• Title/Summary/Keyword: analysis parameters

Search Result 18,325, Processing Time 0.05 seconds

Measuring Consumer-Brand Relationship Quality (소비자-브랜드 관계 품질 측정에 관한 연구)

  • Kang, Myung-Soo;Kim, Byoung-Jai;Shin, Jong-Chil
    • Journal of Global Scholars of Marketing Science
    • /
    • v.17 no.2
    • /
    • pp.111-131
    • /
    • 2007
  • As a brand becomes a core asset in creating a corporation's value, brand marketing has become one of core strategies that corporations pursue. Recently, for customer relationship management, possession and consumption of goods were centered on brand for the management. Thus, management related to this matter was developed. The main reason of the increased interest on the relationship between the brand and the consumer is due to acquisition of individual consumers and development of relationship with those consumers. Along with the development of relationship, a corporation is able to establish long-term relationships. This has become a competitive advantage for the corporation. All of these processes became the strategic assets of corporations. The importance and the increase of interest of a brand have also become a big issue academically. Brand equity, brand extension, brand identity, brand relationship, and brand community are the results derived from the interest of a brand. More specifically, in marketing, the study of brands has been led to the study of factors related to building of powerful brands and the process of building the brand. Recently, studies concentrated primarily on the consumer-brand relationship. The reason is that brand loyalty can not explain the dynamic quality aspects of loyalty, the consumer-brand relationship building process, and especially interactions between the brands and the consumers. In the studies of consumer-brand relationship, a brand is not just limited to possession or consumption objectives, but rather conceptualized as partners. Most of the studies from the past concentrated on the results of qualitative analysis of consumer-brand relationship to show the depth and width of the performance of consumer-brand relationship. Studies in Korea have been the same. Recently, studies of consumer-brand relationship started to concentrate on quantitative analysis rather than qualitative analysis or even go further with quantitative analysis to show effecting factors of consumer-brand relationship. Studies of new quantitative approaches show the possibilities of using the results as a new concept of viewing consumer-brand relationship and possibilities of applying these new concepts on marketing. Studies of consumer-brand relationship with quantitative approach already exist, but none of them include sub-dimensions of consumer-brand relationship, which presents theoretical proofs for measurement. In other words, most studies add up or average out the sub-dimensions of consumer-brand relationship. However, to do these kind of studies, precondition of sub-dimensions being in identical constructs is necessary. Therefore, most of the studies from the past do not meet conditions of sub-dimensions being as one dimension construct. From this, we question the validity of past studies and their limits. The main purpose of this paper is to overcome the limits shown from the past studies by practical use of previous studies on sub-dimensions in a one-dimensional construct (Naver & Slater, 1990; Cronin & Taylor, 1992; Chang & Chen, 1998). In this study, two arbitrary groups were classified to evaluate reliability of the measurements and reliability analyses were pursued on each group. For convergent validity, correlations, Cronbach's, one-factor solution exploratory analysis were used. For discriminant validity correlation of consumer-brand relationship was compared with that of an involvement, which is a similar concept with consumer-based relationship. It also indicated dependent correlations by Cohen and Cohen (1975, p.35) and results showed that it was different constructs from 6 sub-dimensions of consumer-brand relationship. Through the results of studies mentioned above, we were able to finalize that sub-dimensions of consumer-brand relationship can viewed from one-dimensional constructs. This means that the one-dimensional construct of consumer-brand relationship can be viewed with reliability and validity. The result of this research is theoretically meaningful in that it assumes consumer-brand relationship in a one-dimensional construct and provides the basis of methodologies which are previously preformed. It is thought that this research also provides the possibility of new research on consumer-brand relationship in that it gives root to the fact that it is possible to manipulate one-dimensional constructs consisting of consumer-brand relationship. In the case of previous research on consumer-brand relationship, consumer-brand relationship is classified into several types on the basis of components consisting of consumer-brand relationship and a number of studies have been performed with priority given to the types. However, as we can possibly manipulate a one-dimensional construct through this research, it is expected that various studies which make the level or strength of consumer-brand relationship practical application of construct will be performed, and not research focused on separate types of consumer-brand relationship. Additionally, we have the theoretical basis of probability in which to manipulate the consumer-brand relationship with one-dimensional constructs. It is anticipated that studies using this construct, which is consumer-brand relationship, practical use of dependent variables, parameters, mediators, and so on, will be performed.

