• Radiation Oncology Journal
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• 제34권2호
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• pp.96-105
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• 2016

Purpose: The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45-50 Gy in 25-28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. Materials and Methods: A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Results: Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Conclusion: Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.

• 대한두경부종양학회지
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• 제12권1호
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• pp.3-7
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• 1996

Nasopharyngeal carcinoma(NPC) is a disease whose primary initial treatment is radiation. Results of radiation therapy in early stage disease is promising; however, in stage IV disease, the best reported five-year survival is only about 30%. In patients with post-radiation recurrent disease, radiation controls only a small portion of patients, as well as being associated with significant radiation injury. In this paper we discuss the use of salvage treatment modalities for post-radiation recurrence. A retrospective chart review and analysis of salvage treatment results were performed for 39 patients with recurrent post-radiation NPC and positive cervical lymph nodes during the period beginning 1985 until 1995. Mean age of these patients was 52.3$\pm$10.37 years and male: female ratio was 1.8 : 1. Twenty patients were treated with salvage treatment, and ten patients were treated by salvage chemotherapy. A total of nine patients underwent surgical salvage treatment, including neck dissection(6), transnasal laser surgery and booster radiotherapy(2), and primary surgery(1). Salvage treatment were effective in reducing patients' pain in twenty patients (51.3%) and prolonging life in nine patients(23.1%); however, recurrence of disease within six months and/or residual disease by clinical or radiologic exam was noted in all patients receiving salvage radiotherapy, chemotherapy, laser surgery with radiotherapy, and primary site surgery. In the group undergoing salvage neck dissection, three patients(50%) were disease free for at least two years. Of the different modalities, radiotherapy was associated with the best quality of life while catastrophic salvage surgery resulting in insignificant prolongation of life was associated with the poorest quality of life. We conclude that salvage surgery is the optimal choice of treatment for regional recurrence such as nodal failure, however palliative salvage therapy could be preferred in other cases with recurrent post-radiation NPC.

• 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.

• Radiation Oncology Journal
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• 제20권3호
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• pp.253-263
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• 2002

목적 : bFGF (basic fibroblast growth factor)는 섬유아세포(fibroblast)에서 분비하는 대표적인 성장인자로 섬유아세포뿐 아니라 간질조직과 골수 및 다른 상피 근원세포의 성장에도 관여하며 방사선보호제 역할에 관한 연구가 시도되고 있다. 이 연구는 방사선보호제로서의 bFGF의 기능을 알아보고자 하였다. 대상 및 방법 : 간엽조직 기원(mesenchymal origin)인 마우스육종 180 종양세포를 생쥐 대퇴부 피하에 이식하고 bFGF를 투여한 후 전신방사선조사(6, 8, 10 Gy)하여 생쥐의 생존률을 조사하고 bFGF (3, $6\;{\mu}g$/쥐)의 방사선보호효과를 관찰하였다. 동시에 이식한 마우스 180 고형종양을 국소방사선조사한 후 bFGF가 종양성장에 미치는 영향을 알아보았다. 또한 bFGF에 의한 방사선보호효과의 기전을 이해 하고자 소장점막, 골수, 폐조직 및 이식종양조직에 대한 병리 조직학적 검사와 DNA terminal transferase nick-end labeling assay 방법으로 아포프토시스(apoptosis) 빈도를 측정하였다. 결과 : 1) 방사선조사단독군에 비해 방사선조사와 $6\;{\mu}g$ bFGF 투여병행군에서 생쥐의 골수치사를 감소시켜 생존률이 증가되었다(p<0.05). 2) 방사선조사단독군에 비해 방사선조사와 $6\;{\mu}g$ bFGF 투여병행군에서 공장 소낭선 깊이 및 미세융모 길이가 의의 있게 증가되었다(p<0.05). 소낭선세포의 아포프토시스 빈도는 방사선조사단독군에 비해 방사선조사와 bFGF 투여병행군에서 방사선조사후 8시간, 24시간에 감소하였으며 bFGF를 고용량 투여한 군에서 뚜렷하였다. 3) 골수조직에서는 방사선조사 후 7일, 14일째 세포 밀도가 방사선조사단독군에 비해 방사선조사와 $6\;{\mu}g$ bFGF 투여병행군에서 증가하였으며 특히 거핵구(megakaryocyte) 계열의 증가가 뚜렷하였다. 4) 폐조직의 H-E 염색 조직소견에서 방사선단독군과 방사선조사와 bFGF 투여병행군 간의 차이는 없었다. 5) 골수 및 폐 조직에서 bFGF 투여에 따른 초기 아포프토시스 빈도의 차이는 려었다(p>0.05). 6) 양성대조군과 bFGF단독투여군 비교시 bFGF투여에 의한 종양성장은 관찰되지 않았으며(p>0.05) 방사선조사단독군과 방사선조사와 $6\;{\mu}g$ bFGF 투여병행군에서도 종양성장곡선의 차이는 없었다(p>0.05). 결론 : 이상의 결과로 bFGF는 소장점막 및 골수세포에 방사선보호효과가 있었으며 그 기전은 조혈모세포 및 소장낭선세포의 성장 및 재생을 촉진하고 조기에 방사선으로 유도된 아포프토시스를 감소시키기 때문인 것으로 생각된다.

