• Radiation Oncology Journal
• /
• 제14권4호
• /
• pp.307-315
• /
• 1996

목적 : 방사선치료를 시행한 자궁경부암 환자들의 생존율을 예후인자별로 비교분석함으로써 방사선 치료의 지표로 삼고자 하였다. 방법 : 1987년 1월부터 1988년 12월까지 자궁경부암으로 진단받고 본원 치료방사선과에서 방사선치료를 시행하였던 460명의 환자에 대한 치료결과를 후향적으로 분석하였다. 방사선치료 방법으로는 외부방사선 조사만 시행한 군이 103예, 외부방사선 조사 및 자궁강내 방사선 치료를 함께 시행한 군이 357예였다. 추적율은 88%, 총 추적 기간의 중앙값은 48개월이었다. 결과 : 전체 환자의 5년 생존율은 66.2%였다. FlGO 병기에 따른 5년 생존율은 Ib 81.2%, IIa 76.3%, IIb 73.1%, IIIa 50%, IIIb 52.3%, IVa 11.5%였다. 예후인자에 대한 분석에서 종양의 크기(P=0.0002), 림프절의 전이여부(p=0.0001), 종양의 성장형태(p=0.003), 치료 당시의 혈중 혈색소 농도(p=0.0001), 종양 세포의 종류(p=0.0001)등이 통계적으로 유의한 예후인자였으며, 35세 미만의 조기 발병인 경우 생존율의 감소가 관찰되었다(p=0.03). 그외 편평상피세포암의 종양 세포의 각질화 유무, 강내 방사선 치료 회수 등에 의한 생존율의 차이는 유의하지 않았다. 결론 : 자궁경부암의 방사선 치료시 주요 예후인자로는 종양의 크기 및, 성장형태, 림프절의 전이여부, 방사선치료시의 평균 혈중 혈색소치, 종양 세포의 종류등 이었다. 또한 35세 이전의 조기 발병 시에도 생존율이 감소하였다. 종양의 크기가 크면서 내장성 종양이거나, III기 이상이면서 종양이 큰 경우 등은 생존율의 향상을 위해 좀더 적극적인 치료가 필요하다.

• Radiation Oncology Journal
• /
• 제13권3호
• /
• pp.259-266
• /
• 1995

Purpose : The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. Materials and Methods : From January 1980 through December 1985, 227 patients with stage III uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients($317{\%}$) were stage IIIa, and 155 patients($68.3{\%}$) were stage IIIb according to FIGO classification. Age distribution was 32-71 years (median: 62 years). Sixty nine patients($95.8{\%}$) in stage IIIa and 150 patient ($96.8{\%}$) in stage IIIb were squamous cell carcinoma. pelvic lymph node metastasis at initial diagnosis was 8 patients($11.1{\%}$) in stage IIIa and 29 patients($18.7{\%}$) in stage IIIb, Among 72 patients with stage IIIa, 36 patients ($50{\%}$) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr.) and 36 patients($50{\%}$) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with $Cs^{137}$ sources, and among 155 patients with stage IIIb, 80 patients ($51.6{\%}$) were treated with external radiation therapy alone and 75 patients ($48.4{\%}$) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median: 78.5 Gy) and 65-125.5 Gy (median 83.5 Gy). Survival rate was calculated by life-table method. Results : Complete response rates were $58.3{\%}$(42 patients) in stage IIIa and $56.1{\%}$(87 patients) in stage IIIb. Overall 5 year survival rates were $57{\%}$ in stage IIIa and $40{\%}$ in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were $64{\%},\;40{\%}$ in the group treated in combination of external radiation and ICR, and $50\%,\;40\%$ in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were $90\%,\;66\%$ in responder group and $10\%,\;7\%$ in non-responder group (P<0.001) There were statistically no significant differences of 5 year survival rate by total radiation doses and external radiation doses(40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatment failures rates were $40.3\%$(29 patients) in stage IIla and $57.4\%$(89 patients) in stage IIIb. 17 patients ($23.6\%$) in stage IIIa and 46 patients ($29.7\%$) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa($50\%$) and IIIb($50\%$). Serious complication rates were higher in group received external radiation doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Serious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of death was cachexia due to locoregional failure in both stage IIIa($34.7\%$) and IIIb($43.9\%$). Conclusion : From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy to whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.

