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A Influence Effect of Mid-life Religious Life and Faith Maturity on the Couples' Life Satisfaction (중년기 종교 활동과 신앙성숙도가 부부생활만족도에 미치는 영향분석연구)

  • Jeong, Jin-O;Byeon, Sang-Hae;Kim, Jong-Su
    • 한국벤처창업학회:학술대회논문집
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    • 2009.10a
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    • pp.265-288
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    • 2009
  • The study has found that the main reasons affecting to the mature conjugal relations of middle-aged persons are closely related with sede factors brought about after marriage. Comparatively the factors before marriage have more or less weak power on the conjugal relations. They are mature relations wp between husbands and wives, stable and enough incede, and religious activities, which have deep relations with the satisfactory conjugal relations. C. G. Jung divided the whole life span as self-assuredness period in the first half and self-convergence period in the second half. The first is the period when one does his or her best to get external and physical self. On the contrary, the second is the middle-aged period one finds his or her meaning of life in the religious, philosophical, intuitional, and spiritual world, which lead life into harmony and integration. Therefore if one overcomes some psychological crisis related with middle-aged development he or she can enjoy happy senescence(old age). The study has suggested through literature investigation the definition of middle age and the developmental traits of middle age, and the relations between religions and conjugal relations of middle-aged husbands and wives. Futhermore, it has analyzed the theories which religions have close relations with the life satisfaction of middle-aged conjugal relations. In order to give an analysis the influence of the variable of religious activities and religious maturity, with the degree of conjugal satisfaction, 400 middle age are selected as the object of the study whose ages are ranging from 35 years to 60 years, and who reside in Seoul or near Seoul. They were asked to fill out the questionnaires asking about religious activities, religious maturity, and the conjugal satisfaction from March 25th to April 30th, 2009. The results of the survey have been statistically processed and analyzed. First, the higher religious maturity gives positive influence on the general religious activities including public service, human relations, and spiritual stability. That is, this result indicates that the individual, spiritual, and formal religious activities give to a degree influence on the religious maturity. Second, the maturity of religious life resulting from religious activities has a causation with the satisfaction of conjugal life. In more details, religious activities has a positive influence on the satisfaction of conjugal life(T=31.36, p<.001) In more details, religious activities has a positive influence on the religious maturity(T=31.36, p<.001), and religious activities has a positive influence on the satisfaction of conjugal life(T=33.81, p<.001), and the religious maturity has a positive influence on the satisfaction of conjugal life(T=28.64, p<.001) Third, as we analyze the main effects which religious activities and the religious maturity could give influence on the satisfaction of conjugal life, it is found that both religious activities(F=15.95, p<.001) and the religious maturity(F=23.94, p<.001) give a positive influence on the satisfaction of conjugal life. In conclusion, it is sure that religious activities and the religious maturity have a close relations with the satisfaction of conjugal life. Therefore it can be said that religious activities at the protestant religion, buddhism, and catholic religion can give an important influence on the satisfaction of middle-aged conjugal life.

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The Effect of Pleural Thickening on the Impairment of Pulmonary Function in Asbestos Exposed Workers (석면취급 근로자에서 늑막비후가 폐기능에 미치는 영향)

  • Kim, Jee-Won;Ahn, Hyeong-Sook;Kim, Kyung-Ah;Lim, Young;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.923-933
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    • 1995
  • Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

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Effect of Boswellia serrata Extracts on Degenerative Osteoarthritis in vitro and in vivo Models (보스웰리아 추출물의 골관절염 억제 효과 연구)

