• 제목/요약/키워드: Complete response

검색결과 1,062건 처리시간 0.024초

임상적 IIIA병기 비소세포폐암의 다각적 치료의 효과 (Multimodality Treatement in Patients with Clinical Stage IIIA NSCLC)

  • 이연선;장필순;강현모;이정은;권선중;안진영;정성수;김주옥;김선영
    • Tuberculosis and Respiratory Diseases
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    • 제57권6호
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    • pp.557-566
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    • 2004
  • 연구배경 : 비소세포폐암 중 IIIA병기는 같은 병기라도 다양한 임상적 경과를 밟고 어느 한가지 치료만으로는 치료 성적이 좋지 못하다. 이에 최근에는 다각적치료(항암, 화학치료, 방사선치료 및 수술적 치료)가 치료의 근간이 되고 있고 이에 대한 연구가 많이 시도되고 있으며 일부에서는 긍정적인 결과를 보고 하고 있다. 이에 저자들은 유도화학요법에 근간을 둔 다각적 치료의 효과를 살펴보고자 연구를 계획하였다. 방 법 : 1997.1월부터 2002.12월까지 충남대학교 병원에 내원하여 임상적으로 비소세포폐암 IIIA병기 진단을 받고 초치료로 유도화학치료를 시행받은 환자에 대하여 다각적 치료의 반응률, 재발율 및 생존기간등을 살펴보았다. 결 과 : 1) 유도화학요법은 74명에게서 시행되었고 반응률은 44.6%(완전관해 1.4% 및 부분반응 3.2%)였고, 고전적약(VPP)과 신약과의 반응률은 차이가 없었다(38.9%vs. 50%, p=0.506). 임파선의 반응률은 다발성 N2이상 병기로 수술적 치료에 어려움이 있다고 판단됐던 37명중 18명(54%)에서 단발성 N2이하로 병기하향을 보였고 이중 수술거부 6명과 폐기능문제 4명을 제외한 8명(21%)이 수술을 시행 받았다. 단발성 N2병기의 경우는 37명중 33명(89%)에게서 단발성 N2이하로 병기유지 내지 하향을 보였고 수술거부 7명과 폐기능문제 5명을 제외한 21명(56.7%)이 수술을 시행 받았다. 유도화학요법 후 다발성 N2였으나 수술적 절제가 가능하다고 판단됐던 4명의 경우에도 수술이 시행되어 전체 환자 중 수술적 치료는 33명(44.5%)에게서 시행되었으며, 완전절제는 30명(40.5%)이었고, 2명(2.6%)의 경우는 불완전 절제, 그리고 1명(1.3%)의 경우는 산소 포화도가 유지가 되지 않아 바로 봉합하였다. 2) 유도화학요법후 WHO기준 3이상의 호중구 감소증은 20명(25.7%)에서 발생하였고 이에 병발된 폐렴은 3명에게서 발생하였으나 이로 인한 사망은 없었다. 3) 수술적 절제가 불가능하여 방사선 치료를 시행하였던 27명의 반응률은 완전관해가 4.8%였고 부분반응은 11.9%였다. 4) 완전 절제되었던 군의 무병지속기간은 13.6개월이었고, 2년의 추적관찰기간 시점의 재발률은 52%였으며, 추가 방사선 치료군의 국소 재발율은 의미있게 적었다(0% vs. 40%, 0.02). 완전 절제되지 못하였거나 불완전 절제된 군의 무진행 질병기간은 11.2개월이었고, 2년의 추적관찰기간 시점의 병의 진행률은 66.7%였다. 5) 전체 대상환자의 중앙생존기간은 25.1개월이었고, 유도화학요법 후 수술 적으로 완전절제를 이루었던 군이 국소 치료로 방사선 치료를 시행하였던 군에 비하여 생존기간이 유의하게 길었지만(31.7개월 vs. 26.1개월, p=0.04), 완전절제 된 군의 추가 방사선 치료에 따른 생존 이득은 없었다. (34.9개월 vs. 32.2개월, p=0.48) 결 론 : 이상의 결과로 임상적 IIIA병기 비소세포폐암의 치료로 다각적 치료시 유도화학요법 후 가능하다며 수술적으로 완전절제를 이루는 것이 가장 좋은 치료라 생각된다. 하지만 전체적인 생존율은 그다지 높지 못하여 유도화학요법시 추가적인 방사선 치료, 수술 후 보조적 항암화학요법, 그리고 생물학적 치료제 등에 대한 보다 많은 3상 연구가 필요하리라 생각된다.

