• Title/Summary/Keyword: 수술후 방사선치료

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The Role of Postoperative Adjuvant Radiation Therapy in the Management of Adenocarcinoma of the Colon -A Review of 21 Patients- (대장선암의 치료에 있어 수술후 방사선 치료의 역할)

  • Park Kyung Ho;Loh Jonh J.K.;Suh Chang Ok;Kim Dong Won
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.49-54
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    • 1988
  • Form March 1970 to December 1984, 21 patients treated initially with curative surgery for adenocarcinoma of the colon, referred to the Department of Radiation Oncology, College of Medicine, Yonsei University, were analyzed retrospectively. Thirteen of 21 patients who were considered to be a high risk group (i.e, mainly stage B2 or above), received adjuvant postoperative radiation therapy. However,2 of 13 patients did not complete their courses of radiotherapy as planned because of poor tolerance to radiotherapy or patient's refusal and were excluded from this study. Remaining 8 of 21 patients who did not receive postoperative radiotherapy, presented with recurrence at the time of referral and treated with palliative radiotherapy. In 11 patients with postoperative radiotherapy, overall local failure rate was $9\%$(1/11) and the 5year acturial survival rate was $55\%$. Local failure rates by stage were 0(0/4), $14\%(1/7)$ for stage B2+ B3, C1+C2+C3 respectively and 0(0/2), $17\%(1/6),\;0(0/3)$ for stage C1, B2+C2, B3+C3 respectivly.

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The Role of Postoperative Adjuvant Radiation Therapy in the Management of Adenocarcinoma of the Colon -A review of 21 Patients- (대장선암의 치료에 있어 수술후 방사선 치료의 역할)

  • Park Kyung Ho;Kim Dong Won;Loh J. K.;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.51-57
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    • 1989
  • From March 1970 to December 1984, treatment results of 21 patients treated initially with curative surgery for adenoarcinoma of the colon and referred to the Department of Radiation Oncology, College of Medicine, Yonsei University, were analyzed retrospectively. Thirteen of 21 patients who were considered to be at high risk (i.e, stage B2 or above), received postoperative adjuvant radiation therapy. However,2 of 13 patients did not complete their courses of radiotherapy as planned because of poor tolerance to radiotherapy or patient's refusal and were excluded from this study. Remaining 8 of 21 patients who did not receive postoperative radiotherapy, presented with recurrence at the time of referral and treated for palliation. In 11 patients who finished postoperative radiotherapy, overall local failure rate was $9\% (1/11)$ and the 5 year actuarial suwival rate was $55\%$. Local failure rates by stage were 0 (0/4), $14\%$ (1/7) for stage B2+B3, Cl+C2+C3 respectively and 0(0/2), $17\%$ (1/6), 0(0/3) for stage C1, B2+C2, B3+C3 respectively.

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Postoperative Radiotherapy for Intracranial Meningioma (뇌수막종 환자의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.95-99
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    • 2001
  • Purpose : To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. Materials and Methods : The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebelli. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. Results : The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61%, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p<0.05). Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Conclusion : Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone.

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Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.327-334
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    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

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Postoperative Radiation Therapy in Non-Small-Cell Lung Cancer (비소세포성 폐암의 수술후 방사선 치료)

  • Park, Charn-Il;Kim, Jong-Hoon;Kim, Joo-Hyun
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.195-201
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    • 1988
  • Sixty patients with proven lung cancer were retrospectively studied to determine whether postoperative radiation therapy improves survival. Patterns of treatment failure and 5 year survival were assessed according to extent of tumor spread, histology, type of operation, positive resection margin and radiation dose. Of the 60 patients, excluding S patients who received incomplete treatment or poor pulmonary function,55 patients received postoperative radiation therapy following curative resection. The overall survival at 5 years was $39\%$. The hilar and mediastinal lymph node involvement had an influence on survival. The authors recommend that patients with resection. lung cancer involving the hilar and mediastinal lymph nodes may require postoperative radiotherapy to reduce the local recurrence and improve survival.

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Postoperative Complications after Preoperative Chemoradiotherapy Combined with Hyperthermia in Locally Advanced Rectal Cancer (국소 진행성 직장암의 수술전 동시 화학방사선치료와 온열치료병합시 수술후 부작용)

  • Yea, Ji Woon
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.89-94
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    • 2014
  • We investigated whether regional hyperthermia (HT) increased post-surgical complications in patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT). Between 1996 and 2007, 205 patients treated with preoperative CCRT and curative surgery were evaluable for the analysis of acute and late toxicities. A total dose of 39.6 Gy or 45 Gy was delivered concurrently with one or two cycles of chemotherapy (5-fluorouracil, leucovorin). Eighty-eight patients received regional HT twice a week using an 8-MHz radiofrequency capacitive heating device. Surgery was performed 4~6 weeks after the completion of preoperative CCRT. The median age was 59 years (range, 18~83) and the median follow-up period was 61months (range, 2~191). The 5-year overall survival and complication-free survival rate of all patients was 77.4% and 73.7%, respectively. Early leakage, delayed leakage, anastomotic stricture, fistula, and small bowel obstruction occurred in 1.0%, 2.9%, 1.5%, 5.9%, and 17.1%, respectively. HT did not increase all kinds of complications. The 5-year complication-free survival rate was 71.8% in the non-HT group and 76.3% in the HT group (p=0.293). Regional HT did not increase postoperative complications in patients with locally advanced rectal cancer treated with preoperative CCRT followed by curative surgery.

