Objectives: Angiocentric T-cell lymphoma of the head and neck is an angiocentric and angiodestructive lymphoreticular proliferative disorder. It has been treated with various treatment modalities, but its prognosis is poor and the treatment modality is controversial. We performed this study to suggest a treatment modality with improved results. Materials and Methods: We studied 40 cases of pathologically confirmed angiocentric T-cell lymphoma from July 1984 to December 1996, 35 cases of which showed complete response after initial treatment. All the patients were divided into two groups according to treatment modality. 15 cases received radiotherapy alone (Group I) and 20 cases received radiotherapy after five cycles of CHOP-Bleo chemotherapy(Group II). We analyzed the subsites of tumor, stage, treatment modality and treatment outcome and causes of failure for each group, and compared the three-year no evidence of disease(NED) between the two groups. Results: The three-year NED of a combined chemoradiotherapy was higher than that of a radiotherapy alone (p=0.0478). The three-year NED according to groups and stage were as follows: Group I=6/15(40.0%), stage IE=5/10(50.0%), stage IIE=1/5(20%), Group II=13/20(65.0%), stage IE=9/13(69.2%), stage IIE=4/7(57.1%). Radiotherapy alone is not well effective for the nasal cavity lymphoma extended to paranasal sinus and the palate. Conclusion: We are unable to provide clear guidelines for treatment, but recommend the initial treatment with oral alkylating agents and steroids followed by radiotherapy for Ann Arbor stage II tumors and stage I of the palate lymphoma and the nasal cavity lymphoma extended to paranasal sinus.
Cho Seung-Ho;Kim Hyung-Tae;Kim Min-Sik;Kim Hoon-Kyo;Yoon Sei-Chul;Kim In-Ah;Yoo Woo-Jeong;Kim Sung-Won
Korean Journal of Head & Neck Oncology
/
v.13
no.2
/
pp.161-168
/
1997
Background: Cancers of the maxillary sinuses are not common and are the most difficult head and neck malignancies in which to make an early diagnosis. Objectives: This reports was conducted to evaluated the efficacy of combination therapy and the relationship between the treatment modalities and their outcome of maxillary sinus cancers. Materials and Methods: We retrospectively analyzed a clinical datas of 46 patients who were treated at the department of Otolaryngology-Head and Neck Surgery. The Catholic University of Korea over 10 years between 1987 and 1996. Results: According to AJCC TNM system, 35 patients presented with $T_4$, 10 with $T_3$, one with T1. Two patients were treated with radiotherapy alone, 4 patients with chemotherapy alone, 17 patients with radiotherapy and chemotherapy, 23 patients with combination of surgery, radiotherapy and chemotherapy. The overall 5 years survival rate for combination therapy group were 57%, but 23 patients treated with the other treatment modalities all died within 2 years except two cases with chemotherapy and radiotherapy or radiotherapy alone. There was a statistical trend for better survival and local control in those patients treated with combination therapy than others(p<0.05). Conclusion: The results of this study suggest that it may be possible to acheive better results with aggressive combination treatment including surgery in advanced cases and to avoid orbital excentration in patients with orbital invasion.
Kim, Dong-Yun;Song, Changhoon;Kim, Se Hyun;Kim, Yu Jung;Lee, Jong Seok;Kim, Jae-Sung
Radiation Oncology Journal
/
v.37
no.3
/
pp.176-184
/
2019
Purpose: It is unclear whether adding concurrent chemotherapy (CT) to definitive radiotherapy (RT) following induction CT is a tolerable and cost effective treatment for non-small-cell lung cancer (NSCLC) patients aged 70 years or older with comorbidities. This study evaluated the actual clinical outcomes between concurrent chemoradiotherapy (CCRT) and RT alone following induction CT or not in patients (≥70 years) in a single institution's clinical practice. Materials and Methods: A total of 82 patients with unresectable stage III NSCLC between 2004 and 2016 were retrospectively analyzed. Their treatment tolerance and clinical outcomes such as overall survival (OS), locoregional recurrence (LRR), treatment toxicities and distant metastasis (DM) were evaluated. Early mortality rates were also evaluated as 4-month mortality after RT. Results: Fifty-four patients received CCRT and 28 patients received RT alone. Induction CT before RT was performed for 68.5% and 50.0% in CCRT and RT alone groups. Treatment tolerance was significantly worse in CCRT (p = 0.046). The median survival was 21.1 and 18.1 months for CCRT and RT alone, which was not statistically significant. LRR and DM were also not different. Most early deaths after CCRT were attributed to non-cancer-related mortality. Acute esophagitis of grade ≥2 occurred more following CCRT (p = 0.017). In multivariate analysis, a Charlson Comorbidity Index (CCI) of ≥5 and a weight loss of ≥5% after RT were associated with poor OS. The factors adversely affecting 4-month survival were a CCI of ≥5 and CCRT. Conclusion: There were no significant differences in OS, LRR, and DM between CCRT and RT alone treatment in elderly patients. However, there was a poorer tolerance and higher incidence of acute esophagitis in the CCRT group. Specifically, when the patients had a CCI of ≥5, RT alone seems to be reasonable with a low probability of early death.