  • Nam, Da-Eun;Kim, Ok Kyung;Shim, Tae Jin;Kim, Ji Hoon;Lee, Jeongmin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.5
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    • pp.631-640
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    • 2014
  • The inhibitory effects of Boswellia serrata (BW) extracts on degenerative osteoarthritis were investigated in primary-cultured rat cartilage cells and a monosodium-iodoacetate (MIA)-induced osteoarthritis rat model. To identify the protective effects of BW extract against $H_2O_2$ ($800{\mu}M$, 2 hr) in vitro, cell survival was measured by MTT assay. Cell survival after $H_2O_2$ treatment was elevated by BW extract at a concentration of $20{\mu}g/mL$. In addition, BW extract treatment significantly reduced and normalized the productions of pro-inflammatory factors, nuclear transcription factor ${\kappa}B$, cyclooxygenase-2, tumor necrosis factor-${\alpha}$, and interleukin-6 at a concentration of $20{\mu}g/mL$. Treatment of chondrocytes with BW extract significantly reduced 5-lipoxygenase activity and production of prostaglandin E2, especially at a concentration of $10{\sim}20{\mu}g/mL$. For the in vivo animal study, osteoarthritis was induced by intra-articular injection of MIA into knee joints of rats. Consumption of a diet containing BW extract (100 and 200 mg/kg) for 35 days significantly inhibited the development and severity of osteoarthritis in rats. To determine the genetic expression of arthritic factors in articular cartilage, real-time PCR was applied to measure matrix metalloproteinases (MMP-3, MMP-9, and MMP-13), collagen type I, collagen type II, and aggrecan, and BW extract had protective effects at a concentration of 200 mg/kg. In conclusion, BW extract was able to inhibit articular cartilage degeneration by preventing extracellular matrix degradation and chondrocyte injury. One can consider that BW extract may be a potential therapeutic treatment for degenerative osteoarthritis.

The Consideration of nuclear medicine technologist's occupational dose from patient who are undergoing 18F-FDG Whole body PET/CT : Aspect of specific characteristic of patient and contact time with patient (18F-FDG Whole Body PET/CT 수검자의 거리별 선량 변화에 따른 방사선 작업종사자의 유효선량 고찰: 환자 고유특성 및 응대시간 측면)

  • Kim, Sunghwan;Ryu, Jaekwang;Ko, Hyunsoo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.67-75
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    • 2018
  • Purpose The purpose of this study is to investigate and analyze the external dose rates of $^{18}F-FDG$ Whole Body PET/CT patients by distance, and to identify the main factors that contribute to the reduction of radiation dose by checking the cumulative doses of nuclear medicine technologist(NMT). Materials and Methods After completion of the $^{18}F-FDG$ Whole Body PET/CT scan($75.4{\pm}3.3min$), the external dose rates of 106 patients were measured at a distance of 0, 10, 30, 50, and 100 cm from the chest. Gender, age, BMI(Body Mass Index), fasting time, diabetes mellitus, radiopharmaceutical injection information, creatine value were collected to analyze individual factors that could affect external dose rates from a patient's perspective. From the perspective of NMT, personal pocket dosimeters were worn on the chest to record accumulated dose of NMT who performed the injection task($T_1$, $T_2$ and $T_3$) and scan task($T_4$, $T_5$ and $T_6$). In addition, patient contact time with NMT was measured and analyzed. Results External dose rates from the patient for each distance were calculated as $246.9{\pm}37.6$, $129.9{\pm}16.7$, $61.2{\pm}9.1$, $34.4{\pm}5.9$, and $13.1{\pm}2.4{\mu}Sv/hr$ respectively. On the patient's aspect, there was a significant difference in the proximity of gender, BMI, Injection dose and creatine value, but the difference decreased as the distance increased. In case of dialysis patient, external dose rates for each distance were exceptionally higher than other patients. On the NMT aspect, the doses received from patients were 0.70, 1.09, $0.55{\mu}Sv/person$ for performing the injection task($T_1$, $T_2$, and $T_3$), and were 1.25, 0.82, $1.23{\mu}Sv/person$ for performing the scan task($T_4$, $T_5$, $T_6$). Conclusion we found that maintaining proper distance with patient and reducing contact time with patient had a significant effect on accumulated doses. Considering those points, efforts such as sufficient water intake and encourage of urination, maintaining the proper distance between the NMT and the patient(at least 100 cm), and reducing the contact time should be done for reducing dose rates not only patient but also NMT.