• Radiation Oncology Journal
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• 제33권2호
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Molecules and Cells
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• 제25권2호
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• pp.272-278
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• 2008

The carbon-ion beam (CIB) generated by the heavy-ion medical accelerator in Chiba (HIMAC) was targeted to 7-day-old rice. Physiological parameters such as growth, and gene expression profiles were examined immediately after CIB irradiation. Dose-dependent growth suppression was seen three days post-irradiation (PI), and all the irradiated plants died by 15 days PI. Microarray (Agilent rice 22K) analysis of the plants immediately after irradiation (iai) revealed effects on gene expression at 270 Gy; 353 genes were up-regulated and 87 down-regulated. Exactly the same set of genes was affected at 90 Gy. Among the highly induced genes were genes involved in information storage and processing, cellular processes and signaling, and metabolism. RT-PCR analysis confirmed the microarray data.

• 대한두경부종양학회지
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• 제9권2호
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• pp.227-233
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• 1993

For malignant neoplasms of salivary tissues. two of the better determinants of progosis are histologic classification and size of the neoplasm. Proper management of these tumors requires an accurate diagnosis by the pathologist and correct interpretation by the surgeon. Malignant mixed tumors account for between 3 and 13 precent of all cancers of the salivary glands and 2 percent of all tumors in these locations. The typical history of these tumors is that of slowly growing mass demonstrating a sudden increase in growth. The duration of onset of the tumor mass and the diagnosis of malignancy has been demonstrated to be 10 to 18 years. The risk of malignat transformation of a benign mixed tumor increases with the duration of the tumor. We analyzed retrospectively 13 cases of malignant mixed tumor who visited from Jan. 1985 to Dec. 1992. Mean age of the patients was 56.5 years. The origin of tumors were parotid gland 7 cases, submandibular gland 2 cases, and minor salivary gland 4 cases(palate 3 cases, tonsil pillar 1 case). According to the criteria of the AJCC on staging, stage I was 1 case, stage II 1 case, stage III 2 cases, and stage IV 9 cases. Histopathologically, carcinma ex pleomorphic adenoma were 12 cases and the true malignant mixed tumor was 1 case. The major treatment modalities were curative surgery, and radiation therapy followed. In conclusion, aggressive therapy of combined surgery and postoperative radiation therapy is required for these lesions, and patients with known or suspected benign tumor should be encouraged to undergo surgery early on in their disease to avoid malignant degeneration at a later dete.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.93-93
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• 1993

저자들은 1985년 1월부터 1992년 12월까지 원자력병원 이비인후과를 방문하여 병리 조직학적 확진을 받은 100명의 환자를 후향적으로 조사하여, 그 임상상과 병기별 분류, 치료에 따른 결과와 생존율에 대해 보고하고자 한다. 연령별로는 50대, 60대의 순이었으며, 남녀비는 4.6:1로 남자에서 많았다. 흡연자가 95명이었고, 하루에 필터담배 1갑 이상을 흡연하는 경우가 13명이었다. 음주의 경우 하루에 2홉들이 소주 1병 이상을 섭취하는 음주자가 51명이었다. 대부분의 경우인 95례에서 편평세포암종이었고, 그 이외에 선양낭포암종, 점액표피양암종 등이 있었다. 병기별로는 4기가 62례로 가장 많았고, 림프절 전이의 경우 71례에서 병리 조직학적으로 확진되었다. 2례에서 원격전이가 있었고, 1례에서 다발암이 확인되었다. 치료방법에 따른 5년 생존율은 주로 초기 암종의 경우 외과 단독요법만을 시행하였고, 71.4%의 좋은 결과를 얻었다. 항암약물요법에 상관없이 방사선조사를 시행한 경우는 대다수가 진행성 암종이었고, 전례에서 사망하였다. 방사선 외과 복합요법의 경우, 5년 생존율은 32.4%이었다.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.259-266
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• 2018

