• 제목/요약/키워드: Fractionated radiotherapy

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Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

  • Park, Sunmin;Yoon, Sang Min;Lee, Sumin;Park, Jin-hong;Song, Si Yeol;Lee, Sang-wook;Ahn, Seung Do;Kim, Jong Hoon;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • 제35권3호
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    • pp.268-273
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    • 2017
  • Purpose: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. Materials and Methods: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31-65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was $34.1cm^3$ (range, $6.8-83.2cm^3$), and fractionated radiation was administered to a total dose of 50-54 Gy with a daily dose of 2 Gy. Results: The median follow-up period was 6.8 years (range, 2.2-8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9-95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Conclusion: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

Radiobiological mechanisms of stereotactic body radiation therapy and stereotactic radiation surgery

  • Kim, Mi-Sook;Kim, Wonwoo;Park, In Hwan;Kim, Hee Jong;Lee, Eunjin;Jung, Jae-Hoon;Cho, Lawrence Chinsoo;Song, Chang W.
    • Radiation Oncology Journal
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    • 제33권4호
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    • pp.265-275
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    • 2015
  • Despite the increasing use of stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS) in recent years, the biological base of these high-dose hypo-fractionated radiotherapy modalities has been elusive. Given that most human tumors contain radioresistant hypoxic tumor cells, the radiobiological principles for the conventional multiple-fractionated radiotherapy cannot account for the high efficacy of SBRT and SRS. Recent emerging evidence strongly indicates that SBRT and SRS not only directly kill tumor cells, but also destroy the tumor vascular beds, thereby deteriorating intratumor microenvironment leading to indirect tumor cell death. Furthermore, indications are that the massive release of tumor antigens from the tumor cells directly and indirectly killed by SBRT and SRS stimulate anti-tumor immunity, thereby suppressing recurrence and metastatic tumor growth. The reoxygenation, repair, repopulation, and redistribution, which are important components in the response of tumors to conventional fractionated radiotherapy, play relatively little role in SBRT and SRS. The linear-quadratic model, which accounts for only direct cell death has been suggested to overestimate the cell death by high dose per fraction irradiation. However, the model may in some clinical cases incidentally do not overestimate total cell death because high-dose irradiation causes additional cell death through indirect mechanisms. For the improvement of the efficacy of SBRT and SRS, further investigation is warranted to gain detailed insights into the mechanisms underlying the SBRT and SRS.

전골반 방사선 분할 조사시 방사선량에 따른 염색체이상 빈도의 변화 양상 (Chromosomal Aberration in Fractionated Radiotherapy)

  • 윤형근;하성환
    • Radiation Oncology Journal
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    • 제16권2호
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    • pp.115-123
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    • 1998
  • 자궁 경부암으로 전 골반에 균일하게 방사선 치료를 받은 3명의 환자들을 대상으로 말초혈액임파구의 염색체이상 빈도를 정기적으로 측정함으로써 반복 피폭에 의한 염색체이상 빈도의 변화양상을 구명하고자 하였다. 방사선 조사전에 채취한 혈액에서 얻은 Ydr 값은 0.0060, 0.0000, 0.0029였다. 방사선량이 증가함에 따라 Ydr 값은 직선적으로 증가하였고 측정치들로부터 구한 선형 회귀식은 $Ydr=7.31{\times}10^{-5}D(cGy)+1.45{\times}10^{-2}$(r2=0.8798)이었다 Qdr(d, r)값도 선량 증가에 따라 직선적으로 증가하는 양상을 보였으며 회귀식은 $Qdr=1.01{\times}10^{-4}D(cGy)+1.04$(r2=0.5912)이었다. 따라서 신체 일부에 방사선을 분할 조사할 경우 일정범위 이하의 방사선량에서는 방사선에 의한 염색체이상의 빈도가 직선적으로 증가함을 알 수 있었다.

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비인강암환자에서 시행한 3차원 입체조형 방사선치료의 조기 임상결과 (Initial Experience for 3-D Conformal Boost Treatments in Carcinoma of the Nasopharynx)

