Cancer Research and Treatment

Original Articles

Breast cancer

Locoregional Recurrence in Adenoid Cystic Carcinoma of the Breast: A Retrospective, Multicenter Study (KROG 22-14): Sang Min Lee, Bum-Sup Jang, Won Park, Yong Bae Kim, Jin Ho Song, Jin Hee Kim, Tae Hyun Kim, In Ah Kim, Jong Hoon Lee, Sung-Ja Ahn, Kyubo Kim, Ah Ram Chang, Jeanny Kwon, Hae Jin Park, Kyung Hwan Shin; Cancer Res Treat. 2025;57(1):150-158. Published online July 12, 2024; DOI: https://doi.org/10.4143/crt.2024.201

Purpose
This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data.
Materials and Methods
A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed.
Results
Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS.
Conclusion
BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

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Adenoid Cystic Carcinoma of the Breast: A Narrative Review and Update on Management
Taylor Neilson, Zaibo Li, Christina Minami, Sara P. Myers
Cancers.2025; 17(7): 1079. CrossRef

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Clinical Usefulness of Hydromorphone-OROS in Improving Sleep Disturbances in Korean Cancer Patients: A Multicenter, Prospective, Open-Label Study: Seong Hoon Shin, Ho Sup Lee, Yang Soo Kim, Young Jin Choi, Sung Hyun Kim, Hyuk Chan Kwon, Sung Yong Oh, Jung Hun Kang, Chang Hak Sohn, Sang Min Lee, Jin Ho Baek, Young Joo Min, Choongrak Kim, Joo Seop Chung; Cancer Res Treat. 2014;46(4):331-338. Published online July 21, 2014; DOI: https://doi.org/10.4143/crt.2013.130

Abstract PDF PubReader ePub

Purpose
To evaluate the efficacy of hydromorphone-OROS (HM-OROS) in reducing sleep disturbance and relieving cancer pain. Materials and Methods One hundred twenty cancer patients with pain (numeric rating scale [NRS] ≥ 4) and sleep disturbance (NRS ≥ 4) were evaluated. The initial HM-OROS dosing was based on previous opioid dose (HM-OROS:oral morphine=1:5). Dose adjustment of the study drug was permitted at the investigator’s discretion. Pain intensity, number of breakthrough pain episodes, and quality of sleep were evaluated. Results A total of 120 patients received at least one dose of HM-OROS; 74 of them completed the final assessment. Compared to the previous opioids, HM-OROS reduced the average pain NRS from 5.3 to 4.1 (p < 0.01), worst pain NRS from 6.7 to 5.4 (p < 0.01), sleep disturbance NRS from 5.9 to 4.1 (p < 0.01), incidence of breakthrough pain at night from 2.63 to 1.53 times (p < 0.001), and immediate-release opioids use for the management of breakthrough pain from 0.83 to 0.39 times per night (p = 0.001). Of the 74 patients who completed the treatment, 83.7% indicated that they preferred HM-OROS to the previous medication. The adverse events (AEs) were somnolence, asthenia, constipation, dizziness, and nausea. Conclusion HM-OROS was efficacious in reducing cancer pain and associated sleep disturbances. The AEs were manageable.

Citations

Citations to this article as recorded by

Pain and Analgesic Related Insomnia
Jana Mlíchová, Zoltán Paluch, Ondřej Šimandl
Pain Management Nursing.2023; 24(3): 254. CrossRef
Initial titration with 200 μg fentanyl buccal tablets: a retrospective safety analysis in Korean cancer patients
Mi-Young Kwon, Ha-Na Cho, Dong-Hoe Koo, Yun-Gyoo Lee, Sukjoong Oh, Seung-Sei Lee
The Korean Journal of Internal Medicine.2018; 33(3): 577. CrossRef
Endogenous Opiates and Behavior: 2015
Richard J. Bodnar
Peptides.2017; 88: 126. CrossRef
Drug Formulation Advances in Extended-Release Medications for Pain Control
Mark R. Jones, Martin J. Carney, Rachel J. Kaye, Amit Prabhakar, Alan D. Kaye
Current Pain and Headache Reports.2016;[Epub] CrossRef
The Clinical Applications of Extended-Release Abuse-Deterrent Opioids
Nalini Vadivelu, Erika Schermer, Gopal Kodumudi, Jack M. Berger
CNS Drugs.2016; 30(7): 637. CrossRef
Once-Daily OROS Hydromorphone for Management of Cancer Pain: an Open-Label, Multi-Center, Non-Interventional Study
Cheol Kyu Park, Hyun-Wook Kang, In-Jae Oh, Young-Chul Kim, Yeo-Kyeoung Kim, Kook-Joo Na, Sung-Ja Ahn, Tae Ok Kim, Young Jin Choi, Geun Am Song, Min Ki Lee
Journal of Korean Medical Science.2016; 31(12): 1914. CrossRef

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An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea: Do Yeun Kim, Sang Min Lee, Kyoung Eun Lee, Hye Ran Lee, Jee Hyun Kim, Keun-Wook Lee, Jong Seok Lee, Soon Nam Lee; Cancer Res Treat. 2006;38(4):214-217. Published online December 31, 2006; DOI: https://doi.org/10.4143/crt.2006.38.4.214

Abstract PDF PubReader ePub

Purpose

We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not-resuscitate (DNR) consent on the use of intravenous nutrition during the patient's last week of life and at the time of death.

