• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.62-67
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• 1999

Sternal recurrence has been defined as a diffuse infiltrate of neoplastic tissue at the junction of the amputated trachea and the skin. The overall prognosis is poor, resulting from progressive tracheostomal obstruction or massive hemorrhage due to erosion of major vessels. Neither radiation therapy nor chemotherapy has demonstrated any efficacy in controlling these sternal recurrence. Surgery, especially mediastinal dissection, may benefit only an occasional patient. Recently authors experienced one case of mediastinal dissection for sternal recurrence after total laryngectomy for laryngeal cancer. We report our case with a brief review of literature.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.54-58
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• 2001

Granular cell tumor or also called Abrikossoff's tumor, is a rare benign tumor that can occur anywhere in the body. Granular cell tumor may single or multiple (synchronous or metachronous). Approximately half of all granular cell tumors occur in the head and neck. most commonly in the tongue. But granular cell tumors of the larynx are rare, accounting for only 7 to 10% of all reported cases. Laryngeal tumors are usually small and men are more frequently affected than women. The exact histogenesis is still not known but most recent data support the neurogenic Schwann cell origin. The preferred treatment is local excision using cold knife or laser. Radiation therapy is of little benefit. We report a case of granular cell tumor of the larynx which was confirmed by histopathology.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.243-247
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• 2006

$\underline{Purpose}$: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. $\underline{Materials\;&\;Methods$: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with $1{\sim}2\;cm$ margin, and total dose was $3,240{\sim}5,580\;cGy$ (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. $\underline{Results}$: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (p>0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (p<0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any prognostic significance (p>0.05). $\underline{Conclusion}$: Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other targeted agents.

• Journal of Radiation Protection and Research
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• v.37 no.2
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• pp.75-83
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• 2012

Marking the first anniversary of the Fukushima nuclear accident, which took place on March 11th, 2011, the level of adolescent awareness and understanding of radiation was surveyed, and the results were then compared with those for adults with the same questionnaires conducted at similar times. A qualitative survey and frequency analysis were made for the design of the study methodology. Those surveyed were limited to 3rd grade middle school students, 15 years of age, who are the future generation. The questionnaire, which is a survey tool, was directly distributed to the students and 2,217 answers were analysed. The questionnaires were composed of 40 questions, and it was found that Cronbach's coefficient was high with 'self awareness of radiation' at 0.494, 'risk of radiation' at 0.843, 'benefit of radiation' at 0.748, 'radiological safety control' at 0.692, 'information sources of radiation' at 0.819, and 'impacts of Fukushima accident'. The results of the survey analysis showed that the students' knowledge of radiation was not very high with 67.4 points (69.5 points for adults) calculated on a maximum scale of 100 points (converted points). The impacts of the Fukushima nuclear accident were found to be less significant to adolescents than adults, and the rate of answer of "so" or " very so" in the following questions demonstrates this well. It was also shown that the impacts of the Fukushima accident to adolescents were comparatively low with 27.0% (38.9% for adults) on the question of "attitude changed against nuclear power due to the Fukushima accident," 65.7%(86.6% for adults) on the question of "the damages from the Fukushima accident was immeasurably huge," and 65.0% (86.3% for adults) on "the Fukushima accident contributed to raising awareness on the safety of nuclear power plants". The adolescents had a high rate of "average" answers on most of the questions compared with adults, and it can be construed that this resulted from adolescent awareness of radiation not being firmly rooted on themselves. This study was the first of its kind for surveying adolescents regarding the level of awareness of radiation after the Fukushima accident, and the results were compared with the survey results of adults, and they are expected to greatly contribute toward establishing a radiation policy by the government in the future.

