• Radiation Oncology Journal
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• v.11 no.2
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• pp.277-283
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• 1993

Background: We peformed a retroslective study in patients with previously untreated advanced (Stage III or IV) laryngeal and hypopharyngeal cancer to compare the results of induction chemotherapy followed by definitive radiation therapy (CT+ RT) with those of conventional laryngectomy and postoperative radiation therapy (OP + RT). Method: Between 1985 and 1990, twenty-four patients were treated with two or three courses of chemotherapy and radiation therapy (66-75 Gy). Twenty-five patients were received laryngectomy and radical neck dissection (except 3 patients) and postoperative radiation therapy (55~64 Gy). Result: After a median fellow-up of 20 months, the actusrial 5-year overall survival rate was $24\%$ (chemotherapy group) and $36\%,$ (op group). (P>0.1). The local control rate was the $65\%,$ (13/20) and $68.2\%,$ (15/22). (p>0.1). The rate of laryngeal preservation was $65\%$ (13/20) in chemotherapy group. Conclusion: Induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients with advanced laryngeal and hypopharyngeal cancer.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.283-289
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• 1998

Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed 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 III 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.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.172-176
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• 2004

Background and Objectives: Standard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we designed induction chemotherapy followed by definitive radiation in patients with potentially respectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival. Materials and Methods: The twenty-six patients diagnosed advanced head and neck squamous cell carcinoma, Stage III or IV (AJCC 2002) and performed organ preservation protocols in Ajou university hospital from 1994 to 2001 were included in this study. Results: Neoadjuvant chemotherapy showed an overall response rate of 84.6% and a complete remission (CR) rate was 59.1% following neoadjuvant chemotherapy and radiation. Seven of thirteen patients were able to preserve their larynges for more than two years by chemotherapy and radiation. There were no treatment related mortality after 2 cycles of induction chemotherapy. Conclusion: Although Organ preservation protocol through neoadjuvant chemotherapy and radiation need more controlled randomized study, it was considered alternative treatment modality in advanced head and neck cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2663-2665
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• 2013

Objective: To compare the efficacy and complications of chemotherapy and late course three-dimensional conformal radiotherapy (3DCRT) in treating patients with stage III non-small cell lung cancer (NSCLC). Patients and Methods: All patients were divided into two groups: to receive chemotherapy and late course 3DCRT (3DCRT group), or chemotherapy and conventional fraction radiation (control group). In the 3DCRT-group, patients were given 6~15 MV X-rays with a total dose of 40 Gy, followed by 3DCRT, 2.5 Gy~3.0 Gy per fraction, 1 fraction/every day, total 68 Gy~70 Gy; in the control group, with conventional fraction radiation the total dose was 64~66 Gy. The chemotherapy regimen in both cases was EP (VP-16 and DDP). Results: Sixty four patients with stage III NSCLC were divided into two groups: 32 patients into 3DCRT, 32 into the control group. One and 2-year survival rates in 3DCRT and control group were 87.5%, 56.3%mad 65.6%, 34.4%, respectively (P<0.05); local control rates were 90.6%, 81.3% and 65.6%, 53.1%, respectively (P<0.05). Conclusion: Chemotherapy and late course 3DCRT is associated with improved survival rate in patients with stage III NSCLC with good tolerability.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4825-4832
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• 2015

Incidence rates of nasopharyngeal carcinoma are high in Indonesia, Singapore and South-Eastern China. Chemoradiotherapy has been the standard regimen for locally advanced nasopharyngeal carcinoma according to guidelines from the National Comprehensive Cancer Network. Recently, advances in the management of nasopharyngeal carcinoma have transferred into better treatment outcomes. Most phase III clinical trials support the addition of concurrent chemotherapy to radiotherapy for the initial treatment of these patients. Studies evaluating effects and toxicity of concurrent chemotherapy with different regimens have been reported. However, the status of adding adjuvant chemotherapy or induction chemotherapy remains controversial. Recent studies have shown that adjuvant chemotherapy with two or three cycles may improve survival for nasopharyngeal carcinoma with stage N2-3 disease or with persistently detectable plasma EBV DNA after radiotherapy. This review examines the pertinent issues and latest studies concerning the management of loco-regionally advanced NPC, regarding concurrent chemotherapy, adjuvant chemotherapy, and induction chemotherapy in decades.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.115-122
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• 1984

Total 125 patinets with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 Patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to treatment groups and was $16.8\%$. Local 15 yr survival was $33\%$ and 8 yr survival of T-6 group was $64.9\%$. An analysis of time were pattern of recurrence of each group, and the correlation of with radiation dose with local recurrence done. This study concluded that intensive multiagent chemotherapy RT and/or surgery (T-6 regimen) reduced distant metastases, and produced significant increase in local control and survival.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.181-190
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• 2011

Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients. Materials and Methods: The medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently. Results: Twenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ${\geq}2$ radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ${\geq}2$ radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), $V_{20}$, $V_{30}$, $V_{40}$, MLDipsi, $V_{20}$ipsi, $V_{30}$ipsi, and $V_{40}$ipsi were associated with grade ${\geq}2$ radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ${\geq}2$ radiation pneumonitis. Conclusion: Concurrent chemotherapy, MLD and $V_{30}$ were statistically significant predictors of grade ${\geq}2$ radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and $V_{30}$ were 16 Gy and 18%, respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6207-6213
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• 2015

The supportive care of patients receiving antineoplastic treatment has dramatically improved over the past few years and development of effective measures to prevent nausea and vomiting after chemotherapy serves as one of the most important examples of this progress. A patient who starts cancer treatment with chemotherapy lists chemotherapy-induced nausea and vomiting as among their greatest fears. Inadequately controlled emesis impairs functional activity and quality of life, increases the use of health care resources, and may occasionally compromise adherence to treatment. New insights into the pathophysiology of chemotherapy-induced nausea and vomiting, a better understanding of the risk factors for these effects, and the availability of new antiemetic agents have all contributed to substantial improvements in emetic control. This review focuses on current understanding of chemotherapy-induced nausea and vomiting and the status of pharmacological interventions for their prevention and treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5747-5752
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• 2012

Purpose: The main objective of the present study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone in the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. Randomized controlled trials (RCTs) that compared concurrent chemoradiotherapy followed by adjuvant chemotherapy with concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma were included. Meta-analysis was performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Five studies were included. Risk ratios of 1.02 (95%CI 0.89-1.15), 0.93 (95%CI 0.72-1.21), 1.07 (95%CI 0.87-1.32), 0.95 (95%CI 0.80-1.13) were observed for 3 years overall survival, 5 years failure-free survival, 5 years locoregional failure-free survival and 5 years distant metastasis failure-free survival. There were no treatment-related deaths in both groups of five studies. Hematologic and gastrointestinal toxicity were the most significant for patients during adjuvant chemotherapy. The level of evidence was low. Conclusion: Compared with concurrent chemoradiotherapy alone, concurrent chemotherapy followed by adjuvant chemotherapy did not improve prognosis. More toxicity was found during adjuvant chemotherapy.

• Radiation Oncology Journal
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• v.13 no.2
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• pp.129-142
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• 1995

Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.