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Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children (일부 초등학생의 대표적 신체활동의 에너지소비량 측정 및 에너지소비량과 체중과의 상관성 분석)

  • Kim, Jae-Hee;Son, Hee-Ryoung;Choi, Jung-Sook;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.180-191
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    • 2015
  • Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

Seedling - Emergence of Rice, Weedy Rice, and Echinochloa species Sown before Wintering and in the Early Spring (월동전(越冬前) 초춘(初春)에 파종(播種)한 재배(栽培)벼, 잡초성(雜草性)벼 및 피의 출현특성(出現特性))

  • Kwon, Y.W.;Lee, B.W.;Kim, D.S.
    • Korean Journal of Weed Science
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    • v.16 no.2
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    • pp.88-99
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    • 1996
  • In recent years dry direct-seeding of rice has been encouraged by the government and increasingly practiced by farmers in Korea. This has been bringing up an increased occurrence of weedy rites. Some farmers in the southern region dare to sow the rice before winter after harvest, while most farmers wish to sow as early as possible in the spring to secure the growing period, and to disperse the intensive labor in early May. The purpose of this study was to determine the feasibility of moving the sowing of rice to an earlier date under dry direct-seeding, and to elucidate the nature of emergence of an old strain of rice, weedy rites, and barnyardgrasses tinder this farming practice and their adaptive competence over present cultivate. The presently recommended rice cultivar, Dongjinbyo and an old rice strain, Dadajo which prevailed in early 1900s, almost could not emerge from soil deeper than 6cm and could emerge to only 5.3% at best from 1cm deep loamy soil field when the seeds were sown on Nov. 28. However, two strains of weedy rites being weedy for over 200 years emerged by 17.0 to 63.0% from the loamy and sandy clay loam field 1 to 6cm deep. Emergence of the weedy rites was greater in the loamy soil and at a shallow depth, and negligible from the soil depth of 9cm. Barnyardgrasses sown on Nov. 28 emerged by 13.4 to 51 % from the 1 to 3cm deep loamy soil, and 8.6 to 46.7% from the 1cm deep sandy clay loam. Echinochloa crus-galli var. crus-galli emerged more than var. praticola, and var. oryzicola least. Most of the non-emerged barnyardgrasses seem to have entered secondary dormancy. Seeding rice a month earlier than the season lowered the emergence of Dongjinbyo by ca. 10, 18, and 26%, respectively at 1, 3, and 6cm soil depths, indicating that moving the seeding date a month earlier is impractical. The old strain, Dadajo sown in the soil at a depth of 6cm responded similarly. However, the strain has shown a significantly higher ability in emergence from 9cm deep soil. Weedy rices sown a month earlier A month earlier sown weedy rices have shown very similar emergence rates at various soil depths to those sown on May 1. Barnyardgrasses have also shown similar emergence rates when sown between April 3 and May 1. Like barnyardgrasses, the old strain and weedy rices apparantly posessed a greater adaptability to emerge under lower temperatures, and from deeper soil ; Dongjinbyo${\leq}$ Echinochloa species in that order. However, emergence- speed under lower temperature(sown on April 3) was faster in the order of weedy rice

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A Study on the Smoking Status of the Korean Middle and High School Students (한국인(韓國人) 중고교생(中高校生)들의 흡연실태(吸煙實態)에 관(關)한 연구)

