• Radiation Oncology Journal
• /
• 제29권3호
• /
• pp.174-180
• /
• 2011

Purpose: To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma. Materials and Methods: From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions. Results: The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS. Conclusion: This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.

• 대한한방종양학회지
• /
• 제5권1호
• /
• pp.1-17
• /
• 1999

Large bowel cancer shows the 4-5th frequency in cancers that occurs in Korea. The western medicine cures the Large bowel cancer by radiation, surgery and chemotherapy. While, Oriental medicine cures the Large bowel cancer by Herb-drugs, acupuncture, moxa and et al. With just one way of treating Large bowel cancer can't be effective remedy. Because each medicine has a strength and weakness, it is effective treatment when two medicine combines and supplement each other. We got the following result about a trend of oriental and western combination treatment for Large bowel cancer through studding records. 1. In Large bowel cancer, colon cancer is referred hematochezia(腸風下血), rectal cancer is refereed enterotoxin(腸毒), and anal cancer is accumulation of pathogens in yin(結陰). 2. The western medicine treats Large bowel cancer patient with surgery first. They need on assembly treatment such as chemical, radiation and immune treatment. In oriental medicine, they treats Large bowel cancer patients with differentiation of symptom and signs and treatment(辨證施治) for example, insufficiency of spleen and stomach(脾胃虛弱), collapse of the spleen-ql(脾氣下陷), stagnation of blood stasis and toxic agent(瘀毒內結), reinforcing both qi and blood(脾血下陷), stagnation of damp-phlegm(痰濕凝結) and cure for them by acupuncture and moxa too. 3. In combination with oriental and western medical treatment princple of Large bowel cancer by each stage is as follows. First stage is cured with radical surgery and herb-drugs without chemotherapy. The intermediate and terminal stage patients is used radiation before surgery, or after palliative surgery cour with chemotherapy, radiation and Herb-drugs. In terminal stage patients, unable for surgery, is used combination between chemotherapy, palliative radiation and Herb-drugs. 4. After radiation surgery, the terminal stage patients who have extensively lymph node metastasis or local contraindication is able to undergo combination of Herb-durgs and chemotherapy. 5. The cure-effect with oriental and western medicine combination treatment was better than that just with oriental or western medical treatment. 6. The merits of oriental and western medicine combination treatment lengthen one's life and diminish the bad effect of chemotherapy and complete radiation treatment, prevent from relapsing, maintain the balance in their environment of body and improve immunity.

