• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.6
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• pp.282-288
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• 2018

Objectives: The purpose of this study was to evaluate the neck node metastasis pattern and related clinical factors in oral cavity cancer patients. Materials and Methods: In total, 76 patients (47 males, 29 females) with oral squamous cell carcinoma (OSCC) who had no previous malignancies and were not undergoing neoadjuvant concomitant chemoradiotherapy or radiotherapy were selected for analysis. Results: Occult metastases were found in 8 of 52 patients with clinically negative nodes (cN0, 15.4%). Neck node metastases were found in 17 patients (22.4%). There was a statistically significant relationship between neck node metastasis and T stage (P=0.014) and between neck node metastasis and distant metastasis (Fisher's exact test, P=0.019). Conclusion: Neck node metastasis was significantly related to tumor size and distant metastasis during follow-up.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.337-346
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• 1993

This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.128-134
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• 2016

Purpose: To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC). Materials and Methods: A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration. Results: At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ${\geq}2$ toxicities were observed during or after radiotherapy. Conclusion: Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.152-155
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• 2013

Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

• Journal of Korean Traditional Oncology
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• v.14 no.1
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• pp.45-52
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• 2009

Lung cancer is the most common primary tumor of brain metastasis. Metastasis to the brain is a frequent complication of non-small cell lung cancer (NSCLC) occuring in 12 ~ 18% of patient. The incidence of brain metastasis is rising because of longer survival of cancer patients as a result of the increase in early diagnosis of primary tumors and aggressive management, and improvements in imaging quality and accessibility such as widespread use of MRI. The most common symptoms are gradual onset of headache, focal weakness, and mental changes. Surgery, chemotherapy, radiotherapy and steroid therapy are treatment of NSCLC with brain metastasis. We report a patient with NSCLC metastasis to the brain. This patient underwent chemotherapy, radiotherapy and steroidtherapy. However, the patient requested oriental medical treatment for the patient's continuous headache and disease. We administered Banhabaekchulchoenma-tang gagambang with Allergen-removed Rhus Verniciflua Stokes(aRVS). The patient showed remarkable improvement in terms of frequency and severity of headache. Further study will be needed in order to determine the long-term effectiveness of oriental medical treatment on cancer patient with headache.

• Radiation Oncology Journal
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• v.31 no.4
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• pp.267-272
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• 2013

Although significant advances in the treatment of intrahepatic lesions, it is reported that the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. We report a patient with lung, liver, brain, bone and subcutaneous metastasis from HCC who has survived more than 7 years maintaining relatively good performance status as a result of repeated therapies. A 55-year-old male patient with HCC underwent right lobectomy of the liver and cholecystectomy in September 2006. He received wedge resection for lung metastasis twice (July 2009, January 2011) and Gamma Knife stereotactic radiosurgery for brain metastasis (April 2011). Over the last 3 years, he has developed metastasis in subcutaneous tissues, muscle, and bone with pain. He has undergone 7 courses of radiotherapies for subcutaneous tissues, muscle, and bone metastasis and been prescribed sorafenib and he is still capable of all self-care.

• Radiation Oncology Journal
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• v.32 no.4
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• pp.266-271
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• 2014

In the clinical state of oligometastases or oligorecurrence, a transitional state between localized and widespread systemic disease, local control of the disease may yield improved systemic control. Radiotherapy may be a good means for controlling oligometastatic tumors, particularly in very old patients for whom surgery may be infeasible. A combination of systemic therapy and local therapy is necessary to prevent systemic progression. Some kinds of cancers found in the elderly are known to be somewhat indolent for systemic progression. So, for very old patients who refuse or cannot tolerate chemotherapy, the use of radical radiotherapy alone to treat oligorecurrences may be very helpful. We successfully treated an 87-year-old patient who had been diagnosed with oligorecurrences three times over six years with radiotherapy alone. The patient is now, about four years after his first radiotherapy for liver metastasis, alive without any evidence of cancer and with fully active performance status.

• Radiation Oncology Journal
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• v.29 no.4
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• pp.228-235
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• 2011

Purpose: To evaluate the impact of postoperative radiotherapy (PORT) on patterns of failure and survivals in uterine carcinosarcoma patients treated with radical surgery. Materials and Methods: Between October 1998 and August 2010, 19 patients with stage I-III uterine carcinosarcoma received curative hysterectomy and bilateral salpingo-oophorectomy with or without PORT at Seoul National University Hospital. Their hospital medical records were retrospectively reviewed. PORT and non-PORT groups included 11 and 8 patients, respectively. They were followed for a mean of 22.7 months (range, 7.8 to 126.6 months). Results: At 5 years, the overall survival rates were 51.9% for entire, 61.4% for PORT, and 41.7% for non-PORT groups, respectively. There was no statistical difference between PORT and non-PORT groups with regard to overall survival (p = 0.682). Seven out of 19 (36.8%) patients showed treatment failures, which all happened within 12 months. Although the predominant failures were distant metastasis in PORT group and loco-regional recurrence in non-PORT group, there was no statistically significant difference in locoregional recurrence-free survival (LRRFS) (p = 0.362) or distant metastasis-free survival (DMFS) (p = 0.548). Lymph node metastasis was found to be a significant prognostic factor in predicting poor LRRFS (p = 0.013) and DMFS (p = 0.021), while the International Federation Gynecology and Obstetrics (FIGO) stage (p = 0.043) was associated with LRRFS. Conclusion: Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.207-215
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• 2014

Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.63-67
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• 1995

A retrospective study was carried out of 20 patients with histologically proven invasive carcinoma of the vagina from 1979 to 1993; 17 cases with curative primary radiotherapy and three cases with postoperative radiotherapy. The five and ten year overall survival rates were $79\%$ and $53\%$, respectively. Survival was strongly correlated with stage. Five year survival rates of stage I, stage II, and stage III, IV were $100\%$, $78\%$, and $0\%$, respectively. Eight patients experienced recurrences: five within the irradiated volume, two distant metastasis, and one combined both local and distant metastasis. There was no significant late complication. From these data, radiation is effective in the management of the vaginal cancer patients and optimum treatment modality and total dose recommendation are made.