• Title, Summary, Keyword: Adjuvant

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The Role of Adjuvant Treatment in Patients with High-Grade Meningioma

  • Cho, Minjae;Joo, Jin-Deok;Kim, In Ah;Han, Jung Ho;Oh, Chang Wan;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.527-533
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    • 2017
  • Objective : To investigate the efficacy of adjuvant treatment in patients with high-grade meningioma. Methods : A retrospective analysis was performed for patients with high-grade meningioma, World Health Organization grade 2 or 3, in a single center between 2003 and 2014. The patients were reviewed according to age at diagnosis, sex, the location of meningioma, degree of tumor resection, histological features, and type of adjuvant treatment. These factors were analyzed by Firth logistic regression analyses. Results : Fifty-three patients with high-grade meningioma were enrolled. Thirty-four patients received adjuvant treatment; conventional radiotherapy or radiosurgery. Clinical follow-up ranged from 13-113 months with a median follow-up of 35.5 months. Gross total removal (GTR), Simpson grade 1 or 2, was achieved in 29 patients and, among them, 13 patients received adjuvant treatment. In the other 24 patients with non-GTR, conventional adjuvant radiotherapy and radiosurgery were performed in 11 and 10 patients, respectively. The other 3 patients did not receive any adjuvant treatment. Radiation-related complications did not occur. Of the 53 patients, 19 patients had suffered from recurrence. The recurrence rate in the adjuvant treatment group was 23.5% (8 out of 34). On the other hand, the rate for the non-adjuvant treatment group was 57.9% (11 out of 19) (odds ratio [OR]=0.208, p=0.017). In the GTR group, the recurrence rate was 7.5% (1 out of 13) for patients with adjuvant treatment and 50% (8 out of 16) for patients without adjuvant treatment (OR=0.121, p=0.04). Conclusion : Adjuvant treatment appears to be safe and effective, and could lead to a lower recurrence rate in high-grade meningioma, regardless of the extent of removal. Our results might be used as a reference for making decisions when planning adjuvant treatments for patients with high-grade meningioma after surgery.

Efficacy of adjuvant radiotherapy in non-extremity soft tissue sarcoma with moderate chemosensitivity

  • Lee, Eun Mi;Kim, Dong Hyun;Kim, Do Young;Seol, Young Mi;Choi, Young Jin;Kim, Hyojeong
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.325-331
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    • 2018
  • Purpose: Soft tissue sarcoma (STS) is a rare and heterogeneous cancer with over 50 known subtypes. It is difficult to understand the role of adjuvant treatment in STS. We aimed to determine the benefits of adjuvant treatment for a rare STS subset: non-extremity STS with moderate chemosensitivity. Materials and Methods: We reviewed medical records from Pusan National University Hospital and Kosin University Gospel Hospital, which had detailed pathological reports on patients diagnosed between 2006 and 2016. The most important inclusion criterion was resection with curative intent. We grouped STS by chemosensitivity based on reported data and analyzed non-extremity STS with moderate chemosensitivity. Results: We investigated 142 patients with 20 pathological subtypes of STS. Eighty-six patients had extremity STS and 56 had non-extremity STS. Thirty-eight of 56 patients were categorized as having moderate chemosensitivity. Seventeen of 38 patients (44.7%) received adjuvant radiotherapy and 14 (36.8%) received adjuvant chemotherapy. A log-rank test showed longer disease-free survival (DFS) in the adjuvant radiotherapy group than in the group treated without adjuvant radiotherapy (not reached vs. 1.468 years, p = 0.037). Multivariate Cox proportional hazard analysis, with covariates including age, stage, resection margin, adjuvant chemotherapy, and adjuvant radiotherapy, revealed that adjuvant radiotherapy was associated with longer DFS (odds ratio = 0.369, p = 0.045). Overall survival was not correlated with adjuvant radiotherapy. Conclusion: Adjuvant radiotherapy may be associated with longer DFS in patients with non-extremity STS with moderate chemosensitivity.

Secondary Adjuvant Operation after Free Flap for Functional and Aesthetic Purposes (유리 피판술 후 기능적, 미용적 목적을 위한 2차 보완수술)

  • Ahn, Hee-Chang;Yang, Eun-Zin;Kim, Chang-Yeon
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.101-107
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    • 2010
  • Purpose: The free flap has been widely used as one stage reconstructive procedure the skin and soft tissue defect. The secondary adjuvant operations are often needed for better results as functional and aesthetic compartment. Therefore, we focus on the secondary adjuvant surgeries for better outcome after free flaps. Methods: One hundred ninety six consecutive patients underwent free flaps between January, 2002 and February 2009. The cases constituted ninety two male patients and one hundred four female patients. For the patients who got free flap operation, we investigated secondary adjuvant operations what type of procedures was applied according to the reconstructed sites. All clinical data were based on the patient's medical records. Results: Of one hundred ninety six patients in whom free flap was performed, a total of eighty two patients(41.8%) received the secondary adjuvant operation. Because of many patients got multiple secondary adjuvant operations, the number of the secondary adjuvant operation become one hundred fifty five cases. The most common used procedure is a liposuction, and the second one is a lipoinjection. Conclusion: As the secondary adjuvant operation like a liposuction, lipoinjection, etc., satisfaction for operative result was increased in the aspects of function and aesthetics. So the secondary adjuvant operation in free flap surgeries contributed in raising the patient's quality of life.

