Cancer Research and Treatment

Establishment of SNUH Cell Lines in Serum - free Defined Medium and SNU Cell Lines in Serum Supplemented Medium: Jae Gahb Park, Nam Sook Kwon, Jin Pok Kim, Seung Keun Oh, Kuhn Uk Lee, Kuk Jin Choe, Soo Tae Kim, Yung Jue Bang, Noe Kyeong Kim, Soon Beom Kang, Myon Woo Shin, Sang Hoon Lee, Joo Hyun Kim, Chong Wook; J Korean Cancer Assoc. 1988;20(2):105-117.

Abstract PDF: Serum-free, defined medium ACL-4 has proven to be useful for the establishment and maintenance of human colorectal carcinoma and lung adenocarcinoma cell lines. To determine the general usefulness of ACL-4 as a medium for establishing cell lines, we compared the growth of cells from many different tumor specimens in R10, ACL-4 and AR5 (ACL-4 plus 5% FBS). From June 1987 to July 1988, 69 specimens from a wide variety of human tumors were cultured in R10 and ACL-4 or AR5. Eleven cancer cell lines were established ...... seven cell lines (4 stomach carcinoma, 1 rectal carcinoma, 1 ovarian carcinoma, 1 osteosarcoma) in R10; two cell lines (1 uterine cervical cancer, 1 laryngeal carcinoma) in ACL-4; and two cell lines in AR5 (1 colon carcinoma, 1 rectal carcinoma) (Table I & 2). Of interest, two B lymphoblastoid (non-neoplastic) cell iines were established from a stomach cancer and an acute myeloblastic leukemia specimen grown in ACL-4. We have found that sodium pyruvate, transferrin, and insulin were very important for the growth of uterine cervical cancer cells. Early in this study, we also found that fibroblast growth was effectively suppressed by culturing tumor cells in the serum free medium ACL-4. Therefore, in later attempts, when possible loss of cultures by fibroblast overgrowth was observed, serum containing media were replaced by ACL-4 to suppress and eventually eliniinate the fibroblast contamination. Although we were able tu establish only 11 new cancer cell lines from 69 specimens, our study has extended the use of ACL-4 medium with or without serum for the growth of uterine cervical and laryngeal cancer cells.

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Effect of Radiofrequency Hyperthermia on Hepatocellular Carcinoma - Preliminary report -: Chang Ok Suh, John J. K. Loh, Jin Sil Seong, Jae Kyung Roh, Byung Soo Kim, In Suh Park, Heung Jae Choi; J Korean Cancer Assoc. 1988;20(2):117-126.

Abstract PDF: Effectiveness of hyperthermia in the treatment of hepatocellular carcinoma was evaluated by the restrospective analysis of 31 patients who received radiofrequency hyperthermia at Department of Radiation Oncology, Yonsei Cancer Center, Yonsei Univ. College of Medicine between May 1985 and March 198B. All patients had advanced unresectable tumors, either unsuitable or re,fractory to conventional treatment modalities. B MHz radiofrequency capacitive type of hyperthermia was used either alone (1 case) or combined with other treatment modalities; i.e. 16 cases with external radiation, 7 cases with chemotherapy, 4 cases with l-131 Lipoidol and 3 cases with external radiation+ chemotherapy. Hyperthermia was given once or twice a week, usually 30 minutes after radiotherapy or chemotherapy. External radiotherapy was given with an average dose of 2,500-3000 cGy in 3 weeks. Response rate (CR! PR+ MR) was 32.3% (10/31); CR was achieved in one patient, PRa in 2 cases, PRb in 4 cases, and MR in 3 cases. All responders except for one received external radiotherapy with hyperthermia. Response rate of the patients who received combined radiotherapy and hyperth- ermia was 47.4% (9/19). On the other hand, only one of tweleve patients who received combination of hyperthermia and chemotherapy or I-131-Lipiodol showed partial response. As a result, hyperthermia was more effective when combined with external radiation than when combining with chemotherapy or other modality. In conclusion, hyperthermia, combined with external radiotherapy, is promising treatment method in the management of unresectable hepatocelluar carcinomas.

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Restoration of Adriamycin and Vincristine Dependent Tumoricidal Activity by Ginseng Saponin in Mice with Implanted Tumor Cells: Won Young Lee, Won Young Lee, Joo Deuk Kim, Eun Hee Koh, Byung Soo Kim; J Korean Cancer Assoc. 1988;20(2):126-133.