Radiotherapy as a First-Line Modality for Tongue Base Adenoid Cystic Carcinoma : Report of 3 Cases (설근부에 발생한 샘낭암종의 방사선치료 : 증례보고 3예)

  • Kim, Kyung Su;Wu, Hong-Gyun;Sung, Myung-Whun;Hah, J. Hun;Kim, Tae Min
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.104-108
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    • 2014
  • 주로 작은 침샘에서 발생하는 샘낭암종의 치료 방침은 수술과 수술 후 보조적 방사선치료가 주로 행해져 왔다. 그러나 설근부에 발생한 샘낭암종에 대해서는 수술적 치료가 가져오는 삶의 질의 저하가 크기 때문에 수술적 치료를 적용하기 쉽지 않다. 또한 샘낭암종의 치료에 있어서 항암제의 역할이 거의 없는 상황에서 방사선치료가 중요한 역할을 할 수 있겠다. 이에 본 저자들은 설근부에 발생한 샘낭암종 세 증례의 방사선치료 결과를 보고 하며 샘낭암종의 치료에 대해서 문헌고찰을 통해 논의하고자 한다.

CANCER OF THE NASAL FOSSAE (비강 및 부비동암)

  • Seel David J.;Yoo Bong-Ok;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.2 no.1
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    • pp.13-22
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    • 1986
  • Nasal fossae 의 암이란 비강과 부비동들에서 발생하는 것으로서 환자를 가장 괴롭히며 또한 가장 믿을수 없는 악성종양들중의 하나이다. 비록 본 예수병원 암환자 등록부에 의하면 전 암환자의 2.2% 발생빈도로서 주요한 발생빈도를 보이지는 않지만, 이 부위의 암을 치유하는데는 세심하고 철저한 모든 진단적 검사와 과감한 외과 및 치료방사선의 병합치료가 요구된다. 저자들은 지난 22 년간 비강 및 부비동 (Nasal fossae) 에서 발생한 원발성 악성종양중 치유목적의 근치수술을 시행한 68 예를 임상고찰 하였다. 근치수술을 시행했던 68 예중 91% 에서 제 3 병기 또는 4 병기의 진행된 경우 이었다. 외과적 수술은 한예의 사골동 (篩骨洞) 종양적출술 및 부분상악동(上顎洞)절제술 한 예를 제외한 66 예 모두에서 전상악동(全上顎洞)절제술 (total maxillectomy) 또는 확장 전상악동(全上顎洞)절제술 (extended total maxillectomy) 을 시 하였다. 저자들은 역학적(疫學的), 병리학적(病理學的), 병기(病期) 및 치료, 재발율과 생존율들을 분석 고찰하였으며 3가지 치료형태를 서로 비교하였다. 즉 수술만 시행한 군, 수술전 방사선 치료 및 수술병합군, 수술과 수술후 방사선치료 병합 군으로 나눴다. 저자들의 예비적 (preliminary) 관찰 결과는 2 년간 무병생존율 (disease-free 2-year survival) 만을 볼때, 수술만 시행한 군에서 40%로써 통계학적으로는 가장 좋았으나 실제는 수술만 시행한 군에서는 단지 40%만이 제 4 병기(病期)의 진행된 경우였으나 수술전 방사선치료 또는 수술후 방사선치료등의 병합치료에서는 제 4 병기(病期)의 진행된 상태가 무려 60 %나 되었다. 전체적인 재발율 (Overall recurrence rate) 은 68.2%로써 무서울 정도로 높았으며 전체적인 2 년 무병율은 23.7%였다. 저자들은 이 분야에서 실패의 원인분석과 치료방법의 선택등에 대한 지침을 제시하고저 한다.

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The Role of Postoperative Radiotherapy for Ameloblastic Carcinoma of the Mandible: Case Report (사기질모세포 암종에서 수술 후 방사선치료의 역할: 증례보고)

  • Kim Won Taek;Chung In Kyo;Ki Yong Kan;Nam Ji Ho;Gwon Byung Hyun;Kim Dong Won
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.194-200
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    • 2005
  • An ameloblastic carcinoma is a very rare odontogenic malignant tumor, which sometimes have a benign clinical nature, but typically have aggressive features, with large ulcerative lesion and extensive local destruction. These clinical characteristics make the complete surgical removal of a tumor difficult. As a consequence, a poor prognosis may result due to local recurrence and distant metastasis. For this reason, it is important to consider adjuvant therapies for high-risk ameloblastic carcinoma patients. Here, the case of a recurrent ameloblastic carcinoma that occurred in the mandible after primary surgery is reported. The lesion was treated with further local excision, followed by postoperative radiotherapy. Also, a few remarks on the role of postoperative radiotherapy in patient with ameloblastic carcinoma have been made from a review of the current literatures on the treatment of this type of lesion.

Radiation Therapy in Carcinoma of the Vulva A Review of Fifteen Patients (외음부 암의 방사선 치료)

  • Lee H. S.;Oh W. Y.;Suh C. O.;Kim G. E.;Park C. K.
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.51-58
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    • 1985
  • This study analyzes fifteen patients who underwent a course of radiation therpy for their vulva cancer in the Department of Radiation Oncology, College of Medicine, Yonsei University from January, 1971 to April, 1985. Four patients had initial surgery for their vulva cancer and were subsequently treated by a course of adjuvant radiation therapy. Eleven patients were given radiation therapy as the initial course of therapy, and one of these was in adjuvant setting before radical surgery. Treatment in each instance was individuilzed and usually consisted of some components of external beam, brachytherapy, and/or electron beam therapy. Primary local control rate in all cases was $53\%(8/15),\;40\%(4/10)$ in the radiation therapy alone group and $80\%(4/5)$ in the radiation therapy combined with surgery group. Treatment failures were noted in 7/10 in the radiation therapy alone group and 2/5 in the radiation therapy combined with surgery group. The most common failure site was primary site failure(vulva).

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