• 대한두경부종양학회지
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• 제40권1호
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• pp.7-13
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• 2024

The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.

• Journal of Hospice and Palliative Care
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• 제10권2호
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• pp.74-77
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• 2007

목적: 호스피스 병동에 입원한 암환자에서 얼마나 고식적 방사선치료가 이용되는지, 방사선치료를 받는 환자중 끝마치지 못하는 환자는 얼마나 되는지, 그 이유는 무엇인지 알아보고자 하였다. 방법: 2003년 11월부터 2005년 10월까지 2년간 성 빈센트 병원 호스피스 병동에 입원한 환자 404명중 고식적 방사선치료를 시작한 33명에 대해 환자의 일반 특징과 방사선치료를 끝마치지 못한 이유와 그 방사선조사량에 대해 후향적으로 조사하였다. 결과: 404명 중 33명(8.2%)이 고식적 방사선치료를 시작하였다. 방사선치료의 주 적응증은 뇌전이, 동통성 골전이, 동통성 종양과 폐쇄성 호흡곤란 순이었다. 방사선 치료를 시작한 환자 중 45%는 방사선치료를 끝마치지 못했고 20%는 계획한 방사선 조사량의 1/3 이하만을 투여받았다. 치료를 마치지 못한 이유는 불량한 전신 상태가 대부분이었다. 결론: 성빈센트병원 호스피스 병동에서 고식적 방사선치료가 진행성 암 환자에게 많이 이용되고 있으나 마치지 못하는 경우가 많았다. 적절한 환자의 선별기준과 방사선 치료기간의 단축을 통해 더 많은 환자가 방사선 치료로 증상 완화에 도움이 될 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1255-1258
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• 2015

Background: Locally advanced head and neck cancer is generally incurable and has a short survival rate. This study aimed to evaluate symptom relief, disease response, and acute toxicity after palliative hypo-fractionated radiotherapy and long-term survival in affected patients. Materials and Methods: Between January 2011 to December 2011, 80 patients who were histopathologically diagnosed as having stage III or stage IV head and neck squamous cell carcinoma based on Eastern Cooperative Oncology Group (ECOG) performance status 1-3, were offered palliative radiotherapy (20 Gy/5Fr/5 Days). Later these patients were evaluated on 30th day after completion of treatment for disease response based on World Health Organisation (WHO) criteria and palliation of symptoms using symptomatic response grading and acute toxicities by the Radiation Therapy Oncology Group (RTOG). Many patients were given post radiation therapy (RT) palliative chemotherapy for appropriate palliative care and a few patients were selected for further curative RT. The overall survival was also evaluated among this group of patients with last follow up date of 1st May, 2014. Results: The most common presenting complaint was pain followed by dysphagia. Most patients (60-70%) had appreciable relief in their presenting symptoms. A good response was observed in the majority following palliative RT; a few patients had progressive disease and some had stable and regressed disease. None of the patients experienced radiation toxicity that required hospital admission. Almost all showed grade one and two acute skin and mucosal toxicity one month after completion of treatment. The mean survival days for patients given only hypofractionated palliative RT was 307 days, those with post palliative RT and palliative chemotherapy was 390 days and patients who went on to receive further palliative RT and curative RT dose had significantly overall survival of 582 days. Conclusions: Advanced head and neck cancer should be identified for suitable palliative hypofractionated radiotherapy to achieve acceptable symptom relief in a great proportion of patients and should be followed by palliative chemotherapy or curative RT in suitable cases for long-term symptom-free survival.

• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.256-261
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• 2016

방사선치료는 암과 관련된 증상을 완화시키는 목적으로 자주 사용되고 있다. 정확하고 안전한 방사선치료를 받기 위해서는 방사선이 나오는 동안 치료 테이블 위에 가만히 누워 있어야 한다. 그러나 일부 환자는 기질적인 문제 외에 심리적인 문제에서 기인한 증상으로 인해 가만히 누워 있지 못한다. 이 논문에서는 모의치료 단계 전부터 치료 테이블에 바로 누워 있지 못했지만 별 다른 장소에서의 교육 참여 없이 침상에서 쉽게 할 수 있는 이완요법을 배워 방사선치료 하는 동안 가만히 누워 있는 게 가능했던 두 명의 말기암환자 사례를 보고하고자 한다.

