복강경 보조 원위 위 절제 환자의 장기적인 '삶의 질' 평가

김동원,김용진,김민주,조규석,김형수,이문수,김재준,이민혁,문철,Kim, Dong-Won,Kim, Yong-Jin,Kim, Min-Ju,Cho, Kyu-Seok,Kim, Hyeong-Su,Lee, Mun-Su,Kim, Jae-Jun,Lee, Min-Hyeok,Mun, Cheol 대한위암학회 2007 대한위암학회지 Vol.7 No.4

목적: 조기위암 수술에 복강경 적용의 용이성 및 종양학적 안정성에 대해서는 많은 연구가 아루어지고 있으나, 복 강경 적용의 또 다른 목적인 '삶와 질' 향상에 대한 연구 는 아직 미흡한 현실이다. 이에 저자들은 위암 수술에 복강경 적용이 '삶의 질' 향상에 미치는 장기적 영향을 평가 하고자 본 연구를 고안하였다. 대상 및 방법: 2003년 1월부터 2004년 12월까지만 2년간 순천향대학병원 외과에서 위 절제 수술 후 위암 1기로 진단된 154명의 환자들을 대상으로 수술 후 1년 이상 경과한 시점에서 설문조사를 시행하였다. EORTC OLQ-C30(3판)과 EORTC QLQ-ST022 한글판을 이용하여 한 명의 전문 간호사에 의해 외래 방문 시 직접 면담 혹은 전화 상담을 통해 설문조사를 시행했으며, 통계처리는 SPSS 12.0 for Windows를 이용하였다. 결과: 전체 대상 환자 154명 중 86명에서 설문 조사가 이루어져 58%의 응답률을 보였으며, 86명(개복군: 57명, 복강경군: 29명)의 평균 연령은 55세였고, 남자가 60명 여자가 26명으로 남녀 비는 2.3 : 1 이었다. 개복 군의 종양 크기는 평균 2.42 cm로 복강경군의 평균 종양 크기 1.8 cm에 비해 유의하게 크기가 컸으며(P=0.003), 평균 획득 림프절 수도 개복 군에서 36개로 유의하게 더 많았다(P=0.000). 그 외 종양관련 인자인 원발암와 침윤도, 림프절 전이 및 TNM 병기에 있어서 양 군 간에 차이는 없었다. 전반적인 건강 상태와 관련된 2 항목의 평균 점수는 개복 군이 57 (${\pm}20.6$), 복강경 군이 60.3 (${\pm}20.4$)으로 양 군 간에 유의한 차이는 없었으며, 기능과 관련된 15 항목과 증상과 관련된 13항목에 있어서도 양군 간에 유의한 차이는 없었다. EORTC QLQ-STO22를 이용한 '삶의 질' 비교 결과 개복군의 평균 점수는 94.5 (${\pm}97.3$), 복강경군은 68.9 (${\pm}64.9$)로 개복군에서 전반적으로 불편한 증상을 많이 호소하였으나 통계학적인 차이는 없었다. 결론: EORTC QLQ-C30 (3판)과 EORTC QLQ-STO22 한글판을 이용한 설문조사 결과 장기적인 측면에서 위 절제술에 복 강경 적용이 환자의 '삶의 질' 향상에 영향을 미치지 못했다. Purpose: Laparoscopy-assisted distal gastrectomy (LADG) is gaining wider acceptance for the treatment of early gastric cancer. However, firm evidence supporting the long-term outcome after LADG for gastric cancer is unknown. This study compared long-term quality of life after LADG versus an open distal gastrectomy (ODG) for early gastric cancer. Methods: This study included 29 patients who underwent LADG and 57 patients who underwent ODG for the treatment of stage I gastric cancer. Quality of life was evaluated based on the Korean version of EORTC QLQ-C30 (version 3.0) and EORTC QLQ-STO22 one year after surgery. All patients underwent a Billroth II gastrectomy for stage I gastric cancer between January 2003 and December 2004. Results: A total of 86 (58%) out of 154 patients responded to the questionnaire. Demographic features showed no difference between the two groups of patients for age, sex, depth of invasion, lymph node metastasis except for tumor size and the number of retrieved lymph nodes. The mean score for global health status was not statistically different (LADG, $60.3{\pm}20.4$ vs ODG, $57{\pm}20.6$; P=0.413). The total score of 21 items related to stomach cancer (EORTC QLQ-STO22) also was not statistically different (LADG, $68.9{\pm}64.9$ vs ODG, $94.5{\pm}97.3$; P=0.340). Conclusion: Based on the results of the Korean version of EORTC QLQ-C 30 (version 3.0) and EORTC. QLQ-STO22, LADG does not seem to have any long-term benefit over ODG on 'quality of life'.

