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민영주(Young Joo Min),서철원(Cheol Won Suh),이제환(Je Hwan Lee),채영란(Young Ran Chae),김신(Shin Kim),배창황(Chang Whang Bae),박진희(Jin Hee Park),최성준(Sung Joon Choi),김태원(Tae Won Kim),윤환중(Whan Jung Yoon),정병학(Byung Hak Ju 대한내과학회 1997 대한내과학회지 Vol.53 No.4
N/A Objectives: Recently high dose chemotherapy with autologous peripheral blood stem cell transplantation (APBSCT) has been investigated with the hope of maximizing tumor response and increasing survival. The purpose of this study is to evaluate the effect, feasibility, and toxicity of high-dose cyclophosphamide, thiotepa, and carboplatin (CTCb) with APBSCT in patients with metastatic or high risk primary breast cancer. Methods: Four cases of high-risk primary breast cancer (with more than 10 involved axillary nodes) and three cases of metastatic disease in complete or partial response were enrolled. Peripheral blood stem cells were mobilized by G-CSF plus chemotherapy, and median number of collected mononuclear cells was 5.44×108/㎏(range, 1.95-7.08×108/㎏). High-dose chemotherapy of cyclophosphamide (1,500㎎/㎡/day), thiotepa (125㎎/㎡/day) and carboplatin (200㎎/㎡/day) was administered for 4 days and peripheral blood stem cells were reinfused to the patients 72 hours after the completion of chemotherapy. Results. The median days of recovery for neutrophil (over 500/㎣) and for platelet (over 50,000/㎣) were 10 (range, 8 to 33) and 30 (range, 10 to 40). One patient suffered from seizure attack and grade 3 hepatotoxicity during high dose chemotherapy, There were no treatment-related death. Four patients with high-risk primary breast cancer remained disease-free at 2, 8, 12 and 19 months post-transplant. In one patient with bone metastasis, complete response was induced following APBSCT. All three patients with metastatic disease remained progression-free at 8, 18 and 19 months post-transplant. Conclusion: High-dose chemotherapy and autologous peripheral blood stem cell transplantation was feasible and would be a potentially effective treatment modality in high risk and metastatic breast cancer.
Lung cancer is not only the most common cancer of the elderly but is also the leading cause of cancer related mortality in Korea. Therefore, the elderly form a large subgroup of patients with advanced lung cancer. Aging is associated with co-morbidities, poor performance status, and impaired organ function. These problems can cause uncertainty when selecting the optimal treatment for advanced lung cancer, and some elderly patients could be undertreated. Patients with non-squamous histology lung cancer, regardless of age or performance status, should be tested for epidermal growth factor receptor (EGFR) mutations; patients with EGFR mutations such as del 19 or L858R are able to receive EGFR tyrosine kinase inhibitors. The treatment options for elderly patients with lung cancer include best supportive care, single agent chemotherapy, platinum-based doublet chemotherapy, and targeted therapy. The optimum therapeutic option for elderly individuals with advanced lung cancer must be selected carefully, taking into account both the risks and benefits. (Korean J Med 2014;87:537-541)