• Radiation Oncology Journal
• /
• 제31권4호
• /
• pp.185-190
• /
• 2013

Purpose: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). Materials and Methods: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. Results: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. Conclusion: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.

• Radiation Oncology Journal
• /
• 제24권4호
• /
• pp.237-242
• /
• 2006

목 적: 국소적으로 진행된 비소세포성 폐암에서 예후영향인자를 찾기 위하여 근치적 방사선 치료에 대한 성적을 후향적으로 평가하였다. 대상 및 방법: $1991{\sim}2002$년에 걸쳐 본원에서 방사선치료를 받은 stage IIIB 비소세포성 폐암 환자 216명의 의무기록을 후향적으로 분석하였다. 완전관해와 부분관해를 반응군(response group), 불변 및 진행성질환을 무반응군(non-response group)으로 묶어 분류하였다. 결 과: 근치목적의 방사선치료를 시행한 총 140명의 환자 중 방사선단독치료를 받은 환자는 68명, 항암화학제와 병용요법을 시행한 환자는 72명이었다. 계획된 방사선치료가 완료된 것은 단독에서는 30예, 병용요법에서는 39예였다. 중앙생존기간은 방사선 단독치료군에서는 4.6개월, 병용요법군에서는 9.9개월이었다. 1년, 2년 및 3년 생존율이 방사선 단독치료군에서는 13.3%, 3.3%, 0%였으며, 항암화학제 병용요법군에서는 각각 35.9%, 20.5%, 15.4%였다(p<0.001). 반응군에서 방사선 단독으로 치료한 환자는 중앙생존기간 7.2개월, 항암화학제 병용치료환자는 16.5개월이었고, 무반응군에서 단독치료 환자는 4.4개월, 병용치료환자는 6.7개월이었다(p=0.001). 치료반응과 항암화학요법의 병용이 전체생존율에 영향을 주었다(p<0.001). Grade 3 이상의 심한 합병증은 방사선 단독요법에서 2예(6.7%), 항암화학 병용요법에서 7예(17.9%)였다. 결 론: Stage IIIB 비소세포성 폐암에서 방사선치료와 더불어 항암화학치료를 병용했을 때, 방사선단독요법에 비해 치료반응률과 생존율이 더 높았다.

• Journal of Korean Neurosurgical Society
• /
• 제55권1호
• /
• pp.5-11
• /
• 2014

Objective : We evaluated pseudoprogression (PsPD) following radiation therapy combined with concurrent temozolomide (TMZ), and we assessed pseudoresponse following anti-angiogenic therapy for patients with recurrent disease using the Response Assessment of the Neuro-Oncology Working Group. Methods : Patients who were pathologically confirmed as having high-grade glioma received radiotherapy with concurrent TMZ followed by adjuvant TMZ. Bevacizumab (Avastin) with CPT-11 were used as a salvage option for cases of radiologic progression. Magnetic resonance imaging (MRI) was routinely performed 1 month after concurrent radiochemotherapy (CRT) and every 3 months thereafter. For cases treated with the bevacizumab-containing regimen for progressive disease, MRI was performed every 2 months. Results : Of 55 patients, 21 (38%) showed radiologic progression within 4 weeks after CRT. Of these patients, 16 (29%) showed progression at second post-CRT MRI (etPD) and five (9%) showed improvement (PsPD). Seven of thirty-four initially non-progressed patients showed progression at the second post-CRT MRI (ltPD). No difference in survival was observed between the etPD and ltPD groups (p=0.595). Five (50%) of ten patients showed a radiological response after salvage bevacizumab therapy. Four of those patients exhibited rapid progression immediately after discontinuation of the drug (drug holiday). Conclusion : Twelve weeks following treatment could be the optimal timing to determine PsPD or true progression. MRI with gadolinium enhancement alone is not sufficient to characterize tumor response or growth. Clinical correlation with adequate follow-up duration and histopathologic validation may be helpful in discriminating PsPD from true progression.

• Radiation Oncology Journal
• /
• 제30권4호
• /
• pp.153-157
• /
• 2012

Purpose: There has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior. Materials and Methods: Medical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy. Results: No KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables. Conclusion: RT is effective in local control of NAKS resulting great response rate.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.627-633
• /
• 2015

Background: To study the effect of parecoxib, a novel cyclooxygenase-2 selective inhibitor, on the radiation response of colorectal cancer (CRC) cells and its underlying mechanisms. Materials and Methods: Both in vitro colony formation and apoptosis assays as well as in vivo mouse xenograft experiments were used to explore the radiosensitizing effects of parecoxib in human HCT116 and HT29 CRC cells. Results: Parecoxib sensitized CRC cells to radiation in vitro with a sensitivity enhancement ratio of 1.32 for HCT116 cells and 1.15 for HT29 cells at a surviving fraction of 0.37. This effect was partially attributable to enhanced apoptosis induction by parecoxib combined with radiation, as illustrated using an in vitro apoptosis assays. Parecoxib augmented the tumor response of HCT116 xenografts to radiation, achieving growth delay more than 20 days and an enhancement factor of 1.53. In accordance with the in vitro results, parecoxib combined with radiation resulted in less proliferation and more apoptosis in tumors than radiation alone. Radiation monotherapy decreased microvessel density (MVD) and microvessel intensity (MVI), but increased the hypoxia level in xenografts. Parecoxib did not affect MVD, but it increased MVI and attenuated hypoxia. Conclusions: Parecoxib can effectively enhance radiation sensitivity in CRC cells through direct effects on tumor cells and indirect effects on tumor vasculature.

