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Development of High-Resolution Fog Detection Algorithm for Daytime by Fusing GK2A/AMI and GK2B/GOCI-II Data (GK2A/AMI와 GK2B/GOCI-II 자료를 융합 활용한 주간 고해상도 안개 탐지 알고리즘 개발)

  • Ha-Yeong Yu;Myoung-Seok Suh
    • Korean Journal of Remote Sensing
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    • v.39 no.6_3
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    • pp.1779-1790
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    • 2023
  • Satellite-based fog detection algorithms are being developed to detect fog in real-time over a wide area, with a focus on the Korean Peninsula (KorPen). The GEO-KOMPSAT-2A/Advanced Meteorological Imager (GK2A/AMI, GK2A) satellite offers an excellent temporal resolution (10 min) and a spatial resolution (500 m), while GEO-KOMPSAT-2B/Geostationary Ocean Color Imager-II (GK2B/GOCI-II, GK2B) provides an excellent spatial resolution (250 m) but poor temporal resolution (1 h) with only visible channels. To enhance the fog detection level (10 min, 250 m), we developed a fused GK2AB fog detection algorithm (FDA) of GK2A and GK2B. The GK2AB FDA comprises three main steps. First, the Korea Meteorological Satellite Center's GK2A daytime fog detection algorithm is utilized to detect fog, considering various optical and physical characteristics. In the second step, GK2B data is extrapolated to 10-min intervals by matching GK2A pixels based on the closest time and location when GK2B observes the KorPen. For reflectance, GK2B normalized visible (NVIS) is corrected using GK2A NVIS of the same time, considering the difference in wavelength range and observation geometry. GK2B NVIS is extrapolated at 10-min intervals using the 10-min changes in GK2A NVIS. In the final step, the extrapolated GK2B NVIS, solar zenith angle, and outputs of GK2A FDA are utilized as input data for machine learning (decision tree) to develop the GK2AB FDA, which detects fog at a resolution of 250 m and a 10-min interval based on geographical locations. Six and four cases were used for the training and validation of GK2AB FDA, respectively. Quantitative verification of GK2AB FDA utilized ground observation data on visibility, wind speed, and relative humidity. Compared to GK2A FDA, GK2AB FDA exhibited a fourfold increase in spatial resolution, resulting in more detailed discrimination between fog and non-fog pixels. In general, irrespective of the validation method, the probability of detection (POD) and the Hanssen-Kuiper Skill score (KSS) are high or similar, indicating that it better detects previously undetected fog pixels. However, GK2AB FDA, compared to GK2A FDA, tends to over-detect fog with a higher false alarm ratio and bias.

Efficient Deep Learning Approaches for Active Fire Detection Using Himawari-8 Geostationary Satellite Images (Himawari-8 정지궤도 위성 영상을 활용한 딥러닝 기반 산불 탐지의 효율적 방안 제시)

  • Sihyun Lee;Yoojin Kang;Taejun Sung;Jungho Im
    • Korean Journal of Remote Sensing
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    • v.39 no.5_3
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    • pp.979-995
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    • 2023
  • As wildfires are difficult to predict, real-time monitoring is crucial for a timely response. Geostationary satellite images are very useful for active fire detection because they can monitor a vast area with high temporal resolution (e.g., 2 min). Existing satellite-based active fire detection algorithms detect thermal outliers using threshold values based on the statistical analysis of brightness temperature. However, the difficulty in establishing suitable thresholds for such threshold-based methods hinders their ability to detect fires with low intensity and achieve generalized performance. In light of these challenges, machine learning has emerged as a potential-solution. Until now, relatively simple techniques such as random forest, Vanilla convolutional neural network (CNN), and U-net have been applied for active fire detection. Therefore, this study proposed an active fire detection algorithm using state-of-the-art (SOTA) deep learning techniques using data from the Advanced Himawari Imager and evaluated it over East Asia and Australia. The SOTA model was developed by applying EfficientNet and lion optimizer, and the results were compared with the model using the Vanilla CNN structure. EfficientNet outperformed CNN with F1-scores of 0.88 and 0.83 in East Asia and Australia, respectively. The performance was better after using weighted loss, equal sampling, and image augmentation techniques to fix data imbalance issues compared to before the techniques were used, resulting in F1-scores of 0.92 in East Asia and 0.84 in Australia. It is anticipated that timely responses facilitated by the SOTA deep learning-based approach for active fire detection will effectively mitigate the damage caused by wildfires.