• Radiation Oncology Journal
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• 제16권3호
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• pp.347-350
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• 1998

목적 : 본 연구는 계획된 방사선치료의 과정 도중에 방사선치료를 완료하지 못하는 환자들의 빈도를 조사하고 그 이유를 분석하고자 하였다. 대상 및 방법 :삼성서울병원 치료방사선과에서 방사선치료를 받은 환자 중에서 1996년 4월부터 1997년 5월까지 방사선치료를 시행 받은 1,100명의 환자들을 대상으로 하였다. 대상 환자들 중에서 최초 계획 방사선량의 95$\%$ 이하를 받은 경우를 불완전 방사선치료로 정의하여 그 빈도와 이유를 조사하였다. 결과 : 불완전 방사선치료의 빈도는 1,100명 중 128명으로 12$\%$였다. 불완전 방사선치료 환자들의 운동수행능력은 전체 환자들에 비하여 불량하였으며, 방사선치료의 목적은 고식적 목적이 많았다. 불완전 방사선치료의 가장 흔한 이유는 환자의 거부였으며 이는 주로 환자의 방사선치료에 대한 불신과 경제적 부담 때문이었다. 결론 : 불완전 방사선치료의 빈도를 줄이기 위해서는 방사선치료의 임상적 적응 여부는 물론 환자의 사회 경제적인 여건을 잘 고려하여 방사선치료의 대상 환자를 선정하는 것이 요망되며 이는 특히 고식적 방사선치료의 경우에 더욱 중요하다고 할 수 있겠다.

• Radiation Oncology Journal
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• 제2권1호
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• pp.81-86
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• 1984

The preliminary analysis has been made of 63 Patients who were treated in the Department of Radiation Therapy at Korea University Hospital for the lung cancer from April 1981 to December 1983. The patients were treated via Co-60 teletherapy unit and the doses were 5,400 rad/ 6 week for the curative, $3,600\~4,500\;rad/2\;1/2\;\~3$ week for the Palliative treatment. Thirty two $(32/63=51\%)$ patients have been for curative, $25/63 (40\%)$ were for Palliative, and $6/63 (9\%)$ were for post-operative radiation. A post-radiation treatment, $28/63 (53\%)$ were able to follow from 2 months to 3 yrs. During the follow up, chest X-rays and/or CT scans were taken and $22/27 (81.4\%)$ of patients were responded more than $50\%$ of tumor regression one month following completion of radiation.

• 대한핵의학회지
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• 제32권5호
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• pp.436-442
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• 1998

Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.207-215
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• 2014

암의 다발성 뼈 전이는 폐암, 유방암, 전립선암, 신장암 등 다양한 암에서 흔히 관찰된다. 뼈 전이는 뼈에 발생한 이차적인 암으로 통증, 골절, 그리고 체중을 지지하는 뼈의 불안정성을 유발할 수 있어 신체활동과 삶의 질을 저하시킨다. 뼈 전이 치료 시 병리조직소견, 환자의 전신 상태, 침범 부위, 그리고 환자의 신경학적 소견등 다양한 요인을 고려하여 진통제, 수술, 항암화학요법 그리고 방사선 치료 등을 시행하게 된다. 외부 방사선 치료는 전통적으로 국소 뼈 전이로 인한 통증의 치료에 이용되어왔지만 특히 유방암이나 전립선암의 다발성 골형성 뼈 전이의 경우 $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ 등의 방사성동위원소를 이용한 치료가 시행되고 있는데, 약제 투여의 간편함, 낮은 부작용, 방사능 피폭위험에서의 안전성, 높은 치료 반응 등 다양한 장점을 가진 치료로 임상에서의 유용성이 점차 증가되고 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4637-4642
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• 2016

Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

• Radiation Oncology Journal
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• 제12권2호
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• pp.201-207
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• 1994

To objectively compare the response of the palliative radiotherapy in bone metastatic patients which decreases pain and prevents pathologic fractures, we introduced and applied the RTOG pain and narcotic measure system. From Oct in 1991 to July in 1993, thirty-two patients with painful bone metastases, 17 of them were solitary lesions and others were multiple lesions, were treated with mainly 6 MV photon otherwise 15 MV photon. Radiation doses to bone metastatic sites ranged about from 2000 to 4600cGy. Responses of radiation therapy were compared with days of pre-RT, RT finish, 3, 6, 9 months after the start of RT and solitary versus multiple lesions and follow up scores according to the RTOG measure system. Survival analysis was done. Pain and narcotic score of the entire patients were 7.3, 7.8 at the pre-RT period and 2.6, 3.9 at the immediate or 2 weeks after RT, which was $64{\%},\;50{\%}$ decrement compared with the pre-RT score, Pain scores of 3, 6 and 9 months after the beginning of irradiation were 3.6, 3.7 and 3.3. The best response found in the breast and prostate primaries was $84\%,\;78\%$ decrement of pain score as compared with pre-RT score(statistically insignificant). Median survival was 5.5 months and mean survival was 5 months. We conclude that the RTOG pain and narcotic measure system is relatively effective scale in the comparison of before and after palliative irradiation to the painful bone metastatic sites but more detailed parameters will be required in the narcotic scoring system. More aggressive but less or similiar toxic radiotherapy is needed in the patients having relatively long life expected time.