ABSTRACT: BackgroundWe conducted a prospective phase II trial of IrOx in patients with advanced non-small cell lung cancer to evaluate the efficacy
Patients and methodsPatients with histologically or cytologically proven non-small cell lung cancer (NSCLC), aged ≥18 years, Eastern Cooperative
Oncology Group performance status 0–1, at stage IIIB (pleural effusion)/IV or with recurrent disease not suitable for primary
surgical treatment, with no palliative chemotherapy or radiotherapy to the chest or immunotherapy or biologic therapy, the
presence of measurable disease by RECIST, and who had given signed written informed consent, were eligible. Treatment consisted
of irinotecan 65 mg/m2 on days 1 and 8 and oxaliplatin 130 mg/m2 on day 1, repeated every 3 weeks.
ResultsA total of 18 patients were enrolled in June and August 2007, the median age was 59 years (47–73). In total, 71 cycles were
administered with a median of 4 cycles per patient (range, 1–6 cycles) and 18 patients were evaluable for treatment response.
An independent review of tumor responses gave an overall response rate of 27.7% (CR: 0, PR: 5/18; 95% CI, 7–48.4%) by intent-to-treat
analysis. The median overall survival of all patients was 14 months and the median time-to-progression was 4.2 months (95%
CI, 1.959–6.441). The most common grade 3/4 toxicities were diarrhea (7% of all cycles) and neutropenia (5.6% of all cycles).
Grade 3 peripheral neuropathy occurred in one patient and one patient died due to sepsis.
ConclusionThis study suggests that IrOx combination therapy has moderate activity with a tolerable toxicity profile. However, it was
not warranted to evaluate further this regimen as first-line treatment for patients with advanced or metastatic NSCLC using
the current dosages and schedule.
Cancer Chemotherapy and Pharmacology 04/2012; 64(5):917-924. · 2.83 Impact Factor
ABSTRACT: Non-transitional cell carcinomas of the urothelial tract comprise 5–10% of urothelial cancers. Clinical information regarding
the clinical behavior and chemotherapy outcome of non-transitional cell carcinomas of the urothelial tract are incomplete
due to their rarity. The object of this study was to evaluate the clinical features and the efficacy of palliative chemotherapy
in advanced non-transitional cell carcinomas of the urothelial tract. We analyzed the clinical records of 21 consecutive patients
who received palliative chemotherapy for unresectable or metastatic non-transitional cell carcinomas of the urothelial tract
between January 1995 and November 2007. All the 21 patients received first-line chemotherapy with platinum-based regimens
which are known to be effective in transitional cell urothelial carcinomas. The median age of the patients was 57years (range,
27–71years). The primary sites of involvement were the bladder, urethra, urachus, and ureter in 43%, 29%, 19%, and 10% of
the patients, respectively. Adenocarcinoma was the most common histological type (67%); squamous cell carcinoma and small
cell carcinoma comprised 24 and 10% of the histologic types, respectively. With a median duration of follow-up of 32months
(range, 12–71months), the median overall survival for all 21 patients from the day of first-line chemotherapy was 13months
(95% CI, 6.8–19.2). The expected 1-year survival rate was 50.6% (95% CI, 28.6–72.5). Univariate analysis showed a better median
overall survival in patients with adenocarcinoma, compared to non-adenocarcinomas (47 vs. 10months, P=0.049). The median overall survival of patients who received platinum-based palliative chemotherapy for advanced non-transitional
cell carcinomas was comparable to previous studies for patients with transitional cell carcinomas. Adenocarcinomas appear
to have a favorable prognosis for the survival of the patients who received platinum-based chemotherapy for advanced non-transitional
Medical Oncology 04/2012; 26(2):186-192. · 2.14 Impact Factor
ABSTRACT: PurposeS-1 showed clinical activity in colorectal cancer, and the preclinical data of S-1 with oxaliplatin showed synergistic activity
in an animal model. This phase I study was conducted to determine the maximum tolerated dose of S-1 with oxaliplatin and to
define its recommended dose for the subsequent phase II study.
Materials and MethodsPatients with untreated colorectal adenocarcinoma were eligible in this study if they had measurable lesions. S-1 was administered
on days 1–14, with doses starting from 60mg/m2 per day and escalating by 10mg/m2 at each dose level. Oxaliplatin was given at the fixed dose of 130mg/m2, through 2-h i.v. infusion on day 1. The treatment was repeated every 3weeks.
