• 제목/요약/키워드: Local lymph node metastasis

검색결과 104건 처리시간 0.029초

비인강암(鼻咽腔癌) 방사선치료성적(放射線治療成績) (The Radiotherapy Result of the Nasopharyngeal Carcinoma)

  • 박찬일;고경환;김종선;김노경
    • Radiation Oncology Journal
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    • 제1권1호
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    • pp.85-94
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    • 1983
  • A total of 47 patients with a diagnosis of nasopharyngeal carcinoma was treated in Department of Therapeutic Radiology, Seoul National University Hospital during last 4 years. Of the 47 patients, 23(49%) had undifferentiated carcinoma, 20(43%) had squamous cell carcinoma, while 4(8%) had lymphoepithelioma. Most of the patients(71%) has Stage IV disease, cervical lymph node metastases were found in 36(77%) and distant metastasis was found in 1 at the time of diagnosis. Complete response rate after radiotherapy for 47 patients of nasopharyngeal carcinoma was 85.1%. The overall actuarial 3 year survival rates was 0.718 and the disease free actuarial 3 year survival rates was 0.468. Nodal involvement and symptom duration were statistically significiant influencing factors for actuarial survival rate. Treatment failures were found in 20 patients (42.6%), local recurrence only in 6(30%), local and neck recurrence in 3(15%), local recurrence with metastasis in 4(20%) and distant metastasis only in 7(35%). Local failures were more frequent in the patients with cranial nerve symptoms (P=0.032). Distant metastases were more frequent with T4 lesions (P=0.047), and with nodal involvement (P<0.01). Retreatment after the tumor recurrence was chemotherapy and/or radiotherapy, two pationts refreated for local recurrence were alive without evidence of disease for more than 19 and 44 months after retreatment.

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Successful Treatment of Advanced Gastric Cancer with Brain Metastases through an Abscopal Effect by Radiation and Immune Checkpoint Inhibitor Therapy

  • Muto, Momotaro;Nakata, Hirotaka;Ishigaki, Kenichi;Tachibana, Shion;Yoshida, Moe;Muto, Mizue;Yanagawa, Nobuyuki;Okumura, Toshikatsu
    • Journal of Gastric Cancer
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    • 제21권3호
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    • pp.319-324
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    • 2021
  • The abscopal effect refers to the phenomenon in which local radiotherapy is associated with the regression of metastatic cancer that is distantly located from the irradiated site. Here, we present a case of a patient with advanced gastric cancer and brain metastases who was successfully treated with brain radiotherapy and anti-programmed death-1 (PD-1) therapy-induced abscopal effect. Although anti-PD-1 therapy alone could not prevent disease progression, the metastatic lesions in the brain and also in the abdominal lymph node showed a drastic response after brain radiotherapy and anti-PD-1 therapy. To our knowledge, this is the first reported case of successful treatment of advanced gastric cancer with multiple brain and abdominal lymph node metastases, possibly through anti-PD-1 therapy combined with brain radiotherapy-induced abscopal effect. We suggest that the combination of brain radiotherapy and anti-PD-1 therapy may be considered as a therapeutic option for advanced gastric cancer, especially when there is brain metastasis.

유방암 진단에서 유방스캔의 역할 (The Role of Scintimammography in the Diagnosis of Breast Cancer)

  • 김인주
    • 대한핵의학회지
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    • 제35권4호
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    • pp.213-223
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    • 2001
  • Breast cancer accounts for the higher proportion of cancer related deaths among women, and the incidence of this malignant disease is still increasing. The commonly used screening method is mammography. However, mammography has the drawback of low specificity in differentiating malignant and benign breast diseases. To overcome this low specificity of mammography, scintimammography using various radiopharmaceuticals such as Thallium-201, Tc-99m MIBI, Tc-99m tetrofosmin and Tc-99m MDP was introduced and now actively under the investigation. Several studios have shown that high sensitivity and specificity in detection of primary breast cancer and axillary lymph node metastases using these radiopharmaceuticals. Scintimammography may play important roles in the diagnosis of primary breast cancer, evaluation of the patients with high risk, determining axillary lymph node metastasis, evaluation of the response to chemotherapy, determining the extent of disease, and surveillance of local recurrence. In the future, we should investigate the prognostic role of scintimammography after treatment of breast cancer patients and cost-effectiveness of scintimammography in the detection of primary breast cancer.

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식도암의 수술 후 방사선 치료: 실패 양상 분석 (Post-operative Radiation Therapy for Esophageal Cancer; Analysis of Failure Pattern)