• Progress in Medical Physics
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• v.13 no.1
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• pp.32-36
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• 2002

For Intensity Modulated Radiation Therapy(IMRT), the spatial resolution of intensity map(IM) is limited by the width of multi-leaf collimator, which would make an effect on the conformity of the target, as well as organs at risk. Several Methods are suggested to increase the spatial resolution, which can be categorized by the hardware-dependent technique and the software-based technique. However the best solution might be to make the width of MLC finer. it has several obstacles in the respects of technical difficulty and cost. This preliminary study is designed to investigate the clinical effectiveness of the virtual-micro IMRT(VMIMRT) technique, one of the software-based technique. A particular intensity map was created, which has 42$\times$54 pixel dimension ,0.5cm pixel size and 15 intensity levels. Using this intensity map, segment fields of IMRT were generated with 1$\times$lcm, 0.5$\times$1cm, 0.5$\times$0.5cm(VMIM) beamlet size, respectively As results, we found that there was no evidence of improvement for VMIMRT, compared with the 0.5$\times$lcm beamlet size which can be delivered by 1cm width MLC. The reason seems to be due to the constraint of VMIMRT. Further study is required to prove the benefit of the VIMRT in clinical case like head and neck cancer, where is expected that higher resolution than 1cm is necessary.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.287-296
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• 1997

Purpose : This is study of whether 3-D conformal radiotherapy for carcino-mas of the ethmoid sinus were better than those treated with conventional 2-D plan, Materials and Methods : The 3-D conformal treatment Plans were compared with conventional 2-D plans in 4 patients with malignancy of the ethmoid sinus. Isodose distribution, dose statistics, and dose volume histogram of the planning target volume were used to evaluate differences between 2-D and 3-D plans. In addition. the risk of radiation exposure of surrounding normal critical organs are evaluated by means of point dose calculation and dose volume histogram. Results : 3-D conformal treatment plans for each patient that the better tumor coverages by the planning target volume with improved dose homo-geneity, compared to 2-D conventional treatment Plans in the same Patient. On the other hand, the radiation dose distributions to the surrounding nor-mal tissue organs, such as the orbit and optic nerves are not significantly reduced with our technique, but a substantial sparing in the brain stem and optic chiasm for each patient. Conclusion : Our findings represented the potential advantage of 3-D treatment planning for dose homogeniety as well as sparing of the normal tissue surrounding the tumor. However, further investigational studies are required to define the clinical benefit.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.228-239
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• 2009

Purpose: 4DCT scans performed for radiotherapy were retrospectively analyzed to assess the possible benefits of respiratory gating in non-small cell lung cancer (NSCLC) and established the predictive factors for identifying patients who could benefit from this approach. Materials and Methods: Three treatment planning was performed for 15 patients with stage I~III NSCLC using different planning target volumes (PTVs) as follows: 1) PTVroutine, derived from the addition of conventional uniform margins to gross tumor volume (GTV) of a single bin, 2) PTVall phases (patient-specific PTV), derived from the composite GTV of all 6 bins of the 4DCT, and 3) PTVgating, derived from the composite GTV of 3 consecutive bins at end-exhalation. Results: The reductions in PTV were 43.2% and 9.5%, respectively, for the PTVall phases vs. PTVroutine and PTVgating vs. PTVall phases. Compared to PTVroutine, the use of PTVall phases and PTVgating reduced the mean lung dose (MLD) by 18.1% and 21.6%, and $V_{20}$ by 18.2% and 22.0%, respectively. Significant correlations were seen between certain predictive factors selected from the tumor mobility and volume analysis, such as the 3D mobility vector, the reduction in 3D mobility and PTV with gating, and the ratio of GTV overlap between 2 extreme bins and additional reductions in both MLD and $V_{20}$ with gating. Conclusion: The additional benefits with gating compared to the use of patient-specific PTV were modest; however, there were distinct correlations and differences according to the predictive factors. Therefore, these predictive factors might be useful for identifying patients who could benefit from respiratory-gated radiotherapy.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.145-156
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• 2010