ResultsA total of 27 patients received six different S-1 dose levels. The dose-limiting toxicities (DLTs) were neutropenia, diarrhea,
and vomiting. At dose level 5 (100mg/m2), two patients experienced DLTs, while none of the third cohorts did. At dose level 6 (110mg/m2), two patients experienced DLTs, and one of them died from treatment-related toxicity. The accrual was then stopped.
ConclusionsThe recommended dose is S-1 100mg/m2 on days 1–14, with 130mg/m2 oxaliplatin on day 1, every 3weeks. This regimen is proposed for the phase II study.
International Journal of Colorectal Disease 04/2012; 24(11):1311-1316. · 2.38 Impact Factor
ABSTRACT: Pulmonary pleomorphic carcinoma is an uncommon malignant tumor of the lung, which has the dual cell components of spindle
or giant cells and epithelial cells. The objective of this study was to investigate the clinical course and efficacy of palliative
chemotherapy in patients with advanced pulmonary pleomorphic carcinoma. Twelve patients were diagnosed with advanced pulmonary
pleomorphic carcinoma and received palliative chemotherapy from February 2000 to December 2007. Among the 12 patients, five
patients received gemcitabine/cisplatin, three patients received gemcitabine/carboplatin, two patients received paclitaxel/carboplatin,
one patient received paclitaxel/cisplatin, and one patient received docetaxel/cisplatin as first-line chemotherapy. The median
patient's age was 62 (range, 32–72years). Among the 12 patients, nine patients had relapsed disease after curative resection
and three patients had metastatic disease at the initial presentation. After treatment with first-line palliative chemotherapy,
seven patients (58%) had progressive disease, three patients (25%) had stable disease, and only two patients (17%) had a partial
response. The median overall survival from the day of initiation of first-line chemotherapy was only 8months (95% CI, 6–10)
with median follow-up of 26months. These results showed the dismal prognosis and the poor response to chemotherapy of advanced
pulmonary pleomorphic carcinoma. Further studies are needed to investigate whether the current strategy of palliative chemotherapy
for the treatment of advanced pulmonary pleomorphic carcinoma can be justified or not. Moreover, additional novel treatment
approaches are required.
Medical Oncology 04/2012; 26(3):287-291. · 2.14 Impact Factor
ABSTRACT: PurposeThe phase II study was conducted to evaluate the efficacy and safety of irinotecan as salvage single-agent chemotherapy in
patients with advanced pancreatic cancer.
MethodsPatients with measurable metastatic pancreatic cancer, progressive after previous gemcitabine-based chemotherapy were treated
with irinotecan 150mg/m2 every 2weeks. Treatment was repeated until disease progression or unacceptable toxicity.
ResultsBetween March 2004 to February 2007, 33 patients were registered and treated with irinotecan monotherapy. The patients’ median
age was 59years (range 36–70) and two had an ECOG performance status of 2. A total of 167 chemotherapy cycles were delivered
(median, 4; range 2–12). In an intent-to-treat analysis, three (9%) confirmed partial response and 13 patients with stable
disease were observed for a disease control rate of 48%. The median progression-free and overall survivals were 2.0months
(95% CI, 0.7–3.3) and 6.6months (95% CI, 5.8–7.4), respectively. Toxic effects were mainly gastrointestinal (nausea in 64%
of patients, diarrhea in 36%), Toxicity profiles were generally predictable and manageable, and there was no treatment-related
ConclusionsSecond-line chemotherapy with single-agent irinotecan is marginally effective and well tolerated regimen for gemcitabine-pretreated
patients with advanced pancreatic cancer.
Cancer Chemotherapy and Pharmacology 04/2012; 63(6):1141-1145. · 2.83 Impact Factor
ABSTRACT: PurposeWe designed a phase II trial of the combination with oxaliplatin and doxorubicin for patients with unresectable HCC to evaluate
the overall response rate (ORR) and the toxicity.
MethodsForty patients with inoperable, systemic chemotherapy naive HCC were enrolled. Finally, 32 patients received oxaliplatin (130mg/m2) and doxorubicin (60mg/m2) every 3weeks.
