• 제목/요약/키워드: Tumor depth

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Intraoperative Radiotherapy (IORT) for Locally Advanced Colorectal Cancer (대장-직장암의 수술중 방사선 치료)

  • Kim, Myung-Se;Kim, Sung-Kyu;Kim, Jae-Hwang;Kwan, Koing-Bo;Kim, Heung-Dae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.265-270
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    • 1991
  • Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from $20\%\;to\;50\%$. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than $5\%$, in spite of massive combination therapy. Intraoperative radiotherapy (IORT) with or without external beam irradiation has been advocated for reducing local recurrence and improving survival. The recent report of local failure by this modality was only $5\%$, this indicated that significant improvement of local control could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is the first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly.

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A Nomogram for Predicting Extraperigastric Lymph Node Metastasis in Patients With Early Gastric Cancer

  • Hyun Joo Yoo;Hayemin Lee;Han Hong Lee;Jun Hyun Lee;Kyong-Hwa Jun;Jin-jo Kim;Kyo-young Song;Dong Jin Kim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.355-364
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    • 2023
  • Background: There are no clear guidelines to determine whether to perform D1 or D1+ lymph node dissection in early gastric cancer (EGC). This study aimed to develop a nomogram for estimating the risk of extraperigastric lymph node metastasis (LNM). Materials and Methods: Between 2009 and 2019, a total of 4,482 patients with pathologically confirmed T1 disease at 6 affiliated hospitals were included in this study. The basic clinicopathological characteristics of the positive and negative extraperigastric LNM groups were compared. The possible risk factors were evaluated using univariate and multivariate analyses. Based on these results, a risk prediction model was developed. A nomogram predicting extraperigastric LNM was used for internal validation. Results: Multivariate analyses showed that tumor size (cut-off value 3.0 cm, odds ratio [OR]=1.886, P=0.030), tumor depth (OR=1.853 for tumors with sm2 and sm3 invasion, P=0.010), cross-sectional location (OR=0.490 for tumors located on the greater curvature, P=0.0303), differentiation (OR=0.584 for differentiated tumors, P=0.0070), and lymphovascular invasion (OR=11.125, P<0.001) are possible risk factors for extraperigastric LNM. An equation for estimating the risk of extraperigastric LNM was derived from these risk factors. The equation was internally validated by comparing the actual metastatic rate with the predicted rate, which showed good agreement. Conclusions: A nomogram for estimating the risk of extraperigastric LNM in EGC was successfully developed. Although there are some limitations to applying this model because it was developed based on pathological data, it can be optimally adapted for patients who require curative gastrectomy after endoscopic submucosal dissection.

Evaluation of Dosimetric Leaf Gap (DLG) at Different Depths for Dynamic IMRT (동적 세기조절방사선치료에서 깊이에 따른 DLG변화 분석)

  • Chang, Kyung Hwan;Kwak, Jungwon;Cho, Byungchul;Jeong, Chiyoung;Bae, Jae Beom;Yoon, Sang Min;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.153-159
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    • 2015
  • This study is to evaluate thedosiemtric leaf gap (DLG) at different depths for dynamic intensity-modulated radiation therapy (IMRT) in order to evaluate the absolute dose and dose distribution according to the different positions of tumors and compare the measured and planned the multileaf collimator (MLC) transmission factor (T.F.) and DLG values. We used the 6 MV and 15 MV photon beam from linear accelerator with a Millenium 120 MLC system. After the import the DICOM RT files, we measured the absolute dose at different depths (2 cm, 5 cm, 10 cm, and 15 cm) to calculate the MLC T. F. and DLG. For 6 MV photon beam, the measured both MLC T. F. and DLG were increased with the increase the measured depths. When applying to treatment planning systemas fixed transmission factor with its value measured under the reference condition at depth of 5 cm, although the difference fixed and varied transmission factor is not significant, the dosiemtric effect could be presented according to the depth that the tumor is placed. Therefore, we are planning to investigate the treatment planning system whichthe T. F. and DLG factor according to at the different depths can be applied in the patient-specific treatment plan.

