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Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer (절제 불가능한 식도암의 근치적 항암화학방사선치료의 성적)

  • Noh, O-Kyu;Je, Hyoung-Uk;Kim, Sung-Bae;Lee, Gin-Hyug;Park, Seung-Il;Lee, Sang-Wook;Song, Si-Yeol;Ahn, Seung-Do;Choi, Eun-Kyung;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.195-203
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    • 2008
  • Purpose: To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) ($42{\sim}46\;Gy$) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to $54{\sim}66\;Gy$, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, $9{\sim}12\;Gy/3{\sim}4\;fx$). Two cycles of concurrent FP chemotherapy (5-FU $1,000\;mg/m^2$/day, days $2{\sim}6$, $30{\sim}34$, cisplatin $60\;mg/m^2$/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range $1{\sim}149$ months)). The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range $44.4{\sim}66$) and a total radiation dose, including BT, of 60 Gy (range $44.4{\sim}72$), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29.0% at 2 years and 22.7% at 5 years (median 10.4 months). The response to treatment and N-stage were significant factors affecting overall survival. In addition, total radiation dose (${\geq}50\;Gy$ vs. < 50 Gy), BT and fractionation scheme (qd. vs. bid.) were not significant factors for overall survival and disease-free survival. Conclusion: Survival outcome after definitive chemoradiation therapy in unresectable esophageal cancer was comparable to those of other series. The main failure pattern was local recurrence. Survival rate did not improve with increased radiation dose over 50 Gy or the use of brachytherapy or hyperfractionation.

The Studies on the Physiological Active Substances of Mugwort Components for the Utilization to the Foods of Animal Husbandry (축산식품에 이용하기 위한 쑥 성분중의 생리활성에 관한 연구)

  • Lee, Chi-Ho
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1998.05a
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    • pp.37-54
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    • 1998
  • This study was conducted to investigate the effects of mugwort extracts on the blood ethanol concentration, liver function and low level of cadmuim(Cd) in rats. The effects of mugwort extracts on the blood ethanol concentration was studied in Sprague-Dawley rats (10 weeks old) administered p.o. with 25% ethanol (5g/1kg body weight) and then injected with mugwort extracts (at the 2% levels of daily feed consumption compared with the concentration of catechins level in mugwort extracts) in caudal vein. SD rats were divided into five groups : control group (CON-E, only ethanol and 0.85% saline sol'n treated instead of each extracts), water extracts of mugwort treated to the control (MDW-E), ethanol extracts of mugwort treated to the control (POH-E). And then rat plasma of each time (0hr, 1hr, 2hr, 3hr) was investigated ethanol concentration by gas chromatography. Another rats were measured at the time of 0 and 5hr for the test of GOD(Glutamic Oxaloacetic Transaminase) and GPT(Glutamic Pyruvic Transaminase). Components of each extracts were analyzed by using high performance liquid chromatography. The effects of mugwort extracts on the liver function were studied in culture of rat hepatocyte composed of three groups : Control group and two groups treated with each extracts (1% & 2% MDW, 1% & 2% MOH). Condition of rat hepatocytes cultured for 36hr at $37^{\circ}C$(5% $CO_2$ incubator), number of cells, GOT and GPT activity were investigated. The results obtained were summarized as follows ; 1. Catechins level of mugwort extracts was $8{\sim}10mg/100g(MDW)$, $3{\sim}4mg/100g(MOH)$ 2. The contents of (-)-Epigallocatechin was high in MDW 3. The effects of mugwort extracts on the blood ethanol concentration were as follows; 1) The order in ethanol degradation efficiency was MDW-E > MOH-E > CON-E. 2) Ethanol concentration significantly decreased (p<0.05) in MDW-E and MOH-E. 4. The effects of mugwort extracts on the liver function were as follows; (rat hepatocytes cultured for 36hr at $37^{\circ}C$) 1) Cells condition of MDW-L was better than other groups. 2) The order in number of cells (rat hepatocytes) was 2% MDW-L >1% MDW-L >1% MOH-L > Con-L > 2% MOH-L 5. Cd treatment increased concentrations of hepatic GSH level, and decreased GOT activity in plasma. Therefore, this results suggest that the effects of mugwort extracts may an important rols in degradation ethanol and recovery liver function in body. Also, Mugwort extracts may modify the toxicities of Cd in Cd-treated rats and play an important roles in preventing the liver from various toxicants including Cd in Cd treated rats.