ResultsEighty-two treatment cycles were administered (median 2 cycles, range 1–6). There was no treatment-related mortality. The
ORR was 15.6% (95% CI, 3.3–28.7) with five partial responses. The median overall survival and median overall progression free
survival were 31weeks (95% CI, 22–40weeks) and 12weeks (95% CI, 5-19weeks). Nausea and peripheral neuropathy were most
frequent non-hematologic toxicities (nausea, n=15; peripheral neuropathy, n=10). The most frequent grade 3–4 hematologic adverse event was neutropenia (14 of 82 cycles) including three cases of febrile
ConclusionsThe combination of oxaliplatin and doxorubicin showed modest activity and a tolerable toxicity profile in advanced HCC patients.
Cancer Chemotherapy and Pharmacology 04/2012; 63(5):929-935. · 2.83 Impact Factor
ABSTRACT: Sorafenib, a multitargeted tyrosine kinase inhibitor, is now the treatment of choice for systemic therapy of patients with advanced hepatocellular carcinoma (HCC). Herein, we present the clinical characteristics and outcomes of patients with advanced HCC who were treated with sorafenib.
Data of 201 sorafenib-treated, metastatic HCC patients were collected from a single institution tumor registry. The primary and secondary endpoints were overall survival (OS) and failure-free survival (FFS).
Chronic hepatitis B was the predominant cause of HCC (84%). Of 162 evaluable patients, 4 partial responses were recorded. With a median follow-up of 15.7 months, the median FFS and OS were 2.5 months (95% CI 2.3-2.7) and 5.3 months (95% CI 4.4-6.3), respectively. In multivariate analysis, the prognostic factors associated with FFS were the presence of ascites, portal venous thrombosis, serum α-fetoprotein ≥400 ng/ml, albumin, bilirubin, tumor size and number, and performance status. Likewise, the presence of ascites, portal venous thrombosis, tumor size and number, performance status and baseline levels of α-fetoprotein, albumin and bilirubin were significantly related with OS. After adjusting for performance status, the Cancer of the Liver Italian Program scoring system and Okuda stages can better predict the hazard of failure or death than the Child-Pugh classification.
Our results suggest that Cancer of the Liver Italian Program scores or Okuda stages, along with performance status, can be useful in stratifying patients with advanced HCC treated with sorafenib.
Oncology 06/2011; 80(3-4):167-74. · 2.27 Impact Factor
ABSTRACT: Gefitinib and erlotinib are potent EGFR TKIs, with antitumor activity. In this randomized, single-center, non-comparative phase II trial, the efficacy and safety of gefitinib and erlotinib was evaluated as the second-line therapy for advanced non-small cell lung cancer (NSCLC).
Patients with locally advanced, metastatic stage IIIB/IV NSCLC who failed first-line chemotherapy and had either EGFR mutation or at least two out of three clinical factors associated with higher incidence of EGFR mutations (female, adenocarcinoma histology, and never-smoker) were eligible.
A total of 96 (48 per arm) patients were randomly assigned to gefitinib- or erlotinib-arm, respectively. Baseline characteristics were well-balanced between the two arms. The response rates (RR) were 47.9% in the gefitinib arm and 39.6% in the erlotinib arm. Median PFS was 4.9 months (95% CI, 1.3-8.5) in the gefitinib arm and 3.1 months (95% CI, 0.0-6.4) in the erlotinib arm. The most common grade 3/4 toxicity was skin rash. Exploratory analyses showed that there was no significant difference in RR and PFS in the gefitinib arm compared to the erlotinib arm (RR (%) 47.9 vs. 39.6, p=0.269; median survival (months) 4.9 vs. 3.1, p=0.336). There was no significant difference in QOL between the two arms.
Both gefitinib and erlotinib showed effective activity and tolerable toxicity profiles as second-line treatment for the selected population of NSCLC. We may consider conducting a phase III trial to directly compare the efficacy and toxicity between gefitinib and erlotinib in an enriched patient population.
Lung cancer (Amsterdam, Netherlands) 06/2011; 75(1):82-8. · 3.14 Impact Factor
ABSTRACT: Pediatric-type sarcomas such as Ewing's sarcoma (EWS)/primitive neuroectodermal tumor family and rhabdomyosarcoma are relatively uncommon in adult patients. Optimal treatment strategies for this population and prognosis in adult patients compared with pediatric patients remain controversial.
