• Radiation Oncology Journal
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• 제32권2호
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• pp.99-102
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• 2014

We present a case of unresectable cancer of the base of tongue treated with hypofractionated 3D conformal radiotherapy and concomitant chemotherapy. Based on the excellent tumour response in this radiotherapy regimen and international experience in short course treatments we shortly reviewed, we propose that this therapeutic approach could be considered in a curative setting for patients unsuitable for the a standard long course radiochemotherapy schedule.

• 대한두경부종양학회지
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• 제9권1호
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• pp.98-101
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• 1993

Surgery has been known to be traditional treatment modality for the malignant salivary gland tumor, the tumors being considered as radioresistant. However, reviews of the literature have shown a high recurrence rate, especially in advanced and/or high grade tumors. The retrospective data suggests that conservative surgery with adjunctive radiation therapy is justified in view of the enhanced locoregional control. In inoperable and recurrent tumor, definitive radiotherapy can achieve $30{\sim}40%$ of average 5 year survival rate, but in early stage, local control and survival rate could be raised more than 80%. This results shown to be aggressive radiotherapy can replace surgical management for the selected cases of small sized tumor. Neutron therapy is another option for curative treatment of malignant salivary gland tumors.

• Journal of Gastric Cancer
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• 제23권1호
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• pp.194-206
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• 2023

Although continuous improvement in the treatment outcome of localized gastric cancer has been achieved through early screening, diagnosis, and treatment and the active application of surgery and adjuvant chemotherapy, the necessity of adjuvant radiotherapy (RT) remains controversial. In this review, based on the results of two recently published randomized phase III studies (Adjuvant Chemoradiation Therapy In Stomach Cancer 2 and ChemoRadiotherapy after Induction chemoTherapy of Cancer in the Stomach) and a meta-analysis of six randomized trials including these two studies, the role of adjuvant RT in gastric cancer was evaluated and discussed, especially in patients who underwent curative gastrectomy with D2 lymphadenectomy. This article also reported the possible indications for adjuvant RT in the current clinical situation and in future research to enable patientspecific treatments according to the risk of recurrence.

• Journal of Digestive Cancer Research
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• 제6권2호
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• pp.50-54
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• 2018

The incidence of gastric cancer has steadily declined and the overall mortality rate from gastric cancer has similarly decreased. However, compared to other malignancies, the quality of life and life expectancy remain relatively poor in patients with gastric cancer. For gastric cancers, surgical resection is the main treatment, but the optimal therapeutic strategy for locally advanced gastric cancer remains undefined. For many patients with gastric cancer, not only chemotherapy but also radiotherapy plays a crucial role in both the curative and palliative settings. In this article, we review the evidence for the different treatment paradigms with a particular focus on the role of radiotherapy.

• 한국방사선학회논문지
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• 제10권8호
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• pp.611-618
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• 2016

암의 3대 표준요법중의 하나인 방사선치료는 전통적으로 악성 종양인 암의 근치적 혹은 고식적 치료외에도 일부 증식성이거나 염증성을 보이는 양성 질환에서도 그동안 꾸준하게 시행되어왔다. 양성질환의 경우 악성 종양과는 달리 약물요법이나 보존요법 또는 수술로 만족할 만한 치료성적을 낼 수 있으나 이런 치료들이 실패하거나 불가능한 경우 저선량의 방사선치료를 추가하거나 병용하여 시행하는 경우 인체에 큰 문제없이 안전하고 용이하게 통증완화나 재발율을 의미있게 낮출 수 있다. 최근 방사선치료기법의 발달로 정상조직을 최대한 보존하면서 원하는 부위로의 집중적 치료가 가능해지면서 특히 노인에게서 유용한 대안이 될 수 있을 것으로 생각된다.

• Radiation Oncology Journal
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• 제13권3호
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• pp.253-258
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• 1995

Purpose : To evaluate the effects of postoperative radiotherapy and chemotherapy on the pattern of failure and survival for locally advanced rectal carcinoma, we analyzed the two groups of patients who received curative resection only and who received postoperative radiochemotherapy retro-spectively. Materials and Methods : From June 1989 to December 1992, ninety nine patients with rectal cancer were treated by curative resection and staged as B2-3 or C. Group I(25) patients received curative resection only and group II(74) patients postoperative adjuvant therapy. Postoperative adiuvant group received radiation therapy (4500cGy/25fx to whole pelvis) with 5-FU (500mg/$m^2$, day 1-3 IV infusion) as radiosensitizer and maintenance chemotherapy with 5-FU(400mg/$m^2$ for 5 days) and leucovorin (20mg/m^2$ for 5 days) for 6 cycles. Results : The patients in group I and group II were comparable in terms of age sex, performance status, but in group II $74{\%}$ of patients showed stage C compared with $56{\%}$ of group I. All patients were followed from 6 to 60 months with a median follow up of 29 months. Three year overall survival rates and disease free survival rates were $68\%,\;64\%$ respectively in group I and $64\%,\;61\%$, respectively in group II. There was no statistical difference between the two treatment groups in overall survival rate and disease free survival rate. Local recurrences occurred in $28{\%}$ of group I, $21{\%}$ of group II (p>.05) and distant metastases occurred in $20{\%}$ of group I, $27{\%}$ of group II(p>.05). The prognostic value of several variables other than treatment modality was assessed. In multivariate analysis for prognostic factors stage and histologic grade showed statistically significant effect on local recurrences and lymphatic or vessel invasion on distant metastasis. Conclusion : This retrospective study showed no statistical difference between two groups on the pattern of failure and survival. But considering that group II had more advanced stage and poor prognostic factors than group I, postoperative adjuvant radiochemotherapy improves the results for locally advanced rectal carcinoma as compared with curative surgery alone.

