• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6523-6526
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• 2012

Objective: This study was designed to investigate treatment efficacy and side effects of concomitant Aisu$^{(R)}$ (docetaxel) with three-dimensional conformal external beam radiotherapy for the treatment of inoperable patients with esophageal cancer. Methods: Inoperable patients were treated with three-dimensional conformal external beam radiotherapy (5/week, 2 GY/day, and total dose 60GY) plus docetaxel ($30-45mg/m^2$, iv, d1, 8). Results: Twenty eight patients met the study eligibility criteria and the response rate was evaluated according to RICIST guidelines. Among 28 patients, 2 achieved CR, 22 PR, 3 SD and 1 patient was documented PD. Mild gastrointestinal reaction and bone marrow suppression were also documented. All treatment related side effects were tolerable. Conclusion: Three-dimensional conformal external beam radiotherapy combined with docetaxel is an active and safe regimen for inoperable patients with esophageal cancer.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.17-18
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• 2002

Last year, a three-year research program was started in order to establish an external audit system to radiotherapy QA in Japan. It consists of questionnaire surveys, mailed (off-site) dosimetry and visited (on-site) dosimetry at radiotherapy facilities in Japan. The first questionnaire was sent to all Japanese radiotherapy facilities in October 2001, surveying basic QA procedures at each facility. 628 answers were returned with the return rate of 87%. In February 2002, the second questionnaire was sent. Off-site and on-site dosimetry have been tested in several facilities, and will be started soon. We anticipates that this program will gradually grow to a radiotherapy quality control center similar to Radiological Physics Center at MD Anderson Hospital.

• Radiation Oncology Journal
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• 제11권1호
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• pp.143-148
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• 1993

From September 1985 through September 1989,56 patients with stage IIIB carcinoma of the cervix were treated with radiation therapy with curative aim. The overall survival at 5 year was $38{\%}$. The survival rate was better for patients treated with combined external radiotherapy and high dose rate intracavitary radiotherapy than with external radiotherapy alone. No significant survival difference was observed between the unilateral and bilateral parametrial extension of the tumor Seventeen patients experienced recurrence within the irradiated field with a loco-regional recurrence rate of $30{\%}$. Ten patients had complications ($18{\%}$). The complications were mild in three, moderate in four, and severe in three patients. A study was made on the relationship between the fraction numbers of intracavitary radiotherapy, vaginal packing and the complication rate, respectively. In this analysis author observed that the significant treatment factor influencing the survival of cervical cancer was the use of intracavitary radiation, and meticulous vaginal packing could decrease the late complication rate of radiotherapy of cervical cancer.

• 대한방사선치료학회지
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• 제23권1호
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• pp.7-12
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• 2011

목 적: 자궁경부암 환자의 방사선 치료는 일반적으로 외부 방사선 치료 후 근접치료를 시행하는데, 외부 방사선 치료 후 종양의 위치나 부피가 변화하므로 근접치료 시 이전의 MR 영상만을 참고하여 applicator 삽입을 할 경우 많은 오류가 발생할 수 있다. 이에 본원에서는 외부 방사선 치료 전후의 MR 영상 비교를 통해 근접치료 시 발생할 수 있는 applicator 삽입 오류를 분석하여 외부 방사선 치료 후 MR 영상의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 2009년 1월부터 2010년 12월까지 Fletcher CT/MR applicator를 사용한 자궁경부암 환자 35명을 대상으로 외부 방사선 치료 전후에 촬영한 MR 영상을 비교하였다. 결 과: MR 영상 분석 결과 외부 방사선 치료 후 종양이 줄어들면서 전굴이었던 자궁이 후굴로 바뀌게 된 경우가 17.1%, tandem 삽입시 방향이나 길이 등이 잘못된 경우가 14.3%로 나타났다. 결 론: 외부 방사선 치료 후 MRI를 촬영하면 줄어든 종양과 함께 정확한 자궁의 위치와 길이를 확인할 수 있어 근접치료 시행 시 applicator 삽입으로 인해 발생할 수 있는 오류를 줄여 환자에게 최적의 치료를 시행할 수 있었다.

