• Title/Summary/Keyword: Radiation Therapy

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Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers (비소세포성 폐암의 방사선치료 성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.72-81
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    • 1994
  • Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns, follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

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Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

Surgical Approaches to the Middle Cranial Base Tumors (중두개와저 종양에 대한 수술적 치료)

  • Kim, Il Seub;Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Cho, Jeung Ki;Kang, Jun Ki;Choi, Chang Rhack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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Feasibility Study of the Radiophotoluminescent Glass Dosimeter for High-energy Electron Beams (유리선량계를 이용한 고에너지 전자선 측정 이용 가능성에 관한 연구)

  • Son, Ki-Hong;Jung, Hai-Jo;Shin, Sang-Hun;Lee, Hyun-Ho;Lee, Sung-Hyun;Kim, Mi-Sook;Ji, Young-Hoon;Kim, Kum-Bae
    • Progress in Medical Physics
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    • v.22 no.1
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    • pp.52-58
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    • 2011
  • Our goal is to assess the suitability of a glass dosimeter on detection of high-energy electron beams for clinical use, especially for radiation therapy. We examined the dosimetric characteristics of glass dosimeters including dose linearity, reproducibility, angular dependence, dose rate dependence, and energy dependence of 5 different electron energy qualities. The GD was irradiated with high-energy electron beams from the medical linear accelerator andgamma rays from a cobalt-60 teletherapy unit. All irradiations were performed in a water phantom. The result of the dose linearity for high-energy electron beams showed well fitted regression line with the coefficient of determination; $R^2$ of 0.999 between 6 and 20 MeV. The reproducibility of GDs exposed to the nominal electron energies 6, 9, 12, 16, and 20 MeV was ${\pm}1.2%$. In terms of the angular dependence to electron beams,GD response differences to the electron beam were within 1.5% for angles ranging from $0^{\circ}$ to $90^{\circ}$ and GD's maximum response differencewas 14% lower at 180o. In the dose rate dependence, measured dose values were normalized to the value obtained from 500 MU/min. The uncertainties of dose rate were measured within ${\pm}1.5%$ except for the value from 100 MU/min. In the evaluation of the energy dependence of the GD at nominal electron energies between 6 and 20 MeV, we obtained lower responses between 1.1% and 4.5% based on cobalt-60 beam. Our results show that GDs have a considerable potentiality for measuring doses delivered by high-energy electron beams.

Measurement of Effective Half-life Using Dual Time I-131 Whole Body Scan in Patients with Differentiated Thyroid Cancer Treated by High Dose Therapy (고용량 방사성옥소 치료를 받은 갑상선분화암 환자에서 Dual Time I-131 Whole Body Scan을 이용한 유효반감기의 측정)

  • Yoon, Jae Sik;Lee, Jae Gon;Lee, Ki Hyun;Lim, Kwang Seok;Choi, Hak Ki;Lee, Sang Mi
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.98-103
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    • 2014
  • Purpose: The effective half life of I-131 is useful to calculate radiation dose, period of hospitalization, and exposure dose of surrounding people from patient. However, it is difficult to measure. This study estimates the effective half life in whole body and thyroid in using of value of residual radioactivity obtained from the early and delay images of Dual time I-131 whole body scan. Also, the correlations between the effective half life and serum creatinine, GFR, and administration dose were investigated in this study. Materials and Methods: The targets were 50 patients administration high dose of I-131 from February to August in 2013, having normal range of serum creatinine and over $30{\mu}IU/mL$ of TSH levels. After administration radioactive I-131, the early scan in the 3rd day and the delay scan in the 5-6th days were performed. To measure the residual radioactivity in the whole body and thyroid, ROI was set and then background radioactivity was corrected to estimate. The effective half life was estimated by calculating the ratio of measured values between the early and delay images. To compare the effective half lives of the whole body and thyroid, it was analyzed by Independent t-test, and each correlation of the effective half life, GFR, serum creatinine, and the dose of administration were analyzed by calculating the pearson's correlation coefficient. All of the analysis were determined to be statistically significant when P<0.05. Results: The effective half life of the whole body was $17.06{\pm}5.50$ hours and of the thyroid was $17.22{\pm}5.41$ hours. The two effective half life did not show significant difference (P=0.887). As the value of GFR was increased, the effective half life of whole body (r=-0.407, P=0.003) and of thyroid (r=-0.473, P=0.001) were significantly decreased; as the value of serum creatinine was increased, the effective half life of whole body (r=0.309, P=0.029) and of thyroid (r=0.371, P=0.008) were significantly increased. In the administration dose, effective half life did not have correlations. Conclusion: The effective half life of I-131 of patients treated for their thyroids were estimated only by using the images of Dual time I-131 whole body scan. Also, the correlations with the effective life, GFR, and serum creatinine were examined. This study might be utilized for a study on optimization for the period of hospitalization of patients treated by high dose of I-131 and on evaluation for internal absorbed dose of MIRD schema in application of the effective half life.