• Tuberculosis and Respiratory Diseases
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• 제42권5호
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• pp.731-736
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• 1995

연구배경: 제1기 비소세포폐암의 경우 근치적절제술이 최선의 치료법이나 환자가 수술을 거부하거나 폐질환 또는 순환기질환과 같은 기저질환으로 수술을 할 수 없는 경우에는 근치적 방사선 요법이 차선의 치료법이다. 그러나 근치적 방사선치료 과 외과적 절제술후 치료성적에 관해서는 논란이 많다. 방법: 저자들은 경북대학교병원에서 1986년 6월부터 1992년 12월까지 제1기 비소세포폐암으로 진단받았으나 방사선치료를 받았던 15예와 1989년 1월부터 1992년 12월까지 제1기 비소포폐암으로 진단받고 외과적 절제술만을 시행하였던 24예를 대상으로 후향성조사(retrospective study)를 통하여 이들의 치료경험 및 생존율을 검토하였다. 생존율과 생존기간은 Kaplan-Meier 방법으로 산출하였다. 결과: 대상 환자들중 방사선치료를 받은 이유는 폐기능이 나쁜 경우가 8예, 수술을 거부한 경우가 5예, 수행상태가 나쁜 경우가 2예였다. 중간생존기간은 수술을 받은 군이 37.7개월, 방사선치료를 받은 군이 14.9개월이었다. 방사선치료를 받은 군 가운데 수술을 거부한 경우는 17.9개월, 폐기능이 나쁘거나 수행상태가 나쁜 경우는 10.5개월이었다. 수출을 받은 군의 2년 생존율은 65%, 5년 생존율은 41%, 방사선치료를 받은 군의 2년 생존율은 22%, 5년생존율은 없었다. 결론: 제1기 비소세포폐암에서 수술전후 효과적인 치료를 한다면 여러가지 이유로 수술이 힘든 경우라도 근치적절제술이 최선의 치료법이다. 그러나 수술을 시행하지 못할 경우 차선의 치료법으로 방사선치료를 시행할 수 있으며, 향후 전향성조사가 필요하리라 생각된다.

• Radiation Oncology Journal
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• 제35권1호
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• pp.55-64
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• 2017

Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

• Radiation Oncology Journal
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• 제36권4호
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• pp.325-331
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• 2018

Purpose: Soft tissue sarcoma (STS) is a rare and heterogeneous cancer with over 50 known subtypes. It is difficult to understand the role of adjuvant treatment in STS. We aimed to determine the benefits of adjuvant treatment for a rare STS subset: non-extremity STS with moderate chemosensitivity. Materials and Methods: We reviewed medical records from Pusan National University Hospital and Kosin University Gospel Hospital, which had detailed pathological reports on patients diagnosed between 2006 and 2016. The most important inclusion criterion was resection with curative intent. We grouped STS by chemosensitivity based on reported data and analyzed non-extremity STS with moderate chemosensitivity. Results: We investigated 142 patients with 20 pathological subtypes of STS. Eighty-six patients had extremity STS and 56 had non-extremity STS. Thirty-eight of 56 patients were categorized as having moderate chemosensitivity. Seventeen of 38 patients (44.7%) received adjuvant radiotherapy and 14 (36.8%) received adjuvant chemotherapy. A log-rank test showed longer disease-free survival (DFS) in the adjuvant radiotherapy group than in the group treated without adjuvant radiotherapy (not reached vs. 1.468 years, p = 0.037). Multivariate Cox proportional hazard analysis, with covariates including age, stage, resection margin, adjuvant chemotherapy, and adjuvant radiotherapy, revealed that adjuvant radiotherapy was associated with longer DFS (odds ratio = 0.369, p = 0.045). Overall survival was not correlated with adjuvant radiotherapy. Conclusion: Adjuvant radiotherapy may be associated with longer DFS in patients with non-extremity STS with moderate chemosensitivity.

• Radiation Oncology Journal
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• 제32권1호
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• pp.7-13
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• 2014

Purpose: To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. Materials and Methods: Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). Results: The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (${\geq}50$ Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). Conclusion: In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.