• Title/Summary/Keyword: 두경부환자

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Nodal Status of the Head and Neck Cancer Patients (두경부 암 환자의 경부 림프절 전이 분석)

  • Yang, Dae-Sik;Choi, Myung-Sun;Choi, Jong-Ouck
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.321-329
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    • 1997
  • Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

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Analysis of Intraoral Squamous Cell Carcinoma Reconstructed with Radial Forearm Flap (전완부 유리 피판으로 재건한 구강내 편평상피암환자의 예후분석)

  • Park Myong-Chul;Soutar David S.
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.53-62
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    • 1994
  • 미세외과 수술에 의한 유리 피판술의 도입은 두경부 종양제거후 재건에 괄목할 만한 진보를 가져왔다. 특히 광범위한 종양의 제거가 필요하며 인근의 조직으로 수복이 어렵고 기능 및 외모상의 재건이 문제가 되는 경우 유리 피판은 절대적인 적응이 된다. 구강은 언어구사 와 연하(deglutition)기능을 담당하므로 재건을 위해서는 얇고 부드러운 조직으로 수복하여 주어야 한다. 전완부 유리피판은 혈관경의 위치가 대부분 일정하고 종양 제거후 결손의 모양에 따라 피판을 계획할 수 있기 때문에 구강암 제거후 가장 많이 이용되는 유리피판이다. 저자는 1982년 부터 1988년까지 영국 글라스고우 소재 서부 스코틀랜드 성형 및 구강외과 병원에서 구강의 편평상피암환자로 암종제거 후, 전완부 피판에 의한 재건 및 방사선 치료를 받은 151명의 치료결과(재발율 및 생존율)를 분석하였다. 절제연의 종양조직의 양성(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001), 경부 임파절 곽청술의 종류(P<0.05) 등은 재발율과 관련하여 통계적으로 유의하였다. 반면에 종양의 구강내 위치, 하악골의 침범여부등은 통계적의의가 없었다. 생존율에 관하여는 종양의 구강내 위치 (P<0.05), 종양절제연 종양여부(P<0.005), 하악골의 침범여부(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001) 등이 통계적으로 유의할 만한 요소로 밝혀졌다. 젊은 나이의 환자들에서(50세이하) 특징적으로 높은 사망률을 보였다. 하악골절제방법의 차이는 환자의 생존예후에 통계적으로 유의할 만한 영향을 주지 못했다.

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Influence of Aquaplastic Mask Immobilization on Patient Positioning in Head & Neck Radiotherapy (두경부암 방사선 치료 시 Aquaplastic Mask가 환자 고정에 미치는 영향)

  • Lee, Ho-Yeon;Bae, Sun-Myung;Kim, Jin-San;Kang, Tae-Young;Kwak, Jung-Won;Back, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.175-181
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    • 2012
  • Purpose: This study aimed to analyze the influence of aquaplastic mask which is used for the radiotherapy for patients with head and neck cancer on patient positioning by analyzing the results of 2D/2D matching with the use of Exactrac 6D couch system. Materials and Methods: 2D/2D matching-based Image guidance was performed with the use of Exactrac 6D couch system on a total of 14 patients with head and neck cancer who received radiotherapy at this hospital in a period from June 2010 to June 2011. The adjusted 6D values obtained after the image guidance were classified into values related with patients and values not related with patients as to the correlation between the results. Results: In the analysis of the relation of each adjusted value to patients, the coefficient of determination ($R^2$) of longitudinal and pitch direction was 0.76, of longitudinal and yaw direction was 0.48, and of pitch and yaw direction was 0.42 although the coefficient of determination for above factors was 0.03 or less when the dependency of patients was excluded. Conclusion: It was demonstrated that intrinsic factors of aquaplastic mask had influence on the immobilization of patients by aquaplastic mask although various factors related with patients had influence on the immobilization of patients. It is believed that if these factors are adjusted, the treatment of patients with head and neck cancer can be more accurate.

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After retrospective evaluation of the SETUP rate change during the treatment of head and neck cancer patient with Helical Tomotherapy (두경부환자의 토모테라피 치료시 SETUP 변화율에 대한 후향적 평가)

  • Ha, Tae-young;Kim, Seung-jun;Hwang, Cheol-hwan;Son, Jong-gi
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.27-34
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    • 2016
  • Purpose : Retrospective evaluation of setup changes using the corrected position during helical tomotherapy Materials and Methods : Head and neck cancer patients were randomly sampled and summarized into 3 groups: Group 1(32) Brain, Group 2 2(28)Maxillar, Nasal cavity, Group 3 (35) Nasopharynx(NPX), Tongue, Tonsil, and Oropharynx(OPX). In 3 groups, the statistical tests based on repeated measurements among 30 times of the duration of treatment by applying X, Y, Z axis errors, roll, weight changes, and vectors as variables. Results : The statistical test results showed that there was no difference between x-axis (p = 0.458) and y-axis (p=0.986) and in roll (p = 0.037), weight change (p <0.001), and the vector (p <0.001). In addition, the pattern between the three groups based on the fraction revealed no difference in x-axis (p = 0.430) and roll (p = 0.299) but a difference in y-axis (.023), weight change (p = 0.001), and vector (p = 0.028). Conclusion : The results of the retrospective evaluation found the change in the group 3 with respect Y, Z, weight, and vector and a larger random error during the treatment including low neck.

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PECTORALIS MAJOR MYOCUTANEOUS FLAP FOR THE COMPLICATIONS OF POSTIRRADIATION HEAD & NECK CANCER SURGERY (방사선 치료후 두경부암 수술의 합병증에 대한 Pectoralis Major Myocutaneous Flap의 이용)

  • 송달원;백재한;김중강
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.19.2-19
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    • 1987
  • 방사선치료후 재발성 또는 잔존성 두경부암의 수술후에 피부판의 괴사 및 slough, 감염, 누공, 부종과 경동맥 노출 심지어는 경동맥 파열 등의 술후 합병증이 빈발함으로 수술에 큰 어려움을 겪게 된다. Pectoralis major myocutaneous flap은 진행된 두경부암의 광범위한 절제후에 그 결손부를 보충해 주는 데 좋은 방법으로 사용할 수 있을 뿐아니라 방사선치료후에 생긴 합병증에도 이 flap을 이용하여 좋은 치료결과를 얻을 수 있다. 저자들은 수술 전에 방사선치료를 받고 심한 부종으로 후두조직의 괴사 및 기능이 손실된 환자와 방사선 치료후 재발된 상인두암환자의 경우에서 수술 후 생긴 pharyngocutaneous fistula와 피부판감염 및 경동맥노출 등으로 치유가 곤란하여 여기에 pectoralis major myocutaneous flap을 사용하여 pharyngostoma를 재건하고 노출된 경동맥부위를 보호하여 좋은 치료효과를 얻었기에 문헌을 고찰하여 보고하는 바이다.

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