  • Park, Soon-Young
    • Journal of the Korean Society of School Health
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    • v.7 no.1
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    • pp.57-71
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    • 1994
  • I investigated actual conditions of smoking of teenagers who were randomly chosen middle and high school students. 1. Juvenile smoking 1) Parents' opinions of juvenile smoking Most parents do not want their children to smoke after growth : 88.6% of fathers (middle school students: 88.9%, high school students: 88.4%) and 95.1% of mothers (middle school students: 93.4%, high school students :95.5%). 2) Teenagers' opinions of smoking after growth The rate of students who will smoke after growth is 10.8% (middle school students: 12.0%, high school students: 9.9%): students in agricultural areas show the higher rate than those in cities. 3) Parents' opinions of their children's smoking now 1.5% of fathers want their children to smoke now (middle school students: 1.3%, high school students: 1.6%) and 1.1% of mothers do (middle school students: 0.6%, high school students: 1.5%). This shows that most parents do not want their children to smoke now. 4) Students' opinions of their friends' smoking now Students who want their friends smoke now cover 7.8% (middle school students: 7.1%, high school students: 8.4%). This rates are higher than those of parents shown in (3). And more high school students and more girl students gave the positive reponse than middle school boy and girl students, respectively. 5) Students' views of smoking "Look like an adult" covers the rate of 4.0% (boy: 7.8%, girl:3.6%) 6.7% of middle school students have this view, while 3.7% of high school students have. 16.1% of students had an experience of smoking during the last one year (boy: 29.9%, girl: 8.6%): this shows that the rate of the boy students is more than 3 times greater than that of the girl students and high students who experienced smoking last year covers 20.2%, while middle school students shows 10.9%. 6) Actual conditions of students' smoking The present rate of students' smoking is 22.4% (boy:38.3%, girl:13.8%): the rate of boy students is greater than that of girl students. Students who smoke more than pack of cigarettes a day cover 8.2% (boy: 17.5%, girl: 3.2%): 5.2% of middle school students (boy:11.4%, girl: 2.1%) smoke more than one pack while 10.7% of high school students do (boy:21.5%, girl: 4.2%). This shows that the rate of boy students' smoking is greater than that of girl students' smoking. 7) The rate of smoking of students' parents 75.4% of fathers (city: 74.5%, agricultural area:75.9%) smoke: and more than a half (62.4%) smoke more than a pack cigarettes a day. On the other hand, the rate of smoking mothers is 5.2%(city: 4.3%, agricultural area: 7.3%): the rate is higher in agricultural areas. 8) Opinions of smoking population in the future 61.4% of students answered that smoking population will increase, while 27.0% have the opinion that smoking population will decrease. 2. Opinions of the effects of smoking on health 1) Have you heard that smokers are likely to suffer from tuberclosis? 78.3% of students said yes (boy: 80.8%, girl: 76.4%): it is shown that the rate of boys is greater than that of girls. 2) Have you heard that smokers are likely to get out of endurance? 76.6% of students (boy: 69.3%, girl: 49.7%) answered yes: it is shown that the rate of boys is greater than that of girls. 3) Have you heard that heart-beats get fast when one smokes? 32.5% of students (boy: 35.5%, girl: 30.9%) answered yes: 32.2% in cities(boy: 33.0%, girl: 31.8%) and 33.5% in agricultural areas(boy: 41.8%, girl: 28.8%): and 28.7% middle students and 35.5% of high school students answered yes. 4) Have you heard that smokers are likely to have heart-diseases? 35.1% of students (boy: 34.0%, girl: 34.1%) answered yes: 35.3% in cities (boy: 37.2%, girl: 34.2%) and 36.7% in agricultural areas (boy: 39.0%, girl: 33.9%): 34.8% of middle school students and 35.4% of high school students. 5) Have you heard that smokers are likely to have a lung cancer? 91.4% of students (boy: 93.2%, girl: 89.9%) answered yes: 90.35% in cities and 94.2% in agricultural areas. 6) Have you heard that the life of smokers gets shorter? 94.3% of students (boy:94.6%, girl: 92.2%) answered yes. 7) Have you heard that pregnant smokers will deliver a baby with low birth weight? 29.6% of students (boy: 29.8%, girl: 29.4%) answered yes: the rates of boys and girls almost the same. 8) Have you heard that one feels calm when one smokes? 80.1% of students (boy: 81.8%, girl: 79.2%) answered yes: boys and girls showed almost the same rate. 3. Preventive measures Smoking people continued to increase all over the world because smoking not only mitigated emotional uneasiness such as loneliness, nervousness and so on, but also could be very helpful from the social perspective. This was so because they did not consider harmful effects of smoking on health, and victims. However, because any -one can have physical disorders caused by smoking, people should always keep in mind the following preventive measures. 1) Doctors or teachers should set an example of giving up smoking. Informing patients or students of harmful effects of smoking to persuade their family and relatives not to smoke. 2) Through mass media like newspapers, periodicals or broadcasting, to make people know harmful effects of smoking and not smoke. 3) To prohibit selling teenagers cigarette by law. 4) To prohibit smoking in public places like work places, offices, lecture rooms, recreation rooms, buses, trains and so on. 5) To decrease the rate of life insurance for non-smokers as in foreign countries and to give a warming of the harmful effects on cigarette packets or ads.

