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Combined Treatment of Residual, Recurrent and Unresectable Gastric Cancer (수술후 잔존 위암, 재발성 위암 및 절제 불가능한 위암의 병용 요법)

  • Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.85-93
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    • 1990
  • A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

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Breast Conserving Operation and Radiation Therapy in Early Breast Cancer : Interim Analysis (초기유방암에서 유방보존수술 후 방사선치료 : 중간분석)

  • Kim, Jin-Hee;Kim, Ok-Bae;Kim, You-Sah
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.27-33
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    • 2001
  • Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.

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Preliminary Result in Patients with Primary Hepatoma Treated by Stereotactic Radiotherapy (원발성 간암에 대한 정위방사선치료의 예비결과)

  • Kang Ki Mun;Choi Ihl Bohng;Kim In Ah;Choi Byung Ock;Kang Young Nam;Chai Gyu Young;Han Sung Tae;Chung Gyu Won
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.34-39
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    • 2001
  • Purpose : It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. Materials and Methods : From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of $ 44\~66$ year old (median : 59) and the tumor size of $10\~825\;cc$ (median : 185 cc). SRT was given to them $3\~5$ fractions a week (5 Gy/fraction, $90\%$ isodose line) for $2\~3$ weeks. Median dose of SRT was 50 Gy and the range was $30\~50\;Gy$. Results : Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression $(7.7\%)$, 7 partial regression $(53.8\%)$, 4 minimal regression $(30.8\%)$, 1 stable disease $(7.7\%)$. The positive responses more than partial remission were 8 patients $(61.5\%)$ after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been $92.3\%$ decreased. There was no severe complication except dyspepsia $84.6\%$, mild nausea $69.2\%$, transient decreased of hepatic function $15.4\%$ and fever $7.7\%$. Conclusion : SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

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Postoperative Radiotherapy for Low Grade Glioma of the Brain (뇌 신경교종의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.79-84
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    • 2000
  • Purpose : To evaluate the effectiveness and tolerance of postoperative e지ernai beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Materials and Methods : Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58$\%$), mixed oligodendrogliomas-19 patients (27$\%$), oiigodendrogliomas-11 patients (15$\%$). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. Ail of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000 $\~$ 5500 cGy. Results : The overall 5 and 7 year survival rates for entire group of 72 patients were 61$\~$ and 50$\~$. Corresponding disease free survival rates for entire patients were 53$\~$ and 45$\~$, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogiiomas, and oligodendrogiiorras were 48$\%$ and 45$\%$, 76$\%$ and 56$\%$, and 80$\%$ and 52$\%$, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for sub total resection patients and biopsy alone patients were 57$\%$ and 43$\%$, respectively. Forty six patients who were 40 years or younger survived batter than 26 patients who were 41 years or older (overall survival rate at 5 years, 69$\%$ vs 45$\%$). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Conclusion : Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.

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The Role of Postoperative External Irradiation for the Incompletely Resected Meningiomas (불완전절제된 수막종에서 수술 후 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Young;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.85-91
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    • 2000
  • Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

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Role of Radiation Therapy for Stage III Thymoma (제 3기 흉선종에서 방사선치료의 역할)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.16-20
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    • 2001
  • Purpose : To evaluate the effectiveness and tolerance of the postoperative radiation therapy for patients with Stage III thymoma and to define the optimal radiotherapeutic regimen Materials and Methods : We retrospectively analyzed the records of 24 patients with Stage III thymoma who were referred for postoperative radiation therapy in our institution from June, 1987 to May, 1999. Surgical therapy consisted of total resection in one patient, subtotal resection in seventeen, and biopsy alone in six patients. Age of the patients was ranged from 20 to 62 years with mean age of 47 years. Male to female ratio was 14 to 10. Radiation therapy was delivered with linear accelerator producing either 6 MeV or 10 MeV photons. The irradiated volume included anterior mediastinum and known residual disease. The supraclavicular fossae were not irradiated. The delivered total dose was ranged from 30 to 56 Gy. One patient received 30 Gy and eighteen patients received minimum of 50 Gy. Follow up period was ranged from 12 months to 8 years with median follow up of 40 months. Results : The overall local control rate for entire group of patients was $67\%$ at 5 years. The cumulative local failure rates at one, three and five year were $18\%,\;28\%\;and\;33\%$, respectively. In patients treated with subtotal resection and biopsy alone, local control rate was $76\%\;and\;33\%$, respectively. The actuarial observed survival rate at 5 years was $57\%$, and actuarial adjusted survival at 5 years was $72\%$. The difference between 5 year survival rates for patients treated with subtotal resection and biopsy alone was not statistically significant $(62\%\;vs\;30\%)$. Conclusion : We might conclude that postoperative radiation therapy was safe and effective treatment for patients with Stage III thymoma. Postoperative radiation therapy is recommended in cases where tumor margin is close or incomplete resection is accomplished.

