• Title/Summary/Keyword: 장기 생존율

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Factors for Survival and Complications of Malignant Bone Tumor Patients with a Total Femoral Replacement (대퇴골 전치환술 받은 악성 골종양 환자의 생존인자와 합병증)

  • Cho, Wan Hyeong;Jeon, Dae-Geun;Song, Won Seok;Park, Hwan Seong;Nam, Hee Seung;Kim, Kyung Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.244-252
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    • 2020
  • Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

The Results of Radiation Therapy in Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포폐암의 방사선치료 성적)

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Joon;Kim Jae Young;Shim Jae Won;Lee Choon Taek;Kang Yoon Koo;Kim Tae You
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.233-241
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    • 1997
  • Purpose : This study was done to evaluate the survival rate and Prognostic factors of patients with inoperable non-small cell lung cancer(NSCLC) treated with radiation therapy. Materials and Methods A retrospective analysis was undertaken of 62 Patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC slaging, stage IIIA was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5days per week. Thirty-seven patients received neoadjuvant chemotherapy. Results : Complete, partial and no response to radiation therapy were 3 patients, 34 Patients and 25 patients, respectively The median survival period of all patients was 11 month. One rear survival rate, 2 year survival rateand 5 rear survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB In univariaite analysis, prognostic factors affecting survival were T-s1aging, AJCC staging, and response after radiation therapy (P<0.05) . Pretreatment peformance status affected survival but was not statistically significant (0.050.1). In multivariate analysis, Pathology and response to radiation therapy are independently significant prognostic factor. T stage was marginally significant (P=0.0809). During follow-up duration, distant metastasis developed in 20 patients-bone metastasis in 10 patients, brain metastasis in 3 patients, liver mentastasis in 3 patients, contralateral lung metastasis in 1 patients and multiple metastases in 3 patients. Conclusion : Conventional radiotherapy alone or combined chemoradiotherapy are unlikely to achieve long term survival in patients with NSCLC. Surgery after concurrent chemoradiotherapy is Ivied to improve the local control in our hospital

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In vitro Long Term Conservation of Potato Germplasms (감자 유전자원의 기내 장기보존 방법)

  • Yi, Jung-Yoon;Cho, Hyun-Mook;Park, Kuen-Woo
    • Horticultural Science & Technology
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    • v.16 no.4
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    • pp.508-510
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    • 1998
  • This study was carried out to establish the in vitro culture system of potato germplasms for minimizing the occurrence of variation and maximizing the culture period. We used osmoticum such as sorbitol or mannitol with sucrose in the absence of plant growth regulators. The growth of potato germplasms in the medium containing osmoticum was increased when the growth temperature was lowered. After six months storage in low temperature, plant heights of tetraploid was somewhat higher than those of diploid with the exception of stn-16 and the difference due to media was not observed. But after twelve months storage, survival rates of plants cultured in LSM 1(sucrose and sorbitol) was higher than those of plants cultured in LSM 2(sucrose and mannitol). The survival rate of stn-16, diploid wild species, was approximately 75% and it was considerably high. In Atlantic, tetraploid cultivated variety, every individual was survived.

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Locally Advanced, Unresectable Pancreatic Cancer Treated by Stereotactic Radiation Therapy (국소적으로 진행된, 절제 불가능한 췌장암에서 정위 방사선 치료)