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Update of Adjuvant Chemotherapy for Resected Gastric Cancer

  • Oh, Sang-Cheul
    • Journal of Gastric Cancer
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    • v.12 no.1
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    • pp.3-6
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    • 2012
  • Gastric cancer is the second cause of cancer that is related to death and the fourth most common cancer, worldwide. Complete resection of cancer is the only curative treatment for gastric cancer. However, even if complete resection is possible, recurrence is frequently observed in Gastric patients. Therefore, adjuvant treatment modality for resectable gastric cancer is needed to increase the survival of patients. This study wants to describe the role of adjuvant chemotherapy for resectable gastric cancer, with updated data of recent studies. Several meta-analysis studies demonstrated a benefit of adjuvant chemotherapy for resectable gastric cancer. Due to the heterogeneity of the population and regimens, there is no consensus regarding the adjuvant chemotherapy. Recently published, well designed phase III studies demonstrated the statistically significance of adjuvant chemotherapy for the resectable gastric cancer, with the extended lymph node dissection. Further phase III trials, to determine the best regimen and schedule of adjuvant chemotherapy, was suggested to use the fluoropyrimidine based regimen as control group.

Could Adjuvant Chemotherapy after Surgery Benefit Elderly Patients with Advanced Gastric Cancer?

  • Jeong, Jin Woon;Kwon, In Gyu;Son, Young-Gil;Ryu, Seung Wan
    • Journal of Gastric Cancer
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    • v.16 no.4
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    • pp.260-265
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    • 2016
  • Purpose: The aim of this study was to evaluate tolerance to adjuvant chemotherapy, and to compare survival between treatments using only surgery and using surgery with adjuvant chemotherapy, in elderly patients with advanced gastric cancer who were ${\geq}75years$ of age. Materials and Methods: Patients ${\geq}75years$ of age who were diagnosed with pathological stage II or III gastric cancer were identified retrospectively and categorized into the surgery only and surgery with adjuvant chemotherapy groups. Clinicopathological and survival data were compared between these two groups. Results: Among the 130 patients studied, 67 patients underwent curative surgery only, and 63 patients received adjuvant chemotherapy after curative surgery. In the latter group, adverse events were reported in 24 patients (38.1%). The treatments were discontinued in 19 patients (30.2%) owing to any reason. The overall 5-year survival rates of the surgery only and the surgery with adjuvant chemotherapy groups did not differ significantly (44.1% vs. 30.7%, respectively; P=0.804). Among 90 death events, deaths from recurrences of gastric cancer occurred in 42 patients. Multivariate analyses revealed that the American Society of Anesthesiologists score and the depths of tumor invasions were related to survival, and the addition of adjuvant chemotherapy after surgery did not influence survival. Conclusions: The decision for the addition of adjuvant chemotherapy for elderly patients should be taken after considering the condition of individual patients and their life expectancies.

Optimal Adjuvant Treatment for Curatively Resected Thoracic Esophageal Squamous Cell Carcinoma: A Radiotherapy Perspective

  • Kim, Kyung Hwan;Chang, Jee Suk;Cha, Ji Hye;Lee, Ik Jae;Kim, Dae Joon;Cho, Byoung Chul;Park, Kyung Ran;Lee, Chang Geol
    • Cancer Research and Treatment
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    • v.49 no.1
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    • pp.168-177
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    • 2017
  • Purpose The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), disease-free survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.

Nine months versus 12 months of adjuvant trastuzumab for patients with HER2-positive breast cancer

  • El-Enbaby, Ashraf Mahmoud;El Moneim, Nadia Ahmed Abd;Khedr, Gehan Abd El atti;Elwany, Yasmine Mohamed Nagy
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.108-115
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    • 2018
  • Purpose: This study aimed to compare the results of treatment with adjuvant trastuzumab for 9 months versus 12 months in human epidermal growth factor 2 (HER2)-positive breast cancer patients. The primary endpoint was disease-free survival. Secondary endpoints included cardiac safety, tolerability, and overall survival. Methods: The study included 60 non-metastatic HER2-positive breast cancer patients. All study patients underwent surgery, received adjuvant chemotherapy, radiotherapy and hormonal therapy if indicated. Thirty patients were randomized in each group. Group I patients received adjuvant trastuzumab for 12 months, while group II patients received adjuvant trastuzumab for 9 months. Patients were assessed by clinical examination and Echocardiography during treatment. Results: After median follow-up of 12 months, 90% of the patients in group I were disease free and 83.3% of patients in group II were disease free (P=0.402). All studied population in both groups I and II were alive at the end of the 1-year follow-up period after the completion of adjuvant trastuzumab treatment thus overall survival is 100%. Conclusion: Trastuzumab is tolerable and its side effects are reversible. Nine months of adjuvant trastuzumab treatment is more cost effective than the standard 12 months.