한국(韓國) 인문과학연구(人文科學硏究) 현황(現況) 특집(特輯) : 1960년대의 력사학(歷史學) -서양사학(西洋史學)을 중심(中心)으로-

김동원 ( Dong Won Kim ) 전남대학교 인문학연구소 1974 용봉인문논총 Vol.3 No.-

The research of western history in Korea began largely in the 1950`s. With the organization of the Korean Historical Association (KHA) in 1952, some historians began researches in western history and published their articles in The Korean Historical Review, The membership of the KHA covers the histories of Korea, Asia and Europe, and its members have performed their studies in their respective fields. Since the late 1950`s, researchers of western history increased in number and they felt the necessity of having their own organization and journal to have their research articles published. The Korean Western Historical Association (KWHA) was established with Dr. EuiSul Choe, Hyun-Mo Keel, Bo-Hyung Lee, Suk-Hong Min, as charter members in 1958 and its organ, The Western Historical Review, began to be published in the same year. With the coming of the 1960`s researchers of western history greatly increased and they did research with vigorous spirit of inquiry. Those who led the Association from the beginning and contributed much to the development of KWHA are Dr. Eui-Sul Choe, Dr. Byung-Woo Yang, Suk-Hong Min, Hyuo-Mo Keel, Bo-Hyung Lee, Jong-Il Rah, and Mun-Hyung Choi. The present article is to survey the activities of western historical researches in the 1960`s and to examine articles in this field, For the sake of convenience, this paper is divided as follows: 1. Ancient History of Europe 2. Medieval History of Europe 3. Modern and Contemporary History of Europe a. Age of Renaissance b. History of France c. History of Germany d. History of England e. History of America 4. Historical Theory 5. Western Historians` Comments on Current Korean Problems In part 1 , Greek history, mainly the political and socio-economic history of Athens, was inquired very deeply by Dr. Eui-Sul Choe, Dr. Byung-Woo Yang, and Jung-Su Kim. Compared with the vigorous research of Greek hislory, the history of Rome was scarcely investigated. In Part 2,researches were concentrated on the end of the Medieval age, especially on the Manorial decline. The formation of the age, problems of religion,and Feudalism were never studied. In Part 3, movern history was most vigorously studied, but contemporary history seemed to be weak, compared with its necessity of research. Most of the researchers were concentrated on this part. Hyun-Mo Keel, Suk-Hong Min, Bo-Hyung Lee, Jong-Il Rab, Mun-Hyung Choi and Dr. Ha-Sun Cha, were the most active scholars in this part. 1n Part 4, we find a special feature of research in the 1960`s. Late in the 1960`s, new theories of historical method were introduced and many historians took part in this. Dr. Byung-Woo Yang, and Dr. Ha- Sun Cha were the most active scholars in this part. They also contributed to Korean historical research with their studies in historical theories. In the last part, we find the maturity of western historical studies in Korea. Out of many writings, we can select the following: The first was to find the characteristics of the April 19 revolution, written by Suk-hong Min. The second was to point out “ the intellectual chaos in the eaIiy 1960`s, written by Hyun-Mo Keel This meant historian`s duty to his own society alld his participation in the present. In condusion, though the western historical research in Korea had economic, geographical, and linguistic handicaps the inquiring spirit of the western history was raised to the great extent, beginning in the late 1960`s. The scholarly activities of the 1960`s prepared a good promise for the development of western historical studies in Korea.

8-HQR 및 8-HQRS 킬레이트 수지의 합성과 그의 이온교환 성질

김동원,김공수,김홍수,Dong Won Kim,Kong Soo Kim,Hong Soo Kim 대한화학회 1986 대한화학회지 Vol.30 No.1

8-Hydroxyquinoline-resorcinol(8-HQR) and 8-hydroxyquinoline-resorcinol-salicylic acid (8-HQRS) chelate resins were prepared by the condensation reaction of 8-hydroxyquinoline, or 8-hydroxyquinoline-salicylic acid, in the presence of resorcinol with formaldehyde. The ion exchange capacities of 8-HQR and 8-HQRS resins were 4.1 meq/g and 5.4 meq/g, respectively. The adsorption and distribution coefficient of metal ions, such as Fe(III), Cu(II), Pb(II), Co(II) and Ni(II) on these resins were discussed. The adsorption of metal ions on these chelate resins showed that the maximum adsorption condition is pH 7. And the distribution coefficient of metal ions on these resins was increased with decreasing of hydrochloric acid concentration. 8-히드록시퀴놀린, 또는 8-히드록시퀴놀린-살리실산을 모체로 하고, 레졸신을 가교제로 하여 그것들을 포름알데히드와 축중합시켜, 8-히드록퀴놀린-레졸신(8-HQR) 및 8-히드록시퀴놀린-레졸신-살리실산(8-HQRS)킬레이트 수지를 합성하였다. 8-HQR 및 8-HQRS수지의 이온교환용량은 각각 4.1 meq/g 및 5.4 meq/g이었다. 이들 수지에 대한, Fe(III), Cu(II), Pb(II), Co(II) 및 Ni(II)금속이온들의 흡착과 분포계수에 대하여 논의하였다. 이들 킬레이트 수지들에 대한 금속이온들의 흡착은, pH=7에서 가장 크게 나타났다. 그리고 이들 금속이온들의 분포계수는, 염산의 농도가 감소함에 따라 증가하였다.

