성인여성의 인유두종바이러스와 자궁경부암 예방백신에 대한 지식, 암예방 수행 및 자궁경부암 예방백신 수용도 분석

송갑선,전은미,김주연 대한암예방학회 2013 Journal of cancer prevention Vol.18 No.1

This study was conducted to identify the knowledge of HPV and HPV vaccines and the acceptance of cancer preventive vaccine targeting adult women. The convenience sampling was conducted on subjects of 271 adult women who have visited Gynecologic Clinics residing in the B-city. For data analysis, it conducted the analysis of mean and standard deviation, t-test, ANOVA, and Pearson's Correlation Coefficient. The research results demonstrate that the knowledge about HPV vaccine was higher in less than 40's in their age, subjects over college-graduates, single status in marriage condition, and subjects who have jobs, but the knowledge appeared to be very low with mean score, 5.34 (range 0∼22). In terms of the performance of cancer prevention, subjects of college graduates, those who have religion and were in higher economic level, those who are married, have no job, have a sex-partner and sexually transmitted diseases experience specially made an effort to prevent cancer. Of the subjects, 66.7% responded that they had a will to receive HPV vaccination and 86% subjects wanted to make their children vaccinate. In addition, there was no correlation found between the knowledge of HPV vaccine and the cancer- preventive performance.

The Frequency of and Risk Factors for the Use of Bisphosphonates in the Adjuvant Setting of Primary Breast Cancer in Germany

Eva-Maria Fick,Alexander Katalinic,Annika Waldmann 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose The aim of this cross-sectional health care study (use of bisphosphonates in primary tumorsof the mammae, EBisMa) is to determine how often bisphosphonate medication is used inpatients with non-metastatic primary breast cancer treatment, but who do not suffer fromosteoporosis. Furthermore, we describe patients’ characteristics and the most frequentlyused type of bisphosphonate in adjuvant therapy. Materials and MethodsThe study population included primary breast cancer patients of four breast centers in northernGermany. Data on bisphosphonate therapy were collected by use of patient questionnaires;clinical data were extracted from the registers. Patients with and without prescribedbisphosphonate adjuvant treatment were tested for statistically significant differencesregarding their characteristics. ResultsFour hundred seventy-four of 663 contacted patients participated in the study. Thirty-nineout of 474 patients (9.6%) were on adjuvant bisphosphonate therapy. Zoledronic acid wasthe most frequently reported bisphosphonate used for prevention of bone metastases. Comparedto patients who did not report bisphosphonate medication, women who did reportbisphosphonate therapy had a significantly higher advanced tumor stage (p < 0.001). Boththe T2-T4 stage and N+ stage remained significant predictors in multivariate-adjustedregression models. ConclusionBisphosphonates are rarely used in the adjuvant treatment of primary breast cancer. Patients with advanced tumor stage were more likely to use bisphosphonates in the adjuvanttreatment of primary breast cancer. Further research is needed to identify patientswho may benefit most from adjuvant bisphosphonate treatment.

Using the Lymph Node Ratio to Evaluate the Prognosis of Stage II/III Breast Cancer Patients Who Received Neoadjuvant Chemotherapy and Mastectomy

San-Gang Wu,Qun-Li Zeng,Juan Zhou,Jia-Yuan Sun,Fengyan Li,Qin Lin,Huan-Xin Lin,Xun-Xing Gaun,Zhen-Yu He 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose This study was conducted to investigate the prognostic value of lymph node ratio (LNR) instage II/III breast cancer patients who undergo mastectomy after neoadjuvant chemotherapy. Materials and MethodsClinical and pathological data describing stage II/III breast cancer patients were includedin this retrospective study. The primary outcomes were locoregional recurrence-free survival(LRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overallsurvival (OS). ResultsAmong 277 patients, there were 43 ypN0, 64 ypN1, 89 ypN2, and 81 ypN3 cases. Additionally, there were 43, 57, 92 and 85 cases in the LNR 0, 0.01-0.20, 0.21-0.65, and> 0.65 groups, respectively. The median follow-up was 49.5 months. Univariate analysisshowed that both ypN stage and LNR were prognostic factors of LRFS, DMFS, DFS, and OS(p < 0.05). Multivariate analysis showed that LNR was an independent prognostic factor ofLRFS, DMFS, DFS, and OS (p < 0.05), while ypN stage had no effect on prognosis (p > 0.05). ConclusionThe integrated use of LNR and ypN may be suitable for evaluation the prognosis of stageII/III breast cancer patients who undergo mastectomy after neoadjuvant chemotherapy.