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Effect of Hydrocortisone Aceponate - Gentamicin - Miconazole Topical Otic Combination for Treating Canine Otitis Externa (개 외이염 치료에서 하이드로코티손 아세포네이트-겐타마이신-미코나졸 국소 혼합제제의 효과)

  • Park, Seol-Hee;Lee, Yong-Uk;Nam, Eui-Hwa;Yi, Hak-Jin;Jung, Ji-Young;Han, Seung-Hee;Song, Chi-Youn;Hwang, Cheol-Yong
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.1-7
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    • 2012
  • Fifty-four dogs with otitis externa were enrolled in the study for the Evaluation of efficacy of a Hydrocortisone aceponate - Gentamicin - Miconazole otic combination ($Easotic^{(R)}$, Virbac, Carros, France). Otitis externa patients were treated by $Easotic^{(R)}$ once daily for 5 days and 2 days off treatment and evaluated on $7^{th}$ day. If otitis externa persisted, additional $Easotic^{(R)}$ treatment was administered once daily for 5 days and rested 2 days and reevaluated on $14^{th}$ day. For the evaluation of efficacy of $Easotic^{(R)}$, eight clinical signs were scored on a severity scale and infectious agents from ear sample were also graded using semi-quantitative scale at each visit. Sum of clinical scores and cytological scores was defined as Global Clinical Score. When $Easotic^{(R)}$ was applied once daily for 5 days, global clinical score was reduced 76.0%. When $Easotic^{(R)}$ was administered for 10 days, during first 5 days administration, 46.6% reduction of global clinical score was detected. During additional 5 days administration, 82.2% reduction of global clinical score was observed compared with Day 0. Any relevant adverse effect was not reported during the study in all cases. Thus, $Easotic^{(R)}$ treatment once daily for 5 days and 10 days appears to be effective and safe treatment for canine otitis externa.

The Listing Procedure for environmental friendly organic materials in Korea (한국의 친환경유기농자재 목록공시 제도)