Evaluation of response to stereotactic radiosurgery in patients with radioresistant brain metastases

  • Sayan, Mutlay;Mustafayev, Teuta Zoto;Sahin, Bilgehan;Kefelioglu, Erva Seyma Sare;Wang, Shang-Jui;Kurup, Varsha;Balmuk, Aykut;Gungor, Gorkem;Ohri, Nisha;Weiner, Joseph;Ozyar, Enis;Atalar, Banu
    • Radiation Oncology Journal
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    • 제37권4호
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    • pp.265-270
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    • 2019
  • Purpose: Renal cell carcinoma (RCC) and melanoma have been considered 'radioresistant' due to the fact that they do not respond to conventionally fractionated radiation therapy. Stereotactic radiosurgery (SRS) provides high-dose radiation to a defined target volume and a limited number of studies have suggested the potential effectiveness of SRS in radioresistant histologies. We sought to determine the effectiveness of SRS for the treatment of patients with radioresistant brain metastases. Materials and Methods: We performed a retrospective review of our institutional database to identify patients with RCC or melanoma brain metastases treated with SRS. Treatment response were determined in accordance with the Response Evaluation Criteria in Solid Tumors. Results: We identified 53 radioresistant brain metastases (28% RCC and 72% melanoma) treated in 18 patients. The mean target volume and coverage was 6.2 ± 9.5 mL and 95.5% ± 2.9%, respectively. The mean prescription dose was 20 ± 4.9 Gy. Forty lesions (75%) demonstrated a complete/partial response and 13 lesions (24%) with progressive/stable disease. Smaller target volume (p < 0.001), larger SRS dose (p < 0.001), and coverage (p = 0.008) were found to be positive predictors of complete response to SRS. Conclusion: SRS is an effective management option with up to 75% response rate for radioresistant brain metastases. Tumor volume and radiation dose are predictors of response and can be used to guide the decision-making for patients with radioresistant brain metastases.

Effect of therapeutic radioiodine activity on ablation response in differentiated thyroid cancer patients with cut-off serum thyroglobulin levels after 2 weeks of thyroid hormone withdrawal: a retrospective study

  • Ji Young Lee;Hee-Sung Song;Young Hwan Kim
    • Journal of Medicine and Life Science
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    • 제19권3호
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    • pp.95-102
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    • 2022
  • This retrospective study aimed to investigate whether there was a difference in the success rate of removal of residual thyroid tissue in patients with the same cutoff serum thyroglobulin (Tg) value-measured 2 weeks after thyroid hormone withdrawal (THW)-for different radioactive iodine (RAI) activities. We identified 132 patients with papillary thyroid cancer who were treated with total thyroidectomy and RAI therapy to evaluate the efficacy of three radioactivities of I-131: 1,110, 3,700, and 5,550 MBq. Serum Tg testing was performed 1 week before RAI treatment and 2 weeks after THW (pre-Tg); the cutoff pre-Tg level was below 10 ng/mL. Stimulated Tg levels were measured on the day of I-131 administration (off-Tg). After 6 months of treatment, we compared the groups for complete ablation, defined as no uptake on a diagnostic I-131 scan, stimulated Tg level of <1.0 ng/mL, and Tg antibody level of <100 ng/mL. Ninety-five patients (72.0%) achieved complete ablation, with 57.1% (8/14), 78.2% (68/87), and 61.3% (19/31) in the 1,110 MBq, 3,700 MBq, and 5,550 MBq groups, respectively. There was no significant difference in the complete ablation rates between the three groups. In the multivariate analysis, the off-Tg level was a significant predictor of complete ablation. RAI therapy with low radioactivity (1,110 MBq) seemed sufficient for ablation in patients with papillary thyroid cancer with a pre-Tg level below 10 ng/mL. The off-Tg level is a promising and useful predictor of complete ablation after initial RAI therapy.