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Characteristic and Application Under the Sericulture of Subtropical Zones Mulberry Adapted Itself to the Field Cultivation (노지재배(露地栽培)에 적응(適應)한 아열대산(亞熱帶産) 뽕나무의 특성(特性)과 양잠(養蠶)에서의 응용(應用))

  • Seok Young-Seek;Park Sang-Jo;An Sin-Hun;Han Sang-Mi;Yeo Joo-Hong;Han Myung-Sae
    • Journal of Sericultural and Entomological Science
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    • v.47 no.2
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    • pp.68-77
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    • 2005
  • A characteristic of subtropical zones region MK-T2 compares with an gaeryangppong, and the 9-10 schedule the times when a leaf blooms to are fast, and ratio that a branch edge by the colds becomes lean showed 5.7%, and a growth of the new branch which went out delivers 67.2 cm, mulberry loaves of the new branch which went out, and 18.6, a form of a leaf is the 1.10 that length of a leaf grew more a bit than width of a leaf up. Thickness of a leaf is $228.2{\mu}m$, and an area is more similar than gaeryangppong as $225.6cm^2$. in plant taxonomy, the hair whom the style exists short with 0.7 mm, and go to the pistil head inside so as to be rare is distributed, and belong to Dolichostylae Pubescentes. The new branch cutting which executed without remedy processes was independent of a thickness of a case branch, and the form and 100% root was said, and an gaeryangppong compared with the fact that 10% root went out of 15 mm ideal, and was excellent very, and looked, a root went out a root the soil and water, all showed a characteristic to go out at central of a branch bases at 45% ratio. Length was 24.6 mm, and were water rate 78.8%, and mulberry of MK-T2 was carrying together sweetness and acidity to pH 4.7 while, besides, arrival was 19.21 Brix%. A larva period and pupa ratio, cocoon thickness ratio are almost similar to gaeryangppong, or weight of one cocoon, cocoon thickness, 20,002 cocoon quantity shows some results to drop, and be soft of a leaf, and feed value certifications are comparatively top-ranking. As a result of having analyzed amino acid of the 3rd day of 5th silkworm larva which bred to MK-T2, a collation absorbing an gaeryangppong went, and looked, but compared with a collation in case of tests to eat MK-T2, and looked, and the lie collations were not detected a difference at Leu, but MK-T2 tests were detected mutual almost similar amino acid creation. medical efficacy of the 3rd day of 5th silkworm larva ethanol extract which bred to MK-T2 and black results, histologic a case did not appear at HE dyeing about the kidney organization which extracted form the rats which ate a silkworm ethanol extract and dyeing all chemical organization immunity, and one step protein revelation became lower with almost unidentified levels.