Materials and Methods

The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient's last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.

Results

In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient's surrogates did not have any effect on reducing the use of parenteral nutrition.

Conclusion

The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care.

Citations

Citations to this article as recorded by

Report of the Lancet Commission on the Value of Death: bringing death back into life
Libby Sallnow, Richard Smith, Sam H Ahmedzai, Afsan Bhadelia, Charlotte Chamberlain, Yali Cong, Brett Doble, Luckson Dullie, Robin Durie, Eric A Finkelstein, Sam Guglani, Melanie Hodson, Bettina S Husebø, Allan Kellehear, Celia Kitzinger, Felicia Marie Kn
The Lancet.2022; 399(10327): 837. CrossRef
A National Study of Life-Sustaining Treatments in South Korea: What Factors Affect Decision-Making?
So-Youn Park, Bomyee Lee, Jeong Yeon Seon, In-Hwan Oh
Cancer Research and Treatment.2021; 53(2): 593. CrossRef
The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan
Ying Hsin Hsu, Ming Yueh Chou, Hsiu-Min Chen, Wei-Cheng Chang, Che Sheng Chu, Yu-Chun Wang, Chiao-Lin Hsu, Chih-Kuang Liang, Ching-Chih Lee, Yu Te Lin
Journal of the American Medical Directors Association.2020; 21(6): 858. CrossRef
Implication of the Life-Sustaining Treatment Decisions Act on End-of-Life Care for Korean Terminal Patients
Jung Sun Kim, Shin Hye Yoo, Wonho Choi, Yejin Kim, Jinui Hong, Min Sun Kim, Hye Yoon Park, Bhumsuk Keam, Dae Seog Heo
Cancer Research and Treatment.2020; 52(3): 917. CrossRef
Nutrition Intervention through Interdisciplinary Medical Treatment in Hospice Patients: From Admission to Death
Hyelim Kang, Yu Jin Yang, Juyeon Park, Gyu Jin Heo, Jeong-Im Hong, Hye-Jin Kim
Clinical Nutrition Research.2018; 7(2): 146. CrossRef
Evidence for overuse of medical services around the world
Shannon Brownlee, Kalipso Chalkidou, Jenny Doust, Adam G Elshaug, Paul Glasziou, Iona Heath, Somil Nagpal, Vikas Saini, Divya Srivastava, Kelsey Chalmers, Deborah Korenstein
The Lancet.2017; 390(10090): 156. CrossRef
A Randomized Phase II Study To Assess the Effectiveness of Fluid Therapy or Intensive Nutritional Support on Survival in Patients with Advanced Cancer Who Cannot be Nourished via Enteral Route
So Yeon Oh, Hyun Jung Jun, Sung Jae Park, In Ki Park, Ga Jin Lim, Yeonsil Yu, Sung-Ja Cho, Aeran Song
Journal of Palliative Medicine.2014; 17(11): 1266. CrossRef
Evaluation of parenteral nutritional support in the surgical and medical wards of a referral teaching hospital
Samaneh Bairami, Sepideh Elyasi, Hossein Khalili, Saeed Reza Jamali-Moghadam
DARU Journal of Pharmaceutical Sciences.2012;[Epub] CrossRef
Awareness and Attitude Change after End-of-Life Care Education for Medical Students
Hyun Kyung Kim, Eunmi Nam, Kyoung Eun Lee, Soon Nam Lee
The Korean Journal of Hospice and Palliative Care.2012; 15(1): 30. CrossRef
Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy
Younsuck Koh, Dae-Seog Heo, Young Ho Yun, Jeong-Lim Moon, Hyoung Wook Park, Ji Tae Choung, Hyo Sung Jung, Bark Jang Byun, Yoon-Seong Lee
Journal of the Korean Medical Association.2011; 54(7): 747. CrossRef
Nasogastric feeding at the end of life: A virtue ethics approach
Lalit Krishna
Nursing Ethics.2011; 18(4): 485. CrossRef
Chinese Familial Tradition and Western Influence: A Case Study in Singapore on Decision Making at the End of Life
Zheng Jie Marc Ho, Lalit Kumar Radha Krishna, Chung Pheng Alethea Yee
Journal of Pain and Symptom Management.2010; 40(6): 932. CrossRef

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