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이소성 ACTH 생산에 의해 야기된 Cushing 증후군이 동반된 소세포 폐암
곽영임 ( Young Im Kwak ),임영혁 ( Young Hyuck Im ),천영국 ( Young Kug Cheon ),이가희 ( Ka Hee Yi ),남현석 ( Hyeon Seok Nam ),이춘택 ( Choon Taek Lee ),강윤구 ( Yoon Koo Kang ),이진오 ( Jhin Oh Lee ),강태웅 ( Tae Woong Kang ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.6
전이성 또는 재발성 식도암에 대한 Cisplatin , Etoposide 및 5 - Fluorouracil ( PEF ) 복합화학요법의 치료 효과
류백렬(Baek Yeol Ryoo),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),정상훈(Sang Hoon Jeong),김현각(Hyun Kag Kim),이창희(Chang Hee Lee),윤종길(Jong Kil Yoon),천영국(Young Kug Cheon),김서운(Seo Woon Kim),김유철(You Cheoul Kim),김창민(C 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A Esophageal cancer is widely disseminated in more than 80% of patients at the time of diagnosis and the prognosis of advanced esophageal cancer is dismal with a median survival of 5 to 8 months. Therefore, systemic chemotherapy has assumed an important role in the treatment of these patients. Among various combination chemotherapy regimens, the combination of cisplatin and 5-fluorouracil has been one of the most effective for esophageal cancer because of their synergism. Etoposide, although reported ineffective as a single agent, has been shown to be synergistic with cisplatin in vitro and in vivo. So, we conducted a phase 2 trial to evaluate the effect of a combination of cisplatin, etoposide and 5- FU (PEF) in patients with metastatic or recurrent esophageal cancer. Thirty-four patients with measurable lesion(s) received cisplatin (20㎎/㎡ i.v. Day 1~5), etoposide (100㎎/㎡ i.v. Day 1, 3 & 5) and 5-FU (800㎎/㎡ continuous i.v. for 12 hours, Day 1~5). Of 30 evaluable patients, 1(3.3%) had a complete response and 11(37%) had partial responses. The median duration of response was 29 weeks. The overall median survival was 34 weeks and the survival time in the responders was longer significantly than that of the non-responders. There was no significant prognostic factor influencing the response rate. Among total 135 cycles of chemotherapy, leukopenia was observed in 36% and thrombocytopenia in 4%. There was no treatment-related death. Main non-hematologic toxicities were neurotoxicity (17%), nephrotoxicity (3%), and stomatitis (10%) and diarrhea (10%). All the toxicities were mild and well tolerated. Conclusion: A combination chemotherapy of cisplatin, etoposide and 5-FU (PEF) was effective and well tolerated in patients with metastatic or recurrent esophageal cancer.
