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진행성 악성종양별 맞춤 항암요법의 최신 지견 ; 진행성 비소세포폐암의 표적치료 및 맞춤항암치료
윤탁 ( Tak Yun ) 대한내과학회 2009 대한내과학회지 Vol.77 No.1
The prognosis of advanced non-small cell lung cancer (NSCLC) is very poor and the median overall survival is 10 to 12 months, despite the use of chemotherapy and targeted therapy. Recently, many targeted agents for NSCLC have been developed and tested in clinical trials. Of these, chemotherapeutic agents targeting epidermal growth factor receptor (EGFR), such as gefitinib, erlotinib and cetuximab, have been very efficacious in the treatment of NSCLC. Many phase III trials have evaluated the efficacy of these agents in combination with cytotoxic chemotherapy. Based on the results of these trials, clinical and molecular predictors of the response to EGFR-targeted agents, such as EGFR mutations or gene amplification, have been elucidated. Recent advances in understanding the biologic basis of acquired resistance to these agents have potential to improve the clinical effectiveness of agents targeting EGFR. Another agent, bevacizumab, targets an angiogenesis inhibitor, and has improved the survival in advanced NSCLC when used in combination with chemotherapy. In addition, many agents targeting tyrosine kinase inhibitors are being used in clinical trials. This review summarizes the outcomes of clinical trials evaluating agents targeting EGFR, angiogenesis inhibitors, and other molecules used alone or in combination with chemotherapy for the treatment of advanced NSCLC. Also, the predictive role of NSCLC histology for chemotherapy response will be summarized from the results of phase III studies. (Korean J Med 77:9-17, 2009)
정상준 ( Sang Joon Chong ),곽호신 ( Ho Shin Gwak ),민혜숙 ( Hye Sook Min ),윤탁 ( Tak Yun ),유헌 ( Heon Yoo ),신상훈 ( Sang Hoon Shin ),이승훈 ( Seung Hoon Lee ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.1
Primary central nervous system lymphomas(PCNSLs) are uncommon intracranial tumors and almost of them are known to be of B-cell lineage. PCNSLs of T-cell lineage should be differentiated from that of B-cell lineage with reactive T-cell infiltrations. We report a 62-year-old female presented with gait disturbance and slurred speech. Brain magnetic resonance imaging showed multilobulated homogenous enhancing mass with peritumoral edema in left basal ganglia. With the assistance of detecting T-cell receptor gamma gene rearrangement by polymerase chain reaction, it was diagnosed as PCNSL of T-cell lineage pathologically.
김태용(Tae Yong Kim),조요한(Yo Han Joh),김진수(Jin Su Kim),홍용상(Yong Sang Hong),이근욱(Keun Wook Lee),윤탁(Tak Yun),송은기(Eun Ki Song),나임일(Im Il Na),신현춘(Hyun Chun Shin),김동완(Dong Wan Kim),이재서(Chae Seo RLee),성명훈(Myung W 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.2
Background: About 3% of all cancer patients suffer from cancer of unknown primary origin. Generally, carcinoma of unknown primary (CUP) carries a grave prognosis, but primary tumor presented to the neck is exception to this. The aims of study are to determine the role of chemotherapy and to find the prognostic factors in unknown primary tumor presented to the neck. Method and Material: Eighty-four patients were diagnosed with unknown primary tumor presented to the neck between January 1996 and June 2002. Among 84 patients, 43 patients (52%) received chemotherapy, radiation or surgery were performed in 20 patients (23%), 21 patients (25%) had no treatment. Results: The response rates to chemotherapy were 87.5% in CUP only localized to the neck and 44.0% in CUP systemically involved (p=0.012). A median follow-up duration was 6.4 years and overall median survival time was 9 months. The median overall survival time of patients treated with chemotherapy were 17 months and that of patients who received surgery or radiation were 20 months (p=0.3548). The important prognostic factors were performance status and the number of involved organ. Conclusion: The prognosis of patients with CUP presented to the neck is more favorable than that of patients with CUP of other localization. The effectiveness of chemotherapy for CUP only localized to the neck was similar to that of surgery or radiation. The important prognostic factors were performance status and the number of involved organ.
전신적인 피부병변으로 발현한 모세포성 NK세포 림프종 1예
이근욱,윤탁,김동완,김태유,허대석,박영주,김노경 대한내과학회 2004 대한내과학회지 Vol.66 No.4
저자들은 다른 장기의 침범 없이 전신적인 피부 병변만으로 발현한 모세포성 NK세포 림프종 1예를 국내에서 처음으로 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. Reports of blastic natural killer (NK)-cell lymphoma are rare. In previous reports, primary cutaneous blastic NK-cell lymphomas were even rarer. In asian patients, most CD56+ lymphomas are classified as nasal type extranodal NK/T-cell lymphoma and mostly associated with the presence of Epstein-Barr virus (EBV) and have an aggressive clinical course. Few cases of blastic NK-cell lymphoma were reported previously in Korea but there was report about blastic NK-cell lymphoma initially presented as disseminated skin lesions without any other organ involvement. We report such a young patient who was treated by systemic chemotherapy.