Analysis of the Radiation Therapy Outcomes and Prognostic Factors of Thymoma (흉선종에 대한 방사선치료 성적 및 예후인자분석)
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- Radiation Oncology Journal
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- v.28 no.1
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- pp.1-8
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- 2010
Purpose: This retrospective study was performed to evaluate the efficacy of radiation therapy (RT) and to investigate the prognostic factors for thymoma when treated with RT. Materials and Methods: We analyzed 21 patients with thymoma and also received RT from March 2002 to January 2008. The median follow-up time was 37 months (range, 3 to 89 months). The median patient age was 57 years (range, 24 to 77 years) and the gender ratio of males to females was 4：3. Of the 21 patients, complete resections (trans-sternal thymectomy) and R2 resections were performed in 14 and 1 patient, respectively. A biopsy was performed in 6 patients (28.7%). The WHO cell types in the 21 patients were as follows: 1 patient (4.8%) had type A, 10 patients (47.6%) had type B1-3, and 10 patients (47.6%) had type C. Based on Masaoka staging, 10 patients (47.6%) were stage II, 7 patients (33.3%) were stage III, and 4 patients (19.1%) were stage IVa. Three-dimensional RT was adminstered to the tumor volume (planned target volume), including the anterior mediastinum and the residual disease. The total RT dose ranged from 52.0 to 70.2 Gy (median dose, 54 Gy). Consistent with the WHO criteria, the response rate was only analyzed for the 6 patients who received a biopsy only. The prognostic factors analyzed for an estimate of survival included age, gender, tumor size, tumor pathology, Masaoka stage, the possibility of treatment by performing surgery, the presence of myasthenia gravis, and RT dose. Results: The 3-year overall survival rate (OS) and the progression free survival rate (PFS) were 80.7% and 78.2%, respectively. Among the 10 patients with WHO cell type C, 3 of 4 patients (75%) who underwent a complete resection and 3 of 6 patients (50%) who underwent a biopsy survived. Distant metastasis developed in 4 patients (19.1%). The overall response rate in the 6 patients who received biopsy only were as follows: partial remission in 4 patients (66.7%), stable disease in 1 patient (16.6%), and progressive disease in 1 patient (16.6%). Acute RTOG radiation pneumonitis occurred in 1 patient (4.8%), grade 2 occurred in 2 patients (9.5%), grade 3 occurred in 1 patient (4.8%), and grade 4 occurred in 1 patient (4.8%). A univariate analysis revealed that the significant prognostic factors for OS were age (
Gwonwu Hong Chan-yu is one of the modern and contemporary Korean scholars of Sino-Korean literature and one of the literati of his era, so is respected as a guiding light by academic descendants. Gwonwu was a teacher of his era, who experienced all the turbulence of Korean society, such as the Japanese occupation by force, the Korean War, the military dictatorship, and the struggle for democracy, and who educated and led young scholars of his time. However, academia has not payed attention to his life and achievements since his death. This paper is to examine the poetry of Gwonwu Hong Chan-yu, one of the representative modern and contemporary scholar of Sini-Korean literature, which has not yet been discussed by academia. The minimal meaning of this paper is that it is a first work based on his anthology, which has not been discussed by academia, and a first full-scale study on Gwonwu Hongchan-yu. For the reason, this paper aims at the detailed inspection of his poetic pieces recorded in his anthology. Nonetheless, despite such intentions, some limits cannot be avoided here and there in this paper for the insufficient knowledge and academic capability of this paper's writer and for the lack of academic sources. Gwonwu's poetry examined through his anthology shows the characteristic which is that his poems focus on exposing his own internal emotions. Such a characteristic says that his idea of poetic literature payed attention more to individuality, that is exposition of private emotions, than to social utility of poems. Gwonwu's such an idea of poetic literature can be generally affirmed throughout his poetry. Accordingly, Gwonwu preferred classical Chinese poems to archaistic poems, and single poems to serial poems; and avoided writing poems within social relations such as farewell-poems, bestowal-poems, and mourning-poems. When the characteristics of Gwonwu's poetic literature get summarized as such, however, some questions remain. The preferential question is whether the poems in his anthology are the whole poetry of him. Although Gwonwu's poetic pieces that the writer of this paper have checked out till now are all in his anthology, it is very much questionable whether Gwonwu's poetry can be summed up only with these poems. The next question is what is the writing method for taking joy(spice), sentiment, and full-heart into his poems if Gwonwu's poems focus on exposing his internal emotions, and if poems exposing joy and poems exposing sentiment and full-heart appear coherently in various different spaces and circumstances of writing. The final question is what are the meanings of Gwonwu's poems if his poetry checked out through his anthology directly shows either the reality carried in his poems or the reality of a time in his life. The questions listed above are thought to be resolved by the synchronizing process of stereoscopic searches both for Gwonwu as an individual and for the era of his life. Especially, spurring deeper researches toward a new direction regarding Gwonwu's poetry has an important meaning for construction of a complete modern and contemporary history of Sino-Korean literature and for procurement of continuous research on Sino-Korean literature and its history. For the reason, it is thought that more efforts of researchers are required.
