• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.107-111
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• 2013

Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2491-2494
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• 2014

Objective: To explore the mechanism and significance of tumor angiogenesis by observing changes of microvessel density (MVD) and expression of vascular endothelial growth factor (VEGF) in residual tumor tissues after cryoablation. Materials and Methods: A total of 18 nude mice xenograft models with transplanted lung adenocarcinoma cell line A549 were established and randomly divided into 3 groups when the maximum diameter of tumor reached 1 cm: control, cisplatin (DDP) and cryoablation. The nude mice were sacrificed after 21-d cryoablation to obtain the tumor tissues. Then immunohistochemistry was applied to determine MVD and the expression of VEGF in tumor tissues. Results: The tumor volumes of control group, DDP group and cryoablation group were $1.48{\pm}0.14cm^3$, $1.03{\pm}0.12cm^3$ and $0.99{\pm}0.06cm^3$ respectively and the differences were significant (P<0.01), whereas MVD values were $21.1{\pm}0.86$, $24.7{\pm}0.72$ and $29.2{\pm}0.96$ (P<0.01) and the positive expression rates of VEGF were $36.2{\pm}1.72%$, $39.0{\pm}1.79%$ and $50.8{\pm}2.14%$ (P<0.01), respectively, showing that MVD was proportional to the positive expression of VEGF (r=0.928, P<0.01). Conclusions: Cryoablation can effectively inhibit tumor growth, but tumor angiogenesis significantly increases in residual tumors, with high expression of VEGF playing an important role in the residual tumor angiogenesis.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.159-167
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• 2007

Vestibular schwannoma (VS) is a benign tumor typically originated in the schwann cell of vestibular nerve and usually accompany hearing symptom. Microsurgical removal and radiosurgery have a great role for the treatment of VS. Recently radiosurgery has been considered as an alternative or primary treatment for VS with the tremendous increase of patients who were treated with gamma knife radiosurgery (GKS) though microsurgery still takes the premier. By many published results, it is proved that GKS is a effective and noninvasive technique for VS, especially small sized tumors with satisfactory tumor control rate. The authors assumed that GKS can be expected to achieve satisfactory tumor control rate for small VS under 5cc in volume. A major interest regarding radiosurgery nowadays is to determine the optimal radiation dose for hearing preservation to improve the quality of life of patients. The more high radiation dose are used for effective tumor growth control, the more radiation-related complications like as hearing deficit, the impairment of other cranial nerve function are increased. Since 1990's the mean radiation dose for tumor margin was more than 18 Gy, but there were high complication rate in spite of good tumor growth control. After the year of 2000, under the influence of advanced neuro-imaging techniques and radiosurgical planning system which enable clinicians to do more precise planning, marginal dose for VS has been decreased to 12-13 Gy and the radiation-related complications has been reduced. But because there may be a unexpected radiation induced complications as time goes by after the latency period, optimal radiation dose for VS should be established on the basis of more long term follow-up observation.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.179-184
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• 2011

Objective : The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods : We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up. Results : The overall median survival after GKRS was $9.1{\pm}1.7$ months. Among various factors, primary tumor control was a significant prognostic factor ($11.1{\pm}$1.3 months vs. $3.3{\pm}2.4$ months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor control. The actuarial peritumoral edema reduction rate was 22.4% at 6 months. Conclusion : According to our results, GKRS can provide beneficial effect for the patients with multiple (4 or more) brain metastases, when systemic cancer is controlled. And, careful dosimetry is essential for local tumor control. Therefore, GKRS can be considered as one of the treatment modalities for multiple brain metastase.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.81-84
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• 2004

It is well known that malignant tumor have hypoxic cell fraction, which is radio resistant and is one of the most important cause of local recurrence after radiotherapy. One of the causes of hypoxia in tumor is blood flow decrease due to increase in blood flow resistance and one of the causes of increased blood flow resistance could be attributed to the increase in blood viscosity. For the evaluation of the change of blood viscosity in oral cancer, experiments were carried out to test the change of blood viscosity among the normal control and xenografted oral cancer nude mice. Relative viscosity measured against distilled water was $3.30{\pm}0.14$ for normal control, and $3.67{\pm}0.62$ for tumor bearing mice at the first time of blood sampling in experimental period ($100mm^3$ $200mm^3$). There was no statistically significant difference between the control group and experimental group (p>0.05). However, as the tumor grew, significant difference of blood viscosity was detected at the third time of blood sampling (control group:$3.37{\pm}0.59$, and experimental group: $4.31{\pm}0.41\;300mm^3$

• The Journal of Korean Medicine
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• v.31 no.3
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• pp.8-16
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• 2010