국소적으로 진행된 식도암 환자에서 Cisplatin , Etoposide 및 5 - Fluorouracil ( PEF ) 선행화학요법의 효과 ; A Pilot Study
정상훈(Sang Hoon Jeong),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),손태용(Tae Yong Son),곽영임(Young Im Kwak),천영국(Young Kug Cheon),김현각(Hyun Kag Kim),류백렬(Baek Yeol Ryoo),김유철(You Cheoul Kim),이춘택(Choon Taek Lee),김창민( 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A The prognosis of esophageal cancer is very poor. Even for those with localized disease who are potentially curable, 5-year survival rates are under 20% in almost all series. We conducted a pilot study to evaluate the safety and possibility of efficacy of neoadjuvant chemotherapy followed by surgery in patients with locally advanced esophageal cancer. Two or three cycles of neoadjuvant combination chemotherapy with cisplatin (20㎎/㎡/day i.v., D1-5), etoposide (100㎎/㎡/day i.v., D1,3,5), and 5-fluorouracil (800㎎/㎡/day continuous i.v., D1-5) were planned to be given before surgery. Total 21 patients entered this trial. Three patients were lost to follow-up after 1 cycle of chemotherapy to make eighteen patients evaluable. Thirteen out of eighteen patients (72%) had objective improvement after neoadjuvant chemotherapy and four (22%) had no change and one (6%) had progression. Among 18 evaluable patients, surgery was performed in 11 patients. Surgery could not be done in 7 patients because of patient's refusal (5), progression of disease (1), and development of lung abscess (1). In 13 patients who were candidates for surgery, curative resection was done in 10 patients to make curative resection rate 10/13 (77%). One of eleven patients having surgical resection had no pathologic evidence of tumor (pathologic complete remission 9%). Postoperative complications of wound dehiscence and anastomotic site fistula developed in 2 patients. Three courses of postoperative adjuvant chemotherapy with PEF regimen were administered to 9 patients. The median survival time for all 18 patients was 60 weeks. Toxicities of PEF neoadjuvant chemotherapy were leukopenia, nausea/vomiting and alopecia, but they were mild and reversible. There was no treatment-related deaths. In conclusion, neoadjuvant chemotherapy with PEF regimen were tolerable, safe and possibly effective in locally advanced esophageal cancer. Based on this study, we will perform phase 2 or 3 study to assess the efficacy of PEF neoadjuvant chemotherapy for locally advanced esophageal cancer.
간세포암의 비수술적 치료후 생존율 평가에 의한 UICC 병기의 타당성에 관한 후향적 연구
윤종길(Jong Kil yoon),김현각(Hyun Kag Kim),이창희(Chang Hee Lee),천영국(Young Kug Cheon),김유철(You Cheoul Kim),김창민(Chang Min Kim),홍원선(Weon Seon Hong),이진오(Jhin Oh Lee),강태웅(Tae Woong Kang),최수용(Soo Yong Choi) 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A Objectives: The management of hepatocellular carcinoma(HCC) has been frequently complicated due to the variable hepatic dysfunction from underlying chronic liver disease. The validity of UICC staging system based on the anatomical extent of malignant lesion has been questioned because of the poor correlation between stages and clinical outcomes. The purpose of this study is to elucidate the validity of UICC staging system as a prognostic factor and to compare with Child`s classification which represents the functional status of liver. Methods: A total of 831 patients with HCC who received no specific anti-cancer treatment, TACE and/or systemic chemotherapy, between January 1988 and December 1991, were analyzed retrospectively. Factors influencing the prognosis were analyzed by Cox proportional-hazard regression model. Results: Median survival of overall HCC patients was 4 months. There was no significant difference in overall median survival between UICC stage III and IVA; but significant differences between Child A and B, Child B and C were found. UICC staging system for HCC gave less significant clinical value in predicting the survival of HCC patients regardless of the treatment modalities given. In contrast, Child`s classification was better correlated with the survival of HCC patients who received systemic chemotherapy and no specific treatment. In Cox proportional-hazard regression model, Child`s classification was the most influential prognostic factor exceeding the role of UICC system.. Conclusion: UlCC staging system is not a good system for the staging of HCC. We beIieve that the poor correlation between stages and survival originated from the neglect of hepatic dysfunction which is the major prognostic factor in HCC. It is necessary to develop a new staging system which can represent the prognosis better.
악성 갈색세포종 및 갑상선수질암의 131I - MIBG 을 이용한 치료
최창운(Chang Woon Choi),임상무(Sang Moo Lim),홍성운(Sung Woon Hong),윤종길(Jong Kil Yoon),류백렬(Baek Yeol Ryoo),이창희(Chang Hee Lee),정상훈(Sang Hoon Jeong),천영국(Young Kug Cheon) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.3
N/A 131I-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[l multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of 131I-MIBG administered by slow I.V. infusion, given at 3-6 months intervals. Cummulative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. 131I-MIBG therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion)after sugery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb); stable disease in 1 recurred pheochromocytoma(MEN IIb); stable disease but symptomatic improvement in 1 MTC; progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.