• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.347-352
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• 2016

Background: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) adenosquamous carcinoma data to identify predictive models and potential disparities in outcome. Materials and Methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for adenosquamous carcinoma. For the risk modeling, each factor was fitted by a generalized linear model to predict the cause specific survival. An area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. Results: A total of 20,712 patients diagnosed from 1973 to 2009 were included in this study. The mean follow up time (S.D.) was 54.2 (78.4) months. Some 2/3 of the patients were female. The mean (S.D.) age was 63 (13.8) years. SEER stage was the most predictive factor of outcome (ROC area of 0.71). 13.9% of the patients were un-staged and had risk of cause specific death of 61.3% that was higher than the 45.3% risk for the regional disease and lower than the 70.3% for metastatic disease. Sex, site, radiotherapy, and surgery had ROC areas of about 0.55-0.65. Rural residence and race contributed to socioeconomic disparity for treatment outcome. Radiotherapy was underused even with localized and regional stages when the intent was curative. This under use was most pronounced in older patients. Conclusions: Anatomic stage was predictive and useful in treatment selection. Under-staging may have contributed to poor outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.969-975
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• 2013

Aim: The aim of this study was to determine the impact of age on the occurrence, severity, and timing of acute side effects related to radiotherapy. Materials and Methods: We analysed the data of 423 patients. Results: Of the patients, 295 (70%) were under the age of 65 (group 1) and 128 (30%) were over the age of 65 (group 2). The frequencies of radiotherapy-induced side effects were 89% in group 1 and 87% in group 2 (p=0.286). The mean times to occurrence were $2.5{\pm}0.1$ weeks in group 1 and $2.2{\pm}0.1$ weeks in group 2 (p=0.013). Treatment was ended in 2% of patients in group 1 and 6% of those in group 2 (p=0.062). Treatment interruption was identified in 18% of patients in group 1 and 23% in group 2 (p=0.142). Changes in performance status were greater in older patients (p=0.013). There were no significant differences according to the frequency or severity of side effects, except skin and genitourinary complications, between the groups. Conclusions: Early normal tissue reactions were not higher in older versus younger patients, though there was a tendency towards an earlier appearance.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2641-2646
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• 2014

Background: To evaluate efficacy and side effects of glycididazole sodium (CMNa) combined with chemotherapy (cisplatin plus 5-FU/folic acid, PLF) and radiotherapy in treating patients with locally advanced nasopharyngeal carcinoma. Materials and Methods: Patients with III~IV stage nasopharyngeal carcinoma (NPC),were randomly divided into treatment group (46 patients) and control group (45 patients). Both groups received radiotherapy concomitant with PLF chemotherapy. The treatment group at the same time cwas given CMNa ($800mg/m^2$ before radiotherapy), by l h intravenous drip, three times a week. Results: When the dose of radiation was over 60 Gy, complete response rates of nasopharyngeal tumor and lymph node metastases in treatment group were significantly higher than in the control group (93.5% vs 77.8%; 89.1% vs 93.5%, p<0.05). Three months after radiotherapy, complete response rate of nasopharynx cancer and lymph node metastases in treatment group was both 97.8%, again higher than in the control group (84.4% and 82.2%) (p<0.05). In the treatment group, 1, 3, 5 year disease-free survival rates were 95.7%, 86.7% and 54.5%; and in control group, the corresponding disease-free survival rates were 93.3%, 66.2% and 38.6%, respectively, the difference being statistically significant (log-rank =5.887, p=0.015). One, 3, 5 year overall survival rates in two groups of patients were 97.8%, 93.5%, 70.4% and 95.5%, 88.07%, 48.4%, respectively, again with a statistically significant difference (log-rank=6.470, p=0.011). Acute toxicity and long-term radiotherapy related toxicity in the two groups did not differ (p>0.05). Conclusions: Glycididazole sodium could improve curative effects without increasing adverse reactions when treating paitents with locally advanced nasopharyngeal carcinoma.