Characterizing of Rice Blast Lesion Mimic

  • Lee, Joo-Hee;Jaw, Nam-Soo
    • 한국식물병리학회:학술대회논문집
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    • 한국식물병리학회 2003년도 정기총회 및 추계학술발표회
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    • pp.68.1-68
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    • 2003
  • When plants are infected by plant pathogens, typical disease symptom termed lesion, appears in compatible interaction. Whereas, in incompatible interactions, only small speck of lesions are visible on the leaf surfaces. Hypersensitive response (HR) of plant which is the result of infection by incompatible pathogens, is a well known defense response inducing rapid cell death resulting in complete resistance. However, some rice mutants show spontaneous disease symptoms during the growth stages without interaction with pathogens. We investigated the spontaneous cell death mutant called Blast Lesion Mimic(BLM) generated by EMS mutation, on the relationship with the hypersensitive response as well as resistant characteristics. Accumulation of phenolic compounds were detected around the lesions as lesions develop on leaf surface. Activation of PR gene was detected before the lesion appeared, and that result indicates the defense-related response are started earlier than lesion formation. The BLM mutant showed resistant response to inoculation of Magnaporthe grisea KJ201 with which the wild type Hwacheong is totally susceptible. Informations on the formation of spontaneous lesions and detail analysis of lesion mimic mutants and related genes are very limited to date. It is really important to understand the phenomenon of the defense-related lesion formation for developing resistant cultivar for rice blast pathogens

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스마트폰을 이용한 Challenge-Response 인증 (Challenge-Response Authentication with a Smartphone)

  • 논 싸이라난;요브네 탄 잉 후이;김태용;이훈재
    • 한국컴퓨터정보학회:학술대회논문집
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    • 한국컴퓨터정보학회 2012년도 제46차 하계학술발표논문집 20권2호
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    • pp.187-190
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    • 2012
  • This paper proposes an one-time authentication system for web applications by making use of the quick-response code, which is widely used nowadays. The process is not time-consuming. It does not require any browser extensions or specific hardware to complete a task. The system uses QR code which is basically a two-dimensional black and white image encoding a piece of digital information. When a user logs into a site, the web server will generate a challenge encoded to form a QR code. The user captures a picture of QR code with a mobile camera which results in decoding the QR code. The challenge shall be sent back to the server; the web server then logs the PC browser in. The authentication using Challenge-Response is easy to understand and the process is fast. The system proposes the improvement of usability and security of online authentication.

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디지털 실험장치를 이용한 판의 모우드 해석 (Model Analysis of Plate using by Digital Test System)

  • 홍봉기;배동명;배성용
    • 수산해양기술연구
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    • 제29권1호
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    • pp.39-55
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    • 1993
  • Modal Analysis is the process of characterizing the dynamic properties of an elastic structure by identifying its modes of vibration. A mode of vibration is a global property of an elastic structure. That is, a mode has a specific natural frequency and damping factor which can be identified from response data at practically any point on a structure, and it has a characteristic mode shape which identifies the mode spatially over the entire structure. Modal testing is able to be performed on structural and mechanical structure in an effort to learn more about their elastic behavior. Once the dynamic properties of a structure are known its behavior can be predicted and therefore controlled or corrected. Resonant frequencies, damping factors and mode shape data can be used directly by a mechanical designer to pin point weak spots in a structure design, or this data can also be used to confirm or synthesize equations of motion for the elastic structure. These differential equations can be used to simulate structural response to know input forces and to examine the effects of pertubations in the distributed mass, stiffness and damping properties of the structure in more detail. In this paper the measurement of transfer functions in digital form, and the application of digital parameter identification techniques to identify modal parameters from the measured transfer function data are discussed. It is first shown that the transfer matrix, which is a complete dynamic model of an elastic plate structure can be written in terms of the structural modes of vibration. This special mathematical form allows one to identify the complete dynamics of the structure from a much reduced set of test data, and is the essence of the modal approach to identifying the dynamics of a structure. Finally, the application of transfer function models and identification techniques for obtaining modal parameters from the transfer function data are discussed. Characteristics on vibration response of elastic plate structure obtained from the dynamic analysis by Finite Element Method are compared with results of modal analysis.

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식도암의 방사선치료 성적 (The Result of Radiotherapy in Esophageal Cancer)

  • 박찬일;최은경;정웅기;방영주;김노경
    • Radiation Oncology Journal
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    • 제6권2호
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    • pp.227-233
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    • 1988
  • 1979년 3월부터 1986년 8월까지 식도의 편평상피암으로 진단되어 서울대학교병원 치료방사선과에서 방사선치료를 받은 177명중 근치적 방사선 치료를 시행한 152명을 대상으로 후향성 분석을 시행하여 다음과 같은 결과를 얻었다. $80\%$이상의 환자에서 관해를 보였으며, 이중 완전관해는 $22\%$, 부분 관해는 $63\%$이었다. 전체 환자의 2년, 5년 생존율은 각각 $22.9\%,\; 13.3\%$이었으며 식도암의 위치, 크기, 병기 그리고 관해 정도에 따라 생존율에 차이가 있었다. 식도 촬영상 5cm 이하$(17\%)$ 또는 식도의 상부 1/3에 종양이 있는 경우$(25.6\%)$에 가장 좋은 5년 생존율을 보였다. 관해 정도에 따른 생존율은 완전관해를 보인 경우의 5년 생존율이 $34.3\%$인 반면 반응이 없던 경우는 $0\%$이었다

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The value of prophylactic cranial irradiation in limited-stage small cell lung cancer: should it always be recommended?

