• Title/Summary/Keyword: 재발율

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The Significance of Ku70 Expression in Patients with Nasopharyngeal Carcinoma (비인강암에서 방사선치료의 예측인자로써 Ku70 발현의 의의)

  • Song Si Yeol;Lee Sang-wook;Yu Eunsil;Cho Kyung-Ja;Park Jin-hong;Kim Sang Yoon;Nam Soon Yuhl;Lee Bong-Jae;Kim Sung Bae;Choi Seung-Ho;Ahn Seung Do;Shin Seong Soo;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.1-8
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    • 2005
  • Purpose : The objective of this study was to determine whether the expressions of the two components of DNA-dependent protein kinase, Ku70 and DNA-PKcs, influence the response to radiotherapy (RT) and outcome of treatment of non-disseminated nasopharyngeal carcinoma (NPC) in patients who received definitive RT. Materials and Methods : Sixty-six patients with NPC who were treated with radiotherapy alone or with concurrent chemotherapy between June 1995 and December 2001 were divided into groups based on the levels of immunoreactivity for Ku70 and DNA-PKcs in pretreatment biopsy specimens. The over-expression of Ku70 or DNA-PKcs groups Included patients whose biopsy specimens showed at least 50% immunopositive tumor cells; patients in which less than 50% of the tumor cells in the biopsy tissues were immunopositive were placed in the low Ku70 and DNA-PKcs groups. The immunoreactivities for Ku70 and DNA-PKcs were retrospectively compared with the sensitivity of the tumor to radiation and the patterns of therapy failure. Univariate analyses were peformed to determine the prognostic factors that influenced locoregional control of NPC. Results : The five-year locoregional control rate was significantly higher in the low Ku70 group (Ku(-)) (85%) than in the high Ku70 group (Ku(+)) (42%) (p=0.0042). However, there were no differences in the metastases-free survival rates between the two groups (Ku70 (+), 82%; Ku70 (-), 78%; p=0.8672). Univariate analysis indicated that the over-expression of Ku70 surpassed other well-known predictive clinocopathologic parameters as an Independent prognostic factor for locoregionai control. Eighteen of 22 patients who had locoregional recurrences of the tumor displayed an over-expression of Ku70. No significant association was found between the level of DNA-PKcs expression and the clinical outcome. Conclusion : Our data suggest that the level of Ku70 expression can be used as a molecular marker to predict the response to RT and the locoregional control after RT and concurrent chemotherapy in patients with non-disseminated NPC.

Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear (외이도 및 중이 편평상피암의 방사선치료)

  • Kang, Hyun-Cheol;Wu, Hong-Gyun;Lee, Ji-Hye;Park, Charn-Il;Kim, Chong-Sun;Oh, Seung-Ha;Heo, Dae-Seog;Kim, Dong-Wan;Lee, Se-Hoon
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.173-180
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    • 2009
  • Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.

The Results of Definitive Radiation Therapy and The Analysis of Prognostic Factors for Non-Small Cell Lung Cancer (비소세포성 폐암에서 근치적 방사선치료 성적과 예후인자 분석)

  • Chang, Seung-Hee;Lee, Kyung-Ja;Lee, Soon-Nam
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.409-423
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    • 1998
  • Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

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Effects of Natural Compounds from Various Plant Eradicate the Persister Cell of Edwardsiella tarda Treated with Antibiotics of Florfenicol and Amoxicillin (천연 식물 추출물 첨가에 의한 어류 에드워드증(Edwardsiellosis) 발생균인 Edwardsiella tarda에 항생제 투여로 생성되는 persister cell 저감 효과)