• Radiation Oncology Journal
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• 제14권2호
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• pp.129-136
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• 1996

목적 : 담낭과 간외 담도를 포함한 간외 담도계암에 대한 방사선치료의 효과를 평가하고 방사선치료의 역할에 관하여 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1986년 4월에서 1994년 7월까지 본원 치료방사선과에서 외부 방사선치료를 받은 43명의 담낭 및 간외 담도계암 환자를 후향적으로 분석하였다. 23명은 담낭암이었고 20명은 간외 담도암이었다. 23명의 담낭암 환자중에서 제 2병기는 2명, 제 3 병기는 12명, 제 4병기는 9명이었다. 남녀비는 11명대 12명이었다. 15명은 근치적 절제술을 시행하였고, 8명은 조직생검과 우회수술만을 시행하였다. 3명을 제외한 모든 환자에서 수술후 4500 cGy 이상의 방사선을 조사하였으며, 추적기간은 11-82개월 이었다. 20명의 간외 담도암 환자중에서 제 1병기는 1명, 제 2병기는 2명, 제 3병기는 10명, 제 4병기는 7명이었다. 남녀비는 16명대 4명이었다. 16명이 근치적 목적으로 위플씨 수술 또는 절제와 배액술을 시행하였고, 나머지 4명은 우회수술만을 시행하였다. 16명은 수술후 방사선 치료로 4500 cGy 이상 조사하였고, 4명은 3180-4140cGy를 조사하였다. 추적기간은 8-34개월 이었다. 결과 : 담낭암 환자의 전체 중앙 생존기간은 11개월이었다. 제 3병기와 제 4병기의 중앙생존기간은 14개월과 5개월이었으며, 2년 생존율은 각각 $36\%$(4/11)와 $13\%$(1/8) 이었다. 근치적 목적으로 수술을 받은 환자들이 우회수술 만으로 치료받은 환자들보다 통계적으로 유의하게 생존율이 높았다. ($67\%$ : $13\%$ 12개월) 치료와 연관된 합병증으로 사망한 환자는 없었다. 20명의 간외 담도암 환자의 전체 중앙 생존기간은 10개월이었다. 제 3병기 10명과 제 4병기 7명의 중앙 생존기간은 각각 10개월과 8개월이었다. 위플씨 수술을 시행한 2명은 각각 11개월과 14개월간 생존하였으며, 절제와 배액술로 치료한 환자들의 중앙 생존기간은 10개월이었다. 결론 : 간외 담도계암 환자에서 수술후 외부 방사선치료에 의한 합병증은 미미하였으며, 특히 수술후 현미경적 또는 육안적 잔여병변이 있는 환자에서 방사선 치료에 의해 생존율이 증가하는 양상을 나타내었다.

• Radiation Oncology Journal
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• 제32권3호
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• pp.147-155
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• 2014

Purpose: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. Materials and Methods: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). Results: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age ${\geq}66$ years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. Conclusion: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.

• Radiation Oncology Journal
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• 제16권3호
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• pp.245-250
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• 1998

목적 : 조기 성문암의 방사선 치료 후 생존율, 실패 양상, 그리고 예후 인자에 대해 분석하였다. 대상 및 방법 : 1985년 6월부터 1992년 11월까지 방사선 치료를 위해 의뢰된 57례의 성문암환자를 대상으로 후향적 분석을 실시하였다. 연령 분포는 17세부터 71세까지 광범위했고 (중앙값 39세), 남자 55례와 여자 2례로 남성에서 호발하였다. 방사선 치료는 6 MV X-ray를 이용하여 1회 선량 2 Gy씩, 주 5회, 총선량 66 Gy를 조사하였다. 결과 : 방사선 치료에 대한 반응은 완전 관해 89.5% (51/57), 부분 관해 혹은 무반응 10.5%(6/57) 였다. 51례의 완전관해 환자 중에서 7례의 재발이 관찰되었고 7례 모두 수술로 구제되었다. 부분 관해 혹은 무반응 6례 중 4례에 대하여 구제수술을 시행하였고 2례에서는 수술을 시행하지 못하였다. 구제수술을 시행한 4례 중 3례가 구제되었고 1례는 다시 국소재발하였다. 3년 및 5년 무병생존율은 각각 72.9% 및 63.8%였다. 병소의 위치에 따른 5년 무병생존율은 후방인 경우 85.5%, 전방인 경우 61.6%였다 (P<0.05). 방사선치료에 대해 부분 관해 혹은 무반응을 보인 5례를 포함하여 13/57 (22.8%) 례의 치료 실패가 관찰되었고 그 중 10/13 (76.9%) 례가 수술로 구제되었다. 최종 5년 국소제어율은 92.3%였고 전체적으로 47/57 (82.5%) 례에서 음성을 보존할 수 있었다. 결론 : 높은 음성 보존율을 고려하면 초기 성문암에서 방사선치료가 우선적으로 고려되어야 한다.

