• Radiation Oncology Journal
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• v.36 no.2
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• pp.85-94
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• 2018

Radiation-induced second malignancies (RISM) is one of the important late side effects of radiation therapy and has an impact on optimal treatment decision-making. Many factors contribute to the development of RISM such as age at radiation, dose and volume of irradiated area, type of irradiated organ and tissue, radiation technique and individual and family history of cancer. Exact mechanism of RISM is unknown. But nowadays, it is a growing concern in oncology because of the increased number of cancer survivors and efforts are being made to prevent or decrease the incidence of RISM. The primary search for articles was carried via Google Scholar and PubMed with keywords included 'radiation induced malignancies, second malignancies, and chemotherapy induced malignancies'. Additional papers were found through references from relevant articles. In this review article, we have discussed about the pathogenesis, factors contributing to RISM, screening and prevention strategies of RISM.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.257-267
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• 2017

Purpose: Pulmonary toxicities, including infectious pneumonia (IP) and idiopathic pneumonia syndrome (IPS), are serious side effects of total body irradiation (TBI) used for myeloablative conditioning. This study aimed to evaluate clinical factors associated with IP and IPS following TBI. Materials and Methods: Fifty-eight patients with hematologic malignancies who underwent TBI before allogeneic hematopoietic stem cell transplantation between 2005 and 2014 were reviewed. Most patients (91%) received 12 Gy in 1.5 Gy fractions twice a day. Pulmonary toxicities were diagnosed based on either radiographic evidence or reduced pulmonary function, and were subdivided into IP and IPS based on the presence or absence of concurrent infection. Results: Pulmonary toxicities developed in 36 patients (62%); 16 (28%) had IP and 20 (34%) had IPS. IP was significantly associated with increased treatment-related mortality (p = 0.028) and decreased survival (p = 0.039). Multivariate analysis revealed that the risk of developing IPS was significantly higher in patients who received stem cells from a matched unrelated donor than from a matched sibling donor (p = 0.021; hazard ratio [HR] = 12.67; 95% confidence interval [CI], 1.46-110.30). Combining other conditioning agents with cyclophosphamide produced a higher tendency to develop IP (p = 0.064; HR = 6.19; 95% CI, 0.90-42.56). Conclusion: IP and IPS involve different risk factors and distinct pathogeneses that should be considered when planning treatments before and after TBI.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.233-240
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• 2017

Purpose: To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Materials and Methods: Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Results: Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). Conclusion: The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

• Radiation Oncology Journal
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• v.37 no.3
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• pp.224-231
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• 2019

Purpose: To investigate the patterns of recurrence in patients with neuroblastoma treated with radiation therapy to the primary tumor site. Materials and Methods: We retrospectively analyzed patients with high-risk neuroblastoma managed with definitive treatment with radiation therapy to the primary tumor site between January 2003 and June 2017. These patients underwent three-dimensional conformal radiation therapy or intensity-modulated radiation therapy. A total of 14-36 Gy was delivered to the planning target volume, which included the primary tumor bed and the selected metastatic site. The disease stage was determined according to the International Neuroblastoma Staging System (INSS). We evaluated the recurrence pattern (i.e., local or systemic), progression-free survival, and overall survival. Results: A total of 40 patients with high-risk neuroblastoma were included in this study. The median patient age was 4 years (range, 1 to 11 years). Thirty patients (75%) had INSS stage 4 neuroblastoma. At the median follow-up of 58 months, there were 6 cases of local recurrence and 10 cases of systemic recurrence. Among the 6 local failure cases, 4 relapsed adjacent to the radiation field. The other 2 relapsed in the radiation field (i.e., para-aortic and retroperitoneal areas). The main sites of distant metastasis were the bone, lymph nodes, and bone marrow. The 5-year progression-free survival was 70.9% and the 5-year overall survival was 74.3%. Conclusion: Radiation therapy directed at the primary tumor site provides good local control. It seems to be adequate for disease control in patients with high-risk neuroblastoma after chemotherapy and surgical resection.