• Radiation Oncology Journal
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• 제9권2호
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• pp.253-263
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• 1991

1985년부터 1990년까지 연세대학교, 연세암센터 치료방사선과에 내원하였던 27명의 간외담도종양환자를 대상으로 외부방사선조사 및 관내 근접조사(intraluminal brachytherapy)를 병용하였을 경우 적절한 국소관해율을 얻을 수 있는지에 대한 후향적 분석을 하였고 이러한 치료방법에 대한 결과를 불완전한 절제술후 방사선치료를 시행한 군의 치료성적과 비교분석하였다. 16명은 남성이었고 11명은 여성이었으며, 평균나이는 58세($34\~70$세)였다. 외부방사선치료는 10 MV Linear Accelerator, 4 문조사방법을 이용하였고 총 조사량은 $45\~55$ Gy이었다. 관내 근접조사는 외부방사선조사후 시행하였고 Ir-192를 사용한 고선량치료기기인 Gamma-Med 12i를 이용하여 총 15Gy를 조사하였다. 최소 추적조사기간은 12개월이었다. 치료방법에 따라 3개의 군으로 대별해 보았는데, 1군(6명)은 불완전 절제술후 미시적 잔류암존재로 방사선치료를 시행했던 경우이고 2군(13명)은 수술불가능하여 방사선치료 단독으로 치료하였던 경우이며, 3군(8명)은 외부방사선조사와 관내근접조사를 병용하였던 경우로 분류하였다. 치료실패요인은 대부분 국소실패였고 원격전이는 관찰되지 않았다. 중앙생존기간은 10개월이었고 2년 생존율은 $30\%$이었다. 각 치료군에 따른 치료실패율은 1군 $67\%(4/6),\;2군\;79\%(10/13),\;3군\;38\%(3/8)$이었으며 중앙생존기간은 각각 10개월, 6개월, 10개월이었다. 또한 2년 생존율은 각각 $56\%,\;18\%,\;50\%$로서 종합적으로 1군과 3군간의 생존율과 중앙생존기간은 의미있는 차이는 없었다. 따라서 본 저자들은 간외담도종양 환자의 경우 외부 방사선치료만으로는 만족할 만한 결과를 얻을 수 없었으며 외부방사선 치료와 관내근접조사를 병용하였을 경우 수술적 절제술이 시행되었던 경우와 비슷한 치료성적을 얻었기에 이를 보고하는 바이며 향후 이러한 결과를 바탕으로 생존율을 향상시키기 위해 적극적인 방사선치료 방법이 모색되어야 하리라 생각하는 바이다.

• Radiation Oncology Journal
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• 제31권2호
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• pp.88-96
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• 2013

Purpose: This study identifies accident sequences from the past accidents in order to help the risk analysis application to the external radiotherapy. Materials and Methods: This study reviews 59 accidental cases in two retrospective safety analyses that have collected the incidents in the external radiotherapy extensively. Two accident analysis reports that accumulated past incidents are investigated to identify accident sequences including initiating events, failure of safety measures, and consequences. This study classifies the accidents by the treatments stages and sources of errors for initiating events, types of failures in the safety measures, and types of undesirable consequences and the number of affected patients. Then, the accident sequences are grouped into several categories on the basis of similarity of progression. As a result, these cases can be categorized into 14 groups of accident sequence. Results: The result indicates that risk analysis needs to pay attention to not only the planning stage, but also the calibration stage that is committed prior to the main treatment process. It also shows that human error is the largest contributor to initiating events as well as to the failure of safety measures. This study also illustrates an event tree analysis for an accident sequence initiated in the calibration. Conclusion: This study is expected to provide sights into the accident sequences for the prospective risk analysis through the review of experiences.

