• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6919-6922
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• 2015

Background: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality. Materials and Methods: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time. Results: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of $352{\pm}281.7$ days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of $112{\pm}144.0$ days. Conclusions: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

• Journal of Chest Surgery
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• 제19권3호
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• pp.484-488
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• 1986

Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2875-2878
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• 2014

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The majority of the patients present at advance stage and are not suitable for curative intent treatment. Even among patients with localized disease, there has been underutilization of curative treatment modalities. The aim of this study was to analyze the radical treatment utilization rates in patients with non small cell lung cancer (NSCLC) treated at our centre. Materials and Methods: We analyzed case records of 104 patients with a pathologically confirmed diagnosis of NSCLC having stage 1-3B disease who were treated at our centre over last 3 years, to assess the utilization of curative treatment modalities i.e. surgery or radical radiotherapy. Results: The median age of this cohort was 58 years. Out of 104 patients only 33 (31.7%) received curative intent treatment, 14 undergoing curative resection and 19 receiving radical doses of radiotherapy. The baseline characteristics of both the groups (with or without radical treatment) were not different. Major factors associated with underutilization with curative treatment were progressive disease or loss of follow up after chemotherapy and inappropriate use of TKI and/or palliative radiotherapy in patients with stage 1-3B disease. Patients who did not receive radical treatment had inferior PFS and OS than those who received radical treatment. Conclusions: In our practice we observed gross underutilization of curative intent treatment modalities in patients with NSCLCs which is associated with inferior survival.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.283-288
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• 2018

Historically, the standard treatment for early-stage cervical cancer has been radical surgery in patients with operable disease. Patients with locally advanced disease (defined as FIGO stage IB2 and usually with tumors greater than 4 cm, IIB, III and IVA) are usually treated with radical radiotherapy, which consists of external beam radiotherapy and internal brachytherapy. However, the discovery that cervical cancer tumors are sensitive to chemotherapy led to the initiation of studies looking at adding chemotherapy to both radiotherapy and surgery. Following a National Cancer Institute (NCI) alert in 1999 (NCI 1999), chemoradiotherapy became the standard of care for women with locally advanced cervical cancer.

• Radiation Oncology Journal
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• 제33권4호
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• pp.344-349
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• 2015

Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

• Radiation Oncology Journal
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• 제32권4호
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• pp.266-271
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• 2014

In the clinical state of oligometastases or oligorecurrence, a transitional state between localized and widespread systemic disease, local control of the disease may yield improved systemic control. Radiotherapy may be a good means for controlling oligometastatic tumors, particularly in very old patients for whom surgery may be infeasible. A combination of systemic therapy and local therapy is necessary to prevent systemic progression. Some kinds of cancers found in the elderly are known to be somewhat indolent for systemic progression. So, for very old patients who refuse or cannot tolerate chemotherapy, the use of radical radiotherapy alone to treat oligorecurrences may be very helpful. We successfully treated an 87-year-old patient who had been diagnosed with oligorecurrences three times over six years with radiotherapy alone. The patient is now, about four years after his first radiotherapy for liver metastasis, alive without any evidence of cancer and with fully active performance status.

• Radiation Oncology Journal
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• 제15권4호
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• pp.357-367
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• 1997

목적 : 근치적 절제술과 골반림프절 절제술을 시행한 자궁경부암 환자 중에서 치료실패의 위험인자가 있어서 술후 방사선치료를 시행한 환자를 대상으로 치료성적, 예후인자, 실패양상을 알아보기 위하여 후향적 분석을 시행하였다. 대상 및 방법 : FIGO 병기 IB, IIA와 IIB 환자 중에서 근치적 수술과 방사선치료를 시행하고 추적조사가 가능하였던 124명을 대상으로 하였다. 환자들은 1985년 3월부터 1994년 3원까지 수술후 방사선치료를 시행하였으며 최소 추적기간은 24개월이었다. 모든 환자는 4-MV 선형가속기를 이용한 외부방사선치료를 전골반에 50-6OGy를 조사하였고 일부 환자는 코발트를 이용한 고선량율 강내치료를 추가하였다. 결과 : 전체 환자의 5년 생존율과 5년 무병 생존율은 각각 $75.4\%,\;73.5\%$였고, 단변수 분석상 5년 무병 생존율에 영향을 미치는 인자는 림프절 전이 유무, 개수와 위치, 종양의 크기, 자궁체부 침운, 자궁주위조직 침윤, 병기, 자궁경부벽 침윤정도, 질 절제면 양성, 그리고 치료 관계 인자로 방사선량, 강내치료, 항암제 등이 통계상 유의하였으며, 다변량 분석상 림프절 전이와 종양의 크기, 질 절제면 양성이 유의하였다. 치료 실패는 33명이었고 2명은 다른 원인으로 사망하였고 부위별로는 국소재발이 13명, 원격전이 13명 국소-원격 동시 실패가 7명이었고 추적 종료시점까지 5명이 생존하였다. 국소재발은 병기 IB, 림프절 전이 양성 또는 질 절제면 양성 환자에서 많이 발생하였으며 림프절 전이 음성환자에서는 빈도는 낮았으나 원격전이가 상대적으로 더 많았다. 그리고 병기 lIB에서 5년 생존율 은 $56\%$ 였고 22명 중에서 9명이 재발하였다. 결론 : 수술후 방사선치료는 비교적 효과적인 방법이지만 다수의 재발 위험인자들을 가진 환자에게 술후 방사선치료만으로는 재발을 막기가 충분하지 않으므로 방사선감작제의 추가나 동시방사선-항암치료 등의 보다 효과적인 방법이 필요할 것으로 성각되며, 술혹 방사선치료의 효율을 정하기 위하여 무작위 표본 추출에 의한 전향적 연구가 필오하다. 그리고 병기 IIB는 항암치료와 수술후 방사선치료를 시행해도 치료 성적이 나쁘므로 일차적으로 근치적 방사선치료를 시행해야한다.

