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Preliminary Results of Phase I/II Study of Simultaneous Modulated Accelerated (SMART) for Nasopharyngeal Carcinoma (비인강암의 치료에서 동시차등조사가속치료를 적용한 제1상/2상 연구의 예비적 결과)

  • Park Jin-Hong;Back Geum-Mun;Yi Byong-Yong;Choi Eun-Kyung;Ahn Seung-Do;Shin Seong-Soo;Kim Jung-Hun;Kim Sang-Yoon;Lee Bong-Jae;Nam Soon-Yuhl;Choi Seung-Ho;Kim Seung-Bae;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.1-10
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    • 2006
  • Puroose: To present preliminary results of intensity-modulated radiotherapy (IMRT) using the simultaneous modulated accelerated radiation therapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC). Materials and Methods: Twenty patients who underwent IMRT for non-metastatic NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. IMRT was delivered using the 'step and shoot' SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume (GTV), 60 Gy (2 Gy/day) to the clinical target volume (CTV) and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received concurrent chemotherapy using cisplatin once per week. Results: The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had RTOG grade 3 mucositis, whereas nine (45%) had grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no grade 3 or 4 chronic xerostomia. All patients showed complete response. Two patients had distant metastases and loco-regional recurrence, respectively. Conclusion: IMRT using the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and may also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

The Pathological and Clinical Effects of Preoperative Chemoradiation in Rectal Cancer (직장암의 수술 전 항암화학방사선치료 후 병리학 및 임상적 효과 분석)

  • Song, Jin-Ho;Jang, Hong-Seok;Kim, Yeon-Sil;Chung, Su-Mi;Son, Seok-Hyun;Kang, Jin-Hyeong;Youk, Eui-Gon;Lee, Doo-Seok;Lee, Suk-Hi;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.11-19
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    • 2011
  • Purpose: To evaluate the pathological and clinical effects of preoperative chemoradiation (CCRT) in cases of locally advanced rectal cancer and to determine the predictive factors for tumor downstaging. Materials and Methods: From March 2004 to August 2008, 33 patients with locally advanced rectal cancer were treated with preoperative CCRT. Twenty-eight patients (84.8%) were treated using a concomitant boost technique while five (15.2%) patients were treated using a cone down boost technique. All patients received 50.4 Gy of irradiation and concurrent chemotherapy with 5-fluorouracil. The median follow-up duration was 24.2 months (range, 9.8 to 64.7 months). Results: Thirty-one (93.9%) patients underwent surgery. Twenty-four patients (72.7%) underwent anal sphincter-preserving surgery. The 3-year disease free survival (DFS) and overall survival rates were 63.4% and 78.8%, respectively. Post-operative factors were more important for DFS. Pathologic N stage, margin status, and pathologic differentiation were significant prognostic factors (p=0.001, 0.029, 0.030). Tumor size and lymphovascular invasion were also associated with marginal significance (p=0.081, 0.073). However, only pre-treatment T stage was a significant pre-operative factor (p=0.018). The complete pathological response rate was 9.1 %. T-downstaging was observed in ten (30.3%) patients, whereas N-downstaging was found in 24 (72.7%) patients. Pre-treatment T stage and the interval between CCRT and operation were the predictive factors for downstaging in a univariate analysis (p=0.029, 0.027). Pre-treatment carcinoembryogenic antigen was also associated with marginal significance (p=0.068). Conclusion: The survival of rectal cancer patients can be better determined based on post-operative findings. Therefore, pre-operative CCRT for downstaging of the tumor seems to be important. Pre-treatment T stage and the interval between CCRT and operation can be used to predict downstaging.

Adaptive Lock Escalation in Database Management Systems (데이타베이스 관리 시스템에서의 적응형 로크 상승)