• Radiation Oncology Journal
• /
• 제7권1호
• /
• pp.81-83
• /
• 1989

This study, involving thirty-two patients with carcinoma of uterine cervix treated by high dose rate intracavitary irradiation using a remotely controlled afterloading system, compares the doss at point A and 8 with the Curie-minutes prescription. A linear least-square regression analysis was used to compare the two sets of date. Correlation coefficients between doses at points A and B and the Ci-min prescription are 0.92 (p<0.001) and 0.90 (p<0.001), respectively, and linear relationship is observed between these two system. The limitation and significance of the comparison of the two approaches to intracavitary dosimetry is discussed.

• 대한의생명과학회지
• /
• 제2권2호
• /
• pp.153-158
• /
• 1996

Verapamil은 항암제에 대한 내성을 극복하기 위하여 실험적으로 사용하는 대표적인 약제로 알려져 있다 본 연구에서는 부인과 종양중 자궁경부암 치료시에 발생하는 항암 화학요법제에 대한 내성을 극복하기 위한 기초적인 실험으로 인체 자궁경부암 유래의 HeLa 및 Caski 세포주를 이용, MTT법으로 verapamil과 5-FU 및 DDP를 단독 혹은 병용 처리하여 세포독성 상승효과를 측정하였다. Verapamil 단독투여시 각 세포주는 용량에 비례하여 세포독성이 증가하였으며, 각 항암제와의 병용 투여시에 세포독성의 상승효과가 관찰이 되었으며, HeLa세포주에서 그 효과가 가장 높았다. 이러한 결과를 바탕으로 세포내 내성발현의 기전의 탐구가 필요하며 자궁경부암 화학요법에 verapamil사용의 이론적인 가능성을 제시하고 있다

• 대한한방부인과학회지
• /
• 제19권4호
• /
• pp.47-60
• /
• 2006

Purpose : This study was conducted to investigate the inhibitory effects of Scutellaria barbata D. D on on the cell proliferation of HeLa Cells. Methods : Human uterine cervical carcinoma HeLa cells were cultured in the 1%, 5% and 10% concentration of Scutellaria barbata D. D on solution for 24, 48 and 72 hours for the direct inhibitory effects of Scutellaria barbata D. D on. Then we examined the effect of Scutellaria barbata D. D on solution on the cell proliferation inhibition by XTT assay. DNA fragmentation, MAP kinase activity and caspase activity by FACS analysis in HeLa cells. Results : We found that the proliferation of HeLa cells was significantly decreased in Scutellaria barbata D. D on solution containing groups comparing with a control group in a concentration-dependant manner. When HeLa cells were cultivated for 24 hours with 5% Scutellaria barbata D. D on solution containing group, the percentage of HeLa cells with activated caspase was the highest. Scutellaria barbata D. D on solution reduced the MAP kinase activity of HeLa cells comparing with the control group. By the XTT assay, the cell's activity was decreased in 5% and 10% Scutellaria barbata D. D on solution containing groups in 24 and 72 hours cultivation and 10% group in 48 hours. DNA fragmentation and caspase-3 activity of HeLa cells, however, were changed insignificantly. Conclusion : From this study we could suggest that Scutellaria barbata D. D on is available to the inhibition and apoptosis of human cervical carcinoma cell line, HeLa cells in vitro.