Fly Ash Application Effects on CH4 and CO2 Emission in an Incubation Experiment with a Paddy Soil (항온 배양 논토양 조건에서 비산재 처리에 따른 CH4와 CO2 방출 특성)

  • Lim, Sang-Sun;Choi, Woo-Jung;Kim, Han-Yong;Jung, Jae-Woon;Yoon, Kwang-Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.5
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    • pp.853-860
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    • 2012
  • To estimate potential use of fly ash in reducing $CH_4$ and $CO_2$ emission from soil, $CH_4$ and $CO_2$ fluxes from a paddy soil mixed with fly ash at different rate (w/w; 0, 5, and 10%) in the presence and absence of fertilizer N ($(NH_4)_2SO_4$) addition were investigated in a laboratory incubation for 60 days under changing water regime from wetting to drying via transition. The mean $CH_4$ flux during the entire incubation period ranged from 0.59 to $1.68mg\;CH_4\;m^{-2}day^{-1}$ with a lower rate in the soil treated with N fertilizer due to suppression of $CH_4$ production by $SO_4^{2-}$ that acts as an electron acceptor, leading to decreases in electron availability for methanogen. Fly ash application reduced $CH_4$ flux by 37.5 and 33.0% in soils without and with N addition, respectively, probably due to retardation of $CH_4$ diffusion through soil pores by addition of fine-textured fly ash. In addition, as fly ash has a potential for $CO_2$ removal via carbonation (formation of carbonate precipitates) that decreases $CO_2$ availability that is a substrate for $CO_2$ reduction reaction (one of $CH_4$ generation pathways) is likely to be another mechanisms of $CH_4$ flux reduction by fly ash. Meanwhile, the mean $CO_2$ flux during the entire incubation period was between 0.64 and $0.90g\;CO_2\;m^{-2}day^{-1}$, and that of N treated soil was lower than that without N addition. Because N addition is likely to increase soil respiration, it is not straightforward to explain the results. However, it may be possible that our experiment did not account for the substantial amount of $CO_2$ produced by heterotrophs that were activated by N addition in earlier period than the measurement was initiated. Fly ash application also lowered $CO_2$ flux by up to 20% in the soil mixed with fly ash at 10% through $CO_2$ removal by the carbonation. At the whole picture, fly ash application at 10% decreased global warming potential of emitted $CH_4$ and $CO_2$ by about 20%. Therefore, our results suggest that fly ash application can be a soil management practice to reduce green house gas emission from paddy soils. Further studies under field conditions with rice cultivation are necessary to verify our findings.

Radiation Therapy for Carcinoma of the Oropharynx (구인두암의 방사선치료)

  • Park, In-Kyu;Kim, Jae-Choel
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.95-103
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    • 1996
  • Purpose : A retrospective analysis for patients with oropharyngeal carcinoma who were treated with radiation was performed to assess the results of treatment and patterns of failure, and to identify the factors that might influence survival. materials and methods : From March 1985 through June 1993, 53 patients with oropharyngeal carcinoma were treated with either radiation therapy alone or combination of neoadjuvant chemotherapy and radiation therapy at the Department of Radiation Oncology, Kyungpook National University Hospital. Patients' ages ranged from 31 to 73 years with a median age of 54 years. There were 47 men and 6 women, Forty-two Patients ($79.2\%$) had squamous cell carcinoma, 10 patients ($18.9\%$) had undifferentiated carcinoma and 1 patient ($19\%$) had adenoid cystic carcinoma. There were 2 patients with stage I, 12 patients with stage II, 12 Patients with stage III and 27 patients with stage IV. According to the TNM classification, patients were distributed as follows: T1 7, T2 28, T3 10, T4 7, TX 1, and N0 17, Nl 13, N2 21, N3 2. The primary tumor sites were tonsillar region in 36 patients ($67.9\%$), base of the tongue in 12 patients ($22.6\%$), and soft palate in 5 patients ($9.4\%$). Twenty-five patients were treated with radiation therapy alone and twenty-eight Patients were treated with one to three courses of chemotherapy followed by radiation therapy. Chemotherapeutic regimens used were either CF (cisplatin and 5-fluorouracil) or CVB (cisplatin, vincristine and bleomycin). Radiation therapy was delivered 180-200 cGy daily, five times a week using 6 MV X-ray with or without 8-10 MeV electron beams A tumor dose ranged from 4500 cGy to 7740 cGy with a median dose of 7100 cGy. The follow-up time ranged from 4 months to 99 months with a median of 21 months. Results : Thirty-seven patients ($69.8\%$) achieved a CR (complete response) and PR (partial response) in 16 patients ($30.2\%$) after radiation therapy. The overall survival rates were $47\%$ at 2 years and $42\%$ at 3 years, respectively. The median survival time was 23 months. Overall stage (p=0.02) and response to radiation therapy (p=0.004) were significant prognostic factors for overall survival. The 2-year disease-free survival rate was $45.5\%$. T-stage (p=0.03), N-stage (p=0.04) and overall stage (P=0.04) were significant prognostic factors for disease-free survival. Age, sex, histology, primary site of the tumor, radiation dose, combination of chemotherapy were not significantly associated with disease-free survival. Among evaluable 32 Patients with CR to radiation therapy, 12 patients were considered to have failed Among these, 8 patients failed locoregionally and 4 Patients failed distantly. Conclusion : T-stage, N-stage and overall stage were significant prognostic factors for disease-free survival in the treatment of oropharyngeal cancer Since locoregional failure was the predominant pattern of relapse, potential methods to improve locoregional control with radiation therapy should be attempted. More controlled clinical, trials should be completed before acceptance of chemotherapy as a part of treatment of oropharyngeal carcinoma.

