• Radiation Oncology Journal
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• 제7권1호
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• pp.37-43
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• 1989

1979년 3월부터 1984년 2월까지 성문상부의 편평상피암으로 진단되어 근치적 방사선치료를 시행한 66명을 대상으로 치료성적을 분석하였다. 전체 환자군의 최소 추적기간은 4년이었다. 진단당시 전체 환자군의 $78\%$가 T3 T4 병변이었고 임파절 전이율은 $58\%$이었으며, 전체 환자군의 5년 생존율은 $31.3\%$, 병기에 따른 생존율은 병기 II, III, IV에서 각각 $60.7\%,\;46.7\%\;및\;13.5\%$이었다. 3명의 환자$(5\%)$에서 원격전이가 관찰되었으며 수술을 요하는 주부작용률은 $11\%$이었다. 방사선치료 후 잔유병변 또는 재발에 대한 구제수술 성공률은 $57\%$이었다. 병기 I, II및 병기 III 초기의 성문상부암은 방사선 단독 치료만으로도 높은 근치율과 생존자의 성대기능 보존이 가능 하나, 병기 III과 IV의 성문상부암 환자 중 경부에 전이된 임파절의 절제가 가능한 환자는 수술과 방사선치료의 병용이 권장된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4957-4961
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• 2014

Background: Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India. Materials and Methods: The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012-December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon. Results: Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively. Conclusions: An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.

• Journal of Chest Surgery
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• 제43권1호
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• pp.113-116
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• 2010

심한 호흡곤란을 주소로 내원한 67세 남자의 영상소견상 종격동의 거대 낭성 종양이 기관을 압박하여 편이시키는 소견이 보여 응급 개흉술을 통해 종양을 절제하였다. 조직 소견상 갑상선의 유두상 암종에 합당하였고 수술 후 시행한 갑상선 초음파 검사와 양성자 단층촬영상 잠재성 갑상선 암종에 합당한 소견을 보였다. 갑상선의 유두상 암종이 초기에 원격 전이를 보이는 경우는 드물며 대부분 단독 결절의 형태를 취하나, 잠재성 암종이 종격동에 거대 낭성 전이를 하는 경우는 극히 드물어 보고하는 바이다.

• 대한두경부종양학회지
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• 제21권2호
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• pp.174-177
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• 2005

Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.

• 대한두경부종양학회지
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• 제24권2호
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• pp.169-173
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• 2008

Purpose：This is a retrospective study to evaluate the results of concurrent chemoradiotherapy in nasopharyngeal carcinoma. Material and Methods：From Mar 2000 to June 2005, 18 patients with nasopharyngeal carcinoma completed planned concurrent chemoradiotherapy. Stages were I in 1 patients, II in 2 patients, III in 7 patients and IV in 8 patients. Pathologic type was squamous cell carcinoma(WHO type 1) in 2 patients, non-keratinizing type(WHO type 2) in 8 patients and undifferetiated carcinoma(WHO type 3) in 8 patients. The follow up period ranged from 30 months to 95 months with a median of 56 months. Follow up was possible in all patients. Results：Response to concurrent chemoradiation therapy was a complete response in all patients. Patterns of failure were as follows：local recurrence in only one patient(5.6%) and distant metastases in three patients with N3 diseases(16.7%). The overall 5 year survival rates were 88.5%, the 5 year disease free survival rate was 77% and these were very good results. There were no significant differences in the local control and survival rates between the clinical stages and pathologic types. Conclusion：The outcome of the nasopharyngeal carcinoma treated with concurrent chemoradiotherapy was very good, even though most of the patients(15/18=83.3%) were in stage III and IV diseases. We concluded that concurrrent chemoradiotherapy in nasopharyngeal carcinoma showed the good local control and survival rates without significant complications. In the patients with N3 disease, we have to consider the more effective and strong chemotherapeutic regimens to prevent distant metastases.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.60-65
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• 2008

Hepatocellular carcinoma is the most common primary tumor in the liver. FDG PET has been applied for staging and treatment planning of hepatocellular carcinoma. It could reflect tumor prognosis because glucose metabolism assessed by FDG PET is known to have correlations with the differentiation and aggressiveness of the tumor. Although the ability of FDG PET to detect well-differentiated or low grade tumors and intra-hepatic lesions is not good, it is expected to playa major role in pre-surgical assessments for liver transplantation because it is useful in detecting extra-hepatic lesions and unexpected distant metastases with a better diagnostic performance than other conventional imaging modalities. Additionally, FDG PET has an advantage to screen other cancers through whole body scanning. As a new tracer for PET, Acetate demonstrates higher sensitivity and specificity to FDG in evaluating hepatocellular carcinoma. It thus seems that simultaneous use of Acetate PET with FDG PET could be helpful in diagnosis, especially detecting extra-hepatic metastases.

