• Radiation Oncology Journal
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• v.16 no.4
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• pp.441-446
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• 1998

Purpose : The incidence of esophageal carcinoma is increasing. Radical surgery is the treatment of choice, but large proportion of the esophageal cancer patients are with unresectable disease at the time of initial diagnosis, so radiation therapy has been the major treatment modality. We carried out retrospective analysis to see the outcome and prognostic factors of radiation therapy alone for esophageal carcinoma. Methods and Materials : From June of 1979 through December 1992, 289 patients with esophageal carcinoma were treated with radiation therapy alone at Department of Therapeutic Radiology, Seoul National University Hospital. Of these patients, 84 patients were excluded as they were ineligible for the current analyses. Twenty-two patients had distant metastasis other than supraclavicular lymph node metastasis, 52 patients received less than 45 Gy, and 10 patient were lost from follow-up. Therefore 205 patients constituted the base population of this study. According to AJCC s1aging system, there were 2 patients with stage 1, 104 with stage IIA, 26 with stage IIB, 48 with stage III, and 25 with stage IV Radiation dose ranged from 4500 cGy to 6980 cGy with median dose of 5940 cGy. Follow-up period of the alive patients ranged from 77 to 180 months. Results : The Median survival period of all the patients was II months and the 2-, 5-, and 10-year overall survival rates were 22.4$\%$, 10.2$\%$ and 5.3$\%$, respectively. Most of the failures were local recurrences. Of 169 failures, 134 had local failure as a component and 111 had local recurrence only. The Lymph node was most common distant metastatic site and the next was the lung. The stage, T-stage, N-stage, functional status, tumor size, and aim of treatment were statistically significant prognostic factors for survival by univariate analyses. But only tumor size and N-stage were significant by multivariate analyses. Conclusion : We could get 10.2$\%$ of 5 year survival rate and 5.3$\%$ of 10 year survival rate with radiation therapy alone. The size of tumor and N-stage were statistically significant prognostic factors for survival on multivariate analyses.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.164-171
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• 2019

Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.286-291
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• 2004

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for lipesarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondresarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.65-72
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• 1991

One hundred and thirty five patients with carcinoma of the nasopharyx were treated by radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University between August 1977 and July 1987. Of the 30 patients omitted: 8 had distant metastases at initial diagnosis or during radiotherapy; 18 Patients refused or did not receive a full course of radiation therapy, and four had not been confirmed histologically. The remaining 105 patients were analysed to determine the incidence and pattern of distant metastases. Diagnosis of distant metastases was made based on clinical signs and radiography, even though histologic confirmation was not made. Twenty-six patients developed distant metastases after definite irradiation of nasopharyx and neck, an incidence rate of $24.8\%$ . The common sites of distant metastases were, in descending order, bone, lung, liver, and brain. There was a strong correlation between Ho's N stage and distant metastases rate. But sex, age, histologic subtype (squamous cell and undifferentiated cell), AJC T and N stage, treatment modalities (radiotherapy alone and radiotherapy combined with chemotherapy) were not significant. Of those patients who developed distant metastases, $80.8\%$ were discovered within 2 years of their radical radiotherapy. The prognosis for nasopharyngeal carcinoma patients developing distant metastases was poor: median survival was nine months and $80\%$ of those patients died within two years of the initial diagnosis of distant metastasis.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.2
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• pp.208-215
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• 2015

The aim of the study was to investigate the antioxidant activities of ethanol extract of perilla seed (PSE) and its inhibitory effects against major characteristics of cancer cells, such as unrestricted growth and activated metastasis in vitro. The total polyphenol and flavonoid levels of PSE were 222.6 mg gallic acid equivalent/100 g and 285.7 mg quercetin equivalent/100 g, respectively. The radical scavenging activity and ferric reducing antioxidant power of PSE at concentration of 87.5 to $350{\mu}g/mL$ were 24~45% and 28~62%, respectively. Treatment of HCT116 colorectal carcinoma cells and H1299 non-small cell lung carcinoma cells with PSE dose-dependently inhibited growth by 18~94% (at concentration range of 87.5 to $350{\mu}g/mL$) and completely abolished colony formation (at concentration of $175{\mu}g/mL$). PSE was also effective in inhibiting migration of H1299 cells (by 30~37% at concentration range of 87.5 to $350{\mu}g/mL$) and adhesion of both HCT116 and H1299 cells (by 14~16% at concentration of $350{\mu}g/mL$). These results indicate that PSE exerts antioxidant and anti-cancer activities in vitro. It needs to be determined whether or not similar effects can be reproduced in vivo.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.91-97
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• 1995

