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G E Kim

Publications and source records attributed to G E Kim.

At least 37 records · Page 2Linked to original sources

Spontaneous apoptosis as a predictor of radiotherapy in patients with stage IIB squamous cell carcinoma of the uterine cervix.

The purpose of this study was to investigate the correlation between the spontaneous apoptotic index (SAI) determined from pretreatment biopsy specimens with the various clinical outcomes of patients with FIGO stage IIB squamous cell carcinoma of the uterine cervix in a retrospective analysis. Forty-eight patients treated with curative radiotherapy between 1989 and 1993 were evaluated. Pretreatment biopsy specimens of those patients were scored for apoptosis, mitosis, and proliferating cell nuclear antigen (PCNA) immunohistochemical staining. The range of the SAI was 0.2-4.7% (median 1.1%). Patients whose tumours had a SAI above the median had better local control (p = 0.0062) and overall survival (p = 0.0053) than those with a lower SAI. Furthermore, the SAI was marginally significant on local control by a multivariate Cox regression analysis (p = 0.0571). There was no correlation between the SAI and proliferation (mitosis and PCNA).

Adult↗

Role of definitive radiation therapy for larynx preservation in patients with advanced laryngeal cancer.

OBJECTIVE: Recently, neoadjuvant chemotherapy (CT) and radiation therapy (RT) have been advocated as a standard treatment for laryngeal preservation in patients with locally advanced laryngeal cancer. However, it is still being debated whether adding neoadjuvant CT to conventional RT makes an effective contribution to laryngeal preservation. The current study was designed to resolve this controversy. DESIGN: Retrospective clinical study. SETTING: The Severance Hospital, Yonsei Cancer Center, Yonsei University, Seoul, Korea. METHOD: Eighty patients (stages III, IV) with squamous cell carcinoma of the larynx were divided into two groups according to treatment modalities, which consisted of RT alone (N = 40, Group 1) and neoadjuvant CT plus RT (N = 40, Group 2). Comparative analysis was undertaken to investigate the differences in the organ preservation rate and treatment results between the two groups. RESULTS: There was no significant difference in the response rate and patterns of treatment failure between the two groups. The 5-year survival rate was similar between Group 1 (24%) and Group 2 (31%) (p = .1556). In addition, the larynx was almost equally preserved in Group 1 (62%) versus Group 2 (63%). CONCLUSIONS: Radiation therapy without neoadjuvant CT seems to be a valid alternative treatment for the purpose of laryngeal preservation in locally advanced laryngeal cancer.

Adult↗

Sensory and motor dysfunction assessed by anorectal manometry in uterine cervical carcinoma patients with radiation-induced late rectal complication.

PURPOSE: To investigate the effects of radiation on anorectal function in patients with carcinoma of the uterine cervix. METHODS AND MATERIALS: Anorectal manometry was carried out on 24 patients (complication group) with late radiation proctitis. All of the manometric data from these patients were compared with those from 24 age-matched female volunteers (control group), in whom radiation treatment had not yet been performed. RESULTS: Regardless of the severity of proctitis symptoms, 25% of patients demonstrated all their manometric data within the normal range, but 75% of patients exhibited one or more abnormal manometric parameters for sensory or motor functions. Six patients (25%) had an isolated sensory dysfunction, eight patients (33.3%) had an isolated motor dysfunction, and four patients (16.7%) had combined disturbances of both sensory and motor functions. The maximum tolerable volume, the minimal threshold volume, and the urgent volume in the complication group were significantly reduced compared with those in the control group. The mean squeeze pressure in the complication group was significantly reduced, whereas the mean resting pressure and anal sphincter length were unchanged. CONCLUSIONS: Physiologic changes of the anorectum in patients with late radiation proctitis seem to be caused by a variety of sensory and/or motor dysfunctions in which many different mechanisms are working together. The reduced rectal reservoir capacity and impaired sensory functions were crucial factors for functional disorder in such patients. In addition, radiation damage to the external anal sphincter muscle was considered to be an important cause of motor dysfunction.

Adult↗

Hepatic metastases from carcinoma of the uterine cervix.