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Clinical Studies on Locally Invasive Thyroid Cancer (국소침범한 갑상선암의 임상적 고찰)

  • Kim Young-Min;Lee Chang-Yun;Yang Kyung-Hun;Rho Young-Soo;Park Young-Min;Lim Hyun-Jun
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.236-243
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    • 1998
  • Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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Preparation and Animal Imaging of $^{153}Sm$-EDTMP as a Bone Seeking Radiopharmaceutical (골친화성 방사성의약품 $^{153}Sm$-EDTMP의 합성과 동물영상)

  • Choi, Tae-Hyun;Kim, Se-Jung;Shin, Byung-Chul;Woo, Kwang-Sun;Chung, Wee-Sup;Choi, Chang-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.44-48
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    • 2005
  • Purpose: Ethylenediamine-tetramethylenephosphonic acid (EDTMP) has widely used chelator for the labeling of bone seeking radiopharmaceuticals complexed with radiometals. $^{153}Sm$ can be produced by the HANARO reactor at the Korea Atomic Energy Research Institute, Taejon, Korea. $^{153}Sm$ has favourable radiation characteristics $T1/2=46.7\;h,\;{\beta}_{max}=0.81\;MeV\;(20%),\;0.71\;MeV\;(49%),\;0.64\;MeV\;(30%)\;and\;{\gamma}=103\;keV\;(30%)$ emission which is suitable for imaging purposes during therapy. We investigated the labeling condition of $^{153}Sm$-EDTMP and imaging of $^{153}Sm$-EDTMP in normal rats. Materials and methods: EDTMP 20 mg was solved in 0.1 mL 2 M NaOH. $^{153}SmCl^3$ was added to EDTMP solution and pH of the reaction mixtures was adjusted to 3 and 12, respectively. Radiochemical purity was determined with paper chromatography. After 30 min. reaction, reaction mixtures were neutralized to pH 7.4, and the stability was estimated upto 120 hrs. Imaging studies of each reaction were perfomed in normal rats (37 MBq/0.1 mL). Results: The labeling yield of $^{153}Sm$-EDTMP was 99%. The stability of pH 8 reaction at 60, 96 and 120 hr was 99%, 95%, 89% and that of pH 12 at 36, 60, 96 and 120 hr was 99%, 95%, 88%, 66%, respectively. The $^{153}Sm$-EDTMP showed constantly higher bone uptake from 2 to 48 hr after injection. Conclusion: $^{153}Sm$-EDTMP, labeled at pH 8 reaction condition, has been stably maintained. Image of $^{153}Sm$-EDTMP at 2, 24, 48 hr after injection, demonstrate that $^{153}Sm$-EDTMP is a good bone seeking radiopharmaceuticals.

Epstein-Barr Virus in Nasal Angiocentric Lymphoma with Malignant Histiocytosis-like Hemophagocytic Syndrome (악성조직구증과 유사한 혈구탐식증후군을 동반한 코의 혈관중심위 림프종과 Epstein-Barr 바이러스의 관련성 연구)

  • Han Ji-Youn;Kim Hoon-Kyo;Moon Han-Lim;Seo Eun-Joo;Kwon Hi-Jeong;Park Yeon-Joon;Min Ki-Ouk;Yoon Sei-Cheol;Kim Min-Shik;Cho Seong-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.9-15
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    • 1997
  • Malignant histiocytosis(MH)-like hemophagocytic syndrome(HS) is a fatal complication of nasal angiocentric lymphoma(AL) and difficult to distinguish from MH. Ten of total 42 patients with nasal AL had HS and 9 of them were initially suspected to have MH. Five patients had HS as initial manifestation, 3 at the time of relapse, and 2 during the clinical remission of lymphoma. Four patients were treated by combination chemotherapy(CHOP) and others had only supportive care. Immunohistochemical study and in situ hybridization were performed on the specimen obtained from 10 patients. The median survival of all patients from HS was 18 days(range 2 - 44 days) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1(CD45RO) and Epstein-Barr virus (EBV) by EBER in situ hybridization. MH-like HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in future.

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