Radiotherapy result was analyzed in 23 children with retinoblastoma treated in Seoul National University Hospital from 1980 to 1987. Three ($17\%$) had bilateral tumor at diagnosis. Among 20 children with unilateral retinoblastoma 13 children got radiotherapy after enucleation, 2 were treated with radiotherapy alone, and 5 were delivered with radiotherapy after relapse. Of 15 non-recurrent unilateral tumors, there were 5 stage II children, 8 stage III, and 2 stage IV by staging system proposed by St. Jude Children's Research Hospital. Chemotherapy was combined when resection margin of the optic nerve was positive or when malignant cell was found in CSF. Of 12 children who completed radiotherapy, local or distant failure was not found but 2 cases of relapse at the contralateral retina were observed. Their 5 year survival rate was $82.2\%$. Another case of contralateral relapse was detected in children who was treated with radiotherapy alone. Thus overall frequency of the bilateral disease was $33\%$. Prognosis of recurrent tumors were so poor that no cases of CR was obtained and that 3 year survival rate was $20\%$. Two of 3 bilateral cases at diagnosis were in NED status. Complication were sunken orbit only. Result of radiotherapy was so good in early stage or small bulk tumor that treatment delay after diagnosis must not be allowed.
Intranasal tumors were diagnosed in 21 dogs for 5 years. Sneezing, nasal discharge, nasal bleeding were the most common clinical signs. Diagnosis was performed by blood test, histological examination, radiography, and computed tomography. Among the 27 nasal tumors, adenocarcinornas, squamous cell carcinomas, and chondrosarcomas were relatively common. Breeds with nasal tumor were shetland sheepdog, mongrel, and shiba. The dogs were treated by surgical resection, radiotherapy, chemotherapy, cryosurgery, and radiofrequency ablation. Each therapy alone was not effective, but the combination of two or more therapies had good effects on progression of tumor and made the survival time extended.
Kim, Mi Sun;Lee, Eun-Jung;Kim, Jae-Won;Chung, Ui Seok;Koh, Won-Gun;Keum, Ki Chang;Koom, Woong Sub
Radiation Oncology Journal
/
v.34
no.3
/
pp.230-238
/
2016
Purpose: Hypoxia can impair the therapeutic efficacy of radiotherapy (RT). Therefore, a new strategy is necessary for enhancing the response to RT. In this study, we investigated whether the combination of nanoparticles and RT is effective in eliminating the radioresistance of hypoxic tumors. Materials and Methods: Gold nanoparticles (GNPs) consisting of a silica core with a gold shell were used. CT26 colon cancer mouse model was developed to study whether the combination of RT and GNPs reduced hypoxia-induced radioresistance. Hypoxia inducible $factor-1{\alpha}$ ($HIF-1{\alpha}$) was used as a hypoxia marker. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were conducted to evaluate cell death. Results: Hypoxic tumor cells had an impaired response to RT. GNPs combined with RT enhanced anti-tumor effect in hypoxic tumor compared with RT alone. The combination of GNPs and RT decreased tumor cell viability compare to RT alone in vitro. Under hypoxia, tumors treated with GNPs + RT showed a higher response than that shown by tumors treated with RT alone. When a reactive oxygen species (ROS) scavenger was added, the enhanced antitumor effect of GNPs + RT was diminished. Conclusion: In the present study, hypoxic tumors treated with GNPs + RT showed favorable responses, which might be attributable to the ROS production induced by GNPs + RT. Taken together, GNPs combined with RT seems to be potential modality for enhancing the response to RT in hypoxic tumors.
Purpose: To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMT-RT) without surgery. Materials and Methods: A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January $1^{st}$, 2003 and December $31^{st}$, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMT-RT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5-fluorouracil short infusion plus leucovorin and/or capecitabine or 5-fluorouracil infusion alone. All patients received pelvic irradiation. Results: There were 5 patients (10.4%) with a complete pathological response. The 3 year-overall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (p<0.01). The respective 5 year-overall survival rates were 70.3% and 0% (p<0.01). The 5 year-overall survival rates in Gr.I for patients who received surgery within 56 days after complete CCRT as compared to more than 56 days were 69.5% and 65.1% (p=0.91). Preoperative CCRT used for 12 of 30 patients in Gr.I (40%) with lower rectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. Conclusions: The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.
Kim, Eunji;Song, Changhoon;Kim, Mi Young;Kim, Jae-Sung
Radiation Oncology Journal
/
v.35
no.1
/
pp.55-64
/
2017
Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.
Cho Heung Lae;Joo Young Don;Sohn Seung Chang;Sohn Chang Hak
Radiation Oncology Journal
/
v.16
no.3
/
pp.283-289
/
1998
Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed by radiation therapy in locally advanced non-small cell lung cancer Materials and Methods : Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine Patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. Results : Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). Conclusion : In stage III non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.
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