• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.177-182
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• 2011

Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.222-225
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• 2011

에크린 한공암종은 흔하지 않으며, 전이성 에크린 한공암종은 매우 드문 암이다. 에크린 한공암종은 표피내 한관에서 기원하는 피부 부속기 악성 종양으로, 대부분 에크린 한공암종은 항암치료와 방사선치료에 효과가 없으며, 따라서 유일한 치료방법은 전이되기 전에 국소 및 광범위 절제술을 시행하여야 한다. 본 환자는 두피에 발생한 에크린 한공암종이 점점 진행하여 피부, 림프절, 폐 등으로 전이하였고, 다수의 광범위 절제술에 이어 항암치료와 방사선치료를 받았지만, 결국 폐전이가 악화되어 사망하였다. 본 저자들은 항암치료와 방사선치료에 불응한 에크린 한공암종 1예를 치료에 대한 문헌고찰과 더불어 보고하는 바이다.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.3-8
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• 2007

연구목적：국소적 진행성 편도암환자에서 수술적치료와 비수술적치료의 결과를 비교 분석하고자 하였다. 연구방법 : 수술 후 보조방사선요법을 시행한 군과 유도화학요법 시행 유무에 상관없이 근치적 방사선 치료 또는 항암화학-방사선 동시치료를 받은 비수술군의 임상결과를 후향적으로 분석하였다. 연구결과：52.4개월의 중앙 추적기간결과, 대상환자의 중앙 연령은 53세 이었다. 대상 환자 중 병기 Ⅲ, Ⅳ기 환자는 72명(82.8%)이었고, 49명(56.3%)이 수술적 치료를, 38명(43.7%)명이 비수술적 치료를 받았다. 방사선 조사량외에 양군간의 차이는 없었다 (수술군：60.4Gy, 비수술군：70.2Gy, p=0.02). 비수술군의 전체 생존율은 81.6%이었다. 수술군의 8명(16.3%), 비수술군의 6명 (15.8%)에서 재발이 발생하였다. 흥미로운 사실은 원격재발은 2명 모두 수술군에서 발생하였다. 병기 III, IV기의 5년 무병생존율과 전체생존율은 수술군이 각각 82.1%, 86.9%이고, 비수술군이 각각 83.3%, 83.1%이었다(p=0.96, p=0.96). 결론：수술적 치료에 비해 비수술적 치료가 활동능력이 불량한 환자에게 선호되었을 가능성이 있었음에도 불구하고, 치료성적은 비슷하였다. 편도암에서 수술적 치료와 비수술적 치료의 전향적 무작위 비교연구가 필요하다.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.179-184
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• 2001

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.186-192
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• 2002

Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.