• Radiation Oncology Journal
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• 제29권2호
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• pp.121-126
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• 2011

담도암 환자의 방사선치료 기간 중, 총담도에 삽입된 스텐트가 환자 복부의 우측부터 좌측까지 매우 넓은 범위로 움직인 경우를 발견하였다. 환자는 80세 노령의 여자로 흉추가 심한 척추 후만증을 보였고 흉추와 요추 몇 부위들에 압박골절이 있어서 키가 작았고 복부장기들이 아래로 내려와 있었다. 환자는 쇠약하고 야윈 상태였는데 방사선치료 기간 중 매주 컴퓨터단층촬영을 시행하여 비교한 결과 몸의 좌우방향으로 4 cm 이상의 스텐트의 위치 이동을 보였다. 따라서 흉추 후만증이 있으며서 몸이 매우 야윈 담도암 환자의 경우 방사선치료 범위 설정 시에 치료 기간 중 담도나 스텐트가 크게 움직일 가능성을 고려해야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4285-4289
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• 2015

Purpose: Blood hemoglobin levels are known to influence response to radiotherapy. This retrospective analysis compared the effect of hemoglobin levels upon response to radiation among patients treated with radiation alone (by accelerated hyperfractionated radiotherapy) versus those treated with concurrent cisplatin chemoradiotherapy. Materials and Methods: Among patients treated for locally advanced carcinoma of the cervix (LACC) during 2009-10, a total of 60 fulfilled the eligibility criteria. In this time frame, external beam radiotherapy was delivered with either concurrent chemoradiotherapy (CRT, n=31) (45Gy over 25 fractions, with weekly cisplatin at 40mg/m2), or with accelerated hyperfractionated radiotherapy (AHRT, n=29) (20Gy over 10 daily fractions over the first two weeks, followed by 30Gy over 20 fractions over the next two weeks, with two fractions of 1.5Gy per day, without the use of chemotherapy). Mean weekly hemoglobin (MWH) levels of all patients were calculated as the arithmetic means of weekly recorded blood hemoglobin levels. As per MWH, patients in both of the AHRT or the CRT groups were classified into two subgroups-those with MWH between 10-10.9g/dL, or with MWH>11g/dL. Complete response (CR) to external beam RT phase (prior to brachytherapy) was declared after clinical examinations and computed tomography. The CR rate was noted for both MWH sub-groups within each of the AHRT and CRT groups. Results: Within the AHRT group, patients with MWH>11g/dL had a much better CR rate in comparison to those with MWH:10-10.9g/dL (80% vs. 21.1%) which was statistically significant (p 0.0045). Within the CRT group, there was no significant difference in the outcomes within the MWH>11g/dL and MWH:10-10.9g/dL sub-groups (CR rates of 80% vs. 61.9%, p=0.4285). Conclusions: The importance of maintaining a minimum hemoglobin level of 11g/dL during RT is much greater for patients treated with RT alone, than for patients treated with concurrent chemoradiotherapy. Enhanced haemoglobin levels during RT may to an extent negate the ill-effects that may otherwise arise due to non-use of concurrent chemotherapy.

• Radiation Oncology Journal
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• 제30권1호
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• pp.20-26
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• 2012

Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2217-2220
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• 2014

Purpose: To evaluate the survival outcome of early stage endometrioid adenocarcinoma of the endometrium with risk factors for locoregional recurrence treated with combined pelvic external beam radiotherapy (EBRT) and vaginal brachytherapy (VBT) after comprehensive surgery. Materials and Methods: Post-operative radiotherapy by pelvic EBRT and VBT for early stage endometrioid endometrial carcinoma resulted in excellent pelvic control with acceptable complications. This study showed no significant relationships between age, stage, histologic grade and LVSI and overall survival rate. Results: The 5-year overall survival rate (OS) of early stage endometrioid type of endometrial carcinoma was 85.7%. Acute toxicity occurred in 38.1% of the patients, all of whom were grade 1 or 2. Total late toxicity developed in 42.9% of study group, in which 36.99% of them were grade 1-2 and 4.76% were grade 3-4. Conclusions: Post-operative radiotherapy by pelvic EBRT and VBT is acceptable for early stage endometrioid endometrial carcinoma, independent of age, stage, histologic grade and LVSI.