OBJECTIVE: To investigate the patterns of hepatic involvement and the outcome of patients with hepatic metastases from carcinoma of the uterine cervix. METHODS: Of 1665 patients with carcinoma of the uterine cervix, 20 patients with hepatic metastases were detected clinically during the course of the disease. Clinical presentation and detailed patterns of hepatic involvement were retrospectively reviewed for these patients. Comparative analysis between patterns of heaptic metastases and survival data was also undertaken. RESULTS: Hepatic metastasis from carcinoma of the uterine cervix were nearly always accompanied by uncontrolled locoregional diseases and/or extrahepatic metastases, whereas only 1 patient developed an isolated hepatic metastasis. Ninety percent of the hepatic metastases were metachronously detected. The median time from the appearance of primary carcinoma to detection of hepatic metastases was 39 months, but late metastases after 5 years were not uncommon. Metastatic lesion in 16 patients consisted of multiple tumors distributed in either one or both anatomical lobes, whereas only 4 patients had a solitary lesion confined to a single lobe. Patients with hepatic metastases were unlikely to survive 2 years with a median survival of 10 months. CONCLUSION: Favorable patterns of hepatic metastases in patient with carcinoma of the uterine cervix were not major determinants of favorable survival if components of extrahepatic disease were concomitantly present.

Adult↗

Cyclic AMP analogue as a triggering signal for the induction of nitric oxide synthesis in murine peritoneal macrophages.

To understand the role of cAMP during macrophage activation, we investigated the effects of various cAMP analogues in the induction of nitric oxide (NO) synthesis in murine peritoneal macrophages. Intracellular cAMP modulators such as N6,O2'-dibutyryl cyclic AMP (DB-cAMP), 8-bromo-cAMP, or 8-chloro-cAMP had no effect on NO synthesis by themselves, whereas cAMP analogues in combination with interferon-gamma (IFN-gamma) had a marked cooperative induction of NO synthesis in a dose-dependent manner. This increase in NO synthesis was reflected as an increased amount of inducible NO synthase mRNA, as determined by Northern blotting. To find the point in the signaling pathways of macrophage activation at which cAMP is involved, we carried out several of the following experiments. Although DB-cAMP showed synergistic action with rIFN-gamma to induce NO synthesis when the cells were treated with DB-cAMP after or with simultaneous treatment with rIFN-gamma, there is no synergistic induction of NO synthesis when the cells were treated with DB-cAMP 6 hr before treatment with rIFN-gamma. In addition, when phorbol 12-myristate 13-acetate (PMA), which is known to provide a triggering signal in the induction of NO synthesis in murine macrophages, was added to the cells 6 hr after the treatment with DB-cAMP, PMA showed no synergistic cooperation with DB-cAMP. On the other hand, DB-cAMP alone induced the release of NO to the incubation medium from bacillus Calmette-Guerin-infected peritoneal macrophages just as lipopolysaccharide (LPS) did. However, DB-cAMP, unlike LPS, decreased the secretion of tumor necrosis factor-alpha from IFN-gamma-treated macrophages. Based on the results obtained in this study, we suggest that cAMP analogue could give a "triggering" signal which might be different from one given by LPS in the production of NO by primed macrophages.

8-Bromo Cyclic Adenosine Monophosphate↗

Radiation treatment in patients with recurrent Kimura's disease.

PURPOSE: To assess the benefits of radiotherapy for patients with recurrent Kimura's disease and to document the role of radiation treatment as a successful mode of therapy. METHODS AND MATERIALS: From 1985 to 1991, a total of 26 patients with Kimura's disease were treated by local excision and/or systemic steroids at Yonsei University, Yonsei Cancer Center Hospital. Seventeen patients among them eventually had local recurrence after surgical excision. The 17 patients with recurrent Kimura's disease were divided into two groups on the basis of those who received radiation treatment and those who did not. Eight patients in the nonradiation group were treated by systemic steroids alone with individualized doses and schedules. The remaining nine patients in the radiation group were treated by external beam irradiation. The prescribed radiation doses varied from 21.6 to 45 Gy. A comparative analysis on treatment results between both groups was undertaken retrospectively. RESULTS: The majority of the recurrent cases in the nonradiation group treated by steroids alone experienced rapid rerecurrence of the disease. In contrast, all of the patients except one case in the radiation group achieved excellent local control with moderate doses of radiation. There was a significant difference in the rerecurrence rate between the patients of the radiation group (11%) and the nonradiation group (75%). No clear dose-response relationship could be derived from the patients of the radiation group. No secondary malignancies in the irradiated areas have been observed. CONCLUSION: Our results suggest that radiation treatment is preferable as an alternative option for patients with recurrent Kimura's disease who have failed to achieve local control by other modalities.

