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Radical Radiotherapy for Carcinoma of the Prostate (전립선암의 근치적 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.40-44
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    • 2001
  • Purpose : To evaluate effect and tolerance of external beam radiotherapy for carcinoma of the prostate and define the optimal radiotherapeutic regimen. Materials and methods : We retrospectively analyzed the records of 60 patients with prostate cancer who were treated with external beam radiotherapy with curative intent in our institution between September, 1987 and March, 2000. Histologic diagnosis was established by transurethral resection or ultrasonography guided biopsy. The major presenting symptoms were a nodule at routine prostatic examination and frequency and urgency of urination, along with dysuria. The median age was 63 years with range of 51 to 87 years. There were 6 patients in Stage A, 20 in Stage 8, 26 in Stage C, and 8 in Stage Dl. All patients were treated with megavoltage equipment producing 10 MV photons. The 4 field pelvic brick technique was used to a dose of 45 Gy or 50.4 Gy at 1.8 Gy per day in 5 to 6 weeks, after which a small boost field was delivered 2.0 Gy per day to a total dose of 66 to 70 Gy. The follow-up period ranged from 1 to 8 years. Results : Actuarial 5-year and 7-year survival rates for Stage A, B, C, and D1 were $100\%\;and\;84\%$, $83\%\;and\;72\%$, $67\%\;and\;54\%$, and $v$, respectively. The corresponding 5-year and 7-year relapse free survival rates were $84\%\;and\;84\%$, $77\%\;and\;67\%$, $48\%\;and\;40\%$, and $33\%\;and\;25\%$, respectively. Relapse free 5-year survival rates for Stage B were $80\%,\;80\%,\;and\;50\%$ for well, moderately, and poorly differentiated tumors, respectively. These were $64\%,\;44\%,\;and\;33\%$ for Stage C, respectively. The local control rates at 5 years were $84\%,\;85\%,\;78\%,\;and\;60\%$ for Stage A, B, C, and D1, respectively. Mild to moderate complications were observed in $22\%$ of patients. Severe complications requiring surgical procedures were documented in only $3\%$ of patients. Conclusion : This study confirms that external beam irradiation is an effective and safe treatment for prostatic cancer, providing long-term local control and good survival with acceptable complications.

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Postoperative Adiuvant Radiation Therapy in Endometrial Carcinoma (자궁내막암의 수술 후 보조적 방사선치료)

  • Shin Kyung Hwan;Choi Eun Kyung;Ahn Seung Do;Chang Hyesook;Mok Jung-Eun;Nam Joo Hyun;Kim Young Tak;Kim Yong Man;Kim Jong Hyeok
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.40-45
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    • 2000
  • Purpose : To evaluate the histopathological prognostic factors, relapse pattern and survival in patients with endometrial carcinoma who were treated with surgery and postoperative adjuvant radiotherapy (RT). Methods and Materials : From September 1991 to December 1997, 27 patients with endometrial carcinoma treated with surgery and postoperative adjuvant RT at Asan Medical Center were entered in this study. Surgery was peformed with total abdominal hysterectomy in six, total abdominal hysterectomy with pelvic lymph node dissection in eight and radical hysterectomy in 13 patients. External RT of 50.4 Gy was done to all patients and among these, additional high dose rate vaginal vault irradiation of 20$\~$25 Gy with fractional dose of 4$\~$5 Gy was boosted In 16 patients. The patients were followed for 6$\~$95 months(median 30). Results : The number of patients according to FIGO stage were I 18 (67$\%$), II 1 ($4\%$) and III 7 ($26\%$). Patients with poor histologic grade, deep myometrial invasion, adnexal involvement, lymphovascular invasion showed more pelvic lymph node involvement, but no statistical significance was indicated. The 5 year overall and disease free survival were 100$\%$ and 76.8$\%$, respectively. Relapse sites were pelvic, para-aortic lymph node, and multiple metastases including lung, and no vaginal relapse was developed. Factors that were associated with disease free survival were FIGO stage (p=0.01), lymphovascular invasion (p=0.03), pelvic lymph node involvement (p=0.0001). There was only one Grade 1 rectal bleeding without moderate to severe complications. Conclusion : Postoperative adjuvant RT is considered to reduce the loco-regional failure, resulting the improvement of survival. The group of patients with the risk of vaginal failure without vaginal vault irradiation should be investigated according to stage and grade.

