (p<0.05). Additionally, the GST-pi negative group showed a greater improvement of survival and response rate than the positive group (p<0.05). Pgp expression status appeared to have no significant differential effect on chemotherapy response and survival. CONCLUSION: These results suggest that immunohisto chemical staining of p53 and GST-pi may be useful in predicting the response to chemotherapy as well as survival in advanced NSCLC. However, this study is limited by its retrospective nature and the small numbers of tumors studied from a heterogenous group of patients.
Subject(s)
Humans , Biopsy , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Glutathione , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Retrospective StudiesABSTRACT
The genetically determined CYP2D6 activity is considered to be associated with cancer susceptibility with inter-individual variation. Genetic polymorphism of CYP2D6(B) and CYP2D6(T) was determined by the two polymerase chain reaction(PCR) and BstN1 and EcoN1 restriction fragment length polymorphisms(RFLP) for 67 lung cancer cases and 95 healthy volunteer controls. The cases were composed of 26 squamous cell carcinoma, 14 small cell carcinoma, 10 adenocarcinoma, 3 large cell undifferentiated carcinoma, and 14 not histologically diagnosed. The results were gained from the 142 subjects (57 cases and 85 controls) who observed successfully in two PCR and BstN1/EcoN1 RFLP. Only one and no mutant allele of the CYP2D6(B) and CYP2D6(T) gene was detected, that is, the frequency of mutant allele was very low; 0.7%(1/142) and 0%(0/142), respectively. Detected mutant allele of the CYP2D6(B) was heterozygous type(WM). The odds ratios for lung cancer susceptibility with CYP2D6(B) and CYP2D6(T) genotype were not calculated. These results are similar to the previous understanding that the mutant allele is very rare in Orientals compared to Caucasians, therefore, it considered that CYP2D6(B) and CYP2D6(T) genotypes have maybe no association with lung cancer susceptibility in Koreans. This is the basic data of CYP2D6(B) and CYP2D6(T) genotypes for Koreans. It would be hepful for further study to determine lung cancer susceptibility of Koreans with the data about CYP1A1, CYP2E1, GSTM1 from future study.
Subject(s)
Adenocarcinoma , Alleles , Carcinoma , Carcinoma, Small Cell , Carcinoma, Squamous Cell , Cytochrome P-450 CYP1A1 , Cytochrome P-450 CYP2D6 , Cytochrome P-450 CYP2E1 , Genotype , Healthy Volunteers , Lung Neoplasms , Lung , Odds Ratio , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment LengthABSTRACT
PURPOSE: This study was performed to analyze the efficacy of induction chemotherapy followed by radiation therapy in locally advanced non-small cell lung cancer. MATERIALS AND METHODS: Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median, 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. RESULTS: Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). CONCLUSION: In stage lll non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance. Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.