• Title/Summary/Keyword: Re-RT

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Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation

  • Kim, Il Han
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.1-12
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    • 2019
  • Despite recent innovation in treatment techniques and subsequently improved outcomes, the majority of glioblastoma (GBL) have relapses, especially in locoregional areas. Local re-irradiation (re-RT) has been established as a feasible option for recurrent GBL of all ages with safety, tolerability, and effectiveness both in survival and quality of life regardless of fractionation schedule. To keep adverse effects under acceptable range, cumulative dose limit in equivalent dose at 2 Gy fractions by the linear-quadratic model at α/β = 2 for normal brain tissue (EQD2) with narrow margin should be observed and single/hypofractionated re-RT should be undertaken very carefully to recurrent tumor with large volume or adjacent to the brainstem. Promising outcome of re-operation (re-Op) plus re-RT (re-Op/RT) need to be validated and result from re-RT with temozolomide/bevacizumab (TMZ/BV) or new strategy is expected. Development of new-concept prognostic scoring or risk group is required to select patients properly and make use of predictive biomarkers such as O(6)-methylguanine-DNA methyltransferase (MGMT) promotor methylation that influence outcomes of re-RT, re-Op/RT, or re-RT with TMZ/BV.

Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

  • Kim, Young Suk;Lee, Chang Geol;Kim, Kyung Hwan;Kim, Taehyung;Lee, Joohwan;Cho, Yona;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.182-188
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    • 2012
  • Purpose: For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. Materials and Methods: We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). Results: The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). Conclusion: Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

Re-irradiation of unresectable recurrent head and neck cancer: using Helical Tomotherapy as image-guided intensity-modulated radiotherapy

  • Jeong, Songmi;Yoo, Eun Jung;Kim, Ji Yoon;Han, Chi Wha;Kim, Ki Jun;Kay, Chul Seung
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.206-215
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    • 2013
  • Purpose: Re-irradiation (re-RT) is considered a treatment option for inoperable locoregionally recurrent head and neck cancer (HNC) after prior radiotherapy. We evaluated the efficacy and safety of re-RT using Helical Tomotherapy as image-guided intensity-modulated radiotherapy in recurrent HNC. Materials and Methods: Patients diagnosed with recurrent HNC and received re-RT were retrospectively reviewed. Primary endpoint was overall survival (OS) and secondary endpoints were locoregional control and toxicities. Results: The median follow-up period of total 9 patients was 18.7 months (range, 4.1 to 76 months) and that of 3 alive patients was 49 months (range, 47 to 76 months). Median dose of first radiotherapy and re-RT was 64.8 and 47.5 $Gy_{10}$. Median cumulative dose of the two courses of radiotherapy was 116.3 $Gy_{10}$ (range, 91.8 to 128.9 $Gy_{10}$) while the median interval between the two courses of radiation was 25 months (range, 4 to 137 months). The response rate after re-RT of the evaluated 8 patients was 75% (complete response, 4; partial response, 2). Median locoregional relapse-free survival after re-RT was 11.9 months (range, 3.4 to 75.1 months) and 5 patients eventually presented with treatment failure (in-field failure, 2; in- and out-field failure, 2; out-field failure, 1). Median OS of the 8 patients was 20.3 months (range, 4.1 to 75.1 months). One- and two-year OS rates were 62.5% and 50%, respectively. Grade 3 leucopenia developed in one patient as acute toxicity, and grade 2 osteonecrosis and trismus as chronic toxicity in another patient. Conclusion: Re-RT using Helical Tomotherapy for previously irradiated patients with unresectable locoregionally recurrent HNC may be a feasible treatment option with long-term survival and acceptable toxicities.

Enhancing value of quality assurance rounds in improving radiotherapy management: a retrospective analysis from King Hussein Cancer Center in Jordan