• Progress in Medical Physics
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• v.30 no.1
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• pp.14-21
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• 2019

Purpose: To report the initial experience of patient-specific quality assurance (pQA) for the wobbling and line-scanning proton therapy at Samsung Medical Center. Materials and Methods: The pQA results of 89 wobbling treatments with 227 fields and 44 line-scanning treatments with 118 fields were analyzed from December 2015 to June 2016. For the wobbling method, proton range and spread-out Bragg peak (SOBP) width were verified. For the line-scanning method, output and two-dimensional dose distribution at multiple depths were verified by gamma analysis with 3%/3 mm criterion. Results: The average range difference was -0.44 mm with a standard deviation (SD) of 1.64 mm and 0.1 mm with an SD of 0.53 mm for the small and middle wobbling radii, respectively. For the line-scanning method, the output difference was within ${\pm}3%$. The gamma passing rates were over 95% with 3%/3 mm criterion for all depths. Conclusions: For the wobbling method, proton range and SOBP width were within the tolerance levels. For the line-scanning method, the output and two-dimensional dose distribution showed excellent agreement with the treatment plans.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.136-139
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• 2004

In this study, we used the rectal balloon to overcome the dose limit of the radiation therapy in the prostate cancer. Using the rectal balloon, we could minimize the planning target volume (PTV) by minimizing the internal motion of prostate and increased the gap between the rectum wall and the high dose region. To this purpose, we analyzed the position reproducibility of rectal balloon during the patient setup. Moreover, we studied the clinical feasibility of rectal balloon by performing the IMRT plan.

• Journal of Korean Academy of Nursing
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• v.53 no.6
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• pp.597-609
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• 2023

Purpose: The degree of caring behavior of oncology nurses is a crucial factor in the care provided to patients with cancer. In this study, we aimed to investigate factors related to oncology nurses' caring behavior, including their resilience and professional quality of life. Methods: A cross-sectional descriptive study was conducted with 107 oncology nurses at an urban tertiary hospital from May 18 to 24, 2015. We used a self-report questionnaire to measure resilience, professional quality of life, and degree of caring behavior. Data analysis included descriptive statistics, correlations, and multiple regression analysis using SPSS/WIN 20.0. Results: Oncology nurses presented with low levels of resilience and caring behavior, and high levels of compassion satisfaction, burnout, and secondary traumatic stress. There was a statistically significant relationship between the degree of caring behavior, resilience (r = .43, p < .001), compassion satisfaction (r = .51, p < .001), and burnout (r = - .42, p < .001), as well as between secondary traumatic stress and burnout (r = .34, p < .001). Factors associated with oncology nurses' degree of caring behavior were compassion satisfaction (t = 6.00, p < .001) and educational level (t = 3.45, p = .001). Conclusion: This study demonstrates that oncology nurses' degree of caring behavior is related to their professional quality of life and education. These findings suggest that enhancing oncology nurses' healthy coping strategies at both the individual and organizational levels can further develop holistic nursing care. Additionally, it is necessary to examine the factors affecting nurses' compassion satisfaction and to try to promote this aspect.

• Korean Circulation Journal
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• v.53 no.2
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• pp.69-91
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• 2023

Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.

• Journal of Korean Traditional Oncology
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• v.10 no.1
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• pp.57-74
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• 2005

Objectives : Many cancer patients use therapies promoted as literal alternative and complementary medicine to conventional medical care. So the health provider has to guide it by appropriate clinical guideline. The purpose is to indicate the international research tool of korean medical oncology for related investigators and help to make the clinical guideline for korean oncology. Method : We reviewed complementary and alternative therapies for cancer and cancer-related symptoms by searching MEDLINE, and using the name and synonyms of the therapy. Publications on complementary medicine were identified by searching the Cochrane Library. Results and Conclusion : Most complementary and alternative medicine used by cancer patients have demonstrable, important benefits, including decreased symptoms and better quality of life. We have to standardize the scientific research protocol for korean oncology and build evidence based medicine in the future.

• Journal of The Korean Radiological Technologist Association
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• v.25 no.1
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• pp.305-310
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• 1999