• Radiation Oncology Journal
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• 제9권1호
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• pp.59-63
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• 1991

1983년에서 1989년까지 가톨릭의대 부속 성모병원 방사선치료실에서 비인강종양으로 확진되어 치료를 시행한 환자 31명중 치료가 불완전했던 환자 8명을 제외한 23명의 치료성적으로 후향조사 하였다. 이들 중 11명의 환자에 있어서는 방사선 단독요법을 시행하였으며, 12명의 환자에소는 cispiatin+5-fluorouracil 혹은 cisplatin-bleomycin-vincristine을 이용하여 1회 내지 3회에 걸친 유도 화학요법후 방사선치료를 시행하였다. 방사선 단독요법으로 치료된 11명의 환자에서 완전 관해율은 55%(6/11), 부분관해율은 45%(5/11)였다. 유도화학요법을 시행한 12명의 환자중 약물 치료후 완전관해율은 25%(3/12)였으며, 부분관해율은 75%(9/12)였고, 연속적으로 시행된 방사선 치료후에는 완전 관해율이 83%(10/12)로 증가되었으며, 부분 관해율은 17%(2/12)였다. 유도 항암요법에 부분관해를 보였던 환자중 stage 111 환자 1명과 stage IV 환자 6명이 추가 방사선 치료후 완전 관해를 보였다. 방사선 단독요법군에서는 4명에 국소재발이 발생했으며,-약물요법과 방사선치료를 병행했던 군에서는 국소재발 3명과 폐로의 원격전이가 1명에서 발생되었다. 방사선단독으로 치료한 환자군과 유도화학요법과 방사선 치료를 병행한 환자군에서의 생존율의 차이가 통계적으로 유의하지 않았다. $28.55{\pm}15$ and $M{\pm}SD=28.588{\pm}25.39$, p>0.05) 치료환자군의 수가 적은 이유로 통계분석 결과 큰 의의를 발견할 수 없었다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2243-2248
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• 2013

Background: To compare the dosimetric coverage of target volumes and organs at risk in the radical treatment of nasopharyngeal carcinoma (NPC) between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: Data from 10 consecutive patients treated with IMRT from June-October 2011 in Penang General Hospital were collected retrospectively for analysis. For each patient, dose volume histograms were generated for both the IMRT and 3DCRT plans using a total dose of 70Gy. Comparison of the plans was accomplished by comparing the target volume coverage (5 measures) and sparing of organs at risk (17 organs) for each patient using both IMRT and 3DCRT. The means of each comparison target volume coverage measures and organs at risk measures were obtained and tested for statistical significance using the paired Student t-test. Results: All 5 measures for target volume coverage showed marked dosimetric superiority of IMRT over 3DCRT. V70 and V66.5 for PTV70 showed an absolute improvement of 39.3% and 24.1% respectively. V59.4 and V56.4 for PTV59.4 showed advantages of 18.4% and 16.4%. Moreover, the mean PTV70 dose revealed a 5.1 Gy higher dose with IMRT. Only 4 out of 17 organs at risk showed statistically significant difference in their means which were clinically meaningful between the IMRT and 3DCRT techniques. IMRT was superior in sparing the spinal cord (less 5.8Gy), V30 of right parotid (less 14.3%) and V30 of the left parotid (less 13.1%). The V55 of the left cochlea was lower with 3DCRT (less 44.3%). Conclusions: IMRT is superior to 3DCRT due to its dosimetric advantage in target volume coverage while delivering acceptable doses to organs at risk. A total dose of 70Gy with IMRT should be considered as a standard of care for radical treatment of NPC.

• Annals of Clinical Neurophysiology
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• 제22권2호
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• pp.109-111
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• 2020

Germ-cell tumors (GCTs) are common in the central nervous system. GCTs are highly sensitive to radiotherapy and chemotherapy and can be cured without radical surgery. However, this tumor produces nonspecific imaging findings, and its rarity can make diagnosis challenging. Here we report a case in which the first diagnosis was uncertain and follow-up imaging revealed intramedullary germinoma. The patient underwent chemotherapy and radiotherapy after the diagnosis.