• Quality Improvement in Health Care
• /
• v.19 no.1
• /
• pp.56-61
• /
• 2013

Objectives: This video has been produced to provide better awareness for our patients about radiotherapy treatment for anxiety and stress. This video will give inexperienced patients a better understanding of the processes and expectations of the radiotherapy. We have produced a radiotherapy guidance video regarding work flow and a method of radiotherapy to relieve anxiety and stress. It also improves patients satisfaction and understanding of radiotherapy to provide a high-quality health care for radiotherapy patients with indirect experience. Methods: We have evaluated the effectiveness of the video compared to our existing verbal method. See below for the evaluation criteria; 1) Patients satisfaction rate of guidance 2) a comparison of understanding of radiotherapy 3) a comparison of a time of education for patients 4) a researching of an incidence rate of radiotherapy. Results: When compared to the verbal explanation the patients had a increased level of understanding of the radiotherapy treatment. The time to educate patient was decreased and the level of incidents during the treatment was decreased due to the patient having a better understanding of the whole process. Conclusion : In conclusion, the audiovisual education increased the understanding of radiotherapy for patients compared to verbal education. The video also helped patients to cooperate in treatment room so we can provide premium radiotherapy treatment. By reducing the treatment time and education processa we improved the patients overall experience.

• Korean Journal of Adult Nursing
• /
• v.15 no.1
• /
• pp.33-44
• /
• 2003

Purpose: The purpose of this study was to identify the patterns and related factors of fatigue in patients with breast cancer undergoing radiotherapy. Method: 31 women with breast cancer receiving radiotherapy were recruited from the out-patient radiologic clinic of the university hospital in Seoul, Korea over a period of 3 months. Data was collected prospectively concerning three points for $5\frac{1}{2}\;-\;6\frac{1}{2}$ weeks : before radiotherapy(T1), 2 weeks after starting radiotherapy(T2) and the completion of radiotherapy(T3). Data were analysed by repeated measure ANOVA, Pearson correlaton, and multiple regression. Result: 1. Score of fatigue increased significantly over the course of radiotherapy. 2. Score of symptom distress and emotional distress increased and functional status scores decreased significantly over time. 3. Fatigue was positively related with symptom distress and emotional distress and negatively related with functional status over the course of radiotherapy. 4. At T2, emotional distress explained 24.7% of the variation in fatigue. At T3, symptom distress(41.9%) and emotional distress(7.2%) explained the variance in fatigue. Conclusion: The results of this study provided evidence that fatigue increased over the course of radiotherapy and symptom distress and emotional distress were influencing factors of fatigue in this group. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following radiotherapy considering these factors.

• Journal of Korean Academy of Nursing
• /
• v.33 no.5
• /
• pp.562-569
• /
• 2003

Purpose: The purpose of this longitudinal prospective study was to assess changes in fatigue and quality of life for a 6-week course of radiotherapy. Method: A descriptive and longitudinal design was used to this study. Twenty-three subjects receiving radiotherapy from a radiotherapy clinic of a general hospital completed the questionnaires. Fatigue was measured using Lee's scale(1999) and quality of life using Yang's scale(2002) weekly for 6 weeks. Result: Fatigue significantly increased(F=6.043, p=.000), and quality of life significantly decreased (F=3.938, p=.003) and physical symptoms also significantly increased(F=2.432, p=.039) during a 6-week radiotherapy. Multiple regression analysis revealed that fatigue at the first week and physical symptoms at the 6th week were the significant affecting variables(60.1% of the variance) on fatigue. And 63.2% of the variance in quality of life was explained by quality of life and fatigue at the first week and body weight change for 6 weeks radiotherapy. Conclusion: Based on these results, the fatigue and quality of life at the beginning time of radiotherapy have a lasting impact throughout the course of treatment. It suggests that nurses provide patients with information about the occurrence of fatigue during radiotherapy and the practical methods of intervening physical symptoms.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4819-4823
• /
• 2016

Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0-64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences between groups regarding cosmetic results (p = 0.857), locoregional control or survival. Conclusions: The results confirm that hypofractionated radiotherapy with a subsequent boost is as effective as conventional radiotherapy, is well-tolerated and can be used as an alternative treatment method following breast conservation surgery.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2002.09a
• /
• pp.144-145
• /
• 2002

Stereotactic radiotherapy is required to irradiate a small tumor accurately. The radiotherapy showing improves when making an accidental error little boundlessly. It is performed according to treatment planning that is established by the outside landmark of head. At present, when stereotactic radiotherapy for a head is done, the Leksell Flame is fixed on the head, and positioning based on the point and so on which it is in that fixed implement is performed. However, there are problems on the method done at present in the point such as reappearance when the fractionated irradiation method in which the Leksell Flame is removed and installed at every treatment is done because there are landmarks outside the head. Landmarks in the skull were decided, and that precision was examined for the purpose of the improvement of the radiation therapeutic gain. Linac-graphy with longitudinal and lateral view were taken with 6 MV photon beams. A distance to base point inside the skull, each film measured the angle from a center of the small irradiation field, and comparison was done. From the results, a large accidental error wasn't seen as a result of the measurement by every film. Stereotactic radiotherapy for a head treatment had an accidental error of about several millimeters when treatment positioning was done. Therefore, it was thought that there was no problem about an accidental error to arise by putting a landmark in the skull. And, because an accidental error was easy to discover, we thought that modification could be done easily. It was suggested that a landmark in the skull on thus study were useful for improvement of stereotactic radiotherapy.

• Radiation Oncology Journal
• /
• v.32 no.3
• /
• pp.125-131
• /
• 2014

Purpose: We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. Materials and Methods: A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Results: Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Conclusion: Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

• Korean Journal of Adult Nursing
• /
• v.15 no.4
• /
• pp.617-627
• /
• 2003

Purpose: The purpose of this study is to investigate fatigue and its related factors in cancer patients receiving radiotherapy. Method: The subjects of this study consisted of 98 patients receiving radiotherapy. Subjects were recruited from C University Hospital radiation oncology unit located in Gwangju from March to May, 2001. Questionnaire and medical records were used for data collection. The obtained data was analyzed using SAS program that included descriptive statistics, t-test, ANOVA, Post-hoc test(Fisher's LSD) and Pearson's correlation coefficients. Result: The fatigue perceived by the subjects was middle level ($5.59{\pm}1.59$) and 72.4% of them reported greater than 5 points. The subjects in no religion, low income, and spouse caregiver groups experienced the higher fatigue than another groups, respectively. The subjects in nasopharyngeal cancer, head & neck radiation site, and analgesics medication groups did, experience fatigue as well. The fatigue not only positively correlated with symptom distress, disruption of usual activity, sleep dissatisfaction, and mood state, but also negatively with less family support. Conclusion: Cancer patients receiving radiotherapy experience the middle level of fatigue and it correlates with the multi-dimensional factors. However, further research is needed to identify the changes in fatigue over the radiotherapy period through longitudinal design and to develop nursing intervention for fatigue decrease.

• Journal of Korean Academy of Nursing
• /
• v.33 no.4
• /
• pp.478-487
• /
• 2003

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. Design. A correlational and crossectional study design was used. Method. One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. Results. The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. Conclusion: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

• Radiation Oncology Journal
• /
• v.34 no.1
• /
• pp.64-75
• /
• 2016

Purpose: In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. Materials and Methods: In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. Results: The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median $R^2$ of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Conclusion: Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.

• Radiation Oncology Journal
• /
• v.13 no.2
• /
• pp.129-142
• /
• 1995

Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.