• Radiation Oncology Journal
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• 제37권2호
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• pp.67-72
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• 2019

Concurrent chemoradiation therapy (CCRT) has played the most important and central role in the definitive therapy for the patients with locoregionally advanced stage nasopharynx cancer. The addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) to CCRT have been widely accepted with the rationale of improving distant control in the clinical practices. This review article investigated the role of IC and AC based on 11 recent meta-analysis publications, and found that the clinical benefits obtained by the additional IC or AC to CCRT, at the cost of the increased risks of more frequent and more severe side effects, seemed not big enough. More intervention is not always better, however, less seems frequently good enough. The author would speculate that 'less is more' and would advocate CCRT alone as the current standard.

• Radiation Oncology Journal
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• 제17권4호
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• pp.275-280
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• 1999

목 적 :국소적으로 진행된 비인두암환자에서 선행보조 항암화학요법의 실행 용이성과 부작용의 정도를 평가한다. 대상 및 방법 : 77명의 조직학적으로 비인두암으로 확진 되고 이전에 치료를 받은 적이 없는 진행된 병기의 비인두암 환자들이 1984년부터 1996년까지 서울대학교병원에서 선행보조 항암화학요법과 방사선치료를 시행 받았다. 환자군의 병기분포는 다음과 같다. 1992년 AJCC 분류법에 따라 제 3 병기에 속하는 환자가 2명이었고 제 4병기에 속하는 환자가 75명이었다. 방사선치료 시행 전에 선행보조 항암화학요법으로 66명의 환자가 5-FU와 Cisplatin의 정맥 내 투여를 시행 받았고, 11명의 환자가 5-FU와 Carboplatin의 정맥 내 투여를 시행 받았다. 생존환자의 중앙추적기간은 44개월이었다. 결 과 :항암화학요법에의 반응율은 87$\%$였다. 항암화학요법의 부작용은 심하지 않았다. 3명의 환자만이 3도의 부작용을 경험하였다. 1명은 백혈구 감소증을 보였고 2명은 오심과 구토의 부작용을 보였다. 방사선에 의한 점막염도 심하지 않았는데, 10명의 환자에서 2도의 점막염이 발생하였다. 5년 생존율과 5년 무병생존율은 각각 68$\%$와 65$\%$였다. 5년 무원격전이율은 82$\%$였으며 5년 국소 치유율은 75$\%$였다. 결 론 : 선행보조 항암화학요법이 진행된 병기의 비인두암 환자에 있어서 부작용을 크게 증가시키지 않으면서 효과적인 치료방법임을 알 수 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4759-4763
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• 2014

Radiation therapy in ovarian cancers has been considered an outdated concept for many years, mainly due to its toxicity and failure to show benefit in terms of survival. Chemotherapy has been extensively used after surgery for these cancers and it has almost replaced radiation therapy as an adjuvant treatment. Nevertheless, failures in ovarian cancers continue to occur even with the use of newer and effective chemotherapy regimens. About 70% patients demonstrate recurrence in the abdomen or pelvis after first line chemotherapy in ovarian cancers. With advances in technology and sophistication of radiation techniques, along with the molecular and biological knowledge of distinct histological subtypes, there is a need to redefine the role of radiation therapy. This review article focuses on the literature on use of radiation in ovarian cancers and its rationale and indications in the present day. For this, a literature pub med/medline search was performed from January 1975 to March 2014 to redefine the role of radiotherapy in ovarian cancers.

• Journal of Chest Surgery
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• 제25권9호
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• pp.962-967
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• 1992

Eight patients with proven clinical stage Ill lung carcinoma of which six were epidermoid cell carcinoma and two were small cell carcinoma underwent concomitant radiation therapy and chemotherapy before surgical resection from March 1990 to February 1992 at the thoracic surgical department, Yongdong Severance Hospital, Yonsei University College Medicine The therapy consisted of more than one cycle of chemotherapy every 4 weeks and concomitant irradiation. Three to four weeks after chemotherapy and radiation therapy, the patient were reevaluated for thoracotomy and pulmonary resection. Two patients were found to have unresectable lesions and, radiosotopes were implanted to the remaining tumors. Three patients had complete pneumonectomies and two patients had pericardial penumonectomyo. Only one patient had complete pneumonectomy & concomitant resection of ribs attached to tumors with reconstruction of chest wall with Marlex mesh. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 2 patients, without operative mortality. The median survival of all patients was eight months, but the median survival of survivors which lung tumor were completely resected completely and whose pathologic reports showed stage I or 0, was about 18 months to now. The overall result indicates some benefit from this preoperative chemotherapy and radiation therapeutic regimen in patients with advanced unresectable lung cancer.

