• Title/Summary/Keyword: quality of relationship

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A Study on Improvement of Collaborative Filtering Based on Implicit User Feedback Using RFM Multidimensional Analysis (RFM 다차원 분석 기법을 활용한 암시적 사용자 피드백 기반 협업 필터링 개선 연구)

  • Lee, Jae-Seong;Kim, Jaeyoung;Kang, Byeongwook
    • Journal of Intelligence and Information Systems
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    • v.25 no.1
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    • pp.139-161
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    • 2019
  • The utilization of the e-commerce market has become a common life style in today. It has become important part to know where and how to make reasonable purchases of good quality products for customers. This change in purchase psychology tends to make it difficult for customers to make purchasing decisions in vast amounts of information. In this case, the recommendation system has the effect of reducing the cost of information retrieval and improving the satisfaction by analyzing the purchasing behavior of the customer. Amazon and Netflix are considered to be the well-known examples of sales marketing using the recommendation system. In the case of Amazon, 60% of the recommendation is made by purchasing goods, and 35% of the sales increase was achieved. Netflix, on the other hand, found that 75% of movie recommendations were made using services. This personalization technique is considered to be one of the key strategies for one-to-one marketing that can be useful in online markets where salespeople do not exist. Recommendation techniques that are mainly used in recommendation systems today include collaborative filtering and content-based filtering. Furthermore, hybrid techniques and association rules that use these techniques in combination are also being used in various fields. Of these, collaborative filtering recommendation techniques are the most popular today. Collaborative filtering is a method of recommending products preferred by neighbors who have similar preferences or purchasing behavior, based on the assumption that users who have exhibited similar tendencies in purchasing or evaluating products in the past will have a similar tendency to other products. However, most of the existed systems are recommended only within the same category of products such as books and movies. This is because the recommendation system estimates the purchase satisfaction about new item which have never been bought yet using customer's purchase rating points of a similar commodity based on the transaction data. In addition, there is a problem about the reliability of purchase ratings used in the recommendation system. Reliability of customer purchase ratings is causing serious problems. In particular, 'Compensatory Review' refers to the intentional manipulation of a customer purchase rating by a company intervention. In fact, Amazon has been hard-pressed for these "compassionate reviews" since 2016 and has worked hard to reduce false information and increase credibility. The survey showed that the average rating for products with 'Compensated Review' was higher than those without 'Compensation Review'. And it turns out that 'Compensatory Review' is about 12 times less likely to give the lowest rating, and about 4 times less likely to leave a critical opinion. As such, customer purchase ratings are full of various noises. This problem is directly related to the performance of recommendation systems aimed at maximizing profits by attracting highly satisfied customers in most e-commerce transactions. In this study, we propose the possibility of using new indicators that can objectively substitute existing customer 's purchase ratings by using RFM multi-dimensional analysis technique to solve a series of problems. RFM multi-dimensional analysis technique is the most widely used analytical method in customer relationship management marketing(CRM), and is a data analysis method for selecting customers who are likely to purchase goods. As a result of verifying the actual purchase history data using the relevant index, the accuracy was as high as about 55%. This is a result of recommending a total of 4,386 different types of products that have never been bought before, thus the verification result means relatively high accuracy and utilization value. And this study suggests the possibility of general recommendation system that can be applied to various offline product data. If additional data is acquired in the future, the accuracy of the proposed recommendation system can be improved.

Participation Level in Online Knowledge Sharing: Behavioral Approach on Wikipedia (온라인 지식공유의 참여정도: 위키피디아에 대한 행태적 접근)

