• Title/Summary/Keyword: Local tumor control

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Multidisciplinary Treatment for Maxillary Cancer (상악암에 대한 집합적 치료)

  • 조재식;김성훈;박은호;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.95-95
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    • 1993
  • Even though maxillary cancer is usually discovered in advanced stage, its regional lymph node or distant metastases are not common comparing to other head and neck cancer. So the result of treatment depends upon local control of the tumor. Because maxillary sinus is anatomically located adjacent to orbit and skull base, it is difficult to remove the tumor completely with sufficient safety margin like in other malignant tumor. Traditionally, surgery including aggressive resection, radiotherapy or both combined therapy have been widely accepted in many institutes, but their results are not still satisfactory. Sixteen cases of maxillary cancer( all squamous cancer, T2 1 case, T3 6 cases, T4 9 cases, mean age 57.2 years) were treated by intraarterial chemotherapy, raditherapy and surgery and followed up retrospectively. 5 year survival rate by Kaplan-Meier method was 51.95%, and orbit, palate or cheek skin could be preserved in many cases and their functional result was good.

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RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

EFFECTS OF LOCAL IRRIGATION AND/OR INTRAVENOUS ADMINISTRATION OF ARGATROBAN ON THROMBOSIS IN MICROVASCULAR ANASTOMOSES OF FEMORAL VEIN OF RABBIT (가토대퇴정맥에서 미세혈관문합시 Argatroban의 국소세척 및 전신투여가 혈전형성에 미치는 영향)

  • Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.4
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    • pp.300-305
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    • 2005
  • Purpose: For the reconstruction of maxillofacial defect created by trauma, infection, or tumor etc, the role of microvascular anastomosis or vessel graft has been increased. Many methods has been tried to increase the success rate of microvascular anastomosis. Various anticoagulants and thrombolytic agents have been used to reduce the failure rate of microvascular anastomosis and avoid re-operation. Many drugs, however, have been used in the limited cases because most of these drugs may cause complications, such as allergy, fever or systemic bleeding. This study was performed to evaluate the influence of the Argatroban on patency and thrombosis in microvascular anastomosis when it is used for local irrigation or general administration. Materials & methods: Eight mature rabbits, weighing 2kg, were used. After exposing both femoral veins, the artificial thrombotic model was made by crushing injury using a smooth needle holder, and the transverse incision were made on femoral vein. The animals were divided into 4 groups according to Argatroban administration methods; control group (n=4), topical irrigation of lumen with saline solution; experimental group 1 (n=4), topical irrigation of lumen with Argatroban saline solution; experimental group 2 (n=4), topical irrigation of lumen with heparin followed by intravenous injection of Argatroban; experimental group 3 (n=4), topical irrigation of lumen with Argatroban followed by IV of Argatroban. Microvascular anastomosis was done with 10-0 Ethilon. The patency was evaluated by empty-and-refill test 30 minutes and 3 days after microanastomosis. The thrombus formation was examined 3 days after microanastomosis by surgical microscope. The histologic findings were also examined. Results: 1. Thirty minutes after microvascular anastomosis, the patency of all experimental groups was better than that of control group, but there was no significant difference among groups. 2. Three days after microvascular anastomosis, the patency of all experimental groups was more improved than that of control group (p<0.05). There was no significant difference among experimental groups. 3. Three days after microvascular anastomosis, the amount of thrombus in all experimental groups was less than that of control group (p<0.05). There was no significant difference among experimental groups. 4. Histologically, a lot of luminal thrombus was observed around sutured area in control group. Few luminal thrombus was observed in all experimental groups. The necrotic changes were observed on the sutured vein wall in all specimens. Conclusion: These results indicate that topical irrigation and/or intravenous administration of Argatroban is effective in improving patency and preventing thrombus formation after microvascular anastomosis.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

  • Doh, Re-Mee;Kim, Sungtae;Keum, Ki Chang;Kim, Jun Won;Shim, June-Sung;Jung, Han-Sung;Park, Kyeong-Mee;Chung, Moon-Kyu
    • The Journal of Advanced Prosthodontics
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    • v.8 no.5
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    • pp.363-371
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    • 2016
  • PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma

  • Jung, Da Hoon;Kim, Mi-Sook;Cho, Chul Koo;Yoo, Hyung Jun;Jang, Won Il;Seo, Young Seok;Paik, Eun Kyung;Kim, Kum Bae;Han, Chul Ju;Kim, Sang Bum
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.163-169
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    • 2014
  • Purpose: To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma. Materials and Methods: From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL). Results: The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. ${\geq}50mL$), and pre-SBRT CEA level (<5 vs. ${\geq}5ng/mL$) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with ${\leq}12$ months (p = 0.026). Six patients (10%) experienced ${\geq}$grade 3 complications. Conclusion: SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.

