• Title/Summary/Keyword: 재발율

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Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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Clinical Significance of the Expression of Oncosuppressor Gene Protein and Epidermal Growth Factor Receptor in Squamous Cell Carcinomas of Larynx (후두 편평세포암에서 암억제유전자 단백 및 상피성장인자 수용체 발현의 임상적 의의)

  • 정광윤;최종욱
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.85-85
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    • 1993
  • The clinical staging system for laryngeal cancers is not sufficient for prognosticator due to different biologic characteristics and their microenvironment according to primary sites. For determining the prognosticators, the authors peformed immunohistochemical staining to EGFR, p53 protein, and pRB in 40 cases of surgically treated squamous cell carcinomas of larynx in our institute during the past 5 years. The results are as followings; 1. The positive expression rate of p53 protein and negative expression rate of pRB showed correlations with clinical parameters. 2. The three-year survival rate for p53 protein positive cases was worse than the p53 protein negative cases. 3. Expression rate of EGFR was not correlated with the clinical parameters. As a conclusion, expression rates of p53 protein and pRB not only reflect well the biologic behavior of laryngeal cancer, but correlate closely with the tumor factors. Therefore they may be useful as the prognosticator to predict the malignant potency of laryngeal squamous cell carcinomas.

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Control of Powdery Mildew on Cucumber by Using Oleic Acid in the Greenhouse (올레산을 이용한 오이의 흰가루병 방제)

  • Lee, Moon-Haeng;Kim, Young-Shik
    • Korean Journal of Organic Agriculture
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    • v.22 no.4
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    • pp.695-703
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    • 2014
  • We experimented with the effect of oleic acid and its appropriate concentration to prevent powdery mildew eco-friendly in a cucumber greenhouse cultivation. 'Baekbongdadaki' (Nongwoo Bio. co. Korea) was treated in the plastic greenhouse at Sangmyung University. We treated four levels of concentration of oleic acid, which were 0, 2000, 4000, 6000, and 8000 ppm. There were investigated diseased severity, diseased leaf area, control value, and pesticide injury. The degree of control values by oleic acid treatments was investigated at 3 days after treatment. The recurrence of powdery mildew was checked for 55 days. The day and night temperature in the greenhouse were controlled to 23 and $15^{\circ}C$ respectively. The humidity inside the greenhouse was not controlled to prevent outbreak of the disease. From the experimental results, oleic acid was very efficient to control powdery mildew. 2000 ppm of oleic acid was shown to be the most control efficiency without any pesticide injury. The recommended method to treat it was to spray three times every 3 weeks.

Retinoblastoma: Result of Radiotherapy (망막아세포종의 방사선치료 성적)

  • Kim, Il-Han;Kim, Jong-Hoon;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.169-176
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    • 1990
  • Radiotherapy result was analyzed in 23 children with retinoblastoma treated in Seoul National University Hospital from 1980 to 1987. Three ($17\%$) had bilateral tumor at diagnosis. Among 20 children with unilateral retinoblastoma 13 children got radiotherapy after enucleation, 2 were treated with radiotherapy alone, and 5 were delivered with radiotherapy after relapse. Of 15 non-recurrent unilateral tumors, there were 5 stage II children, 8 stage III, and 2 stage IV by staging system proposed by St. Jude Children's Research Hospital. Chemotherapy was combined when resection margin of the optic nerve was positive or when malignant cell was found in CSF. Of 12 children who completed radiotherapy, local or distant failure was not found but 2 cases of relapse at the contralateral retina were observed. Their 5 year survival rate was $82.2\%$. Another case of contralateral relapse was detected in children who was treated with radiotherapy alone. Thus overall frequency of the bilateral disease was $33\%$. Prognosis of recurrent tumors were so poor that no cases of CR was obtained and that 3 year survival rate was $20\%$. Two of 3 bilateral cases at diagnosis were in NED status. Complication were sunken orbit only. Result of radiotherapy was so good in early stage or small bulk tumor that treatment delay after diagnosis must not be allowed.

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Comparison of Effectiveness between Two Different Protocols of Treatment of IV γ-globulin in Idiopathic Thrombocytopenic Purpura (특발성 혈소판 감소성 자반증에서 정주용 감마 글로불린의 투여 방법에 따른 효과 비교)