  • Kim, Na-Kyoung;Kweon, Dae-Hyuk;Kim, Sung-Koo
    • Journal of Life Science
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    • v.22 no.6
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    • pp.788-793
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    • 2012
  • High concentration of antibiotics has been used to treat the outbreak of edwardsiellosis caused by Edwardsiella tarda in aquaculture. However, not all of the bacteria have been killed with high concentrations of antibiotics treatment by the formation of persister cells with a dormant state. The main objective of this study was to kill persister cell using antibiotics with the addition of natural plant compounds. Antibiotics used in this study consist of 100 mg/ml florfenicol and 100 mg/ml amoxicillin. Ten natural plant compounds with persister cell inhibitor activity to E. coli were obtained from Protein Engineering and Systems Biology Lab. of Sungkyunkwan University. The persister cell inhibition activities of those natural plant compounds were evaluated in test tube. Concentrations of the antibiotics were in the ranges of 25~200 ${\mu}g/ml$. The persister cell formation was observed after 16 hours of culture. Persister cells were killed by antibiotics with natural plant compounds. Among ten natural plant compounds, Gynostemma pentaphyllum, Mallotus japonicus, and Orixa japonica showed persister cell formation inhibition activities. The optimal concentrations of G. pentaphyllum, M. japonicus, and O. japonica for the inhibitor of persister cell formation were 100 ${\mu}g/ml$, 100 ${\mu}g/ml$, and 200 ${\mu}g/ml$, respectively. In vivo study was carried out to evaluate the effect of the antibiotics with natural plant compounds using aquacultural fish, olive flounder, as test animals. G. pentaphyllum, M. japonicus, and O. japonica of 30 ${\mu}g/ml$, 10 ${\mu}g/ml$, and 10 ${\mu}g/ml$ with antibiotics reduced cumulative mortalities, showing the effectiveness of persister cell inhibition.

Synovial Sarcoma (활막 육종)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Jin-Yong;Cho, Nan-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.91-97
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    • 1995
  • Synovial sarcoma is a malignant soft tissue tumor which is the most prevalent in adolescents and young adults between 10 and 40 years of age. It occurs primarily in the para-articular regions, usually in close association with tendon sheath, bursae and joint capsules. Favorable clinical factors are young age of the patients, tumor size smaller than 5cm, and distal rather than proximal location in the extremities. We analysed clinical findings of 13 cases of synovial sarcoma that had been experienced from January 1983 to December 1992. There were 8 females and 5 males, whose age was averaged as 28 years and 10 months ranging from 6 years to 54 years. The mean follow-up was 3 years(range : 9 months- 9 years 1 month). Palpable mass was frequent clinical symptom and lower extremity especially around the knee was the most prevalent site. Treatment modalities were the combination of surgery, radiotherapy and chemotherapy. Distant metastasis occured in 5(38%) cases : 4 cases to lung and 1 case to neck, and 2 cases had local recurrences. At final follow-up 6 cases were continous disease free, 2 alive with disease and 5 died of disease. The Kaplan-Meier's estimated 5 year survival rate of total 13 cases was 66% and satisfactory results were obtained with mass size smaller than 5cm.

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Radiotherapy Results of Pineal Tumors (송과선종의 방사선치료 성적)

  • Chai Kyu Young;Park Woo Yoon;Choi Doo Ho;Chung Woong Ki;Kim Il Han;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.177-182
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    • 1988
  • A retrospective analysis was peformed on 23 patients with pineal region tumors treated with radiation from 1979 through 1985 at the Department of Therapeutic Radiology, Seoul National University Hospital. Histologic confirmation was done in only one case by surgical removal, and in the remaining 22 patients, the diagnosis was based on clinical and radiological findings. The radiation volume was the primary tumor site in 1 case, whole brain in 14 cases, and the whole craniospinal axis En 8 cases. The overall 5 year survival was $71.5\%$. The 5 year survival was $69.3\%$ for whole brain treated group and $73.3\%$ for craniospinal axis treated group. The survival for the two groups did not differ significantly. In two cases sites of recurrence were detected, one in supratentorial area, and the other in the lung. The results from this retrospective analysis and the review of other reports indicate that routine use of prophylactic spinal irradiation is not warranted in pineal region tumor, and the craniospinal irradiation is recommended in cases with high risk for subarachnoid seeding such as positive CSF cytology, surgical removal or biopsy.

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Radiation Treatment for Primary Adenocarcinoma of Bartholin's Gland - A Case Report and Review of Literature - (Bartholin 씨선(氏腺)에서 발생한 선암(腺癌)의 방사선치료)

  • Oh, Won-Yong;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.71-76
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    • 1989
  • A patient with primary adenocarcinoma of Bartholin's gland is reported and the literatures relevant to this disease reviewed. Not only this disease is very rare but also primary carcinomas of Bartholin's gland are misdiagnosed as cysts or abscesses in half of the cases, leading to considerable delay in diagnosis. And so, It was wasted long time before definitive therapy. However, because of a different clinical behavior, cancer of the Bartholin's gland should be distinguished from other vulvar carcinomas. Histologically, squamous cell carcinoma and adenocarcinoma are the most common. Virtually all histologic types of Bartholin's gland carcinoma metastasize to lymph node, bone, lung and liver in distant sites. The authors data and a review of the literature support the concept that radical vulvectomy with or without bilateral inguinal-femoral lymphadenectomy is required. On the other hand, except primary radiation treatment for small or medium sized cancers, the results obtained by radiation therapy in carcinoma of the vulva including Bartholin's gland are generally discouraging. A role for postoperative adjuvant radiation therapy suggests because of high incidence of positive inguinal-femoral Iymph nodes. In the near time, natural history and biological behavior of Bartholin's gland cancer must be disclosed in detail. And also optimal treatment modality and prognostic factors shall be determine.