Production of Lignan-Rich Eggs as Functional Food by Supplementing Schisandra chinensis By-Product in Laying Hens (사료에 오미자 가공부산물 분말의 첨가 급여가 계란의 리그난 함량에 미치는 영향)

  • Hye Mi Kang;Eun Ji Park;Sun Young Park;Dae Youn Hwang;Jong-Choon Lee;Myunghoo Kim;Young Whan Choi
    • Journal of Life Science
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    • v.34 no.1
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    • pp.18-27
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    • 2024
  • Laying hens are known to be able to 'bio-accumulate' the health-promoting ingredients of their diet into eggs. The purpose of this study was to characterize lignan-rich eggs as functional food fed with Schisandra fruit by-product (SCP). Experimental diets were formulated using yellow corn, rice bran, soybean meal, fish meal, meat bone meal, poultry meal, vitamin premix, mineral premix, CaCO3, and supplemented Schisandra chinensis by-product. This experiment conducted a completely randomized design with 5 treatments for 5 laying hens. Levels of SCP were fed control diet or each formulated diet containing 1%, 3%, 5% and 7% SCP powder. The weight of eggs and the lignan content in white and yolk of egg were investigated every 7 days. Egg production and egg weight were not affected by diet at less than 5% SCP in the diet, but were significantly reduced when the diet was supplemented with a high concentration of 7% SCP after 3 weeks. Yolks and white in eggs were analyzed by using a high performance liquid chromatography (HPLC) to determine the lignans profile. Higher dietary SCP supplementation significantly increased gomisin N and schisandrin C in Acetonitrile (p<0.05). Gomisin N in egg white increased in a concentration-dependent manner, but shisandrin C not detected. These results indicated that the use of SCP powder in layering diets was effective in egg quality and for the production of lignans fortified eggs. In conclusion, dietary supplementation of Schisandra by-product with less than 5% can produce lignans-enrich eggs used as functional foods.

Physicochemical and textural properties of thawed pork by vacuum tumbling (진공 텀블링을 이용한 해동 돈육의 이화학적 및 조직학적 특성)

  • Su-Jin Park;Won-Ho Hong;Seung-Min Oh;Chang-Hee Cho;Jiyeon Chun
    • Food Science and Preservation
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    • v.31 no.3
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    • pp.423-432
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    • 2024
  • In this study, a vacuum tumbler with 4 impellers (DVT) was designed and applied for thawing frozen pork (vacuum -60 kPa, jacket 35℃, 1 rpm). Quality characteristics of the thawed pork were compared with those of industrially thawed meat by natural air at room temperature (NAT) and imported vacuum tumbler (IVT). The thawing time for frozen pork (303.36 kg) using DVT (165 min) was much shorter than that of NAT (4,200 min). DVT-thawed pork had lower drip loss (0.85%) than NAT (2.08%). DVT-thawed pork showed a pH of 5.92, a total bacterial count of 1.96±0.02 log CFU/g and no coliforms. Deteriorations in fat (TBARS 0.31±0.01 MDA mg/kg) and protein (VBN 5.67±1.98 mg%) in DVT-thawed pork were significantly lower than those of NAT (p<0.05). DVT-thawed pork had a high water-holding capacity (WHC, 97.5%). The hardness (34.59±0.46 N) and chewiness (188.21±0.17) of cooked DVT-thawed pork were about 5-6 times lower than those of NTA. Microstructure (SEM) showed myofibrillar damage in NAT-thawed pork, whereas dense myofibrillar structure was observed in DVT-thawed pork. DVT was better or similar to IVT in all evaluation parameters. The designed DVT is expected to be used as an efficient thawing method in terms of processing time and yield and to produce thawed meat with high WHC, soft texture, and low spoilage by minimizing tissue damage.