• 대한두경부종양학회지
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• 제18권1호
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• pp.41-45
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• 2002

Background and Objectives: To evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer, which is notorious for its poor prognosis and severe surgical morbidity with functional deficits. Materials and Methods: Medical records and radiologic findings of 107 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV (AJCC, 1997), were retrospectively reviewed. Results: Neoadjuvant chemotherapy followed by radiation therapy showed 74% complete remission (CR) rate. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Twenty-eight of 57 patients were able to preserve their larynges for more than three years by chemotherapy and radiation. Conclusions: This approach appeared to be as effective as radical surgery with postoperative radiation therapy without comprising of survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and determine the best treatment option for patients who are partially or nonresponsive to chemotherapy.

• 대한두경부종양학회지
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• 제24권2호
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• pp.162-168
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• 2008

Purpose：To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials：From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range：40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median：70.8Gy). Results：Median follow-up time was 39.4 months(range：8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion：Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2185-2190
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• 2014

Chemotherapy has significantly improved the prognosis of cancer patients with various malignancies. However, female patients, especially those whoich are premenopausal, suffer from significant chemotherapy induced ovarian function impairment, which decreases their quality of life. Many new techniques for ovarian preservation have been established in recent years. Although the use of gonadotrophin releasing hormone analogues (GnRHa) for this purpose is not a new concept, its effectiveness in protection of ovarian function is still debatable. This article deals with studies and metaanalyses which have been undertaken in the past, demonstrating the impact of GnRHa in ovarian function preservation, and whether their use can be implemented in routine practice.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.528-531
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• 2013

We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife$^{(R)}$ stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

• Radiation Oncology Journal
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• 제33권4호
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• pp.284-293
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• 2015

Purpose: To determine failure patterns and survival outcomes of T4N0-1 non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. Materials and Methods: Ninety-five patients with T4N0-1 NSCLC who received definitive radiotherapy with or without chemotherapy from May 2003 to October 2014 were retrospectively reviewed. The standard radiotherapy scheme was 66 Gy in 30 fractions. The main concurrent chemotherapy regimen was $50mg/m^2$ weekly paclitaxel combined with $20mg/m^2$ cisplatin or AUC 2 carboplatin. The primary outcome was overall survival (OS). Secondary outcomes were failure patterns and toxicities. Results: The median age was 64 years (range, 34 to 90 years). Eighty-eight percent of patients (n = 84) had an Eastern Cooperative Oncology Group performance status of 0-1, and 42% (n = 40) experienced pretreatment weight loss. Sixty percent of patients (n = 57) had no metastatic regional lymph nodes. The median radiation dose was EQD2 67.1 Gy (range, 56.9 to 83.3 Gy). Seventy-one patients (75%) were treated with concurrent chemotherapy; of these, 13 were also administered neoadjuvant chemotherapy. At a median follow-up of 21 months (range, 1 to 102 months), 3-year OS was 44%. The 3-year cumulative incidences of local recurrence and distant recurrence were 48.8% and 36.3%, respectively. Pretreatment weight loss and combined chemotherapy were significant factors for OS. Acute esophagitis over grade 3 occurred in three patients and grade 3 chronic esophagitis occurred in one patient. There was no grade 3-4 radiation pneumonitis. Conclusion: Definitive radiotherapy for T4N0-1 NSCLC results in favorable survival with acceptable toxicity rates. Local recurrence is the major recurrence pattern. Intensity modulated radiotherapy and radio-sensitizing agents would be needed to improve local tumor control.

• 대한두경부종양학회지
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• 제24권1호
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• pp.26-32
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• 2008

Purpose：Hypopharyngeal carcinoma is usually diagnosed as an advanced disease after an asymptomatic beginning, and it is related to a high frequency of lymph node metastases. An eventual negative outcome may occur not only because of possible locoregional failures but also for frequent distant metastases. Thus, the efficacy of induction chemotherapy followed by radiation therapy, with regards to the response, survival rate and complications for locally advanced hypopharyngeal carcinoma patients, was examined. Methods and Materials：Since July 1998 to February 2001, 18 patients having locally advanced hypopharyngeal carcinoma were treated with induction chemotherapy followed by radiation therapy, and the results were retrospectively analyzed. The regimen of the induction chemotherapy was the 5-flurouracil(5-FU, 1,000mg/$m^2$ daily for 5 consecutive days) and cisplatin(100mg/$m^2$ on day 1) combination at 3-week intervals for 2 cycles. The total radiation dose for the primary tumor and metastatic lymph nodes was 68.4-72.0Gy(median：70.2Gy) Results：The 3-year overall survival rate and disease free survival rate were 31.3% and 22.2%, respectively. In 6 patients(33.3%), preservation of the larynx for over 3 years was possible. After the induction chemotherapy and radiotherapy, a complete response was noted in 14 patients(77.8%), and a partial response in 4 patients (22.2%), with an overall response rate of 100%. Conclusion：Induction chemotherapy followed by radiation therapy is an effective treatment and larynx preservation rate was 33% in patients with locally advanced hypopharyngeal carcinoma in our report.