• Title/Summary/Keyword: Dose analysis

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A Randomized Phase III Study of Patients With Advanced Gastric Adenocarcinoma Without Progression After Six Cycles of XELOX (Capecitabine Plus Oxaliplatin) Followed by Capecitabine Maintenance or Clinical Observation

  • Guk Jin Lee;Hyunho Kim;Sung Shim Cho;Hyung Soon Park;Ho Jung An;In Sook Woo;Jae Ho Byun;Ji Hyung Hong;Yoon Ho Ko;Der Sheng Sun;Hye Sung Won;Jong Youl Jin;Ji Chan Park ;In-Ho Kim;Sang Young Roh;Byoung Yong Shim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.315-327
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    • 2023
  • Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. Materials and Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020). Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

Effect of Fractionated X-ray Irradiation on Sprouted Barley Growth and Chlorophyll Concentration (X선의 분할조사가 새싹보리 생장과 클로로필 농도에 미치는 영향)

  • In Suck Park;Won-Jeong Lee;Sang-Bok Jeong
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1171-1178
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    • 2023
  • In study, we investigated changes on growth and chlorophyll concentration on sprouted barley by fractionated X-ray irradiation (FXI). Group was divided into the control group (CG), 1-time irradiation group (30 Gy once), 2-time irradiation group (15 Gy 2 times), and 3-time irradiation group (10 Gy 3 times), and 20 grains were used per group. Experimental group (EG) was exposed by using linear accelerator (Clinac IS, VERIAN, USA), by 6 MV X-ray, SSD 100 cm, 18×10 cm2, 600 MU/min. Length was measured every day until 9th day, and chlorophyl was analyzed using spectrophotometer(uv-1800, shimadzu, japan) in 9th day. Data analysis was performed the One-way ANOVA using SPSS ver 26.0(Chicago, IL, USA). In the pre-germination irradiation group (Pre-GIG), the CG had greater length than the EG on all measurement days, and as the number of FXI increased, the length became shorter. In the post-germination irradiation group (Post-GIG), the length of the CG was statistically significantly greater than that of the EG on all measurement days, and as the number of FXI increased, the length also became longer. The chlorophyll concentration was higher in the Post-GIG than in the Pre-GIG, and chlorophyll concentrations of EG was higher in the Pre-GIG than in the CG, as well as and Post-GIG. In addition, the smaller the number of FXI, the higher the chlorophyll concentration in both groups. FXI was found to affect the growth and chlorophyll concentration of sprouted barley.

Verification of Anti-Inflammatory Effects of Strawberry (Fragaria x ananassa var. 'Seolhyang') Stems on Macrophages Stimulated by Lipopolysaccharides (LPS로 자극된 대식세포에 대한 딸기 줄기의 항염증 효능 검증)

  • Dan-Hee Yoo;In-Chul Lee
    • Microbiology and Biotechnology Letters
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    • v.51 no.3
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    • pp.280-288
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    • 2023
  • In strawberry farming, most parts of strawberry stems but the fruit have been dumped. Therefore, this study attempted to investigate the antioxidant and anti-inflammatory effects of strawberry stems which are thrown away after farming. For this, strawberry stem extracts were obtained, using hot water and 70% ethanol. First, total polyphenol contents of the hot water and ethanol extract were checked (265.4 ± 0.12 mg TAE/100 g, 503.88 ± 0.2 mg TAE/100 g). For analysis of antioxidant activities, electron donating ability (EDA) and 2,2'-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activity were measured. Both extracts increased in a dose-dependent fashion, and similar effects with vitamin C (control group) were confirmed. In terms of cell viability of the hot water and ethanol extracts of strawberry stems, 'RAW 264.7' was 99% or higher at 500 ㎍/ml. In addition, cell experiments were conducted at 50, 100 and 500 ㎍/ml where cell viability is above 99%. In terms of inhibition of the inflammatory mediator 'nitric oxide (NO)', the hot water and ethanol extracts of strawberry stems were 37.9% and 38.8% respectively, confirming the inhibition of NO production. To check anti-inflammatory activities, protein and mRNA expressions of 'iNOS' and 'COX-2' were measured, using RAW 264.7. Compared to the LPS group, the protein expression of the inflammatory mediators was inhibited in the hot water and ethanol extract-treated groups. The above results confirmed that the hot water and ethanol extracts of strawberry stems are valuable as natural substances with antioxidant and anti-inflammatory activities.