We retrospectively reviewed pediatric-type sarcoma patients older than 15 years at a single institution.
A total of 84 consecutive patients between 1995 and 2009 were identified at the Samsung Medical Center, Seoul, Korea. Median age was 30 years with a range of 15-74 years. Forty-seven patients (56.0%) were diagnosed with Ewing's sarcoma/primitive neuroectodermal tumor family, 34 (40.5%) with rhabdomyosarcoma and 3 (3.6%) with desmoplastic round-cell tumor. Median follow-up duration was 5.9 years. Median overall survival for all patients was 33.1 months (95% CI 13.5-52.7) and median event-free survival for all patients was 14.4 months (95% CI 5.9-22.9 months). Multivariate analysis revealed that localized disease was a significant independent prognostic factor for longer overall survival (hazard ratio 0.30, 95% CI 0.14-0.66, p = 0.003), and favorable primary tumor sites were associated with longer event-free survival (hazard ratio 0.33, 95% CI 0.11-0.98, p = 0.045).
We identified the prognostic variables which may facilitate risk-adapted therapies for this rare adult sarcoma group, which should be further investigated.
Oncology 05/2011; 80(1-2):21-8. · 2.27 Impact Factor
ABSTRACT: Diffuse large B-cell lymphoma (DLBCL) constitutes most primary central nervous system (CNS) lymphoma (PCNSL), whereas T-cell, low-grade and Burkitt's lymphomas (BL) are rarely encountered. Due to the paucity of cases, little is known about the clinical features and treatment outcomes of PCNSL other than DLBCL. The objective of this study was to describe the clinical characteristics and outcomes for patients with PCNSL other than DLBCL. Fifteen patients, newly diagnosed with PCNSLs other than DLBCL between 2000 and 2010, were included. The male to female ratio was 0.67:1 with a median age of diagnosis of 31 years (range 18-59). Pathologic distributions were as follows: peripheral T-cell lymphoma (PTCL; n=7), marginal zone B-cell lymphoma (MZBCL; n=1), lymphoplasmacytic lymphoma (LPL; n=2), Burkitt's lymphoma (n=1), other unspecified (T-cell lineage, n=2; B-cell lineage, n=2). Thirteen patients (87%) showed Eastern Cooperative Oncology Group performance score (ECOG PS) 1-2. The remaining two were one PTCL patient and one Burkitt's lymphoma patient. Of the nine patients with T-cell lymphoma, five (56%) had multifocal lesions, and one (20%) with LPL of the five patients with B-cell lymphoma showed a single lesion. Leptomeningeal lymphomatosis was identified in two patients (one with Burkitt's lymphoma and one with unspecified B-cell lymphoma). Two patients (22%) with T-cell lymphoma died 7.7 and 23.3 months later, respectively, due to disease progression, despite HD-MTX-based therapy. Six patients with T-cell lymphoma (6/9, 66.7%) and four patients with low-grade B-cell lymphoma (4/5, 80%) achieved complete response and have survived without relapse (Table 3). One patient with Burkitt's lymphoma showed poor clinical features with ECOG PS 3, deep structure, multifocal, and leptomeningeal lymphomatosis, and died 7.6 months after the initiation of treatment. In comparison with previously reported DLBCLs (median OS 6.4 years, 95% CI 3.7-9.1 years), T-cell lymphoma showed equivocal or favorable clinical outcomes and low-grade B-cell lymphomas, such as MZBCL and LPL, had a good prognosis. However, primary CNS Burkitt's lymphoma presented poor clinical outcomes and showed a comparatively aggressive clinical course. In conclusion, primary CNS lymphoma other than DLBCL occurred more in younger patients and showed a generally good prognosis, except for Burkitt's lymphoma. Further research on treatment strategies for Burkitt's lymphoma is needed.
Annals of Hematology 04/2011; 90(12):1391-8. · 2.62 Impact Factor
ABSTRACT: We analyzed the responses to first line treatment and clinical outcomes of metastatic breast cancer patients treated with palliative doxorubicin/cyclophosphamide (AC) according to molecular cancer subtype.
A retrospective analysis was performed for 110 metastatic breast cancer patients selected on the basis of palliative AC treatment and the availability of immunohistochemical data for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2/neu) status.