• Radiation Oncology Journal
• /
• 제17권1호
• /
• pp.9-15
• /
• 1999

목적 : 국한성 병기의 소세포 폐암에 대하여 항암 화학 및 흉부 방사선치료의 병합요법을 적용하여 국소 반응율, 급성 부작용의 빈도, 단기 임상 추적 관찰 결과 등을 보고하고자 한다. 대상 및 방법 : 1994년 10월부터 1998년 4월까지 국한성 병기의 소세포 폐암으로 진단되어 VIP 요법(etoposide, ifosfamide, cis-platin) 또는 EP 요법(etoposide, cis-platin)의 복합 항암 화학 및 흉부 방사선치료의 동시 병합요법을 시행받은46명의 환자를 대상으로 하였다. 항암 화학요법은 3주 간격으로 모두 6회의 시행을 목표로 하였고, 흉부 방사선치료는 10MV X-ray를 사용하여 일일선량 2Gy씩 44Gy를 4.5주간에 첫번째 화학요법과 동시에 시행하고자 하였다. 관해율은 예정된 치료가 모두 종료된지 4주만에 판정하였으며, 완전 관해를 얻었던 경우에는 10회에 걸쳐 25Gy의 예방적 전뇌 방사선치료를 예정하였다. 급성 부작용의 빈도와 정도는 SWOG 부작용 판정 등급체계를 적용하였으며, 단기 추적 관찰 결과로서 1년 및 2년 생존율, 무병 생존율 등은 Kaplan-Meter법을 사용하였다. 결과 : 전체 환자에 대한 추적 기간의 중앙값은 16개월이었다(범위 2개월$\~$41개월). 완전 관해는 30명(65$\%$)에서 있었으며, 이 중 22명에서 예방적 전뇌 방사선치료를 시행하였다. 동시 병합요법의 3도 이상의 혈액학적 부작용의 빈도는 각각 백혈구감소증 23명(50$\%$), 적혈구감소증 17명(37$\%$), 혈소판감소증 9명(20$\%$)이었고, 비혈액학적 부작용은 탈모 9명(20$\%$), 오심 및 구토 5명(11$\%$), 그리고 말초신경염 1명(2$\%$)이었으며, 이로 인한 화학요법의 지연은 한명에서, 화학요법제의 용량 감소는 전체 246회의 화학요법 중 58회에서 있었다. 3도 이상의 방사선 식도염은 없었으나 화학요법의 부작용으로 인한 흉부 방사선치료의 일시 중단은 21명에서 평균 8.3일간 필요하였다. 국소 재발은 완전 관해 환자에서 8명, 국소 진행은 부분관해 및 불변 환자에서 6명이 확인되었고, 원격 전이는 17명에서 확인되었으며, 이 중 4명에서 국소 재발과 원격 전이가 함께 확인되었다. 원격 전이의 주요 장기로는 뇌가 10명으로 가장 많았고, 간이 4명으로 다음을 차지하였다. 전체 환자들의 생존기간의 중앙값은 23개월이었으며, 1년, 2년 생존율 및 무재발 생존율은 각각 79%$\%$ 45$\%$ 및 55$\%$, 32$\%$였다. 결론 : 국한성 소세포 폐암환자에서 항암 화학 및 방사선치료의 병합요법을 적용하여 만족할 만한 관해율 및 1년, 2년 생존율을 얻었으며, 대체적인 환자들의 치료 방침에 대한 순응도는 양호한 편으로 판단된다.

• Radiation Oncology Journal
• /
• 제36권4호
• /
• pp.254-264
• /
• 2018

This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.

• 대한두경부종양학회지
• /
• 제15권1호
• /
• pp.22-28
• /
• 1999

Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권6호
• /
• pp.3747-3750
• /
• 2013

Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

• Radiation Oncology Journal
• /
• 제27권2호
• /
• pp.64-70
• /
• 2009

목 적: 국소 진행되어 절제가 불가능한 췌장암에 있어 동시 항암화학 방사선 요법이 표준 요법으로 자리 잡아 왔다. 그러나 최근 들어 항암화학 단독 요법만으로도 좋은 결과를 보이는 연구 결과가 발표되고 있다. 이에 저자들은 국소 진행된 췌장암 환자들의 치료법에 따른 생존율 등을 비교하여 동시 항암화학 방사선 요법의 역할을 재조명하여 보고자하였다. 대상 및 방법: 2000년 1월부터 2008년 1월까지 인하대학교에서 절제 불가능한 췌장암으로 진단되어 치료를 받았던 55명의 환자를 대상으로 후향적 분석을 시행하였다. 동시 항암화학 방사선 요법은 5-FU에 기반한 항암화학 요법과 동시에 원발병소와 주위 림프절을 포함한 부분에 54 Gy (36~59.4 Gy)를 조사하였다. 항암화학 단독 요법은 gemcitabine단독 또는 5-FU와 병용하여 치료하였다. 치료 방법에 따른 치료반응과 전체 생존율 및 무진행생존율을 비교하였으며 예후인자들을 분석하였다. 결 과: 55명의 환자 중 동시 항암화학 방사선 요법을 받은 환자가 34명, 항암화학 단독 요법을 받은 환자가 21명이었다. 치료 방법에 따른 중앙 생존 기간은 각각 12개월, 11개월, 1년 생존율은 43%, 46%로 통계적으로 차이를 보이지 않았다. 중앙 무진행 생존기간은 각각 8개월, 5개월로 다소간 차이를 보였으나 통계적으로 의미있는 결과를 보이지는 않았다. 치료 반응도는 두 군 모두에서 완전 관해는 없었지만 부분 관해는 동시 항암화학 방사선 요법이 26%, 항암화학 단독 요법이 6%로 통계학적으로 의미 있는 차이를 보였다. 치료 중 독성은 동시 항암화학 방사선 요법이 장독성이 더 많았으나 다른 독성에는 차이가 없었다. 예후인자는 림프절 전이가 있는 경우, CA19-9이 1,000 U/ml 이상인 경우, 췌장암이 꼬리부분에 있는 경우가 나빴다. 결 론: 절제 불가능한 췌장암 치료에 있어서 동시 항암화학 방사선 요법이 항암화학 단독 요법에 비하여 무진행생존율을 향상 시키는 경향을 보였고, 치료 반응도에서도 더 좋은 결과를 보였다. 따라서 방사선 치료가 종양의 국소 제어에는 효과적인 것으로 생각된다.