  • 김미숙;김재영;류성렬;조철구;유형준;조재일;백희종;박종호;최수용
    • Radiation Oncology Journal
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    • 제16권4호
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    • pp.447-454
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    • 1998
  • 목적 : 국소 제어율과 생존율, 여러 예후인자 및 국소실패의 원인을 분석하므로 식도암의 수술 후 방사선 치료에 기본 자료로 활용하고자 한다. 대상 및 방법 : 1988년 1월부터 1995년 12월까지 본원에서 수술을 시행 후 40Gy 이상의 방사선 치료를 받은 국소적으로 진행된 식도암 환자 82명을 대상으로 후향적 분석을 하였다. 수술 후 병기는 II가 26례, IIB가 4례, III가 52례 였으며 수술후 병리학 소견으로 편평상피암 77례, Adenosquamous 3례, 선암 2례였다. 수술 후 외부 방사선 치료로 41Gy에서 64.8Gy(중간값 50.4Gy)를 조사하였다. 5례에서 PFC 항암화학요법을 시행하였다. 결과 : 총 환자의 2년 생존율 및 2년 국소제어율은 각각 36.8$\%$ 및 30.4$\%$이며 5년 생존율 및 5년 국소제어율은 각각 9.3$\%$ 및 26.3$\%$이다. 수술 후 병기에 따른 2년 생존율은 IIA가 50.2$\%$, IIB가 0$\%$, III가 23.3$\%$이었다(p=0.004). 2년 국소제어율은 IIA가 49.2$\%$, IIB가 66.6$\%$, III가 24.7$\%$(p=0.01) 이었다. 추적기간중 전체환자의 73.2$\%$인 60례에서 재발이 관찰되었다. 이중 원발병소인 식도에서 재발이 3례, 주위임파절 재발이 23례, 원발병소와 임파절에 함께 재발된 경우가 4례, 원발 병소재발 및 원격전이 재발이 1례, 주위임파절과 원격전이 재발이 9례, 원격전이 재발이 17례였다. 3례에서 재발 부위를 알수 없었다. 생존율에 관련된 예후인자로 흡연유무(p=0.02), 1 병기(p=0.0092), N병기(p=0.0045)가 통계적으로 의미있었다. 국소제어율에 관련된 예후인자로 T 병기(p=0.019), N 병기(p=0.047)가 통계학적으로 의미있었다. 결론 : 수술 후 방사선치료를 시행하여도 국소실패가 여전히 중요 실패 원인이었다. 국소 실패의 원인 중 식도 주위 임파절에 의한 실패가 원발 병소 실패보다 휠씬 높았다. 따라서 수술후 방사선치료에서 림프절에 대한 적절하고 적극적인 치료 전략이 필요하겠다.

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악하림프절 전이를 동반한 하악골의 법랑모세포종 (MALIGNANT AMELOBLASTOMA OF MANDIBLE WITH LYMPH NODE METASTASIS)

  • 박지현;정재화;윤필영;홍종락;명훈;황순정;서병무;최진영;이종호;정필훈;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권5호
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    • pp.298-300
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    • 2003
  • Ameloblastomas are generally considered to be benign tumors of odontogenic epithelial origin with high local recurrence. Rarely ameloblastomas exhibit malignant behavior with development of metastases. In this report, we present a 19-year-old woman with ameloblastoma in the right ascending ramus and multiple recurrences. Eleven years after first therapy, ameloblastoma metastasized to ipsilateral submandibular lymph node. We also review literature about cause, treatment and work-up of malignant ameloblastoma.

갑상선 후방 피막을 침범하는 갑상선미세유두암의 임상양상에 대한 고찰 (Clinical Characteristics of Papillary Thyroid Microcarcinoma Involving Posterior Thyroidal Capsule)

  • 장성욱;오정호;김서빈;김성원;이형신;노웅재;이강대
    • 대한두경부종양학회지
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    • 제31권2호
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    • pp.6-10
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    • 2015
  • Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

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다발성 폐결절로 나타난 폐내림프절 1예 (A Case of Intrapulmonary Lymph Nodes Presenting Multiple Nodules)

  • 이숙영;조건현;김관형;문화식;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제46권6호
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    • pp.879-883
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    • 1999
  • 폐내 림프절은 흉부엑스선상 폐결절로 나타나는 드문 질환으로 방사선 소견만으로는 악성종양과 감별하기 어렵다. 저자는 중엽과 하엽의 늑막표면 근처에 위치하는 직경 1cm 이하의 다발성 결절을 흉강경하 생검하여 폐내 림프절로 확진한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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수부에 발생한 악성 종양 (Malignant Tumor of the Hand)

  • 박홍준;신규호;배임돈;한수봉;강응식
    • 대한골관절종양학회지
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    • 제5권4호
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    • pp.201-207
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    • 1999
  • Malignant tumors of the hand are very rare. Between 1989 and 1998, 17 patients with malignant tumors of the hand were evaluated for clinical features, prevalence, treatment and results. The mean age was 45 years and median duration of follow-up was 38 months. A painless mass was the most common symptom and the most common lesion was the digit. Fifteen cases of soft tissue and 2 cases of bone tumor were diagnosed. On pathology, soft tissue tumors were comprised of 8 cases of malignant melanoma, 2 cases of angiosarcoma and 1 case each of malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, extraskeletal chondrosarcoma, and squamous cell carcinoma. Bone tumors were metastatic tumors and each originated from the rectal cancer or lung cancer. Lymph node involvements were noted in 4 cases of malignant melanoma and 1 case of squamous cell carcinoma. Six cases of metacarpo-phalangeal joint disarticulation and 4 cases of phalanx amputation were performed. Wide excision, ray amputation and below-elbow amputation were also performed. Three cases expired due to metastasis and progression of the original lesion. Among the surviving 14 cases, a malignant melanoma had metastasis on the axillary lymph node and 13 cases showed no local recurrence or metastasis during the follow-up.

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하구순암의 구역 재발로 반대편 악하 공간에 발생한 연조직 전이 1예 (A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer)

  • 홍석정;임성환;김은주;김승우
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제61권12호
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    • pp.702-704
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    • 2018
  • The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

  • Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
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    • 제35권1호
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    • pp.48-54
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    • 2017
  • Purpose: This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was $22.8kg/m^2$ (range, 17.7 to $35.9kg/m^2$). Results: The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, $BMI{\geq}23kg/m^2$) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Conclusion: Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.