Of the 110 patients analyzed, 71 (64.5%) were hormone receptor positive (HR+), 14 (12.7%) were HER2+, and 25 (22.7%) were triple negative (TN). There were no differences in age, stage at diagnosis, total number of cycles of palliative chemotherapy, incidence of visceral metastasis, and metastatic sites with the exception of liver among breast cancer subtypes. The overall response rates to AC were 55.9% for the HR+ subgroup, 42.9% for the HER2+ subgroup, and 56.5% for the TN subgroup. The progression-free survival (PFS) in patients with HER2+ and TN were significantly shorter than in the HR+ (median PFS, 9.1 vs 8.1 vs 11.5 months, respectively; p = 0.0002). The overall survival (OS) was 25.4 months in the TN subgroup and 27.3 months in HER2+ subgroup. The median OS for these two groups was significantly shorter than for patients in the HR+ subgroup (median, 38.5 months; 95% CI, 30.1-46.9 months; p < 0.0001).
The response to palliative AC chemotherapy did not differ among breast cancer subtypes. Despite chemosensitivity for palliative AC, the TN subtype has a shorter overall survival than non-TN subtypes. Innovative treatment strategies should be developed to slow the course of disease.
BMC Cancer 10/2010; 10:527. · 3.01 Impact Factor
ABSTRACT: A retrospective analysis to compare the treatment outcomes of two regimens with different doses of methotrexate (MTX). Seventy-two patients, newly diagnosed with primary central nervous system lymphoma between 1995 and 2006, were included. All patients were treated with one of the two different MTX regimens depending on when the diagnosis was made. Thirty-six patients diagnosed between 1995 and 2002 were treated with 1 g/m(2) of intravenous MTX (HD-MTX 1 g/m(2), cohort 1). The other 36 patients, diagnosed between 2003 and 2006, received 3.5 g/m(2) of intravenous MTX (HD-MTX 3.5 g/m(2), cohort 2). The median age was 47 years (range, 17-78 years) and 42 patients (58.3%) were male. The median overall survival (OS) and progression-free survival (PFS) of all patients was 90.3 and 52.9 months, respectively. Although OS and PFS was not statistically different between the two cohorts, cohort 2 achieved higher complete response/unconfirmed complete response rates than cohort 1 at an evaluation conducted between completion of intravenous MTX therapy and the initiation of radiotherapy (52.8% vs. 16.7%, respectively; p = 0.005). Furthermore, there were no deaths within 6 months of MTX therapy for the cohort 2, whereas there were eight deaths by 6-months for cohort 1 (p = 0.003). Even though cohort 2 failed to show superior survival outcomes compared with cohort 1 after sequential brain radiotherapy and intravenous cytarabine, the higher early CR/CRu rate of cohort 2 compared with cohort 1 might indicate that a high dose of MTX is desirable.
Leukemia & lymphoma 08/2009; 50(7):1110-8. · 2.40 Impact Factor
ABSTRACT: Because treatment of advanced gastric cancer (AGC) patients after failure with first-line chemotherapy remains controversial, we performed this retrospective analysis based on the data obtained from 1455 patients registered in a first-line treatment cohort with respect to receiving or not receiving subsequent chemotherapy.
The decision for administering second-line chemotherapy was, in most cases, at the discretion of the physician. Seven-hundred twenty-five (50%) received second-line chemotherapy after first-line failure. Univariate and multivariate analyses were performed on the recognized baseline parameters for survival.
At the time of initiating second-line chemotherapy, the patients' median age was 56 years (range, 22 to 86) and 139 (19%) had an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or more. Seven (1%) complete and 108 (15%) partial responses to second-line chemotherapy were observed for an overall response rate of 16% (95% confidence interval [CI], 13 to 19%). The median progression-free and overall survivals, calculated from the start of second-line chemotherapy, were 2.9 months (95% CI, 2.6 to 3.3) and 6.7 months (95% CI, 5.8 to 7.5), respectively. Multivariate analysis revealed that low baseline hemoglobin level (hazard ratio [HR], 0.74; 95% CI 0.61-0.90) and a poor performance status (HR, 0.66; 95% CI, 0.52-0.83) were independent negative prognostic factors for overall survival.
Performance status, along with baseline hemoglobin level, could be used to identify the subgroup of patients most likely to benefit from second-line chemotherapy for AGC.