  • 장지영;조문준;김기환;송창준;김병국;김준상;김재성
    • 대한두경부종양학회지
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    • 제16권2호
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    • pp.172-176
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    • 2000
  • Objectives: To improve local control and reduce toxicity, 3-D conformal radiotherapy was used as a boost the primary tumor site following fractionated radiotherapy in patients with nasopharyngeal carcinoma. Materials and Methods: Eight patients with previously untreated nasopharyngeal carcinomas were treated with 3-D conformal radiotherapy following fractionated radiotherapy from September 1998 to April 2000. All patients had biopsy confirmation of disease before radiation therapy. Stages were II in 1, III in 5, and IV in 2. Two patients received cisplatin based chemotherapy in addition to radiation therapy; induction chemotherapy in 1, concurrent chemoradiation in 1. 3-D conformal radiotherapy delivered using 6MV Linac as a boost(range 25.2-28.8Gy, median 25.7Gy) following conventionally fractionated radiotherapy(range 50.4Gy). Average total dose ranged from 75.6-79.2Gy(median 76Gy). Follow-up time was 4-21 months(median 9.6 months). Results: Seven of 8 patients were evaluated radiologically within 3 months after completion of radiation therapy. All 7 patients were seen complete remission. One of 7 patients had distant metastasis after 5 months and local failure after 7 months. The tree interval of local recurrence was ranged from 4 - 21 months(median 10.2 months). One patient without radiological evaluation got complete remission clinically. Treatment related toxicity was grade 1-3 xerostomia, dysphagia, and mucositis. During 3-D conformal radiotherapy, there was no aggravation of any toxicity. Conclusion: Although the number of patients was small and follow-up period was short, 3-D conformal radiotherapy following conventional radiotherapy improved tumor control and dose escalation without increased toxicity. Survival and late toxicity should be evaluated through long term follow-up. In addition, it is necessary to confirm the benefits of 3-D conformal radiotherapy in nasopharyngeal carcinoma with randomized trial.

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Fractionated Stereotactic Radiotherapy in Pediatric Diffuse Intrinsic Brain Stem Gliomas

  • Choi, Woo-Jin;Yee, Gi-Taek;Han, Seong-Rok;Yoon, Sang-Won;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • 제40권3호
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    • pp.154-158
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    • 2006
  • Objective : We treated 10 pediatric diffuse intrinsic brain stem glioma[BSG] patients with Novalis system [linac based radiotherapy unit, Germany] and examined the efficacy of the Fractionated Stereotactic Radiotherapy[FSRT]. Methods : A retrospective review was conducted on 10 pediatric diffuse intrinsic BSG patients who were treated with FSRT between May, 2001 and August, 2004. The mean age of the patient group was 7.7 years old. Male to female ratio was 4 to 1. The mean dose of FSRT was 38.7Gy, mean fractionated dose was 2.6Gy, mean fractionation size was 16.6, and target volume was $42.78cm^3$. The mean follow up period was 14 months. Results : Four weeks after completion of FSRT, improvements on neurological status and Karnofsky performance scale[KPS] score were recorded in 9/10 (90%] patients and magnetic resonance imaging[MRI] showed decrease in target tumor volume in 8 pediatric patients. The median survival period was 13.5 months after FSRT and treatment toxicity was mild. Conclusion : It is difficult for surgeons to choose surgical treatment for diffuse intrinsic BSG due to its dangerous anatomical structures. FSRT made it possible to control the tumor volume to improve neurological symptoms with minimal complications. We expect that FSRT is a feasible treatment modality for pediatric diffuse intrinsic BSG with tolerable toxicities.

Fractionated Aged Black Garlic Extracts Enhance Growth of Anti-My-10 Hybridoma Cells and Production of IgG1 Antibody

  • Lee, Ji Young;Chung, Namhyun;Lee, Yong Kwon
    • Journal of Applied Biological Chemistry
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    • 제57권1호
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    • pp.61-63
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    • 2014
  • Aged black garlic (ABG) was extracted with 20% ethanol and water (crude extracts) and fractionated into three categories (>10, 3-10, and <3 kDa). The effect of crude extract supplements on anti-My-10 hybridoma cell growth and IgG1 antibody production was investigated in suspension culture with a chemically defined protein-free medium. We observed that supplementation of ABG to the cell culture medium stimulated anti-My-10 hybridoma cell growth and production of IgG1 antibody, particularly with fractionated ABG of low molecular weight. The stimulation depended upon the concentration and the size of the fractionated ABG. We also found that the growth-promoting activity was not correlated with high antibody production. These results suggest that fractionated ABG is a novel and promising alternative as an animal cell culture supplement.

Reirradiation with Robotic Stereotactic Body Radiotherapy for Recurrent Nasopharyngeal Carcinoma

