Initial combined treatment with anticholinergics and a-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with a-blocker for initial treatment of both overactive bladder (OAB) and other lower urinary tract symptoms (LUTS), secondary to BPH. A 12-week, randomized, double-blind, placebo-controlled trial was conducted at four urology clinics in Korea, involving men, aged 50 years or older, with LUTS related to BPH and OAB. A total of 176 patients were randomly assigned to receive doxazosin (4 mg) plus placebo or doxazosin (4 mg) plus tolterodine SR (4 mg), once a day for 12 weeks. Changes from baseline in total International Prostate Symptom Score (IPSS), bladder diary variables, patient perception of bladder condition (PPBC), uroflowmetry, postvoid residual volume and IPSS subscores (voiding and storage) were analyzed. Of the 176 enrolled patients, 91 had doxazosin gastrointestinal therapeutic system (GITS) and placebo, and 85 had combined medication with doxazosin GITS and tolterodine SR. Compared with the doxazosin plus placebo group, the doxazosin plus tolterodine group showed significant reductions in IPSS storage subscore and improvement in the quality of life item, urgency episodes, as well as in micturition frequency at weeks 4 and 12. However, it failed to improve PPBC at week 4 as well as at week 12. Earlier intervention with anticholinergics plus a-blocker was tolerated well, including the questions about urinary retention (n ¼ 1) and dry mouth (n ¼ 2). Initial combination treatment of anticholinergics plus a-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.

Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation. Methods and results A technique was developed that allowed chondrogenic primary (uncultured) cells from bone marrow aspirate concentrate, combined with a composite hydrophilic and fibrillar matrix to be applied arthroscopically to a site of a chondral lesion. The construct was tested in vitro and in animal experiments before clinical trials. Clinical trials involved 60 patients in a prospective study. Symptomatic International Cartilage Repair Society grade 3 and 4a lesions were mapped and treated. Pre- and postoperative clinical assessments showed statistically significant improved outcomes; Lysholm Knee Scoring Scale (mean 52.8 to > 76.4; P < 0.05) International Knee Documentation Committee (mean 39 to > 79 P < 0.05) and Knee injury and Osteoarthritis Outcome Score (64.5 to >89.2 P < 0.05). Postoperative magnetic resonance imaging was evaluated morphologically (magnetic resonance observation of cartilage repair tissue, average MOCART score 72) and qualitatively; the regenerate was comparable to native cartilage. Conclusions This technique is effective, affordable, requires no complex tools and delivers a single-stage treatment that is potentially accessible to any centre capable of performing arthroscopic surgery. Good clinical results were found to be sustained at five years of follow-up with a regenerate that appears hyaline like using multiple magnetic resonance measures.

Objective: We evaluated tumour volume changes in patients with lung cancer undergoing concurrent chemoradiotherapy using image-guided radiotherapy (RT). Methods: The kilovoltage image was obtained using CT on rail at every five fractions. The gross tumour volumes (GTVs), including the primary tumour and lymph nodes (LNs), were contoured to analyse the time and degree of tumour regression. Results: 46 patients [32, non-small-cell lung cancer (NSCLC), and 14, small-cell lung cancer (SCLC)] were included in this study. In total, 281 CT scans and 82 sites of GTVs were evaluated. Significant volume changes occurred in both the NSCLC and SCLC groups (p , 0.001 and 0.002), and the average GTV change compared with baseline was 49.85 6 3.65 [standard error (SE)]% and 65.95 6 4.60 (SE)% for the NSCLC and SCLC groups, respectively. A significant difference in the degree of volume reduction between the primary tumour and LNs was observed in only the NSCLC group (p , 0.0001) but not in the SCLC group (p 5 0.735). The greatest volume regression compared with the volume before the five fractions occurred between the 15 and 20 fractions in the NSCLC group and between the 5 and 10 fractions in the SCLC group. Conclusion: Both primary tumour and LNs were well defined using CT on rail. Significant volume changes occurred during RT, and there was a difference in volume reduction between the NSCLC and SCLC groups, regarding the degree and timing of the tumour reduction in the primary tumour and LNs. Advances in knowledge: NSCLC and SCLC groups showed differences in the degree and timing of volume reduction. The primary tumour and LNs in NSCLC regressed differently.Lung cancer is the most common cause of cancer mortality in the Republic of Korea, accounting for 22.2% all cancer deaths. Although the survival rate continues to increase, the prognosis remains poor with a 5-year relative survival rate of 20.7% in patients diagnosed from 2007 to 2011. 1 Multimodality treatment, including radiotherapy (RT), is a mainstay in the treatment of locally advanced non-smallcell lung cancer (NSCLC) and limited-stage small-cell lung cancer (SCLC) because it improves local control and overall survival. [2][3][4][5] Several recent studies have shown that an increasing radiation dose resulted in the improvement of local control and overall survival.6-9 Currently, Phase III randomized studies are under way to determine the optimal dose and fractionation schedule. Radiation oesophagitis and pneumonitis are major complications that limit the potential for dose escalation. Changes in tumour volume, patients' weight, pulmonary atelectasis and pleural effusions were noted during RT and modification of the treatment plan may be required over the course of the treatment. Adaptive planning can reduce the radiation exposure of an organ at risk (such as normal lung and oesophagus) and may improve local control.Several studies have reported that tumour shrinkage occurs during RT using the various image-guided RT modalities, such as electronic portal imaging, mega...