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Effects of Dietary Germanium Biotite in Weaned, Growing and Finishing Pigs (이유자돈, 육성돈 및 비육돈에 있어 게르마늄흑운모의 급여 효과)

  • Kwon, O.S.;Kim, I.H.;Hong, J.W.;Lee, S.H.;Jung, Y.K.;Min, B.J.;Lee, W.B.;Shon, K.S.
    • Journal of Animal Science and Technology
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    • v.45 no.3
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    • pp.355-368
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    • 2003
  • In Exp. 1, this study was conducted to determine the effect of dietary germanium biotite on growth performance and nutrient digestibility in nursery pigs. A total of sixty crossbred pigs (initial body weight 15.09$\pm$0.18kg) were used in this experiment. This study was carried out for 28 days. The five treatments were control (CON; basal diet), GB0.1 (basal diet + germanium biotite 0.1%), GB0.3 (basal diet + germanium biotite 0.3%), GB0.6 (basal diet + germanium biotite 0.6%) and GB1.0 (basal diet + germanium biotite 1.0%). For overall period, ADG and Gain/feed were not significantly different among the treatments. In Exp. 2, a study was conducted to evaluate the effect of germanium biotite as a substitute for antibiotics in growing pigs. A total of fifty five crossbred pigs (initial body weight 32.47$\pm$0.9kg) were used in this experiment. The three treatments were negative control (NC: basal diet without antibiotic), positive control (PC: basal diet + 200ppm CTC) and GB0.3 (basal diet + germanium biotite 0.3%). Pigs fed PC (17%, 385 vs 451 g/d) and GB0.3 (14%, 385 vs 438 g/d) diets grew faster(P<0.05) than pigs fed NC diet. Pigs fed PC and GB0.3 diets resulted higher(P<0.05) ADFI than pigs fed CON diet. However, pigs fed GB0.3 diet had improved gain/feed compared to pigs fed NC diet(P<0.05). Apparent digestibility of DM and N by pigs fed PC and GB0.3 diets were greater(P<0.05) than those by pigs fed NC diet. In Exp. 3, a study was conducted to determine the effect of dietary germanium biotite on growth performance, plasma characteristics, backfat thickness and fecal ammonia gas concentration in finishing pigs. A total of seventy-two finishing pigs (initial body weight 78.56$\pm$1.32kg) were used in this experiment. The treatments included 1) Control (CON; basal diet) 2) GB1.0 (basal diet + germanium biotite 1.0%), 3) GB3.0 (basal diet + germanium biotite 3.0%). Pigs fed GB1.0 diet grew faster than pigs fed CON diet and GB0.3 diet (P<0.05). Also, pigs fed CON diet showed higher(p<0.05) ADFI than pigs fed GB3.0 diet. Pigs fed GB diets had improved gain/feed compared to pigs fed CON diet(P<0.05). Total?and VLDL concentrations in plasma of pigs fed GB diets treatments were significantly decreased compared to those in pig fed CON diet(P<0.05). However, HDL-cholesterol concentration in plasma of the pig was significantly increased compared to those in pigs fed CON diet (P<0.05). Pigs fed CON diet exerted higher(P<0.05) backfat thickness than pigs fed GB1.0 (5.4%, 27.19 vs 25.71mm) and GB3.0 (16.1%, 27.19 vs 22.81mm) diets. Feces from CON treatment were higher in fecal ammonia gas concentration than faces from pigs fed GB1.0 (64.1%, 17.00 vs 6.10mg/kg)and GB3.0 (61.8%, 17.00 vs 6.50mg/kg) treatments(P<0.05). In conclusion, the results suggest that the dietary addition of germanium biotite into diets for nursery pigs did not affect growth performance. The results also suggest the possibility of germanium biotite to replace antibiotic in diets for growing pigs. In finishing pigs, dietary supplementation of germanium biotite was an effective means for improving growth performance and for decreasing Total-and LDL+VLDL-plasma cholesterols, backfat and fecal ammonia gas concentration.