  • Chang, Ji-Woong;Lee, Young-Koo;Whang, Kyu-Young;Yang, Jae-Heon
    • Journal of KIISE:Databases
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    • v.28 no.4
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    • pp.742-757
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    • 2001
  • Since database management systems(DBMSS) have limited lock resources, transactions requesting locks beyond the limit mutt be aborted. In the worst carte, if such transactions are aborted repeatedly, the DBMS can become paralyzed, i.e., transaction execute but cannot commit. Lock escalation is considered a solution to this problem. However, existing lock escalation methods do not provide a complete solution. In this paper, we prognose a new lock escalation method, adaptive lock escalation, that selves most of the problems. First, we propose a general model for lock escalation and present the concept of the unescalatable look, which is the major cause making the transactions to abort. Second, we propose the notions of semi lock escalation, lock blocking, and selective relief as the mechanisms to control the number of unescalatable locks. We then propose the adaptive lock escalation method using these notions. Adaptive lock escalation reduces needless aborts and guarantees that the DBMS is not paralyzed under excessive lock requests. It also allows graceful degradation of performance under those circumstances. Third, through extensive simulation, we show that adaptive lock escalation outperforms existing lock escalation methods. The results show that, compared to the existing methods, adaptive lock escalation reduces the number of aborts and the average response time, and increases the throughput to a great extent. Especially, it is shown that the number of concurrent transactions can be increased more than 16 ~256 fold. The contribution of this paper is significant in that it has formally analysed the role of lock escalation in lock resource management and identified the detailed underlying mechanisms. Existing lock escalation methods rely on users or system administrator to handle the problems of excessive lock requests. In contrast, adaptive lock escalation releases the users of this responsibility by providing graceful degradation and preventing system paralysis through automatic control of unescalatable locks Thus adaptive lock escalation can contribute to developing self-tuning: DBMSS that draw a lot of attention these days.

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Somatic Cell Analysis and Cobalamin Responsiveness Study in Ten Korean Patients with Methylmalonic Aciduria (한국 메틸말로닌산혈증 환아 10례에서 Somatic Cell 분석과 cobalamin 반응성 연구)

  • Lim, Han Hyuk;Song, Wung Joo;Kim, Gu-Hwan;Watkins, David;Rosenblatt, David S.;Kim, Yoo-Mi;Chang, Mea Young;Kil, Hong Ryang;Kim, Sook Za
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.12-19
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    • 2019
  • Purpose: Isolated methylmalonic acidemia (MMA) is an autosomal recessive inherited disorder of propionate metabolism. There are two subtypes of MMUT gene defects. $Mut^0$ represents complete loss of methylmalonyl-CoA mutase (MCM) activity while mut- is associated with residual MCM activity, which can be stimulated by hydroxocobalamin (OHCbl) supplementation. The objective of this study is to investigate cobalamin responsiveness and mutations present in Korean MMA population. Methods: We evaluated 10 MMA patients using somatic cell complementation analysis on their fibroblasts to measure MCM activity and vitamin B12 responsiveness for the optimal treatment. MMUT gene was sequenced to identify the MMA mutations. Results: For all patients, the incorporation of $[^{14}C]-propionate$ was low, and there was no response to OHCbl. The incorporation of $[^{14}C]-methyltetrahydrofolate$ and $[^{57}Co]-CNCbl$ fell within the normal range. There was adequate synthesis of methylcobalamin while the synthesis of adenosylcobalamin was low. The complementation analysis showed all patients were $mut^0$. The sequence analysis identified 12 different MMUT mutations, including 2 novel mutations, p.Gln267Ter and p.Ile697Phe, were identified. All the patients in this study had neonatal onset of symptoms, belonged to $mut^0$ complementation class, and as a result, showed no cobalamin responsiveness. Conclusion: No Korean MMA patient showed cobalamin responsiveness.

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Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.23-32
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    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

A Proposal for Korean armed forces preparing toward Future war: Examine the U.S. 'Mosaic Warfare' Concept (미래전을 대비한 한국군 발전방향 제언: 미국의 모자이크전 수행개념 고찰을 통하여)