후쿠시마원전사고 이후 원전 경제성과 안전성(사회적 수용성)의 최적점 연구

김동원,Kim, Dong-Won 한국방사성폐기물학회 2013 방사성폐기물학회지 Vol.11 No.3

Since the Fukushima nuclear power plant accident in March 2011, critical views on the increase in operation of nuclear power plants including the safety and the economic feasibility thereof have been expanding across the world. In these circumstances, we are to find out solutions to the controversial questions on whether nuclear power plants are economically more feasible than other energy sources, while the safety thereof is fully maintained. Thereby, nuclear power plants will play a key role as a sustainable energy source in the future as well as at present. To measure the social safety level that Korean people are actually feeling after the Fukushima accident, a method of cost-benefit analysis called the Contingent Valuation Method(CVM) was used, whereby we wanted to estimate the amount of expenses the general public would be willing to pay for the safety based on their acceptance rather than the social safety. As a result of calculating the trade-off value of the economic feasibility versus the safety in nuclear power plants through the survey thereon, it caused the nuclear power generation cost to be increased by 4.75 won/kWh. Reflecting this on the current power generation cost of 39.11 won/kWh would increase the cost to 43.86 won/kWh. It is thought that this potential cost is still more competitive than the coal-fired power generation cost of 67 won/kWh. This result will be available as a basic data for the 2nd Energy Basic Plan to be drawn up this year, presenting policy implications at the same time.

N,N-디메틸포롬아미드 용액에서의 알칼리금속이온과 피리디노-아자크라운에테르와의 착물화 반응

김동원,신영국,김창석,오제직,전영신,김태승,Kim, Dong Won,Shin Young-Kook,Kim Chang Suk,Oh Je Jik,Jeon Young Shin,Kim, Tae Seung 대한화학회 1992 대한화학회지 Vol.36 No.5

알칼리금속이온(Li^+, Na^+, K^+, Rb^+, and Cs^+)과 아미드기를 포함하는 피리디노아자 크라운 화합물인 DBPDA와 PDA의 착물형성에 대한 안정도상수, K를 전기 전도도법을 이용하여 여러 온도에서 측정하였다. 각 온도에서 K값은 DBPDA의 경우 Cs^+ > K^+ > Rb^+ > Li^+ > Na^+의 순서였으며, PDA의 경우는 Cs^+ > K^+ > Rb^+ > Li^+ > Na^+이었다. 또한 DBPDA가 PDA보다 이들 알칼리 금속 이온에서 더 큰 K값을 보여주었다. 넓은 의미를 갖는 "Hole-Size-Selectivity" 원리에 이들 착물은 적용되지 않는 것으로 나타났다. 온도 변화에 따른 K값으로부터 {\delta}H와 T{\delta}S를 각각 구했으며, 이들 반응들은 엔탈피 기여에 따르는 착물형성반응으로 나타났다. 그러나 PDA의 경우 부분적인 엔트로피 항의 증가도 착물의 형성에 기여함을 알았다. The stability constants, K for the complexation of alkali metal cations(Li^+, Na^+, K^+, Rb^+, and Cs^+) with both 4,5: 13,14-dibenzo-6,9,12-triaza-bicyclo [15,3,1] heneicosa-1 (21),7,19-trioxa-2,16-dione (DBPDA) and 6,9,12-trioxa-3,15,21-triaza bicyclo [15,3,1] heneicosa-1 (21),17,19-triene-2,16-dione (PDA) in N,N-Dimethylformamide (DMF) were determined conductomatically at various temperatures. At all the experiment temperatures, the K value sequences of the alkali metal ions with DBPDA and PDA are Cs^+ > K^+ > Rb^+ > Li^+ > Na^+ and Cs^+ > K^+ > Rb^+ > Li^+ > Na+, respectively. The K values for DBPDA are larger those of PDA for alkali metal ions. The widely recounted "hole-size-selectivity" principle is not applicable to these complexation systems. From the K values obtained at different temperatures, {\delta}H and T{\delta}S for these complexation reactions were determined. The enthalpy change plays principal important role in the complex formation by DBPDA. However, in the case of PDA, the entropy change also contributes to its complex formation.

