• 제목/요약/키워드: 재발양상

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Cancinoma of Uterine Cervix Treated wvith High Dose Rate Intracavitary Irradiation : 1 Patterns of Failure (자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰)

  • Kim Ok Bae;Choi Tee Jin;Kim Jin Hee;Lee Ho Jun;Kim Yung Ae;Suh Young Wook;Lee Tae Sung;Cha Soon Do
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.369-376
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    • 1993
  • 226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

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A Study of Relationship between the Level of Serum SCC Antigen and Recurrence Patterns after Treatment of Uterine Cervix Cancer (자궁경부암 치료 후 재발양상과 종양표지자 SCC항원의 혈청 수치 변화의 상관관계에 관한 연구)

  • Choi, Doo-Ho;Kim, Eun-Seog;Nam, Kae-Hyun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.120-129
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    • 1999
  • Purpose : Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. Materials and Methods :This is a retrospective study of 181 conical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. Results : The Positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (>1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1 ~13 months). Negative linear correlation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. Conclusion : SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.

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Clinical Characteristics of Recurred Patients with Stage I,II Non-Small Cell Lung Cancer (근치적 절제 후 재발한 1,2기 비소세포폐암 환자의 임상상)

  • Ham, Hyoung-Suk;Kang, Soo-Jung;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Kwhan-Mien;Chung, Man-Pyo;Kim, Ho-Joong;Kim, Jhin-Gook;Kwon, O-Jung;Shim, Yong-Mog;Rhee, Choong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.428-437
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    • 2000
  • Background : Five year survival rate of postoperative stage I non-small cell lung cancer(NSCLC) reaches to 66%. In the remaining one third of patients, however, cancer recurs and the overall survival of NSCLC remains dismal. To evaluate clinical and pathologic characteristics of recurred NSCLC, the patterns and factors for postoperative recurrence in patients with staged I and II NSCLC were studied. Method : A retrospective analysis was performed in 234 patients who underwent radical resection for pathologic stage I and II NSCLC. All patients who were followed up for at least one year were included in this study. Results : 1) There were 177 men and 57 women The median age was 63. The median duration of the follow up period was 732 days (range 365~1,695 days). The overall recurrence rate was 26.5%, and the recurrence occurred $358.8{\pm}239.8$ days after operation. 2) The ages of recurred NSCLC patients were higher ($63.2{\pm}8.8$ years) than those of non-recurred patients ($60.3{\pm}9.8$ years)(p=0.043). The recurrence rate was higher in stage II (46.9%) than in stage I (18.8%) NSCLC p<0.001. The size of primary lung mass was larger in recurred ($5.45{\pm}3.22\;cm$) than that of non-recurred NSCLC ($3.74{\pm}1.75\;cm$, p<0.001). Interestingly, there were no recurrent cases when the resected primary tumor was less than 2cm. 3) Distant recurrence was more frequent than locoregional recurrence (66.1% vs. 33.9%). Distant recurrence rate was higher in females and in cases of adenocarcinoma. Brain metastasis was more frequent in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.024). Conclusion: The tumor size and stage were two important factors for determining the possibility of a recurrence. Because distant brain metastasis was more frequent in patients with adenocarinoma, a prospective study should be conducted to evaluate the effectiveness of preoperative brain imaging.

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People Inside - 김창섭 부회장((주)체리부로 축산사업부문, (주)한국원종 대표)

  • Kim, Dong-Jin
    • KOREAN POULTRY JOURNAL
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    • v.49 no.1
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    • pp.110-112
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    • 2017
  • 2016년 11월 AI가 재발하면서 산란계 농가를 중심으로 전국 확산이 빠르게 일어나는 등 과거와는 다른 양상을 보이고 있다. 본고는 현재 (주)체리부로에서 생산 총괄업무를 맡고 있으며 농림축산식품부 근무시절 동물방역과장을 맡아 AI 퇴치의 일선에 있었던 김창섭 부회장을 만나 양계산업 발전방안을 들어보았다.

Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery (수술후 국소 재발된 자궁경부암의 방사선 치료)

  • Yang, Mi-Gyoung
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.377-386
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    • 1994
  • Purpose: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. Methods and materials: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients($68\%$) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, $82\%$ of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). Results: Complete response(CR) was achieved in 18 patients($54\%$). Five of eighteen patients($28\%$) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was $43\%$ and the disease free survival was $31\%$. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation, The principal cause of death was lung metastasis($36\%$). Conclusion: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well.

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Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma (흉부 식도암의 병기 결정에 있어서 채골상 림프절 전이의 의미)

  • Wu Hong-Gyun;Park Chan Il;Ha Sung Whan;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.108-112
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    • 1999
  • Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

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The Clinical Characteristics of Recurrent Kawasaki Disease (재발한 가와사끼병의 임상적 특징)

  • Jo, Hyuk;Kim, Seong Hyun;Kim, Ki Hwan;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.188-194
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    • 2008
  • Purpose : The purpose of this study is to investigate the clinical characteristics of recurrent Kawasaki disease (KD). Methods : From January 2004 to December 2007, the medical records of 20 children with recurrent KD in Severance Children's Hospital were retrospectively reviewed. The clinical characteristics, laboratory findings, treatment and complications of these patients were compared between the initial episode and the second episode. Results : At the initial episode of the recurrent KD group, the gender ratio was 1.2:1 (male:female) and the mean age was $37.2{\pm}19.9$ months. The interval between the two episodes in the recurrent KD group was 3.3 months. The febrile period before admission was shorter for the second episode (P=0.034). The skin rash was less developed in the second episode. But there were no differences in the laboratory results and complications between the initial episode and the second episode. Three patients (15%) among those with a second episode failed to respond to the initial intravenous immunoglubulin treatment. On comparison between the initial episodes of the recurrent group and the nonrecurrent group, the erythrocyte sedimentation rate was higher in the first episode of the recurrent KD group. Conclusions : For recurrent KD, it tends to present more atypical features than the KD that occurs for the first time. Physicians should consider these characteristics when making the diagnosis and treating recurrent KD.

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The Result of Combined Modality Treatment for Non-Hodgkin's Lymphoma of Head and Neck (두경부 악성 임파종에 대한 병용치료의 결과)

  • Kim Jae Cheol;Kim Sang Bo;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.255-260
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    • 1990
  • From April 1985 to September 1989, 26 patients with stage I and II non-Hodgkin's lymphoma of unfavorable histology localized in head and neck region were treated with combined modality (combination chemotherapy plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 26 patients, 23 showed complete response and 3 partial response. Between these two groups there were no statistical differences according to the variables. Three-year survival and disease-free survival rate were $62.4{\%}$ and $65.2{\%}$, respectively. Unilateral involvement of neck node (p<0.05), radiation dose over 5000 cGy (p<0.01), and 6 or more cycles chemotherapy (p=0.06) had a favorable effect on 3-year survival rate. There were 8 recurrences including 3 partial responders, 1 local failure, 1 distant failure, 1 contiguous failure, and 2 simultaneous local and distant failure. It could be suggested that combined modality treatment might be necessary for the treatment of stage I and II Non-Hodgkin's lymphoma of unfavorable histology.

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