• Radiation Oncology Journal
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• 제2권1호
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• pp.115-122
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• 1984

Total 125 patinets with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 Patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to treatment groups and was $16.8\%$. Local 15 yr survival was $33\%$ and 8 yr survival of T-6 group was $64.9\%$. An analysis of time were pattern of recurrence of each group, and the correlation of with radiation dose with local recurrence done. This study concluded that intensive multiagent chemotherapy RT and/or surgery (T-6 regimen) reduced distant metastases, and produced significant increase in local control and survival.

• Nuclear Medicine and Molecular Imaging
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• 제43권6호
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• pp.582-587
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• 2009

A 59-year-old woman who was diagnosed with malignant pheochromocytoma underwent $^{18}F$-fluorodeoxyglucose positron emission tomography/computed tomography ($^{18}F$-FDG PET/CT). She had undergone left adrenalectomy for pheochromocytoma 4 years previously. Recent multiple metastatic pulmonary nodules were noted on the chest X-ray. After treatment with $^{131}I$-metaiodobenzylguanidine ($^{131}I$-MIBG) with 7.4 GBq, post-therapy $^{131}I$-MIBG scintigraphy depicted multiple distant metastases including lung, liver, abdominal para-aortic and mesenteric lymph nodes. $^{18}F$-FDG PET/CT also depicted multiple metastases in lung, liver, and abdominal para-aortic lymph nodes, but some lesions were not shown. In this case, $^{131}I$-MIBG scintigraphy found additional lesions in metastatic malignant pheochromocytoma.

• 대한두경부종양학회지
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• 제15권2호
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• pp.232-234
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• 1999

두경부 영역에서 발생하는 악성종양은 원격전이가 흔하지 않으나 최근 들어 국소전이에 대한 치료효과가 향상됨에 따라 원격전이가 재발과 사망의 주된 원인이 되고 있다. 원격전이중 뇌전이는 빈도는 적으나 이환시 높은 사망률을 보이므로 뇌전이를 의심하는 증상이 있을 때는 조기발견을 위한 적극적인 진단적 접근과 이에 대한 적절한 치료가 중요하다. 본 증례와 같이 고식적 수술후 국소전이에 대한 조절이 잘 되고 있는 환자에서 지속적인 두통 및 체중감소 등의 증상이 나타나는 경우 뇌전이를 의심하여 적절한 진단 방법을 통한 조기 진단과 치료가 중요하다고 생각된다.

• Journal of Chest Surgery
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• 제35권5호
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• pp.381-386
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• 2002

배경 및 목적: 기관지 유암종은 전체 폐암의 약 2%를 차지하며 전형적 유암종과 이형성 유암종으로 나누어진다. 이형성 유암종은, 신경 내분비성 폐암의 범주에서 양끝을 차지하는, 낮은 악성도의 전형적 유암종과 높은 악성도의 소세포 폐암의 중간형으로 여겨지고 있다. 이형성 유암종의 수술 범위, 수술 후 전신적인 치료의 필요성에 관해서 상반되는 주장이 있다. 이에 본원에서 수술 받은 기관지 유암종 환자들을 대상으로 후향적 연구를 시행하였다. 대상 및 방법: 1990년부터 2000년까지 연세의료원에서 15명의 기관지 유암종 환자가 수술 치료를 받았다. 그중 전형적 유암종이 10명, 이형성 유암종이 5명이었다. 병리학적 진단은 WHO/IASLC(1999)의 기준에 따랐다. 결과: 수술은 전폐 절제술 3예, 폐엽절제술 11예, 구획 절제술 1예였다. 전형적 유암종의 경우 1명(10%)에서 국소 림프절 전이를 보였고, 이형성 유암종의 경우 3명(70%)에서 종격동 림프절 전이를 나타내었다. 수술 후 원격 전이는 전형적 유암종에서는 1명(10%)이었으나, 이형성 유암종에서는 4명(80%)에서 나타났다(p=0.017). 수술 후 5년 생존율은 전형적 유암종에서는 100%인 반면, 이형성 유암종에서는 20%로 통계학적으로 유의하게 전형적 유암종의 생존율이 높았다(p=0.0039). 결론: 이형성 유안종의 경우 진단 당시부터 종격동 림프절 전이가 많고 수술 후 생존율도 낮으므로, 비소세포성 폐암에 준하여 폐엽절제술 이상의 수술을 시행하고 종격동 림프절 전이가 있는 경우에는 수술 후 항암화학 요법이 필요할 것으로 생각된다.