• Radiation Oncology Journal
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• 제33권4호
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• pp.301-309
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• 2015

Purpose: To identify prognostic factors for disease progression and survival of patients with extracranial oligometastatic breast cancer (EOMBC), and to investigate the role of radiation therapy (RT) for metastatic lesions. Materials and Methods: We retrospectively reviewed the medical records of 50 patients who had been diagnosed with EOMBC following standard treatment for primary breast cancer initially, and received RT for metastatic lesions, with or without other systemic therapy between January 2004 and December 2008. EOMBC was defined as breast cancer with five or less metastases involving any organs except the brain. All patients had bone metastasis (BM) and seven patients had pulmonary, hepatic, or lymph node metastasis. Median RT dose applied to metastatic lesions was 30 Gy (range, 20 to 60 Gy). Results: The 5-year tumor local control (LC) and 3-year distant progression-free survival (DPFS) rate were 66.1% and 36.8%, respectively. High RT dose (${\geq}50Gy_{10}$) was significantly associated with improved LC. The 5-year overall survival (OS) rate was 49%. Positive hormone receptor status, pathologic nodal stage of primary cancer, solitary BM, and whole-lesion RT (WLRT), defined as RT whose field encompassed entire extent of disease, were associated with better survival. On analysis for subgroup of solitary BM, high RT dose was significantly associated with improved LC and DPFS, shorter metastasis-to-RT interval (${\leq}1month$) with improved DPFS, and WLRT with improved DPFS and OS, respectively. Conclusion: High-dose RT in solitary BM status and WLRT have the potential to improve the progression-free survival and OS of patients with EOMBC.

• Journal of Gastric Cancer
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• 제4권1호
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• pp.1-6
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• 2004

Purpose: Despite numorous reports on the relationship between the level of carcinoembryonic antigen (CEA) in gall bladder bile and liver metastasis in colorectal cancer, no similar studies have been carried out for gastric carcinomas. We, therefore, undertook the present study to establish the relationship between the gall bladder bile CEA and liver metastasis as well as the post-operative survival rate in gastric carcinoma patients with curative resections. Materials and Methods: In 373 gastric cancer patients (252 males, 121 females, age $21\∼76$ years) operated on at Kosin University Hospital between 1989 1996, the CEA concentration in the gall bladder bile was determined during the operation and the value was related to the rates of post-operative survival and liver metastasis during follow-up period. Results: The overall rate of patient survival decreased gradually with increase in TNM stage. The 13-year postoperative survival rates for stages Ia, Ib, II, IIIa, and IIIb were $95.7\%,\;92.5\%,\;79.9\%,\;50.9\%,\;and\;43.3\$, respectively, and the 10-year survival rate for stage IV was $22.6\%$. The patients with a high ($\geq$10 ng/ml) biliary CEA showed a significantly lower rate of survival than those with a low (<10 ng/ml) biliary CEA. The 13-year cumulative survival rate was $55.4\%$ for the high CEA group and $76.5\%$ for the low CEA group (P<0.01). Also, the patients with a high biliary CEA showed a significantly higher rate ($11.5\%$) of liver metastasis than those with a low biliary CEA ($1.9\%$) (P<0.000). In patients with TNM stages (I and II), the CEA level did not affect the post-operative survival rates ($95.4\%\;and87.7\%$ in the high and low CEA groups, P>0.10), but in those with high TNM stages (III and IV), the survival rate was significantly lower in the high CEA group ($25.9\%$) than in the low CEA group ($57.8\%$) (P<0.05). Conclusion: These result suggest that the gall bladder bile CEA level obtained in an advanced-staged gastric cancer operation may be used in predicting the post-operational survival rate and in sorting out patients with a high risk for cancer recurrence, especially in the liver area.

• Radiation Oncology Journal
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• 제13권3호
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• pp.259-266
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• 1995

