• Radiation Oncology Journal
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• 제33권2호
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• pp.109-116
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• 2015

Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Materials and Methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

• 한국미생물·생명공학회지
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• 제45권3호
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• pp.226-235
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• 2017

Phytoene, lycopene, ${\beta}-carotene$과 같은 카로티노이드는 식품의 착색제나 영양보조제, 사료첨가제, 화장품의 원료로 사용된다. 이전 연구에서 본 연구진은 분홍색의 색소를 생산하는 새로운 해양 세균인 K. gwangalliensis를 분리 동정하였다. Phytoene desaturase (CrtI) 효소는 crtI 유전자에 암호화되어 있으며, phytoene을 lycopene으로 전환하며, 카로티노이드 합성 초기 단계에 있어서 필수적이다. CrtI는 카로티노이드 생합성 조절의 주요 효소 중 하나이며, 다양한 카로티노이드를 생합성하는 생물들의 카로티노이드 생합성 경로에 있어서 속도 조절 단계에 관련이 있다. 본 논문에서는 K. gwangalliensis로부터 lycopene 생합성을 담당하는 crtI 유전자를 클로닝 하였으며, 이 유전자는 1,584개의 염기서열을 가지며, 527개의 아미노산을 암호화하고 있다. crtI 유전자의 염기 서열을 Kocuria rhizophila와 Myxococcus xanthus를 포함한 다른 종의 염기 서열과 비교한 결과, 진화 과정에서 잘 보존되어 있음을 확인하였다. crtI 유전자를 포함하는 발현 플라스미드를 구축하여 발현시킨 결과, 이 플라스미드를 함유하는 대장균은 약 57 kDa의 재조합 단백질을 생산화였으며, 이는 phytoene desaturase의 분자량에 해당한다. lycopene의 생합성은 lycopene 생합성에 필요한 crtE, crtB 유전자를 포함한 pRScrtEB plasmid를 E. coli에 형질전환 했을 때, Escherichia coli에서 합성되는 것을 확인하였다. 이 연구의 결과는 분자 수준에서 K. gwangalliensis CrtI의 1차 구조에 대한 폭 넓은 지식 기반을 제공할 것이다.

• Radiation Oncology Journal
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• 제29권3호
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• pp.174-180
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• 2011

Purpose: To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma. Materials and Methods: From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions. Results: The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS. Conclusion: This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.

• 대한기관식도과학회지
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• 제15권2호
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• pp.49-56
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• 2009

Purpose : To evaluate the treatment outcome for patients with locally advanced, unresectable esophageal cancer treated with relatively high dose radiation therapy(RT). Materials and Methods : From January 2000 to December 2008, 32 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated with radiation therapy(RT) with or without concurrent chemotherapy. Ten patients were excluded from analysis because of distant metastasis and drop off. Patient distributions according to AJCC stages II, III IVa were 7(31.8%), 12(54.6%), 3(13.6%) respectively. The locations of tumor were cervical/upper thorax 3 (13.6%), mid thorax 13(59.1%), and lower thorax/abdominal 6(27.3%), respectively. Eleven patients received RT only, and 11 patients received cisplatin based concurrent chemoradiotherapy(CCRT). Median radiation dose was 65 Gy(range 57.6~72 Gy). Results : The median follow-up was 9.1 months(range 1.9~43.8 months). The response rates for complete response, Partial response, stable disease and Persistent disease were 6(27.3%), 11(50.0%), 4(18.2%) and 1(4.5%), respectively. Two patients(9.1%) suffered from esophageal stenosis and stents were inserted. Two patients(9.1%) had Grade 3 radiation pneumonitis and one of them expired due to acute respiratory distress syndrome(ARDS) at 36 days after completion of radiation therapy. The recurrence rate was 11(50.0%). The patterns of recurrence were persistent disease and local progression in 5(22.7%), local recurrence 3(13.7%) and concomitant local and distant recurrence in 3(13.7%). The overall survival(OS) rate was 32.1% at 2 years and 21.4% at 3 years(median 12.0 months). Disease free survival(DFS) rate was 17.3% at 2 and 3 years. All patients who had no dysphagia at diagnosis showed complete response after treatment and 100% OS at 3 years(p=0.0041). The OS for above 64.8 Gy group and 64.8 Gy or below group at 3 years were 60.6% and 9.1%(p=0.1341). The response to treatment was the only significant factor affecting OS(p=0.004). Conclusion : Relatively high dose radiation therapy in unresectable esophageal cancer tended to have a better outcome without increased complication rate. Further study with more patients is warranted to justify improved result.

• 생명과학회지
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• 제22권8호
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• pp.1024-1033
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• 2012

Kocuria gwangalliensis로부터 카로티노이드 생합성 경로의 첫 번째 단계 기질인 geranylgeranyl pyrophosphate (GGPP)를 생합성하는 GGPP synthase (CrtE)를 암호화하고 있는 crtE를 클로닝 하여 이를 KgGGPP로 명명하였다. 기존 세균에서 밝혀진 GGPP synthase의 아미노산 서열을 NCBI에서 검색하여 KgGGPP synthase의 아미노산 서열과 비교한 결과 Kocuria rhizophila와 59.6%의 상동성을 가지는 것을 확인하였다. crtE 유전자를 대장균에서 발현 시키기 위하여 pCcrtE 재조합 DNA를 구축하였고, 이를 대장균에서 발현시킨 결과 약 41 kDa의 재조합 단백질이 과발현 됨을 확인 할 수 있었으며, 이 단백질은 기존 세균에서 밝혀진 GGPP synthase와 유사한 분자량을 가지고 있다는 것을 알 수 있었다. CrtE 재조합 단백질의 활성을 분석하기 위하여 대장균 내에서 라이코펜의 생합성을 유도 하였다. 대장균의 경우 메발론산 경로를 통하여 FPP와 IPP를 생합성 하지만 crtE, crtB, crtI 유전자가 없기 때문에 라이코펜을 생합성 하지는 못한다. 대장균 내에서 라이코펜의 생합성을 위해서는 crtE, crtB, crtI 유전자의 발현이 필수적으로 요구되기 때문에 crtB, crtI 유전자의 경우는 P. haeundaensis에서 유래한 유전자를 이용하여 pRScrtBI 재조합 DNA를 구축하여 그 발현을 유도하였다. 상기 두 재조합 DNA를 대장균에서 공발현 시켰으며, HPLC 분석법을 이용하여 대장균 내에서 라이코펜의 생산 유무에 따른 KgGGPP synthase의 활성을 분석하였다.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.105-114
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• 2021