Adolescent↗

Epstein-Barr virus in lymphoproliferative diseases in the sino-nasal region: close association with CD56+ immunophenotype and polymorphic-reticulosis morphology.

Association between Epstein-Barr virus (EBV) and nasal T-cell lymphoma (NTL) has been demonstrated. NTL has 2 types of histologic figures: one is ordinary non-Hodgkin's lymphoma (NHL) with monomorphous proliferation, and the other is polymorphic-reticulosis (PR) morphology. The presence of the EBV genome and its sub-types (A and B) were examined on paraffin-embedded specimens from 36 cases of sino-nasal lymphomas (SNL) collected from Seoul, Republic of Korea, where the frequency of NTL is high. Patients' ages ranged from 2 to 74 years (median 54 years) with a male-to-female ratio of 2.5:1. Immunophenotypically, 8 cases were B-cell type, 11 were T-cell type with CD56-, 14 were CD56+ type, and 3 were null-cell type. Five of 11 cases with ordinary NHL of T-cell type and 9 of 14 cases with PR were CD56+. The EBV genome was found by polymerase chain reaction (PCR) and in the tumor cells by in situ hybridization (ISH) in 1 of 4 B-cell type (25%), 5 of 10 T-cell type (50%), 11 of 13 CD56+ type (85%), and in both of null-cell type (100%). Of 16 cases with PR morphology, 15 (94%) were positive for the EBV genome. All of the 5 NTLs of ordinary NHL with CD56- were negative for EBV. Concerning the sub-type of EBV, 16 cases had type A, while none had type-B EBV. These findings suggest that NTL comprises 2 groups: EBV-positive NTLs are CD56+ and/or histologically PR, and EBV-negative NTLs are CD56- and histologically ordinary NHL. The current results on Korean patients, together with earlier studies on Japanese and Malaysian patients, have shown the predominance of type-A EBV in sino-nasal lymphoma in Asia.

Adolescent↗

Sterility of ophthalmic drugs dispensed from spray bottles.

BACKGROUND: Spray application of cycloplegics and mydriatics is efficacious and frequently easier to use than a standard dropper bottle in the pediatric population. However, no documentation regarding the sterility of drugs dispensed from spray bottles is available. This study was conducted to determine whether contamination of ophthalmic drugs occurs with spray bottle use. METHODS: Fifteen milliliters of 1% cyclopentolate hydrochloride or 0.5% tetracaine hydrochloride were transferred to each of 15 disinfected spray bottles, stored at room temperature or refrigerated, and sprayed three times weekly for 12 weeks. Cultures were obtained from the spray bottles and drugs before transfer of the drug and from spray bottle contents at 0, 2, 4, and 6 to 12 weeks of storage. RESULTS: No cultures showed significant bacterial growth. The bactericidal action of the preservative and sterility of the drugs were maintained. CONCLUSIONS: Despite the transfer to and use of a spray bottle there appears to be minimal risk of instilling contaminated diagnostic drugs using the spray method when a single drug is stored in a spray bottle.

Anesthetics, Local↗

Adaptive response to ionizing radiation induced by low doses of gamma rays in human cell lines.