Can Serum be Used for Analyzing the KRASMutation Status in Patients with Advanced Colorectal Cancer?

김승태,장원진,Lihua Jin,성재숙,최윤지,김열홍 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose KRASmutations have been used widely as prognostic or predictive marker in patients withadvanced colorectal cancer (CRC). However, it may be difficult to obtain a tumor tissue foranalyzing the status of KRAS mutation in large proportion of patients with advanceddisease. Materials and MethodsWe obtained pairs of tumor and serum samples from 65 patients with advanced CRC,between March 2008 and July 2011. KRAS mutation status from the tumor samples wasanalyzed by genomic polymerase chain reaction and direct sequence, and KRASmutationstatus from the serum samples was determined by a genomic polymerase chain reaction–restriction fragment length polymorphism assay. ResultsKRAS mutations were detected in the serum samples of 26 patients and in the tumorsamples of 31 patients. KRAS mutation status in the serum and tumor samples wasconsistent in 44 of the 65 pairs (67.7%). There was a significant correlation between themutations detected in the serum sample and the mutations detected in the matched tumorsample (correlation index, 0.35; p < 0.004). Twenty-two of the 57 patients (38.5%) receivedanti-epidermal growth factor receptor therapy as any line therapy. There was no significantdifference in the overall survival (OS) in accordance to the status of KRASmutations in boththe serum and tumor samples (p > 0.05). In a multivariate analysis, liver metastasis andno cytoreductive operation were independent prognostic factors for decreased OS. ConclusionThe serum sample might alternatively be used when it is difficult to obtain

ATAD2 as a Poor Prognostic Marker for Hepatocellular Carcinoma after Curative Resection

황혜원,하상윤,방희진,박철근 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose Cancer cells frequently express genes that are specifically or preferentially expressed inmale germ cells under normal conditions. The ATPase family AAA domain-containing 2(ATAD2) is one such and works as an important cofactor for MYC-dependent transcription. In hepatocellular carcinoma (HCC), ATAD2 has been identified as a candidate driver genelocated within the amplified 8q24 locus. However, the prognostic significance of ATAD2protein expression in HCC remains uncertain. Materials and MethodsWe investigated ATAD2 protein expression by immunohistochemistry in tumor tissue from182 HCC patients who underwent curative resection. Associations of ATAD2 expressionwith clinicopathologic variables or prognosis of HCC patients were analyzed. ResultsATAD2 expression was observed in 119 (65.4%) of the 182 HCCs and tended to be independentpredictor of early recurrence (p=0.059). ATAD2 expression showed an unfavorableinfluence on recurrence-free survival (RFS) (p < 0.001). Subgroup analysis among patientswith tumor size ! 5.0 cm (n=109), patients at Barcelona Clinic Liver Cancer stage 0 or A(n=92), and patients with "-fetoprotein ! 20 ng/mL (n=61), the ATAD2-positive groupsunfavorably influenced RFS (p=0.008, p=0.009, and p=0.013, respectively). In addition,ATAD2 expression was an independent predictor of shorter RFS (p=0.002). ATAD2 expressionshowed an unfavorable influence on disease-specific survival (p=0.001), but was notan independent predictor of shorter disease-specific survival (p=0.109). ConclusionATAD2 protein expression may be a potential predictor of RFS in HCC patients after curativeresection and ATAD2 may have prognostic value in patients with early stage HCC or normalserum "-fetoprotein level.