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Combined Chemotherapy and Radiation Therapy in Limited Disease Small-Cell Lung Cancer (국한성 소세포 폐암에서 항암 화학 및 흉부 방사선치료의 병합요법 적응)

  • Kim Moon Kyung;Ahn Yong Chan;Park Keunchil;Lim Do Hoon;Huh Seung Jae;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Kwon O Jung
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.9-15
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    • 1999
  • Purpose : This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer, Materials and Methods : Firty-six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deli- ver 44 Gy using 1 OMV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylaetic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. Results : The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved En 30 (65$\%$) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50$\%$), anemia in 17 (37$\%$), thrombo- cytopenia in nine (20$\%$), alopecia in nine (20$\%$), nausea/vomiting in five (11$\%$), and peripheral neuropathy in one (2$\%$). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24$\%$) out of the total 246 cycles. No radiation esophagitis over grade 111 was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The overall and progression-free survival rates were 79$\%$ and 55$\%$ in 1 year, and 45'/) and 32% in 2 years, respectively, and the median survival was 23 months. Conclusion : Relatively satisfactory local control and suwival rates were achieved after the combined chemotherapy and radiation therapy with mild to moderate acute morbidities in limited disease small cell lung cancer.

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Individualized Determination of Lower Margin in Pelvic Radiation Field after Low Anterior Resection for Rectal Cancer Resulted in Equivalent Local Control and Radiation Volume Reduction Compared with Traditional Method (하전방 절제술을 시행한 직장암 환자에서 방사선조사 영역 하연의 개별화)

  • Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.194-199
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    • 2000
  • Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

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Results of Curative Treatment for Cancer of the Tonsil (편도암의 근치적 치료 결과)

  • Park, Won;Ahn, Yong-Chan;Lim, Do-Hoon;Baek, Chung-Whan;Son, Young-Ik;Park, Keun-Chil;Kim, Kyoung-Ju;Lee, Jeung-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.261-268
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    • 2003
  • Purpose: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. Materials and Methods: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S$\pm$RT group), and radiation therapy in 10 (RT$\pm$CT group). The median follow-up period was 41 months. Results: AJCC stages were I/II in four, III in two, and IV in 21 patients. The 5-year disease-free survival rate was 73.3$\%$ in all patients, 70.6$\%$ in the S$\pm$RT group, and 77.8$\%$ in the RT$\pm$CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S$\pm$CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4$\%$). Two patients among the RT$\pm$CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0$\%$). The 5-year overall survival rate was 77.0$\%$ in all patients, 80.9$\%$ in the S$\pm$RT group, and 70.0$\%$ in the RT$\pm$CT group. Conclusion: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S$\pm$RT and RT$\pm$CT. RT$\pm$CT is judged to be an alternative option that can avoid the functional disability after surgical resection.