• Title/Summary/Keyword: 촬영지

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Effect of Pelvic Irradiation on the Bone Mineral Content of Lumbar Spine in Cervical Cancer (자궁경부암 환자에서 방사선 치료가 골무기물 함량에 미치는 영향)

  • Youn Seon Min;Choi Tae Jin;Koo Eun Sil;Kim Ok Bae;Lee Seung Moon;Suh Soo Jhi
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.145-151
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    • 1997
  • Purpose : To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. Method and materials : Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using Photon energy of 120 and 80kVp, The numbers of Patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth and 11 in seventh decade, those of patient group were 14 in filth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for Pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer, Results : The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about $13\%\;to\;40\%$ maximally. The BMC of L3 and L4 a region that is out of a radiation field for the Patient group demonstrated $119.5\pm30.6,\;117.0\pm31.7\;for\;fifth,\;83.3\pm37.8,\;88.3\pm46.8\;for\;sixth\;and\;61.5\pm18.3,\;56.2\pm26.6mg/cc$ for seventh, Contrasted by the normal control group has shown $148.0\pm19.9,\;153.2\pm23.2\;for\;fifth,\;96.1\pm30.2,\;105.6\pm26.5\;for\;sixth\;and\;73.9\pm27.9,\;77.2\pm27.2mg/cc$ for seventh decade, respectively The BMG of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In Particular, the BMC of L5 within the radiation field was significantly decresed to $33\%,\;31\%,\;40\%$ compared with the control group of the fifth, sixth and seventh decades, respectively. Conclusion : The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in Patient group with Pelvic irradiation in contrast to that of the normal control groups.

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Image Quality Evaluation of CsI:Tl and Gd2O2S Detectors in the Indirect-Conversion DR System (간접변환방식 DR장비에서 CsI:Tl과 Gd2O2S의 검출기 화질 평가)

  • Kong, Changgi;Choi, Namgil;Jung, Myoyoung;Song, Jongnam;Kim, Wook;Han, Jaebok
    • Journal of the Korean Society of Radiology
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    • v.11 no.1
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    • pp.27-35
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    • 2017
  • The purpose of this study was to investigate the features of CsI:Tl and $Gd_2O_2S$ detectors with an indirect conversion method using phantom in the DR (digital radiography) system by obtaining images of thick chest phantom, medium thickness thigh phantom, and thin hand phantom and by analyzing the SNR and CNR. As a result of measuring the SNR and CNR according to the thickness change of the subject, the SNR and CNR were higher in CsI:Tl detector than in $Gd_2O_2S$ detector when the medium thickness thigh phantom and thin hand phantom were scanned. However, when the thick chest phantom was used, for the SNR at 80~125 kVp and the CNR at 80~110 kVp in the $Gd_2O_2S$ detector, the values were higher than those of CsI:Tl detector. The SNR and CNR both increased as the tube voltage increased. The SNR and CNR of CsI:Tl detector in the medium thickness thigh phantom increased at 40~50 kVp and decreased as the tube voltage increased. The SNR and CNR of $Gd_2O_2S$ detector increased at 40~60 kVp and decreased as the tube voltage increased. The SNR and CNR of CsI:Tl detctor in the thin hand phantom decreased at the low tube voltage and increased as the tube voltage increased, but they decreased again at 100~110 kVp, while the SNR and CNR of $Gd_2O_2S$ detector were found to decrease as the tube voltage increased. The MTF of CsI:Tl detector was 6.02~90.90% higher than that of $Gd_2O_2S$ detector at 0.5~3 lp/mm. The DQE of CsI:Tl detector was 66.67~233.33% higher than that of $Gd_2O_2S$ detector. In conclusion, although the values of CsI:Tl detector were higher than those of $Gd_2O_2S$ detector in the comparison of MTF and DQE, the cheaper $Gd_2O_2S$ detector had higher SNR and CNR than the expensive CsI:Tl detector at a certain tube voltage range in the thick check phantom. At chest X-ray, if the $Gd_2O_2S$ detector is used rather than the CsI:Tl detector, chest images with excellent quality can be obtained, which will be useful for examination. Moreover, price/performance should be considered when determining the detector type from the viewpoint of the user.