Genetic Aspects of the Growth Curve Parameters in Hanwoo Cows (한우 암소의 성장곡선 모수에 대한 유전적 경향)

  • Lee, Chang-U;Choe, Jae-Gwan;Jeon, Gi-Jun;Kim, Hyeong-Cheol
    • Journal of Animal Science and Technology
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    • v.48 no.1
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    • pp.29-38
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    • 2006
  • The objective of this study was to estimate genetic variances of growth curve parameters in Hanwoo cows. The data used in this study were records from 1,083 Hanwoo cows raised at Hanwoo Experiment Station, National Livestock Research Institute(NLRI). First evaluation model(Model I) fit year-season of birth and age of dam as fixed effects and second model(Model II) added age at the final weight as a linear covariate to Model I. Heritability estimates of A, b and k from Gompertz model were 0.22, 0.11 and 0.07 using modelⅠ and 0.28, 0.11 and 0.12 using modelⅡ. Those from Von Bertalanffy model were 0.22, 0.11 and 0.07 using modelⅠ, 0.28, 0.11 and 0.12 using modelⅡ. Heritability estimates of A, b and k from Logistic model were 0.14, 0.07 and 0.05 using modelⅠ, 0.18, 0.07 and 0.12 using modelⅡ. Heritability estimates of A from Gompertz model were higher than those from Von Bertalanffy model or Logistic model in both model Ⅰand model Ⅱ. Heritability estimates of b from Logistic model were higher than those from Gompertz model or Von Bertalanffy model in both modelⅠand model Ⅱ. Heritability estimates of birth weight, weaning weight, 3 month weight, 6 month weight, 9 month weight, 12 month weight, 18 month weight, 24 month weight, 36 month weight were after linear age adjustment 0.27, 0.11, 0.19, 0.14, 0.16, 0.23, 0.52 and 0.32, respectively. Heritability estimates of birth weight, weaning weight, 3 month weight, 6 month weight, 9 month weight and 24 month weight fit by Gompertz model were larger than those estimated from linearly adjusted data. Heritability estimates of 12 month weight, 18 month weight and 36 month weight fit by Von Bertalanffy model were larger than those estimated from linearly adjusted data. In the multitrait analyses for parameters from Gompertz model, genetic and phenotypic correlations between A and k parameters were -0.47 and -0.67 using modelⅠand -0.56 and -0.63 using model Ⅱ. Those between the A and b parameters were 0.69 and 0.34 using modelⅠand 0.72 and 0.37 using model Ⅱ. Those between the b and k parameters were -0.26 and 0.01 using modelⅠand -0.30 and 0.01 using model Ⅱ. In the multitrait analyses for parameters from Von Bertalanffy model, genetic and phenotypic correlations between A and k parameters were -0.49 and -0.67 suing model Ⅰ and -0.57 and -0.70 using modelⅡ. Those between the A and b parameters were 0.61 and 0.33 using modelⅠ and 0.60 and 0.30 using model Ⅱ. Those between the b and k parameters were -0.20 and 0.02 using modelⅠ and 0.16 and 0.00 using modelⅡ. In the multitrait analyses for parameters from Logistic model, genetic and phenotypic correlations between A and k parameters were -0.43 and -0.67 using model Ⅰ and -0.50 and -0.63 using modelⅡ. Those between the A and b parameters were 0.47 and 0.22 using modelⅠ and 0.38 and 0.24 using modelⅡ. Those between the b and k parameters were -0.09 and 0.02 using model Ⅰ and -0.02 and 0.13 using model Ⅱ.

Combined Chemotherapy and Radiation Therapy in Limited Disease Small-Cell Lung Cancer (국한성 소세포 폐암에서 항암 화학 및 흉부 방사선치료의 병합요법 적응)

  • Kim Moon Kyung;Ahn Yong Chan;Park Keunchil;Lim Do Hoon;Huh Seung Jae;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Kwon O Jung
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.9-15
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    • 1999
  • Purpose : This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer, Materials and Methods : Firty-six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deli- ver 44 Gy using 1 OMV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylaetic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. Results : The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved En 30 (65$\%$) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50$\%$), anemia in 17 (37$\%$), thrombo- cytopenia in nine (20$\%$), alopecia in nine (20$\%$), nausea/vomiting in five (11$\%$), and peripheral neuropathy in one (2$\%$). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24$\%$) out of the total 246 cycles. No radiation esophagitis over grade 111 was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The overall and progression-free survival rates were 79$\%$ and 55$\%$ in 1 year, and 45'/) and 32% in 2 years, respectively, and the median survival was 23 months. Conclusion : Relatively satisfactory local control and suwival rates were achieved after the combined chemotherapy and radiation therapy with mild to moderate acute morbidities in limited disease small cell lung cancer.

