• Radiation Oncology Journal
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• v.16 no.3
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• pp.351-355
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• 1998

Cutaneous angiosarcomas are uncommon malignancies which account about 1$\%$ of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed Photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed to the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7$\%$ of the prescribed dose by TLD readings.

• 대한두경부종양학회:학술대회논문집
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• 2004.11a
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• pp.258-258
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• 2004

• Radiation Oncology Journal
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• v.16 no.1
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• pp.35-41
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• 1998

Purpose : To investigate the role of adjuvant chemoradiotherapy in adenocarcinoma of the rectum, we retrospectively compared the treatment results between postoperative adjuvant radiotherapy alone and combined chemoradiotherapy. Material and Methods : From October 1989 to May 1994, 141 patients with rectal carcinoma were treated by postoperative adjuvant therapy in Yonsei Cancer Center. Sixty eight patients were treated by radiation therapy alone. Seventy three patients were treated by combined chemoradiotherapy. Radiation therapy was delivered with 10 MV linear accelerator, 180cGy fraction/5 days per week. Total radiation doses were 5400cGy in the postoperative radiotherapy alone group. Three to twelve cycles of Fluorouracil(mean dose $393.9mg/m^2$) with Leucovorin($20mg/m^2$) and 5040cGy of radiation were delivered in the combined chemoradiotherapy group. Third and 4th cycle of chemotherapy were administrated during the radiation treatment in the combined group. The median follow up was 38 months with a range of 3 to 81 months. Results : The 5 year overall survival rate of radiation alone group and combined group were $60.1\%$ and $66.3\%$, respectively. The 5 year disease free survival rate of radiation aione group and combined group were $54.2\%$ and $65.5\%$, respectively There was no significant difference of overall survival and disease free survival between RT alone group and combined group(p<0.05). But the 5 year Local failure free survival rate of combined group was significantly better than radiotherapy alone group($05.8\%\;vs.\;50.3\%.\;p=0.04$). Conclusion : There was no significant difference in overall survival, disease free survival, and distant metastasis free survival between postoperative adjuvant radiotheray alone group and combinded chemoradiotherapy group. Only the Local failure free survival rate was superior in the combined treatment group. These results confirm the radiosensitizing effect of the chemotherapeutic agent in the combined chemoradiotherapy treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.102-106
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• 2013

The cure rates for early stage laryngeal cancer are similar between laser cordectomy and radiation therapy. As well as the survival outcome, one of the main measures of success in treatment of early laryngeal cancer is voice outcome. Many studies have demonstrated that laser cordectomy and radiation therapy to be equivalent with regard to vocal outcome, whereas others favor radiation. Although such as somewhat disadvantages of voice outcome, laser cordectomy still remains a valid option. Since the patients who treated with laser may benefit from additional phonosurgery to improve postoperative vocal outcome. In this article, we reviewed the techniques of phonosurgery which can be used for laryngeal reconstruction after laser cordectomy. The indications for using each technique are discussed, with particular attention paid to functional outcomes following these reconstructive efforts.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.108-113
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• 2017

Craniopharyngiomas exhibiting histologic malignancy are extremely rare. Herein, we report the case of a 26-year-old male patient who underwent suprasellar mass excision via an interhemispheric transcallosal approach. Histopathological examination indicated that the craniopharyngioma was of the adamantinomatous subtype. The patient received postoperative medical treatment for endocrine dysfunction and diabetes mellitus without radiation treatment. Two years after the operation, he presented with progressive visual disturbance and altered mentality. Magnetic resonance imaging revealed a huge mass in the suprasellar cistern and third ventricle. He underwent a second operation via the same approach. The histopathological examination showed an adamantinomatous craniopharyngioma with sheets of solid proliferation in a spindled pattern, indicating malignant transformation. Malignant transformation of craniopharyngioma in the absence of radiation therapy has been reported in only five cases, including this one. We present a case of malignant transformation of craniopharyngioma with a brief review of relevant literature.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.297-303
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• 1997

Purpose : To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. Methods and Materials : The study involved a retrospective review of out-come in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median : 97 months). Seventeen were men and 10 were women. The numbers of functioning and nonfunctioning pituitary adenorna were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy (median : 5040cGy) were deliverd over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. Results: For radiation therapy alone, the 5YSR was 100% and progression free survival rate was 85.8%, The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy. the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose. radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statisticaIty significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluabie patients with hyperprolactinoma achived normalization in 4 and decrement in S patients. Only 2 patients developed mild degree of Panhypopituitarism. Conclusion: The radiotherapy appears to be effective in controiling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherauy was comparable. There was a trend toward high recurrence rate in Patients with nonfunctioning or prolactin secretion tumor and larger radiation field sizes.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.127-134
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• 2012