Purpose : The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. Materials and Methods : From January 1980 through December 1985, 227 patients with stage III uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients($317{\%}$) were stage IIIa, and 155 patients($68.3{\%}$) were stage IIIb according to FIGO classification. Age distribution was 32-71 years (median: 62 years). Sixty nine patients($95.8{\%}$) in stage IIIa and 150 patient ($96.8{\%}$) in stage IIIb were squamous cell carcinoma. pelvic lymph node metastasis at initial diagnosis was 8 patients($11.1{\%}$) in stage IIIa and 29 patients($18.7{\%}$) in stage IIIb, Among 72 patients with stage IIIa, 36 patients ($50{\%}$) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr.) and 36 patients($50{\%}$) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with $Cs^{137}$ sources, and among 155 patients with stage IIIb, 80 patients ($51.6{\%}$) were treated with external radiation therapy alone and 75 patients ($48.4{\%}$) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median: 78.5 Gy) and 65-125.5 Gy (median 83.5 Gy). Survival rate was calculated by life-table method. Results : Complete response rates were $58.3{\%}$(42 patients) in stage IIIa and $56.1{\%}$(87 patients) in stage IIIb. Overall 5 year survival rates were $57{\%}$ in stage IIIa and $40{\%}$ in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were $64{\%},\;40{\%}$ in the group treated in combination of external radiation and ICR, and $50\%,\;40\%$ in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were $90\%,\;66\%$ in responder group and $10\%,\;7\%$ in non-responder group (P<0.001) There were statistically no significant differences of 5 year survival rate by total radiation doses and external radiation doses(40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatment failures rates were $40.3\%$(29 patients) in stage IIla and $57.4\%$(89 patients) in stage IIIb. 17 patients ($23.6\%$) in stage IIIa and 46 patients ($29.7\%$) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa($50\%$) and IIIb($50\%$). Serious complication rates were higher in group received external radiation doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Serious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of death was cachexia due to locoregional failure in both stage IIIa($34.7\%$) and IIIb($43.9\%$). Conclusion : From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy to whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.

• 한국환경복원기술학회지
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• 제10권5호
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• pp.40-50
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• 2007

One-year-old rooted cuttings of ten poplar clones and one willow clone were planted in a riparian area in Osan. Survival rate, growth performance, biomass, vitality, defoliation, leaf damages by diseases and/or insects and stem borer damage of the poplar and willow clones have been investigated for three growing seasons. Average survival rate of all eleven clones was declined from 80.7% for the first year to 60.7% for the third year. At three years after planting, poplar clones Dorskamp, ST-148 and Eco-28 showed the best survival rate of 80%. For height and DBH growth, the poplar clone Ay-48 and the willow clone 131-25 were the highest 8.3m and 9.5cm, respectively. However, poplar clones 72-30 and 72-31 were lower than those of the other clones. Clones Ay-48 and 131-25 seemed to have strong vitality when compare to the other clones. No serious damages by diseases and insects were found in most clones. Clones Ay-48 and ST-148 were the most tolerant to various diseases and insects. Clone Ay-48 produced the largest biomass for individual and annual total biomass, 22.5kg and 18.7ton $ha^{-1}$, respectively. Clone Dorskamp showed the best adaptability, which was estimated with survival rate, biomass and damages by various diseases and insects in the riparian area and followed by clones Ay-48, 97-19 and Eco-28. As a consequence, the four clones seemed to be the best candidate poplar clones for the establishment of riparian woody buffer.

• Radiation Oncology Journal
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• 제8권1호
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• pp.45-50
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• 1990

1979년 2월부터 1986년 9월까지 서울대학교 병원 치료방사선과에서 치료받은 상악동의 편평상피 암 환자 73예를 분석하였다. 41예에서는 수술과 수술후 또는 수술전 방사선치료를 병용하여 치료하였고 32예에서는 방사선치료만을 주치료로 시행하였다. 전체환자의 5년 생존율은 $40.4\%$였으며 방사선치료만을 주치료로 시행한 집단의 5년 생존율은 $22.1\%$였고 수술과 방사선치료를 함께 시행한 집단의 5년 생존율은 $65.3\%$였다. 치료 후 사망이 확인된 환자 가운데 상세한 치료실패 과정을 알 수 있었던 31예 중 잔류병소를 포함 국소치유실패를 나타냈던 경우가 22예($71.0\%$)였고 경부임파절 재발로 인한 치유실패가 6예($19.3\%$)였으며 인격전이로 인한 치유실패가 3예 ($9.7\%$)에서 나타났다. 그러므로, 상악동 암의 국소치유율을 증가시켜서 생존율을 높이기 위해서는 계획된 수술과 방사선 치료의 병용요법이 필요할 것으로 생각된다.