  • PDF

A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
    • /
    • v.19 no.2
    • /
    • pp.127-135
    • /
    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

  • PDF

Application and Analysis of Ocean Remote-Sensing Reflectance Quality Assurance Algorithm for GOCI-II (천리안해양위성 2호(GOCI-II) 원격반사도 품질 검증 시스템 적용 및 결과)

  • Sujung Bae;Eunkyung Lee;Jianwei Wei;Kyeong-sang Lee;Minsang Kim;Jong-kuk Choi;Jae Hyun Ahn
    • Korean Journal of Remote Sensing
    • /
    • v.39 no.6_2
    • /
    • pp.1565-1576
    • /
    • 2023
  • An atmospheric correction algorithm based on the radiative transfer model is required to obtain remote-sensing reflectance (Rrs) from the Geostationary Ocean Color Imager-II (GOCI-II) observed at the top-of-atmosphere. This Rrs derived from the atmospheric correction is utilized to estimate various marine environmental parameters such as chlorophyll-a concentration, total suspended materials concentration, and absorption of dissolved organic matter. Therefore, an atmospheric correction is a fundamental algorithm as it significantly impacts the reliability of all other color products. However, in clear waters, for example, atmospheric path radiance exceeds more than ten times higher than the water-leaving radiance in the blue wavelengths. This implies atmospheric correction is a highly error-sensitive process with a 1% error in estimating atmospheric radiance in the atmospheric correction process can cause more than 10% errors. Therefore, the quality assessment of Rrs after the atmospheric correction is essential for ensuring reliable ocean environment analysis using ocean color satellite data. In this study, a Quality Assurance (QA) algorithm based on in-situ Rrs data, which has been archived into a database using Sea-viewing Wide Field-of-view Sensor (SeaWiFS) Bio-optical Archive and Storage System (SeaBASS), was applied and modified to consider the different spectral characteristics of GOCI-II. This method is officially employed in the National Oceanic and Atmospheric Administration (NOAA)'s ocean color satellite data processing system. It provides quality analysis scores for Rrs ranging from 0 to 1 and classifies the water types into 23 categories. When the QA algorithm is applied to the initial phase of GOCI-II data with less calibration, it shows the highest frequency at a relatively low score of 0.625. However, when the algorithm is applied to the improved GOCI-II atmospheric correction results with updated calibrations, it shows the highest frequency at a higher score of 0.875 compared to the previous results. The water types analysis using the QA algorithm indicated that parts of the East Sea, South Sea, and the Northwest Pacific Ocean are primarily characterized as relatively clear case-I waters, while the coastal areas of the Yellow Sea and the East China Sea are mainly classified as highly turbid case-II waters. We expect that the QA algorithm will support GOCI-II users in terms of not only statistically identifying Rrs resulted with significant errors but also more reliable calibration with quality assured data. The algorithm will be included in the level-2 flag data provided with GOCI-II atmospheric correction.

The Predictable Factors for the Mortality of Fatal Asthma with Acute Respiratory Failure (호흡부전을 동반한 중증천식환자의 사망 예측 인자)