The Significance of Lymphatic, Venous, and Neural Invasion as Prognostic Factors in Patients with Gastric Cancer (위암 환자의 예후인자로서 림프관 정맥 및 신경 침범의 의의)

  • Kim Chi-Ho;Jang Seok-Won;Kang Su-Hwan;Kim Sang-Woon;Song Sun-Kyo
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.113-119
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    • 2005
  • Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

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Feasibility Study for Development of Transit Dosimetry Based Patient Dose Verification System Using the Glass Dosimeter (유리선량계를 이용한 투과선량 기반 환자선량 평가 시스템 개발을 위한 가능성 연구)

  • Jeong, Seonghoon;Yoon, Myonggeun;Kim, Dong Wook;Chung, Weon Kuu;Chung, Mijoo;Choi, Sang Hyoun
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.241-249
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    • 2015
  • As radiation therapy is one of three major cancer treatment methods, many cancer patients get radiation therapy. To exposure as much radiation to cancer while normal tissues near tumor get little radiation, medical physicists make a radiotherapy plan treatment and perform quality assurance before patient treatment. Despite these efforts, unintended medical accidents can occur by some errors. In order to solve the problem, patient internal dose reconstruction methods by measuring transit dose are suggested. As feasibility study for development of patient dose verification system, inverse square law, percentage depth dose and scatter factor are used to calculate dose in the water-equivalent homogeneous phantom. As a calibration results of ionization chamber and glass dosimeter to transit radiation, signals of glass dosimeter are 0.824 times at 6 MV and 0.736 times at 10 MV compared to dose measured by ionization chamber. Average scatter factor is 1.4 and Mayneord F factor was used to apply percentage depth dose data. When we verified the algorithm using the water-equivalent homogeneous phantom, maximum error was 1.65%.

Prognostic Significance of Lymphatic and Perineural Invasions in Patients with Gastric Cancer Who Have No Lymph Node and Serosal Involvement (장막 침윤과 림프절 전이가 없는 위암에서 림프관 및 신경초 침윤의 의의)

  • Kim Wook;Park Cho Hyun;Park Seung Man;Park Woo Bai;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.1 no.2
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    • pp.77-82
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    • 2001
  • Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

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Effects of essential oil coated with glycerol monolaurate on growth performance, intestinal morphology, and serum profiles in weaned piglets

  • Yanan Wang;Juntao Li;Huakai Wang;Yihai Mi;Yongqiang Xue;Jiaan Li;Yongxi Ma
    • Animal Bioscience
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    • v.36 no.5
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    • pp.753-760
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    • 2023
  • Objective: This study aimed to investigate the effects of essential oil coated with glycerol monolaurate (GML) on the growth performance, intestinal morphology, and serum profiles of weaned piglets. Methods: A total of 144 weaned piglets (Duroc×[Landrace×Yorkshire], average weight 8.07±3.33 kg) were randomly assigned to three groups with six replicate pens and eight piglets per pen: i) CON: a corn-soybean basal diet; ii) LEG: with 1,000 mg/kg essential oil coated with GML; and iii) HEG: with 2,000 mg/kg essential oil coated with GML. Results: Results showed that average daily gain was increased (p<0.05) linearly by essential oil coated with GML supplementation on day 14 to 28 and day 0 to 28 compared with the CON group. Dietary supplementation with HEG increased (p<0.05) total antioxidant capacity and catalase activity on day 14, and immunoglobulin A (IgA) and IgM concentration on day 28 and tended to increase IgG on day 28. In addition, the crypt depth in the jejunum was reduced (p<0.05), and villus height and villus height/crypt depth in the ileum were increased (p<0.05) in the HEG group compared with the CON group. Moreover, lower (p<0.05) concentrations of tumor necrosis factor-α, interferon-γ, interleukin-1β (IL-1β), IL-8, and IL-10 were observed in the jejunum of piglets supplemented with HEG compared with the CON group. In addition, dietary HEG tended to decrease IL-6 level in the jejunum of piglets compared with the CON group. Conclusion: Dietary essential oil coated with GML can improve growth performance of weaned piglets. Moreover, supplementing 2,000 mg/kg essential oil coated with GML was demonstrated to improve antioxidant ability, and intestinal morphology, and reduce jejunal inflammatory factor levels.

