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진행성 비소세포 폐암에 대한 Mitomycin C, Vinblastine 및 Cisplatin(MVP) 3제 복합 화학요법의 치료 효과
김상위 ( Kim Sang Wi ),안명주 ( An Myeong Ju ),서철원 ( Seo Cheol Won ),이규형 ( Lee Gyu Hyeong ),이정신 ( Lee Jeong Sin ),고윤석 ( Go Yun Seog ),김우성 ( Kim U Seong ),김원동 ( Kim Won Dong ),김상희 ( Kim Sang Hui ) 대한내과학회 1993 대한내과학회지 Vol.44 No.2
연구배경 : 진행성 비소세포 폐암은 불치성 질환으로서 암사망의 중요한 원인을 차지하고 이에 대한 치료로는 항암 화학요법을 들 수 있으나 현재 30-40% 정도의 반응율이 보고되고 있는 실정이다. 이에 본 연구는 국내에서 진행성 비소세포 폐암 환자들을 대상으로 mitomycin C, vinblastine 및 cisplatin (MVP) 3제 복합 항암 화학요법을 실시하여 그 성적과 부작용을 관찰하고자 하였다. 방법 : 병기 Ⅲb 5예 및 Ⅳ기 28예의 비소세포 폐암을 대상으로 제1일째 cisplatin 60mg/㎡을 수액요법과 같이 점적 정주하고 제2일째 mitomycin C와 vinblastine을 6mg/㎡씩 급속 정주하였다. 치료는 매 3-4주 간격으로 반복하였으며 최소한 2회이상 실시하였다. 결과 : 총 33예중 본 치료에 의한 완전관해는 없었으나 부분관해는 9예(27%), 불변 15예(45%), 그리고 진행은 9예(27%)로서 27%의 반응율을 보였고 반응기간의 중앙치는 16주(4^+ -28주)이었다. 부작용은 경한 오심, 구토 및 말초 신경엽 증상과 중등도의 백혈구 감소중 등이 있었으나 그정도는 수용할 만한 것이었다. 결론 : 이상의 결과로 진행서 비소세포 폐암에서 mitomycin C, vinblatine 및 cisplatin 3제 복합 항암 화학요법은 심한 부작용 없이 중등도의 반응을 보였다. Background : Advanced non-small cell lung cancer (NSCLC) is still a lethal disease and one of the most important causes of cancer-related death. Role of systemic chemotherapy seems to be pallicative and showed objective response of 30-40%. We treated 33 patients with advanced NSCLC with combination therapy of mitomycin C, vinblastine, and cisplatin (MVP) to evaluate the clinical activity and side effect of this combination. Mothods : Cisplatin was infused intravenously on day l at the dose of 60mg/㎡ with pre-and post-hydration and mitomycin C 6mg/㎡ (maximum 10mg) and vinblastine 6mg/㎡ (maximum 8mg) were given intravenously on day 2. The treatiment was repeated every 3-4 weeks, and at least 2 cycles of chemotherapy were administered. Results : Nine patients (27%) had partial responses and no one had complete response. Median response duration was 16 weeks, reange (4+to 28 weeks). The toxicity included mild and transient nausea/vomiting, mild to moderate leukopenia, and mild peripheral neuropathy, All of them were well tolerated and recovered fully before the next cycle of chemotherapy. Conelusion : MVP combination chemotherapy is moderately active against advanced NSCLC and relatively well tolerated.
만성폐쇄성 폐질환과 승모판협착증 환자에서의 운동부하 검사
김상위(Sang We Kim),고윤석(Youn Suck Koh),김우성(Woo Sung Kim),김재중(Jae Joong Kim),박성욱(Seong Wook Park),박승정(Seung Jung Park),이종구(Jong Koo Lee),김원동(Won Dong Kim) 대한내과학회 1991 대한내과학회지 Vol.41 No.1
N/A There have been many conflicts concerning the mechanism of exercise limitation in chronic obstructive pulmonary disease (COPD) and mitral stenosis(MS). We performed exercise test with incremental cycle ergometer and measured ventilatory response and heart rate response in 10 normal controls, 10 COPD patients, and 10 MS patients. The results were as follows: (1) COPD and MS patients showed decreased maximal exercise capacity (67±16%, 54±4%, of maximal predicted oxygen uptake) compared with the control group (88±11%). (2) COPD patients showed much higher maximal minute ventilation, lower breathing reserve (100±17% of maximum predicted value, 7±6%), and normal anaerobic threshold (45±7% of maximal predicted oxygen uptake) compared with the MS patients (51±10%, 50±8% and 33±4%) and controls (59±15%, 46±125, and 56±9%), which indicated an exercise limitation due to an abnormality in the respiratory system. (3) The MS patients showed loawer anaerobic threshold, lower maximal minute ventilation, and normal breathing reserve compared with the COPD patients and normal controls, which indicate an exercise limitation due to an abnormality in the cardiovascular system. With the above results, it is thought that an incremental cycle ergometer exercise test is useful in diagnosing the limitation factor of maximal exercise in respiratory and cardiovascular system disease.