• 제목/요약/키워드: Local tumor control

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Efficacy and Safety of Fractionated Stereotactic Radiosurgery for Large Brain Metastases

  • Jeong, Won Joo;Park, Jae Hong;Lee, Eun Jung;Kim, Jeong Hoon;Kim, Chang Jin;Cho, Young Hyun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.217-224
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    • 2015
  • Objective : To investigate the efficacy and safety of fractionated stereotactic radiosurgery for large brain metastases (BMs). Methods : Between June 2011 and December 2013, a total of 38 large BMs >3.0 cm in 37 patients were treated with fractionated Cyberknife radiosurgery. These patients comprised 16 men (43.2%) and 21 women, with a median age of 60 years (range, 38-75 years). BMs originated from the lung (n=19, 51.4%), the gastrointestinal tract (n=10, 27.0%), the breast (n=5, 13.5%), and other tissues (n=3, 8.1%). The median tumor volume was 17.6 cc (range, 9.4-49.6 cc). For Cyberknife treatment, a median peripheral dose of 35 Gy (range, 30-41 Gy) was delivered in 3 to 5 fractions. Results : With a median follow-up of 10 months (range, 1-37 months), the crude local tumor control (LTC) rate was 86.8% and the estimated LTC rates at 12 and 24 months were 87.0% and 65.2%, respectively. The median overall survival (OS) and progression-free survival (PFS) rates were 16 and 11 months, respectively. The estimated OS and PFS rates at 6, 12, and 18 months were 81.1% and 65.5%, 56.8% and 44.9%, and 40.7% and 25.7%, respectively. Patient performance status and preoperative focal neurologic deficits improved in 20 of 35 (57.1%) and 12 of 17 patients (70.6%), respectively. Radiation necrosis with a toxicity grade of 2 or 3 occurred in 6 lesions (15.8%). Conclusion : These results suggest a promising role of fractionated stereotactic radiosurgery in treating large BMs in terms of both efficacy and safety.

MAXILLARY MALIGNANT TUMORS : A RETROSPECTIVE STUDY (상악의 악성 종양에 관한 후향적 연구)

  • Choi, Jong-Myung;Choi, Se-Kyung;Kim, Jae-Young;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.299-303
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    • 2009
  • Introduction: Maxillary malignant tumors are primary tumors of the maxillary gingiva, sinus, and palate. The purpose of this study was to research the prognosis and treatment modalities of maxillary malignant tumors. Materials & Methods: For this study, 52 patients, who were treated after being diagnosed for maxillary malignant tumors at the department of OMFS at Yonsei University college of Dentistry from January 1997 till April 2008, were classified, then the prognoses of these patients were evaluated depending on their primary site, histopathology and treatment modalities. The results of this study showed that the most common primary site for maxillary malignant tumors was the gingiva and for histopathology, squamous cell carcinoma. Result & Conclusion: The average follow up period was 32.7 months. In determining prognosis, the most important factors were the control of local site and metastasis of cervical lymph nodes. Therefore, for a better prognosis, a tumor free margin during surgery and a periodic follow up to examine for metastasis to cervical lymph nodes and other organs are necessary.

Effect of Ulmi radicis Cortex Extract on Systemic and Local Anaphaylaxis in Rats (유근피(楡根皮)가 전신적(全身的) 및 국소적(局所的) 아나필락시스에 미치는 효과(效果))

  • Oh, Myung-Jin;Lee, Eon-Jeong;Song, Bong-Keun;Kim, Hyeong-Kyun;Kim, Dong-Hyuk;Kim, Seong-Jae
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.249-260
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    • 1998
  • Ulmi radicis cortex is a herb medicine which has been used for the treatment of such allergic disease as urticaria, allergic rhinitis and athma. To assess the contribution of an aqueous extract of Ulmi radicis cortex(URC) in systemic anaphylaxis, we used compound 48/80 as a fatal anaphylaxis inducer in rats. URC inhibited anaphylactic shock 100% with a dose of 1.0 mg/g body weight (BW) 1 hr before injection of compound 48/80. URC significantly inhibited serum histamine levels induced by compound 48/80. URC (1.0 mg/g BW) also inhibited to 79.1% passive cutaneous anaphylaxis activated by anti-dinitrophenyl (DNP) IgE. URC dose-dependently inhibited the histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80. Moreover, URC had a significant inhibitory effect on anti-DNP IgE-induced histamine release or tumor necrosis $factor-{\alpha}$ production from RPMC. The level of cAMP in RPMC, when URC was added, significantly increased compared with that of normal control. These results indicate that URC may possess strong antianaphylactic effect.

