• Title/Summary/Keyword: Risk-Free Rate

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Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study

  • Kang, Hye Jin;Kay, Chul-Seung;Son, Seok Hyun;Kim, Myungsoo;Jo, In Young;Lee, So Jung;Lee, Dong Hwan;Suh, Hong Jin;Choi, Yong Sun
    • Radiation Oncology Journal
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    • v.34 no.1
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    • pp.45-51
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    • 2016
  • Purpose: The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer. Materials and Methods: Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the ${\alpha}/{\beta}$ ratio is 1.5 Gy. Results: The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ${\geq}3$ acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed. Conclusion: Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.

Immune Checkpoint Inhibitors for Non-Small-Cell Lung Cancer with Brain Metastasis : The Role of Gamma Knife Radiosurgery

  • Lee, Min Ho;Cho, Kyung-Rae;Choi, Jung Won;Kong, Doo-Sik;Seol, Ho Jun;Nam, Do-Hyun;Jung, Hyun Ae;Sun, Jong-Mu;Lee, Se-Hoon;Ahn, Jin Seok;Ahn, Myung-Ju;Park, Keunchil;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.271-281
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    • 2021
  • Objective : Immune checkpoint inhibitors (ICIs) are approved for treating non-small-cell lung cancer (NSCLC); however, the safety and efficacy of combined ICI and Gamma Knife radiosurgery (GKS) treatment remain undefined. In this study, we retrospectively analyzed patients treated with ICIs with or without GKS at our institute to manage patients with brain metastases from NSCLC. Methods : We retrospectively reviewed medical records of patients with brain metastases from NSCLC treated with ICIs between January 2015 and December 2017. Of 134 patients, 77 were assessable for brain responses and categorized into three groups as follows : group A, ICI alone (n=26); group B, ICI with concurrent GKS within 14 days (n=24); and group C, ICI with non-concurrent GKS (n=27). Results : The median follow-up duration after brain metastasis diagnosis was 19.1 months (range, 1-77). At the last follow-up, 53 patients (68.8%) died, 20 were alive, and four were lost to follow-up. The estimated median overall survival (OS) of all patients from the date of brain metastasis diagnosis was 20.0 months (95% confidence interval, 12.5-27.7) (10.0, 22.5, and 42.1 months in groups A, B, and C, respectively). The OS was shorter in group A than in group C (p=0.001). The intracranial disease progression-free survival (p=0.569), local progression-free survival (p=0.457), and complication rates did not significantly differ among the groups. Twelve patients showed leptomeningeal seeding (LMS) during follow-up. The 1-year LMS-free rate in treated with ICI alone group (69.1%) was significantly lower than that in treated with GKS before ICI treatment or within 14 days group (93.2%) (p=0.004). Conclusion : GKS with ICI showed no favorable OS outcome in treating brain metastasis from NSCLC. However, GKS with ICI did not increase the risk of complications. Furthermore, compared with ICI alone, GKS with ICI may be associated with a reduced incidence of LMS. Further understanding of the mechanism, which remains unknown, may help improve the quality of life of patients with brain metastasis.

A Study on the Reliability Analysis and Risk Assessment of Liquefied Natural Gas Supply Utilities (천연가스 공급설비에 대한 기기신뢰도 분석 및 위험성 평가)

  • Ko, Jae-Sun;Kim, Hyo
    • Fire Science and Engineering
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    • v.17 no.1
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    • pp.8-20
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    • 2003
  • Natural gas has been supplied through underground pipelines and valve stations as a new city gas in Seoul. In contrast to its handiness the natural gas has very substantial hazards due to fires and explosions occurring from careless treatments or malfunctions of the transporting system. The main objectives of this study are to identify major hazards and to perform risk assessments after assessing reliabilities of the composing units in dealing with typical pipeline networks. there-fore two method, fault tree analysis ;1nd event tree analysis, are used here. Random valve stations are selected and considered its situation in location. The value of small leakage, large rupture, and no supply of liquefied natural gas is estimated as that of top event. By this calculation the values of small leakage are 3.29 in I)C valve station, 1.41 in DS valve station, those of large rup-lure are $1.90Times10_{-2}$ in DC valve station, $2.32$\times$10^{-2}$ in DS valve station, and those of no supply of LNG to civil gas company are $2.33$\times$10 ^{-2}$ , $2.89$\times$10^{-2}$ in each valve station. And through minimal cut set we can find the parts that is important and should be more important in overall system. In DC valve station one line must be added between basic event 26,27 because the potential hazard of these parts is the highest value. If it is added the failure rate of no supply of LNG is reduced to one fourth. In DS valve station the failure rate of basic event 4 is 92eye of no supply of LNG. Therefore if the portion of this part is reduced (one line added) the total failure rate can be decreased to one tenth. This analytical study on the risk assessment is very useful to prepare emergency actions or procedures in case of gas accidents around underground pipeline networks and to establish a resolute gas safety management system for loss prevention in Seoul metropolitan area.