The Study on the Independent Predictive Factor of Restenosis after Percutaneous Coronary Intervention used Drug-Eluting Stent : Case on MDCT Calcium-Scoring Implementation Patient (약물용출 스텐트를 이용한 관상동맥중재술 후 재협착의 독립적 예측인자에 관한 연구 : MDCT calcium-scoring 시행 환자 대상으로)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo;Jang, Young-Ill
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.37-44
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    • 2010
  • We sought to confirm an independent factor about in-stent restenosis (ISR) in the patients who underwent drug-eluting stent (DES) and know a possibility as a predictor of measured coronary artery calcium score by MDCT. A total of 178 patients (159 men, $61.7{\pm}10.0$ years of age) with 190 coronary artery lesions were included in this study out of 1,131 patients who underwent percutaneous coronary intervention (PCI) with DES implantation for significant stenosis on MDCT at Chonnam National University Hospital between May 2006 and May 2009. All lesions were divided into two groups with the presence of ISR : group I (re ISR, N = 57) and group II (no ISR, N = 133). Compared to group II, group I was more likely to be older ($65.8{\pm}9.0$ vs. $60.2{\pm}9.9$ years, p = 0.0001), diabetic (21.8% vs. 52.6%, p = 0.0001), have old myocardial infarction (8.8% vs. 2.3%, p = 0.040), left main stem disease (5.3% vs. 0.8%, p = 0.047), and smaller stent size ($3.1{\pm}0.3\;mm$ vs. $3.3{\pm}0.4\;mm$, p = 0.004). Group II was more likely to be smokers (19.3% vs. 42.1%, p = 0.003), have dyslipidemia (8.8% vs. 23.3%, p = 0.019). Left ventricular ejection fraction, lesion complexity, and stent length were not different between the two groups. Total CAC score was $389.3{\pm}458.3$ in group I and $371.2{\pm}500.8$ in group II (p = 0.185). No statistical difference was observed between the groups in CAC score in the culprit vessel, left main stem, left anterior descending artery, left circumflex artery, and right coronary artery. On multivariate logistic regression analysis, left main stem disease (OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), male sex (OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), and the presence of diabetes (OR = 2.62, 95% CI = 1.071-6.450, p = 0.035) were independent predictors of ISR after DES implantation. In patients who underwent DES implantation for significant coronary stenosis on MDCT, ISR was associated with left main stem disease, male sex, and the presence of diabetes. However, CAC score by MDCT was not a predictor of ISR in this study population.

A Morphologic Study of head and face for Sasang Constitution (사상체질별(四象體質別) 두면부(頭面部)의 형태학적(形態學的) 특징(特徵))

  • Ko, Byung-Hee;Song, Il-Byung;Cho, Yong-Jin;Choi, Chang-Seok;Kim, Jong-Weon;Hong, Suck-CHull;Lee, Eui-Ju;Lee, Sang-Yong;Seo, Jeong-Sug
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.101-186
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    • 1996
  • The clinical application of constitutional Diagnosis is the most important part of Sasang constitutional medicine. It has been studied in various way. However, the study of morphologic characteristics on the face is applied for the first time. For quantitative analysis of the correlation between the sasang constitution and the shape of the face, the head-facial part of 170 cases were measured by Martin's measurement and analysis of a) the measurement value of height and the component ratio from the Gnathion to each part of face by constitution. b) the measurement value of depth and the component ratio from T-projected to each part of the face by constitution. c) the measurement value of breadth and component ratio between each parts of the facial breadth by constitution. d) the ratio of square on every part of face by constitution. e) the characteristics on each part of the face by constitution. f) the contour line of the forehead. g) the result of discriminant analysis about the constitution. Authors obtained the results from the study as follows; 1. The characteristics of Taeum-IN (1) The measurement value of Height, Breadth, T-Projected had a tendency to maximum value in general. (2) The value of lower opthal height and the square of lower opthal part was maximum. (3) The value of Pronasal T-projected length and Subnasal T-projected length was minimum, so Taeum-In has characteristics of depression in middle face, nasal part. (4) In the ratio of Breadth, T-Projected, T-Projected was minimum. (5) It was maximum that the square of nose, Alare, Middle face, Lower face and it was minimum that the square of eye. The square of nose, Alare, Middle facc, Lower face was maximum and the square of eye was minimum. (6) The curvature of the eyebrow was minimum. (7) The projection of jaw (Pogonion T-projection length) was maximum. (8) The breadth of eye was minimum. (9) There was a tendency that the projection of the forehead to the right in general. 2. The characteristics of Soeum-In (1) In all cases of projected length the measurement value was minimum. (2) The value of lower opthal height and the square of lower opthal part was minimum. (3) By the Pupulare T-projected length, the value of Pronasal T-projected length and Subnasal T-projected length was minimum, so the Soeum In's face shape is flat. (4) The square of eye, mouth, forehead was maximum and the square of nose, Alare, Middle face, Lower face was minimum. (5) The curvature of the eyebrow was maximum. (6) The projection of mouth was minimum. (7) The jaw was flat. (8) The breadth of eye was maximum. (9) There was a tendency that the projection of the forehead to the left in general. 3. The characteristics of Soyang-In. (1) In most cases of 고경 length the measurement value was minimum. (2) By the Pupulare T-projected length, each ratio of projected length was maximum, so the Soyang-In's face shape has many protrusions (3) In the ratio of Breadth, T-Projected, T-Projected was maximum. (4) The square of mouth was minimum. (5) The inclination of the forehead was minimum. (6) The projection of mouth was maximum. (7) The breadth of eye was minimum. (8) There was a tendency that the projection of the forehead to the left in general. (9) The middle face was protruded. 4. Discriminant about the constitution. According to the result of discriminant, the accuracy probability of discriminant was 85.58% in total and Taeum-In was 90.5%, Soeum-In was 70.8%, Soyang-In was 89.5%. The accuracy probability of discriminant about 3 constitutional group increased by 49.03% than the accident probility 36.55% 5. Suggestion (1) The study which gather and analysis the data should be continued. (2) The study which subdivide the characteristics of each part of the face by the constitution should be continued. (3) The analysis method about Moire should be supplement. (4) The study about the morphologic characteristics of the whole body should be continued. (5) Computer program of constitution diagnosis should be developed. (6) To increase utility of this method, the measurement should be automation.