  • Koh, Minji;Song, Si Yeol;Jo, Ji Hwan;Park, Geumju;Park, Jae Won;Kim, Su Ssan;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • 제37권3호
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    • pp.156-165
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    • 2019
  • Purpose: Prophylactic cranial irradiation (PCI) is a standard treatment for limited-stage small cell lung cancer (LS-SCLC) showing a response to initial treatment, but many patients do not receive PCI due to comorbidities or refusal. This study aims to define the patient group for whom PCI can be omitted with minimal risk. Materials and Methods: Patients with LS-SCLC who underwent radiotherapy with curative aim at our institution between January 2004 and December 2015 were retrospectively reviewed. Patients who did not receive PCI were evaluated for brain metastasis-free survival (BMFS), progression-free survival (PFS), overall survival (OS), and prognostic factors for survival, and treatment outcomes were compared with a patient cohort who received PCI. Results: A total of 350 patients achieved a response following thoracic radiotherapy, and 190 of these patients did not receive PCI. Stage I-II and a complete response (CR) to initial therapy were good prognostic factors for BMFS and OS on univariate analysis. Patients with both stage I-II and a CR who declined PCI showed comparable 2-year BMFS to those who received PCI (92% vs. 89%). In patients who achieved CR, PCI did not significantly improve OS or PFS. Conclusion: There should be less concern about omitting PCI in patients with comorbidities if they have stage I-II or a CR, with brain metastasis control being comparable to those patients who receive PCI.

OK-432를 이용한 몰입성 하마종의 경화치료 (The Sclerotherapy of Plunging with the Use of OK-432)

  • 김순곤;이준호;김명구;노명호
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.33-38
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    • 2007
  • Background and Objectives: A plunging ranula represents a mucus escape reaction occuring because of the disruption of the sublingual salivary gland. It is commonly a condition of young adults, although the reported age range is 6-43 years. There is said to be a slightly female preponderance of about 1.9:1(F:M). Surgical incision has been considered the definite treatment, but sometimes complete excision is very difficult. Non-surgical treatment of these lesions has been attempted, but the results have not been satisfactory. In this study, we present our experiences with picibanil (OK-432) sclerotherapy for a plunging ranula. Materials and Methods: We retrospectively reviewed 41 patients who have undergone sclerotherapy with picibanil for plunging ranula. Information was collected on age, sex, a number of injection, post-sclerotherapy side effect and outcome of treatment. Results: 17 patients (41.5%) showed a complete response, and 20 patients (48.7%) showed inter-mediate response. No response was seen in 4 patients (9.8%). As a side effect of intracystic OK-432 injection therapy, fever (26.8%) and pain(39.0%) were observed. However, fever and pain disappeared after several days in all cases. Conclusion: The results are showing that OK-432 injection is an effective and safe treatment for plunging ranula.

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증분동적해석을 이용한 철골모멘트골조의 지진취약도 함수 (Seismic Fragility Functions for Steel Moment Resisting Frames using Incremental Dynamic Analyses)

  • 이승원;이원호;김형준
    • 한국전산구조공학회논문집
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    • 제27권6호
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    • pp.509-516
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    • 2014
  • 일반적으로 지진취약도를 평가할 때 사용되는 해석방법 중 하나인 역량스펙트럼 방법은 증분동적해석에 비해 해석의 정확성이 떨어지는 제한점이 있다. 본 연구에서는 증분동적해석이 가장 정확도가 높은 해석기법이라는 점에 착안하여 증분동적해석을 이용한 지진취약도 곡선의 도출과정을 제안하였다. 타당성 비교를 위하여 역량스펙트럼 방법과 제안된 방법으로 도출한 취약도 곡선을 비교하여 두 해석기법에 의한 지진취약도 곡선의 경향을 분석하였다. 그 결과 Slight damage와 Moderate damage의 경우 두 해석방법이 유사한 곡선 경향을 보이나 Extensive damage와 Complete damage의 경우에는 IDA방법에 의한 곡선이 더 가파른 경향을 보였다. 이는 구조물의 거동을 이상화하여 극한점 이후 구조물의 저항 강도가 떨어지지 않는다고 가정하는 역량스펙트럼 방법의 영향을 받는 것으로 사료된다.