Abstract PDF: The survival of implanted tumor cells in mice which had been treated with ginseng saponin in combination with either adriamycin or vincristine was evaluated. While the majority of tumor cells implanted into normal mice failed to surive(52.1 to 63.%), most of those implanted into mice which had been pretreated with either adriamycin or vincristine survived. If the mice were secondarily treated with ginseng saponin, the ability of adriamycin or vincristine to inhibit the survival of implawted tumor cells was restored within 24 hours. Restoration of tumoricidal activity by ginseng saponin treatment was more evident in the adriamycin pretreated mice. Peritoneal macrophages isolated from mice pretreated with both ginseng saponin and adriamycin had more increased tumoricidal activity, when compared with those isolated from mice treatcd with adriamycin alone. This ginseng saponin enhancement of tumoricidal activity was comparable to that obtained by treating mice with lymphokines, a product of PPD stimulated lymphocytes isolated from BCG treated mice. These results suggested that both adriamycin and vincristine may damage the macrophages required for the natural host defense machanism and allow the implanted tumar cells to survive. Ginseng saponin may, however, protect the macrophages from drug induced damage.

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Inhibition of Development of Benzo(a)purene-induced Mouse Pulmonary Adenoma by Several Natural Products in medium-term Bioassay System: Taik Koo Yun, Sung Ho Kim; J Korean Cancer Assoc. 1988;20(2):133-143.

Abstract PDF: The present experiment adopted the nine week medium-term bioassay system that was established at the auturs' laboratory. In the nine week medium-term assay system,500 ug of benzo(a)pyrene were injected to non-inbred NIH

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Treatment Results of Non - operative Treatment Modality in Esophageal Cancer: John Juhn Kyu Loh, Kyung Ran Park, Chang Ok Suh, Chang Ok Suh, Seung Nok Hong, Byung Soo Kim; J Korean Cancer Assoc. 1988;20(2):143-153.

Abstract PDF: This report is a retrospective study of 99 patients with squamous cell carcinoma of the esophagus, treated with non-operative treatment modality (radiation therapy alone or chemotherapy and radiation therapy) or esophagectomy and radiation therapy+chemotherapy between January 1980 and December 1986. Of 99 patients, fifty three patients received definitive treatment as a curative intent and forty six patients received palliative treatment. Two year survival rate of definitive and palliative group was 24% (median survival of 11.3 months) and 1.5% (median survival of 4.4 months) respectively. Of 53 patients with definitive group, 33 patients were treated by radiation alone, 10 patients were treated by chemotherapy and radiation, and 10 patients were treated by esophagectomy and radiation+chemotherapy. Two year survival rate of radiation alone, chemother- apy and radaition, and esophagectomy and radiation+chemotherapy was 20/i, 33.6%, and 23% respectively. There wasno statistical significance in 2 year survival rate between non-operative and surgical group. Of 46 patients with palliative group, 33 patients (72%) showed symptomatic relief. In conclusion, it is our feeling that surgical intervention may not be necessary in definitive management of esophageal cancer on basis of this study although it is difficult to draw definite conclusion because this report is the retrospective study and the number of patients population is small.

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Clinical Significance of Squamous Cell Carcinoma Associated Antigen in Patients With Invasive Carcinoma of Uterine Cervix: Soo Nyung Kim, Dong Hee Choi, Sung Ho Kang, Tchan Kyu Park; J Korean Cancer Assoc. 1988;20(2):153-160.

Abstract PDF: The squamous cell carcinoma antigen, SCC antigen, is a subfraction of TA-4 tumor antigen which is purified from squamous cell carcinoma tissue of the uterine cervix. Recently, it has been found to be elevated in patients wit.h squamous cell carcinoma. In this study, SCC antigen levels in sera from 43 patients with invasive cervical carcinoma, 10 healthy women, and 10 patients with various behign gynecologic tumors were detennined by radioimmunoassay. The results were summarized as follows: 1) The mean value and positive rate af SCC antigen were higher in invasive cervical cancer (4.6 ng/ ml and 58.1%. respectively) compared with control (1.0 ng/ml and 0%, respectively) and benign gynecologic diseases (1.7 ng/ml and 30.0%, respectively). 2) Mean value of serum SCC antigen before treatment was 2.8 ng/ml in stage I, 4.8 ng/ml in stage lI, and 10.8 in stage lII nr IV, and 2.6 in recurrent cervical carcinoma, respectively. There was an increasing serum SCC antigen value with advancing stage, however, there were no significant differences in the mean values of seum SCC antigen according to stage. 3) Serum Scc antigen values above 2,0 ng/ml were observed in 35.7% of patients with stage I, 73.7 % with stage II, 60.0% with stage III or IV, and 60% with recurrent disease, respectively. According to stage uf ceivical cancer, the posit.ive rate of SCC antigen in stage II or more was higher than stage 1. 4) Mean value of serum SCC antigen level was more elevated in patients with squamous cell carcinoma(53 ng,"ml) than in patients with endocervical adenocarcinoma (1.3 ng/ml). However, this difference was not statistically significant. 5) SCC antigen values were serially determined in eight cases of invasive cervical carcinoma. In patients with cervical cancer who shawed an elevated pretreatment value, the serial determination of SCC antigen correlated well with the clinical course. It would be suggested that serial serum SCC antigen measurements, especially in the cases with high pretreatment antigen levels of the antigen, may be helpful in the early detection of persistent or recurrent cervical cancer and in determining therapeutic response after treatment.