Objective: To analyze the prognostic factors thought to be related with survival time after a spinal metastasis operation. Methods: We retrospectively analyzed 217 patients who underwent spinal metastasis operations in our hospital from 2001 to 2009. Hematological malignancies, such as multiple myeloma and lymphoma, were excluded. The factors thought to be related with postoperative survival time were gender, age (below 55, above 56), primary tumor growth rate (slow, moderate, rapid group), spinal location (cervical, thoracic, and lumbo-sacral spine), the timing of radiation therapy (preoperative, postoperative, no radiation), operation type (decompressive laminectomy with or without posterior fixation, corpectomy with anterior fusion, corpectomy with posterior fixation), preoperative systemic condition (below 5 points, above 6 points classified by Tomita scoring), pre- and postoperative ambulatory function (ambulatory, non-ambulatory), number of spinal metastases (single, multiple), time to spinal metastasis from the primary cancer diagnosis (below 21 months, above 22 months), and postoperative complication. Results: The study cohort mean age at the time of surgery was 55.5 years. The median survival time after spinal operation and spinal metastasis diagnosis were 6.0 and 9.0 months. In univariate analysis, factors such as gender, primary tumor growth rate, preoperative systemic condition, and preoperative and postoperative ambulatory status were shown to be related to postoperative survival. In multivariate analysis, statistically significant factors were preoperative systemic condition (p=0.048) and postoperative ambulatory status (p<0.001). The other factors had no statistical significance. Conclusion: The factors predictive for postoperative survival time should be considered in the surgery of spinal metastasis patients.

• Radiation Oncology Journal
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• v.3 no.1
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• pp.35-39
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• 1985

The details of 5 patients with exramedullary plasmacytoma of the head and neck were reviewed for the period from 1970 to 1984. All patients were presented with localized disease at the time of diagnosis. Out of 5 patients the one treated with surgery alone developed local recurrence and disseminated disease. He died at 3 years and 6 months. Rest of the four were alive with no evidence of the disease. Two patients were treated with radiation therapy alone while other two were treated with surgery and postoperative radiation therapy. Curative radiation therapy is recommanded after the diagnosis is established by biopsy examination.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.472-478
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• 2001

Objectives : The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopharyngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods : The extent of surgical removal was divided into four categories ; GTR(gross total removal), RSTR(radical subtotal removal), STR(subtotal removal),and PR(partial removal). The median follow-up period was 50 months(4-198). CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results : Visual disturbance was the most common presentation, which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively, 82 during the immediate postoperative period, and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196). The median progression-free survival(PFS) time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71%) was significantly higher than that of STR or PR group(30%)(p=0.01). Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002). However, there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group. Conclusion : Visual disturbance can be improved by early diagnosis and surgical decompression. GTR or RSTR in selected patients is considered a proper surgical strategy. Post-operative radiation therapy for residual tumors must be considered, although the ideal timing of radiation therapy is to be determined.

• Radiation Oncology Journal
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• v.29 no.4
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• pp.277-282
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• 2011

Purpose: This study was performed to evaluate the change in the lumpectomy cavity volumes before and after whole breast radiation therapy (WBRT) and to identify factors associated with the change of volume. Materials and Methods: From September 2009 to April 2010, the computed tomography (CT) simulation data from 70 patients obtained before and after WBRT was evaluated. The lumpectomy cavity volumes were contoured based on surgical clips, seroma, and postoperative changes. Significant differences in the data from pre-WBRT CT and post-WBRT CT were assessed. Multiple variables were examined for correlation with volume reduction in the lumpectomy cavity. Results: The mean and median volume reduction in the lumpectomy cavity after WBRT were 17.6 $cm^3$ and 16.1 $cm^3$, respectively with the statistical significance (p < 0.001). The volume reduction in the lumpectomy cavity was inversely correlated with time from surgery to radiation therapy (R = 0.390). The presence of seroma was significantly associated with a volumetric change in the lumpectomy cavity after WBRT (p = 0.011). Conclusion: The volume of lumpectomy cavity reduced significantly after WBRT. As the time from surgery to the start ot WBRT increased, the volume reduction in the lumpectomy cavity during WBRT decreased. A strong correlation was observed between the presence of seroma and the reduced volume. To ensure appropriate coverage and to limit normal tissue exposure during boost irradiation in patients who has seroma at the time of starting WBRT, repeating CT simulation at boost planning is suggested.