Radioimmunotherapy of Nude Mice Bearing Human Colon Carcinoma with I-131 Labeled Anti-carcinoembryonic Antigen Monoclonal Antibody (누드마우스에 이식된 인체대장암에서 I-131표지 항태아성암항원 단일클론항체를 이용한 방사면역치료법 : 치료성적에 관계되는 인자분석)

  • Kim, Byung-Tae;Lee, Kyung-Han;Kim, Sang-Eun;Choi, Yong;Chi, Dae-Yoon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Chung, Hong-Keun
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.332-342
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    • 1995
  • This study was designed to evaluate the effects of various factors on the therapeutic effect of the I-131 labeled anti-carcinoembryonic antigen monoclonal antibody(anti-CEA antibody). Tetrazolium-based colorimetric assay (MTT) was used to compare in vitro cytotoxicity of 3 Korean colon cancer cell lines (SNU-C2A, SNU-C4, SNU-C5) for selection of proper 2 cell lines in this study. The changes of the size of tumor which was xenografted to nude mice (balb/c nu/nu) were compared in 4 groups (group treated I-131 labeled anti-CEA antibody, group treated with non-radiolabeled anti-CEA antibody, group treated with I-131 labeled anti-human chorionic gonadotropin monoclonal antibody (anti-hCG antibody) as nonspecific antibody, and group injected with normal saline as a control). Immunohistochemical staining and in vivo autoradiography were performed after excision of the xenografted tumor. The results were as below mentioned. The in vitro cytotoxic effect of I-131 labeled anti-CEA antibody is most prominent in SNU-C5 cell line between 3 cancer cell lines. The changes of xenografted tumor size in both SNU-C4 and SNU-5S cell tumors at the thirteenth day after injection of the antibodies were smallest in the group treated with I-131 labeled anti-CEA antibody (SNU-C4/SNU-C5; 324/342%) comparing with other groups, group treated with anti-CEA antibody (622/660%), group treated with I-131 anti-hCG antibody (538/546%), and control group(1030/724%)(P<0.02 in SNU-C4 and P<0.1 in SNU-C5 at the 13th day after injection of antibodies). On the thirteenth day after injection of the antibodies nude mice were sacreficed to count the radiouptake of tumor and to check the changes of tumor size. Correlations between radiouptake and change of tumor size were calculated in each groups and significant negative correlation was only obtained in the group treated with I-131 anti-CEA antibody (p<0.05). There were no correlations between antigenic expression of carcinoembryonic antigen and distribution of anti-CEA antibody in both SNU-C4 and SNU-C5 cell tumors on immunoperoxidase staining. On in vivo autoradiography the distributions of anti-CEA antibody were heterogeneous and the intensities of binding were various in SNU-C4 and SNU-C5 cell tumors. It is concluded that I-131 labeled tumor-specific monoclonal antibody, anti-CEA antibody is effective in suppressing the xenografted tumor growth and the effect is influenced by sensitivity of tumor cell itself to the radiolabeled antibody and other local factors instead of specificity of antibody.

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Investigation of Alpha 1-Proteinase Inhibitor in Serum and Specimen of Lung Cancer Patients (폐암 환자의 혈청과 조직 표본상에서 Alpha 1-Proteinase Inhibitor의 조사 연구)

  • 김송명
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.364-373
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    • 1994
  • Alpha 1-Proteinase inhibitor[PI] was known as a major protective enzyme against to excessive hydrolytic and proteolytic reaction. So, it was suggested that Alpha 1-PI may implicated in growth of bronchogenic cancer. This study was undertaken to investigate the role of Alpha 1-PI in local invasion of bronchogenic cancer. Three groups of patients were studied; Preliminary research group of 15 bronchogenic cancer patients, Main research group of 13 bronchogenic cancer patients and Normal control group of 10 nephrectomy donor. Serum Alpha 1-PI level was observed in each group of patients during pre-and postoperative days. Pre-operative serum Alpha 1-PI level in preliminary research group [329.2$\pm$14.21mg/dl]and main research group[406.2$\pm$39.30mg/dl] were higher than in normal control group[236.2$\pm$19.55mg/dl] significantly[p<0.005]. Serial Alpha 1-PI level in each group during pre-and postoperative days shows peaked at 3rd. postoperative day in preliminary and main research group, thereafter decreased gradually. Immunohistochemical study for Alpha 1-antitrypsin[A1AT] was carried out by ABC[avidin-biotin peroxidase complex] method using Alpha-1 antitrypsin DAKOR to tumor tissues of 13 lung cancer patients in main research group. 6 cases[46.2%, squamous cell ca.;5, adenocarcinoma;1] of above 13 cases show positive immunoreactivity for A1AT. In conclusion, alpha 1-PI and elastase are disclosed that have defined actions for lung cancer growing or spreading.