BMC Cancer 05/2009; 9:110. · 3.01 Impact Factor
ABSTRACT: PurposeWe conducted this study to analyze clinicopathologic features and treatment outcomes for various treatment modalities in breast
cancer patients with brain metastases.
Patients and methodsRetrospective analysis was performed using medical records of patients who were diagnosed with metastatic brain tumors from
breast cancer. The treatment modalities applied included whole-brain radiotherapy (WBRT), surgical resection, stereotactic
radiosurgery (SRS) and systemic treatments such as chemotherapy and endocrine therapy.
ResultsAmong 125 female breast cancer patients with brain metastases, 87.2% had Eastern Cooperative Oncology Group (ECOG) performance
status (PS) 0–2. The median overall survival (OS) was 6.6months (95% CI 3.9–9.2). A multivariate analysis using the Cox-regression
test identified three risk factors; poor PS (P=0.023), HER2 positivity (P=0.013), and no additional systemic treatment (P=0.006). Those patients who had no risk factors showed outstanding outcome (median OS 49months). On the contrary, the patients
who had all risk factors (poor PS with HER2 positive and did not receive additional systemic chemotherapy) showed dismal prognosis
(median OS 2months).
ConclusionsOur new classification according to the suggested risk factors for patients with metastatic brain tumor from breast cancer
reflects particular characteristics of each subset of the patients with good prognostic capacity.
Cancer Chemotherapy and Pharmacology 02/2009; 63(4):627-633. · 2.83 Impact Factor
ABSTRACT: The purpose of this retrospective study was to investigate clinical features and treatment outcomes in patients with peripheral T cell lymphoma-unspecified (PTCL-U). Eighty-four patients who were diagnosed with PTCL-U between February 1995 and December 2005 were included in the study. Around 70% of the patients presented with stage III-IV disease; 24% were categorized as high or high-intermediate risk according to the International Prognostic Index (IPI) scoring system, and 45% were classified as groups 3 or 4 using the Prognostic Index for PTCL-U (PIT). Extranodal involvement was found in 51 of 85 patients (60%). Most of the initial chemotherapy regimens were anthracycline-based (75%). The overall response rates for patients treated with initial chemotherapy and salvage chemotherapy were 63.1% (52.6% of complete response (CR), 10.5% of partial response (PR)) and 35% (9% of CR, 26%of PR), respectively. The median progression-free survival and overall survival of all patients were 17.1 months (95% CI, 0.0-40.5) and 35.5 months (95% CI, 1.2-69.8), respectively. Poor performance status, the presence of B symptoms, IPI scores >or=3 and PIT class >or=2 were predictive prognostic factors for survival.
Annals of Hematology 02/2009; 88(2):111-9. · 2.62 Impact Factor
ABSTRACT: The aim of this study was to evaluate the role of platinum-containing chemotherapy for metastatic triple-negative breast cancer (TNBC) patients in terms of the response rate (RR) and progression-free survival. A second aim was to characterize the clinical behavior at the time of relapse of TNBC. We retrospectively analyzed the clinical outcomes of patients with metastatic breast cancer who received taxane-platinum chemotherapy as the first- or second-line treatment, focusing on the TN phenotype. In total, 257 patients with metastatic breast cancer received platinum-containing chemotherapy at Samsung Medical Center from 1999 to 2006. Of these patients, 106 patients with available data on estrogen (ER), progesterone (PgR) and human epidermal growth factor receptor-2 (HER2) receptor status received taxane-platinum regimen as the first- or second-line treatment. The overall RR of patients with TNBC was 39%. This rate did not differ significantly from those of patients with other phenotypes. The time to death after chemotherapy (19 vs. 50 months, p = 0.037) and overall survival (OS) (21 vs. 56 months, p = 0.030) differed significantly between patients with TNBC and non-TNBC. TNBC showed a unique locoregional infiltration pattern at relapse, which might reflect its aggressive clinical behavior. Despite the similar response to platinum-containing chemotherapy, patients with TNBC had a shorter OS than patients with non-TNBC. The implication of TN phenotype as poor prognostic factor is uncertain, because it needs to be defined whether poor outcome is related to the rapid growing characteristics of tumor itself or the resistance to drug therapy. Further prospective studies are warranted.