Results of Preoperative Concurrent Chemoradiotherapy for the Treatment of Rectal Cancer (직장암의 수술 전 동시적 항암화학방사선치료 결과)

  • Yoon, Mee-Sun;Nam, Taek-Keun;Kim, Hyeong-Rok;Nah, Byung-Sik;Chung, Woong-Ki;Kim, Young-Jin;Ahn, Sung-Ja;Song, Ju-Young;Jeong, Jae-Uk
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.247-256
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    • 2008
  • Purpose: The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of $1.8{\sim}2.0\;Gy$ at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of $43.2{\sim}54\;Gy$ (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range $11{\sim}107$ months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59.1% for stage I (n=16), 78.6% for stage II (n=30), 36.9% for stage III (n=23), and one patient with pathologic stage IV was alive for 43 months (p=0.02). The 5-year disease-free survival rates were 77.8% for stage 0, 63.6% for stage I, 58.9% for stage II, 51.1% for stage III, and 0% for stage IV (p<0.001). The 5-year locoregional control rates were 88.9% for stage 0, 93.8% for stage I, 91.1% for stage II, 68.2% for stage III, and one patient with pathologic stage IV was alive without local recurrence (p=0.01). The results of a multivariate analysis with age (${\leq}55$ vs. >55), clinical stage (I+II vs. III), radiotherapy to surgery interval (${\leq}6$ weeks vs. >6 weeks), operation type (sphincter preservation vs. no preservation), pathologic T stage, pathologic N stage, pathologic overall stage (0 vs. I+II vs. III+IV), and pathologic response (complete vs. non-CR), only age and pathologic N stage were significant predictors of overall survival, pathologic overall stage for disease-free survival, and pathologic N stage for locoregional control rates, respectively. Recurrence was observed in 25 patients (local recurrence in 10 patients, distant metastasis in 13 patients, and both in 2 patients). Acute hematologic toxicity ($\geq$grade 3) during chemoradiotherapy was observed in 2 patients, while skin toxicity was observed in 1 patient. Complications developing within 60 days after surgery and required admission or surgical intervention, were observed in 11 patients: anastomotic leakage in 5 patients, pelvic abscess in 2 patients, and others in 4 patients. Conclusion: Preoperative chemoradiotherapy was an effective modality to achieve downstaging and sphincter preservation in rectal cancer cases with a relatively low toxicity. Pathologic N stage was a statistically significant prognostic factor for survival and locoregional control and so, more intensified postoperative adjuvant chemotherapy should be considered in these patients.

The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results (후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발: 예비 결과)

  • Chung Woong-Ki;Kim I1-Han;Ahn Sung-Ja;Nam Taek-Keun;Oh Yoon-Kyeong;Song Ju-Young;Nah Byung-Sik;Chung Gyung-Ai;Kwon Hyoung-Cheol;Kim Jung-Soo;Kim Soo-Kon;Kang Jeong-Ku
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.299-305
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    • 2003
  • Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

Induction Chemotherapy and Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (NSCLC) (국소 진행된 비소세포성 폐암에서 유도 화학요법 및 방사선치료)

  • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.195-202
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    • 1999
  • Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

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Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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Correlates of Subjective Well-being in Korean Culture (한국문화에서 주관안녕에 영향을 미치는 사회심리 요인들)