Community Dynamics of Phytoplankton and Bacteria as Affected by Physicochemical Environmental factors in Hoeya Dam Reservoir (회야댐 저수지에서 물리 ${\cdot}$ 화학적 환경요인에 따른 식물플랑크톤과 세균 군집의 변화)

  • Kim, Dae-Kyun;Choi, Ae-Ran;Lee, Hye-Kyeong;Kwon, O-Seob;Kim, Jong-Seol
    • Korean Journal of Ecology and Environment
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    • v.37 no.1 s.106
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    • pp.26-35
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    • 2004
  • We investigated the effect of physicochemical environmental factors on the community dynamics of phytoplanktons and bacteria at the Hoeya Dam Reservoir, a drinking water reservoir for Ulsan city. Water samples were collected and analyzed every two to four weeks at three sites along the reservoir from April to October, 2001. During the study period, the Secchi depths were between 0.4 and 3.5 m. At the surface layer of water column, temperature ranged 10.2 ~ $32.0^{\circ}C$, pH 7.3${\sim}$9.6, dissolved oxygen 5.5 ${\sim}$ 12.4 mg $L^{-1}$, $BOD_5$ 0.8 ${\sim}$ 5.0 mg $L^{-1}$, $COD_{Mn}$ 3.7 ${\sim}$ 10.0 mg $L^{-1}$, and Chl-a 8.9 ${\sim}$ 60.9 mg $m^{-3}$. At the bottom layer, temperature varied 7.2 ${\sim}$ $28.9^{\circ}C$, pH 7.1 ${\sim}$ 9.3, dissolved oxygen 0.6 ${\sim}$ 9.7 mg $L^{-1}$, $BOD_5$ 0.8 ${\sim}$ 4.5 mg $L^{-1}$, $COD_{Mn}$ 3.9 ${\sim}$ 10.0 mg $L^{-1}$, and Chl-a 4.3 ${\sim}$ 81.9 mg $m^{-3}$. The numbers of phytoplanktons were 7.4${\pm}10^2{\sim}2.6{\pm}10^5$ cells $mL^{-1}$ at surface and 2.5${\pm}10^2{\sim}2.4{\pm}10^4$ cells $mL^{-1}$ at bottom, and were positively correlated with water temperature and Chl- a concentration. Genus Stephanodiscus and genus Oscillatoria dominated on April and on May, respectively. Cyanobacterial blooms of Aphanizomenon, Microcystis, Anabaena were observed from June to early September, and thereafter Stephanodiscus and Aulacoseiral dominated again. Total microbial counts ranged 1.73${\pm}10^4{\sim}1.68{\pm}10^5$ cells $mL^{-1}$, and were positively correlated with water temperature and phytoplankton counts at surface water. Heterotrophic plate counts (HPCs) ranged 30${\sim}4.1{\pm}10^3$ CFU $mL^{-1}$, and were positively correlated with $BOD_5$ and $NO^3\;^-$-N concentration at bottom water. Unlike the total microbial counts, the numbers of fecal coliforms and fecal streptococci as well as HPCs were higher at the bottom than the surface layer and were highest at the upper a site among the three sampling sites. Since the concentrations of fecal coliforms and streptococci were still high at the bottom of site c, where intake for water treatment plant is located, it appeared that special management of water treatment processes may be needed especially after strong rainfall.