  • Choi Chul-Won;Kim Mi-Sook;Cho Chul-Koo;Yoo Seong-Yul;Yang Kwang-Mo;Yoo Hyung-Jun;Lee Dong-Han;Ji Young-Hoon;Han Chul-Ju;Kim Jin;Kim Young-Han
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.11-20
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    • 2006
  • Puroose: In order to find out whether stereotactic radiation therapy (RT) using CyberKnife (CK) could improve survival rate and lower acute toxicity compared to conventional RT. Materials and Methods: From April 2003 through April 2004, 19 patients with Eastern Cooperative Oncology Group (ECOG) performance status ${\leq}3$ and locally advanced pancreas cancer without distant metastasis, evaluated by CT or PET/CT, were included. We administered stereotactic RT consisting of either 33 Gy, 36 Gy or 39 Gy in 3 fractions to 6, 4 and 9 patients, respectively, in an effort to increase the radiation dose step by step, and analyzed the survival rate and gastrointestinal toxicities by the acute radiation morbidity criteria of Radiation Therapeutic Oncology Group (RTOG). Prognostic factors of age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9, planning target volume (PTV), and adjacent organ and vessel invasion on CT scan were evaluated by Log Rank test. Results: The median survival time was 11 months with 1-year survival rate of 36.8%. During follow-up period (range $3{\sim}20$ months, median 10 months), no significant gastrointestinal acute toxicity (RTOG grade 3) was observed. In univariate analysis, age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9 level, and adjacent organ and vessel invasion did not show any significant changes of survival rate, however, patients with PTV (80 cc showed more favorable survival rate than those with PTV>80 cc (p-value<0.05). In multivariate analysis, age younger than 65 years and PTV>80 cc showed better survival rate. Conclusion: In terms of survival, the efficacy of stereotactic radiation therapy using CK was found to be superior or similar to other recent studies achieved with conventional RT with intensive chemotherapy, high dose conformal RT, intraoperative RT (IORT), or intensity modulated RT (IMRT). Furthermore, severe toxicity was not observed. Short treatment time in relation to the short life expectancy gave patients more convenience and, finally, quality of life would be increased. Consequently, this could be regarded as an effective novel treatment modality for locally advanced, unresectable pancreas cancer. PTV would be a helpful prognostic factor for CK.

Postoperstive Chemoradiotherapy in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 수술 후 화학방사선요법)

  • Chai, Gyu-Young;Kang, Ki-Mun;Choi, Sang-Gyeong
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.221-227
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    • 2002
  • Purpose : To evaluate the role of postoperative chemoradiotherapy in locally advanced rectal cancer, we retrospectively analyzed the treatment results of patients treated by curative surgical resection and postoperative chemoradiotherapy. Materials and Methods : From April 1989 through December 1998, 119 patients were treated with curative surgery and postoperative chemoradiotherapy for rectal carcinoma in Gyeongsang National University Hospital. Patient age ranged from 32 to 73 years, with a median age of 56 years. Low anterior resection was peformed in 59 patients, and abdominoperineal resection in 60. Forty-three patients were AJCC stage II and 76 were stage III. Radiation was delivered with 6 MV X rays using either AP-PA two fields, AP-PA both lateral four fields, or PA both lateral three fields. Total radiation dose ranged from 40 Gy to 56 Gy. In 73 patients, bolus infusions of 5-FU $(400\;mg/m^2)$ were given during the first and fourth weeks of radiotherapy. After completion of radiotherapy, an additional four to six cycles of 5-FU were given. Oral 5-FU (Furtulone) was given for nine months in 46 patients. Results : Forty $(33.7\%)$ of the 119 patients showed treatment failure. Local failure occurred in 16 $(13.5\%)$ patients, 1 $(2.3\%)$ of 43 stage II patients and 15 $(19.7\%)$ of 76 stage III patients. Distant failure occurred in 31 $(26.1\%)$ patients, among whom 5 $(11.6\%)$ were stage II and 26 $(34.2\%)$ were stage III. Five-year actuarial survival was $56.2\%$ overall, $71.1\%$ in stage II patients and $49.1\%$ in stage III patients (p=0.0008). Five-year disease free survival was $53.3\%$ overall, $68.1\%$ in stage II and $45.8\%$ in stage III (p=0.0006). Multivariate analysis showed that T stage and N stage were significant prognostic factors for five year survival, and that T stage, N stage, and preoperative CEA value were significant prognostic factors for five year disease free survival. Bowel complication occurred in 22 patients, and was treated surgically in 15 $(12.6\%)$, and conservatively in 7 $(5.9\%)$. Conclusion : Postoperative chemoradiotherapy was confirmed to be an effective modality for local control of rectal cancer, but the distant failure rate remained high. More effective modalities should be investigated to lower the distant failure rate.