Air Pollution and Its Effects on E.N.T. Field (대기오염과 이비인후과)

  • 박인용
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.6-7
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    • 1972
  • The air pollutants can be classified into the irritant gas and the asphixation gas, and the irritant gas is closely related to the otorhinolaryngological diseases. The common irritant gases are nitrogen oxides, sulfur oxides, hydrogen carbon compounds, and the potent and irritating PAN (peroxy acyl nitrate) which is secondarily liberated from photosynthesis. Those gases adhers to the mucous membrane to result in ulceration and secondary infection due to their potent oxidizing power. 1. Sulfur dioxide gas Sulfur dioxide gas has the typical characteristics of the air pollutants. Because of its high solubility it gets easily absorbed in the respiratory tract, when the symptoms and signs by irritation become manifested initially and later the resistance in the respiratory tract brings central about pulmonary edema and respiratory paralysis of origin. Chronic exposure to the gas leads to rhinitis, pharyngitis, laryngitis, and olfactory or gustatory disturbances. 2. Carbon monoxide Toxicity of carbon monoxide is due to its deprivation of the oxygen carrying capacity of the hemoglobin. The degree of the carbon monoxide intoxication varies according to its concentration and the duration of inhalation. It starts with headache, vertigo, nausea, vomiting and tinnitus, which can progress to respiratory difficulty, muscular laxity, syncope, and coma leading to death. 3. Nitrogen dioxide Nitrogen dioxide causes respiratory disturbances by formation of methemoglobin. In acute poisoning, it can cause pulmonary congestion, pulmonary edema, bronchitis, and pneumonia due to its strong irritation on the eyes and the nose. In chronic poisoning, it causes chronic pulmonary fibrosis and pulmonary edema. 4. Ozone It has offending irritating odor, and causes dryness of na sopharyngolaryngeal mucosa, headache and depressed pulmonary function which may eventually lead to pulmonary congestion or edema. 5. Smog The most outstanding incident of the smog occurred in London from December 5 through 8, 1952, because of which the mortality of the respiratory diseases increased fourfold. The smog was thought to be due to the smoke produced by incomplete combustion and its byproduct the sulfur oxides, and the dust was thought to play the secondary role. In new sense, hazardous is the photochemical smog which is produced by combination of light energy and the hydrocarbons and oxidant in the air. The Yonsei University Institute for Environmental :pollution Research launched a project to determine the relationship between the pollution and the medical, ophthalmological and rhinopharyngological disorders. The students (469) of the "S" Technical School in the most heavily polluted area in Pusan (Uham Dong district) were compared with those (345) of "K" High School in the less polluted area. The investigated group had those with subjective symptoms twice as much as the control group, 22.6% (106) in investigated group and 11.3% (39) in the control group. Among those symptomatic students of the investigated group. There were 29 with respiratory symptoms (29%), 22 with eye symptoms (21%), 50 with stuffy nose and rhinorrhea (47%), and 5 with sore thorat (5%), which revealed that more than half the students (52%) had subjective symptoms of the rhinopharyngological aspects. Physical examination revealed that the investigated group had more number of students with signs than those of the control group by 10%, 180 (38.4%) versus 99 (28.8%). Among the preceding 180 students of the investigated group, there were 8 with eye diseases (44%), 1 with respiratory disease (0.6%), 97 with rhinitis (54%), and 74 with pharyngotonsillitis (41%) which means that 95% of them had rharygoical diseases. The preceding data revealed that the otolaryngological diseases are conspicuously outnumbered in the heavily polluted area, and that there must be very close relationship between the air pollution and the otolaryngological diseases, and the anti-pollution measure is urgently needed.

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