• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8559-8561
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• 2016

Purpose: To evaluate efficacy of radiofrequency ablation (RFA) in treating colorectal cancer patients with liver metastases. Methods: During January 2010 to April 2012, 56 colorectal cancer patients with liver metastases underwent RFA. CT scans were obtained one month after RFA for all patients to evaluate tumor response. (CR+PR+SD)/n was used to count the disease control rates (DCR). Survival data of 1, 2 and 3 years were obtained from follow up. Results: Patients were followed for 10 to 40 months after RFA (mean time, $25{\pm}10months$). Median survival time was 27 months. The 1, 2, 3 year survival rate were 80.4%, 71.4%, 41%, 1 % respectively. 3-year survival time for patients with CR or PR after RFA was 68.8% and 4.3% respectively, the difference was statistically significant. The number of CR, PR, SD and PD in our study was 13, 23, 11 and 9 respectively. Conclusions: RFA could be an effective method for treating colorectal cancer patients with liver metastases, and prolong survival time, especially for metastatic lesions less than or equal to 3 cm. But this result should be confirmed by randomized controlled studies.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1597-1602
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• 2014

The purpose of this study was to investigate whether whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases. From January 2007 to December 2012, 19 patients who exhibited massive (with a longest diameter > 5 cm) and invasive liver metastases and multiple metastases were treated with radiotherapy and concurrent chemotherapy. The total radiation dose was 53.4 Gy (range 38.8 Gy-66.3 Gy). All of the patients received a continuous intravenous dose of 5 fluorouracil (5-FU) 225 mg/m2 concurrently with radiation. The median survival time was 19 months. The 1- and 2- year overall survival rates were 78.3% and 14.3%, respectively. Of all of the patients who presented with abdominal pain, 100% experienced a decrease in pain. Decreases in the rates of ascites and jaundice were confirmed by ultrasound and bilirubin levels. No cases of Grade 4 or 5 acute or late toxicity were recorded. There were only two cases of Grade 3 toxicity (elevated bilirubin). These data provide evidence that whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases.

• Radiation Oncology Journal
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• 제32권2호
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• pp.77-83
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• 2014

Purpose: To determine the prognostic and predictive value of liver volume in colorectal cancer patients with unresectable liver metastases. Materials and Methods: Sixteen patients received whole liver radiotherapy (WLRT) between January 1997 and June 2013. A total dose of 21 Gy was delivered in 7 fractions. Results: The median survival time after WLRT was 9 weeks. In univariate analysis, performance status, serum albumin and total bilirubin level, liver volume and extrahepatic metastases were associated with survival. The mean liver volume was significantly different between subgroups with and without pain relief (3,097 and 4,739 mL, respectively; p = 0.002). Conclusion: A larger liver volume is a poor prognostic factor for survival and also a negative predictive factor for response to WLRT. If patients who are referred for WLRT have large liver volume, they should be informed of the poor prognosis and should be closely observed during and after WLRT.

• Radiation Oncology Journal
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• 제33권4호
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• pp.320-327
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• 2015

Purpose: To investigate the treatment outcome and the toxicity of helical tomotherapy (HT) in patients with metastatic colorectal cancer (mCRC). Materials and Methods: We retrospectively reviewed 18 patients with 31 lesions from mCRC treated with HT between 2009 and 2013. The liver (9 lesions) and lymph nodes (9 lesions) were the most frequent sites. The planning target volume (PTV) ranged from 12 to 1,110 mL (median, 114 mL). The total doses ranged from 30 to 70 Gy in 10-30 fractions. When the ${\alpha}/{\beta}$ value for the tumor was assumed to be 10 Gy for the biologically equivalent dose (BED), the total doses ranged from 39 to $119Gy_{10}$ (median, $55Gy_{10}$). Nineteen lesions were treated with concurrent chemotherapy (CCRT). Results: With a median follow-up time of 16 months, the median overall survival for 18 patients was 33 months. Eight lesions (26%) achieved complete response. The 1- and 3-year local progression free survival (LPFS) rates for 31 lesions were 45% and 34%, respectively. On univariate analysis, significant parameters influencing LPFS rates were chemotherapy response before HT, aim of HT, CCRT, PTV, BED, and adjuvant chemotherapy. On multivariate analysis, $PTV{\leq}113mL$ and $BED>48Gy_{10}$ were associated with a statistically significant improvement in LFPS. During HT, four patients experienced grade 3 hematologic toxicities, each of whom had also received CCRT. Conclusion: The current study demonstrates the efficacy and tolerability of HT for mCRC. To define optimal RT dose according to tumor size of mCRC, further study should be needed.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.214-220
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• 2004

목적: 말기암 환자의 장 폐색은 예후가 비교적 나쁘다. 의사들도 삶의 질 측면에서 완화적인 시술이나 수술을 고려하고 있으나 결정하기가 어려운 경우가 있다. 본 연구는 말기암 환자의 장 폐색 진단 후 임상적 특징, 완화적 시술이나 수술을 받았던 환자에서 생존 기간과 예후 인자를 조사하여 보고자 하였다. 방법: 2002년 5월부터 2004년 5월까지 본원을 방문한 말기암 환자로 장 폐색 진단을 받았던 40명 환자의 의무기록을 후향적으로 조사하였다. 결과: 남자가 21명(53%), 여자가 19명(47%)였고 나이의 중간값은 $64.1{\pm}1.58$세였다. 장 폐색의 가장 많은 원인은 대장직장암이 18명(45%)이였으며 위암 11명(28%), 췌장암 4명(10%), 기타 7명(19%) 순이였다. 장 폐색 진단 시 가장 많은 전이는 복막전이가 14명(35%) 가장 많았고 다음이 간 전이가 13명(33%)였다. 폐색 시 증상은 구토가 15명(38%)로 가장 많았고 복부통증 10명(25%), 변비 6명(15%), 복부 팽만 5명(13%) 이였다. 일상수행능력(ECOG)은 3점이 20명(50%0, 2점 16명(40%), 4점(10%)였다. 완화적 시술이나 수술을 받았던 군이 30명이였고 받지 않았던 군이 10명이였다. 완화적 시술이나 수술을 받았던 군에서 치료를 받았던 시점에서 중간생존기간은 142일로 받지 않았던 군의 장 폐색 진단시부터 중간생존기간 30일에 비하여 유의하게 중간 생존기간이 길었다. 예후 인자로는 생활수행능력상태 2점과 하부 장 폐색과 대장암에 의해서 폐색이 있는 경우에 유의하게 생존기간이 길었다. 결론: 말기암 환자의 장 폐색은 적응증이 될 경우에 적극적인 완화적 시술이나 수술을 고려하는 것이 좋을 것으로 생각된다.