• 대한한의학회지
• /
• 제27권1호
• /
• pp.23-35
• /
• 2006

Objectives : This study was conducted to investigate the inhibitory effects of Gaejibokryunghwan on cell proliferation in HeLa cells. Methods : Human uterine cervical carcinoma HeLa cells were cultured in the 1%, 5% and 10% concentration of Gaejibokryunghwan extract solution. All three were cultured for 24 hours, 48 hours and 72 hours each, to examine the inhibitory effects of Gaejibokryunghwan. Afterwards, we drew out the effect of Gaejibokryunghwan extract solution by making 5 analysis. First analysis was to measure the proliferation rate of cells. Second was FACS analysis. Third was to estimate the activity or caspase-3. Fourth, we used XTT assay to analyze the activation or cells. Ana lastly, a molecular biological method was used to determine activation of MAP kinase in the HeLa cells. Results : After 24, 48 and 72 hours cultivation, the proliferation of HeLa cells showed the dose-dependent decrease in all Gaejibokryunghwan extract solution groups compared to the control group. In the FACS analysis, Gaejibokryunghwan extract solution groups showed increased caspase expression compared to the control group, except for the group for 48 and 72 hours in 1 % concentrate. Caspase-3 activities were increased in all, except tile group cultured for 24 hours in 5% concentrate and the groups cultured for 48 hours in 1% and 5% concentrate. In the XTT study, 1% Gaejibokryunghwan extract solution groups showed increase compared to the control group, but other Gaejibokryunghwan extract solution containing groups showed significant decrease compared to the control after 24, 48 and 72 hours of cultivation. The expressions of MAP kinase were decreased in all Gaejibokryunghwan extract solution containing groups compared to the control group after 24, 48 and 72 hours of cultivation. Conclusions : From this study, we could suggest that Gaejibokryunghwan be available to the inhibition of proliferation of human cervical carcinoma cell line, HeLa cells in vitro.

• 대한한방부인과학회지
• /
• 제19권2호
• /
• pp.34-48
• /
• 2006

Purpose : This study was conducted to investigate the inhibitory effects of Dangguijakyaksan on cell proliferation in HeLa cells. Methods : Human uterine cervical carcinoma HeLa cells were cultured in the 1%, 5% and 10% concentration of Dangguijakyaksan extract solution for 24 hours, 48 hours and 72 hours for the direct inhibitory effects of Dangguijakyaksan. Afterwards, we executed the analysis of the effect of Dangguijakyaksan extract solution on cell proliferation inhibition using XTT assay, molecular biological method through MAP kinase activity and FACS analysis of caspase activity in the HeLa cells. Results : After 24, 48 and 72 hours cultivation, Dangguijakyaksan extract solution group showed significant decrease of HeLa cells except 1% solution after 24 hours compared with the control group. In the FACS analysis, Dangguijakyaksan extract solution groups showed increase of caspase activity except 1% solution after 48 hours compared with the control group. In the XTT assay, the caspase-3 activities were increased in Dangguijakyaksan extract solution groups except 1% solution after 24 hours in a dose-dependent manner. In the XTT study, cell activities were significantly decreased in 10% Dangguijakyaksan extract solution groups after 48 and 72 hours cultivation compared with the control group. In all Dangguijakyaksan extract solution groups, The activities of MAP kinase were decreased after 24, 48 and 72 hours cultivation compared with the control group. Conclusion : It could be concluded that Dangguijakyaksan is available to the inhibition of proliferation of human cervical carcinoma cell line in vitro.