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The Role of Radiation Therapy in Adenocarcinoma of Endometrium (자궁 체부암의 방사선 치료)

  • Yun Hyong Geun;Ha Sung Whan;kang Soon Beom;Lee Hyo Pyo
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.95-102
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    • 1990
  • From May, 1979 to October,1987, 38 patients with endometrial carcinoma were treated with radiotherapy at Seoul National University Hospital. Of these, 32 patients received radiotherapy Postoperatively, one received radiotherapy preoperatively, and five received radiotherapy only. Relative frequencies of obesity, nulliparity, late menopause, diabetes mellitus, and hypertension were all higher than those reported in normal women in Korea, and those of obesity, diabetes mellitus, and nulliparity were significantly high. The overall actuarial five-year survival rate was $75.6\%$. The overall actuarial five year survival rates of stage I (22 cases), stage II (six cases), and stage III (10 cases) were $90.0\%,\;80.0\%,\;and\;44.4\%$, respectively, and were significantly different from each other. Among various factors, stage only proved to be prognostic by multivariate analysis. There were two local failures, three local failures combined with distant metastasis, and three distant metastasis. Stages I and II could be adequately controlled by local modalities without severe complications, stage III endometrial carcinoma might need more aggressive treatment for better survival.

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Radiation Treatment of Esophageal Cancer (식도암의 방사선치료)

  • Oh W. Y.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.41-50
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    • 1985
  • 63 patients who were irradiated with a goal of long term control among 101 patients with esophageal cancer seen during an 11 fears period between Jan, 1970 and Dec, 1980 at Yonsei Cancer Center in Seoul, Korea have retrospectively analysed. 52(82.5%) among the 63 Patients were confirmed to have epidermoid carcinoma in the histology. 46 cases(73.0%) except 17 cases of $T_1$, were locally or far advanced extension. Tumor dose of radical radiation in the management of esophageal cancer had delivered from 50 Gy to 74 Gys. 2 Gys daily fractions, between 5weeks and 8 weeks. After 1 month from the completion of radiation, 23 of the 63 patients had a repeat barium esophagogram for the assessment of tumor response, there had showed 7 cases of complete response and 15 cases of partial response. 45(71.4%) patients were followed up and the remaining 18 patients were lost to follow-up within 1 year after the completion of irradiation. Actuarial overall 3 and 5 years survival rate of all 63 Patients were 11.8% and 8.8%, respectively. The actuarial 3 and 5 years survival rates of 17 cases of $T_1$, esophageal cancer were 24.7% and 20.8%. Statistically, there was no significant difference in survival rate according to tumor location (p>0.05). Radical Radiotherapy, Esophageal Cancer

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The First Year of the Moon Jae-In Government: An Assessment (문재인 정부 1년의 평가와 전망)

  • Kang, Won-Taek
    • Korean Journal of Legislative Studies
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    • v.24 no.1
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    • pp.5-29
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    • 2018
  • This paper aims at making an assessment about the first year of the Moon Jae-in government. President Moon was elected amid political insecurity over the impeachment of then-president Park Geun-hye. However, the Moon administration settled in fairly smoothly despite no transition period of presidential power. Political and economic stability was soon restored, and the tensions between the US and North Korea over the North's nuclear weapons program were, to some extent, managed along with the agreement of the North-South summit and the US-North Korea summit. Pyeongchang hosted the 2018 winter olympics and paralympics successfully. Moon continued very positive approval ratings of higher than 70%. However, he has something to be desired. His leadership seems to rely heavily on a limited number of close staff in the Blue House, alienating the governing the Minjoo Party of Korea. He should build better relationship with opposition parties particularly given a divided government. Rectification of the lingering negative practices should also produce institutional solutions. Above all, Moon should carefully watch out to prevent scandals over corruption and power abuse around him and his family, which would lead to a precipitous decline of the approval ratings and the abrupt weakening of the leadership.