• 대한치과의사협회지
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• 제55권2호
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• pp.116-127
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• 2017

Objectives : The aim of this study was to evaluate the cumulative survival rates of the implants placed into grafted sinus and determine the effect of age, gender, smoking, and systemic disease on the implant cumulative survival rates. Materials and Methods : The retrospective study was performed on 51 implants placed in 26 patients by one dentist at the Dental Implant Center, Seoul National University Dental Hospital in the years 2000-2010. The cumulative survival rates were calculated by the Kaplan-Meier method. The differences within the factors were analyzed using log-rank test and the correlations between the factors and implant survival rates were analyzed using Cox proportional hazard model. Results : 1. Among the total of 51 implants placed in 26 patients, 7 implants failed and 44 implants remained stable. The 1-year, 5-year, and 10-year cumulative survival rates were 92%, 88%, and 85%, respectively. 2. Patients in their 50s and in their 70s showed statistically significant difference in the cumulative survival rates (P < 0.05). Gender and the existence of systemic disease did not show significant results. 3. In the implant treatment, smokers showed 7.5 times higher risk of implant failure than non-smokers (P < 0.05). Conclusion: Implants installed in combination with sinus elevation can be considered as a reliable treatment method.

• 대한기관식도과학회지
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• 제9권2호
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• pp.36-43
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• 2003

Background and objectives; Esophageal cancer is one of the most malignant tumors and has a poor prognosis. Many clinical studies have been tried for improving prognosis of esophageal cancer. Some clinical studies used molecular markers as the predictor of prognosis & the indicator for the choice of multimodality treatments. We investigated the relationship between some molecular markers, including p53 mutation, expression of bc12, Ki67 index, expression of E-Cadherin and the prognosis of esophageal cancer, Materials and Method; The materials used in this study were the tumor specimens from 72 esophageal cancer patients who underwent esophagectomy from 1987 to 2002 in our institute. The mutation of p53, expression of bc12, Ki67 index, and expression of E-cadherin were examined by using the tissue array and immunohistochemical staining method. The patients were subgrouped into higher Ki67 index group if the index was higher than 30. The patients were also subgrouped into grade 1(>90%), grade 2(50∼90%), grade 3 (10∼50%), and grade 4(<10%) according to the rate of E-Cadherin expression. We studied the relationship between the rates of immunohistochemical staining and the survival rate. Results: Seventy two tumor specimens from 72 patients were studied. (mean age ; 59.6 years, male female = 69 : 3) The histologic type of the specimens was all squamous cell carcinoma. The patient's number of stage IIA, IIB, and Ⅳ was 30, 37, and 7 respectively, Thirty patients were alive and overall 5 year-survival rate was 28%. The mutation of p53 was shown in 54.2% of the patients. Five year survival rates of negative and positive groups were 29% and 28% respectively.(p=0.4) Expression of bc12 gene was found in 13.9% of the specimens. Five year survival rates of negative and positive groups were 30% and 21%.(p=0.3) Higher Ki67 index was correlated to poorer differentiation.(p=0.05) Five year survival rates of higher and lower groups of Ki67 index were 47% and 30%.(p=0.15) Higher expression rate of E-Cadherin showed better differentiation.(p=0.04). However we couldn't find any survival differences between these 4 groups.(p=0.23) Conclusion; We could not find any molecular markers meaningful in the prognosis of esophageal cancer patients. We just found the tumor markers correlated to the differentiation of esophageal cancer. However, we knew that we need further study with some more samples to stratify other important prognostic factors of esophageal cancer.

• Radiation Oncology Journal
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• 제14권3호
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• pp.191-199
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• 1996