Effect of Carbon Dioxide and Fluorine from Soft Drinks on Teeth

Kim, Dong-Won김동원,Hong, Young-Gwan,Ryu, Hai-Il 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

탄산 음료 속에 Carbon Dioxide 와 Fluorine이 치아에 미치는 영향을 치아의 질량변화를 통하여 알아 보았다. 음료수 중 콜라 속에서 치아의 질량 변화가 가장 컸으며, 콜라 속의 Phosphorus의 양을 정량한 결과, 142 ppm 이었으며, Carbon trioxide와 Phosphorus가 치아에 영향을 주는 물질임을 확인할 수 있었다. 또한 Fluorine의 농도가 진한 경우, 치아의 질량변화에 영향을 주었다.

인천지역 노인의 국민연금 수급이 여가문화활동 및 생활체육활동에 미치는 영향

김동원(Dong Won Kim) 한국여가레크리에이션학회 2012 한국여가레크리에이션학회지 Vol.36 No.1

The purpose of this study was based on identifying the current status of senior citizens` leisure activity and sport activities based on the benefits of receiving pension. To achieve the result of this study, the research target has been to narrowed to senior citizens over 60 years old in 8 districts of Incheon city and 366 data were used for final analysis. To verify research problem, frequency analysis, and t-test were conducted. following results have been come out. First, the pension beneficiary citizens showed higher participation of leisure and sport activities than non-beneficiary citizens. Second, the most favorable leisure type for both pension beneficiary and non-beneficiary citizens were spending time with friends. Third, pension beneficiary citizens showed higher satisfaction of leisure and sport activities than non-beneficiary citizens. Forth, pension beneficiary citizens participated more in walking and non-beneficiary citizens participated more in hiking. Fifth, pension beneficiary citizens showed to participate sport activities 3~4 times and non-beneficiary citizens F2 times a week and mostly in 30 minutes to 1 hour. Sixth, the pension beneficiary citizens showed to spend average 81,149.43 won and non-beneficiary citizens 59,857.02 won.

Synthesis of (4,5) : (13,14)-Dibenzo-6,9,12-trioxa-3,15,21-triazabicyclo[15.3.1]heneicosa-(1,17,19)(18,20,21)triene and Aza-Crown Polymers

김동원,김창석,최기영,김태승,Dong Won Kim,Chang Suk Kim,Ki Young Choi,Tae Seung Kim Korean Chemical Society 1992 대한화학회지 Vol.36 No.6

젖소의 사양관리 시스템 개발

김동원,한병성,정길도,김용준,김명순,임태영,채석,Kim, Dong-Won,Han, Byung-Sung,Chong, Kil-To,Kim, Yong-Jun,Kim, Myoung-Soon,Lim, Tae-Yeong,Chae, Seok 대한산업공학회 1998 산업공학 Vol.11 No.3

The agriculture and fishery share in the Korean GDP is continuously decreasing after 1960s. Furthermore the proportion of these industries in the GDP has diminished as low as 10 percent in recent years. However, the stockbreeding sector in these industries are considerably expanded. More than 50 percent of the whole farmhouses are involved in the livestock farming, and the stock farming portion is steadily increased in its size and scope. Thus, the mechanization and the automization of stockbreeding equipments are greatly required to reduce down production cost, as well as to win the competitiveness in the global market. From this aspect, developed in this paper is a stockbreeding management system (SMS) for dairy cattle, which can be used in small and medium sized dairy farms. First, the basic schema of the stockbreeding management system are addressed in view of stockbreeding management for individual dairy cattle. Electronic identification (EI) systems and sensory devices have changed stockbreeding management strategy from group stock control into individual stock control manner. The SMS receives stock body measurement data through the sensory devices such as weight, temperature, and milk conductivity meters. A common database then integrates those measuring data together so that the SMS can determine the appropriate solution on each stock's breeding such as feeding and milking. Thus, each stock can be supervised by a sophisticated SMS that provides the best solution to the stockbreeding throughout the stock's whole life-cycle. Secondly. six major submodules of the SMS, based on the EI and sensory devices, are proposed. They are individual stock management, disease management, health management, feeding management, milking management, and a propagation management submodule. Finally, a prototype system for the SMS is demonstrated. The system is developed using Delphi 2 client-server system run under the Windows 95 environment.

