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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.

Analysis of Vegetation Structures and Vegetation-Environment Relationships of Medicinal on Short-term Income Forest Products, in Korea - Cudrania tricuspidata (Carrière) Bureau ex Lavallèe·Sorbus commixta Hedl.·Hovenia dulcis Thunb. - (임산물 약용수의 자생지 식생 구조와 환경과의 상관관계 분석 - 꾸지뽕나무·마가목·헛개나무 -)

  • Hyoun-Sook Kim;Sang-Myong Lee;Kil-Nam Kang;Seog-Gu Son;Si-Chul Ryu;Kyung-Joon Lee;Jong-Hoon Lee;Byung-Seol Lee;Joong-Ku Lee
    • Korean Journal of Environment and Ecology
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    • v.37 no.5
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    • pp.347-366
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    • 2023
  • In the present study, the vegetation was classified using the phytosociological method and canonical-correlation analysis (CCA) was implemented to analyze correlation between community structure and environmental factors in the natural habitats of forest byproducts, especially medicinal plants, such as Cudrania tricuspidata, Sorbus commixta, and Hovenia dulcis, in 2021-2022 to provide primary ecological data to establish environmental conditions for wild vegetable cultivation. A total of 11 plots in five regions, 8 plots in three regions, and 17 plots in 5 regions were selected for the natural habitats of C. tricuspidata in southern Korea, S. commixta in high mountains, and H. dulcis in valleys of central Korea, respectively. The importance value in each community was respectively analyzed as follows, in C. tricuspidata community, the importance value of C. tricuspidata (61.10) was the highest, followed by Celtis sinensis, Pinus thunbergii, Neolitsea aciculata, Styrax japonica, Carpinus coreana, Quercus serrata, and Q. acutissima. In Sorbus commixta community, Q. mongolica (57.21) was the highest, followed by, S. commixta (42.58), Betula ermani, Tilia amurensis, A. pseudosieboldianum, A. tschonoskii var. rubripes, Cornus controversa, Magnolia sieboldii, and Taxus cuspidata. In H. dulcis community, H. dulcis (64.58) was the highest, followed by Zelkova serrata, Cornus controversa, A. mono, Q. serrata, C. cordata, and Juglans mandshurica. As the result of the analysis on DBH of the major species having the high importance value, in C. tricuspidata community, C. tricuspidata, C. sinensis, Neolitsea aciculata, and C. coreana show the density of normal distribution, so the dominant status of these species is likely to continue. In S. commixta community, S. commixta show the density of reverse J-shaped curve, so the dominant status of these species is likely to be stable, and Q. mongolica, B. ermani and T. amurensis, show the density of normal distribution, so the dominant status of these species is likely to continue. In H. dulcis community, C. cordata, and J. mandshurica show the density of reverse J-shaped curve, so the dominant status of these species is likely to be stable, and H. dulcis, Z. serrata, C. controversa and A. mono had a formality distribution, suggesting a continuous domination of these species over the other species for the time being. The results of CCA ordination analysis using 11 environmental factors and 30 communities of three taxa classified by TWINSPAN analysis revealed that the altitude showed the strongest correlation with the vegetation. C. tricuspidata community was distributed on the moderate and gentle northeastern slope at low altitude with the highest pH, C.E.C, Ca2+, and Mg2 and various P2O5, whereas S. commixta community was distributed on the steep slope at high altitude with the highest O.M and T-N and lower P2O5, Ca2+, Mg2+, C.E.C and pH, which is the opposite tendency of the environment of C. tricuspidata community. H. dulcis community was distributed on the gentle northern slope at lower altitude with an average pH, O.M, T-N, Ca2+, Mg2+, and C.E.C, except higher P2O5.

Dynamical Study on the Blasting with One-Free-Face to Utilize AN-FO Explosives (초유폭약류(硝油爆藥類)를 활용(活用)한 단일자유면발파(單一自由面發破)의 역학적(力學的) 연구(硏究))

  • Huh, Ginn
    • Economic and Environmental Geology
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    • v.5 no.4
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    • pp.187-209
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    • 1972
  • Drilling position is one of the most important factors affecting on the blasting effects. There has been many reports on several blasting factors of burn-cut by Messrs. Brown and Cook, but in this study the author tried to compare drilling positions of burn-cut to pyramid-cut, and also to correlate burn-cut effects of drilling patterns, not being dealt by Prof. Ito in his theory, which emphasized on dynamical stress analysis between explosion and free face. According to former theories, there break out additional tensile stress reflected at the free face supplemented to primary compressive stress on the blasting with one-free-face. But with these experimented new drilling patterns of burn-cut, more free faces and nearer distance of each drilling holes make blasting effects greater than any other methods. To promote the above explosive effect rationary, it has to be considered two important categories under-mentioned. First, unloaded hole in the key holes should be drilled in wider diameter possibly so that it breaks out greater stress relief. Second, key holes possibly should have closer distances each other to result clean blasting. These two important factors derived from experiments with, theories of that the larger the dia of the unloaded hole, it can be allowed wider secondary free faces and closes distances of each holes make more developed stress relief, between loaded and unloaded holes. It was suggested that most ideal distance between holes is about 4 clearance in U. S. A., but the author, according to the experiments, it results that the less distance allow, the more effective blasting with increased broken rock volume and longer drifted length can be accomplished. Developed large hole burn-cut method aimed to increase drifting length technically under the above considerations, and progressive success resulted to achieve maximum 7 blasting cycles per day with 3.1m drifting length per cycle. This achievement originated high-speed-drifting works, and it was also proven that application of Metallic AN-FO on large hole burn-cut method overcomes resistance of one-free-face. AN-FO which was favored with low price and safety handling is the mixture of the fertilizer or industrial Ammonium-Nitrate and fuel oil, and it is also experienced that it shows insensible property before the initiation, but once it is initiated by the booster, it has equal explosive power of Ammonium Nitrate Explosives (ANE). There was many reports about AN-FO. On AN-FO mixing ratio, according to these experiments, prowdered AN-FO, 93.5 : 6.5 and prilled AN-FO 94 : 6, are the best ratios. Detonation, shock, and friction sensities are all more insensitive than any other explosives. Residual gas is not toxic, too. On initation and propagation of the detonation test, prilled AN-FO is more effective than powered AN-FO. AN-FO has the best explosion power at 7 days elapsed after it has mixed. While AN-FO was used at open pit in past years prior to other conditions, the author developed new improved explosives, Metallic AN-FO and Underwater explosive, based on the experiments of these fundmental characteristics by study on its usage utilizing AN-FO. Metallic AN-FO is the mixture of AN-FO and Al, Fe-Si powder, and Underwater explosive is made from usual explosive and AN-FO. The explanations about them are described in the other paper. In this study, it is confirmed that the blasting effects of utilizing AN-FO explosives are very good.

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