  • Khader, Jamal K.;Al-Mousa, Abdelatif M.;Mohamad, Issa A.;Abuhijlih, Ramiz A.;Al-Khatib, Sondos A.;Alnsour, Anoud Z.;Asha, Wafa A.;Ramahi, Shada W.;Hosni, Ali A.;Abuhijla, Fawzi J.
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.60-65
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    • 2019
  • Purpose: The quality assurance (QA) chart rounds are multidisciplinary meetings to review radiation therapy (RT) treatment plans. This study focus on describing the changes in RT management based on QA round reviews in a single institution. Materials and Methods: After 9 full years of implementation, a retrospective review of all patients whose charts passed through departmental QA chart rounds from 2007 to 2015. The reviewed cases were presented for RT plan review; subcategorized based on decision in QA rounds into: approved, minor modifications or major modifications. Major modification defined as any substantial change which required patient re-simulation or re-planning prior to commencement of RT. Minor modification included treatment plan changes which didn't necessarily require RT re-planning. Results: Overall 7,149 RT treatment plans for different anatomical sites were reviewed at QA rounds. From these treatment plans, 6,654 (93%) were approved, 144 (2%) required minor modifications, while 351 (5%) required major modifications. Major modification included changes in: selected RT dose (96/351, 27%), target volume definition (127/351, 36%), organs-at-risk contouring (10/351, 3%), dose volume objectives/constraints criteria (90/351, 26%), and intent of treatment (28/351, 8%). The RT plans which required major modification according to the tumor subtype were as follows: head and neck (104/904, 12%), thoracic (12/199, 6%), gastrointestinal (33/687,5%), skin (5/106, 5%), genitourinary (16/359, 4%), breast (104/2387, 4%), central nervous system (36/846, 4%), sarcoma (11/277, 4%), pediatric (7/251, 3%), lymphoma (10/423, 2%), gynecological tumors (2/359, 1%), and others (11/351, 3%). Conclusion: Multi-disciplinary standardized QA chart rounds provide a comprehensive and an influential method on RT plans and/or treatment decisions.

Weatherability of biodegradable polybutylene succinate(PBS) monofilaments (생분해성 PBS monofilament의 내후성)

  • Park, Seong-Wook;Bae, Jae-Hyun
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.44 no.4
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    • pp.265-272
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    • 2008
  • Biodegradable polybutylene succinate(PBS) is an environment friendly plastics for fisheries, because it can mitigate the ghost fishing problem caused by gill-net and trap fisheries. To evaluate photodegradability of PBS monofilament in comparison with polyamide(PA) and polyethylene(PE) monofilament, these 3 types of monofilaments were spun and exposed to ultraviolet light(UV) of weather-ometer for 900 hours, and then their modification, crystal structure, strength, and extensibility were analysed. PBS monofilament did not show any crack and maintained its crystal structure after 900 hour exposure to UV whereas PE monofilament began showing cracks and structure modification after 600 hour exposure. Under UV exposure, the strength and extensibility decreased more rapidly in PBS than in PA and PE. We estimate that gill nets made of PBS monofilament can endure for about 1 year. The breaking strength and elongation decreased linearly with the exposure time for the 3 types of monofilaments. The derived regression equations of the residual tenacity(RT, kg/$mm^2$) and the residual extensibility(RE, %) with the exposure time in year(Y) for each monofilament were; PBS : RT=48.598 - 8.6437Y($R^2=0.93$), RE=28.165 - 7.3233Y($R^2=0.98$), P A : RT=59.771 - 8.6437Y($R^2=0.98$), RE=32.198 - 5.2772Y($R^2=0.92$), P E : RT=60.898 - 5.6528Y($R^2=0.98$), RE=11.887 - 0.7188Y($R^2=0.98$).

Genetic Reassortment of Rice stripe virus RNA Segments Detected by RT-PCR Restriction Enzyme Analysis-based Method

  • Jonson, Miranda Gilda;Lian, Sen;Choi, Hong-Soo;Lee, Gwan-Seok;Kim, Chang-Suk;Kim, Kook-Hyung
    • The Plant Pathology Journal
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    • v.27 no.2
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    • pp.148-155
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    • 2011
  • Our previous sequence and phylogenetic analyses of the Korean Rice stripe virus (RSV) suggested possible genetic reassortment of RNA segments, but whether this RNA variation contributed to the recent RSV outbreaks in Korea is yet unclear. To further clarify these RSV-RNA segment variations, we developed a reverse transcription-polymerase reaction/restriction enzyme (RT-PCR/RE) analysis-based method. We identified five REs, including DraI, EcoR1, NdeI/AseI, and SpeI, that could differentiate RSV RNA 1-4 subtypes, respectively. Our RT-PCR/RE results provided a clear pattern of RNA reassortment, i.e., different groups of isolates having their RNA segments derived from two to three different RSV ancestors, such as from Eastern and Southwestern Chinese or Japanese M and T isolates. We also found that the migratory small brown planthopper from Eastern China caught by aerial net traps that possesses RSV-RNA3 genotypes corresponds mainly to Eastern China, with a few for Southwestern China based on RT-PCR/RE, sequence and phylogenetic analyses, indicating that RSV populations in Eastern China may also have strong RNA variation. The development of an RE analysisbased method proved a useful epidemiological tool for rapid genotyping and identification of mixed infections by RSV strain and by different subtype.