Background: Complementary and alternative medicine (CAM) has been used frequently, and its use continues to increase in lung cancer patients, despite insufficient scientific of its efficacy. To investigate this situation, we analyzed the current awareness and use of CAM in Korean lung-cancer patients. Methods: This prospective survey-based study was performed at seven medical centers in South Korea between August and October 2019. The survey assessed general patient characteristics and the awareness and use of CAM. We analyzed differences in the clinical parameters of patients aware and not aware of CAM and of CAM non-users and users. Results: Of the 434 patients included in this study, 68.8% responded that they were aware of CAM and 30.9% said they had experienced it. In univariate analysis, the patients aware of CAM were younger with poor performance status, had advanced-stage lung cancer, received more systemic therapy, and received concurrent chemoradiation therapy (CCRT). By multiple logistic regression, younger age, poor performance status, advanced stage, and prior CCRT were identified as independent risk factors for CAM awareness. There were no significant differences in the general characteristics and cancer-associated clinical parameters of CAM non-users and users. Conclusion: Specific clinical parameters were associated with patients' awareness of CAM, although there were no significantly different characteristics between CAM users and non-users.

• Radiation Oncology Journal
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• 제33권2호
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• pp.83-88
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• 2015

Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

• Radiation Oncology Journal
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• 제32권1호
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• pp.31-42
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• 2014

Purpose: To evaluate the usefulness of positron emission tomography/computed tomography (PET/CT) for field modification during radiotherapy in esophageal cancer. Materials and Methods: We conducted a retrospective study on 33 patients that underwent chemoradiotherapy (CRT). Pathologic findings were squamous cell carcinoma in 32 patients and adenocarcinoma in 1 patient. All patients underwent PET/CT scans before and during CRT (after receiving 40 Gy and before a 20 Gy boost dose). Response evaluation was determined by PET/CT using metabolic tumor volume (MTV), total glycolytic activity (TGA), MTV ratio (rMTV) and TGA ratio (rTGA), or determined by CT. rMTV and rTGA were reduction ratio of MTV and TGA between before and during CRT, respectively. Results: Significant decreases in MTV ($MTV_{2.5}$: mean 70.09%, p < 0.001) and TGA ($TGAV_{2.5}$: mean 79.08%, p < 0.001) were found between before and during CRT. Median $rMTV_{2.5}$ was 0.299 (range, 0 to 0.98) and median $rTGAV_{2.5}$ was 0.209 (range, 0 to 0.92). During CRT, PET/CT detected newly developed distant metastasis in 1 patient, and this resulted in a treatment strategy change. At a median 4 months (range, 0 to 12 months) after completion of CRT, 8 patients (24.2%) achieved clinically complete response, 11 (33.3%) partial response, 5 (15.2%) stable disease, and 9 (27.3%) disease progression. $SUV_{max}$ (p = 0.029), $rMTV_{50%}$ (p = 0.016), $rMTV_{75%}$ (p = 0.023) on intra-treatment PET were found to correlate with complete clinical response. Conclusion: PET/CT during CRT can provide additional information useful for radiotherapy planning and offer the potential for tumor response evaluation during CRT. $rMTV_{50%}$ during CRT was found to be a useful predictor of clinical response.

• 대한두경부종양학회지
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• 제30권1호
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• pp.5-9
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• 2014

Background and Objectives : The objective of this study was to investigate clinical factors associated with recurrence of nasopharyngeal carcinoma(NPC). Materials and Methods : We performed a retrospective review of 112 diagnosed as nasopharyngeal carcinoma, treated concurrent chemo-radiotherapy(CCRT) and had complete response from March 1, 1995, to March 31, 2012. Results : Of the recurrent NPC patients, patients received 2nd line chemotherapy had more recurrence within 2 years(p=0.010). Especially, patients received 2nd line chemotherapy longer than 4 months tend to have recurrence early(p=0.035). Other factors are not different between recurrent and non-recurrent NPC patients. Conclusion : The presence and the duration of 2nd line chemotherapy are associated with early recurrence.

• 대한한방내과학회지
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• 제43권4호
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• pp.751-760
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• 2022

Objective: To show a decrease in tumor recurrence and improvement in quality of life in patients with recurrent cervical cancer. Method: A 58-year-old female patient diagnosed with recurrent cervical cancer in February 2021 was treated for 14 months with integrative cancer treatment (ICT) to decrease the tumor size and improve chemotherapy-induced peripheral neuropathy (CIPN) and nausea. The patient underwent chemotherapy or concomitant chemoradiation therapy (CCRT) with ICT. Radiologic outcomes were assessed by abdomen & pelvis computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the 14 months of treatment, the size and metabolic activity of the recurrent tumor decreased and underwent partial remission based on RECIST. The NRS scores for CIPN and nausea were improved, and the ECOG score improved from grade 2 to 1. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a synergetic effect with chemotherapy or radiotherapy for recurrent cervical cancer.