  • Park, Hyun Jung;Lee, Hong Joo;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.97-121
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    • 2013
  • With the growing importance of knowledge for sustainable competitive advantages and innovation in a volatile environment, many researches on knowledge sharing have been conducted. However, previous researches have mostly relied on the questionnaire survey which has inherent perceptive errors of respondents. The current research has drawn the relationship among primary participant behaviors towards the participation level in knowledge sharing, basically from online user behaviors on Wikipedia, a representative community for online knowledge collaboration. Without users' participation in knowledge sharing, knowledge collaboration for creating knowledge cannot be successful. By the way, the editing patterns of Wikipedia users are diverse, resulting in different revisiting periods for the same number of edits, and thus varying results of shared knowledge. Therefore, we illuminated the participation level of knowledge sharing from two different angles of number of edits and revisiting period. The behavioral dimensions affecting the level of participation in knowledge sharing includes the article talk for public discussion and user talk for private messaging, and community registration, which are observable on Wiki platform. Public discussion is being progressed on article talk pages arranged for exchanging ideas about each article topic. An article talk page is often divided into several sections which mainly address specific type of issues raised during the article development procedure. From the diverse opinions about the relatively trivial things such as what text, link, or images should be added or removed and how they should be restructured to the profound professional insights are shared, negotiated, and improved over the course of discussion. Wikipedia also provides personal user talk pages as a private messaging tool. On these pages, diverse personal messages such as casual greetings, stories about activities on Wikipedia, and ordinary affairs of life are exchanged. If anyone wants to communicate with another person, he or she visits the person's user talk page and leaves a message. Wikipedia articles are assessed according to seven quality grades, of which the featured article level is the highest. The dataset includes participants' behavioral data related with 2,978 articles, which have reached the featured article level, with editing histories of articles, their article talk histories, and user talk histories extracted from user talk pages for each article. The time period for analysis is from the initiation of articles until their promotion to the featured article level. The number of edits represents the total number of participation in the editing of an article, and the revisiting period is the time difference between the first and last edits. At first, the participation levels of each user category classified according to behavioral dimensions have been analyzed and compared. And then, robust regressions have been conducted on the relationships among independent variables reflecting the degree of behavioral characteristics and the dependent variable representing the participation level. Especially, through adopting a motivational theory adequate for online environment in setting up research hypotheses, this work suggests a theoretical framework for the participation level of online knowledge sharing. Consequently, this work reached the following practical behavioral results besides some theoretical implications. First, both public discussion and private messaging positively affect the participation level in knowledge sharing. Second, public discussion exerts greater influence than private messaging on the participation level. Third, a synergy effect of public discussion and private messaging on the number of edits was found, whereas a pretty weak negative interaction effect of them on the revisiting period was observed. Fourth, community registration has a significant impact on the revisiting period, whereas being insignificant on the number of edits. Fifth, when it comes to the relation generated from private messaging, the frequency or depth of relation is shown to be more critical than the scope of relation for the participation level.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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A Study on the Outlook of Dentists on Dental Coordinators and Their Job (치과의사의 치과 코디네이터 업무 및 인식에 관한 조사연구)

  • Yoo, Jung-Sook;Jang, Mi-Hwa;Jung, Jae-Yeon;Cho, Myung-Sook;Choi, Bu-Geun;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.201-218
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    • 2005
  • The purpose of this study was to examine how dentists perceived dental coordinators including their education, hiring criteria, working condition and job. It's basically attempted to help define the job and role of 5 and to suggest how they should be nurtured. The subjects in this study were dentists at dental hospitals and clinics where dental coordinators were employed among approximately 200 dental institutions in Seoul, Cyeonggi province and Incheon. After a survey was conducted in June 2005, answer sheets from 99 respondents were analyzed. The findings of the study were as follows: 1. Regarding education for dental coordinators, 99.9% of the dentists investigated felt the need for separate education programs for dental coordinators, 42.4% knew what would-be dental coordinators learned about, and 81.8% considered it necessary for them to take intermediate or higher courses. An organization affiliated with the Korea Dental Hygienists Association was viewed as the best institute to educate dental coordinators, and educational institutes that included a department of dental hygiene was looked upon as the second best one. 68.7% believed that dental coordinators should take an official examination to test their qualifications, and concerning educational subsidy, the largest group of the dentists thought that a certain amount of subsidy should be provided. 2. As for coordinator hiring, the top priority was the impression(look) of applicants(55%), followed by adjustability to existing employees(24.5%) and professional competency(17.3%). As to the route of hiring, 41.4 percent, the largest group, reeducated some of existing employees, and dental hygienists were regarded as the best personnels to serve as a coordinator. Concerning job performance, they put the most emphasis on interpersonal relationship, which was followed by executive ability, impression and career, 58.6% the largest group, believed that dental coordinators should have a three-year or higher career to work at a dental institute. 3. As to working conditions, 75.7%, the largest group, paid dental coordinators based on their job performance, and 23.2%, the second largest group, had their pay equal to that of dental hygienists, 88.9% allowed them to determine their own retirement age. 4. In regard to their perception of dental coordinators, the largest number of the dentists considered it necessary for them to keep receiving education(4.29), and the second largest group felt that they served to enhance the image of dental institutes(4.18). The third largest group thought that they contributed to letting patients more satisfied with the quality of dental services. But they tended not to agree that their turnover rate was low(3.04), and they didn't find them to receive appropriate education, either(3.10). 5. The current major job of coordinators associated with customer services was handling appointments with customers(91.9%), treating unsatisfied customers(85.9%), and controling waiting time(84.8%). Regarding self-management, coordinators directed their energy into having good manners(89.9%), acquiring fundamental dental knowledge(84.8%), and learning how to treat customers(83.8%). Concerning hospital affairs handling, they were most responsible for information desk(87.9%), which was followed by receiving(86.9%). As a result of investigating what type of job the dentists hoped dental coordinators to fulfill in consideration of their career, their age and type of investment, the dentists wanted them the most to speak a foreign language, which belonged to the field of self-management.