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Chondrasarcoma of the Head and Neck - 4 Cases Report - (두경부에 발생한 연골육종 4 예)

  • Lee C.G.;Park K.R.;Kim S.K.;Suh C.O.;Kim G.E.;Loh J.K.;Koh E.H.;Kim B.S.;Hong W.P.
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.97-105
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    • 1987
  • Chondrosarcoma of the head and neck is very rare tumor and this incidence was reported to be about 10% of all chondrosarcomas. Maxilla is the most common site of involvement and mandible, paransal sinus, nasal cavity and base of skull in that order. In general, chondrosarcoma has been known to be radioresistant, however since the Princess Margaret Hospital reported that it was radioresponsive tumor in 1980, the role of radiotherapy has been emphasized in terms of local control, especially in head and neck regions where complete excion is often difficult to achieve. The authors experienced 4 cases of chondrosarcoma of head and neck among all 29 chondrosarcoma patients from 1971 to 1985. The clinical and pathologic feature of this disease, it's treatment and prognosis were reviewed along with the literatures.

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Transcatheter Irradiation of Advanced Extrahepatic Biliary Tract Carcinoma (진행된 담도암의 경관조사)

  • Kim Kyeoung Ae;Kim Sung Kyu;Shin Sei One;Kim Myung Se;Song Sun Kyuo;Kwon Koing Bo
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.173-176
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    • 1987
  • Carcinoma of extrahepatic biliary tract is slow growing tumor but curative resection is rarely successful. Radiation therapy has been introduced for enhancing palliation and possible longterm survival. We treated a case of advanced extrahepatic biliary tract carcinoma with high dose rate remote afterloading system through T-tube as a initial irradiation postoperatively. We hope that this treatment may affect not only ennancing palliation and better quality of life but also in local tumor control.

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Therapeutic Results of Postoperative Radiation Therapy for Early Stage Uterine Cervical Cancer (초기 자궁경부암의 수술후 방사선치료 결과)

  • Kang, Seung-Hee;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.347-354
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    • 1993
  • This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991, Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 $(3\%),$ 39 $(58.2\%),\;and\;26\;(38.8\%),$ respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were $88.0\%\;and\;82.1\%,$ respectively. The survival rates by stage were $87.1\%$ in IB and $88.4\%$ in IIA. Local control rate was $80.6\%(58\;pts).$ The treatment failure was noted in 12 of 67 patients $(17.9\%):$ locoregional failure in $7(10.4\%),$ distant metastasis in 3 $(4.5\%),$ and locoregional and distant metastasis in $2(3\%),$ The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence $(70.0\%\;vs\;91.1\%\;P<0.05\;&\;30.0\%\;vs\;15.8\%,\;respectively).$ The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size $(\geqq3\;cm),$ parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.

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Treatment Outcomes of Pediatric Craniopharyngioma : A 15-Year Retrospective Review of 35 Cases

  • Jo, Kwang-Wook;Shin, Hyung-Jin;Kong, Doo-Sik;Seol, Ho-Jun;Nam, Do-Hyun;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.37-41
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    • 2012
  • Objective : The aim of this study was to describe a single center's experience in the management of craniopharyngiomas in children over a 15-year period. Methods : The clinical records of pediatric patients treated for craniopharyngiomas between December 1995 and February 2011 were reviewed. Thirty-five pediatric patients diagnosed with craniopharyngioma were treated, and their medical records and imaging data were analyzed retrospectively. Results : The mean follow-up duration was 76 months (range, 10-195). Overall survival and local control rates at 10 years were $94.7{\pm}5.1%$ and $37.1{\pm}11.9%$, respectively. The female-to-male ratio was 16 : 19, and the mean age was 8.6 years (range, 1-17). Initially, gross total resection (GTR) was performed in 30 patients; subtotal resection (STR) followed by radiotherapy was performed in 5 patients. Of the 14 cases that showed recurrence after GTR, 5 patients were treated with GTR, 1 with radiation therapy (RT), 4 with gamma knife radiosurgery (GKRS), and 4 with subtotal resection followed by RT. No patients who underwent RT or GKRS had recurrences. Two cases with recurrence after STR followed by RT were treated with GTR. One patient died of hormonal insufficiency 64 months after the first surgery. The overall median time progression was 51.2 months (range, 3-182) : 49.7 months in the patients who underwent GTR and 60.2 months in the patients who underwent STR followed by RT. Conclusion : If safe resection is possible, GTR at the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, RT or GKRS with/without reoperation may be an effective salvage treatment for recurrent craniopharyngioma.