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Clinico - pathological Study of Endometrial Cancer in Seoul National University Hospital: Soon Beom Kang, Dong Geun Chung, Seung Cheol Kim, Hyo Pyo Lee, Myon Woo Shin; J Korean Cancer Assoc. 1988;20(2):160-172.

Abstract PDF: Clinical and pathological studies were performed on 56 patients with endometrial cancer who were diagnosed and treated in the Department of OB/GY of Seoul National University Hospital from Jan. 1975 ta Dec. 1986. The results were as follows; 1) Of 56 cases, 17 (30.4%) were in stage la, 22 (39.3%) in stage Ib, 5 (8.9%) in stage II, 10 (17.9%) in stage III, and 2 (3.6%) in stage IV according to FIGO classification. 2) The average age was 54.2 and the range 28 to 73. 3) Forty two (75.0%) patients were postmenopausal and the average menopausal age was 49.8 years. 4) All cases except two were symptomatic and in 51 (91.9%) cases, abnormal vaginal bleeding was noted as a chief complaint. 5) The major complications were obesity (37.5%), hypertension (48.2%), diabetes mellitus (16.1%), and irifertility (23.2%). In 5 cases (8.9%), obesity, hypertension, and diabetes mellitus were complicated at the same time. 6) When the depth of the invasion was classified into 3 grades, less than 1/3 of the muscular layer, between 1/3 and 2/3, and over 2/3 in 52 cases examined, they were observed in 15 (2S.8%), 9 (17.3%), 14 cases (26.9%) respectively. And in 14 cases (26.9%), there was no myometrial invasion and the cancer was limited within the endometrium. 7) There were 2 cases (11.1%) with lymph node involvement in 18 cases examined. In one case, the depth of myometrial invasion was less than I/3, and in another case, the depth of invasion was over 2/3. And the histological grade of these cases was G2 in both. 8) The three year survival rate was 69.7% (23/33) for all cases. The clinical stage and age of the patients may be correlated with t.he prognosis of the endometrial cancer (p<0.05). 9) The three year survival rate for the group treated by surgical treatment with pelvic lymph node dissection was 100% (9/9) which was significantly higher than the 68.2% (15/22) of the group treated by simple hysterectomy (p<0.05). We can think that the effort to diagnose the endometrial cancers in the earlier clinical stages and the surgical treatment with pelvic lymph node dissection may improve the prognosis of the endometrial cancer.

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Combined Radiotherapy and Hyperthermia for Locally Advanced Cervical Carcinoma: John Juhn Kyu Loh, Jin Sil Seong, Chang Ok Suh, Gwi Eon Kim, Byung Soo Kim, Jae Wook Kim, Tchan Kyu Park; J Korean Cancer Assoc. 1988;20(2):172-180.

Abstract PDF: Twenty-one patients with locally advanced cervical carcinoma, who all thought to refractory to conventional treatment modality, i.e., mass size above 5 cm in shortest diameter and/or had poor response to radiotherapy at the dose of 3000 cGy/3 wk, treated with combined radiotherapy and hyperthermia between May 1985 and December 1987, at the Dept. of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, were retrospectively analysed. 8 MHz radiofrequency capacitive type of hyperthermia was combined with radiotherapy in 21 patients. Extemal radiothcrapy with a total dose of 4500-6000 cGy/4-6 wk and high dose rate ICR with a total dose 3000-390(l cGy in 10-13 fractions/4 wks were given. Hyperthermia was given twice a week with a total of 4 10 treatment sessions. In all cases hyperthermia was given within 30 minutes after radiotherapy. Temperature was measured by inserting thermocouple through the vaginal fornix and an attempt was made to maintain 40C or above for at least 30 minutes. As a result, CR was achived in 15 patients(17%), and PR in 6 patients. The overall response rate was 100%. Side effects were 1 case of pelvic abscess, 2 second degree burn, and 4 fat necrosis, and prognostic factors associated with tumor response.

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Adenocarcinoma of the Uterine Corpus Following Irradiation for cervical Cancer: Gun Chae Park, Yoo Kon Kim, Soo Nyung Kim, Tchan Kyu Park; J Korean Cancer Assoc. 1988;20(2):180-185.

Abstract PDF: The incidence of malignancy of the uterine corpus following radiation therapy for carcinoma of the cervix is rare. The prognosis is generally poor due to failure of early diagnosis, deep mvometrial invasion and low grade differentiation. We report two cases of adenocarcinoma of the uterine corpus following irradiation for cervical carcinoma and its literatures are briefly reviewed.

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