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홍용상,김태원 대한의사협회 2010 대한의사협회지 Vol.53 No.7
Survival outcomes have been steadily improving for last 50 years in patients with colorectal cancer. The 5-fluorouracil (5-FU) is still one of the major chemotherapeutic agents. New cytotoxic agents, irinotecan and oxaliplatin, or targeted agents, bevacizumab and cetuximab,have been studied in the treatment of colon cancer. Adjuvant chemotherapy is indicated in patients with colon cancer at high-risk stage II and III, and after complete resection. Oxaliplatinbased regimens, FOLFOX, are considered as the standard adjuvant chemotherapy. If there are contraindications for oxaliplatin, the best alternatives are capecitabine or 5FU/LV. In rectal cancer, adjuvant chemotheradiotherapy is indicated in patients who had curative resection with stage II and III cancer. Adjuvant chemotherapy is necessary after neoadjuvant chemoradiotherapy in rectal cancer. The introduction of novel agents targeted to specific molecular features of cancer cells promises more options and marked improvements in efficacy for treatment of metastatic colon cancer. Bevacizumab has been shown to extend survival in colorectal cancer when used in combination with irinotecan and 5-fluorouracil-based chemotherapy, and the addition of cetuximab to irinotecan and 5-fluorouracil-based chemotherapy eliminates irinotecan resistance. Interestingly, there has been no clear association between the expression of epidermal growth factor receptor (EGFR) and response to the EGFR inhibitors. Instead, KRAS mutation has been accepted as a negative predictive factor for the treatment of cetuximab. In contrast, no valid biomarkers for bevacizimab were found so far. More studies are necessary to identify biomarkers of targeted agents. Recent advancement of chemotherapeutic agents extended survival in colorectal cancer.
홍용상,구보경,최인실,김진수,김태민,김태용,선종무,한세원,윤성수,박선양,김병국 대한혈액학회 2004 Blood Research Vol.39 No.3
A 65 year-old female visited because of neck mass. Tumors were found in thyroid, neck nodes, lung parenchyma, liver, kidney and bone. Biopsy of neck node revealed malignant lymphoma (diffuse large B cell lineage) and metastatic papillary thyroid carcinoma simultaneously. Her thyroid function was normal. She was treated with chemotherapy targeting malignant lymphoma initially, and achieved near complete remission. Additional biopsy of neck node after first chemotherapy revealed no papillary carcinoma. To our knowledge, this is the first report of malignant lymphoma and papillary carcinoma simultaneously involving thyroid gland in Korea.
홍용상 ( Yong Sang Hong ),김태원 ( Tae Won Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.6
Recent advances in chemotherapy lead to improved survival outcomes in patients with colorectal cancer. The 5-fluorouracil (5-FU) is still one of the important chemotherapeutic agents since 1950s, but the introduction of newer cytotoxic agents, irinotecan and oxaliplatin, or targeted agents, bevacizumab and cetuximab, have changed treatment strategies for these patients. A deliberate choice should be made for adjuvant chemotherapy, because it has became complicated more than ever before. Oxaliplatin plus 5-FU seemed to be superior in terms of disease-free and overall survival than 5-FU alone after curative surgery for colon cancers. However not all of these patients seemed to receive benefit from this intensive adjuvant treatment, and some limitations are present according to the postoperative stage, tumor biology and clinical characteristics. For metastatic disease, there is no doubt that more complicated strategies are present because we have more abundant chemotherapeutic agents available for metastatic setting compared to adjuvant setting. Recently, targeted agents, such as bevacizumab or cetuximab, also took an important place in the treatment of metastatic colorectal cancer, and many efforts are also made to find the biomarkers for predicting treatment responses to these targeted agents. In this review, we intended to sort up the standard strategies of chemotherapy for patients with colorectal cancer according to the latest pivotal publications. (Korean J Gastroenterol 2009;54:355-363)