• 제목/요약/키워드: Local tumor control

검색결과 245건 처리시간 0.026초

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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    • 제58권3호
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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.

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

  • 최종명;최세경;김재영;김형준;차인호;남웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권5호
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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.

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

  • 오명진;이언정;송봉근;김형균;김동혁;김성재
    • 대한한방내과학회지
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    • 제19권2호
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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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두경부에 발생한 연골육종 4 예 (Chondrasarcoma of the Head and Neck - 4 Cases Report -)

  • 이창걸;박경란;김수곤;서창옥;김귀언;노준규;고은희;김병수;홍원표
    • 대한두경부종양학회지
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    • 제3권1호
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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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진행된 담도암의 경관조사 (Transcatheter Irradiation of Advanced Extrahepatic Biliary Tract Carcinoma)

  • 김경애;김성규;신세원;김명세;송선교;권굉보
    • Radiation Oncology Journal
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    • 제5권2호
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    • pp.173-176
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    • 1987
  • 담도암은 서서히 자라며 원격전이가 늦은데 비하여 완전절제가 어렵고 수술 후 재발율이 높아. 생존율은 매우 낮다. 많은 예에서 국소치료의 실패가 치료실패의 요인으로 밝혀짐에 따라 술후 방사선 치료의 중요성이 인정되어 왔다. 외부방사선치료 만으로는 충분한 선량을 조사할 수 없으므로 국소적인 고선량치료법으로서 술중방사선치료, 간질방사선치료 (interstitial irradiation), 경관방사선치료(transcatheter irradiation) 등이 사용되고 있으나 경관방사선치료의 보고는 드물다. 영남대학병원 치료방사선과에서는 진행된 담도암 1예에서 암 종괴의 부분절제 후 삽입된 T-자관을 통하여 고선량 방사선 치료를 실시하였기에 문헌고찰과 함께 보고하는 바이다.

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

  • 강승희;서현숙
    • Radiation Oncology Journal
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    • 제11권2호
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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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    • 제52권1호
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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.

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

  • 한양희
    • 대한한의학회지
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    • 제29권2호
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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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    • 제16권17호
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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.

노령의 피부암에서 방사선치료 (Radiation Therapy in Elderly Skin Cancer)

  • 김진희
    • Radiation Oncology Journal
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    • 제26권2호
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    • pp.113-117
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    • 2008
  • 목적: 노령의 피부암에서 방사선치료 후 국소 제어률, 생존율, 실패양상, 부작용을 알아보기 위해 이 연구를 시행하였다. 대상 및 방법: 1990년 1월부터 2002년 10월까지 계명대학교 동산의료원 방사선종양학과에서 방사선치료를 받은 노령 환자 15명을 대상으로 하였다. 연령 분포는 72세에서 95세로 평균 78.8세였다. 병리학적으로 10명은 편평상피암이었고 3명은 기저세포암이었고 1명은 사마귀상암, 1명은 피부부속기원암이었다. 종괴의 위치로는 두부가 13명으로 대부분을 차지하였다. 종괴의 장경은 평균 4.9cm($2{\sim}9cm$)이었다. 방사선치료는 $6{\sim}15$ MeV의 전자선을 종괴의 크기와 깊이에 맞추어 사용하였으며 80% 등선량곡선에 하루에 2 Gy 씩 주 5회 사용하였으며 총방사선량은 $50{\sim}80$ Gy(평균 66 Gy)를 조사하였다. 림프절전이가 있었던 1명은 6 MV X-선으로 치료한 후 전자선으로 추가 조사하였다. 추적기간은 10개월에서 120개월로 중앙값 48개월이었다. 결과: 모든 환자에서 완전관해를 얻었으며 5년 무병생존율은 80%이었다. 전체 15명 중 12명은 재발이 없었다. 3명은 재발없이 평균 90개월($68{\sim}120$개월)동안 생존하고 있으며 방사선치료 후 20%(3/15)에서 재발하였고 9명은 재발이나 전이없이 평균 55.8개월 살다가 다른 병으로 사망하였다. 방사선치료 중 방사선 피부염 외에는 특별한 부작용은 없었으며 방사선피부염은 치료 종료 후 보존적 치료로 회복 되었다. 결론: 노령의 피부암의 방사선치료는 매우 효과적이며 안전하며 좋은 생존율을 보인다고 사료된다.