  • Jang, Jae Ho;Lee, Moonsouk;Park, Mira;Choeh, Kyuchul
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.358-362
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    • 2003
  • Purpose : Several methods of IV ${\gamma}-globulin$(IVG) infusion are effective in the treatment of autoimmune disease, including idiopathic thrombocytopenic purpura(ITP). But it is not known which method is more effective in the treatment of ITP. The effectiveness of these two methods of IVG infusion was studied in terms of platelet recovery rate, side effects and recurrence rate. Methods : Forty seven patients with acute ITP in the department of pediatrics, Eulji University Hospital from January 1995 to June 2001 were enrolled. We assesssed the treatment effects of 47 patients blindly selected; IV ${\gamma}-globulin$ 2 g/kg/day in one day(treatment group A, n=25), 400 mg/kg/day in five days(treatment group B, n=22). Results : Treatment group A increased platelet count more rapidly on the 2nd, 4th and 6th day of treatment than treatment group B. Side effects like fever, chill and vomiting were more frequent in treatment group A than treatment group B. The platelet count on the sixth day of treatment showed a greater increase in the cases which had side effects than in the cases which did not. There was no difference between the two groups in the recurrence rate. Conclusion : IV ${\gamma}-globulin$ 2 g/kg/day in one day increases platelet count more rapidly than 400 mg/kg/day in five days, and is favorable for the prevention of a severe hemorrhagic episode like early intracranial hemorrhage.

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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Video-Assisted Thoracic Surgery for the Spontaneous Pneumothorax (비디오 흉강경을 이용한 자연성 기흉의 수술)

  • 김경훈;강경훈
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1111-1116
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    • 1997
  • In a period from Sep 1994 to Sep 1996, 38 patients were treated for spontaneous pneumothorax by video-assisted thoracic surgery(VATS). 31 male and 7 female patients with ages between 17 and 79(mean 30.0 years). No death occured. The postoperative complication rate of VATS was 7.9%(3/38). We noted no recurrence of pneumothorax, 3 wound dehiscence, 3 persistent air leak(>7days) in the patients. We compared theses results with thoracoscopic surgery of spontaneous pneumothorax in 38 cases(Group A), with cases of 21 patients(Group B) performed by the thoracotomy in the same period. There have been no recurrence in groud A, and one recurrence in group B at a median follow-up of 14.37$\pm$7.48 months and 16.81 $\pm$7.12 months, respectively. There was no significant difference in the duration of operation time including induction time between VATS and thoracotomy, but postoperative hospital stay and chest tube drainage periods were all less for these undergone VATS. Postoperative complication was less in group A(3/38=7.9%, 3 cases with persistent air leak >7days, all developed wound dehiscence, too), than in group B(9/21=42.9%, 8 cases with persistent air leak more than 7days, including 2 wound dehiscence, one recurrence, and the other one case of empyema). In our experience, VATS has the effectiveness of thoracic surgery for treating thoracic problems, has resulted in surgical intervention in spontaneous pneumothorax.

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The Cumulative Recurrence Rate of Colonic Adenomatous Polyps After Colon Polypectomy in a Single University Hospital Health Check-up Examinees (일개 대학병원 건강검진 수진자를 대상으로 한 선종성 대장용종절제술 후 대장용종의 누적재발률)

  • Hwang, Hye-Lim;Jung, Woo-Geun;Kim, Yun-Jin;Lee, Sang-Yeoup;Cho, Byung-Mann;Yi, Yu-Hyeon;Cho, Young-Hye;Tak, Young-Jin;Jeong, Dong-Wook;Lee, Jeong-Gyu
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.137-145
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    • 2014
  • Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.

New Technique for the Reconstruction of Both Anteromedial & Posterolateral Bundles of ACL (전방십자인대의 전내측 다발 및 후외측 다발을 각각 재건하는 새로운 수술 수기)

  • Ha Chul-Won;Awe Soo-Ik
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.195-199
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    • 2002
  • This article is to report a new technique for reconstruction of the anteromedial and posterolateral bundles of anterior cruciate ligament by separate tensioning and fixation of the each bundle. Method : Tibial and femoral tunnels were made with conventional technique of anterior cruciate ligament reconstruction. Tibial tunnel was enlarged $5\~7$ mm in anterior-posterior direction to make oval it in cross section. When preparing the Achilles tendon allograft, bone plug portion was trimmed as the conventional technique. The tendinous portion was trimmed as two separate bundles by dividing the tendinous portion longitudinally, so the graft is shaped like 'Y'. The bone plug portion of allograft was inserted into the femoral tunnel and fixed with absorbable cross pins. Two ligamentous portionss of the distal part of the grafts were tensioned separately at the external orifice. Anteromedial bundle was fastened under maximum tension with the knee flexed 90 degrees by post-tie method. The posterolateral bundle was fixed by the same technique with the knee in full extension. Then, an absorbable interference screw was inserted between the two bundles upto the upper end of the tibial tunnel, to get more initial rigidity of the reconstructed graft as well as to locate the two bundles in more anatomic position.

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Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma (후복막 연조직 육종의 수술 후 외부 방사선 치료)

  • Jang, Na-Young;Kim, Il-Han;Choi, Jin-Hwa;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.135-141
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    • 2008
  • Purpose: To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. Materials and Methods: The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, $8{\sim}240$ months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, $3{\sim}50\;cm$). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. Results: The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Conclusion: Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.