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Earthquake impacts on hydrology: a case study from the Canterbury, New Zealand earthquakes of 2010 and 2011

  • Davie, Tim;Smith, Jeff;Scott, David;Ezzy, Tim;Cox, Simon;Rutter, Helen
    • Proceedings of the Korea Water Resources Association Conference
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    • 2011.05a
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    • pp.8-9
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    • 2011
  • On 4 September 2010 an earthquake of magnitude 7.1 on the Richter scale occurred on the Canterbury Plains in the South Island of New Zealand. The Canterbury Plains are an area of extensive groundwater and spring fed surface water systems. Since the September earthquake there have been several thousand aftershocks (Fig. 1), the largest being a 6.3 magnitude quake which occurred close to the centre of Christchurch on 22February 2011. This second quake caused extensive damage to the city of Christchurch including the deaths of 189 people. Both of these quakes had marked hydrological impacts. Water is a vital natural resource for Canterburywith groundwater being extracted for potable supply and both ground and surface water being used extensively for agricultural and horticultural irrigation.The groundwater is of very high quality so that the city of Christchurch (population approx. 400,000) supplies untreated artesian water to the majority of households and businesses. Both earthquakes caused immediate hydrological effects, the most dramatic of which was the liquefaction of sediments and the release of shallow groundwater containing a fine grey silt-sand material. The liquefaction that occurred fitted within the empirical relationship between distance from epicentre and magnitude of quake described by Montgomery et al. (2003). . It appears that liquefaction resulted in development of discontinuities in confining layers. In some cases these appear to have been maintained by artesian pressure and continuing flow, and the springs are continuing to flow even now. In spring-fed streams there was an increase in flow that lasted for several days and in some cases flows remained high for several months afterwards although this could be linked to a very wet winter prior to the September earthquake. Analysis of the slope of baseflow recession for a spring-fed stream before and after the September earthquake shows no change, indicating no substantial change in the aquifer structure that feeds this stream.A complicating factor for consideration of river flows was that in some places the liquefaction of shallow sediments led to lateral spreading of river banks. The lateral spread lessened the channel cross section so water levels rose although the flow might not have risen accordingly. Groundwater level peaks moved both up and down, depending on the location of wells. Groundwater level changes for the two earthquakes were strongly related to the proximity to the epicentre. The February 2011 earthquake resulted in significantly larger groundwater level changes in eastern Christchurch than occurred in September 2010. In a well of similar distance from both epicentres the two events resulted in a similar sized increase in water level but the slightly slower rate of increase and the markedly slower recession recorded in the February event suggests that the well may have been partially blocked by sediment flowing into the well at depth. The effects of the February earthquake were more localised and in the area to the west of Christchurch it was the earlier earthquake that had greater impact. Many of the recorded responses have been compromised, or complicated, by damage or clogging and further inspections will need to be carried out to allow a more definitive interpretation. Nevertheless, it is reasonable to provisionally conclude that there is no clear evidence of significant change in aquifer pressures or properties. The different response of groundwater to earthquakes across the Canterbury Plains is the subject of a new research project about to start that uses the information to improve groundwater characterisation for the region. Montgomery D.R., Greenberg H.M., Smith D.T. (2003) Stream flow response to the Nisqually earthquake. Earth & Planetary Science Letters 209 19-28.