The overall study of Samsaebulhoedo (painting of the Assembly of Buddhas of Three Ages) at Yongjusa Temple has focused on dating it, analyzing the painting style, identifying its painter, and scrutinizing the related documents. However, its greater coherence could be achieved through additional support from empirical evidence and logical consistency. Recent studies on Samsaebulhoedo at Yongjusa Temple that postulate that the painting could have been produced by a monk-painter in the late nineteenth century and that an original version produced in 1790 could have been retouched by a painter in the 1920s using a Western painting style lack such empirical proof and logic. Although King Jeongjo's son was not yet installed as crown prince, the Samsaebulhoedo at Yongjusa Temple contained a conventional written prayer wishing for a long life for the king, queen, and crown prince: "May his majesty the King live long / May her majesty the Queen live long / May his highness the Crown Prince live long" (主上殿下壽萬歲, 王妃殿下壽萬歲, 世子邸下壽萬歲). Later, this phrase was erased using cinnabar and revised to include unusual content in an exceptional order: "May his majesty the King live long / May his highness the King's Affectionate Mother (Jagung) live long / May her majesty the Queen live long / May his highness the Crown Prince live long" (主上殿下壽萬歲, 慈宮邸下壽萬歲, 王妃殿下壽萬歲, 世子邸下壽萬歲). A comprehensive comparison of the formats and contents in written prayers found on late Joseon Buddhist paintings and a careful analysis of royal liturgy during the reign of King Jeongjo reveal Samsaebulhoedo at Yongjusa Temple to be an original version produced at the time of the founding of Yongjusa Temple in 1790. According to a comparative analysis of formats, iconography, styles, aesthetic sensibilities, and techniques found in Buddhist paintings and paintings by Joseon court painters from the eighteenth and nineteenth centuries, Samsaebulhoedo at Yongjusa Temple bears features characteristic of paintings produced around 1790, which corresponds to the result of analysis on the written prayer. Buddhist paintings created up to the early eighteenth century show deities with their sizes determined by their religious status and a two-dimensional conceptual composition based on the traditional perspective of depicting close objects in the lower section and distant objects above. This Samsaebulhoedo, however, systematically places the Buddhist deities within a threedimensional space constructed by applying a linear perspective. Through the extensive employment of chiaroscuro as found in Western painting, it expresses white highlights and shadows, evoking a feeling that the magnificent world of the Buddhas of the Three Ages actually unfolds in front of viewers. Since the inner order of a linear perspective and the outer illusion of chiaroscuro shading are intimately related to each other, it is difficult to believe that the white highlights were a later addition. Moreover, the creative convergence of highly-developed Western painting style and techniques that is on display in this Samsaebulhoedo could only have been achieved by late-Joseon court painters working during the reign of King Jeongjo, including Kim Hongdo, Yi Myeong-gi, and Kim Deuksin. Deungun, the head monk of Yongjusa Temple, wrote Yongjusa sajeok (History of Yongjusa Temple) by compiling the historical records on the temple that had been transmitted since its founding. In Yongjusa sajeok, Deungun recorded that Kim Hongdo painted Samsaebulhoedo as if it were a historical fact. The Joseon royal court's official records, Ilseongnok (Daily Records of the Royal Court and Important Officials) and Suwonbu jiryeong deungnok (Suwon Construction Records), indicate that Kim Hongdo, Yi Myeong-gi, and Kim Deuksin all served as a supervisor (gamdong) for the production of Buddhist paintings. Since within Joseon's hierarchical administrative system it was considered improper to allow court painters of government position to create Buddhist paintings which had previously been produced by monk-painters, they were appointed as gamdong in name only to avoid a political liability. In reality, court painters were ordered to create Buddhist paintings. During their reigns, King Yeongjo and King Jeongjo summoned the literati painters Jo Yeongseok and Kang Sehwang to serve as gamdong for the production of royal portraits and requested that they paint these portraits as well. Thus, the boundary between the concept of supervision and that of painting occasionally blurred. Supervision did not completely preclude painting, and a gamdong could also serve as a painter. In this light, the historical records in Yongjusa sajeok are not inconsistent with those in Ilseongnok, Suwonbu jiryeong deungnok, and a prayer written by Hwang Deok-sun, which was found inside the canopy in Daeungjeon Hall at Yongjusa Temple. These records provided the same content in different forms as required for their purposes and according to the context. This approach to the Samsaebulhoedo at Yongjusa Temple will lead to a more coherent explanation of dating the painting, analyzing its style, identifying its painter, and interpreting the relevant documents based on empirical grounds and logical consistency.