Development of Short-term Cultivation Technology Using the Rain Shelter Greenhouse of Gastrodia elata Blume (천마 비가림시설을 활용한 단기재배기술 개발)

  • Chang Su Kim;Sang Young Seo;Min Sil Ahn;Eun Suk Lee;Young Eun Song;So Ra Choi
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2022.09a
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    • pp.82-82
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    • 2022
  • 천마(天麻, Gastrodia elata Blume)는 난초과(蘭草科, Orchidaceae)에 속하는 식물로 잎과 뿌리가 없어 탄소동화능력이 없으며, 뽕나무버섯균과 공생하는 기생식물이다. 주요 함유된 성분은 gastrodin, 4-hydroxylbenzyl alcohol, vanillin, vanillyl alcohol, ergothioneine 등이 있고, 주로 진정(鎭靜), 진경(鎭痙), 통락(通絡)의 효능이 있으며, 두통, 반신불수, 언어장애, 현훈(眩暈), 고혈압 등에 사용되고 있다. 천마는 노지 재배에 따른 안정생산 문제가 지속적으로 발생하고 있다. 혹한, 폭우 등 기상환경에 따른 연차간 수량성 차가 673~1,175kg/10a로 크고, 정식 후 원목·종균·자마의 공생관계 형성이 늦어져 자마 생존율이 70% 이하로 낮으며, 18개월 장기 재배 시 생육 환경이 불량해져 썩음병이 많이 발생하고 있다. 본 연구는 비가림시설, 종균 선(先) 접종 배양목 및 20g 이상의 자마를 사용하여 재배기간을 18개월에서 12개월로 6개월을 단축하고자 수행하였다. 본 실험은 종균 선접종 배양목 생산을 위해 원목의 종균 접종 시기는 4월 하순, 6월 상순, 7월 중순으로 40일 간격으로 처리하였고, 이렇게 생산된 배양목을 활용하여 정식은 이듬해 4월 상순, 수확은 그 이듬해 3월 하순으로 설정하였다. 또한, 종균 선접종 배양목을 활용한 천마의 정식 시기는 3월 상순, 4월 상순, 5월 상순으로 30일 간격으로 처리하였고, 수확 시기는 이듬해 2월 하순, 3월 하순, 4월 하순으로 설정하여 천마의 생육상황 및 생산성을 조사하였다. 원목의 종균 접종시기를 검정한 결과, 자마 생존율은 4월 하순과 6월 상순 처리가 무처리에 비해 15%가 높았고, 천마 수량은 무처리 대비 4월 하순과 6월 상순 처리구에서 각각 2.07배, 1.64배 높았다. 천마의 정식 시기를 검정한 결과, 천마의 유효적산온도는 2,400℃로 3월 상순 처리구는 2,446℃로 충족하였고, 4월 중순 처리구는 2,375℃로 거의 충족하였으나, 5월 상순 처리구는 2,178℃로 222℃가 부족하였다. 자마 생존율은 3월 상순 처리 시 95%로 가장 높았고, 정식 시기가 늦어질수록 자마 생존율이 낮아지는 경향을 보였으며, 수량성은 5월 상순 처리 대비 3월 상순이 3.56배, 4월 상순이 3.43배 높았다. 따라서, 자마 생존율, 유효적산온도, 천마 수량성 등의 결과에 따라 원목의 적정 종균 접종 시기는 4월 하순과 6월 상순 사이고, 천마의 적정 정식 시기는 3월 상순과 4월 상순 사이며, 비가림시설, 종균 선접종 배양목 및 우량자마를 활용하면 재배기간을 노지 대비 6개월 이상 단축할 수 있을 것으로 판단되었다.

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Long-Term Results of 2-Dimensional Radiation Therapy in Patients with Nasopharyngeal Cancer (이차원방사선치료를 시행한 코인두암 환자의 장기 추적 결과 및 예후인자 분석)