• Journal of Radiation Protection and Research
• /
• 제27권1호
• /
• pp.51-57
• /
• 2002

반도체 검출기를 이용하여 Hybrid 전치증폭기를 갖는 전자식 개인선량계를 설계 제작하고, 방사선 검출 반응특성과 기계적 및 주변 환경 요건에 따른 각종 성능을 평가하였다. $^{137}Cs$ 감마 방사선을 이용한 방사선 조사 시험결과 감도는 $3.8\;cps/Gy{\cdot}h^{-1}$이고, $10{\mu}Sv{\sim}4Sv$ 범위의 선량당량 조사시 선량계의 지시값은 오차 8%이하에서 선형성이 잘 유지되었다. 방향의존성을 ${\pm}60^{\circ}$ 이내에서 4%이하이며, ISO 기준선장에 의한 에너지 반응영역은 $60{\sim}1,250\;keV$로 나타났으며, IEC 61526에 의한 선량계의 성능검사시 9개 영역의 시험항목에 대한 국제기준을 만족하였다.

• Radiation Oncology Journal
• /
• 제11권1호
• /
• pp.91-96
• /
• 1993

From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.

• 대한두경부종양학회지
• /
• 제24권1호
• /
• pp.26-32
• /
• 2008

Purpose：Hypopharyngeal carcinoma is usually diagnosed as an advanced disease after an asymptomatic beginning, and it is related to a high frequency of lymph node metastases. An eventual negative outcome may occur not only because of possible locoregional failures but also for frequent distant metastases. Thus, the efficacy of induction chemotherapy followed by radiation therapy, with regards to the response, survival rate and complications for locally advanced hypopharyngeal carcinoma patients, was examined. Methods and Materials：Since July 1998 to February 2001, 18 patients having locally advanced hypopharyngeal carcinoma were treated with induction chemotherapy followed by radiation therapy, and the results were retrospectively analyzed. The regimen of the induction chemotherapy was the 5-flurouracil(5-FU, 1,000mg/$m^2$ daily for 5 consecutive days) and cisplatin(100mg/$m^2$ on day 1) combination at 3-week intervals for 2 cycles. The total radiation dose for the primary tumor and metastatic lymph nodes was 68.4-72.0Gy(median：70.2Gy) Results：The 3-year overall survival rate and disease free survival rate were 31.3% and 22.2%, respectively. In 6 patients(33.3%), preservation of the larynx for over 3 years was possible. After the induction chemotherapy and radiotherapy, a complete response was noted in 14 patients(77.8%), and a partial response in 4 patients (22.2%), with an overall response rate of 100%. Conclusion：Induction chemotherapy followed by radiation therapy is an effective treatment and larynx preservation rate was 33% in patients with locally advanced hypopharyngeal carcinoma in our report.

• Journal of Yeungnam Medical Science
• /
• 제18권1호
• /
• pp.30-38
• /
• 2001

본 연구는 골 전이암에 대한 치료에 통상적으로 이용되는 방사선치료 후 치료반응을 객관적으로 평가하는 데 필요한 새로운 영상진단 방법의 적용 가능성을 확인하기 위하여 시행되었다. 척추에 혈행성 전이를 일으킨 21명의 환자를 대상으로 방사선치료 전 후에 확산 강조 자기공명 영상을 시행한 10명의 환자에서 방사선치료 전 후에 골수 조직의 신호 강도의 변화가 현저하였으므로 기존의 진단방법인 단순 X-선 촬영, 방사성 동위원소 골 주사, 전산화 단층 촬영 및 스핀 에코 자기공명 영상진단을 보완할 수 있다는 가능성을 확인하였다. 그렇지만 대상 환자의 숫자가 적고 추적기간이 짧기 때문에 이 촬영기법이 척추에 혈행성 골 정기가 의심되는 환자에서 기본적인 검사방법으로 자리잡기 위해서는 더 많은 화자를 대상으로 가능한 병리조직학적 검사를 병행하여 장기간에 걸쳐 전향적인 검토가 필요하다고 생각되었다.

• Environmental Engineering Research
• /
• 제14권2호
• /
• pp.81-87
• /
• 2009

The decomposition of antibiotics (cefaclor) by gamma irradiation in aqueous solutions was experimentally evaluated. To obtain a mutual interaction between two factors (antibiotics concentrations and radiation doses) and to optimize these factors during the process, experimental design and statistical analysis were employed. The decomposition capability of the gamma radiation was also mathematically described as a function of cefaclor concentration and gamma-ray dose using the statistical analysis. The results showed that the cefaclor concentration ($X_1$) in the response $Y_1$ (Reduction of cefaclor concentration) and gamma-ray dose ($X_2$) in the response $Y_2$ (Removal efficiency (%) of cefaclor concentration) exhibited a significantly positive effect, whereas gamma-ray dose ($X_2$) in the response $Y_1$ showed a significantly negative effect. The estimated ridge of maximum responses and optimal conditions for $Y_1$:($X_1$,$X_2$)=(25 mg/L, 350 Gy) and $Y_2$:($X_1$,$X_2$)=(21 mg/L, 565 Gy) using canonical analysis were 4.37 mg/L of reduction of cefaclor concentration and 98.35% of removal efficiency of cefaclor concentration, respectively. The measurement values agreed well with the predicted ones, thereby confirming the suitability of the model for $Y_1$ and $Y_2$ and the success of the experimental design in optimizing the conditions of the gamma irradiation process.