  • Park, Joo-Hun;Moon, Hee-Bom;Na, Joo-Ock;Song, Hun-Ho;Lim, Chae-Man;Lee, Moo-Song;Shim, Tae-Sun;Lee,, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.47 no.3
    • /
    • pp.356-364
    • /
    • 1999
  • Backgrounds: Previous reports have revealed a high morbidity and mortality in fatal asthma patients, especially those treated in the medical intensive care unit(MICU). But it has not been well known about the predictable factors for the mortality of fatal asthma(F A) with acute respiratory failure. In order to define the predictable factors for the mortality of FA at the admission to MICU, we analyzed the relationship between the clinical parameters and the prognosis of FA patients. Methods: A retrospective analysis of all medical records of 59 patients who had admitted for FA to MICU at a tertiary care MICU from January 1992 to March 1997 was performed. Results: Over all mortality rate was 32.2% and 43 patients were mechanically ventilated. In uni-variate analysis, the death group had significantly older age ($66.2{\pm}10.5$ vs. $51.0{\pm}18.8$ year), lower FVC($59.2{\pm}21.1$ vs. $77.6{\pm}23.3%$) and lower $FEV_1$($41.4{\pm}18.8$ vs. $61.l{\pm}23.30%$), and longer total ventilation time ($255.0{\pm}236.3$ vs. $98.1{\pm}120.4$ hour) (p<0.05) compared with the survival group (PFT: best value of recent 1 year). At MICU admission, there were no significant differences in vital signs, $PaCO_2$, $PaO_2/FiO_2$, and $AaDO_2$, in both groups. However, on the second day of MICU, the death group had significantly more rapid pulse rate ($121.6{\pm}22.3$ vs. $105.2{\pm}19.4$ rate/min), elevated $PaCO_2$ ($50.1{\pm}16.5$ vs. $41.8{\pm}12.2 mm Hg$), lower $PaO_2/FiO_2$, ($160.8{\pm}59.8$ vs. $256.6{\pm}78.3 mm Hg$), higher $AaDO_2$ ($181.5{\pm}79.7$ vs. $98.6{\pm}47.9 mm Hg$), and higher APACHE III score ($57.6{\pm}21.1$ vs. $20.3{\pm}13.2$) than survival group (p<0.05). The death group had more frequently associated with pneumonia and anoxic brain damage at admission, and had more frequently developed sepsis during disease progression than the survival group (p<0.05). Multi-variate analysis using APACHE III score and $PaO_2/FiO_2$, ratio on first and second day, age, sex, and pneumonia combined at admission revealed that APACHE III score (40) and $PaO_2/FiO_2$ ratio (<200) on second day were regarded as predictive factors for the mortality of fatal asthma (p<0.05). Conclusions: APACHE III score ($\geq$40) and $PaO_2/FiO_2$ ratio (<200) on the second day of MICU, which might reflect the response of treatment, rather than initially presented clinical parameters would be more important predictable factors of mortality in patients with FA.

  • PDF

Estimation of GARCH Models and Performance Analysis of Volatility Trading System using Support Vector Regression (Support Vector Regression을 이용한 GARCH 모형의 추정과 투자전략의 성과분석)

  • Kim, Sun Woong;Choi, Heung Sik
    • Journal of Intelligence and Information Systems
    • /
    • v.23 no.2
    • /
    • pp.107-122
    • /
    • 2017
  • Volatility in the stock market returns is a measure of investment risk. It plays a central role in portfolio optimization, asset pricing and risk management as well as most theoretical financial models. Engle(1982) presented a pioneering paper on the stock market volatility that explains the time-variant characteristics embedded in the stock market return volatility. His model, Autoregressive Conditional Heteroscedasticity (ARCH), was generalized by Bollerslev(1986) as GARCH models. Empirical studies have shown that GARCH models describes well the fat-tailed return distributions and volatility clustering phenomenon appearing in stock prices. The parameters of the GARCH models are generally estimated by the maximum likelihood estimation (MLE) based on the standard normal density. But, since 1987 Black Monday, the stock market prices have become very complex and shown a lot of noisy terms. Recent studies start to apply artificial intelligent approach in estimating the GARCH parameters as a substitute for the MLE. The paper presents SVR-based GARCH process and compares with MLE-based GARCH process to estimate the parameters of GARCH models which are known to well forecast stock market volatility. Kernel functions used in SVR estimation process are linear, polynomial and radial. We analyzed the suggested models with KOSPI 200 Index. This index is constituted by 200 blue chip stocks listed in the Korea Exchange. We sampled KOSPI 200 daily closing values from 2010 to 2015. Sample observations are 1487 days. We used 1187 days to train the suggested GARCH models and the remaining 300 days were used as testing data. First, symmetric and asymmetric GARCH models are estimated by MLE. We forecasted KOSPI 200 Index return volatility and the statistical metric MSE shows better results for the asymmetric GARCH models such as E-GARCH or GJR-GARCH. This is consistent with the documented non-normal return distribution characteristics with fat-tail and leptokurtosis. Compared with MLE estimation process, SVR-based GARCH models outperform the MLE methodology in KOSPI 200 Index return volatility forecasting. Polynomial kernel function shows exceptionally lower forecasting accuracy. We suggested Intelligent Volatility Trading System (IVTS) that utilizes the forecasted volatility results. IVTS entry rules are as follows. If forecasted tomorrow volatility will increase then buy volatility today. If forecasted tomorrow volatility will decrease then sell volatility today. If forecasted volatility direction does not change we hold the existing buy or sell positions. IVTS is assumed to buy and sell historical volatility values. This is somewhat unreal because we cannot trade historical volatility values themselves. But our simulation results are meaningful since the Korea Exchange introduced volatility futures contract that traders can trade since November 2014. The trading systems with SVR-based GARCH models show higher returns than MLE-based GARCH in the testing period. And trading profitable percentages of MLE-based GARCH IVTS models range from 47.5% to 50.0%, trading profitable percentages of SVR-based GARCH IVTS models range from 51.8% to 59.7%. MLE-based symmetric S-GARCH shows +150.2% return and SVR-based symmetric S-GARCH shows +526.4% return. MLE-based asymmetric E-GARCH shows -72% return and SVR-based asymmetric E-GARCH shows +245.6% return. MLE-based asymmetric GJR-GARCH shows -98.7% return and SVR-based asymmetric GJR-GARCH shows +126.3% return. Linear kernel function shows higher trading returns than radial kernel function. Best performance of SVR-based IVTS is +526.4% and that of MLE-based IVTS is +150.2%. SVR-based GARCH IVTS shows higher trading frequency. This study has some limitations. Our models are solely based on SVR. Other artificial intelligence models are needed to search for better performance. We do not consider costs incurred in the trading process including brokerage commissions and slippage costs. IVTS trading performance is unreal since we use historical volatility values as trading objects. The exact forecasting of stock market volatility is essential in the real trading as well as asset pricing models. Further studies on other machine learning-based GARCH models can give better information for the stock market investors.