• Radiation Oncology Journal
• /
• 제15권2호
• /
• pp.113-119
• /
• 1997

목적 : 국소적으로 진행된 위암치료는 수술이 주 치료로 5년 생존율은 그리높지 않아 좀더 완치율을 높이기 위하여 화학요법이나 화학요법과 병용하여 방사선치료 등이 시행되고 있다 저자들은 위암환자에서 수술후 방사선치료를 받은 환자의 치료성적을 후향적으로 분석하였다. 방법 : 1985년 3월부터 1993년 6월까지 한양대학병원 치료방사선과에서 위절제수술후 방사선 치료를 3500cGy 이상 받고 병기 3및 4기인 68명을 대상으로 후향적인 분석을 하였다. 연령분포는 28세부터 66세였고 중앙연령은 50세였다. 추적기간은 3개월에서 133개월(3명이 36개월 미만)로 중앙값은 50개월이었다. 조직병리상 37명이 non signet ring adenocarclnoma였고 29명이 signet ring cell이었다. 병기로 IIIA가 19명, IIIB가 25명, IV가 24명이었다. 항암화학요법은 65명의 환자에게 투여되었으며 FAM계통의 치료가 28예 cispiatln, 5FU계통이 26예이었다. 결과 : 5년생존율은 36.6% 5년무병생존율은 33.6%였다. 예후인자로 병소침입 임파선개수, 조직세포 종류 등이 생존율에 통계적으로 유의하게 영향을 주었고 잔존세포의 유무, 병기, 나이, 세포분화도 및, 방사선치료 총 기간 등도 생존율에 영향을 주었으나 통계적인 유의성은 없었고 항암화학제의 종류에따른 생존율의 차이는 없었다. 37명환자에서 재발이 있었고 위치로는 장망(omentum) 및 복막에 23.5%로 가장 재발율이 놀았으며 남은 위나 봉합부위에 13.2%의 재발율을 보였다. 전체 국소재발은 20.7% 전체 원격전이는 39.7%였다. 방사선치료로 인한 부작용은 22.1%에서 grade 3의 백혈구감소가 있었고 1.5%에서 grade 4 부작용이 있었다. 치료중 10% 이상의 체중감소는 8.8%였다. 결론 : 본 연구결과 수술후 화학요법과 방사선치료요법은 큰 부작용이 없었으며 실패양상은 주로 장망 및 복막이었고 치료부위내 국소재발율이 다음으로 많았다. 국소재발은 원격전이에 비해 많이 낮아지는 추세를 보였다 방사선역할에 평가를 조금 더 명확하게 규명하기위해 향후 재발 위험이 큰 환자에서 수술후 화학요법만 한 군과 화학요법 및 방사선치료를 병용한 군과의 재발 양상 및 생존율 등의 전향적 비교 연구가 필요할 것으로 생각되며 더 나아가 수술후 항암화학요법 및 방사선 병용요법에 복강내 약물치료도 고려되어야 하겠다.

