Browsing by Author "Chang, Yue-Cune"

Now showing 1 - 3 of 3

Comparing the Effectiveness of Combined External Beam Radiation and Hyperthermia Versus External Beam Radiation Alone in Treating Patients With Painful Bony Metastases: A Phase 3 Prospective, Randomized, Controlled Trial
(2018-01-01)
Chi, Mau-Shin
;
Yang, Kai-Lin
;
Chang, Yue-Cune
;
Ko, Hui-Ling
;
Lin, Yi-Hsien
Purpose: To compare the response, duration of pain relief, and time to achieve complete pain relief after radiation therapy (RT) with or without hyperthermia (HT) in patients with painful bony metastases. Methods and Materials: Cancer patients with bony metastases and pain score >= 4 on the Brief Pain Inventory (BPI) were randomized to RT of 30 Gy in 10 fractions combined with HT (RT + HT) versus RT alone. Hyperthermia was performed by the Thermotron RF-8, with maintenance of the target temperature for 40 minutes per treatment within 2 hours after RT, twice weekly for 2 weeks. Patients were stratified by lesion number (solitary or multiple), BPI score (4-6 vs 7-10), and primary site. The primary endpoint was complete response (CR) (BPI = 0 with no increase of analgesics) within 3 months after treatment. This study was registered with ClinicalTrials.gov. Results: The study was terminated early after an interim analysis of 57 patients, 3 years after the first enrollment (November 2013 to November 2016): 29 patients in the RT + HT group and 28 patients in the RT-alone group. The CR rate at 3 months after treatment was 37.9% in the RT + HT group versus 7.1% in the RT-alone group (P=.006). The accumulated CR rate within 3 months after treatment was 58.6% in the RT + HT group versus 32.1% in the RT-alone group (P=.045). Median time to pain progression was 55 days in patients with CR (n=9) in the RT-alone group, whereas the endpoint was not reached during the 24-week follow-up in the RT + HT group (P<.01). Conclusions: The addition of HT to RT significantly increases the pain control rate and extends response duration compared with RT alone for painful bony metastases. (C) 2017 Elsevier Inc. All rights reserved.
Persistent cognitive decline in older hospitalized patients in Taiwan
(2010-09-01)
Chen, Cheryl Chia-Hui
;
Chang, Yue-Cune
;
Huang, Guan-Hua
;
Peng, Jui-Hua
;
Tseng, Chien-Ning
P>Aim. This paper is a report of a study conducted to determine the prevalence and predictors of persistent and transient cognitive decline in older hospitalized patients over 6 months after hospital discharge. Background. Cognitive decline occurs in 16-35 center dot 5% of older hospitalized patients, but this decline may be persistent rather than transient. Distinguishing persistent from transient cognitive decline is clinically useful. Methods. For this prospective cohort study, 291 older patients were recruited from five medical and surgical units at a tertiary medical centre in Taiwan between 2004 and 2006. Participants were assessed for cognitive status by scores on the Mini-Mental State Examination at admission, discharge, 3 and 6 months postdischarge. Persistent cognitive decline was defined as continuing score reduction and >= 3-point reduction 6 months postdischarge. Transient decline was defined as >= 3-point reduction at some stage, with a total decline < 3 points 6 months postdischarge. Findings. The cognitive status of the majority of participants (57 center dot 4%, n = 167) decreased >= 3 points during follow-up. Of these decliners, 59 (35 center dot 3%) had persistent cognitive decline, with an average 5 center dot 32-point reduction 6 months postdischarge. Forty-six (27 center dot 5%) participants experienced transient cognitive decline. After multiple adjustments in logistic regression analysis, persistent decline was predicted by no in-hospital functional decline (OR = 0 center dot 16, P = 0 center dot 002), more re-admissions after discharge (OR = 2 center dot 42, P = 0 center dot 020), and older age (OR = 1 center dot 09, P = 0 center dot 048). Conclusion. A new perspective is needed on discharge planning on patients at risk for persistent cognitive decline. Nurses can oversee the delivery of care, identify cognitive decline, refer patients, and educate families on strategies to enhance cognitive functioning for their aging relatives.
Pharmacologically upregulated carcinoembryonic antigen-expression enhances the cytolytic activity of genetically-modified chimeric antigen receptor NK-92MI against colorectal cancer cells
(2018-08-03)
Shiozawa, Masayuki
;
Chang, Chuan-Hsin
;
Huang, Yi-Chun
;
Chen, Yi-Ching
;
Chi, Mau-Shin
Background: The natural killer cell line, NK-92MI, is cytotoxic against various types of cancer. The aim of this study was to develop chimeric antigen receptor-modified (CAR) NK-92MI cells targeting carcinoembryonic antigen-expressing (CEA) tumours and increase killing efficacy by pharmacologically modifying CEA-expression. Result: We generated anti-CEA-CAR NK-92MI cells by retroviral vector transduction. This genetically-modified cell line recognised and lysed high CEA-expressing tumour cell lines (LS174T) at 47.54 +/- 12.60% and moderate CEA-expressing tumour cell lines (WiDr) at 31.14 +/- 16.92% at a 5:1 effector: target (E/T) ratio. The cell line did not lyse low CEA-expressing tumour cells (HCT116) as they did their parental cells (NK-92MI cells). The histone deacetylase-inhibitor (HDAC) sodium butyrate (NaB) and the methylation-inhibitor 5-azacytidine (5-AZA), as epigenetic modifiers, induced CEA-expression in HCT116 and WiDr cells. Although the IC50 of 5 fluorouracil (5-FU) increased, both cell lines showed collateral sensitivity to anti-CEA-CAR NK-92MI cells. The cytolytic function of anti-CEA-CAR NK-92MI cells was increased from 22.99 +/- 2.04% of lysis background to 69.20 +/- 11.92% after NaB treatment, and 69.70 +/- 9.93% after 5-AZA treatment, at a 10:1 UT ratio in HCT116 cells. The WiDr cells showed similar trend, from 22.99 +/- 4.01% of lysis background to 70.69 +/- 10.19% after NaB treatment, and 59.44 +/- 10.92% after 5-AZA treatment, at a 10:1 E/T ratio. Conclusions: This data indicates that the effector-ability of anti-CEA-CAR NK-92MI increased in a CEA-dependent manner. The combination of epigenetic-modifiers like HDAC-inhibitors, methylation-inhibitors, and adoptive-transfer of ex vivo-expanded allogeneic-NK cells may be clinically applicable to patients with in 5-FU resistant condition.