Water Quality Level Model Using the Discriminant Analysis for the Small Streams of Rural Area in the Han River Watersheds (판별분석을 이용한 한강권역 농업용 하천수의 수질등급모형)

  • Choi, Chul-Mann;Lee, Jong-Sik;Cho, Nam-Jun;Ryu, Hui-Yong;Park, Seong-Jin;Kim, Jin-Ho;Yun, Sun-Gang;Lee, Jeong-Taek
    • Korean Journal of Environmental Agriculture
    • /
    • v.27 no.2
    • /
    • pp.105-110
    • /
    • 2008
  • The main purpose of this work is the development of water quality level model using the data such as DO, EC, BOD, $COD_{Cr},\;NH_3-N,\;NO_3-N,\;PO_4-P$, T-N, T-P, and SS in 88 agricultural streams of the Han river watersheds. To grant water quality level for each parameters, it divided into 20% respectively in the order of water quality level. On the basis of the lowest water quality level, water quality of streams was assigned. As the result, number of stream corresponding to Level Ⅰ was 0, Level II was 1 stream, Level III was 3 streams, Level IV was 22 streams, and Level V was 62 streams. By standardized canonical discriminant function coefficient, $NO_3-N$ was the highest in 0.427 at the discriminant power. According to discriminant function for water quality level, it was equal to $-4.648+3.246{\times}[NO_3-N],\;-5.084+3.456{\times}[NO_3-N],\;-4.298+3.067{\times}[NO_3-N],\;and\;-7.369+4.396{\times}[NO_3-N]$ from Level II to Level V, respectively. As a result of test at real data of the Han river watersheds in 2007, the suitability of water quality level model was high to 88.4%.

Antioxidative Properties of Chinese Artichoke (Stachys sieboldii Miq) added White Bread (초석잠 첨가 식빵의 항산화 활성)

  • Jeon, Ki-Suk;Park, Shin-In
    • Culinary science and hospitality research
    • /
    • v.21 no.6
    • /
    • pp.120-132
    • /
    • 2015
  • The purpose of this study was to provide preliminary information for the utilization extension of Chinese artichoke(Stachys sieboldii Miq) as a functional food material. The effects of the addition of Chinese artichoke powder(0, 3, 6, 9, and 12%) in white bread formulation on phenolics content and antioxidant properties, and sensory analysis(seven-point hedonic test) were examined. The contents of total polyphenols(TPC), flavonoids (TFC), and tannins(TTC) in Chinese artichoke powder were $139.09{\pm}1.97mg\;GAE/g\;dw$, $74.33{\pm}2.69mg\;QE/g\;dw$, and $40.41{\pm}2.54 mg\;TAE/g\;dw$, respectively. As the amount of Chinese artichoke powder increased, the phenolics contents also significantly increased(p<0.001, p<0.001, and p<0.001 on TPC, TFC, and TTC, respectively), the highest TPC($104.27{\pm}0.13mg\;GAE/g\;dw$), TFC($71.03{\pm}1.75mg\;QE/g\;dw$), and TTC($8.76{\pm}0.12mg\;TAE/g\;dw$) were achieved in the white bread having the highest percentage of Chinese artichoke powder(12%). The $IC_{50}$ values of Chinese artichoke extract for 1,1-diphenyl-2-picrylhydrazyl(DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid(ABTS) radical scavenging activities were 1.42 mg/mL and 1.57 mg/mL, respectively. Scavenging activities of DPPH and ABTS radicals of white bread were significantly increased according to the levels of added Chinese artichoke powder(p<0.001 and p<0.001, respectively). In the acceptance test, the white bread containing 9% Chinese artichoke powder was ranked significantly higher than the other groups according to all sensory parameters such as appearance, flavor, taste, texture, and the overall acceptability. Overall, Chinese artichoke enhanced white bread could be developed as an antioxidant-enriched bread with good sensorial properties.

