• Radiation Oncology Journal
• /
• v.1 no.1
• /
• pp.95-102
• /
• 1983

The radical treatment of uterine cervical cancer by interacavitary radium or cesium, in combination with teletherapy are well known. Although the result of such treatment should not give rise to complacency, problem of radiation exposure to medical staff had not been resolved. Fortunately, many attempts have been made to reduce this hazard, most of which take the form of afterloading applicators with a suitably shielded radioisotope. In order to avoid hazardous radiation exposure to staffs concerned with brachytherapy, RALS using high intensity source of Co-60, have been employed at Yonsei Cancer Center since May, 1979. It allows rectal and bladder doses to be kept low, while maintaining a satifactory usual dose distribution of the other type of applicators, and the short treatment time allow four or five patients to be treated per hour. It also removes much patient's discomfort and the difficulties of nursing these patients. Since the first introduction in Korea, over seven hundred cases with various stage of uterine cervical cancer have been treated on a radical basis at this center last 4 years. These authors have strongly attracted attention to the results in terms of local control rate, survival s and morbidity compared with those of conventional low dose rate radiotherapy. Retrospective interim analysis of data was preliminarily accomplished through the labored follow-up study of 340 cases treated during initial 2 years and the radiobiologic standpoint of high dose rate intracavitary irradiation will be discussed.

• Radiation Oncology Journal
• /
• v.21 no.3
• /
• pp.245-249
• /
• 2003

A primary malignant melanoma of the vagina is a very rare gynecological malignant tumor. Its clinical behavior is more aggressive than that of cutaneous and vulvar melanomas. We present a case of a large sized primary melanoma of the lower third of the vagina, with a cervical lesion, in a 58-year-old postmenopausal woman. The patient was treated with conventional external radiation therapy and intracavitary radiotherapy (ICR), without surgical treatment. Although the primary lesion showed a partial response, the patient died of extensive metastases, which were found 4.5 months after the initial diagnosis. We suggest that shortening the treatment period, such as hypofractionated radiation therapy and surgical removal, and various systemic therapies for preventing early distant metastasis, are appropriate treatments for a primary malignant melanoma of the vagina, with a large tumor size.

• Radiation Oncology Journal
• /
• v.10 no.2
• /
• pp.227-236
• /
• 1992

From March 1979 through December 1986, 232 previously untreated patients with invasive carcinoma of the uterine cervix stage IIB were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. The patients studied were staged according to the FIGO recommendations and the majority of patients were treated with external beam whole pelvis radiation and intracavitary radiation. Pretreatment parameters, including physical examination findings, blood parameters, prior medical illnesses, histology and abdomino-pelvic CT findings were studied, employing univariate and multivariate analyses to identify the potentially significant prognostic factors on locoregional control, disease free survival and overall survival. Histology, extent of parametrial involvement on physical examination and paraaortic lymph node metastasis on CT were found to have prognostic significance in the carcinoma of uterine cervix stage IIB.

• Radiation Oncology Journal
• /
• v.12 no.3
• /
• pp.369-376
• /
• 1994

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4837-4844
• /
• 2016

Objectives: To describe the survival experience of cervix cancer patients in a screened rural population in India. Methods: Included 558 cervical cancer patients diagnosed in 2000-2013 in a cohort of 100,258 women invited for screening during 2000-2003. The primary end point was death from cervical cancer. We used the Kaplan-Meier method to estimate cumulative observed survival and Cox proportional hazards regression to assess the effect of patient characteristics on survival after diagnosis. Results: Of the 558 cases included, 143 (26%) and 114 (20%) were diagnosed in stages IA and IB respectively; 252 (45.2%) were dead, and 306 (54.8%) were alive at the last follow-up. The overall 5-year observed survival was 60.5%. The 5-year survival of stage IA patients was 95.1% and 5.3% for stage IV patients. All surgically treated stage IA patients, 94.1% of stage IB patients receiving intracavitary radiotherapy, 62% of stage IIB, 49% of stage III and 25% of stage IV patients receiving radiotherapy survived for 5 years. Conclusion: Higher 5-year survival in our study than elsewhere in India is due to the high proportion of early stage cancers detected by screening combined with adequate treatment, resulting into a favourable prognosis.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.1
• /
• pp.99-108
• /
• 1998