  • Lee, Sang-Beom;Seung, J.O.;Kim, S.S.;Kim, B.S.;Lee, B.M.;Oh, Y.J.;Kang, C.K.;Choi, K.J.;Hong, M.K.
    • Proceedings of the Korean Society of Organic Agriculture Conference
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    • 2009.12a
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    • pp.275-276
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    • 2009
  • 민간단체들에 의하여 자율적으로 시작된 국내 유기농업은 친환경농업육성법(1997. 12.13)이 제정되면서 국가기관의 친환경농업 활성화 노력과 더불어 2008년 유기농재배 농가(8,460호)와 면적(12,033호)이 급격히 증가되었다. 또한 유기농업의 확산과 더불어 화학비료 및 유기합성 농약대체 친환경농자재들의 유통이 증가되고 있으나 관리규정이 없어 검증되지 않은 다양한 농자재들이 유통되어 친환경실천 농가들의 혼란이 초래되어 국정감사 시 문제점으로 지적과 함께 각계에서 관리제도의 필요성이 대두되었다. 친환경농업육성법 시행령 개정(대통령령 제19964호, 2007.3.27.공포, 2007.3.28.시행)으로 농촌진흥청에 친환경농자재심의회가 설치되어 효과와 효능을 검증하지 아니하고 친환경농산물 중 유기농산물 생을 해 사용가능한 자재인지 여부를 검토하여 그 결과를 공개하는 목록공시제가 마련되었다. 친환경유기농자재 목록공시는 1년에 4회 매분기말에 농촌진흥청 농자재관리과에서 접수를 받아 친환경농자재 분야별 전문위원회 검토 후 심의위원회 심의를 거쳐 접수일로부터 90일 이내에 농촌진흥청장이 공시(농진청 홈페이지, 관보게재)하고 친환경농업 관련기관 및 검토 신청자에게 통보함으로서 마무리된다. 목록 공시된 친환경유기농자재의 유효기간은 2년이다. 친환경농자재심의위원회는 토양개량 및 작물생육분야 전문위원회 위원 11명, 병 해충 관리분야 전문위원회 위원 11명 및 심의위원회 의원 20명으로 구성되어 있다. 2007년 3월부터 2009년 11월 30일 현재 목록 공시된 친환경유기농자재 제품은 (1) 양개량용 자재 25 개, (2) 작물생육용 자재 282개, (3) 토양개량 및 작물생육용 자재 308개, (4) 작물병해 관리용 자재 110개, (5) 작물충해 관리용 자재 : 224개, (6) 작물병해충 관리용 자재 5개 및 (7) 기타 자재 1개 제품으로 총 955개 제품에 이르고 있다. 한편, 공시연장 미신청, 현재 검토기준안에 필요로 하는 추가요청 자료 미제출 및 공시이외의 물질 사용으로 국내유통 중 단속되어 부적합한 판정을 받아 20여 제품이 목록공시가 취소되었다. 앞으로 목록 공시되는 친환경유기농자재는 제품의 주성분 함량 표기, 시용효과 검정방법 선, 제조방법 현장점검, 안전성 검정 등 여러가지 제도보완 및 사후관리 방안이 시급히 마련되어야 할 것으로 사려된다.

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Multiplex PCR method for environmental monitoring of approved LM cotton events in Korea (국내 승인 LM면화의 자연환경 모니터링을 위한 multiplex PCR 개발)

  • Jo, Beom-Ho;Seol, Min-A;Shin, Su Young;Kim, Il Ryong;Choi, Wonkyun;Eum, Soon-Jae;Song, Hae-Ryong;Lee, Jung Ro
    • Journal of Plant Biotechnology
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    • v.43 no.1
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    • pp.91-98
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    • 2016
  • The growth area of living modified (LM) cotton has steadily increased every year, since its first commercialization in 1996. Development of environmental risk assessment tools and techniques for LM cotton is required for ecosystem safety. We therefore developed multiplex PCR assays for simultaneous detection of two (MON15985, MON531) and four (GHB614, LLCOTTON25, MON88913 and MON1445) LM cotton events approved in Korea, with event specific primer pairs. The PCR reactions were optimized by using event specific primers of six LM cottons at various concentrations. The reactions allows amplification of estimated amplicons of MON15985 (214 bp), MON531 (270 bp), GHB614 (119 bp), LLCOTTON25 (164 bp), MON88913 (276 bp), and MON1445 (389 bp) from multiplex PCR reactions. The multiplex PCR assay developed allowed that two annealing steps (15 cycles at $55^{\circ}C$ and 25 cycles at $60^{\circ}C$) were performed for amplification of distinguished two LM cottons, and only one annealing step (50 cycles at $60^{\circ}C$) was necessary for tetraplex PCR. Primer extension step of all PCR reactions was skipped for time-effective amplification. Our methods suggest that two multiplex PCR assays can be cost-effective and a rapid diagnostic tool for environmental LMO monitoring of six LM cottons.

The Study of Intravenous-gammaglobulin Therapy in Acute phase of Measles (급성기 홍역 환자의 정주용 인면역글로부린 치료 효과에 대한 연구)

  • Kim, Min Shik;Cha, Yoon Hwa
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.101-106
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    • 2001
  • Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.

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