목적 : 자궁경부암에서 근치적 방사선치료후 치료결과 및 예후에 영향을 미치는 인자와 치료후 합병증, 실패 양상을 알고자 후향적 연구를 시행하였다. 대상 및 방법 1986년 3월부터 1990년 5월까지 조직학적 검사로 확진되고 근치적 목적으로 외부조사 및 강내치료를 받은 59명의 환자를 대상으로 후향적 분석을 시행하였다. FIGO 병기에 따른 환자분포는 병기 IIa이하인 Ib, IIa가 각각 2예($3.4\%$), IIb가 31예($52.5\%$), IIIb가 15예 ($25.4\%$), IV가 9예($15.3\%$)였다. 외부조사를 시행한 후, 강내조사를 실시하였는 데, 강내치료는 A점을 기준으로 병기에 따라서 중앙값 3460 cGy(범위: 3000-4366 cGy)까지 조사하였으며, 강내 치료와 외부방사선 치료 전체조사량의 중앙값은 8500 cGy(범위: 8040-10980 cGy)였다. 추적조사 기간은 2개월에서 110개월이었고, 중앙값은 61개월이었다. 결과 : 전체환자의 5년생존율 및 무병생존율은 각각 $55.9\%$와 $55.0\%$였으며, FIGO 병기에 따른 5년 생존율은 병기 IIa이하인 경우 $75.0\%$, 병기 IIb는 $74.8\%$, 병기 IIIb는 $26.7\%$, 병기 IV는 $33.3\%$였다. 단변량 분석에 의하면 병기 IIb이하인 경우 5년 생존율은 $74.8\%$였고, IIIb이상인 경우 $29.2\%$ (p<0.005)였다 방사선치료중 혈색소 수준이 한 번이라도 10 gm/dL미만인 환자군의 5년 생존율은 $0\%$였고, 10 gm/dL이상 군은 $73.3\%$ (p<0.005)였다. 종양의 크기가 5 cm이상인 18예($30.5\%$)에서 5년 생존율은 $22.2\%$였고, 5cm미만인 39예($66.1\%$)에서는 $71.8\%$(p<0.005)였다. 또한 50세이상인 경우와 50세미만인 경우 5년 생존율은 각각 $65.3\%$, $34.2\%$ (p<0.05)였다. ECOG 수행능력 정도, 병리소견, 전체 선량, 전체 치료기간은 통계학적 의미는 없었다. 다변량분석에 의하면 방사선 치료중 혈색소 수준(p=0.0001), 종양의 크기(p=0.0390), FIGO병기 (p=0.0468)가 통계학적 의의를 나타냈다. 전체 환자의 재발율은 $23.7\%$(14/59)로 국소재발이 $15.2\%$(6/59), 원격전이가 $6.8\%$(4/59), 국소재발과 원격전이가 $1.7\%$(1/59)를 보였다. 결장직장과 비뇨생식기에서 각각 $15.3\%$(9/59), $8.5\%$(5/59)를 보이고, Grade 2는 10예($17.0\%$), Grade 3은 3예($5.1\%$), Grade 4도 1예($1.7\%$)를 나타내고 있다 빈도는 방사선 직장염, 직장 출혈, 방사선 대장염, 설사, 방사선 방광염 순서로 발생하였다. 결론 : 치료결과를 향상시키기 위해서는 전향적인 무작위 표본에 의한 새로운 예후인자 발견 및 예후가 좋지 않을 것으로 예상되는 경우, 치료방법의 개선 및 방사선 감작제 또는 항암제를 병용하여 국소재발과 원격전이 억제를 위한 적극적인 치료방법이 연구되어져야 한다고 사료된다.

• Radiation Oncology Journal
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• 제8권2호
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• pp.261-267
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• 1990

인제대학교 백병원 치료 방사선과 교실에서는 1984년에서 1990년 까지 조직학적으로 확진된 Waldeyer's ring 임파종 환자 20명이 치료를 받았으며 이 중 17명의 환자가 조사기능하여 후향성으로 분석하였다. 방사선 조사량은 Waldeyer's ring에 35내지 50 Gy를 조사하였고 원발 병소 부위에 5 내지 10 Gy를 첨가로 조사하였다. 경부 하부 임파절은 35내지 60 Gy를 조사 받았다. 관찰기간은 9개월에서 78개월(중앙값 : 23개월)이었다. 5년 생존율은 $46.8{\%}$이고 5년 무병 생존율은 $43.8{\%}$였다. 재발은 치료 후 평균 10개월에 발견되었으며 대부분의 재발은 전신적으로 발생하였다. 1기 환자는 병소가 진행된 경우보다 경과가 좋았으며, 세포 유형도 예후에 영향을 나타내었다. 조기 병기의 환자에서는 방사선 조사의 결과와 방사선 조사와 화학요법을 병행한 결과의 차이가 거의 없었으나 진행된 병기의 환자에서는 병행요법이 단독 치료 방법에 비해 예후가 좋았다.

• 대한두경부종양학회지
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• 제10권2호
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• pp.145-151
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• 1994

The malignant tumor of nasopharynx occurs in china and other oriental contries as high incidence and its prognosis is relatively poor because of frequent intracranial extension and early metastasis. Traditional therapeutic modality of nasopharyngeal cancer was definite radiotherapy, but recently some cancer institute had tried combined modality with induction chemotherapy and reported it may be valuable. We report the clinical evaluation and therapeutic result about 28 nasopharyngeal cancer patients which were treated with 2 courses of induction chemotherapy(Cisplatin+5-FU) and radiotherapy. The results were as follows: 1) The 3 years and 5 years survival rate were 76% and 47% in total patients. 2) The 3 years and 5 years survival rate were 92% and 63% in T1, T2, T3 group, and 25% and 0% in T4 group. 3) The 3 year and 5 year survival rate were 100% and 60% in neck node negative group, and 60% and 40% in neck node positive group. 4) The 3 year and 5 years survival rate were 100% and 50% in stage I II group, and 71% and 44% in stage III, IV group.