PURPOSE: The aim of this study was to investigate whether the adaptive response could be induced in human lymphoblastoid cell lines and human tumor cell lines. The time necessary for the expression of the adaptive response was also investigated. MATERIALS AND METHODS: Three lymphoblastoid cell lines from ataxia telangiectasia (AT) homozygote (GM 1526), AT heterozygote (GM 3382), and normal individual (3402p) and two hepatoma cell lines, Hep G2 and Hep 3B, were used in this study. Experiments were carried out by delivering 0.01 Gy followed by 0.5 Gy of gamma radiation to the exponentially growing cells. The time necessary for the expression of the adaptive response was determined by varying the time interval between the two doses from 1 to 72 h. In some experiments, 3-aminobenzamide, a potent inhibitor of poly (ADP-ribose) polymerase, was added immediately after the 0.5 Gy exposure. The cultures were fixed 30 min (for the G2 chromatid) and 6 h (for the S chromatid) after the 0.5 Gy exposure. Metaphase chromosome assay was carried out to score chromatid breaks as an end point. RESULTS: A prior exposure to 0.01 Gy of gamma rays significantly reduced the number of chromatid breaks induced by subsequent higher doses (0.5 Gy) in all the tested cell lines. The magnitude of the adaptive response was similar among the cell lines despite their different radiosensitivities. In the G2 chromatids, the adaptive response was observed both at short-time intervals, as early as 1 h, and at long-time intervals. In the S chromatids, however, the adaptive response was shown only at long-time intervals. When 3-aminobenzamide was added after the 0.5 Gy, the adaptive responses were abolished in all the experimental groups. CONCLUSION: The adaptive response was observed in human lymphoblastoid cell lines and hepatoma cell lines. The magnitude of the adaptive response did not seem to be related to the radiosensitivity of the cells. The elimination of the adaptive response with 3-aminobenzamide is consistent with the proposal that this adaptive response is the result of the induction of a certain chromosomal repair mechanisms.

Adaptation, Physiological↗

Primary lymphoma of the thyroid.

Primary lymphoma presenting in the thyroid gland is uncommon. A review of the Yonsei University Medical Center experience between 1982 and 1994 was performed retrospectively to assess the treatment outcome and prognostic factors. There were four females and one male, and the median age was 65 years. All 5 cases presented with a neck mass. Two of them had co-existing biopsy-proved Hashimoto's thyroiditis and three cases were each in a hypothyroid state. All cases with non-Hodgkin's disease were of intermediate grade. One case was in stage IE and four were in stage IIE. Three cases were treated with surgery alone and two cases with bulky inoperable stage IIB were treated with chemo-radiotherapy. Chemotherapy induced a complete response in one and a partial response in the other with minimal transient toxicity. As the questions regarding justification for extensive surgical intervention increase, combined chemo-radiotherapy can be suggested as an initial treatment even in stage I, and stage II thyroid lymphoma based on prognostic factor evaluation.

Aged↗

Thermosensitization by increasing intracellular acidity with amiloride and its analogs.

PURPOSE: The major mechanisms that regulate the intracellular acidity of pHi in mammalian cells are the Na+/H+ exchange and HCO3-/Cl- exchange through the plasma membrane. The purpose of this study was to investigate the feasibility of increasing the thermosensitivity of tumors by increasing intracellular acidity with the use of drugs that inhibit the pHi regulatory mechanisms. METHODS AND MATERIALS: The pHi of SCK tumor cells in vitro was determined with the fluorescence spectroscopy method. The thermosensitizing effects of the drugs on the cells in neutral (pH 7.2-7.5) and acidic (pH 6.6) media were determined by clonogenic assay. The thermosensitization of SCK tumors in vivo by the drugs was determined with the tumor growth delay and the in vivo-in vitro assay for clonogenic cells. RESULTS: The pHi of SCK tumor cells in pH 7.2-7.5 media was similar to the media pH, while the pHi of the cells in pH 6.6 media was about 7.0. The pHi declined and the thermosensitivity of the tumor cells increased when the Na+/H+ exchange was inhibited with amiloride (3,5 diamino-6-chloro-N-(diaminomethylene) pyrazinecarboxamide) and its analogs, HMA (3-amino-6-chloro-5-(1-homopiperidyl)-N-(diaminomethylene) pyrazinecarboxamide) or EIPA (3-amino-6-chloro-5-(N-ethyl-N-isopropylamino)-N-diaminomethylene) pyrazinecarboxamide), especially in acidic medium. The potencies of HMA and EIPA to decrease the pHi and increase the thermosensitivity in vitro were more than 50 times greater than that of amiloride. DIDS (4,4-diiosothiocyanatostilbene-2,2'-disulfonic acid), an inhibitor of the Na(+)-dependent HCO3-/Cl- exchange, exerted little effect on the pHi and thermosensitivity of SCK cells in vitro, but it enhanced the effects of amiloride and its analogs. Amiloride and HMA also significantly enhanced the thermal effect on tumors in vivo, as judged by the tumor growth delay and also by the in vitro-in vivo assay for clonogenic cells. Combinations of DIDS with amiloride or HMA were more effective than either of them alone in increasing the thermal damage in vivo. As in vitro, HMA was far more potent than amiloride in increasing the thermosensitivity of tumor cells in vivo. However, EIPA was not effective in vivo, probably due to a rapid metabolic breakdown of the drug. CONCLUSION: The drugs that interfere with the pHi regulatory mechanism significantly thermosensitized the tumor cells in vitro, particularly those in acidic media. The drugs were also effective in increasing the thermosensitivity of tumors. Because the interstitial environment in tumors is acidic relative to that in normal tissues, the thermosensitization by the drugs may be greater in tumors than that in normal tissues.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