Bone Density and Related Factors of Food and Nutrition Major and Non-Major University Students in Seoul Area (서울지역 식품영양전공.비전공대학생의 골밀도에 미치는 영향요인에 관한 연구)

  • 정남용;최순남
    • Journal of the East Asian Society of Dietary Life
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    • v.13 no.5
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    • pp.391-407
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    • 2003
  • This study was conducted to investigate the factors affecting the born density of food and nutrition major and non-major university students in Seoul area. Data for food habits, dietary and health-related behavior were obtained by self administered questionnaires. BQI(bone quality index) of the subjects were measured by Quantitative Ultrasound (QUS). The results are summarized as follows: The average height, weight, BMI and osteopenia percentage of the major and non-major male and female student were l74.49cm, 67.05kg, 21.96 and 22.0%; l74.34cm, 65.98kg, 21.69 and 11.8%; l60.76cm, 54.48kg, 21.07 and 40.0%; l61.30cm, 54.22kg, 20.84 and 40.2%, respectively. The BQI of the major and non-major subjects were 108.07 and 110.47 in male student group, and 89.13, 88.18 in female student group, respectively. The T-score and Z-score of bone density of the subjects were not significantly different. Weight and BMI were positively related with BQI in male and female group but the relationship with BMI tended to be stronger in non-major female group than other groups. BQI was positively affected by exercise time, favorite food, and intake of seafood and tea in major and non-major male student group. One-side eating habit and intake of instant foods were negatively related with BQI in both male groups. In major and non-major female student group, exercise time, meal regularity, favorite food, amount of meal, intake of tofu were related with BQI positively and intake of tea and/or meats negatively. The result of this study revealed that desirable food habits, dietary behavior and health-related lifestyle may have a beneficial effect on bone density. They need practically and systematically organized nutrition education on optimum body weight, good eating habits, weight bearing exercise and intakes of good quality nutrient for higher bone density level.

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Effect of Health Promotion Programs in Schoolchildren (초등학교 학생을 대상으로 한 건강증진 프로그램의 효과)

  • Yoo, Joong-Sun;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Choi, Kwang-Hae;Kim, Mee-Kyung
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.397-411
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    • 2000
  • The present study was conducted to analyze the degree of changes in knowledge and attitude toward health, arid health promoting activities after providing health education intervention for a year to elementary school children, to examine the factors effecting knowledge, attitude and health promoting practices for obesity and diet, and to analyze whether changes are present in health level according to changes in knowledge on health and health promoting activities. After conducting a pre-survey rio 354 subjects of 3rd and 4th grade students and their mothers in the city area of Kyungju, in April, 1999, 301. responses with the responding rate of 85% were obtained. Final analysis was done with 231 pairs of a student and his/her mother who could be followed up after a year among 301 pairs of the respondents, excluding those students who transferred, those who were excused from school early, those who did not take abdominal fat measurements, and those students and mothers respondents whose survey was incomplete. Based on the changes before and after the intervention, the scores on knowledge about obesity and diet showed a significant difference in normal weight group, and the scores on the attitude toward obesity and diet increased significantly in obesity group but decreased significantly in normal weight group(p<0.01). The scores of practicing health promoting activities were significantly increased in both groups, and although the waist-hip ratio (WHR) did not change in obesity group, the rate increased significantly in normal weight group(p<0.01). As for changes on the knowledge of obesity and diet before and after the intervention while dividing the scores into 3 levels based on the scores of the pre-survey and compared to changes in the scores one year after, in the case of the changes in the scores in the 1st third, the score on the knowledge about obesity and diet changed from 1.3 in the pre survey to 3.7 after the intervention, showing significant increase(p<0.01) The scores of practicing health promoting activities for obesity and diet were significantly increase in all three levels(p<0.01), and the degree of changes in the scores was 7.0 points in the 1st third, 4.4 points for the and third and 1.8 points for the 3rd third, showing a significant difference among the three levels(p<0.01). It was shown that the increase in BMI in those students whose mothers have the education level higher than university was significantly higher than the increase in BMI in those students whose mothers have the education level under high school, and those students whose mothers are in their 30's showed higher changes in practicing health promoting activities for obesity and diet. When the scores of mothers' knowledge and attitude toward obesity and diet were compared by dividing the scores into tertile, the score of students' knowledge changed significantly according to the scores of mothers' attitude toward obesity and diet. In multiple regression analysis on changes in the scores of knowledge about obesity and diet, the student variables of the degree of awareness on the seriousness of obesity, and the scores of previous knowledge on diet and obesity were selected the significant variables, and among the mother variables, the degree of guiding the child on diet and the education level were the significant variables. In multiple regression analysis to analyze the factors effecting changes in the attitude toward obesity and diet, the student variables of the BMI, scores of previous knowledge on obesity and diet, and scores on the previous attitude toward obesity and diet were shown to be significant. In multiple regression analysis on the factors effecting changes in health promoting activities for obesity and diet, the student variables of the BMI, scores on the previous attitude toward obesity and diet, and changes in the scores of obesity and diet were selected the significant variables.