  • Chang, Jin O;Jung, Jae-young
    • Maritime Security
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    • v.1 no.1
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    • pp.215-240
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    • 2020
  • In 2017, the U.S. DARPA coined 'mosaic warfare' as a new way of warfighting. According to the Timothy Grayson, director of DARPA's Strategic Technologies Office, mosaic warfare is a "system of system" approach to warfghting designed around compatible "tiles" of capabilities, rather than uniquely shaped "puzzle pieces" that must be fitted into a specific slot in a battle plan in order for it to work. Prior to cover mosaic warfare theory and recent development, it deals analyze its background and several premises for better understanding. The U.S. DoD officials might acknowledge the current its forces vulnerability to the China's A2/AD assets. Furthermore, the U.S. seeks to complete military superiority even in other nation's territorial domains including sea and air. Given its rapid combat restoration capability and less manpower casualty, the U.S. would be able to ready to endure war of attrition that requires massive resources. The core concept of mosaic warfare is a "decision centric warfare". To embody this idea, it create adaptability for U.S. forces and complexity or uncertainty for the enemy through the rapid composition and recomposition of a more disag g reg ated U.S. military force using human command and machine control. This allows providing more options to friendly forces and collapse adversary's OODA loop eventually. Adaptable kill web, composable force packages, A.I., and context-centric C3 architecture are crucial elements to implement and carry out mosaic warfare. Recently, CSBA showed an compelling assessment of mosaic warfare simulation. In this wargame, there was a significant differences between traditional and mosaic teams. Mosaic team was able to mount more simultaneous actions, creating additional complexity to adversaries and overwhelming their decision-making with less friendly force's human casualty. It increase the speed of the U.S. force's decision-making, enabling commanders to better employ tempo. Consequently, this article finds out and suggests implications for Korea armed forces. First of all, it needs to examine and develop 'mosaic warfare' in terms of our security circumstance. In response to future warfare, reviewing overall force structure and architecture is required which is able to compose force element regardless domain. In regards to insufficient defense resources and budget, "choice" and "concentration" are also essential. It needs to have eyes on the neighboring countries' development of future war concept carefully.

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Assessing Middle School Students' Understanding of Radiative Equilibrium, the Greenhouse Effect, and Global Warming Through Their Interpretation of Heat Balance Data (열수지 자료 해석에서 드러난 중학생의 복사 평형, 온실 효과, 지구 온난화에 대한 이해)

  • Chung, Sueim;Yu, Eun-Jeong
    • Journal of the Korean earth science society
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    • v.42 no.6
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    • pp.770-788
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    • 2021
  • This study aimed to determine whether middle school students could understand global warming and the greenhouse effect, and explain them in terms of global radiative equilibrium. From July 13 to July 24 in 2021, 118 students in the third grade of middle school, who completed a class module on 'atmosphere and weather', participated in an online assessment consisting of multiple-choice and written answers on radiative equilibrium, the greenhouse effect, and global warming; 97 complete responses were obtained. After analysis, it was found that over half the students (61.9%) correctly described the meaning of radiative equilibrium; however, their explanations frequently contained prior knowledge or specific examples outside of the presented data. The majority of the students (92.8%) knew that the greenhouse effect occurs within Earth's atmosphere, but many (32.0%) thought of the greenhouse effect as a state in which the radiative equilibrium is broken. Less than half the students (47.4%) answered correctly that radiative equilibrium occurs on both Earth and the Moon. Most of the students (69.1%) understood that atmospheric re-radiation is the cause of the greenhouse effect, but few (39.2%) answered correctly that the amount of surface radiation emitted is greater than the amount of solar radiation absorbed by the Earth's surface. In addition, about half the students (49.5%) had a good understanding of the relationship between the increase in greenhouse gases and the absorption of atmospheric gases, and the resulting reradiation to the surface. However, when asked about greenhouse gases increases, their thoughts on surface emissions were very diverse; 14.4% said they increased, 9.3% said there was no change, 7.2% said they decreased, and 18.6% gave no response. Radiation equilibrium, the greenhouse effect, and global warming are a large semantic network connected by the balance and interaction of the Earth system. This can thus serve as a conceptual system for students to understand, apply, and interpret climate change caused by global warming. Therefore, with the current climate change crisis facing mankind, sophisticated program development and classroom experiences should be provided to encourage students to think scientifically and establish scientific concepts based on accurate understanding, with follow-up studies conducted to observe the effects.

STUDIES ON THE DIMORPHISM AND FERTILITY OF PERSICARIA JAPONICA (MEISSNER) GROSS ET NAKAI (Persicaria Japonica (MISSNER) Gross et Nakai의 이형화와 수정력에 관한 연구)

