• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.463-466
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• 2016

Glioblastoma (GBM) is the most common and aggressive type of primary brain neoplasm. The current standard therapy for GBM consists of maximal surgical resection within safe limits, followed by radiation therapy (RT) and chemotherapy with temozolomide. Despite advances in treatment, the prognosis of GBM remains poor. Epileptic seizure is one of the most common symptoms in patients with GBM. Valproic acid (VPA), a histone deacetylase inhibitor, is often used as an anti-epileptic drug in patients with brain neoplasms due to its effectiveness and low toxicity profile. Several in vivo and in vitro studies have indicated that VPA has radiosensitizing effects for gliomas and radioprotective influence on normal brain tissue or hippocampal neurons. The results of several retrospective studies have also indicated potential benefit to improve survival of patients with GBM. Moreover, the promising treatment results of a phase 2 trial of concurrent radiation therapy, temozolomide, and VPA for patients with GBM have been recently reported. The use of VPA in patients with GBM has thus recently receiving more attention. In this article, we review the role of VPA in radiation therapy for GBM, focusing on the clinical evidence.

• Radiation Oncology Journal
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• 제34권3호
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• pp.216-222
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• 2016

Purpose: To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. Materials and Methods: We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169). Results: Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087). Conclusion: RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.

• Radiation Oncology Journal
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• 제11권2호
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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.

• Journal of Radiation Protection and Research
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• 제37권1호
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• pp.1-9
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• 2012

2011년 3월 11일 발생한 일본 후쿠시마 원전 사고 1주년을 계기로 한국 국민의 방사선 인식도를 조사하고자 하였다. 연구 방법론적 설계는 양적 조사로 하고, 빈도 분석을 하였다. 분석 대상은 전국에서 무작위로 추출한 일반인으로부터 수거한 설문 응답지 2754부이다. 연구 도구는 설문지이며, 직접 배포한 뒤 수거하였다. 설문은 40문항으로 구성하였으며, 하위영역별 크론바하 알파(Cronbach's ${\alpha}$) 계수는 '방사선의 자아인식' 0.620, '방사선의 위험' 0.830, '방사선의 편익' 0.781, '방사선의 관리' 0.685, '방사선의 정보원' 0.831, '후쿠시마 사고의 영향 정도' 0.763으로 모두 높게 나타났다. 설문 분석 결과 응답자의 방사선 개념에 대한 지식은 100점 만점 환산 평균 69.5점이며, 이는 자신들이 '방사선에 대해 잘 알고 있다'고 응답한 비율 53.7%, '보통 알고 있다'는 응답이 37.4%인 것과는 상당히 다른 결과다. '방사선이 위험하다'고 느끼는 중요 원인 중 하나는 '방사선에 노출되면 지금은 아니더라도 다음 세대에 문제가 생길 수 있기 때문'(66.1%)으로 분석됐다. 방사선에 대한 정부 발표를 믿지 못하는 응답자가 41%에 이르러 정부에 대한 불신이 높았다. 후쿠시마 원전 사고 때문에 원전을 운영하지 말아야 한다는 쪽으로 생각을 바꾼 응답자도 39.5%나 됐다. 본 연구는 후쿠시마 원전 사고 이후 방사선에 대한 한국 국민의 인식을 처음 조사한 것으로 그 의의가 크다. 향후 방사선에 대한 정부의 정책 수립에도 크게 기여할 것으로 기대된다.

• 대한두경부종양학회지
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• 제18권1호
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• pp.30-35
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• 2002

Objective: To determine the effectiveness and toxicity of chemoradiation therapy in nasopharyngeal carcinoma by comparing with radiation therapy alone. Materials and Methods: Between October 1989 and July 2000, One hundred eleven patients with newly diagnosed and histologically proven nasopharyngeal carcinoma treated in Department of Radiation Oncology, Asan Medical Center were retrospectively reviewed. Forty-five patients were treated with radiation therapy alone (Group I) and 66 patients were treated with radiation therapy and concurrent cisplatin (Group II). Cisplatin was administered once a week, on the first day of each successive week of treatment, starting on day 1 of radiation therapy and given as a intravenous bolus at a dose of $20mg/m^2$ of body-surface area. Radiation therapy was given in doses of 1.8Gy, once a day, 5 days per week with 4MV or 6 MV photons. Initial field was received a total of 60Gy and a primary tumor and enlarged lymph nodes were boosted with an high dose intracavitory brachytherapy and 3D conformal therapy. Results: The complete response rate was 86.7% in Group I, and was 90.9% in Group II. The 5 year overall survival rate for Group I was 60% and for Group II was 45% (p=0.2520). The 5 year disease free survival rate was 52% versus 45%, respectively (p=0.7507). The median follow up was 44 months versus 34 months, respectively. Conclusion: Analysis of the III patients showed no significant difference in disease free survival and overall survival in two treatment group. This retrospective analysis did not demonstrate benefit with concurrent chemoradiation using cisplatin at a dose of $20mg/m^2$ of body-surface area in treatment result than radiation alone.