The purpose of this study is one of high price medical equipment wished to grasp propriety factor about the MRI introduction, analyzing payability through cost accounting into compensation. It was investigated from January 1 to December 31, 2007 about the MRI of a General Hospital. Expectation availability was 23.2 cases, but actual availability did achievement more than 196.1% with 45.5 items. It is estimated that there are a lot of occurrence cases because great reasons that actual availability increases more than expectation availability is excellent resolving power than a CT, and is device that prefer to reason back that radiation damage is less in person body. The followings show the main results of this study. 1. The MRI was construed in order of cost accounting, wave and personnel expenses 45.4%, administrative expenses 53.0%, and material costs 1.6%. 2. According to CVP (Cost-volume-profit) analysis, BEP (Break Even Point) profit is 173,931,428 won for 11 months, and break even usage number of items are 37.5 cases, and separation usage number of items were confirmed by 1.4 cases. Therefore, was construed that can achieve BEP within 11 months though usage number of items keeps 1.4 items day to create the MRI's hospital operation profit. 3. Estimated limit profitability appears high by 96.7%, exceed fixed charges even if when is non-benefit and when it is benefit consider variable, is judged that the MRI's addition induction helps in hospital management enhancing earning rates.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.475-479
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• 2013

Background: In this study we aimed to determine the rate and habitual patterns of smoking, intentions of cessation, dependence levels and sociodemographic characteristics of relatives of patients with a diagnosis of cancer. Materials and Methods: This study was designed by the Turkish Oncology Group, Epidemiology and Prevention Subgroup. The relatives of cancer patients were asked to fill a questionnaire and Fagerstrom test of nicotine dependence. Results: The median ages of those with lower and higher Fagerstrom scores were 40 years and 42 years, respectively. We found no evidence of variation between the two groups for the remaining sociodemographic variables, including the subject's medical status, gender, living in the same house with the patient, their educational status, their family income, closeness to their cancer patients or spending time with them or getting any help or wanting to get some help. Only 2% of the subjects started smoking after cancer was diagnosed in their loved ones and almost 20% of subjects had quit smoking during the previous year. Conclusions: The Fagerstrom score is helpful in determining who would be the most likely to benefit from a cigarette smoking cessation program. Identification of these people with proper screening methods might help us to pinpoint who would benefit most from these programs.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.207-215
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• 2003

Purpose: Extracellular signal-regulated kinase (ERK), which is part of the mitogen-activated protin kinase cascade, opposes initiation of the apoptotic cell death which is programmed by diverse cytotoxic stimuli. In this regard, the inhibition of ERK may be useful in improving the therapeutic efficacy of established anticancer agents. Materials and Methods: Murine hepatocarcinoma, HCa-I is known to be highly radioresistant with a TCD50 (radiation dose yield in $50\%$ cure) of more than 80 Gy. Various anticancer drugs have been found to enhance the radioresponse of this particular tumor but none were successful. The objective of this study was to explore whether the selective inhibition of MEK could potentiate the antitumor efficacy of radiation in vivo, particularly in the case on radioresistant tumor. C3H/HeJ mice hearing $7.5\~8\;mm$ HCa-I, were treated with PD98059(intratumoral injection of $0.16\;\mug/50\;\mul$). Results: Downregulation on ERK by PD98059 was most prominent 1h after the treatment. In the tumor growth delay assay, the drug was found to Increase the effect of the tumor radioresponse with an enhancement factor (EF) of 1.6 and 1.87. Combined treatment of 25 Gy radiation with PD98059 significantly increased radiation induced apoptosis. The peak apoptotic index (number on apoptotic nuclei in 1000 nuclei X100) was $1.2\%$ in the case of radiation treatment alone, $0.9\%$ in the case of drug treatment alone and $4.9\%,\;5.3\%$ in the combination treatment group. An analysis of apoptosis regulating molecules with Western blotting showed upregulation of p53, p$p21^{WAF1/CIP1}\;and\;Bcl-X_s$ in the combination treatment group as compared to their levels in either the radiation alone or drug alone treatment groups. The level of other molecules such as $Bcl-X_L4, Bax and Bcl-2 were changed to a lesser extent. Conclusion: The selective inhibition of MEK in combination with radiation therapy may have potential benefit in cancer treatment.