Introduction: Small-cell lung cancer (SCLC) accounts for about 20% of all lung cancers and it has poor prognosis. For extensive disease (ED), combination chemotherapy (CT) with platinum and etoposide is standard, with response rate of 60-80%, but the overall long-term survival is less than 10% (at 5 years) with a median progression-free survival of 4 months. Topotecan produces a response rate of about 24% in sensitive relapse patients (pts). Material and Methods:The authors reviewed 146 consecutive pts with SCLC, diagnosed from January of 2002 to December of 2006, at Portuguese Institute of Oncology -Porto Center, and they evaluated those treated with topotecan as second-line CT, regarding topotecan's efficacy and toxicity. Results: From 146 pts reviewed, 23 were treated with topotecan as second-line CT. 91% were male, the median age was 59 years (range: 23-73) and all of them were smokers or ex-smokers. At time of diagnosis, 78% had ED treated with platinum and etoposide; 22% had limited disease treated with platinum and etoposide plus thoracic radiotherapy. The median time from first line treatment to progression was 7.6 months. At beginning of second-line treatment with topotecan, 74% had a performance status (PS) less than 2 and 26% had a PS of 2. It was used the standard regimen i.v. topotecan at a dose of 1,5 mg/m 2 on days 1-5 of a 21 day cycle. The mean of number of cycles of topotecan done was 3.4 with a range of 1 to 6. Topotecan's disease control was 31.8% (partial response -4 pts, stable disease -3 pts) and median time to progression was 2.6 months. Topotecan grade 3 toxicities described were: anemia in 5 pts, trombocitopenia in 4 pts, neutropenia in 3 pts and vomiting in 1 pt. It was described 2 cases of febrile neutropenia. Median overall survival was 18.2 months. Conclusion: Topotecan has clinical activity in pts with relapsed SCLC, with acceptable toxicity. In this serie of our current daily practice pts, disease control, median time to progression and median overall survival were comparable to other published results. P1-218SCLC: Cytotoxic Chemotherapy Posters, Mon, Sept 3 Evaluation of the Recommended Dose and Efficacy of Amrubicin as 2nd and 3rd-line Chemotherapy for Small-Cell Lung CancerIgawa, Satoshi; Yamamoto, Nobuyuki; Ono, Akira; Nnakamura, Yukiko; Tsuya, Asuka; Murakami, Haruyasu; Endo, Masahiro; Takahashi, Toshiaki Shizuoka Cancer Center, Sunto-gun, Japan Background: After successful induction therapy for small-cell lung cancer (SCLC), most patients relapse within 2 years as a result of emergence of drug-resistant tumor cells. This study was conducted to evaluate the recommended dose and activity of amrubicin (AMR) as 2nd-or 3rd-line chemotherapy for SCLC. Methods: SCLC patients with measurable disease who had previously been treated with at least one platinum-based chemotherapy regimen and had an ECOG performance status of 0-2 were eligible. Two groups of patients were selected: i) a group to be treated with 2nd-line chemotherapy and ii) a group to be treated with 3rd-line chemotherap...

Background Since the consensus-based diagnostic algorithm for intestinal Behcet’s disease (iBD) was proposed by the IBD Study Group of the Korean Association for the Study of Intestinal Diseases, there were few studies regarding the prognosis of iBD according to the diagnostic algorithm. Methods We reviewed the medical records of patients who had ileocecal ulcers with clinical impression of iBD from March 1986 to August 2019 in Seoul St. Mary’s Hospital and evaluated factors at the time of diagnosis which were related with adverse events (AEs, major operation or admission from iBD) and disease-free survival (DFS). Results Among 204 eligible patients, a total of 163 were included in the study after exclusion of 41 patients with ileocecal ulcers from other disorders. The male-to-female ratio was 1:1 and the mean age at the time of diagnosis was 48.9 ± 15.9. The number of definite, probable, suspected, and non-diagnostic iBD was 18 (11.0%), 64 (39.3%), 37 (22.7%), and 44 (27.0%), respectively. Patients with definite, probable, and suspected iBD developed more AEs compared with patients with non-diagnostic iBD (p = 0.026). After exclusion of patients with non-diagnostic iBD, univariate analysis showed accompanying haematologic disorders, haemoglobin &lt;10 g/dl, fever, colonic involvement, and hypoalbuminemia (&lt;3.0 g/dl) were significantly related to the development of AEs (all p &lt; 0.05). Multivariate analysis revealed accompanying haematologic disorders, haemoglobin &lt;10 g/dl, fever, and colonic involvement were significantly associated with development of AE (all p &lt; 0.05). Poor DFS was significantly associated with accompanying with haematologic disorders, haemoglobin &lt;10 g/dl, and colonic involvement (p &lt; 0.001, p = 0.022, and p = 0.034) in univariate analysis. Only haemoglobin &lt;10 g/dl was significant in multivariate analysis. Conclusion Patients with definite, probable, and suspected iBD have a poor prognosis compared with patients with non-diagnostic iBD. Accompanying with haematologic disorders, anaemia, fever, and colonic involvement at the time of diagnosis are poor prognostic factors in patients with iBD.