• Journal of Radiation Protection and Research
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• 제24권2호
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• pp.65-72
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• 1999

가축의 사료로서 오염 농작물의 이용에 대한 최적기간 결정 방법론을 비용-편익 분석법에 근거하여 모델링하였다. 많은 농작물의 왕성한 성장시기인 8월 15일을 방사성물질의 침적시점 (사고시점)으로 가정하여 잡식성 가축인 돼지에 대해 적용한 결과를 논의하였다. 또한 사료로서 오염 농작물의 이용에 대한 상대적 비용 효과를 고찰하기 위해 오염 농작물을 바로 폐기시켰을 경우와 순이득을 비교 논의하였다. 침적후 농작물내 방사성물질의 농도는 동적섭식경로모델 DYNACON으로부터 예측되었다. 대응행위에 의한 순이득은 피폭선량의 금전가와 수행에 소요되는 금전적 비용에 의해 정량적으로 평가하였다. 오염 농작물을 사료로 이용함에 대한 순이득은 핵종, 농작물의 공급분율, 공급기간 등에 따라 다양하게 나타났다. 사료로서 오염 농작물의 이용은 $^{137}Cs$ 침적에 비해 $^{90}Sr$ 또는 $^{131}I$ 침적의 경우에 비용측면에서 보다 효과적이었다.

• 환경생물
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• 제21권4호
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• pp.384-391
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• 2003

The induction of chromosome aberrations in Hordeum vulgare germs after irradiation is studied for the dose range of 10 to 1,000 mGy. The relationship between the frequency of aberrant cells and the absorbed dose is shown to be non -linear and has a dose-independent plateau within the range of 56-467 mGy where the level of cytogenetic damage is statistically significantly distinguished from the spontaneous level. The comparison of the goodness of the experimental data fitting with mathematical models of different complexities, using the most common quantitative criteria, demonstrates the benefit of the piecewise linear model over the linear and polynomial ones in approximating the cytogenetical disturbance frequency. The results of our study support the conclusion about indirect mechanism of chromosome aberrations induced by low doses or dose rates mutagenesis.

• Journal of Radiation Protection and Research
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• 제18권1호
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• pp.71-82
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• 1993

원자력 발전소 작업과의 피폭량은 발전소의 안전 운영에 관한 척도일 뿐 아니라, 일반 대중이 원자력 발전의 안전을 평가하는 기본 요소이다. 또한, 최근 ICRP 60에 의한 개인 피폭선량 한도의 하향조정 권고는 지속적인 피폭저감에의 노력을 요구하고 있다. 본 논문에서는 작업자의 피폭저감에 관한 대안선정시 사용할 수 있는 최적화 기법을 제시하고 실제로 원전 운영자예 의해 제안된 대안들을 검토하는데 이 기법을 적용하여 보았다. 분석과정에서 기본분석이외에 가변 경제변수를 고려한 민감도 분석을 통해 계산 결과의 불확실성을 보완하였다. 분석결과를 살펴보면, 먼저 비용-이득 분석에서는 '증기 발생기 Nozzle Dam 및 Torquing Machine'이 총 이득면에서 가장 우수한 것으로 평가되었고, 다속성 효용 분석의 경우 'Co-No Seal 조임장치'가 가장 높은 효용을 가진 것으로 나타나 약간의 차이를 보이고 있다. 따라서, 최적화 기법의 적용시에는 두 가지이상의 정량적 기법을 보완적으로 사용하고, 정성적 인자도 충분히 고려하는 것이 필요하다.

• Radiation Oncology Journal
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• 제31권1호
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• pp.1-11
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• 2013

Purpose: Compared to conventional radiotherapy (RT), intensity-modulated radiotherapy (IMRT) significantly reduces the rate of treatment-induced late toxicities in head and neck cancer. However, a clear survival benefit of IMRT over conventional RT has not yet been shown. This study is among the first comparative study to compare the survival rates between conventional RT and helical tomotherapy in head and neck cancer. Materials and Methods: From January 2008 to November 2011, 37 patients received conventional RT and 30 patients received helical tomotherapy for management of head and neck cancer. We retrospectively compared the survival rates between patients treated with conventional RT and helical tomotherapy, and analyzed the prognostic factors for survival. Results: The 1- and 2-year locoregional recurrence-free survival rates were 61.2% and 58.1% for the conventional RT group, 89.3% and 80.3% for the helical tomotherapy group, respectively. The locoregional recurrence-free survival rates of the helical tomotherapy group were significantly higher than conventional RT group (p = 0.029). There were no significant differences in the overall and distant metastasis-free survival between the two groups. RT technique, tumor stage, and RT duration were significant prognostic factors for locoregional recurrence-free survival. Conclusion: This study showed the locoregional recurrence-free survival benefits of helical tomotherapy in the treatment of head and neck cancers.

• Radiation Oncology Journal
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• 제36권4호
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• pp.304-316
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• 2018

Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.