Fluorescence Molecular Imaging

  • Choi, Heung-Kook;Ntziachristos, Vasilis;Weissleder, Ralph
    • Proceedings of the KSMRM Conference
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    • 2004.09a
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    • pp.23-32
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    • 2004
  • The chemotherapy sensitive Lewis lung carcinoma (LLC) and chemotherapy resistant Lewis lung carcinoma (CR-LLC) tumors concurrently implanted in mice, and compare these findings with histological macroscopic observations against 3D reconstruction of Fluorescence Molecular Tomography (FMT) preformed in vivo on the same animals. For the 3D image reconstruction we used 32 laser source images, a flat image and 3D surface rendering that confused for 3D Fluorescence Molecular Imaging (FMI). A minimum of ten tissue sections were analyzed per tumor for quantification of the TUNEL-positive cells, cell-associated Cy5.5-Annexin and vessel-associated Alexa Fluor-Lectin. These are useful apoptosis and angiogenesis markers, and they serve as validation experiments to data obtained in vivousing a Cy5.5-Annexin V conjugate injected intravenously in chemotherapy-treated animals carrying the tumors studied histologically. We detected higher levels of apoptosis and corresponding higher levels of Cy5.5 fluorescence in the LLC vs. the CR-LLC tumors according to tissue depth and these findings confirm that in vivo staining with the Cy5.5-Annexing conjugate correlates well with in vitro TUNEL staining and is consistent with the higher apoptotic index expected from the LLC line. There appeared to be 1.38% more apoptosis for LLC than CR-LLC. Consequently there is good correlation between the histology results and in vivo fluorescence-mediated optical imaging. In conclusion the apoptotic images of 3D FMI were validated by microscopic histological image analysis. This is a significant result for the continuous progress of fluorescence 3D imaging research.

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Expression of C4.4A is a Potential Independent Prognostic Factor for Patients with Gastric Cancer

  • Cheng, Da-Qing;Gu, Xiao-Dong;Li, Zhen-Yang;Xiang, Jian-Bin;Chen, Zong-You
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3895-3899
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    • 2014
  • C4.4A, a metastasis-associated gene, encodes a glycolipid-anchored membrane protein which is overexpressed in several human malignancies. However, there are few data available on C4.4A expression and its relationship with progression in gastric cancer. Our study was designed to explore the expression of C4.4A in gastric cancer and to correlate it with clinical outcome. C4.4A expression was studied by quantitative real-time RT-PCR and immunohistochemistry for assessment of correlations with clinicopathological factors. C4.4A mRNA expression was significantly up-regulated in gastric cancer as compared with noncancerous tissue (p<0.05)., being observed in 107 (88.4%) of the 121 gastric cancer cases by immunohistochemistry. We found that the expression of C4.4A mRNA was correlated with size of the tumor, depth of invasion, lymph node metastasis, distant metastasis and TNM stage. Moreover, patients with overexpression of C4.4A has a significantly worse survival (p<0.05). Further multivariable analysis indicated that the expression of C4.4A was an independent prognostic indicator for gastric cancer (p<0.05). In conclusion, overexpression of C4.4A correlates with metastatic potential of gastric cancer and C4.4A could be a novel independent prognostic marker for predicting outcome.

Relationship Between Expression of Gastrokine 1 and Clinicopathological Characteristics in Gastric Cancer Patients

  • Xiao, Jiang-Wei;Chen, Jia-Hui;Ren, Ming-Yang;Tian, Xiao-Bing;Wang, Chong-Shu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5897-5901
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    • 2012
  • The aim of the study was to clarify the role of gastrokine 1 in the process of formation and development of gastric cancer. The expression of gastrokine 1 in gastric cancer and corresponding non-cancerous gastric tissues of 52 gastric cancer patients was assessed with the real-time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry. We also analyzed the relationship between the expression level and clinicopathological characteristics. Gastrokine 1 gene and protein expression in gastric cancer tissues was in both cases significantly lower than in corresponding non-cancerous gastric tissues (both P<0.01), but no significant relationship was found with clinicopathological parameters including tumor location, depth of invasion, differentiation, lymph node metastasis, stage, gender, age and carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) level in peripheral blood preoperation of patients (P>0.05, respectively). Furthermore, gastrokine 1 gene expression was markedly lower in gastric cancer tissues of Helicobacter pylori (HP)-positive patients than negative ones (P<0.05). The result of the study showed that gastrokine 1 might play a significant role in the process of formation and development of gastric cancer as an anti-oncogene. Its effect might be weakened by HP infection.