The paintings Gyeongpodae Pavilion and Chongseokjeong Pavilion were recently donated to the National Museum of Korea and unveiled to the public for the first time at the 2019 special exhibition "Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea." These two paintings carry significant implications for understanding Joseon art history. Because the fact that they were components of a folding screen produced after a sightseeing tour of the Gwandong regions in 1557 has led to a broadening of our understanding of sixteenth-century landscape painting. This paper explores the art historical meanings of Gyeongpodae Pavilion and Chongseokjeong Pavilion by examining the contents in the two paintings, dating them, analyzing their stylistic characteristics, and comparing them with other works. The production background of Gyeongpodae Pavilion and Chongseokjeong Pavilion can be found in the colophon of Chongseokjeong Pavilion. According to this writing, Sangsanilro, who is presumed to be Park Chung-gan (?-1601) in this paper, and Hong Yeon(?~?) went sightseeing around Geumgangsan Mountain (or Pungaksan Mountain) and the Gwandong region in the spring of 1557, wrote a travelogue, and after some time produced a folding screen depicting several famous scenic spots that they visited. Hong Yeon, whose courtesy name was Deokwon, passed the special civil examination in 1551 and has a record of being active until 1584. Park Chung-gan, whose pen name was Namae, reported the treason of Jeong Yeo-rip in 1589. In recognition of this meritorious deed, he was promoted to the position of Deputy Minister of the Ministry of Punishments, rewarded with the title of first-grade pyeongnan gongsin(meritorious subject who resolved difficulties), and raised to Lord of Sangsan. Based on the colophon to Chongseokjeong Pavilion, I suggest that the two paintings Gyeongpodae Pavilion and Chongseokjeong Pavilion were painted in the late sixteenth century, more specifically after 1557 when Park Chung-gan and Hong Yeon went on their sightseeing trip and after 1571 when Park, who wrote the colophon, was in his 50s or over. The painting style used in depicting the landscapes corresponds to that of the late sixteenth century. The colophon further states that Gyeongpodae Pavilion and Chongseokjeong Pavilion were two paintings of a folding screen. Chongseokjeong Pavilion with its colophon is thought to have been the final panel of this screen. The composition of Gyeongpodae Pavilion recalls the onesided three-layered composition often used in early Joseon landscape paintings in the style of An Gyeon. However, unlike such landscape paintings in the An Gyeon style, Gyeongpodae Pavilion positions and depicts the scenery in a realistic manner. Moreover, diverse perspectives, including a diagonal bird's-eye perspective and frontal perspective, are employed in Gyeongpodae Pavilion to effectively depict the relations among several natural features and the characteristics of the real scenery around Gyeongpodae Pavilion. The shapes of the mountains and the use of moss dots can be also found in Welcoming an Imperial Edict from China and Chinese Envoys at Uisungwan Lodge painted in 1557 and currently housed in the Kyujanggak Institute for Korean Studies at Seoul National University. Furthermore, the application of "cloud-head" texture strokes as well as the texture strokes with short lines and dots used in paintings in the An Gyeon style are transformed into a sense of realism. Compared to the composition of Gyeongpodae Pavilion, which recalls that of traditional Joseon early landscape painting, the composition of Chongseokjeong Pavilion is remarkably unconventional. Stone pillars lined up in layers with the tallest in the center form a triangle. A sense of space is created by dividing the painting into three planes(foreground, middle-ground, and background) and placing the stone pillars in the foreground, Saseonbong Peaks in the middle-ground, and Saseonjeong Pavilion on the cliff in the background. The Saseonbong Peaks in the center occupy an overwhelming proportion of the picture plane. However, the vertical stone pillars fail to form an organic relation and are segmented and flat. The painter of Chongseokjeong Pavilion had not yet developed a three-dimensional or natural spatial perception. The white lower and