Objectives. Carcinomas of the external auditory canal (EAC) are rare, and management remains challenging. Previous studies seeking prognostic factors for EAC cancers included cancers other than carcinomas. In this study, we analyzed the treatment outcomes of, prognostic factors for, and survival rates associated with specifically squamous cell carcinoma (SCC) of the EAC. Methods. A retrospective review of 26 consecutive patients diagnosed with SCCs of the EAC in a 10-year period was performed in terms of clinical presentation, stage, choice of surgical procedure, and adjunct therapy. Overall survival (OS) and recurrence-free survival (RFS) were calculated and univariate analysis of prognostic factors was performed. Results. The median age of the 26 patients with SCCs of the EAC was 63 years (range, 40 to 72 years), and 16 males and 10 females were included. According to the modified University of Pittsburgh staging system, the T stages were T1 in 11, T2 in six, T3 in four, and T4 in five cases. The surgical procedures employed were wide excision in three cases, lateral temporal bone resection (LTBR) in 17, and extended LTBR in four, and subtotal temporal bone resection in two. Two patients underwent neoadjuvant chemotherapy, and two underwent adjuvant chemotherapy. One patient received preoperative radiation therapy, and eleven received postoperative radiation therapy. Of the possibly prognostic factors examined, advanced preoperative T stage and advanced overall stage were significant predictors of RFS, but not of OS. Conclusion. The advanced T stage and overall stage were associated with decreased survival after surgical treatment in patients with SCC of the EAC, highlighting the importance of clinical vigilance and early detection.

• Radiation Oncology Journal
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• 제13권2호
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• pp.181-189
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• 1995

목적: 국소적으로 진행된 자궁경부암의 치료는 방사선 단독요법이 주 치료였으나 근래에는 좀 더 완치율을 높이기위해 약물치료와 병행하여 방사선치료가 시행되고 있다. 저자들은 45명의 방사선 단독요법과 77명의 항암화학과 방사선의 병용요법의 치료성적을 후향적으로 분석하였다. 방법: 1985년 1월부터 1991년 12원까지 한양대학병원 치료방사선과에서 외부방사선 및 강내방사선치료를 받은 환자 122명을 대상으로 후향적으로 분석하였다. 34명은 ICR 1회, 77명은 ICR 2회, 11명은 고선량 강내근접 방사선치료를 받았다. 연령분포는 29세부터 81세였고, 중앙연령은 58세였다. 추적기간은 5개월에서 117개월(5명이 34개원 미만)로 중앙값은 60개월이었다. 조직병리상 111명이 squamous cell ca, 5명이 large cell ca, 4명이 adenoca, 2명이 adenosquamous cell ca였다. FIGO 병기로 IB $6명(4.9\%),$ IIA 11명$(9.0\%),$ IIB 37명$(30.3\%),$ IIIA 3명$(2.5\%),$ IIIB 63명$(51.6\%),$ IVA 2명$(1.6\%)$이었다. 항암화학요법을 병용한 환자 77명중 36명은 VBP, 39명은 cispiatin 과 5-FU, 2명은 5-FU 제제로 치료받았다. 결과: 외부방사선조사량 3900 cGy에서 5500 cGy를 받은환자에서 61명$(50\%)$이 육안적으로 완전관해를보였다. 5년 및 9년 생존율은 전체환자에서 각각 $57.8\%,\;53.9\%$였고 방사선 단독요법의 5년 생존율이 $63.1\%,$ 방사선과 항암화학복합요법의 5년 생존율은 $55.9\%$였다. 항암제 VBP(vinblastin, bleomycin, cisplatinum)로 치료받은 환자에서 5년 생존율이 $63\%$이고 cisplatin으로 치료받은 환자는 $50\%$이나 통계적인 유의성은 없었다. ICR 회수에따른 5년 생존율은 1회 ICR에서 $36.5\%,$ 2회 ICR에서 $67\%$였다. 방사선단독요법으로 치료받은 환자중 A point에 8000 cGy이상 받은 환자에서 5년 생존율이 $91.4\%$이었고 8000 cGy 미만 환자는 $27.2\%$로 통계적으로 유의한 생존율의 향상을 보였다(p<0.01). 항암화학요법으로 치료받은 환자는 A point의 dose에 따른 생존율의 차이를 보dl지 않았으며(<8000 cGy $55.6\%\;vs\;<=8000\;cGy\;55.7\%)$ 1회의 ICR 과 2회의 ICR의 5년 생존율에도 큰 차이가 없었다$(50\%\;vs\;56.8\%).$ 병변크기가 3cm 이상인 환자에서 방사선 단독치료법과 항암화학치료법과의 5년 생존율의 차이가 없었다$(48.9\%\;vs\;48.7\%).$ 초기 병변에서 항암화학치료를 받지않은 군과 받은 관의 5년 생존율은 $60\%$와 $78\%$이나 숫자가 매우적어 의미가 없었고 진행된병기에서 5년 생존율은 방사선 단독군이 조금 좋았으나 통계적 유의성은 없었다$(62.6\%\;vs\;53.6\%)$ (p>0.05). 결론: 본 연구결과 방사선치료에 항암화학 병용은 생존율향상을 시키지 못하였다. 방사선단 독요법이 국소적으로 진행된 환자에 치료방법이며 A point에 8000 cGy이상 받은환자에서 생존율이 높았고 항암화학 병용요법 치료에서는 A point의 방사선양이 생존율에 영향을 미치지 않았다.