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Estimation of Reference Crop Evapotranspiration Using Backpropagation Neural Network Model (역전파 신경망 모델을 이용한 기준 작물 증발산량 산정)

  • Kim, Minyoung;Choi, Yonghun;O'Shaughnessy, Susan;Colaizzi, Paul;Kim, Youngjin;Jeon, Jonggil;Lee, Sangbong
    • Journal of The Korean Society of Agricultural Engineers
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    • v.61 no.6
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    • pp.111-121
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    • 2019
  • Evapotranspiration (ET) of vegetation is one of the major components of the hydrologic cycle, and its accurate estimation is important for hydrologic water balance, irrigation management, crop yield simulation, and water resources planning and management. For agricultural crops, ET is often calculated in terms of a short or tall crop reference, such as well-watered, clipped grass (reference crop evapotranspiration, $ET_o$). The Penman-Monteith equation recommended by FAO (FAO 56-PM) has been accepted by researchers and practitioners, as the sole $ET_o$ method. However, its accuracy is contingent on high quality measurements of four meteorological variables, and its use has been limited by incomplete and/or inaccurate input data. Therefore, this study evaluated the applicability of Backpropagation Neural Network (BPNN) model for estimating $ET_o$ from less meteorological data than required by the FAO 56-PM. A total of six meteorological inputs, minimum temperature, average temperature, maximum temperature, relative humidity, wind speed and solar radiation, were divided into a series of input groups (a combination of one, two, three, four, five and six variables) and each combination of different meteorological dataset was evaluated for its level of accuracy in estimating $ET_o$. The overall findings of this study indicated that $ET_o$ could be reasonably estimated using less than all six meteorological data using BPNN. In addition, it was shown that the proper choice of neural network architecture could not only minimize the computational error, but also maximize the relationship between dependent and independent variables. The findings of this study would be of use in instances where data availability and/or accuracy are limited.

Mammary Performance of First Lactation Bali Cows (Bibos banteng) Fed Grass-Legume Based Diets in Relation to the Role of Glucose