  • HARN, Chang Yawl
    • Journal of Plant Biology
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    • v.3 no.1
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    • pp.1-15
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    • 1960
  • HARN, Chang Yawl : Studies on the dimorphism and Fertility of Persicaria japonica (MEISSNER) Gross et Nakai. Kor Jour. Bot. 3(I) 1-15 1960 Numerous investigations, since the works of DARWIN, have been made regarding the heterostylous plants by JOST (1907), CORRENS (1924), LAIBACK (1924), LEWIS (1943), and many others. Studies on the heterostylous Polygomum, however, were not reported except for the buckwhent, Fagopyrum esculentum, which was investigated by SCHOCH-BODMER (1930), EAST (1934), FROLOVA & Co-Workers (1946), MORRIS (1947, 1951) TATEBE (1949, 1951, 1953), present author (1957), and others. It is because no heterostylous species, besides buckwheat, have been known to exist in the Polygonum family. The author, during his studies on both heterostylism and fertility of Polygonaceae, has found that the species, persicaria japonica (Meissner) Gross et Nakai, is not diecious as has been known in taxonomy, but in reality beterostylous both morphologically and physiologically. It was found that this plant, regarded by taxonomist, as a male plant setting no seed, actually set seed (botanical fruit) when legitimate combination was made. Since his brief report on the dimorphic phenomens of this plant in 1956, the author's further research on the manner of fertilization has revealed that this species is a peculiar type whose dimorphism has undergone extreme specialization structurally and physiologically, the short-styled individual behaving in nature as a male plant and the long-styled individual, as female, whereas in controllled pollination the plant shows highly differentiated typical dimorphism. When compared with the other dimorphous species of this family, F. esculentum and P. sentiosa. it has been clarified that these three species differ in the degree of differentiation of their dimorphism morphologically and physiologically. That is, P. japonica has developed such a high specialization as to mislead the taxonomists, while P. senticosa shows almost no noticeable difference between long- and shortstyled individuals retaining most of the inherent physiological character cmmon to the genus except for the fact that it has two forms of flowers. F. esculentum appears to have taken the intermediate position in every respect. The result obtained in the present experiment are summarized as follows: 1) P. japonica has two kinds of individuals, one long style-short stamened; the other, short style-long stamened. The floral structure of this plants shows typical characteristics of dimorphic heterostylism. The differentiation between the two forms of flower has proceeded so highly both in primary and secondary difference of flower structure that this may be regarded as the most specialized form of dimorphism. 2) The differences of floral structure between the long and short styled individuals are remarkable compared with the other dimorphic species of the family. 3) The stamens of long styled plants show the sign of deteriolation whereas those of the short styled flower are well-developed. 4) When legitimate combinations are made, both L- and S-styled individuals are fertilized well and set seed (fruit), while in the illegitimate combination no fertilization and seed setting occur. Physiologically this species exhibits the typical behavior of dimorphic plants. 5) The self-fertile character, so common in other species of the other non-heterostyle Polygonum family, has disappeared completely. 6) Under natural conditions, no or few seed setting is observed in short styled individuals that behave as if they were male plants. 7) In hand pollination, the combination of both $L{\times}S$ and $S{\times}L$ alike yield relatively good fertility and seed-formation, the behavior of short styled individuals in artificial pollination differing remarkably from that in nature. 8) Under controlled pollination, $L{\times}S$ combination sets far more seed than in the combination of $S{\times}L$. In the S-styled individuals, the fertilized flower has the tendency of its seed more readily falling off in every stage of seed development than in the L-styled individuals. 9) The behaviors of pollen tubes just parallels the results of fertility test. That is, in the illegitimate combination, L-selfed, $L{\times}L$, S-selfed, and $S{\times}S$, the growth of pollen tubes is checked in the style, while in legitimately combined $L{\times}S$ and $S{\times}L$, the pollen tubes grow well reaching the ovaries within 40-50 minutes after pollination. The response of short styled individuals, known as male plant among taxonomists, is identical, as far as behavior fo pollen tube growth and fertilization are concerned, to that of long styled individuals, the so-called female plant. 10) The pollen grains from the short-styled plants are complete and fertile, whereas 70% of those of L-styled are found to be abortive, i.e., empty contents. 11) The remaining 30% of pollen of L-plant shows varied degree of stainability when stained with iron-aceto-carmine......mostly light red, while the pollen grains of S-style individuals are dark brown indicating complete fertility and viability. 12) The abundance of sterile pollen in L-styled and the nature of seed-dropping which occurs in S-styled individuals appear to be the main causes why the short styled individuals bear no seed in nature. Under controlled legitimate union, $S{\times}L$, the careful and elaborate pollination would give the S-styoled flowers the opportunities to receive the fertile pollens, though few in number, from L-styled plant, thus enabling S-plant to bear seed. 13) This species is not dioecious as is regarded by taxonomists, but typical dimorphic plant which has so highly specialized in floral structures and funcitons that the long-styled plant behaves just like a female individual; and the short-styled, like a male.

