Concurrent Hyperfractionated Radiotherapy with CDDP / VP-16 Chemotherapy in Limited Stage Small Cell Lung Cancer / 대한암학회지

PURPOSE: The aim of this study was to evaluate local control and long-term survival of concurrent hyperfractionated radiotherapy with CDDP/VP-16 chemotherapy in limited stage small cell lung cancer. MATERIALS AND METHODS: From April 1992 to April 1997, twenty-nine patients with limited stage small cell lung cancer received cisplatin 25 mg/m plus etoposide 120 mg/m(2) on day 1, 2 and 3. Chemotherapy was repeated every 4 weeks for a total of 4 courses. Radiation was given to 60 Gy in 50 twice-daily fractionation separated by at least 6 hours, 5 days per week Thoracic radiotherapy was started with first coese of chemotherapy for 28.8 Gy. After 12 days break, radiotherapy was resumed with second course of chemotherapy for another 31,2 Gy. RESULTS: Twenty-eight patients (96.6%) were evaluable. Patient characteristics include: median age 58.4 years (range 45-67); clinical stage 1IIa 13 pts, stage IIIb 15 pts; ECOG performance status 0 (8 pts), 1 (16 pts) and 2 (4 pts). Objective responses were 21 complete response, 6 partial response, 1 stable disease with overall response rate of 96.4%. Grade III and IV toxicities were leukopenia in 23/28 pts, thrombocytopenia in 8/28 pts, stomatitis in 10/28 pts, and alopecia in 8/28 pts. The median survival time was 19.2 months with 1 year, 2 year, 3 year, and 4 year actuarial survival rates and RFS are 65.6%, 30.6%, 30.6%, 24.5%, and 65.3%, 52.8%, 52.8%, 42.2%, respectively. Overall survival rate according to TNM stage, weight loss, age and sex were not statistically significant. Pattems of relapse were local only in 2 pts, systemic only in 7 pts, and local plus systemic in 1 pt, and brain was the most frequent systemic recurrent site (4 pts). CONCLUSION: Concurrent hyperfractionated radiotherapy with CDDP/VP-16 chemotherapy seems to produce better local contml and survival rates in limited stage small cell lung cancer.

A Case of Primary Signet Ring Cell Carcinoma of the Lung / 결핵

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.

A case of primary plasma cell leukemia / 대한혈액학회지

No abstract available.

Colonoscopic Experience in 3 Cases of Primary Colonic Lymphoma / 대한소화기내시경학회지

Primary colonic lymphoma is a rare disease and open surgical biopsy is usually necessary for hietological confirmation. Despite the submucosal location of the tumors, histological confirmation is frequently made by endoscopic multiple punch biopsies. Recently, three patients were admitted to the hospital with right lower guadrant abdominal pain, mass and abnormalities in the right colon and cecum on the barium enema. We performed colonoscopy and found smooth surfaced polypoid mass with occasional shallow ulcerations without lobulation, so suspected lymphoma endoscopically but failed to confirm histologieal diagnosis by usual punch biopsy. Thereafter, all three cases were undergone to laparntomies, and two were confirmed to be non-Hodgkins lymphoma and the other was Hodgkins disease. Here, we present those three cases of endoscopically found colonic lymphoma with review of literatures.

Aortic Valve Vegetation by Echocardiography

Seven patients with aortic valve vegetation were examined by M-mode and two dimensional echocardiography. Underlying cardiac abnormalities were found in 6 patients, four had rheumatic heart disease, one had congenital bicuspid aortic valve, one had coexistence of asymmetrical septal hypertrophy and aortic regurgitation. Aortic regurgitation were found in all patients. One of seven patients had cerebral embolization and all patients had overt congestive heart failure. Of 5 patients medically treated, three became moribund, one died and one improved clinically. One patient underwent cardiac surgery, the aortic cusps were congenital bicuspid with vegetation, aortic valve replacement was successful. Echocardiogram of 7 patients with aortic valve vegetation showed characteristic shaggy, irregular mass of echoes produced by vegetation in the aortic valve during systole and diastole. Two of seven patients had abnormal mass of echoes in the left ventricular outflow tract. During systole, two had vegetation on the right coronary cusp and one had vegetation on the noncoronary cusp by M-mode echocardiography. In other patients we could not localize invoving aortic cusps by M-mode echocardiogram. All patients had left ventricular volume overload. For of seven patients had fluttering of anterior mitral valve. Two had fluttering of interventricular seputm. Five had premature mitral valve closure before QRS complex.