Intraperitoneal administration of radioisotopes is suggested to treat the metastatic ovarian cancer in the peritoneal cavity. Administering beta-emitting radioisotopes into the peritoneal cavity allows the maximum energy delivery to the cancerous cells of the peritoneal wall surface while sparing the normal cells located in deep site of the peritoneal wall. In this study, dose estimates of the peritoneal wall are provided to be used for prescribing the amount of $^{166}Ho$-chitosan complex administered. The $^{166}Ho$-chitosan complex diffused in the peritoneal fluid may attach to the peritoneal wall surface. The attachment fraction of $^{166}Ho$-chitosan complex to the peritoneal wall surface is obtained by simulating the ascites with Fischer rats. Both volume source in the peritoneal fluid and the surface source over the peritoneal wall surface are counted for the contribution to the peritoneal wall dose. The Monte Carlo code EGS4 is used to simulate the energy transfer of the beta particles emitted from $^{166}Ho$. A plane geometrical model of semi-infinite volume describes the peritoneal cavity and the peritoneal wall. A semi-infinite plane of $10{\mu}m$ in thickness at every 1 mm of depth in the peritoneal wall is taken as the target in dose estimation. Greater than 98 percents of attachment fraction has been observed from the experiments with Fischer rats. Given $1.3{\mu}Ci/cm^2$ and $2.4{\mu}Ci/ml$ of uniform activity density, absorbed dose is 123 Gy, 8.59 Gy, 3.00 Gy, 1.03 Gy, and .327 Gy at 0 mm, 1 mm, 2 mm, 3 mm, and 4 mm in depth to the peritoneal wall, respectively.

• Journal of Yeungnam Medical Science
• /
• v.17 no.2
• /
• pp.123-128
• /
• 2000

Purpose: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. Methods: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). Results: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. Conclusions: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6513-6518
• /
• 2013

Background: To evaluate the treatment outcome and major late complications of all patients with recurrent nasopharyngeal carcinoma (NPC) treated with intracavitary brachytherapy (ICBT) in Hospital Kuala Lumpur. Materials and Methods: This retrospective study was conducted at the Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Malaysia. All patients with histologically confirmed recurrent NPC in the absence of distant metastasis treated in the period 1997-2010 were included in this study. These patients were treated with ICBT alone or in combination with external beam radiotherapy (EBRT). Treatment outcomes measured were local recurrence free survival (LRFS), disease free survival (DFS) and overall survival (OS). Results: Thirty three patients were eligible for this study. The median age at recurrence was 56 years with a median time to initial local recurrence of 27 months. Majority of patients were staged as rT1-2 (94%) or rN0 (82%). The proportion of patients categorised as stage III-IV at first local recurrence was only 9%. Twenty one patients received a combination of ICBT and external beam radiotherapy while 12 patients were treated with ICBT alone. Median interval of recurrence post re-irradiation was 32 months (range: 4-110 months). The median LRFS, DFS and OS were 30 months, 29 months and 36 months respectively. The 5 year LRFS, DFS and OS were 44.7%, 38.8% and 28.1% respectively. The N stage at recurrence was found to be a significant prognostic factor for LRFS and DFS after multivariate analysis. Major late complications occurred in 34.9% of our patients. Conclusions: Our study shows ICBT was associated with a reasonable long term outcome in salvaging recurrent NPC although major complications remained a significant problem. The N stage at recurrence was a significant prognostic factor for both LRFS and DFS.

• Radiation Oncology Journal
• /
• v.2 no.1
• /
• pp.11-20
• /
• 1984

The renewed interest in the use of hyperthermia in cancer therapy is bases on radiobiological and clinical evidence indicated that there may be a significant therapeutic advantage with the use of heat alone or combined with radiation or chemotherapy, There are many methods for generating heat for localized tumor as like radiofrequency, microwave, electromagnetic induction and ultrasound. But it is very difficult to be even thermal dose distribution and stable output of power and then the detection of temperature in tumor is difficult to be precise with thermocouples and semiconductor sensors. We designed the microwave heating generator, dipole antenna applicators and autometic temperature controlled thermocouples for localized hyperthermia on skin and in cavities. 1. The microwave generator with 120 W, 2,450MHz magnetron could be heating up to $40^{\circ}C\~50^{\circ}C\;for\;1\~2$ hours in living tissues. 2. The thermal dose distribution in tissue with microwave was described $42^{\circ}C\~44^{\circ}C$ with in 3 cm depth and $2\~6cm$ diameter area. 3. Skin surface heating applicator with spiral 3 times wave length antenna radiated high Power of microwave. 4, Intracavitary heating applicator with dipole antenna with autometic control temperature sensor kept up continuously constant temperature in tissue. 5. For constant thermal distribution, applied two steps power with 10W microwave after $17\~20W$ during first 10 minutes. 6. The cooling rate by blood flew in living tissue was rised as $10\%$ then meats.

• Radiation Oncology Journal
• /
• v.30 no.3
• /
• pp.108-116
• /
• 2012

Purpose: To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Materials and Methods: Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended field. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Results: Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Conclusion: Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.