dark upper portions of the stone pillars emphasize their loftiness. The textures and cracks of the dense stone pillars were rendered by first applying light ink to the surfaces and then adding fine lines in dark ink. Here, the tip of the brush is pressed at an oblique angle and pulled down vertically, which shows an early stage of the development of axe-cut texture strokes. The contrast of black and white and use of vertical texture strokes signal the forthcoming trend toward the Zhe School painting style. Each and every contour and crack on the stone pillars is unique, which indicates an effort to accentuate their actual characteristics. The birds sitting above the stone pillars, waves, and the foam of breaking waves are all vividly described, not simply in repeated brushstrokes. The configuration of natural features shown in the above-mentioned Gyeongpodae Pavilion and Chongseokjeong Pavilion changes in other later paintings of the two scenic spots. In the Gyeongpodae Pavilion, Jukdo Island is depicted in the foreground, Gyeongpoho Lake in the middle-ground, and Gyeongpodae Pavilion and Odaesan Mountain in the background. This composition differs from the typical configuration of other Gyeongpodae Pavilion paintings from the eighteenth century that place Gyeongpodae Pavilion in the foreground and the sea in the upper section. In Chongseokjeong Pavilion, stone pillars are illustrated using a perspective viewing them from the sea, while other paintings depict them while facing upward toward the sea. These changes resulted from the established patterns of compositions used in Jeong Seon(1676~1759) and Kim Hong-do(1745~ after 1806)'s paintings of Gwandong regions. However, the configuration of the sixteenth-century Gyeongpodae Pavilion, which seemed to have no longer been used, was employed again in late Joseon folk paintings such as Gyeongpodae Pavilion in Gangneung. Famous scenic spots in the Gwandong region were painted from early on. According to historical records, they were created by several painters, including Kim Saeng(711~?) from the Goryeo Dynasty and An Gyeon(act. 15th C.) from the early Joseon period, either on a single scroll or over several panels of a folding screen or several leaves of an album. Although many records mention the production of paintings depicting sites around the Gwandong region, there are no other extant examples from this era beyond the paintings of Gyeongpodae Pavilion and Chongseokjeong Pavilion discussed in this paper. These two paintings are thought to be the earliest works depicting the Gwandong regions thus far. Moreover, they hold art historical significance in that they present information on the tradition of producing folding screens on the Gwandong region. In particular, based on the contents of the colophon written for Chongseokjeong Pavilion, the original folding screen is presumed to have consisted of eight panels. This proves that the convention of painting eight views of Gwangdong had been established by the late sixteenth century. All of the existing works mentioned as examples of sixteenth-century real scenery landscape painting show only partial elements of real scenery landscape painting since they were created as depictions of notable social gatherings or as a documentary painting for practical and/or official purposes. However, a primary objective of the paintings of Gyeongpodae Pavilion and Chongseokjeong Pavilion was to portray the ever-changing and striking nature of this real scenery. Moreover, Park Chung-gan wrote a colophon and added a poem on his admiration of the scenery he witnessed during his trip and ruminated over the true character of nature. Thus, unlike other previously known real-scenery landscape paintings, these two are of great significance as examples of real-scenery landscape paintings produced for the simple appreciation of nature. Gyeongpodae Pavilion and Chongseokjeong Pavilion are noteworthy in that they are the earliest remaining examples of the historical tradition of reflecting a sightseeing trip in painting accompanied by poetry. Furthermore, and most importantly, they broaden the understanding of Korean real-scenery landscape painting by presenting varied forms, compositions, and perspectives from sixteenth-century real-scenery landscape paintings that had formerly been unfound.