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The Effects of Pergola Wisteria floribunda's LAI on Thermal Environment (그늘시렁 Wisteria floribunda의 엽면적지수가 온열환경에 미치는 영향)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.6
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    • pp.115-125
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    • 2017
  • This study was to investigate the user's thermal environments under the pergola($L\;7,200{\times}W\;4,200{\times}H\;2,700mn$) covered with Wisteria floribunda(Willd.) DC. according to the variation of leaf area index(LAI). We carried out detailed measurements with two human-biometeorological stations on a popular square Jinju, Korea($N35^{\circ}10^{\prime}59.8^{{\prime}{\prime}}$, $E\;128^{\circ}05^{\prime}32.0^{{\prime}{\prime}}$, elevation: 38m). One of the stations stood under a pergola, while the other in the sun. The measurement spots were instrumented with microclimate monitoring stations to continuously measure air temperature and relative humidity, wind speed, shortwave and longwave radiation from the six cardinal directions at the height of 0.6m so as to calculate the Universal Thermal Climate Index(UTCI) from $9^{th}$ April to $27^{th}$ September 2017. The LAI was measured using the LAI-2200C Plant Canopy Analyzer. The analysis results of 18 day's 1 minute term human-biometeorological data absorbed by a man in sitting position from 10am to 4pm showed the following. During the whole observation period, daily average air temperatures under the pergola were respectively $0.7{\sim}2.3^{\circ}C$ lower compared with those in the sun, daily average wind speed and relative humidity under the pergola were respectively 0.17~0.38m/s and 0.4~3.1% higher compared with those in the sun. There was significant relationship in LAI, Julian day number and were expressed in the equation $y=-0.0004x^2+0.1719x-11.765(R^2=0.9897)$. The average $T_{mrt}$ under the pergola were $11.9{\sim}25.4^{\circ}C$ lower and maximum ${\Delta}T_{mrt}$ under the pergola were $24.1{\sim}30.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average $T_{mrt}$ compared with those in the sun and was expressed in the equation $y=0.0678{\ln}(x)+0.3036(R^2=0.9454)$. The average UTCI under the pergola were $4.1{\sim}8.3^{\circ}C$ lower and maximum ${\Delta}UTCI$ under the pergola were $7.8{\sim}10.2^{\circ}C$ when compared with those in the sun. There was significant relationship in LAI, reduction ratio(%) of daily average UTCI compared with those in the sun and were expressed in the equation $y=0.0322{\ln}(x)+0.1538(R^2=0.8946)$. The shading by the pergola covered with vines was very effective for reducing daytime UTCI absorbed by a man in sitting position at summer largely through a reduction in mean radiant temperature from sun protection, lowering thermal stress from very strong(UTCI >$38^{\circ}C$) and strong(UTCI >$32^{\circ}C$) down to strong(UTCI >$32^{\circ}C$) and moderate(UTCI >$26^{\circ}C$). Therefore the pergola covered with vines used for shading outdoor spaces is essential to mitigate heat stress and can create better human thermal comfort especially in cities during summer. But the thermal environments under the pergola covered with vines during the heat wave supposed to user "very strong heat stress(UTCI>$38^{\circ}C$)". Therefore users must restrain themselves from outdoor activities during the heat waves.

Results of Preoperative Concurrent Chemoradiotherapy for the Treatment of Rectal Cancer (직장암의 수술 전 동시적 항암화학방사선치료 결과)

  • Yoon, Mee-Sun;Nam, Taek-Keun;Kim, Hyeong-Rok;Nah, Byung-Sik;Chung, Woong-Ki;Kim, Young-Jin;Ahn, Sung-Ja;Song, Ju-Young;Jeong, Jae-Uk
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.247-256
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    • 2008
  • Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.127-135
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    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

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