Objective: This study aimed to investigate the antitumor effects of water extracts of Panax notoginseng (WEPN) in NCI-H460 human lung cancer cell xenografted nude mice. Materials and Methods: We cultured NCI-H460 cell lines and xenografted them to nude mice. The mice were divided into 3 groups; positive control group, NCI-H460+150 mg/kg WEPN-treated group, and NCI-H460+300 mg/kg WEPN-treated group. They had been raised and treated in 28 days. We checked their body weight and tumor weight and volumes twice a week and their absolute organ weight and microhistological observation at the final day. We also calculated their tumor inhibition rate (I.R.), mean survival time and percent increase in life span (% ILS). Results: Body weight of WEPN (300 mg/kg) treated mice tended to slightly greater increase than those of the positive control group, but had no significance. Tumor volume (measurement with a caliper) of WEPN-treated mice tended to be lower than that of the positive control group. Inhibition rate (I.R.) of the WEPN group decreased more than the positive control group, but had no significance. Results of tumor weights and volume (plethysmography) had no significance. Mean survival time and percent increase in life span (% ILS) in the WEPN 300 mg/kg treatment group were higher than those of any other group (p<0.05). In absolute organ weights, the WEPN (150-300 mg/kg) treatment group decreased liver weights (p<0.05). Liver tissue of mice treated with WEPN (300 mg/kg) did not show any specific lesions. Conclusion: We suggest that WEPN may have potential as a growth inhibitor of solid tumors induced by NCI-H460 without any side effects. However, this study has limitations in proving anti-tumor effects of WEPN, so further studies to overcome those limitations will be needed.

• Proceedings of the KOSOMBE Conference
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• v.1991 no.05
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• pp.82-85
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• 1991

Cell kinetics and the chemical mass action principle formulate the basis of immune system dynamics which may be synthesized mathematically as cascades of bilinear systems which are connected by nonlinear nondynamical terms. In this manner, a model for cell-mediated immune response (CMI) to tumor antigens and debris is developed. We also consider parametric control variables relevant to the latest experimental data, i.e., sigmoidal dose-response relationship and Michaelis-Menten dynamics. The preliminary results show that the parametric control variable is important in the destruction of tumors. As well as that, the exacerbation theory is a good method for tumor treatment. Finally, tumor control as an application of immunotherapy is analyzed from the basis established above.

• The Journal of Internal Korean Medicine
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• v.15 no.2
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• pp.174-196
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• 1994

In order to investigate the effect of Samulbyulgapchoengpitang(SB) and one herb added(SBA) on anti-tumor and immune response, the author performed this experimental study, Tumor weight(TW), mean survival days(MSD) and body weight(BW) in vivo, natural killer cell activity(NKCA). rosette forming cells(RFC), phagoctic activity in recticuloendomethrial system(PA), delayed type hypersensitivity(DTH), hemoagglutinin titer(HA) and hemolysine(HL) in vitro were measured in mice. 1. MSD was prolonged in both of treated groups(SB and SBA) as compared with control group. 2. TW was decreased in both of treated groups with statistical significance as compared with control group. 3. BW was increased in both of treated groups and just only in SB with statistical significance as compared with control group. 4. DTH was increased in both of treated groups with statistical significance as compared with control group. 5. HA was increased in both of treated groups with statistical significance as compared with control group. 6. HL was increased in both of treated groups with statistical significance as compared with control group. 7. RFC was increased in both of treated groups and just only in SB with statistical significance as compared with control group. 8. NKCA was increased in both of treated groups with statistical significance as compared with control group. 9. PA was increased in both of treated groups with statistical significance as compared with control group. According to the above experimental results, it is suggested that SB and SBA will have anti-tumor substance and enhance the effect of immune response. But we have to consider the longtime prescription of SBA because there have been no experiments in its side effect or accumulation in body.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.115-118
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• 2004

Respiratory motion in the thorax and abdomen is an important limiting factor in high-precision radiation therapy. The lung tumor and tumor(pancreas, stomach) in abdomen therefore are internal motion due to breathing. We will perform to measurement of dose distributions for these moving tumors. In preliminary study, we investigated displacement of moving tumor such as liver, lung tumor in abdomen with previously reported papers. With reference data, internal movements of tumor are displayed with phantom and moving control device(MCD), which appear three dimension (3-D) motion such as x, y and z axis. These devices are used to access dose delivered in tumor with and without internal motion. The MCD and phantom were used to evaluate a delivered dose under similar condition, although there are not same internal tumor motion. In future, we will obtain the exact evaluation of dose if improved in programed software of moving control device and measure precise internal motion using image modality such as fluoroscopy, simulator in based on this study.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.151-154
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• 1988

To answer the question whether last clonogenic cell should be eradicated for the tumor to be controlled, radiation tumor control study was performed using microscopic tumors of variable sizes ranging from 101 to 10s tumor cells. $TCD_{50}'s$ estimated from experimental data were 14.8, 27. 1, 42.4, 49.9 and 65.5 Gy for $10^1,\;10^2,\;10^3,\;10^4\;and\;10^4$ tumor cells, respectively. Theoretical calculations, assuming that all the clonogenic cells should be inactivated, were 15.65, 8.50, 40.97, 53.41 and 65.85 Gy. From this well matched data, it can be concluded that all the clonogenic cells should be eradicated for tumor control, at least in this tumor model.