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2011

정규원,원영주,공현주,오창모,이덕형,이진수 대한암학회 2014 Cancer Research and Treatment Vol.46 No.2

PurposeThis study aimed to report nationwide cancer statistics in Korea, including incidence,mortality, survival, and prevalence, and their trends. Materials and MethodsIncidence data from 1993 to 2011 were obtained from the Korea National CancerIncidence Database, and vital status was followed through December 31, 2012. Mortality data from 1983 to 2011 were obtained from Statistics Korea. Crude andage-standardized rates for incidence, mortality, and prevalence, and relative survivalwere calculated. ResultsA total of 218,017 cancer cases and 71,579 cancer deaths were reported to haveoccurred in 2011, and there were 1,097,253 prevalent cases identified in Korea asof January 1, 2012. Over the past 13 years (1999-2011), overall incidence rates haveincreased by 3.4% per year. The incidence rates of liver and cervical cancers havedecreased, while those of thyroid, breast, prostate, and colorectal cancers haveincreased. Notably, thyroid cancer increased by 23.3% per year in both sexes, andbecame the most common cancer since 2009. The mortality for all cancers combineddecreased by 2.7% per year from 2002 to 2011. Five-year relative survival rates ofpatients diagnosed in the last 5 years (2007-2011) have improved by 25.1%compared with those from 1993 to 1995. ConclusionOverall cancer mortality rates have declined since 2002 in Korea, while incidencehas increased rapidly and survival has improved.

Dosimetric and Clinical Influence of 3D Versus 2D Planning in Postoperative Radiation Therapy for Gastric Cancer

이정애,안용찬,임도훈,박희철,Margarita S. Asranbaeva 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose The purpose of this study is to investigate the dosimetric and clinical influence of computedtomography–based (3-dimensional [3D]) simulation versus conventional 2-dimensional(2D)–based simulation in postoperative chemoradiotherapy (CRT) for patients withadvanced gastric cancer in terms of parallel opposed anteroposterior-posteroanterior fieldarrangement. Materials and MethodsA retrospective stage-matched cohort study was conducted in 158 patients treated withadjuvant CRT following curative surgery and D2 dissection from 2006 to 2008 at SamsungMedical Center: 98 patients in the 3D group; and 60 patients in the 2D group. For comparisonof the dosimetric parameters between 3D plan and 2D plan, second sets of radiationtreatment plans were generated according to the same target delineation method used inthe 2D group for each patient in the 3D group (V2D). Acute toxicity, recurrence, and survivalwere analyzed. The median follow-up period was 28 months (range, 5 to 51 months). ResultsThe 3D group showed better dose-volume histogram (DVH) profiles than the V2D group forall dosimetric parameters, including the kidneys, liver, spinal cord, duodenum, pancreas,and bowel. However, no difference in acute gastrointestinal toxicity and survival outcomeswas observed between the 3D group and the 2D group. ConclusionThe 3D plan enabled precise delineation of the target volume and organs at risk by visualizationof geometric changes in the internal organs after surgery. The DVH of normal tissuesin the 3D plan was superior to that of the V2D plan, but similar clinical features wereobserved between the 3D group and the 2D group.

Prediction of Cancer Incidence and Mortality in Korea, 2014

정규원,원영주,공현주,오창모,이덕형,이진수 대한암학회 2014 Cancer Research and Treatment Vol.46 No.2

PurposeWe studied and reported on cancer incidence and mortality rates as projected for theyear 2014 in order to estimate Korea’s current cancer burden. Materials and MethodsCancer incidence data from 1999 to 2011 were obtained from the Korea NationalCancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquiredfrom Statistics Korea. Cancer incidence in 2014 was projected by fitting a linearregression model to observed age-specific cancer incidence rates against observedyears, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regressionmodel was used to determine at which year the linear trend changed significantly. ResultsA total of 265,813 new cancer cases and 74,981 cancer deaths are expected tooccur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sitescombined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rateare projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostatecancer cases, it is anticipated to be the fourth most frequently occurring cancer sitein men for the first time. ConclusionCancer has become the most prominent public health concern in Korea, and as thepopulation ages, the nation’s cancer burden will continue to increase.