  • Sukarini, I.A.M.;Sastradipradja, Djokowoerjo;Nusada, N.;Mahardika, I.G.;Kiranadi, B.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.5
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    • pp.615-623
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    • 2001
  • A study of mammary function in relation to glucose metabolism of first lactation Bali cows on grass-legume diets was carried out using 12 primiparous cows (initial BW $263.79{\pm}21.66kg$) for 16 weeks starting immediately post calving. The animals were randomly allocated into 4 dietary treatment groups R1, R2, R3 and R4, receiving from the last 2 months of pregnancy onwards, rations based on a mixture of locally available grass and legume feed ad libitum. On a DM basis R1 contained 70% elephant grass (PP, Penicetum purpureum) plus 30% Gliricidia sepia leaves (GS), R2 was 30% PP plus 25% GS supplemented with 55% Hibiscus tilliacius leaves (HT, defaunating effect), R3 and R4 were 22.5% PP+41.25% GS+11.25% HT+25% concentrate, with R4 supplemented with zinc-diacetate. TDN, CP and zinc contents of the diets were 58.2%, 12.05% and 18.3 mg/kg respectively for R1, 65.05%, 16.9% and 25.6 mg/kg respectively for R2, 66.03%, 16.71% and 29.02 mg/kg respectively for R3 and 66.03%, 16.71% and 60.47 mg/kg respectively for R4. Milk production and body weights were monitored, an energy and protein balance trial conducted, overall glucose kinetics parameters assessed, mammary blood flow (MBF) and metabolite arteriovenous differences (${\Delta}AVs$) measured to get uptake data and mammary performance relationships. Parameters of glucose kinetics at peak lactation or during dry condition were not affected by ration quality. Glucose pool size, space of distribution and flux increased by 61.77, 62.26 and 82.08%, respectively, during lactation compared to the dry period. Mean glucose flux of lactating Bali cows was $5.52mg/min.kgBW^{0.807}$ which resembles the range of values of temperate dairy cows. Calculation showed that glucose requirements for maintenance, milk lactose and fat-glycerol synthesis, and the formation of NADPH reached 461.69 g for a yield of 1 kg/d or equal to 320.62 mg/min, which was less than the average glucose flux of lactating Bali cows of 481.35 mg/min. Mammary blood flow (MBF) values ranged from 56 to 83 l/h for the different treatments and the ratio MBF per kg milk produced improved from av. 1540 l/kg for R1 to av. 967 l/kg for R4 treated cows. Mammary glucose uptake ranged from 6.27 to 12.03 g/h or 120 to 140 g/kg milk. Glucose uptake was mass-wise 2 to 4 times the amount secreted as lactose, which indicated values less than the calculated mammary glucose needs and that little lactose was synthesized. The excess glucose taken-up was used for other metabolic processes. Linear relationships between metabolite ${\Delta}AVs$ and arterial blood plasma concentration [A] showed that in Bali cows triglycerides (TG), phenylalanine (Phe) and tyrosine (Tyr) have high coefficients of determination, i.e. 0.77, 0.81 and 0.69, respectively. For glucose, the relationship is quadratic with an $R^2$ value of 0.49. It was concluded that lactose synthesis was inadequate, which led to a speculation that milk yield could be improved by increased lactose synthesis.

The Characteristics of the Agricultural Management in the Less Favored Metropolitan Areas - A Case study of Bonli, Taegu- (대도시내 영농조건 불리지역의 농업경영 특성 - 대구광역시 본리마을을 사례로 -)

  • Woo, Jong-Hyeon
    • Journal of the Korean association of regional geographers
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    • v.6 no.3
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    • pp.37-52
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    • 2000
  • Generally speaking, the metropolitan agricultural regions have some advantages from the high accessibility to markets. But agriculture inevitably rests on the biological process. This study shows what characteristics of the agricultural management are found in these less favored metropolitan areas with bad natural conditions and how farm household live there. From the view point of farm household, the quality of labors they can get is quite low, and insufficient in quantity. The shortage of labor can be made up for the farming on Trust Farming System And the relatively less favored agricultural conditions prevent people from immigrating into these kind of areas, if they don't have any relationship with there. With bad natural conditions, the farm households usually cultivate relatively small areas for the purpose of self-sufficiency, and with smaller cultivating units(Baemi) of the land than in open fields. The scale of the agricultural management is largely affected by the ages of agricultural managers. The more aged the managers are, the smaller scale of the agricultural management. How to use lands is determined in accordance with the natural conditions such as percentage of sunshine and accessibility to drainage facilities -the two major factors- and more. Either owner-run farmlands or leased farmlands doesn't show any difference in each growing crops. Depending on the conditions of the lands, rice paddy is used for growing rice and field is used for growing self sufficient plants including vegetables for the farm household. Although the lack of infrastructure causes the inconvenience of living, and there exist less favored agricultural conditions, this kind of life and agricultural management style -self-sufficiency type- seems to be sustained quite longer. The less favored natural conditions for farming keeps the agricultural management style from being developed to be the level of commercialization. And the poor economic situation of farmers are continuing again and again. With the result of this study, there should be two conditions to be established previously if they want to develop these regions. First, each farm household should get to know of the importance of commercialization and try to spread it. The commercialization. should be attained through the expansion of the environmental friendly agriculture and the improvement of the previously established distribution system of the crops. Secondly, there should be a support from the government. The support will include the expansion of the infrastructures for fanning to improve the fanning conditions and the compensation system directly from the government to the farmers.