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Clinical Study on Thoracic Actinomycosis (흉부 방선균종의 임상적 고찰)

  • Hong, Sang-Bum;Kim, Woo-Sung;Lee, Jae-Hwan;Bang, Sung-Jo;Shim, Tae-Son;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Lee, In-Chul;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1058-1066
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    • 1998
  • Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

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Excavation of Kim Jeong-gi and Korean Archeology (창산 김정기의 유적조사와 한국고고학)

  • Lee, Ju-heun
    • Korean Journal of Heritage: History & Science
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    • v.50 no.4
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    • pp.4-19
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    • 2017
  • Kim Jeong-gi (pen-name: Changsan, Mar. 31, 1930 - Aug. 26, 2015) made a major breakthrough in the history of cultural property excavation in Korea: In 1959, he began to develop an interest in cultural heritage after starting work as an employee of the National Museum of Korea. For about thirty years until he retired from the National Research Institute of Cultural Heritage in 1987, he devoted his life to the excavation of our country's historical relics and artifacts and compiled countless data about them. He continued striving to identify the unique value and meaning of our cultural heritage in universities and excavation organizations until he passed away in 2015. Changsan spearheaded all of Korea's monumental archeological excavations and research. He is widely known at home and abroad as a scholar of Korean archeology, particularly in the early years of its existence as an academic discipline. As such, he has had a considerable influence on the development of Korean archeology. Although his multiple activities and roles are meaningful in terms of the country's archaeological history, there are limits to his contributions nevertheless. The Deoksugung Palace period (1955-1972), when the National Museum of Korea was situated in Deoksugung Palace, is considered to be a time of great significance for Korean archeology, as relics with diverse characteristics were researched during this period. Changsan actively participated in archeological surveys of prehistoric shell mounds and dwellings, conducted surveys of historical relics, measured many historical sites, and took charge of photographing and drawing such relics. He put to good use all the excavation techniques that he had learned in Japan, while his countrywide archaeological surveys are highly regarded in terms of academic history as well. What particularly sets his perspectives apart in archaeological terms is the fact that he raised the possibility of underwater tombs in ancient times, and also coined the term "Haemi Culture" as part of a theory of local culture aimed at furthering understanding of Bronze Age cultures in Korea. His input was simply breathtaking. In 1969, the National Research Institute of Cultural Heritage (NRICH) was founded and Changsan was appointed as its head. Despite the many difficulties he faced in running the institute with limited financial and human resources, he gave everything he had to research and field studies of the brilliant cultural heritages that Korea has preserved for so long. Changsan succeeded in restoring Bulguksa Temple, and followed this up with the successful excavation of the Cheonmachong Tomb and the Hwangnamdaechong Tomb in Gyeongju. He then explored the Hwangnyongsa Temple site, Bunhwangsa Temple, and the Mireuksa Temple site in order to systematically evaluate the Buddhist culture and structures of the Three Kingdoms Period. We can safely say that the large excavation projects that he organized and carried out at that time not only laid the foundations for Korean archeology but also made significant contributions to studies in related fields. Above all, in terms of the developmental process of Korean archeology, the achievements he generated with his exceptional passion during the period are almost too numerous to mention, but they include his systematization of various excavation methods, cultivation of archaeologists, popularization of archeological excavations, formalization of survey records, and promotion of data disclosure. On the other hand, although this "Excavation King" devoted himself to excavations, kept precise records, and paid keen attention to every detail, he failed to overcome the limitations of his era in the process of defining the nature of cultural remains and interpreting historical sites and structures. Despite his many roles in Korean archeology, the fact that he left behind a controversy over the identity of the occupant of the Hwangnamdaechong Tomb remains a sore spot in his otherwise perfect reputation.