Palliative Radiotherapy in the Presence of Well-Controlled Metastatic Disease after Initial Chemotherapy May Prolong Survival in Patients with Metastatic Esophageal and Gastric Cancer

Mohan Hingorani,Sanjay Dixit,Miriam Johnson,Victoria Plested,Kevin Alty,Peter Colley,Andrew W. Beavis,Rajarshi Roy,Anthony Maraveyas 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose We report the outcomes of patients treated with palliative radiotherapy (pRT) to the primarytumour in the context of well-controlled metastatic disease after initial chemotherapy. Materials and MethodsClinical records of 132 patients with metastatic esophago-gastric (OG) cancer treated withpalliative chemotherapy (pCT) between January 2009 and June 2013 were reviewed. Ninetysevenpatients had responding or stable disease after 3 months of chemotherapy, of whom53 patients received pRT to the primary tumour after initial chemotherapy in the presenceof well-controlled metastatic disease (group A, pCT-RT). The remaining 44 patients weretreated with pCT alone (group B, pCT). Treatment-related outcomes were assessed in abovegroups including time to local progression (TTLP), progression-free and overall survival. ResultsThe median overall survival for patients treated with pRT after initial chemotherapy (groupA) was 23.3 months (95% confidence interval [CI], 17.70 to 28.89 months) and significantlyhigher than the 14 months (95% CI, 10.91 to 17.08 months) in patients treated with pCTalone (group B) (p < 0.001). The use of pCT-RT was an independent predictor of OS in multivariateanalysis. Local recurrence was observed in 12/53 of patients (23%) in group Acompared to 16/44 (36%) in group B. The median TTLP was significantly higher in patientsafter pCT-RT at 17.3 months (5.23 months to 44.50 months) compared to 8.3 months(range, 4.10 to 25.23 months) in patients treated with pCT alone (p=0.006). ConclusionThe possibility of pRT influencing systemic disease in advanced OG cancer has not beenreported, and results from the present study present strong arguments for investigation ofthis therapeutic strategy in a randomized trial.

Interstitial Lung Change in Pre-radiation Therapy Computed Tomography Is a Risk Factor for Severe Radiation Pneumonitis

이윤희,김연실,이상남,이효천,오세진,김승준,김영균,한대희,유이령,강진형,홍숙희 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose We examined clinical and dosimetric factors as predictors of symptomatic radiation pneumonitis(RP) in lung cancer patients and evaluated the relationship between interstitial lungchanges in the pre-radiotherapy (RT) computed tomography (CT) and symptomatic RP. Materials and MethodsMedical records and dose volume histogram data of 60 lung cancer patients from August2005 to July 2006 were analyzed. All patients were treated with three dimensional (3D)conformal RT of median 56.9 Gy. We assessed the association of symptomatic RP with clinicaland dosimetric factors. ResultsWith a median follow-up of 15.5 months (range, 6.1 to 40.9 months), Radiation TherapyOncology Group grade ! 2 RP was observed in 14 patients (23.3%). Five patients (8.3%)died from RP. The interstitial changes in the pre-RT chest CT, mean lung dose (MLD), andV30 significantly predicted RP in multivariable analysis (p=0.009, p < 0.001, and p < 0.001,respectively). MLD, V20, V30, and normal tissue complication probability normal tissue complicationprobability (NTCP) were associated with the RP grade but less so for grade 5 RP. The risk of RP grade ! 2, ! 3, or ! 4 was higher in the patients with interstitial lung change(grade 2, 15.6% to 46.7%, p=0.03; grade 3, 4.4% to 40%, p=0.002; grade 4, 4.4% to 33.3%,p=0.008). Four of the grade 5 RP patients had diffuse interstitial change in pre-RT CT andreceived chemoradiotherapy. ConclusionOur study identified diffuse interstitial disease as a significant clinical risk for RP, particularlyfatal RP. We showed the usefulness of MLD, V20, V30, and NTCP in predicting the incidenceand severity of RP.