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Influence of Seed-filling Temperature on the Seed Quality and Water Soaking Properties of Soybean (등숙온도가 콩의 품질 및 수분흡수 특성에 미치는 영향)

  • Jung, Gun-Ho;Kwon, Young-Up;Lee, Jae-Eun;Kim, Yul-Ho;Kim, Dae-Wook;Son, Beom-Young;Kim, Jung-Tae;Lee, Jin-Seok;Shin, Seong-Hyu;Baek, Seong-Bum;Lee, Byung-Moo;Chung, Ill-Min;Kim, Sun-Lim
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.58 no.3
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    • pp.308-318
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    • 2013
  • Korean soybean varieties, 'Seonyu' and 'Hwangkeum' were planted in 2012, and three temperature gradient, Tc($19.8^{\circ}C$, ambient temperatured), $Tc+1.7^{\circ}C$, and $Tc+2.5^{\circ}C$, were artificially created by controlling the green house system during seed filling period. Mature seeds that developed under these conditions were analyzed for variances in physicochemical properties. The 100-seed weight and seed-coat ratio of soybean were decreased, but small seed rate was increased by high temperature during seed filling period. Protein content was increased, but oil content was decreased significantly with increasing the seed filling temperature. The decrement of carbon to nitrogen ratio (C/N), and the increment of monosaccharide, fructose and sucrose, in seeds explained that carbohydrate assimilation during seed filling was restricted by high temperature. Rapid increments of seed volume and weight were observed in the seeds of high seed filling temperature, but as soaking time increased the highest values were observed in the seeds of ambient seed filling temperature. The 100-seed weight and seed-coat ratio of soybean were closely related not only to the increment of soaking volume and weight, but also the increments of total dissolved solids (TDS) and electro conductivity (EC). Whereas protein content and C/N ratio showed less relationship with the soaking properties, but they had a positive correlation with TDS and EC. From the results, it was considered that high values of TDS and EC in the seeds of high temperature were mainly due to the incomplete conversion of assimilates into storage compounds. However, sugar content showed less influence on the soaking properties and the values of TDS and EC.

Radiation Therapy for Bone Metastases from Hepatocellular Carcinoma: Effect of Radiation Dose Escalation (간세포암에 의한 뼈전이의 방사선치료: 고선량 방사선치료의 효과)

  • Kim, Tae-Gyu;Park, Hee-Chul;Lim, Do-Hoon;Kim, Cheol-Jin;Lee, Hye-Bin;Kwak, Keum-Yeon;Choi, Moon-Seok;Lee, Joon-Hyoek;Koh, Kwang-Cheol;Paik, Seung-Woon;Yoo, Byung-Chul
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.63-70
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    • 2011
  • Purpose: To evaluate the extent of pain response and objective response to palliative radiotherapy (RT) for bone metastases from hepatocellular carcinoma according to RT dose. Materials and Methods: From January 2007 to June 2010, palliative RT was conducted for 103 patients (223 sites) with bone metastases from hepatocellular carcinoma. Treatment sites were divided into the high RT dose and low RT dose groups by biologically effective dose (BED) of 39 $Gy_{10}$. Pain responses were evaluated using the numeric rating scale. Pain scores before and after RT were compared and categorized into 'Decreased', 'No change' and 'Increased'. Radiological objective responses were categorized into complete response, partial response, stable disease and progression using modified RECIST (Response Evaluation Criteria In Solid Tumors) criteria; the factors predicting patients' survival were analyzed. Results: The median follow-up period was 6 months (range, 0 to 46 months), and the radiologic responses existed in 67 RT sites (66.3%) and 44 sites (89.8%) in the high and low RT dose group, respectively. A dose-response relationship was found in relation to RT dose (p=0.02). Pain responses were 75% and 65% in the high and low RT dose groups, respectively. However, no statistical difference in pain response was found between the two groups (p=0.24). There were no differences in the toxicity profiles between the high and low RT dose groups. Median survival from the time of bone metastases diagnosis was 11 months (range, 0 to 46 months). The Child-Pugh classification at the time of palliative RT was the only significant predictive factor for patient survival after RT. Median survival time was 14 months under Child-Pugh A and 2 months under Child-Pugh B and C. Conclusion: The rate of radiologic objective response was higher in the high RT dose group. Palliative AT with a high dose would provide an improvement in patient quality of life through enhanced tumor response, especially in patients with proper liver function.