The role of radiation treatment in management of extrahepatic biliary tract metastasis from gastric carcinoma.

PURPOSE: To determine the proper role of radiation treatment in the management of patients with extrahepatic biliary tract metastasis due to recurrent gastric cancer. METHODS AND MATERIALS: Twenty patients with malignant biliary obstruction due to recurrent gastric carcinoma after gastrectomy were treated with palliative intent at the Yonsei University College of Medicine from 1986 to 1990. Treatment consisted of external drainage alone in 11 patients (Group I) and external drainage followed by radiation treatment in nine patients (Group II). Five of nine patients in Group II underwent external irradiation in combination with intraluminal brachytherapy using high dose rate Iridium-192 (Ir-192) sources within the expandable intrabiliary prosthesis, a Gianturco stent, inserted transhepatically at the site of obstruction. RESULTS: An excellent local response was observed in five of nine patients in Group II, in whom biliary patency was restored following treatment so that the external drainage catheter could be removed. Prolongation of median survival was observed in Group II (9 months) as compared to Group I (2 months). There were no serious treatment-related complications with this approach. CONCLUSION: This treatment approach with external radiotherapy +/- intraluminal brachytherapy could achieve effective palliation and improve the quality of life in selected patients with extrahepatic biliary metastasis from gastric carcinoma.

Adult↗

Effects of atrial natriuretic peptide in clinical acute renal failure.

Fifty-three consenting patients meeting clinical and urine composition criteria for established intrinsic ARF were assigned to two treatment groups. Group I patients were treated with human atrial natriuretic peptide (ANP) with or without diuretics. Groups II patients were treated with or without diuretics and with no ANP. Age, sex, etiology of ARF, entry serum creatinines (SCr) (Group I, 5.3 +/- 1.8; Group II, 5.1 +/- 2.1 mg/dl) and creatinine clearances (CCr) (Group I, 9.9 +/- 2.1; Group II, 9.2 +/- 2.1 ml/min) were similar. Thirty patients received ANP [0.20 micrograms/kg/min i.v. x 24 hr (N = 20) or 0.08 micrograms/kg/min i.a. x 8 hr (N = 10)] and furosemide, 0.5 mg/kg/hr x 24 hr or mannitol, 12.5 g every six hours x 4, or no diuretic; 23 Group II patients received diuretics as above or no diuretic in a similar distribution to Group I. CCr (verified with simultaneous inulin clearances x 12, r = 0.93, P < 0.001) increased significantly by eight hours of ANP treatment to 17.1 +/- 3.2 ml/min and by 24 hours after discontinuing ANP to 21.0 +/- 4.4 ml/min (both P < 0.05). There was no corresponding increase in CCr in Group II. Dialysis was required in 23% of Group I and in 52% of Group II patients (different at P < 0.05). Mortality rates of 17% for Group I and 35% for Group II were not significantly different (P = 0.11). It is concluded that parenteral ANP increases CCr and reduces need for dialysis in patients with established intrinsic ARF.

