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RISS 인기검색어
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- 저자 : ( Choonhee Son ) (검색결과 3 건)
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A case of multiple, severe adverse effects of immunotherapy after complete remission of lung cancer
( Choonhee Son ),( Soojung Um ),( Bo-hyoung Kang ),( Dong-hyun Lee ),( In-soo Kim ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Introduction: Although immunotherapy is promising modality of cancer management, adverse effects are often unpredictable and rapidly change. We experienced a case of lung cancer with multiple, severe adverse effects. Especially in this case, it was difficult to decide whether high dose steroids were infused immediately after recovery from diabetic ketoacidosis. Case Presentation; A 65-year-old male patient was diagnosed as squamous cell carcinoma of lung, and recurred after surgical resection. PET-CT(Fig. A) scan showed bony matastasis. On immunohistochemical staining, PD-L1 was 100% positive. The lesion regressed after pembrolizumab. On 7th cycle, dyspnea, wheeze, urticaria occurred and relieved by peniramine, hydrocortisone which features were consistent with angioedema. Follow-up PET-CT scan(Fig. B) showed complete remission. At that time he complained of dry mouth and FBS was 178 mg/dL. Two days later, he visited emergency room for weakness. Blood test was consistent with diabetic ketoacidosis: glucose 711 mg/dL, C-peptide 0.74 ng/mL, pH 7.185, ketone 8.49 mMol/L. As there is no history of diabetes, it was thought as a side effect of pembrolizumab. Seven days later, blood glucose level returned to 182 mg/dL with insulin. The day before his discharge, he showed abnormal behavior. Twelve hours later, generalized seizure was occurred. Brain MRI finding was nonspecific, and EEG finding was consistent with diffuse encephalopathy. Consciousness level aggravated to semicoma. High dose steroids(methyl prednisolone 1 g/day for 3 days) was started. Two days later, mental status improved to stupor. However, after 3 months of fluctuating mental status, he died of pneumonia. Discussion: Encephalitis is rare, but potentially fatal adverse events of immune checkpoint inhibitors. Prompt use of high dose steroids is essential. In this case, it was very difficult decision to prescribe that. Although it is not always possible, we should be alert to all the possible, rare side effects of therapy.
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Lee, Kwan-Ho,Lee, Kye-Young,Jeon, Young-June,Jung, Maan-Hong,Son, Choonhee,Lee, Min-Ki,Ryu, Jeong-Seon,Yang, Sei-Hoon,Lee, Jae-Cheol,Kim, Young-Chul,Kim, Sun-Young The Korean Academy of Tuberculosis and Respiratory 2012 Tuberculosis and Respiratory Diseases Vol.73 No.6
Background: This study was designed to analyze the efficacy of gefitinib as a second-line therapy, according to the clinical characteristics in Korean patients with non-small-cell lung cancer (NSCLC). Methods: In this Phase IV observational study, we recruited patients, previously failed first-line chemotherapy, who had locally advanced or metastatic NSCLC, and who were found to be either epidermal growth factor receptor (EGFR) mutation-positive or satisfied 2 or more of the 3 characteristics: adenocarcinoma, female, and non-smoker. These patients were administered with gefitinib 250 mg/day, orally. The primary endpoints were to evaluate the objective response rate (ORR) and to determine the relationship of ORRs, depending on each patient's characteristics of modified intent-to-treat population. Results: A total of 138 patients participated in this study. One subject achieved complete response, and 42 subjects achieved partial response (ORR, 31.2%). The subgroup analysis demonstrated that the ORR was significantly higher in patients with EGFR mutation-positive, compared to that of EGFR mutation-negative (45.8% vs. 14.0%, p=0.0004). In a secondary efficacy variable, the median progression-free survival (PFS) was 5.7 months (95% confidence interval, 3.9~8.4 months) and the 6-month PFS and overall survival were 49.6% and 87.9%, respectively. The most common reported adverse events were rash (34.4%), diarrhea (26.6%), pruritus (17.5%), and cough (15.6%). Conclusion: Gefitinib was observed in anti-tumor activity with favorable tolerability profile as a second-line therapy in these selected patients. When looking at EGFR mutation status, EGFR mutation-positive showed strong association with gefitinib by greater response and prolonged PFS, compared with that of EGFR mutation-negative.
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Four Cases of a Cerebral Air Embolism Complicating a Percutaneous Transthoracic Needle Biopsy
엄수정,김기남,이기남,김윤성,Soo-Keol Lee,Doo Kyung Yang,Choonhee Son 대한영상의학회 2009 Korean Journal of Radiology Vol.10 No.1
A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided. A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.
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