  • Dizman, Aysen;Coskun-Breuneval, Mehtap;Altinisik-Inan, Gonca;Olcay, Gokce Kaan;Cetindag, Mehmet Faik;Guney, Yildiz
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3561-3566
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    • 2014
  • Background: Recurrent nasopharyngeal carcinoma (NPC) after previous radiotherapy is challenging. There is no standard approach for salvage treatment. Here we present toxicity and treatment results for recurrent NFC patients who underwent fractionated stereotactic radiotherapy (FSRT) as second line radiotherapy (RT). Materials and Methods: Between April 2009 and July 2012, 24 patients, with a male to female ratio of 3:1, were treated with CykerKnife$^{(R)}$ FSRT for recurrent NFC in our institution. Seven out of 24 patients had metastatic recurrent disease. Median age was 53 years (range, 20-70 years). Initial RT dose was 70Gy. The time period between initial RT and FSRT was a median of 33.2 months. The median prescription dose for FSRT was 30Gy (range, 24-30 Gy) in a median of 5 fractions (range, 4-6). Results: The median follow-up for all patients was 19.5 months (IQR: 12.2.-29.2 months). The locoregional control; progression free survival and overall survival (OS) rates for 1-, 2- and 3-year were 64%, 38%, 21%; 60%, 30%, 17% and 83%, 43%, 31%, respectively. Median OS for the entire cohort was 22 months (95% CI: 16.5-27.5). On multivariate analysis recurrent tumor stage was the only prognostic factor for OS (p=0.004). One patient exhibited grade III temporal lobe necrosis. One died because of grade IV mucositis and overlapping infection. Conclusions: The treatment of recurrent NPC is controversial. Fractionated stereotactic radiotherapy is promising. However, the published trials are heterogeneous with respect to the selection criteria and treatment details. Prospective studies with long term follow-up data are warranted.

Huge Size Intracranial Plasmacytoma Treated with Surgery and Fractionated Stereotactic Radiotherapy

  • Choi, Woo-Jin;Yee, Gi-Taek;Choi, Chan-Young;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • 제40권2호
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    • pp.110-113
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    • 2006
  • Surgery and radiotherapy are mainly used for plasma cell neoplasm which constitutes about $1{\sim}2%$ of human malignancy. The authors carried out Fractionated Stereotactic Radiotherapy[FSRT] on the residual tumor after the subtotal removal of Intracranial plasmacytoma. A huge mass lesion was observed on MRI [magnetic resonance image] in the left anterior and middle cranial fossa of a 63-year-old man with left exophthalmus which lasted for a month, and was suspected as a meningioma with strong contrast enhancement. Extramedullary plasmacytoma was diagnosed on histopathological examination. After the surgery, FSRT was also carried out on the residual tumor which invaded the skull base. One-year follow up after FSRT showed contrast enhancement only in the left sphenoid bone on MRI, which indicated significant decrease in the size of the tumor without any abnormal neurologic deficits. We treated intracranial plasmacytoma which invaded left anterior and middle cranial fossa and surrounded cavernous sinus without cranial nerve deficit through subtotal tumor removal and FSRT.

원발성 간암의 분할 정위방사선치료 효과 (Effects of Fractionated Stereotactic Radiotherapy for Primary Hepatocellular Carcinoma)

  • 최병옥;강기문;장홍석;이상욱;강영남;채규영;최일봉
    • Radiation Oncology Journal
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    • 제23권2호
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    • pp.92-97
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    • 2005
  • 목적 : 원발성 간암에서 근치적 목적의 방사선치료 결과엔 대한 문헌상 보고는 드물다. 이에 저자들이 경험한 원발성 간암의 분할 정위방사선치료에 대한 결과를 보고하고자 하였다. 대상 및 방법 : 1999년 7월부터 2002년 3월까지 원발성 간암으로 조직학적 진단을 받은 후 분할 정위방사선치료를 시행한 20명을 대상으로 후향적 분석을 하였다. 종양의 장경은 $2~6.5\;cm$ (평균: 3.8 cm)였다. 분할 정위방사선치료는 1회 조사량으로 5와 10 Gy였고 선량은 계획용 표적체적(planning target volume)에 맞추어 처방하였으며 회전중심점 선량의 $85\~90\%$등선량 곡선에 치료를 하였다. 주 $3\~5$회 치료하여 2주 동안 총 50 Gy를 조사하였다(중앙선량: 50 Gy). 추적관찰기간은 $3\~55$개월(중간 추적관찰기간: 23개월)이었다. 결과 : 전체 치료 반응률은 $60\%$이었으며 완전 반응 4명($20\%$), 부분 반응 8명($40\%$), 안정성 병변이 8명($40\%$)이었다. 전체 환자의 1년 및 2년 생존율은 각각 $70\%$, $43.1\%$이었으며 중앙 생존기간은 20개월이었다. 1년 및 2년 무병 생존율은 각각 $65\%$, $32.5\%$이었으며 중앙 무병생존기간은 19개월이었다. 치료 부작용으로 소화장애가 16명($60\%$), 오심/구토가 8명($40\%$), 간 기능 저하가 6명($30\%$)에서 발생하였으나 부작용에 의한 사망은 없었다. 결론 : 원발성 간암의 분할 정위방사선치료는 비교적 안전하고 효과적인 방법이었다. 따라서 단일 병변이면서 비교적 종양의 크기가 작은 간암에서 내과적으로 수술이 불가능하거나 수술을 거부하는 환자에서 국소 치료방법으로 고려할 수 있을 것으로 사료된다.