Acute Kidney Injury↗

Pulsatile gonadotrophin-releasing hormone therapy in patients with pituitary tumours treated by surgery and irradiation.

OBJECTIVE: Pulsatile administration of GnRH for induction of ovulation is effective for women with idiopathic hypogonadotrophic hypogonadism. We were interested to assess the pituitary-ovarian response to pulsatile GnRH infusion and the therapeutic effectiveness of restoring ovulation in a group of hypogonadotrophic women previously treated with surgery and irradiation to pituitary tumours. PATIENTS: The group of patients comprised 15 hypogonadotrophic women, aged 29-40 years (mean 32.4 years), who had undergone transsphenoidal adenomectomy or craniotomy and irradiation with a total of 4500-5400 cGy in 25 fractional doses divided over 5-6 weeks. The time interval from irradiation to study was 6.3 +/- 2.0 years (mean +/- SD). TREATMENT: A single bolus GnRH (100 micrograms) test and pulsatile infusion of GnRH were performed to assess the pituitary gonadotrophin reserve and induce ovulation. We tried to correlate the pituitary response with characteristics of intracranial lesions on computerized tomography findings. We undertook ovarian biopsy in one patient who failed to respond to gonadotrophin therapy and pulsatile infusion of GnRH. RESULTS: Twelve women (80%) showed evidence of ovulation in response to pulsatile GnRH treatment and five subsequently became pregnant. Four of 12 ovulators were previous non-ovulators to exogenous gonadotrophin therapy. There was no correlation between pituitary response and character of lesions based on computerized tomography findings. A patient who failed to respond to either gonadotrophin or pulsatile infusion of GnRH had premature ovarian failure on ovarian histology. CONCLUSIONS: The functional reserve capacity of pituitary gonadotrophs may remain less impaired by tumour encroachment, pituitary surgery or irradiation than had previously been thought. This holds promise for ovulation induction in hypogonadotrophic patients who had been treated with surgery and irradiation for pituitary tumours.

Adult↗

Effects of ANG II, ETA, and TxA2 receptor antagonists on cyclosporin A renal vasoconstriction.

The renin-angiotensin system, endothelin (ET), and vasoconstrictor prostaglandins have been reported in separate studies to mediate the renal vasoconstrictor effect of cyclosporin A (CsA). However, direct comparison of the relative importance of these potential mediators has not been performed. In this study, the attenuating effects of comparable agonist-inhibiting doses of receptor antagonists for angiotensin II (ANG II), DuP-753 at 2.5 mg/kg, for ETA, BQ-123 at 0.5 mg/kg, and for thromboxane A2 (TxA2), SQ-29,548 at 1.6 mg.kg-1.h-1, or saline vehicle on acute CsA (20 mg/kg) renal vasoconstriction were compared in anesthetized Sprague-Dawley rats. All three receptor antagonists significantly limited the CsA-induced increase in renal vascular resistance; however, BQ-123 and SQ-29,548 were more effective than DuP-753. Because all three receptor antagonists demonstrated at least some attenuation of CsA-induced renal vasoconstriction, the potential role of acute CsA-related nitric oxide synthase (NOS) inhibition and nonspecific heterologous effects of specific receptor antagonists on other agonists were determined to exclude the possibilities that there was a general increased agonist sensitivity and that detection of a single or primary constrictor mediator was obscured by "crossover" receptor antagonist effects. CsA significantly reduced renal blood flow (39%) in the presence of the NOS inhibitor, N omega-nitro-L-arginine methyl ester, and there was negligible indication that receptor antagonists had nonspecific effects. It is concluded that CsA-induced renal vasoconstriction is complex and involves activation of multiple constrictor agonists independently or sequentially.

Angiotensin Receptor Antagonists↗

Adaptive response to ionizing radiation induced by low dose of gamma ray in human hepatoma cell lines.

