Phase II Study of Paclitaxel and Cisplatin as Second-line Chemotherapy in Advanced Non-small Cell Lung Cancer / 영남의대학술지

BACKGROUND: To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.

A Phase II Study with Gemcitabine and Carboplatin in Patients with Advanced Non-small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To evaluate the efficacy and safety of gemcitabine and carboplatin (GC) in the treatment of advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1999 and April 2001, 34 patients were enrolled in this study. The median age was 66 (range: 52-74) years old and all were male. Sixteen patients demonstrated stage IIIB, 15 stage IV, and 3 recurrence of disease after surgery. Twenty-two patients showed a ECOG performance status of 0 or 1 and 12 had 2. Twenty patients presented with squamous cell carcinoma, 11 adenocarcinoma and 3 unclassified NSCLC. The treatment regimen consisted of intravenous carboplatin AUC of 6 on day 1 and gemcitabine 1,250 mg/m2 on day 1 and 8. The treatment was repeated every 28 days. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All thirty-four patients were evaluable. Partia responses were observed in 15 patients. The overall response rate was 44% (95% confidence interval: 27-61%) and the median response duration was 26 (range 8-60 ) weeks. The median survival of all patients was 50 (range 8-70 ) weeks. During a total of 144 cycles, granulocytopenia greater than WHO grade 2 occurred in 2%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non- hematologic toxicities were minor and easily controlled. CONCLUSION: A combination chemotherapy of intravenous gemcitabine and carboplatin has a relatively high activity with acceptable toxicities in patients with advanced NSCLC.

A case of primary bilateral adrenal non-Hodgkin's lymphoma / 대한내과학회지

Primary adrenal lymphoma is extremely uncommon. The tumor is accidentally discovered by abdominal ultrasonography(USG), computed tomography(CT) or magnetic resonance imaging (MRI) in patients with nonspecific symptoms and diagnosed at operation or autopsy. In this case, a 60-year-old man was admitted for the evaluation of mild left frank discomfort for two months before admission. The abdominal USG was performed and showed the dense masses in both adrenal glands. The laboratory tests including blood count, chemistry and hormonal tests showed the normal levels except for the basal ACTH level of 108 pg/ml(normal range: 9~52 pg/ml). The 123I MIBG scan was normal. The bilateral adrenalectomy was done. The tumor was diagnosed as diffuse large B-cell non-Hodgkin's lymphoma(NHL) according to the Revised European-American lymphoma(REAL) classification. He was treated with the adjuvant combination chemotherapy of CHOP(cyclophosphamide, adriamycin, vincristine and prednisolone) but expired due to sepsis after the second chemotherapy. We describe the first case of primary bilateral adrenal NHL in Korea. Primary adrenal lymphoma should be included in the differential diagnosis of suprarenal mass.

A Phase II Study with Vinorelbine and Carboplatin in Patients with Advanced Non-small Cell Lung Cancer / 대한암학회지

PURPOSE: To evaluate the efficacy and safety of vinorelbine and carboplatin in advanced non- small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Between August 1998 and July 1999, 25 patients were enrolled. The median age was 68 (range, 46~77) years and male:female ratio was 23:2. Two patients had stage IIIa, 15 had stage IIIb and 8 had stage IV. Sixteen patients had ECOG performance status of 0 or 1 and 9 had 2 or 3. Sixteen patients had squamous cell carcinoma, 8 had adenocarcinoma and 1 had undifferentiated NSCLC. Treatment consists of intravenous carboplatin 400 mg/m2 on day 1 and vinorelbine 25 mg/m2 on days 1 and 8. The treatment was repeated every 28 days. RESULTS: Twenty-three of 25 patients were evaluable. Partial response were observed in 11 patients. The overall response rate was 48% (95% confidence interval: 27~69%) and the median response duration was 19 (range 7 ~44 ) weeks. The median survival of 25 patients was 52 (range 3~53 ) weeks. Toxicities were evaluated by WHO criteria. During a total of 108 cycles, granulocytopenia worse than WHO grade 3 occurred in 2%, thrombocytopenia in 4% and anemia in 10%, respectively. Treatment-related death occurred in 1 patient due to sepsis during cytopenic period. Non-hematologic toxicity was minor and easily controlled. CONCLUSION: A combination chemotherapy of intravenous vinorelbine and carboplatin has relatively high activity with acceptable toxicities in patients with advanced NSCLC.

The Effect of Oxygen Therapy on VPB in Patients with Chronic Obstructive Pulmonary Disease / 결핵

BACKGROUND: In patients with chronic obstructive pulmonary disease(COPD), it is well known that hypoxemia increases the frequency of VPB, which is associated with the poor prognosis such as sudden death. The aim of this study is to evaluate the effect of short and long-term low flow oxygen therapy on the development of VPBs in patients with COPD by correcting the hypoxemia. METHOD: In 19 patients with COPD, oxygen saturation and VPB are monitored by pulse oxymeter and 24-hour Holter EKG, with room air and the 1st and the 8th day during oxygen therapy by nasal prong (2L/min). RESULTS: The arterial oxygen saturation was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and also higher on the 8th day of oxygen therapy than on the 1st day. We found that there was significant correlation between the minimal value of the arterial oxygen saturation and the mean value of the arterial oxygen saturation. The number of VPBs per hour was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and also higher on the 8th day of oxygen therapy than on the 1st day. There was no significant correlation between the decrease of the frequency of VPBs and the increase of the minimal arterial oxygen saturation. But, because of the low p value as 0.056, The correlation is highly suggested. CONCLUSION: With oxygen therapy, the arterial oxygen saturation was increased and the number of VPBs was decreased, and with long-term oxygen therapy more than 7days, the number of VPBs was more decreased in patients with COPD.

A Case of Recurred Primary Mediastinal Nonseminomatous Germ Cell Tumor Associated with Klinefelters Syndrome / 결핵

Primary mediastinal nonseminomatous germ cell tumor associated with Klinefelter's syndrome is a rare disorder. We experienced a case of recurred primary mediastinal nonseminomatous germ cell tumor developed in a 24-year-old patient with Klinefelter's syndrome. The patient had been treated with surgery and combination chemotherapy under the diagnosis of primary mediastinal nonseminomatous germ cell tumor before. A round mass was found on the right lower lung field in the chest X-ray during follow up. The patient was diagnosed as recurred primary nonseminomatous germ cell tumor and Klinefelter's syndrome through tumor markers, peripheral blood karyotyping, and other tests including hormonal assay and was treated with combination chemotherapy and surgery again. When the patient is diagnosed as primary mediastinal nonseminomatous germ cell tumor, Klinefelter's syndrome and hematologic malignancies should be considered to be associated diseases and vice versa.