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Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.27-36
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    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

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Relationship between Parental Career Support, Career Self-Regulation, and Career Identity - with Student Dep. of Radiologic Technology - (부모진로지지와 진로자기조절, 진로정체감의 관계 - 방사선과 학생 대상 -)

  • Kim, In-Sook;Lee, In-Ja
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.295-304
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    • 2015
  • This study intended to examine the correlation of career self-regulation (plan and check-up, positive thinking, career feedback, environment formation for career) and career identity (career decision, indecisiveness, career indecision) caused by parental career support (informative, emotional, financial, and empirical) among freshmen, sophomores, and juniors in the radiotechnology department. For assessment, a survey was conducted and according to the results, there existed correlation as follows. Regarding parental career support, emotional support is plan and check-up (r=.25, p<.001), Career feedback (r=.54, p<.001), and positive thinking (r=.46, p<.001) showed high positive correlation while informative support showed correlation in all factors showing high correlation with environment formation for career (r=.22, p<.001), plan and check-up (r=.20, p<.001), career feedback (r=.24, p<.001), and positive thinking (r=.26, p<.001). Financial support career feedback (r=.33, p<.001) and positive thinking (r=.34, p<.001) showed somewhat higher correlation. All factors of environment formation for career (r=.18, p<.001), plan and check-up (r=.25, p<.001), career feedback (r=.37, p<.001), and positive thinking (r=.30, p<.001) showed high correlation. Informative support showed high correlation only with career decision (r=.27, p<.001) and financial support also showed high correlation only with career decision (r=.18, p<.001). Also, empirical support was somewhat highly correlated only with career decision (r=.23, p<.001). Regarding school-year difference depending on parental career support, there was significant difference between emotional support (F=8.52, p<.001), financial support (F=8.97, p<.001), and empirical support (F=5.36, p<.05) while informative support was dismissed. Regarding school-year difference depending on career self-regulation, there was significant difference between career feedback (F=8.48, p<.001) and positive thinking (F=16.29, p<.001) while environment formation for career and plan and check-up were dismissed. Regarding school-year difference depending on career identity, there was significant difference between career indecision (F=4.01, p<.05) and career decision (F=11.72, p<.001) while indecisiveness was dismissed. According to the analysis results, parents' active support to their child like respecting and listening to their opinion on career, provision of career related experience or information, and provision of necessary financial aid for their study or academic preparation made the students plan and exploring their career, examine accomplishment progress, have positive idea to realize their objectives. In addition, the students were able to establish the objective of their career by forming the environment that helped them realize their objectives by seeking advices and encouragement from surroundings. Meanwhile, the parents' attitude to respect and listen to their child's career related opinion affected their career decision and indecision. Although informative support helped the students' career decision, financial and empirical support caused effect only to career decision.

Induction Chemotherapy and Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (NSCLC) (국소 진행된 비소세포성 폐암에서 유도 화학요법 및 방사선치료)

  • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.195-202
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    • 1999
  • Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

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