• 대한두경부종양학회지
• /
• 제17권1호
• /
• pp.32-37
• /
• 2001

Objectives: We performed this study to compare the short term results of induction chemotherapy and radiotherapy versus concurrent chemoradiotherapy in patients with locally advanced head and neck cancer. Materials and Methods: From Oct. 1985 to May 1998, 121 patients with locally advanced head and neck cancer were treated with induction chemotherapy and radiotherapy (induction group) or concurrent chemoradiotherapy (concurrent group), and a retrospective analysis was done. Induction chemotherapy was done for 97 patients, and concurrent chemotherapy for 24 patients. Age, sex, performance status, and pathologic types were evenly distributed between two groups. Primary site showed nasopharynx(72.2%), oropharynx(27.8%) in induction group, and nasopharynx(50%), oropharynx(50%) in concurrent group. Chemotherapy regimen was CF(cisplatin and 5-fluorouracil) for 67 patients and CVB (cisplatin, vincristine, bleomycin) for 30 patients in induction group, and CF for all of 24 patients in concurrent group. Proportion of patients treated with more than 2 cycles of planned chemotherapy was 94.8% in induction group and 87.5% in concurrent group. Conventionally fractionated radiotherapy with daily fraction size of 1.8-2.0Gy and 5 fractions/week was done. Total dose was 61-95Gy (median 73.4Gy) for induction group, and 69.4-75.4Gy (median 69.4Gy) for concurrent group. Follow-up time was 4-161 months (median 38 months) for induction group, 7-35 months (median 21.5 months) for concurrent group, respectively. Results: According to treatment modality, overall 2-year survival rates were 68.0% for induction group, 74.3% for concurrent group (p>0.05). two-year disease-free survival rates were 51 % and 74% (p=0.05). Complete response rates were 67.4% for induction group and 83.3% for concurrent group (p=0.09). The incidence of grade 3-4 hematologic toxicity (2.1% vs. 25%, p=0.001) and grade 3-4 mucositis (9.3% vs. 37.5%, p=0.002) during radiotherapy was higher in concurrent group. Conclusion: Concurrent chemoradiotherapy showed a trend of improvement in short-term survival and treatment response when compared with induction chemotherapy and radiotherapy in locally advanced head and neck cancer. A more controlled randomized trial is needed.

• Radiation Oncology Journal
• /
• 제13권2호
• /
• pp.121-128
• /
• 1995

Purpose: The enhanced cytotoxic effect of combined treatment of hyper-thermia and chemotherapy by increasing intracellular acidity with HMA was investigated. Materials and Methods: FSall tumor cells were injected on the hindlegs of female $C_3H$ mice. When the tumor volume reached about 200mm3, experiments were performed on the groups classified as follows: Group I :Control, Group II : Melphalan alone (2.5mg/kg, 5mg/kg, 10mg/kg, 15mg/kg), Group III : Heat alone $(42.5^{\cdot}C$ for 1 hour) Group IV : Melphalan + Heat $(42.5^{\cdot}C$ for 1 hour), Group V : HMA(10mg/kg) + Melphalan(5.0mg/kg) + Heat$(42.5^{\cdot}C$ for 1hour). Each group included 8-12 mice on each experiment HMA (3-amino-6-chloro-5-(1-homopiperidyl )-N-(diaminomethylene) -c-pyrazinecarboxamide), an analog of amiloride which increases intracellular pH(pHi) was dissolved in dimethyl sulfoxide (DMS) and injected into the tumor-bearing mice through the tail vein. 10mg/kg of HMA and each dose of melphalan were injected into peritoneum of the tumor-bearing mice 30 minutes before heating. Tumor growth delay was calculated when the tumor volme reached at $1500mm^3$ Excision assay was performed on each group and repeated 2-4 times. Results : Tumor growth delay of each experimental groups at $1500mm^3$ were 9, 10, 13 and 19 days respectively. In vivo-in vitro excision assay using FSall tumor cells, the cytotoxicity of each experimental groups was $1.2{\times}10^7,\;1{\times}10^7,\;6{\times}10^6,\;1.7{\times}10^6\;and\;1{\times}10^5$ clonogenic cells/gm respectively When HMA was added to the combined treatment of heat and .chemotherapy, the tumor growth was delayed more than combined treatment without HMA i.e., 6 days tumor growth delay at $1500mm^3$ of tumor volume. Conclusion: The combined effect of cytotoxicity by heat and chemotherapy can be much more enhanced by HMA.