A Case Study on Venture and Small-Business Executives' Use of Strategic Intuition in the Decision Making Process (벤처.중소기업가의 전략적 직관에 의한 의사결정 모형에 대한 사례연구)

  • Park, Jong An;Kim, Young Su;Do, Man Seung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.9 no.1
    • /
    • pp.15-23
    • /
    • 2014
  • A Case Study on Venture and Small-Business Executives' Use of Strategic Intuition in the Decision Making Process This paper is a case study on how Venture and Small-Business Executives managers can take advantage of their intuitions in situations where the business environment is increasingly uncertain, a novel situation occurs without any data to reflect on, when rational decision-making is not possible, and when the business environment changes. The case study is based on a literature review, in-depth interviews with 16 business managers, and an analysis of Klein, G's (1998) "Generic Mental Simulation Model." The "intuition" discussed in this analysis is classified into two types of intuition: the Expert Intuition which is based on one's own experiences, and Strategic Intuition which is based on the experience of others. Case study strategic management intuition and intuition, the experts were utilized differently. Features of professional intuition to work quickly without any effort by, while the strategic intuition, is time-consuming. Another feature that has already occurred, one expert intuition in decision-making about the widely used strategic intuition was used a lot in future decision-making. The case study results revealed that managers were using expert intuition and strategic intuition differentially. More specifically, Expert Intuition was activated effortlessly, while strategic intuition required more time. Also, expert intuition was used mainly for making judgments about events that have already happened, while strategic intuition was used more often for judgments regarding events in the future. The process of strategic intuition involved (1) Strategic concerns, (2) the discovery of medium, (3) Primary mental simulation, (4) The offsetting of key parameters, (5) secondary mental simulation, and (6) the decision making process. These steps were used to develop the "Strategic Intuition Decision-making Model" for Venture and Small-Business Executives. The case study results further showed that firstly, the success of decision-making was determined in the "secondary mental simulation' stage, and secondly, that more difficulty in management was encountered when expert intuition was used more than strategic intuition and lastly strategic intuition is possible to be educated.

  • PDF

Revised Rates of NPK Fertilizers Based on Soil Testing for Sesame and Peanut (토양검정(土壤檢定)에 의한 참깨와 땅콩의 삼요소(三要素) 시비량(施肥量) 조정(調整))

  • Lee, Choon-Soo;Lee, Ju-Young;Lee, Sang-Eun;Huh, Beom-Lyang
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.27 no.2
    • /
    • pp.92-97
    • /
    • 1994
  • An attempt was made to provide the most resonable fertilizer recommendation for sesame and peanut crops based on soil analytical data and yield response to the NPK fertilizer application, which were obtained from field experiments conducted during 1970 to 1993. 1. According to the analytical data of sesame and peanut soils obtained in 1985~1993, the contents of organic matter, available $P_2O_5$, exchangeable K, Ca and Mg were increased in sesame soils, but the those components were decreased in peanut soils. 2. The yield index of the plot without N, $P_2O_5$ and $K_2O$ fertilizer were 81-84, 84~92 and 81~92, respectively, as the yield of NPK plot was regarded as 100. 3. Linear or quadratic equations derived from the relationship between soil analysis data and fertilizer application rates were proposed for NPK recommendation. The parameters of soil analysis used in the equations for N, P and K were organic matter, available $P_2O_5$ and exchangeable K, respectively. 4. Revised fertilizer recommendation based on the soil chemical status enable to save the fertilizer application of sesame and peanut soils. The amounts of saved NPK fertilizers were 5.1kg N/10a(increase in 2.8kg N/10a for peanut), 0.9~2.9kg $P_2O_5/10a$, and 1.7~5.8kg $K_2O$/10a.

  • PDF

Adjuvant Postoperative Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 수술 후 방사선치료)

  • Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
    • Radiation Oncology Journal
    • /
    • v.21 no.3
    • /
    • pp.199-206
    • /
    • 2003
  • Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.