기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험

최영민(Youngmin Choi),이형식(Hyung-Sik Lee),권혁찬(Hyuk-Chan Kwon),한상영(Sang-Young Han),최종철(Jong-Cheol Choi),정주섭(Ju-Seop Chung),김창원(Chang-Won Kim),김동원(Dong-Won Kim),강치덕(Chi-Duk Kang) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.2

목 적: 기존치료에 반응하지 않는 다발성 간전이를 동반한 대장암 환자에서 방사선치료와 병합한 수지상세포 면역 치료의 독성과 반응도를 조사하였다. 대상 및 방법: 2004년 5월부터 2006년 11월까지 다발성 간전이가 동반된 대장암 환자들 중에서 항암화학 요법에 반응하지 않은 환자 중 지원자를 대상으로 연구를 시행하였다. 본 임상 시험에 대하여 동아대학교병원과 부산대학교병원의 임상윤리심의위원회의 허가를 획득하였고, 동의서에 서명한 환자들을 임상 시험의 대상으로 등록하였다. 환자의 말초 혈액으로부터 수지상세포를 추출하여 배양하였다. 임상시험 일자에 맞추어서 6×106개의 수지상세포를 바이알(0.5 ml)에 넣어서 디씨백/아이알 주사를 만들었다. 수지상세포 면역치료는 2주 간격으로 간전이암조직에 3회 주사하고, 5주에 내약성 평가를 하였다. 내약성 평가를 통과한 환자에게는 8주에 4번째 수지상세포 면 역치료를 하였다. 병의 악화가 없거나 임상시험에 대한 환자의 동의 철회가 없는 경우에는 5, 6번째 수지상세포면역치료를 각각 12, 16주에 시행하였다. 방사선치료는 수지상세포 면역치료를 주사할 간전이암 부위에 주사하기 전일 및 당일에 4 Gy씩을 조사하였다. 내약성 평가는 3×106개의 수지상세포로부터 시작하여, 12×106개의 수지상세포까지 시행하였다. 내약성 평가의 최대 내성 용량으로 추가 임상시험을 하였다. 수지상세포 면역치료 주사를 맞은 모든 환자들에서 안전성 평가를 하였다. 4회 이상 주사를 맞은 환자들을 대상으로 10주에 치료 반응을 평가하여 유효성을 조사하였다. 결 과: 임상시험에 등록한 24명 중 22명에서 수지상세포 면역치료를 시행하였다. 내성약 평가에는 14명이 등록하여 11명에서 평가를 완료하였다. 시험약과의 관련성이 있을 것으로 생각되는 grade 3 이상의 약물반응으로 인한 이상반응은 없었다. 12×106개의 수지상세포를 내성용량으로 확인하였고, 내성용량인 12×106개 수지상세포 면역치료를 이용하여 8명에서 추가로 시험을 하였다. 치료에 대한 환자들의 내성은 양호하였고, grade 3을 초과하는 치명적인 부작용은 발생되지 않았다. 4회 이상의 수지상세포 면역치료 주사를 받은 환자가 17명이었고, 이 중의15명에서는 종양의 반응도 평가가 이루어졌다. 본 연구의 목적은 안전성 평가이지만, 면역치료의 유효성 평가를 위해, 방사선치료와 수지상세포 면역치료 주사가 시행된 부위 외의 간전이암에서 반응도를 조사 하였다. 면역치료의 반응은 평가가 이루어진 환자들에서 정지성 병변이 4명, 진행성 병변이 11명 이었다. 결 론: 수지상세포 면역치료와 병행한 방사선치료는 이론적으로 국소 및 전신 제어에 상승효과가 있을 것으로 기대할 수 있다. 하지만 기존 치료에 반응하지 않는 매우 진행된 직장암 환자들을 대상으로 한 본 연구에서는 방사선 치료와 병합한 수지상세포 면역치료로 인한 심각한 부작용의 발생은 없었다는 결과와 4예에서의 정지성 병변의 관찰을 보고한다. 수지상세포의 최대 투여 용량, 적절한 투여 방법, 적절한 방사선의 양, 방사선과 수지상 세포의적절한 투여 간격 등에 관한 추가 연구를 통하여, 향후 제 2상, 3상 시험으로서의 진행 여부에 긍정적인 결과를얻을 수 있다고 판단한다. Purpose: To assess the toxicity and tumor response induced by DCVac/IRⓇ dendritic cell (DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of 6×106 DCs were packed into a vial (DCVac/IRⓇ, 0.5 ml) at the convenience of each patient’s schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses (3×106 to 12×106 DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The 12×106 DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The DCVac/IRⓇ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials