• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• Journal of The Korean Association For Science Education
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• v.29 no.8
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• pp.990-1010
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• 2009

To derive brain-based evolutionary educational principles, this study examined the studies on the structural and functional characteristics of human brain, the biological evolution occurring between- and within-organism, and the evolutionary attributes embedded in science itself and individual scientist's scientific activities. On the basis of the core characteristics of human brain and the framework of universal Darwinism or universal selectionism consisted of generation-test-retention (g-t-r) processes, a Model of Brain-based Evolutionary Scientific Teaching for Learning (BEST-L) was developed. The model consists of three components, three steps, and assessment part. The three components are the affective (A), behavioral (B), and cognitive (C) components. Each component consists of three steps of Diversifying $\rightarrow$ Emulating (Executing, Estimating, Evaluating) $\rightarrow$ Furthering (ABC-DEF). The model is 'brain-based' in the aspect of consecutive incorporation of the affective component which is based on limbic system of human brain associated with emotions, the behavioral component which is associated with the occipital lobes performing visual processing, temporal lobes performing functions of language generation and understanding, and parietal lobes, which receive and process sensory information and execute motor activities of the body, and the cognitive component which is based on the prefrontal lobes involved in thinking, planning, judging, and problem solving. On the other hand, the model is 'evolutionary' in the aspect of proceeding according to the processes of the diversifying step to generate variants in each component, the emulating step to test and select useful or valuable things among the variants, and the furthering step to extend or apply the selected things. For three components of ABC, to reflect the importance of emotional factors as a starting point in scientific activity as well as the dominant role of limbic system relative to cortex of brain, the model emphasizes the DARWIN (Driving Affective Realm for Whole Intellectual Network) approach.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.15 no.2
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• pp.51-61
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• 2010

Surface particulate organic carbon (POC) concentration was measured in the Northeastern Gulf of Mexico on 9 cruises from November 1997 to August 2000 to investigate the seasonal and spatial variability related to synchronous remote sensing data (Sea-viewing Wide Field-of-view Sensor (SeaWiFS), sea surface temperature (SST), sea surface height anomaly (SSHA), and sea surface wind (SSW)) and recorded river discharge data. Surface POC concentrations have higher values (>100 $mg/m^3$) on the inner shelf and near the Mississippi Delta, and decrease across the shelf and slope. The inter-annual variations of surface POC concentrations are relatively higher during 1997 and 1998 (El Nino) than during 1999 and 2000 (La Nina) in the study area. This phenomenon is directly related to the output of Mississippi River and other major rivers, which associated with global climate change such as ENSO events. Although highest river runoff into the northern Gulf of Mexico Coast occurs in early spring and lowest flow in late summer and fall, wide-range POC plumes are observed during the summer cruises and lower concentrations and narrow dispersion of POC during the spring and fall cruises. During the summer seasons, the river discharge remarkably decreases compared to the spring, but increasing temperature causes strong stratification of the water column and increasing buoyancy in near-surface waters. Low-density plumes containing higher POC concentrations extend out over the shelf and slope with spatial patterns and controlled by the Loop Current and eddies, which dominate offshore circulation. Although river discharge is normal or abnormal during the spring and fall seasons, increasing wind stress and decreasing temperature cause vertical mixing, with higher surface POC concentrations confined to the inner shelf.

• Journal of the Korean Chemical Society
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• v.37 no.2
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• pp.191-198
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• 1993

The crystal structures of $Cd_{6-}A$ evacuated at $2{\times}10^{-6}$ torr and $750^{\circ}C$ (a = 12.204(1) $\AA$) and dehydrated $Cd_{6-}A$ reacted with 0.1 torr of Cs vapor at $250^{\circ}C$ for 12 hours (a = 12.279(1) $\AA$) have been determined by single crystal X-ray diffraction techniques in the cubic space group Pm3m at $21(1)^{\circ}C.$ Their structures were refined to final error indices, $R_1=$ 0.081 and $R_2=$ 0.091 with 151 reflections and $R_1=$ 0.095 and $R_2=$ 0.089 with 82 reflections, respectively, for which I > $3\sigma(I).$ In vacuum dehydrated $Cd_{6-}A$, six $Cd^{2+}$ ions occupy threefold-axis positions near 6-ring, recessed 0.460(3) $\AA$ into the sodalite cavity from the (111) plane at O(3) : Cd-O(3) = 2.18(2) $\AA$ and O(3)-Cd-O(3) = $115.7(4)^{\circ}.$ Upon treating it with 0.1 torr of Cs vapor at $250^{\circ}C$, all 6 $Cd^{2+}$ ions in dehydrated $Cd_{6-}A$ are reduced by Cs vapor and Cs species are found at 4 crystallographic sites : 3.0 $Cs^+$ ions lie at the centers of the 8-rings at sites of $D_{4h}$ symmetry; ca. 9.0 Cs+ ions lie on the threefold axes of unit cell, ca. 7 in the large cavity and ca. 2 in the sodalite cavity; ca. 0.5 $Cs^+$ ion is found near a 4-ring. In this structure, ca. 12.5 Cs species are found per unit cell, more than the twelve $Cs^+$ ions needed to balance the anionic charge of zeolite framework, indicating that sorption of Cs0 has occurred. The occupancies observed are simply explained by two unit cell arrangements, $Cs_{12}-A$ and $Cs_{13}-A$. About 50% of unit cells may have two $Cs^+$ ions in sodalite unit near opposite 6-rings, six in the large cavity near 6-ring and one in the large cavity near a 4-ring. The remaining 50% of unit cells may have two Cs species in the sodalite unit which are closely associated with two out of 8 $Cs^+$ ions in the large cavity to form linear $(Cs_4)^{3+}$ clusters. These clusters lie on threefold axes and extend through the centers of sodalite units. In all unit cells, three $Cs^+$ ions fill equipoints of symmetry $D_{4h}$ at the centers of 8-rings.

• Journal of Global Scholars of Marketing Science
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• v.19 no.1
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• pp.37-46
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• 2009

The Census Bureau of the Department of Commerce announced in May 2008 that U.S. retail e-commerce sales for 2006 reached $ 107 billion, up from $ 87 billion in 2005 - an increase of 22 percent. From 2001 to 2006, retail e-sales increased at an average annual growth rate of 25.4 percent. The explosive growth of E-Commerce has caused profound changes in marketing channel relationships and structures in many industries. Despite the great potential implications for both academicians and practitioners, there still exists a great deal of uncertainty about the impact of the Internet channel introduction on distribution channel management. The purpose of this study is to investigate how the ownership of the new Internet channel affects the existing channel members and consumers. To explore the above research questions, this study conducts well-controlled mathematical experiments to isolate the impact of the Internet channel by comparing before and after the Internet channel entry. The model consists of a monopolist manufacturer selling its product through a channel system including one independent physical store before the entry of an Internet store. The addition of the Internet store to this channel system results in a mixed channel comprised of two different types of channels. The new Internet store can be launched by the independent physical store such as Bestbuy. In this case, the physical retailer coordinates the two types of stores to maximize the joint profits from the two stores. The Internet store also can be introduced by an independent Internet retailer such as Amazon. In this case, a retail level competition occurs between the two types of stores. Although the manufacturer sells only one product, consumers view each product-outlet pair as a unique offering. Thus, the introduction of the Internet channel provides two product offerings for consumers. The channel structures analyzed in this study are illustrated in Fig.1. It is assumed that the manufacturer plays as a Stackelberg leader maximizing its own profits with the foresight of the independent retailer's optimal responses as typically assumed in previous analytical channel studies. As a Stackelberg follower, the independent physical retailer or independent Internet retailer maximizes its own profits, conditional on the manufacturer's wholesale price. The price competition between two the independent retailers is assumed to be a Bertrand Nash game. For simplicity, the marginal cost is set at zero, as typically assumed in this type of study. In order to explore the research questions above, this study develops a game theoretic model that possesses the following three key characteristics. First, the model explicitly captures the fact that an Internet channel and a physical store exist in two independent dimensions (one in physical space and the other in cyber space). This enables this model to demonstrate that the effect of adding an Internet store is different from that of adding another physical store. Second, the model reflects the fact that consumers are heterogeneous in their preferences for using a physical store and for using an Internet channel. Third, the model captures the vertical strategic interactions between an upstream manufacturer and a downstream retailer, making it possible to analyze the channel structure issues discussed in this paper. Although numerous previous models capture this vertical dimension of marketing channels, none simultaneously incorporates the three characteristics reflected in this model. The analysis results are summarized in Table 1. When the new Internet channel is introduced by the existing physical retailer and the retailer coordinates both types of stores to maximize the joint profits from the both stores, retail prices increase due to a combination of the coordination of the retail prices and the wider market coverage. The quantity sold does not significantly increase despite the wider market coverage, because the excessively high retail prices alleviate the market coverage effect to a degree. Interestingly, the coordinated total retail profits are lower than the combined retail profits of two competing independent retailers. This implies that when a physical retailer opens an Internet channel, the retailers could be better off managing the two channels separately rather than coordinating them, unless they have the foresight of the manufacturer's pricing behavior. It is also found that the introduction of an Internet channel affects the power balance of the channel. The retail competition is strong when an independent Internet store joins a channel with an independent physical retailer. This implies that each retailer in this structure has weak channel power. Due to intense retail competition, the manufacturer uses its channel power to increase its wholesale price to extract more profits from the total channel profit. However, the retailers cannot increase retail prices accordingly because of the intense retail level competition, leading to lower channel power. In this case, consumer welfare increases due to the wider market coverage and lower retail prices caused by the retail competition. The model employed for this study is not designed to capture all the characteristics of the Internet channel. The theoretical model in this study can also be applied for any stores that are not geographically constrained such as TV home shopping or catalog sales via mail. The reasons the model in this study is names as "Internet" are as follows: first, the most representative example of the stores that are not geographically constrained is the Internet. Second, catalog sales usually determine the target markets using the pre-specified mailing lists. In this aspect, the model used in this study is closer to the Internet than catalog sales. However, it would be a desirable future research direction to mathematically and theoretically distinguish the core differences among the stores that are not geographically constrained. The model is simplified by a set of assumptions to obtain mathematical traceability. First, this study assumes the price is the only strategic tool for competition. In the real world, however, various marketing variables can be used for competition. Therefore, a more realistic model can be designed if a model incorporates other various marketing variables such as service levels or operation costs. Second, this study assumes the market with one monopoly manufacturer. Therefore, the results from this study should be carefully interpreted considering this limitation. Future research could extend this limitation by introducing manufacturer level competition. Finally, some of the results are drawn from the assumption that the monopoly manufacturer is the Stackelberg leader. Although this is a standard assumption among game theoretic studies of this kind, we could gain deeper understanding and generalize our findings beyond this assumption if the model is analyzed by different game rules.

• Journal of the Korean Geographical Society
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• v.30 no.3
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• pp.269-295
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• 1995

This research is concerned with the social division of labor within the traditional industry district: Damyang bamboo ware industry district and Yeoju pottery industry district in South Korea, Damyang bamboo ware and Yeoju pottery are well known of the Korean traditional industry. The social division of labor in an industry district is considered as an important factor. The social division of labor helps the traditional industry to survive today. This summary shows five significant points from the major findings. First, Damyang bamoo ware industry and Yoeju pottery industry have experienced the growth stages until 1945, the stagnation in the 1960s, and the business recovery in the 1980s. Most Korean traditional industries had been radically declined under the Japanese colonization; while, Damyang bamboo ware industry and Yeoju pottery industry district have been developed during above all stages. The extended market to Japan helped the local government to establish a training center, and to provide financial aids and technical aids to crafts men. During the 1960s and 1970s, mass production of substitute goods on factory system resulted in the decrease of demand of bamboo ware and pettery. During the 1980s, these industries have slowly recovered as a result of the increased income per capita. The high rate of economic growth in the 1960s and 1970s was playing an important role in the emerging the incleased demand of the bamboo ware and pottery. Second the production-and-marketing system in a traditional industry district became diversified to adjust the demand of products. In Damyang bamboo ware industry district, the level of social division of labor was low until the high economic development period. Bamboo ware were made by a farmer in a small domestic system, The bamboo goods were mainly sold in the periodic market of bamboo ware in Damyang. In the recession period in the 1960s and 1970s, the production-and-marketing system were diversified; a manufacturing-wholesale type business and small-factory type business became established; and the wholesale business and the export traders in the district appeared. In the recovery period in the 1980s, the production-and-marketing systems were more diversified; a small-factory type business started to depend On subcontractors for a part of process of production; and a wholesale business in the district engaged in production of bamboo ware. In Yeoju pottery industry district, the social division of labor was limited until the early 1970s. A pottery was made by a crafts man in a small-business of domestic system and sold by a middle man out of Yeoju. Since the late 1970s, production-and-marketing system become being diversified as a result of the increased demand in Japan and South Korea. In the 1970s, Korean traditional craft pottery was highiy demanded in Japan. The demand encouraged people in Yoeju to become craftsmen and/or to work in the pottery related occupation. In South Korea, the rapid economic growth resulted in incline to pottery due to the development of stainless and plastic bowls and dishes. The production facilities were modernized to provide pottery at the reasonable price. A small-busineas of domestic system was transformed into a small-factory type business. The social division of labor was intensified in the pottery production-and-maketing system. The manufacturing kaoline began to be seperated from the production process of pottery. Within the district, a pottery wholesale business and a retail business started to be established in the 1980s. Third the traditional industry district was divided into "completed one" and "not-completed one" according to whether or not the district firms led the function of the social division of labor. The Damyang bamboo ware industry district is "completed one": the firm within the district is in charge of the supply of raw material, the production and the marketing. In the Damyang bamboo ware district, the social division of labor w and reorganized labor system to improve the external economics effect through intensifying the social division of labor. Lastly, the social division of labor was playing an important role in the development of traditional industry districts. The subdivision of production process and the diversification of business reduced the production cost and overcame the labor shortage through hiring low-waged workers such as family members, the old people and housewives. An enterpriser with small amount of capital easily joined into the business. The risk from business recession were dispersed. The accumulated know-how in the production and maketing provided flexiblility to produce various goods and to extend the life-cycly of a product.d the life-cycly of a product.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.99-106
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• 2007

Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

• The Korean Journal of Food And Nutrition
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• v.26 no.4
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• pp.841-849
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• 2013

The aim of this study was to investigate the quality characteristics of Kimchi, prepared with seasoning fluid, vinegar, and mustard extract to inhibit the proliferation of microorganisms and extend the edible period during fermentation at $25^{\circ}C$. We also added perilla leaf, endive, and mustard leaf to Kimchi to improve the flavor. The pH of control Kimchi fluid over 1 day after Kimchi processing, was $5.40{\pm}0.01$ and that of the experimental groups in which vinegar and mustard extract were added was $4.51{\pm}0.01{\sim}4.52{\pm}0.01$, which was lower than that of the control. As the fermentation progresses, the pH of the control decreased rapidly and that of the experimental groups decreased slowly. The initial titratible acidity of the control was low and 3 days later reached $0.95{\pm}0.04$. However, that of the experimental groups was $0.42{\pm}0.01{\sim}0.43{\pm}0.02$ and 5 days later reached a level similar to that of the control. The salinities of the Kimchi juice of both the control and the experimental groups were $2.67{\pm}0.06{\sim}2.80{\pm}0.10$% after 1 day and decreased during fermentation. The amount of lactic acid bacteria of the control was $8.17{\pm}4.01{\times}10^8cfu/g$, 1 day after the Kimchi processing and that of the experimental groups was $2.70{\pm}2.08{\times}10^7{\sim}3.63{\pm}2.80{\times}10^7cfu/g$. After 3 days, these were $3.13{\pm}1.94{\times}10^{11}cfu/g$ and $2.47{\pm}2.23{\times}10^9{\sim}8.03{\pm}3.71{\times}10^9cfu/g$, respectively. According to the result of sensory evaluation, throughout the entire period of the experiment, all sensory items such as color, odor, taste, texture, and total acceptability of the experimental groups were better than those of the control group (p<0.05). Especially, Kimchi in which perilla leaf was added was the best. With the addition of vinegar and mustard extract to the Kimchi, microorganism proliferation was inhibited and the edible period was extended. The minerals, vitamins and antioxidants of leaf vegetables could therefore be obtained.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.192-197
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• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.1-8
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• 1996

Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.