Postoperative Adjuvant MVP Chemotherapy and Radiotherapy for Non-Small Cell Lung Cancer (비소세포성폐암의 수술후 MVP복합화학요법과 방사선병용치료 결과)

  • Kim, Jong-Hoon;Choi, Eun-Kyung;Chang, Hyesook;Kim, Sang-Wee;Suh, Chul-won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Seung-Il;Sohn, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.149-156
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    • 1995
  • Purpose : Since February 1991 a Prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluate the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival. and tolerance of combined treatment. Materials and Methods: Twenty nine patients were registered to this study until Sep. 1993; of these 26 received planned therapy Within 3 weeks after radical resection, two cycles of MVP(Mitomycin C $6mg/m^2,$ Vinblastin $6mg/m^2,$ Cisplatin $60mg/m^2$) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040cGy tumor bed dose and 900cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results: One and two year overall survival rates were $76.5\%\;and\;58.6\%$ respectively. Locoregional failure developed in 6 patients$(23.1\%)$ and distant failure in 9 patients$(34.6\%)$ Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was $90\%$. Conclusion: 1) MVP chemotherapy showed no effect on locoregional recurrence, but appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival.

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Nutrition Diagnostic Analysis for Nutrition Care Process Model in Adults of a Health Screening & Promotion Center (영양관리과정(NCP)을 적용한 건강증진센터 고객의 영양진단분석)

  • Lee, Hye Seung;Chang, Ji Ho;Lee, Hyeon Jeong;Park, So Jeong;Kang, Eun Hee
    • Korean Journal of Community Nutrition
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    • v.20 no.1
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    • pp.61-72
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    • 2015
  • Objectives: This study was performed to examine nutrition problems and causes/contributing risk factors. Methods: This study was conducted using data 1,863 adults visited Asan health screening & promotion center located in Seoul, Korea during May to June of 2013. We used Nutrition Care Process Model developed by the International Dietetics & Nutrition Terminology (IDNT). Results: The most frequent nutrition problem in male subjects was excessive alcohol intake. Men in fifties showed the highest rate of excessive alcohol intake among the age groups examined (22.4%). By comparison, the most frequent nutrition problem in women was inadequate protein intake. Women in fifties exhibited the highest rate of inadequate protein intake (22.5%). The most common contributing factors for these observations were a low preference for dairy products followed by high preference for alcohol and a deficit in food-and nutrition-related knowledge, regardless of the sex and age. The most common nutrition problem observed among the group diagnosed with hyperglycemia or hypertriglyceridemia or hyperuricemia or fatty liver was excessive alcohol intake (p < 0.001), whereas the group diagnosed with hyperglycemia or hypercholesterolemia showed significantly higher rate of inappropriate intake of carbohydrate (fructose) compared to the group not diagnosed with such disease conditions (p < 0.05). The group diagnosed with hypercholesterolemia, hyperuricemia and fatty liver showed significantly higher occurrence of inappropriate intake of fat (saturated fat) than the group free of such diseases (p < 0.001). The osteopenia group showed higher rate of inadequate protein intake (p < 0.001) and the fatty liver group with excessive energy intake (p < 0.001). Overall, the results suggest that there is a significant relationship between nutrition problems and health conditions found in groups diagnosed with a diverse array of medical conditions. Conclusions: Therefore, we strongly suggest that dieticians should implement nutrition interventions with people visiting health screening & promotion center based on nutrition problems and the contributing factors diagnosed by dietitions in order to prevent chronic diseases in this population.

The Necessity of Early Adjuvant Radiotherapy for Better Outcomes in the Treatment of a Desmoid Tumor (데스모이드 종양에 대한 조기 방사선치료의 필요성)

  • Lee, Me-Yeon;Chang, Ah-Ram;Kim, Hak-Jae;Kim, Kyu-Bo;Kim, Jin-Ho;Park, Charn-Il;Ha, Sung-Whan;Wu, Hong-Gyun;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.201-205
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    • 2007
  • Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.