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Colony Size Distributions according to in vitro Aging in Human Skin Fibroblasts (피부 섬유모세포 노화에 따른 세포집락 크기의 분포)

  • Kim, Jun-Sang;Kim, Jae-Sung;Cho, Moon-June;Park, Jeong-Kyu;Park, Tae-Hyun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.158-165
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    • 1999
  • Purpose : To investigate the percentage of colonies wi1h16or more cells distribution of human skin fibroblast according to in vitro aging, and to evaluate the relationship between percentage of colonies with 10 or more cells and in vivo donor age in human skin fibroblast culture. Material and Method : C1, C2, C3a, and C3b human skin fibroblast samples from three breast cancer patients were used as subjects. The C1, C2, and C3a donor were 44, 54, and 55 years old, respectively. C3a and C3b cells were isolated from the same person. Single cell suspension of skin fibroblasts was prepared with primary explant technique. One hundred cells are plated into 100m1 tissue culture flask and cultured for two weeks. The colony size was defined as colonies with 16 or more cells. The cultured cell was stained with crystal violet, and number of cells in each colony was determined with stereo microscope at $\times$10 magnification. Passage number of C1, C2, C3a and C3b skin fibroblast were 12th, 17th, and 14th, respectively. Results : Percentage of colonies with 16 or more cells of skin fibroblast samples decreased with increasing in vitro passage number. In contrast, cumulative population doublings of skin fibroblast sample increased with increasing in vitro passage number. Percentage of colonies with 16 or more cells also decreased with increasing population doublings in human skin fibroblast culture. There was strong correlation with percentage of colonies with 16 or more cells and population doublings En C3a skin fibroblast sampie. At the same point of population doublings, the percentage of colonies with 16 or more cells of the young C1 donor was higher level than the old C3a donor. Conclusion : The population doublings increased with increasing in vitro passage number but percentage of colonies with 16 or more cells decreased. The results of this study imply that percentage of colonies with 16 or more cell is useful as a indicator of in vitro human skin fibroblast aging and may estimate the in vivo donor age.

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Analysis of Prognostic Factors in Patients with Carcinoma of Uterine Cervix (자궁경부암의 방사선치료시 예후인자의 재분석)

  • Kim Jae Young;Cho Chul Koo;Shim Jae Won;Yoo Seong Yul;Kim Mi Sook;Yun Hyong Geun
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.307-315
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    • 1996
  • Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.

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Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear (외이도 및 중이 편평상피암의 방사선치료)

  • Kang, Hyun-Cheol;Wu, Hong-Gyun;Lee, Ji-Hye;Park, Charn-Il;Kim, Chong-Sun;Oh, Seung-Ha;Heo, Dae-Seog;Kim, Dong-Wan;Lee, Se-Hoon
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.173-180
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    • 2009
  • Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.

The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer (절제 불가능한 국소 진행된 췌장암에서 방사선치료의 결과분석)

  • Jang, Hyun-Soo;Kang, Seung-Hee;Kim, Sang-Won;Chun, Mi-Son;Jo, Sun-Mi;Lim, Jun-Chul;Oh, Young-Taek;Kang, Seok-Yun
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.145-152
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    • 2009
  • Purpose: We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. Materials and Methods: Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy ($\geq$30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients. Results: The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1-and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels $\geq$200 U/ml. Conclusion: CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.

The Necessity of Early Adjuvant Radiotherapy for Better Outcomes in the Treatment of a Desmoid Tumor (데스모이드 종양에 대한 조기 방사선치료의 필요성)

  • Lee, Me-Yeon;Chang, Ah-Ram;Kim, Hak-Jae;Kim, Kyu-Bo;Kim, Jin-Ho;Park, Charn-Il;Ha, Sung-Whan;Wu, Hong-Gyun;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.201-205
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    • 2007
  • Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.

Trans-10, cis-12 Conjugated Linoleic Acid Modulates Nuclear Factor-${\kappa}B$ p65 Activity on the Production of Tumor Necrosis Factor-${\alpha}$ in Porcine Peripheral Blood Mononuclear Cells (돼지 말초혈액 단핵구세포에서 trans-10, cis-12 conjugated linoleic acid의 TNF-${\alpha}$ 생산에 대한 nuclear factor-${\kappa}B$ p65 활성 조절 효과)

  • Kim, Young-Beum;Lee, Ill-Woo;Kang, Ji-Houn;Yang, Mban-Pyo
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.190-195
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    • 2011
  • Nuclear factor ${\kappa}B$ (NF-${\kappa}B$) is a nuclear transcription factor that modulates the expression of inflammatory cytokines such as tumor necrosis factor (TNF)-${\alpha}$. trans-10, cis-12 (t10c12)-conjugated linoleic acid (CLA) participates in the inhibition of TNF-${\alpha}$ production upon lipopolysaccharide (LPS)-stimulation. However, in our previous study, t10c12-CLA enhanced the production of TNF-${\alpha}$ by LPS-unstimulated porcine peripheral blood mononuclear cells (PBMCs) and RAW 264.7 macrophages in vitro. To resolve this apparent contradiction, we hypothesized that the effect of t10c12-CLA on TNF-${\alpha}$ production depends on NF-${\kappa}B$ activation induced by LPS stimulation. To test this hypothesis, we assessed the in vitro effect of t10c12-CLA on TNF-${\alpha}$ production and NF-${\kappa}B$ p65 activity in LPS-stimulated and LPS-unstimulated porcine PBMCs. t10c12-CLA treatment resulted in increased TNF-${\alpha}$ production by LPS-unstimulated PBMCs but decreased TNF-${\alpha}$ production by LPS-stimulated PBMCs. t10c12-CLA increased the degradation of inhibitory ${\kappa}B$ ($I{\kappa}B$)-${\alpha}$ protein and activated NF-${\kappa}B$ p65 in LPS-unstimulated PBMCs, but had the opposite effect in LPS-stimulated PBMCs. Notably, t10c12-CLA enhanced NF-${\kappa}B$ p65 binding activity in LPS-unstimulated PBMCs exposed to caffeic acid phenethyl ester (CAPE), a NF-${\kappa}B$ inhibitor. Conversely, it inhibited NF-${\kappa}B$ p65 binding activity in LPS-stimulated PBMCs exposed to CAPE. These results suggest that t10c12-CLA may have different actions under different physiological conditions, and that its effect may be associated with a change in NF-${\kappa}B$ p65 activity.