  • Hahn, Doug-Woong
    • Korean Journal of Culture and Social Issue
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    • v.12 no.5_spc
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    • pp.45-79
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    • 2006
  • The purpose of this paper was to review the results of the subjective well-being(swb) studies performed by Hahn and coworkers in Korean culture. As the correlates of swb, we dealt with demographic/individual difference variables, intrapersonal variables, interpersonal process variables, and Korean cultural variables. We proposed that the components of swb were consisted of quality of life(cognitive swb) and overall happy feelings about one's own life(emotional swb). It was also assumed that a measure of total swb could be calculated by summated mean of cognitive swb and emotional swb measures. The data of the swb studies were analyzed and interpreted according to the above three measures of swb. The results of a nationwide survey(Hahn, 2004) from age of 19 to 75 years ald(n=2,230) showed significant simple correlation coefficients between the following demographic/individual difference variables and swb: Gender difference in swb was found(total swb r=.08, p<.001; life satisfaction r=.10, p<.001; overall emotional swb r=.05, p<.05). Men were happier than women in terms of all three measures of swb. It was also found that women appeared to experience greater positive and negative emotions. Correlation between age and emotional swb(r=.09, p<.001) was significant, but life satisfaction was not significant(r=.04, n.s). Correlations between economic status and swb were also significant(total swb r =.23, p<.001; life satisfaction r=.15 p<.001; overall emotional swb r=.15, p<.001l). Although existence of father was negatively related to emotional swb(r=-.05, p<.05), the existence of mother was not related to any of swb measures. Similarly existence of brothers was related positively to overall emotional swb, but existence of sisters was not. Though existence of son was not related to swb, daughter contributed negatively to swb(total swb -.12, p<.01; life satisfaction -.09, p<.05; emotional swb r=-.12, p<.01). We assumed that family member-in-Iaw also contributed to swb because the extended dose social networks were important in Korean culture. The results showed that the following family member-in-law variables were related to swb: Parents-in-law(total swb r=.11, p<.01; life satisfaction r=.10, p<.01; emotional swb r=.10, p<.01), father-in-law(total swb r=.11, p<.01; life satisfaction r=.11, p<.01; emotional swb r=.06, n.s). The result suggested that especially father-in-law contributed to swb through financial and social support. Correlations between emotional experiences in everyday life and swb were also presented. The range of correlation coefficients between the positive emotion measures and swb were r=.30~.48(p<.001) when the above two measures obtained at same time. But the range decreased to r=.19~32(p<.001) when the swb measure was obtained 9 month later longitudinally. Intercorrelations between positive emotional experience; and life satisfaction were r=.37~58(p<.001) when two measures were obtained at same time. We also examined the effects of the intrapersonal cognitive responses to the most stressful life event upon swb. The results of nationwide survey(n=1,021) showed that self-disclosure(total swb r=.09, p<.010; life satisfaction r=.10, p<.01; emotional swb r=.07, p<.01), rumination(total swb r=-.17, p<.001), thought avoidance(total swb r=.12, p<.001; life satisfaction r=-.08; emotional swb r=-.12, p<.001) and suppression(total swb r=-.13, p<.001; life satisfaction r=-.08, p<.05: emotional swb r=-.13, p<.001) contributed to swb. It was also suggested that mismatch between self-guide and regulatory focus contributed negatively to emotional swb. It was also found that social comparison motives and fulfillment of the motives contributed to swb. The results of a survey research(n=363 college students) revealed that the higher the general social comparison motive, the lower the swb(total swb r=-.15, P<.01: life satisfaction r=-.17. p<.01; emotional swb r=-.10, p<.05). It was also found that satisfaction level of self-evalution motive contributed positively to swb(total swb r=-.14. p<.01: life satisfaction r=-.12, p<.05; emotional swb r=.15, p<.001). Both of self-improvement motive(r=.13, p<.05) and satisfaction level of self-improvement motive(r=.12, p<.05) contributed positively to emotional swb, respectively. The above results suggested that swb was depended upon the interaction effect of social comparison motive; and level of fulfillment of the motives. We also reported the significant multiple predictors of swb in a sample of age from 60years to 89years olds. The results of multiple regression analysis showed that the significant multiple predictors of swb were past illness(β=.174, p<.001), economic status(β=.418, p<.001), marital satisfaction(β=.0841, p<.001), satisfaction of offsprins(β=.065, p<.01), expectation level of social support from offsprings(β=-.049, p<.001), and negative emotions(β=-.454. p<.001) among 16 social psychological factors. It was also found that swb was an important multiple predictors of physical health. This finding was replicated in a longitudinal study. Both of positive and negative emotional experiences were significant multiple predictors of physical health one year later. The results of the discriminant analysis showed both of total swb and positive emotional experiences contributed to discriminate the happy and healthy olds from unhappy and unhealthy olds. We paper also examined the effects of the nonnative social behaviors upon swb in Korean culture. The main hypotheses of the study(Hahn, 2006, in press) was that the important nonnative behaviors would influence on swb through both of the mediation processes of adjustment to social relationships and psychological stress. The survey data were collected from 2,129 adults age of 19 to 75, from 7 regional areas in Korea. The results of the study revealed that almost all of correlation coefficients between 15 normative social behaviors and the above three criteria w-ere significant. The fitness test results of the covariance structural equation model showed that all of the fitness indices were satisfactory (GFI=.974, AGFI=.909, NNFI=.922, NFI=.973, CFI=.974. RMR=.049, RMSEA=.073). The results of the analysis revealed that the following five path coeffi6ents from behaviors to social adjustment were significant; behavior tor family and family members(t=5.87, p<.001), courteous behavior(t=4.39, p<.001), faithful behavior (t=2.15. p<.05). collectivistic behavior(t=8.31, p<.001). Seven path coefficients from the normative behaviors to psychological stress were significant; behavior for family and family members (t=-4.63, p<.001), faithful behavior(t=-3.86, p<.001). suppression of emotional expression(t=3.99, p<.001), trustworthy and dependable behavior(t=-2.21, p<.05), collectivistic behavior(t=3.72, p<.001), effortful and diligent behavior(t=2.94, p<.001), husbandry and saving behavior(t=3.40, p<.001). The above results suggested that four normative behaviors among seven behaviors contributed negatively to psychological stress in current Korean society. The results abo confirmed the hypothesized paths from social adjustment (t=10.40, p<.001) to swb and from psychological stress(t=-19.74, p<.001) to swb. The important results of the study were discussed in terms of the Confucian traditions and recent social changes in Korean culture. Finally limitations of this review paper were discussed and the suggestions for the future study were also proposed.