A Review of Current Status and Placeness on the Yusang-Goksu Ruins in Hwanggak-dong, Geumma, Iksan (익산 금마 황각동 유상곡수 유적 일대의 현황과 장소성에 대한 일고찰)

  • Rho, Jae-Hyun;Han, Min-Soon;Seo, Youn-Mi;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.3
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    • pp.20-35
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    • 2022
  • This study was conducted on the locational results of the 'Yusanggoksu(流觴曲水)' petroglyphs located in Hwanggak-dong(黃閣洞), Shinsong-ri, Geumma-myeon, Iksan-si through literature study, analysis of old maps and aerial photos, field observations, drone photography, elevation surveys, and interviews with residents. It was attempted for the purpose of illuminating and preserving the relics of the domestic Yusanggoksu garden by clarifying the spatiality of this place by tracing the spatiality and examining the possibility of enjoying the Yusanggoksu water system in this place. The conclusion of this study is as follows. The area around Hwanggak-dong, where the Yusanggoksu remains, has been selected as the most beautiful scenic spot in Iksan in various documents. The origin of 'Hwanggak' is considered to be closely related to the nickname of Uijeongbu(議政府). In other words, he paid attention to the relationship with Yanggok, So Se-yang(蘇世讓), who served as Chan-seong Jwa(左贊成). In particular, he paid attention to the relationship with his birthplace, Taeheojeong, a separate book, and Toehyudang, a retreat hall), tombs, and posthumous Confucian academies were distributed in the vicinity. Haseo-dae(荷鋤臺), a wide rock on which a hoe is hung on a rock after field work, seems to express a leisurely rural life and a simple and hermit life, based on the examples of Chinese and Korean poetry. The dark blood on the upper part of the Seobwi Rock with the inscription 'Yusanggoksu', which is the core of this site, is identified as a chailgong(遮日孔) to support the water system, and Ilgan-pavilion and Mojeong(茅亭) nearby are to support the yusanggoksu. It seems to have performed a spatial function for The inscription 'Hwanggak-dong' engraved on the front of Deungzanbawi is the gateway to Hwanggakdongcheon(黃閣洞天) and identified the idealized world existing in the village. Judging from the documentary records of the Iksan-gun 『Chongswaelog(叢瑣錄)』, the rock letters 'Hwanggak-dong' and 'Haseodae' were engraved on March 29, 1901, the 5th year of Gwangmu, the 5th year of the Korean Empire, by Iksan-gun Governor Oh Haeng-mook(吳宖默) and his acquaintance Seokseong Kim In-gil(金寅吉) Confirmed. Also, considering the tense of Lee Bong-gu's 「Hwanggakdongun(黃閣洞韻)」 and So Jin-deok, a descendant of Yanggok, 「Hwanggakdongsihoe(黃閣洞詩會)」, it is presumed that it was related to Goksuyeon(曲水宴) in Hwanggak-dong. It can be inferred that the current affairs meetings were held at least until the early days of Japanese colonial rule. Meanwhile, the maximum width of the current curved waterway was calculated as 11.3m and the transverse slope was 15.0%. If so, it is estimated that the width and extension distance of the curved waterway would have been much longer. Judging from the use of mochun(暮春), drinking and poetry, the tense 'Hwanggakdongsihoe' related to the Yusanggoksu relics in Hwanggak-dong, and the existence of a pavilion presumed to be Yusangjeong(流觴亭) called Ilgan-pavilion in the nearby Yusanggoksu site It is confirmed that it was a space where Yusanggoksuyeon(流觴曲水宴) spread at least until the end of the Joseon Dynasty. Unfortunately, it remains a limitation of the study that it cannot be confirmed due to lack of data on the rock characters of 'Yusanggoksu' and those who enjoyed it before the end of the Joseon Dynasty. This is an area that needs to be elucidated through continuous efforts to find data on this issue in the future.

A Survey on the Perception of the Counterplans of Medical Accident and Dispute of Dental Hygienist (의료사고 및 의료분쟁에 대한 치위생사의 인식도 조사)

  • Oh, Jin-Ho;Kwon, Jeong-Seung;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.9-33
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    • 2007
  • In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.