Rule Extraction from Neural Networks : Enhancing the Explanation Capability

  • Park, Sang-Chan;Lam, Monica-S.;Gupta, Amit
    • Journal of Intelligence and Information Systems
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    • v.1 no.2
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    • pp.57-71
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    • 1995
  • This paper presents a rule extraction algorithm RE to acquire explicit rules from trained neural networks. The validity of extracted rules has been confirmed using 6 different data sets. Based on experimental results, we conclude that extracted rules from RE predict more accurately and robustly than neural networks themselves and rules obtained from an inductive learning algorithm do. Rule extraction algorithm for neural networks are important for incorporating knowledge obtained from trained networks into knowledge based systems. In lieu of this, the proposed RE algorithm contributes to the trend toward developing hybrid and versatile knowledge-based system including expert systems and knowledge-based decision su, pp.rt systems.

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Postlaminectomy Arteriovenous Fistula -Report of a case- (요추궁 절제술후 발생한 동정맥루 -1례 보고-)

  • 이정호
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.130-133
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    • 1980
  • Since the first report of an operation for prolapsed intervertebral disk by Mixter and Barr[1934], many thousands of operations have been successfully performed without incident. Linton and White in 1945 reported the vascular complication, but perforation of large vessels is rare complication of operation for prolapsed disk. A medical student, aged 22 years, was performed to a disk operation [L4-5, Rt. on May 1977.] From postoperative 10th day, palpitation, generalized edema and substernal pain were noted, and 2 months later, wide pulse pressure [70-80 mmHg], continuous bruit and thrill on the Rt. low abdomen were followed. Aortography revealed arteriovenous fistula between just proximal to abdominal aortic bifurcation and inferior vena cava. So, fistulectomy [Resection of proximal 2 cm of C.I.A., Rt, including fistula opening and end to end anastomosis] was performed on July, 77. During follow up study, remained fistula between Rt. internal lilac artery and lilac vein was found 2 months later. Re-operation [Double ligation of the Rt. internal lilac artery] was don on January 1978. Postop. results were excellent, except impossible to ejaculation.

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Study of the re-osseointegration of implant fixture after mechanical unscrewing (임플란트 고정체의 의원성 동요 후 골 유착 반응에 관한 연구)

  • Jang, Ji-Hoon;Cho, Jin-Hyun;Lee, Cheong-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.3
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    • pp.209-214
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    • 2010
  • Purpose: The purpose of this study was to investigate whether the re-osseointegration of the implants that had mechanical unscrewing possibly occurred or not. Furthermore, if it happened, the degree of re-osseointegration was evaluated by comparing with previous osseointegration. Materials and methods: The smooth implant (commercial pure titanium 99%) specimens, whose diameter and length was 3.75 mm, 4 mm, respectively were produced. Two implants were inserted into each tibia of 7 New Zealand female white rabbits weighing at least 3.0 kg. The torque removal force for each implant after 6 weeks of implants placement was measured and included in group I. The torque removal forces were assessed after the fixtures were re-screwed to original position and the subjects were allowed to have 4 more weeks for healing and included in group II. One rabbit was sacrificed after first measurement and produced 4 slide specimens in group I, and two rabbits were sacrificed after 2nd measurement, 7 slide specimens, in group II for histomorphologic investigations. All slide specimens were assessed based on the proportion of BIC (bone-implant contact) as well as CBa (Bone area in the cortical passage) value produced by counting the screw threads embedded in the compact bones under the optical microscopic analysis (${\times}20$). Statistical analysis was conducted to evaluate the torque removal force, BIC and CBa between group I and II. Results: As for the torque removal force, the result was $10.8{\pm}3.6$ Ncm for group I and $20.2{\pm}9.7$ Ncm for group II. Furthermore, the torque removal force of group II increased by 98.1% in average compared to group I (P<.05). On the other hand, histomorphologic analysis displayed that there was no statistical significance in BIC and CBa values between group I and the group II (P>.05), and RT/BIC and RT/CBa between group I and group II were statistically significant (P<.05). Conclusion: It is possible to obtain more substantial re-osseointegration within shorter periods than the period needed for the initial osseointegration in case of iatrogenically unscrewed implants.