The Effect of Swimming and Low Power Laser on the Healing of the Freund's Complete Adjuvant Induced Arthritis in Rat (수영과 저출력 레이저 치료가 Freund's Complete Adjuvant 유발 흰쥐의 관절염 치유에 미치는 영향)

  • Park, Mi-Hee;Kim, Jai-Young;Rho, Min-Hee
    • The Journal of Korean Physical Therapy
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    • v.18 no.3
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    • pp.47-58
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    • 2006
  • Purpose: This study was to find that what mechanism take effects that was Adjuvant Induced Arthritis in Sprague-Dawley rat and then treated the swimming and low power laser. Methods: Adjuvant Induced Arthritis was induced 24 Sprague-Dawley rat by the subcutaneous injection of a 0.2ml Freund's Complete Adjuvant into the right hind paw and right knee joint. Second injection used of 0.05ml Freund's Complete Adjuvant by same method. Arthritic rat were divided 3 groups; arthritic swimming group, arthritic laser group and case control group. The author performed several experimental tests which were the hind paw thickness, step length, knee joint space, activity of enzyme. Results: Hind paw thickness decreased in swimming and laser group. Left step length and knee joint space increased in swimming and laser. Conclusion: Swimming and low power laser therapy on the Adjuvant Induced Arthritis in rats does effective for the rheumatic arthritis therapy by decrease of hind paw thickness, increase of opposite side step length, increase of activity of albumin and IgG and increase of knee joint space.

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The Effect of Swimming and Low Power Laser on the Healing of the Freund's Complete Adjuvant Induced Arthritis in Rat (수영과 저출력 레이저 치료가 Freund's Complete Adjuvant 유발 흰쥐의 관절염 치유에 미치는 영향)

  • Park, Mi-Hee;Rho, Min-Hee;Kim, Jai-Young
    • Journal of Korean Physical Therapy Science
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    • v.13 no.1
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    • pp.7-20
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    • 2006
  • Purpose: This study was to find that what mechanism take effects that was Adjuvant Induced Arthritis in Sprague-Dawley rat and then treated the swimming and low power laser. Methods: Adjuvant Induced Arthritis was induced 24 Sprague-Dawley rat by the subcutaneous injection of a 0.2ml Freund's Complete Adjuvant into the right hind paw and right knee joint. Second injection used of 0.05ml Freund's Complete Adjuvant by same method. Arthritic rat were divided 3 groups; arthritic swimming group, arthritic laser group and case control group. The author performed several experimental tests which were the hind paw thickness, step length, knee joint space, activity of enzyme. Results: Hind paw thickness decreased in swimming and laser group. Left step length and knee joint space increased in swimming and laser. Conclusion: Swimming and low power laser therapy on the Adjuvant Induced Arthritis in rats does effective for the rheumatic arthritis therapy by decrease of hind paw thickness, increase of opposite side step length, increase of activity of albumin and IgG and increase of knee joint space.

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The Analgesic Effect of Bee Venom Aqua-acupuncture and Its Mechanism in the Rat Model with adjuvant-induced Arthritis (봉독약침(蜂毒藥鍼)이 Adjuvant 유발(誘發) 관절염(關節炎)에 미치는 진통효과(鎭痛效果) 및 그 기전(機轉)에 관한 연구(硏究))

  • Seo, Dong-min;Park, Dong-suk;Kang, Sung-keel
    • Journal of Acupuncture Research
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    • v.20 no.2
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    • pp.85-97
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    • 2003
  • Introduction : In this study, the analgesic effect and its mechanism of bee venom aqua-acupuncture on complete Freund's adjuvant-induced arthritis in rats was investigated. It has been reported from a neurochemical standpoint that bee venom exerts antinociceptive effects on inflammation and that the opioid system and adrenergic system play important roles in acupuncture analgesia. however, it is not known whether central opioid and ${\alpha}2$-adrenergic components of the intrinsic descending analgesic system are activated after bee venom aqua-acupuncture. Methods : Bee venom(1mg/kg) was subcutaneously aqua-acupunctured into Joksamni($ST_{36}$) of rats with complete Freund's adjuvant(CFA)- induced arthritis and was checked of increase in TFL. Opioid and ${\alpha}_2$-adrenergic neurotransmitter system were examined by naloxone as an opioid receptor antagonist, and yohimbine as ${\alpha}_2$-adrenoceptor antagonist prior to bee venom aqua-acupuncture. Results : The following results have been obtained. 1. The tail flick latency in the rat model with adjuvant-induced arthritis was significantly decreased in 2 weeks. 2. The tail flick latency in the rat model with adjuvant-induced arthritis was increased in bee venom aqua-acupuncture group compared to the normal saline aqua-acupuncture group. 3. Analgesic effect of bee venom was antagonized by yohimbine not by naloxone pretreatment in the rat model adjuvant-induced arthritis. Conclusions : Bee venom aqua-acupuncture has an analgesic effect on the rat model of adjuvant-induced of adjuvant-induced arthritis and has antinociception mediated by ${\alpha}_2$-adrenergic system.

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