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Studies on the Breeding of the Response to short photoperiod, Fiber weight, and Qualitative characters and of the Associations Among these characters in Kenaf (섬유용양마의 육종에 관한 연구 -단일반응성과 섬유종의 유전 및 연소)

  • Johng-Moon Park
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.4 no.1
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    • pp.115-124
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    • 1968
  • It was shown that the most desirable characters for kenaf are high-fiber weight and moderately early maturity. Therefore, the objectives of this research on this crop is to find varieties possessing these characteristics. The experiments covered in this report provided new information relative to segregation, mode of inheritance, estimate of the number of genes involved in fiber weight and their response to short day length of 10 hours and the qualitative characters, such as, color of stem, capsule, petiole and shape of leaves. The associations which exist among these characters are also indicated. Fiber weight per plant, days to flowering, Stem color, Petiole color, Capsule color, and shape of leaves were studied in parental, $F_1$.$F_2$and backcross populations of a cross between Dashkent, a low-fiber weight but early maturing kenaf variety, and G 38 F-1, a high-fiber weight but late maturing kenaf variety. Crosses were made using the varieties, Dashkent and G 38 F-1 as parents. The Dashkent parent had the following characteristics: green stems, capsules and petioles and lobed shaped leaves; 105.8234 mean-days to flowering in the field, and 106.9222 mean-days under 10 hours short day treatment. The other parent, G 38 F-1 had red stems yellow capsules and red petioles and unlobed shaped leaves; 149.8921 mean-days to flowering in the field, and 62.3684 mean-days under 10 hours short day treatment. Both of the parents, $F_1$, $F_2$, $BC_1$ ($F_1$ X Dashkent, ) and $BC_2$($F_1$ ${\times}$ G38F-1) of the kenaf cross were grown at the Crops Experiment Station, Suwon, Korea in 1965. Color of stems, petioles and capsules, and shape of leaves were noted to be simply inherited as a single factor. Red stem color was dominant over green stem color, red petiole color was dominant over green petiole, lobed shaped leaves were dominant over unlobed shaped leaves and yellow capsules were dominant over green capsule. It was, also, noted that the factor for color of petiole was linked with the factor for shape of leaf with a 11.9587 percent recombination value, however no interaction or linkage were found among the color of stem and capsule color. Using Powers partitioning method, theoretical means and frequency distributions for each population, the days to flowering were calculated with the assumption that two gene pairs were involved. The values obtained fitted the theoretical values. In general this would indicate that Dashkent and G 38 F -1 were differentiated by two gene pairs. Heritability values were calculated as the percent of additive genetic variance. Heritability value of days to flowering, 89.5% in the broad sense and 79.91% in the narrow sense, indicated that the selection for this character would be effective in relatively early generations. Particularly, high positive correlations were found between days to flowering and the color of petioles and shape of leaves. However, there was no relation between days to flowering and capsule color nor between these and stem color. On the basis of the results of this experiment there is evidence that the hereditary factor for shape of leaves and the color of petioles is linked with an effective factor or factors for the characters of days to flowering. The association was sufficiently close to offer a possible simple and efficient means of selection for moderately early mat. uring plants by leaf shape and petiole color selection. Again using Powers partitioning method the frequency distribution for each population to the fiber weight were calculated with the assumption that two gene pairs, AaBb, were involved. Both phenotypic and genotypic dominance were complete. The obtained value did not agree with the theoretical value for $F_2$ and $BC_1$ ($F_1$ ${\times}$ Dashkent.) It seems that Dashkent and G 38 F-1 were differentiated by two major gene pairs but some the other minor genes are necessary. It is certain that the hereditary factor for shape of leaves and color of petioles is linked with an effective factor or factors for fiber weight. Also, high. yielding plants with moderately early maturity were found in the $F_2$ population. Thus, simultaneous selection for high-fiber yield and moderately early maturing plants should be possible in these populations. Phenotypic and genotypic correlation coefficients between fiber weight per plant and days to flowering, stem height and stem diameter were calculated. In general, genotypic correlations are higher than the phenotypic correlation. The highest correlation is found between stem height and fiber weight per plant (0.7852 in genotypic and 0.4103 in phenotypic) and between days to flowering and fiber weight per plant (0.7398 in genotypic and 0.3983 in phenotypic.) It was also expected that the selection of high stem height and moderately early maturing plants were given the efficient means of selection for high fiber weight.

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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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