• Radiation Oncology Journal
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• 제24권2호
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• pp.116-122
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• 2006

목적: 본 연구는 수술 후 방사선치료를 받은 초기 자궁내막암의 치료결과를 분석하여 향후 치료방침 결정에 도움을 주고자 한다. 대상 및 방법: 1994년 10월부터 2002년 8월까지 FIGO I 병기의 자궁내막암으로 수술 후 방사선치료를 받은 환자는 총 42명이었다. 모든 환자들이 근치적 수술을 시행하였으며, 골반림프절곽청술은 26명에서 시행되었다. FIGO 병기는 IA 병기 3명, IB 병기 21명, IC 병기 18명이었고, 조직학적 등급은 1등급 14명, 2등급 16명, 3등급 12명이었다. 19명의 환자는 강내근접치료를 받았으며, 23명은 전골반-방사선치료를 받았다. 추적관찰기간은 $22{\sim}100$개월(중앙값 41개월)이었다. 결과: 전체 환자의 5년 생존율, 무병생존율, 국소제어율, 영역제어율은 각각 86.0%, 87.9%, 100%, 97.5%였다. 재발은 원격전이가 5명에서 발생하였는데, 이들 중 2명은 영역재발이 동반되었다. 강내근접치료만 받은 환자들에서는 국소영역재발이 없었다. 3등급의 만성합병증은 전골반-방사선치료를 받은 1명(4.3%)에서 발생하였다. 결론: 초기 자궁내막암은 근치적 수술과 수술 후 보조적 방사선치료로 높은 국소영역제어율과 생존율을 얻을 수 있었다. 그러나 치료에 의한 부작용을 줄이기 위해서는 위험인자에 따라 방사선치료 방법을 선택하여야 할 것이다.

• 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

• 대한두경부종양학회지
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• 제8권1호
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• pp.25-30
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• 1992

The causes of treatment failure in head and neck cancer are locoregional recurrence, distant metastasis and second primary cancer. The favorite sites of second primary cancer are head and neck, lung and esophagus. But, the incidence of stomach cancer in Korea is the highest of all, high incidence of stomach cancer is expected in head and neck cancer patients. We experienced 2 cases of stomach cancer after successful treatment of primary head and neck cancer at Kang Nam St. Mary's hospital. The first case was a 60-year-old male with nasopharyngeal non-keratinizing carcinoma(stage III, T1N1M0). He received three cycles of induction chemotherapy including cisplatin and 5-fluorouracil followed by radiotherapy which resulted in complete response. Five months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. He received one cycle of FAM chemotherapy and died 4 months after diagnosis of stomach cancer. The second case was a 50-year-old male with pyriform sinus squamous cell carcinoma(stage II, T2N0M0). He received curative partial pharyngolaryngectomy followed by radiotherapy which result in free of disease. Four months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. Bypass gastrojejunostomy was performed. The screening test for stomach cancer including upper gastrointestinal X-xay series and/or endoscope of the stomach should be performed periodically for the patients with head and neck cancer in Korea.

• 대한기관식도과학회지
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• 제17권2호
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• pp.98-103
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• 2011

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.