Nomenclature of the Seas Around the Korean Peninsula Derived From Analyses of Papers in Two Representative Korean Ocean and Fisheries Science Journals: Present Status and Future (국내 대표 해양·수산 과학논문 분석을 통한 우리나라 주변 바다 이름표기에 대한 제언)

  • BYUN, DO-SEONG;CHOI, BYOUNG-JU
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.23 no.3
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    • pp.125-151
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    • 2018
  • We grouped the names attributed to the seas surrounding the Korean Peninsula in maps published in two major Korean ocean and fisheries science journals over the period from 1998 to 2017: the Journal of the Korean Society of Oceanography (The Sea) and the Korean Journal of Fisheries and Aquatic Science (KFAS). The names attributed to these seas in maps of journal paper broadly were classified into three groupings: (1) East Sea and Yellow Sea; (2) East Sea, Yellow Sea, and South Sea; or (3) East Sea, West Sea and South Sea. The name 'East Sea' was dominantly used for the waters between Korea and Japan. In contrast, the water between Korea and China has been mostly labelled as 'Yellow Sea' but sometimes labelled as 'West Sea'. The waters between the south coast of Korea and Kyushu, Japan were labelled as either 'Korea Strait' or 'South Sea'. This analysis on sea names in the maps of 'The Sea' and 'KFAS' reveals that domestic researchers frequently mix geographical and international names when referring to the waters surrounding the Korean Peninsula. These inconsistencies provide the motivation for the development of a basic unifying guideline for naming the seas surrounding the Korean Peninsula. With respect to this, we recommend the use of separate names for the marginal seas between continental landmasses and/or islands versus for the coastal waters surrounding Korea. For the marginal seas, the internationally recognized names are recommended to be used: East Sea; Yellow Sea; Korea Strait; and East China Sea. While for coastal seas, including Korea's territorial sea, the following geographical nomenclature is suggested to differentiate them from the marginal sea names: Coastal Sea off the East Coast of Korea (or the East Korea Coastal Zone), Coastal Sea off the South Coast of Korea (or the South Coastal Zone of Korea), and Coastal Sea off the West Coast of Korea (or the West Korea Coastal Zone). Further, for small or specific study areas, the local region names, district names, the sea names and the undersea feature names can be used on the maps.

Flavonoid Biosynthesis: Biochemistry and Metabolic Engineering (Flavonoid 생합성:생화학과 대사공학적 응용)

  • Park, Jong-Sug;Kim, Jong-Bum;Kim, Kyung-Hwan;Ha, Sun-Hwa;Han, Bum-Soo;Kim, Yong-Hwan
    • Journal of Plant Biotechnology
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    • v.29 no.4
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    • pp.265-275
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    • 2002
  • Flavonoid biosynthesis is one of the most extensively studied areas in the secondary metabolism. Due to the study of flavonoid metabolism in diverse plant system, the pathways become the best characterized secondary metabolites and can be excellent targets for metabolic engineering. These flavonoid-derived secondary metabolites have been considerably divergent functional roles: floral pigment, anticancer, antiviral, antitoxin, and hepatoprotective. Three species have been significant for elucidating the flavonoid metabolism and isolating the genes controlling the flavonoid genes: maize (Zea mays), snapdragon (Antirrhinum majus) and petunia (Prtunia hybrida). Recently, many genes involved in biosynthesis of flavonoid have been isolated and characterized using mutation and recombinant DNA technologies including transposon tagging and T-DNA tagging which are novel approaches for the discovery of uncharacterized genes. Metabolic engineering of flavonoid biosynthesis was approached by sense or antisense manipulation of the genes related with flavonoid pathway, or by modified expression of regulatory genes. So, the use of a variety of experimental tools and metabolic engineering facilitated the characterization of the flavonoid metabolism. Here we review recent progresses in flavonoid metabolism: confirmation of genes, metabolic engineering, and applications in the industrial use.