• Radiation Oncology Journal
• /
• 제20권4호
• /
• pp.396-404
• /
• 2002

목적 : 자궁암의 방사선치료시 호발하는 직장 부작용은 직장 방사선량과 관계가 있다는 보고들이 많다. ICRU 38에 따른 직장 선량을 측정함으로 강내 방사선치료 시에 조사되는 직장선량의 정도 관리에 기여할 수 있다고 생각하여 전산상 계산된 선량과 강내치료시 다이오드 검출기로 직접 측정된 직장 선량의 차이를 비교해 보고자 하였다. 대상 : 2001년 6월-2002년 2월까지 고선량율 Iridium-192 동위원소를 이용하여 고선량율 강내 방사선치료를 시행 받은 자궁경부암 환자 9명을 대상으로 하였다. 강내치료는 주 2회씩 A점에 총 $6\~8$회간 총 $28\~32\;Gy$ 시행되었다 9명에서 총 44회의 강내치료 중 선량 측정이 가능하였고, 모의치료 계획시의 필름 및 분할 고선량율 강내 방사선치료 시에 촬영한 필름을 기준으로 전산화 계획 시스템상 계산한 직장 기준점 선량과 강내치료를 하면서 다이오드 직장 검출기에서 측정된 선량을 각각 분석하였다. 결과 : 모의치료시 필름을 기준한 직장의 전산화 계획상의 선량과 강내치료 시마다 촬영한 필름으로 다시 전산화 계획상 계산한 직장선량값 사이에는 상당한 차이가 있었다. 강내치료시에 촬영한 사진을 기준으로 전산화 설계에서 계산된 값과 강내치료 중에 검출기로 측정한 직장 선량 사이에도 차이가 많았다. 직장 검출기 표시점의 치료계획 선량을 5개 점에서 계산해 보았을 때 ICRU 38 직장 기준점이 최대 직장 선량점과 일치하는 경우는 $22.2\%$ (2/9)에 불과하였다. 결론 : 자궁암에서 고선량율 강내 방사선치료 선량을 계획할 때 모의 치료시 촬영한 필름만 가지고 직장 선량을 최적화하는 것이 가장 적절한 방법이라고 볼 수는 없다. 본 연구를 통해 고선량율 강내치료시의 직장 선량이 치료시마다 상당히 변화가 많다는 사실을 확인하였으므로 가능하면 직장선량을 실측하거나 아니면 최소한 직장표지기를 삽입하고 측방 투시를 함으로 직장 위치를 파악하는 것이 자궁암의 고선량을 강내 방사선치료에서 정도관리 면에서 중요한 과정이라 생각한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권7호
• /
• pp.3281-3285
• /
• 2012

Objectives: To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA). Methods: Formalin-fixed, paraffin-embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region. Results: Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ${\leq}5.00$ copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified. Conclusion: HPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권9호
• /
• pp.5165-5169
• /
• 2013

Background: To evaluate the pathological characteristics of invasive margins in early-stage cervical squamous cell carcinomas and their association with other clinicopathological features including clinical outcomes. Materials and Methods: Patients with FIGO stage IB-IIA cervical squamous cell carcinomas who received surgical treatment and had available follow-up information were identified. Their histological slides were reviewed for prognostic variables including tumor size, grade, extent of invasion, lymphovascular invasion, involvement of vaginal margin or parametrium, and lymph node metastasis. The characteristics of invasive margins including invasive pattern (closed, finger-like, or spray-like type), degree of stromal desmoplasia, and degree of peritumoral inflammatory reaction were evaluated along the entire invasive fronts of tumours. Associations between the characteristics of invasive margins and other clinicopathological variables and disease-free survival were assessed. Results: A total of 190 patients were included in the study with a median follow-up duration of 73 months. Tumour recurrence was observed in 18 patients (9%). Spray-like invasive pattern was significantly more associated as compared with closed or finger-like invasive pattern (p=0.005), whereas the degree of stromal desmoplasia or peritumoral inflammatory reaction was not. Low degree of peritumoral inflammatory reaction appeared linked with lymph node metastasis (p=0.021). In multivariate analysis, a spray-like invasive pattern was independently associated with marked stromal desmoplasia (p=0.013), whilst marked desmoplasia was also independently associated with low inflammatory reactions (p=0.009). Furthermore, low inflammatory reactions were independently associated with positive margins (p=0.022) and lymphovascular invasion (p=0.034). The patients with spray-like invasive pattern had a significantly lower disease-free survival compared with those with closed or finger-like pattern (p=0.004). Conclusions: There is a complex interaction between cancer tissue at the invasive margin and changes in surrounding stroma. A spray-like invasive pattern has a prognostic value in patients with early-stage cervical squamous cell carcinoma.