  • Lee, Nam-Kwon;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Suk;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.193-204
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    • 2010
  • Purpose: To analyze the treatment outcomes, complications, prognostic factors after a long-term follow-up of patients with nasopharyngeal carcinoma treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Materials and Methods: Between December 1981 and December 2006, 190 eligible patients with non-metastatic nasopharyngeal carcinoma were treated at our department with a curative intent. Of these patients, 103 were treated with RT alone and 87 patients received CCRT. The median age was 49 years (range, 8~78 years). The distributions of clinical stage according to the AJCC 6th edition included I: 7 (3.6%), IIA: 8 (4.2%), IIB: 33 (17.4%), III: 82 (43.2%), IVA: 31 (16.3%), IVB: 29 (15.3%). The accumulated radiation doses to the primary tumor ranged from 66.6~87.0 Gy (median, 72 Gy). Treatment outcomes and prognostic factors were retrospectively analyzed. Acute and late toxicities were assessed using the RTOG criteria. Results: A total of 96.8% (184/190) of patients completed the planned treatment. With a mean follow-up of 73 months (range, 2~278 months; median, 52 months), 93 (48.9%) patients had relapses that were local 44 (23.2%), nodal 13 (6.8%), or distant 49 (25.8%). The 5- and 10-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 55.6% and 44.5%, 54.8% and 51.3%, in addition to 65.3% and 57.4%, respectively. Multivariate analyses revealed that CCRT, age, gender, and stage were significant prognostic factors for OS. The CCRT and gender were independent prognostic factors for both DFS and DSS. There was no grade 4 or 5 acute toxicity, but grade 3 mucositis and hematologic toxicity were present in 42 patients (22.1%) and 18 patients (9.5%), respectively. During follow-up, grade 3 hearing loss in 9 patients and trismus in 6 patients were reported. Conclusion: The results of our study were in accordance with findings of previous studies and we confirmed that CCRT, low stage, female gender, and young age were related to improvement in OS. However, there are limitations in the locoregional control that can be achieved by CCRT with 20 conventional radiation therapy. This observation has led to further studies on clarifying the efficacy of concurrent chemotherapy by intensity modulated radiation therapy.

Radiotherapy of Locally Recurrent Rectal Carcinoma (수술 후 국소재발된 직장암의 방사선치료 결과)

  • Jeong Hyeon Ju;Shin Young Ju;Mo Yang Kwang;Suh Hyun Suk;Chun Hachung;Lee Myung Za
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.36-41
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    • 1999
  • Purpose : We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. Methods and Materials: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). Results : The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively Conclusions : Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival : 10 months, 5-year survival : less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence.

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건조공정에 따른 인산가용화균 Penicillium sp. PS-113의 고체분말비료 제제화 효과 비교

  • Tae, Eon-Hui;Lee, Tae-Geun;Gang, Seon-Cheol
    • 한국생물공학회:학술대회논문집
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    • 2002.04a
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    • pp.369-370
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    • 2002
  • A fungus. Penicillium sp. PS-113, with high phosphate-solubilizing activities was isolated from soil and formulated to powder type in order to manufacture it as a solid powder fertilizer. First of all, in this research, we are trying to establish an optimal condition for a drying process based on the drying time, temperature and humidity by testing its viability on potato dextrose agar(PDA) media after storing at $4^{\circ}C$. As a result the number of Penicillium sp. PS-1l3 conidia, which was dried at $80^{\circ}C$ and 15% humidity, and then stored at $4^{\circ}C$, was maximally increased to 60 times more than the control. But the viability of the conidia at $100^{\circ}C$ or over was decreased suddenly in spite of the period of storage.

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Results of Concurrent Chemoradiotherapy and Intraluminal Brachytherapy in Esophageal Carcinoma - Retrospective Analysis with Respect to Survival - (식도암에서 동시 항암화학방사선요법과 관내근접치료의 결과 -생존율을 중심으로 한 후향적 분석-)

  • Nam Taek-Keun;Nah Byung-Sik;Chung Woong-Ki;Ahn Sung-Ja;Song Ju-Young
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.25-32
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    • 2004
  • Purpose : Evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival. Materials and Methods : From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was peformed using 6 or 10 MV X-rays, with a dose range of $46.8~\69.6$ Gy (median; 59.4). The ILB was peformed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin $(75\;mg/m^2)$ was given on each first day of weeks 1, 5, 9 and 13, and 5-FU $(1,000\;mg/m^2)$ as a continuous infusion for the first 4 days of each course. Results : The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and $20.7\%$, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and $27.3\%$, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and $0\%$, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis. Conclusion : This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.