Role of Postoperative Radiation Therapy in the Management of Cervical Cancer (자궁경부암에서 수술 후 방사선치료의 역할)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.265-270
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    • 2004
  • Purpose: To evaluate the effectiveness of postoperative radiation therapy in cervical cancer patients and define the prognostic factors to affect survival rates. Materials and Methods: Eighty one patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between May 1992 and April 2000 were retrospectivelv analyzed. Forty two patients had stage IB disease, 17 had stage IIA disease, and remaining 22 had stage IIB disease, respectively. Histological examination revealed 76 squamous cell carcinoma and 5 adenocarclnoma. Sixty one patients were noted to have stromal invasion greater than 8 mm and 20 patients were noted to have stromal invasion 7 mm or less. Sixteen patients had parametrial invasion and 65 patients did not. Positive vaginal resection margin was documented in only eight patients and positive lymphovascular invasion was in twelve patients. All of the patients were treated with external beam radiation therapy alone. Majority of the patients were treated with 4 field brick technique to encompass whole pelvis. Total of 5,500 cGy was delivered to the primary surgical tumor bed. Minimum follow up period was four years. Results: Actuarial disease free survival rates for entire group of the patients were 95% and 89% at 2 and 5 years, respectively Five year disease free survival rates for patients with stage IB, IIA, and IIB disease were 97%, 87% and 70%, respectivelv. Local recurrences were documented in 5 patients. Cumulative local failure rate at 3 years was 6% Five year disease free survival rates for patients with stromal invasion greater than 8 mm and 7 mm or less were 88% and 92%, respectively (p>0.05). Five year disease free survival rate for patients with parametrial invasion was significantly lower than those with no invasion (72% vs 92%, p<0.05). Also there was significantly lower survival in patients with positive vaginal resection margin, compared with patients with negative resection margin (64% vs 94%, p<0.05). However, lymphovascular invasion was not a statistically significant prognostic factor Parametrial invasion and positive surgical resection margins were noted to be significant prognostic factors. Conclusions: Postoperative radiation therapy appears to be beneficial in controlling local disease in cervical cancer patients with high pathologic risk factors. Parametrial invasion and positive resection margins were noted to be significant prognostic factors to affect survival and more effective treatment should be investigated in these patients.

The Correlations between Renminbi Fluctuations and Financial Results of Venture Companies in the Floating Exchange Rate (변동환율제도하의 위안화 환율변동과 벤처기업의 재무성과 간 상관관계 연구)

  • Sun, Zhong-Yuan;Chang, Seog-Ju;Na, Seung-Hwa
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.5 no.1
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    • pp.45-67
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    • 2010
  • On July 21st in 2005, People's Bank of China (PBOC) turned the currency peg against the U.S. dollar into managed currency system based on a basket of unnamed currencies under China's exchanged rate regime. This change means that China's enterprises are not free from currency fluctuations. The purpose of this study is to analyze the relations between Renminbi fluctuations in the floating exchange rate and financial results of venture companies. The process and outcomes of this study are as follows, First, in order to measure the financial results of venture companies, I choose venture companies in Shandong Province listed on the Shanghai Stock Exchange (SSE) at random and several quarter financial sheets according to safety ratios, profitability ratios, growth ratios, activity ratios. Second, I arrange the daily Renminbi exchange rate data announced from July 21st, 2005 to December 31st, 2008 by PBOC into the quarterly data. Third, in order to confirm the relations between Renminbi fluctuations and financial results of venture companies, I carry out Pearson's correlation analysis. As a result, the revaluation of the Chinese Renminbi has weakly negative effects on debt ratio, total assets turnover ratio and equity turnover ratio in statistics. But the revaluation of the Chinese Renminbi is not related to other financial index in statistics. The result of this study is that the revaluation of the Chinese Renminbi has little influence on the export and import of Chinese venture companies and certifies the fact that Chinese venture companies have much foreign currency assets. In addition to avoid the currency exposure risk, this study shows the effective method about currency exposure risk which adjusts proportion of Renminbi to foreign currency.

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The Correlations between Renminbi Fluctuations and Financial Results of Venture Companies in the Floating Exchange Rate (변동환율제도하의 위안화 환율변동과 벤처기업의 재무성과 간 상관관계 연구)

  • Sun, Zhong Yuan;Chang, Seog-Ju;Na, Seung-Hwa
    • 한국벤처창업학회:학술대회논문집
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    • 2010.08a
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    • pp.139-160
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    • 2010
  • On July 21st in 2005, People's Bank of China (PBOC) turned the currency peg against the U.S. dollar into managed currency system based on a basket of unnamed currencies under China's exchanged rate regime. This change means that China's enterprises are not free from currency fluctuations. The purpose of this study is to analyze the relations between Renminbi fluctuations in the floating exchange rate and financial results of venture companies. The process and outcomes of this study are as follows, First, in order to measure the financial results of venture companies, I choose venture companies in Shandong Province listed on the Shanghai Stock Exchange (SSE) at random and several quarter financial sheets according to safety ratios, profitability ratios, growth ratios, activity ratios. Second, I arrange the daily Renminbi exchange rate data announced from July 21st, 2005 to December 31st, 2008 by PBOC into the quarterly data. Third, in order to confirm the relations between Renminbi fluctuations and financial results of venture companies, I carry out Pearson's correlation analysis. As a result, the revaluation of the Chinese Renminbi has weakly negative effects on debt ratio, total assets turnover ratio and equity turnover ratio in statistics. But the revaluation of the Chinese Renminbi is not related to other financial index in statistics. The result of this study is that the revaluation of the Chinese Renminbi has little influence on the export and import of Chinese venture companies and certifies the fact that Chinese venture companies have much foreign currency assets. In addition to avoid the currency exposure risk, this study shows the effective method about currency exposure risk which adjusts proportion of Renminbi to foreign currency.

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The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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