When cells are exposed to a low dose of a mutagenic or clastogenic agent, they often become less sensitive to the effects of a higher dose administered subsequently. Such adaptive responses were first described in Escherichia coli. Studies on mammalian cells have been limited to human lymphocytes exposed to low doses of an alkylating agent. In this study, the adaptive response to 1 cGy of gamma rays was investigated in human tumor cells using two human hepatoma cell lines, Hep G2 and Hep 3B. Experiments were carried out by delivering 1 cGy followed by 50 cGy of gamma radiation and chromatid breaks were scored as an endpoint. The results of this study indicate that prior exposure to 1 cGy of gamma rays reduces the number of chromatid breaks induced by subsequent higher doses (50 cGy). The time necessary for the expression of the adaptive response was determined by varying the time interval between the two doses from 1 hour to 72 hours. In G2 chromatids, the adaptive response was observed both at short time intervals, as early as 1 hour, and at long time intervals. In S chromatids, however, the adaptive response was shown only at long time intervals. When 3-aminobenzamide, an inhibitor of poly (ADP-ribose) polymerase, was added after 50 cGy, adaptive responses were abolished in all the experimental groups. Therefore, it is suggested that the adaptive response can be observed in human hepatoma cell lines, which is first documented through this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗

Combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma.

Eighty-four patients with unresectable primary hepatocellular carcinoma due either to locally advanced lesion or to association with liver cirrhosis were treated with combined radiotherapy and hyperthermia from April 1988 to January 1991. Purpose of this study was to assess thermometry, response rate, toxicity, and survival in those patients. External radiotherapy was given with a total of 30.6 Gy/3.5 wks. Hyperthermia was given twice a week with a total of 6 treatment sessions using an 8 MHz radiofrequency capacitive type heating machine. Each hyperthermia session was started within 30 min following radiotherapy and continued for 30-60 min. Thermal data were analysed with maximum, minimum, and average temperatures of the tumors. Thermal mapping was also done. In thermometry results, maximum, minimum, and average temperatures of the tumors were 41.9 +/- 1.3 degrees C, 39.9 +/- 1.0 degrees C, and 40.8 +/- 0.9 degrees C, respectively. The fraction over 40 degrees C was 73 +/- 32% with a wide variation from 15% to 100%. Among 67 assessable patients, 27 patients showed tumor regression of more than 50% of the original tumor volume (40.3% response rate). Symptomatic improvement was observed in 78.6% of the patients. Acute toxicities during the treatment were mostly acceptable local pain (51.2%) and local fat necrosis (13.1%). The actuarial 1-year, 2-year, and 3-year survival rates were 44.8%, 19.7%, and 15.6%, respectively. Median survival was 6 months. In view of acceptable toxicities and the current rate of survival, further evaluation of combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma is warranted.

Carcinoma, Hepatocellular↗

Combined chemotherapy and radiation for bulky stages I-II cervical cancer: comparison of concurrent and sequential regimens.

Based on analysis of 5-year survival rates among 386 patients with carcinoma of the cervix treated between 1976 and 1984 at Yonsei University College of Medicine, high risk factors have been defined which identify patients with a poor prognosis when treated with radiation alone. Among patients with FIGO Stages I-II disease, lesions > or = 4 cm were indicative of a higher risk of treatment failure. Between 1984 and 1991, 39 patients with Stages I-II large cell squamous cancers > or = 4 cm in diameter were treated with radiation alone. Between 1984 and 1989, 19 comparable patients were treated with sequential chemotherapy consisting of two or three cycles of cisplatin at 100 mg/m2 and a 5-day infusion of 5-fluorouracil at 1000 mg/m2/24 hr. Between 1988 and 1991, 37 comparable patients were treated with concurrent radiation and one to six cycles of chemotherapy employing the same or equivalent drug and dose schedule. The radiation techniques, dose, and fractionation employed were similar in the three groups. The 30-month survival rate was 100, 89.5, and 79.5% (P < 0.05) following concurrent treatment, sequential treatment, and radiation alone, respectively. Response to chemotherapy administered in cycles was evaluated before instituting radiotherapy in the patients treated with sequential chemotherapy and radiation. In conclusion, the combination of radiotherapy and chemotherapy appeared superior to radiation alone, and the toxicity of combined modality therapy is manageable. Also concurrent chemotherapy may be slightly better than sequential chemotherapy and radiation, and given the lesser overall treatment time and expense, this has become the preferred mode of treatment in our institution.

Adult↗