Synovial sarcoma is a malignant soft tissue tumor which is the most prevalent in adolescents and young adults between 10 and 40 years of age. It occurs primarily in the para-articular regions, usually in close association with tendon sheath, bursae and joint capsules. Favorable clinical factors are young age of the patients, tumor size smaller than 5cm, and distal rather than proximal location in the extremities. We analysed clinical findings of 13 cases of synovial sarcoma that had been experienced from January 1983 to December 1992. There were 8 females and 5 males, whose age was averaged as 28 years and 10 months ranging from 6 years to 54 years. The mean follow-up was 3 years(range : 9 months- 9 years 1 month). Palpable mass was frequent clinical symptom and lower extremity especially around the knee was the most prevalent site. Treatment modalities were the combination of surgery, radiotherapy and chemotherapy. Distant metastasis occured in 5(38%) cases : 4 cases to lung and 1 case to neck, and 2 cases had local recurrences. At final follow-up 6 cases were continous disease free, 2 alive with disease and 5 died of disease. The Kaplan-Meier's estimated 5 year survival rate of total 13 cases was 66% and satisfactory results were obtained with mass size smaller than 5cm.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.44-50
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• 2008

Purpose: To evaluate usefulness in diagnosing primary malignant lesion of metastatic bone tumor using $^{18}F$ FDG PET/CT. Material & Methods: Retrospective analysis was executed on 5,452 patients who were taken with $^{18}F$ FDG PET/CT between December 2003 and December 2007. 180 patients who had not any history of malignancy and complained musculoskeletal pain and had ill-defined osteolytic lesion in plain X-ray, were included. 96 male and 84 female were enrolled and mean age was 59.1 year old (22~90). We analyzed diagnostic accuracy, age and sex distribution of primary malignant lesion, location of metastatic lesion. Results: We could confirmed primary malignant lesion in 152 cases (84.4%). Most common malignant primary lesion was lung (28.3%), breast (18.9%) and gastrointestinal system (16.7%) and spine was the most common metastatic location of primary malignant lesion. Conclusion: $^{18}F$ FDG PET/CT is a effective molecular imaging detecting primary malignant lesion in patients having metastatic bone lesion without history of malignancy.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.83-92
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• 1988

The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.147-155
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• 2011

Purpose: This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). Materials and Methods: The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. Results: Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose $(BED)_3$ (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred ${\geq}6$ months (p = 0.085). Conclusion: Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development.

• Radiation Oncology Journal
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• v.37 no.2
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• pp.101-109
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• 2019

Purpose: The purpose of this study is to evaluate the safety and efficacy of the multimodality treatment with neoadjuvant intensity-modulated radiotherapy (IMRT) for resectable clinical T1-3N0-1M0 malignant pleural mesothelioma (MPM). Materials and Methods: A total of eleven patients who received neoadjuvant chemotherapy and radiotherapy between March 2016 and June 2018 were reviewed. Patients received 25 Gy in 5 fractions to entire ipsilateral hemithorax with helical tomotherapy. Results: All of patients were men with a median age of 56 years. Epithelioid subtype was found in 10 patients. All patients received neoadjuvant chemotherapy with pemetrexed-cisplatin regimen. Ten patients (90.9%) completed 25 Gy/5 fractions and one (9.0%) completed 20 Gy/4 fractions of radiotherapy. IMRT was well tolerated with only one acute grade 3 radiation pneumonitis. Surgery was performed 1 week (median, 8 days; range, 1 to 15 days) after completing IMRT. Extrapleural pneumonectomy was performed in 4 patients (36.3%), extended pleurectomy/decortication in 2 (18.2%) and pleurectomy/decortications in 5 (63.6%). There was no grade 3+ surgical complication except two deaths after EPP in 1 month. Based on operative findings and pathologic staging, adjuvant chemotherapy was delivered in 7 patients (63.6%), and 2 (18.2%) were decided to add adjuvant radiotherapy. After a median follow-up of 14.6 months (range, 2.8 to 30 months), there were 3 local recurrence (33.3%) and 1 distant metastasis (11.1%). Conclusion: Neoadjuvant entire pleural IMRT can be delivered with a favorable radiation complication. An optimal strategy has to be made in resectable MPM patients who would benefit from neoadjuvant radiation and surgery. Further studies are needed to look at long-term outcomes.