International Journal of Cancer 11/2008; 124(6):1457-62. · 5.44 Impact Factor
ABSTRACT: We conducted a retrospective analysis to evaluate the Musshoff staging system for high-grade primary gastric lymphoma (HG-PGL), particularly in those patients with stages IE and IIE localized diseases. One hundred twenty-six patients presented with stage IE or IIE diseases were retrospectively reclassified on the basis of a pretreatment CT examination as to whether there was lymph node involvement. A positive M1 node (by AJCC staging system) on pretreatment CT scanning was associated with poor clinical outcome for localized stage I or II patients.
Leukemia Research 09/2007; 31(8):1039-43. · 2.92 Impact Factor
ABSTRACT: Korea is an endemic area for hepatitis B virus (HBV) infection. Reactivation of HBV is a well-recognized complication in patients with chronic HBV infection undergoing cytotoxic or immunosuppressive therapy, and there are some reports of hepatitis B reverse seroconversion after HSCT. This study evaluated changes in HBV serology after HSCT. We reviewed the medical records of 141 patients who had available HBV serologic data after autologous HSCT. Patient information was retrospectively collected from the BMT database. Before transplantation, 12 patients were positive for hepatitis B surface antigen (HBsAg) and received lamivudine prophylaxis. There was 1 case of reactivation of HBV among these patients. One hundred twenty-nine patients were negative for HBsAg before HSCT, of whom 110 were positive and 19 were negative for hepatitis B surface antibody (anti-HBs). Sixty-two of the 110 patients who were positive for anti-HBs were also positive for hepatitis B core antibody (anti-HBc). Eight patients were negative for anti-HBs and anti-HBc. Seven patients who were initially negative for HBsAg were identified as positive after HSCT, and 5 of those 7 patients developed acute hepatitis, thus indicating reverse seroconversion. Univariate analysis showed that reverse seroconversions were observed more frequently with multiple myeloma than another disease (P = .005; relative risk, 11.854; 95% confidence interval, 1.381-101.770). Other factors, such as age, sex, and presence of HBcAb before HSCT, had no statistically significant affect on reverse seroconversion. In conclusion, reverse seroconversion of HBV is not a rare complication of autologous HSCT, and the risk of reverse seroconversion after treatment is a serious concern due to possible complications arising from patients' suppressed immune systems.
Biology of Blood and Marrow Transplantation 05/2007; 13(4):463-8. · 3.87 Impact Factor
ABSTRACT: This study was performed to evaluate the safety and efficacy of paclitaxel with cisplatin as salvage therapy in patients previously treated with gemcitabine and cisplatin (G/C) for advanced transitional cell carcinoma (TCC) of the urothelial tract.
Twenty-eight patients with metastatic or locally advanced TCC who had received prior G/C chemotherapy were enrolled. All patients received paclitaxel (175 mg/m(2)) and cisplatin (60 mg/m(2)) every 3 weeks for eight cycles or until disease progression.
The median age was 61 years (range, 43-83 years), and the median Eastern Cooperative Oncology Group performance status was 1 (range, 0-2). The overall response rate was 36% [95% confidence interval (95% CI) = 18-54], with three complete responses and seven partial responses. The median time to progression was 6.2 months (95% CI = 3.9-8.5), and the median overall survival was 10.3 months (95% CI = 6.1-14.1). The most common Grade 3/4 nonhematologic and hematologic toxicities were emesis (10 of 28 patients; 36%) and neutropenia (5 of 110 cycles; 5%).
Salvage chemotherapy with paclitaxel and cisplatin displayed promising results with tolerable toxicity profiles in patients with metastatic or locally advanced TCC who had been pretreated with G/C.
Neoplasia (New York, N.Y.) 02/2007; 9(1):18-22. · 5.48 Impact Factor
ABSTRACT: We conducted a retrospective analysis to investigate the natural history and the clinical outcome after treatment of primary gastric lymphoma of T-cell origin. Seventeen cases of T-cell origin among 444 primary gastric lymphoma patients were analyzed. The median age of the 14 male and 3 female patients was 49 years (range 22-76 years). The median progression-free survival (PFS) and overall survival (OS) were only 10 months (95% CI; 0-20 months), and 12 months (95% CI; 4-21 months), respectively. This study showed that the incidence of this subtype of T-cell gastric lymphoma was very rare, and had poor prognosis.
Leukemia Research 11/2006; 30(10):1253-8. · 2.92 Impact Factor