The Effects of Prunella vulgaris on the Cyto-pathological Alterations and Expression of Inflammatory Cytokines in Non-Bacterial Prostatitis Rat Model (하고초(夏枯草)가 만성 비세균성 전립선염 Rat의 전립선세포 조직변화 및 염증관련 Cytokines 발현에 미치는 영향)

  • Han, Yang-Hee
    • The Journal of Korean Medicine
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    • v.29 no.2
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    • pp.71-80
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    • 2008
  • Objective: There is increasing evidence that chronic non-bacterial prostatitis is recognized to be a local inflammatory disease, and there is substantiating evidence to support the role of the inflammatory responses in its pathogenesis, and clinical value in the evaluation of therapeutic efficacy. Prunella vulgaris has been traditionally used in treatment of inflammatory diseases, including of scrofula, goiter, and allergy diseases. In this study, we investigated the effects of Prunella vulgaris on inflammatory cytokines and cytopathological alternation in the rat model of non-bacterial prostatitis induced by castration and $17{\beta}-estradiol$ treatment. Methods: Two-month-old rats were treated with $17{\beta}-estradiol$ after castration for induction of experimental non-bacterial prostatitis, which is similar to human chronic prostatitis in histopathological profiles. Prunella vulgaris as an experimental specimen, and testosterone as a positive control, were administered orally. The prostates were evaluated by histopathological parameters including the epithelial score and epithelial-stromal ratio for glandular damage, and the expression of inflammatory cytokine genes including the interleukin $(IL)-1{\beta}$, IL-5, IL-12, and tumor necrosis factor $(TNF)-{\alpha}$. Results: While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with Prunella vulgaris showed a diminished range of tissue damage. Epithelial score was improved in Prunella vulgaris over that of the control (P<0.05). The epithelial-stromal ratio was lower with Prunella vulgaris when compared to that of the control (P<0.05). In the reverse transcription-polymerase chain reaction (RT-PCR) of inflammatory cytokine genes, Prunella vulgaris inhibited the expression of $IL-1{\beta}$ and $TNF-{\alpha}$ genes, while it modulated the expression of IL-5, which is an anti-inflammatory cytokine. Conclusions: These findings suggest that Prunella vulgaris may protect the glandular epithelial cells and also inhibit stromal proliferation in association with the immune modulation including the suppression of inflammatory cytokines and promotion of anti-inflammatory cytokine. From theses results, we suggest that Prunella vulgaris could be a useful remedy agent for treating chronic non-bacterial prostatitis.

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Lack of Prognostic Impact of Adjuvant Radiation on Oncologic Outcomes in Elderly Women with Breast Cancer

  • Omidvari, Shapour;Talei, Abdolrasoul;Tahmasebi, Sedigheh;Moaddabshoar, Leila;Dayani, Maliheh;Mosalaei, Ahmad;Ahmadloo, Niloofar;Ansari, Mansour;Mohammadianpanah, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7813-7818
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    • 2015
  • Background: Radiotherapy plays an important role as adjuvant treatment in locally advanced breast cancer and in those patients who have undergone breast-conserving surgery. This study aimed to investigate the prognostic impact of adjuvant radiation on oncologic outcomes in elderly women with breast cancer. Materials and Methods: In this retrospective study, we reviewed and analyzed the characteristics, treatment outcome and survival of elderly women (aged ${\geq}60years$) with breast cancer who were treated and followed-up between 1993 and 2014. The median follow up for the surviving patients was 38 (range 3-207) months. Results: One hundred and seventy-eight patients with a median age of 74 (range 60-95) years were enrolled in the study. Of the total, 60 patients received postoperative adjuvant radiation (radiation group) and the remaining 118 did not (control group). Patients in the radiation group were significantly younger than those in the control group (P value=0.004). In addition, patients in radiation group had higher node stage (P value<0.001) and disease stage (P=0.003) and tended to have higher tumor grade (P=0.031) and received more frequent (P value<0.001) adjuvant and neoadjuvant chemotherapy compared to those in the control group. There was no statistically significant difference between two groups regarding the local control, disease-free survival and overall survival rates. Conclusions: In this study, we did not find a prognostic impact for adjuvant radiation on oncologic outcomes in elderly women with breast cancer.

Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.