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Risk factors for locoregional recurrence in patients with pathologic T3N0 rectal cancer with negative resection margin treated by surgery alone

  • Baek, Jong Yun;Yu, Jeong Il;Park, Hee Chul;Choi, Doo Ho;Yoo, Gyu Sang;Cho, Won Kyung;Lee, Woo-Yong;Yun, Seong Hyeon;Cho, Yong Beom;Park, Yoon Ah;Kim, Hee Cheol
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.110-116
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    • 2019
  • Purpose: This study aimed to identify prognostic factors for locoregional recurrence (LRR) in pT3N0 rectal cancer patients who were treated with surgery alone and had negative resection margin including circumferential resection margin (CRM) for optimal indication of adjuvant radiotherapy. Materials and Methods: We reviewed patients with pT3N0 rectal cancer who were treated via upfront surgery and had no other adjuvant treatment from January 2003 to December 2012. In total, 122 patients who had negative resection margin including negative CRM were included in the analysis. Results: The median follow-up period after surgery was 60 months (range, 3 to 161 months). During this time, 6 patients (4.9%) experienced LRR at the anastomotic site (4 patients), and regional lymphatic area (2 patients). The estimated 5-year rates of overall survival, recurrence-free survival, and LRR-free survival were 96.7%, 84.6%, and 94.0%, respectively. Multivariate analysis showed that level of tumor ≤5 cm was a significant prognostic factor for LRR-free survival (LRRFS) (p = 0.04; hazard ratio = 7.08; 95% confidence interval, 1.06-47.30). Patients with level of tumor ≤5 cm had an estimated 5-year LRRFS of 66.8%, which was much higher than 2.3% in patients with level of tumor >5 cm. There was no significant factor for recurrence-free survival or overall survival. Conclusion: In T3N0 rectal cancer, adjuvant chemoradiotherapy should be recommended in patients with level of tumor ≤5 cm for better local control. However, in patients with pT3N0 disease, negative resection margin, and level of tumor >5 cm, adjuvant chemoradiotherapy should be carefully suggested.

The Result and Failure after Adjuvant Postoperative Irradiation in Carcinoma of Recum (직장암의 방사선 치료결과 및 실패양상)

  • Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.133-141
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    • 1993
  • From Jan.1982 to Dec.1990, 77 patients with rectal cancer were treated with curative surgical resection followed by postoperative adjuvant irradiation alone or combined with chemotherapy at the Department of Radiation Oncology, Korea University Hospital (KUH). Fifty-four (54/77, $70.1{\%}$) patients underwent abdominoperineal resection , 20 (20/77, $26{\%}$) patients underwent low anterior resection, and 3 (3/77, $3.9{\%}$,) patients had wide excision only. Thirty-nine (39/77, $50.5{\%}$) received sequential chemotherapy (2 cycles to 12 cycles). The 5-year survival rate for the entire group was $43{\%}:\;78.2{\%}$ in B2+B3, $39.4{\%}$ in stage C1+C2+C3. Survival rates decreased with increasing penetration of the bowel wall by tumor and the presence of regional lymph node metastasis. Those patients survival who underwent an abdominoperineal resection also experienced a significant decrease in compared to low anterior resection ($23.1{\%}$ vs. $63.8{\%}$ in 5-year survival, p <0.05). Local failure occurred in 15 ($19.5{\%}$) out of the 77 patients overall, 1($5.3{\%}$) of 19 in stage B2+B3, and 14 ($24.1{\%}$,) of 58 in stage C1+C2+C3. Presacral area was most common site of local failufre (8/17, $47.1{\%}$). Distant failure occurred in 13 ($16.9{\%}$) of 77 patients. The most frequent site of distant failure was the lung followed by the liver, the bone, and the brain. Combined locoregional and distant failure occurred in 2 ($2.6{\%}$) of 77 patients. Pathological confirmation of perirectal fat and/or regional lymph node involvement resulted in a singificant decrease in survival and local control.

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