• Radiation Oncology Journal
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• v.13 no.1
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• pp.33-40
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• 1995

Purpose : To assess the efficacy and toxicity of the preoperative radiotherapy with or without chemotherapy in locally advanced rectal cancer Methods : Forty three patients (clinically diagnosed stages above or equal to Astler-Coiler stage B2 without distant metastasis) were assigned to preoperative radiotherapy alone arm (n=16) or combined preoperative radiotherapy and chemotherapy arm (n=27). Preoperative radiotherapy of 4500 cGy to whole pel-vis +/-540 cGy boost to primary site and concurrent chemotherapy of 2 cycles of 5-FU (500 mg/$m^2$) and leucovorin (20 mg/$m^2$) were used. Fifteen patients of preoperative radiotherapy alone arm and 19 of combined arm received surgical resection after preoperative treatment. Results : During the preoperative treatment, no significant complication was developed in both groups. Pathologic results were as follows; complete remission 1, Bl 1, B2 6, C1 2, C2, 5 in preoperative radiotherapy alone arm and complete remission 2, Bl 8, B2 4, C2 3, D 2 in combined arm. Postoperative complications were delayed perineal wound healing in three patients, intestinal obstruction in three patients (one managed by conservative medical treatment, two by surgical treatment). Conclusion : The combined preoperative radiotherapy and chemotherapy arm was more effective in pathological response and lymph node negativity rate than the preoperative radiotherapy alone arm. Both the preoperative radiotherapy alone arm and the combined arm were generally well tolerated and did not result in an increased postoperative morbidity.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.23-27
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• 2017

Background and Objectives: Gastric acid reflux is known to be the most important cause of contact granuloma. Therefore, anti-gastric acid reflux medication has been used as the first line treatment although there are other treatment methods such as surgery or steroid injections. Actually, the role of surgery in the treatment of contact granuloma has not been established clearly. The purpose of this study was to evaluate the effectiveness of surgical treatment for contact granuloma. Materials and Methods: We retrospectively reviewed the medical records of 14 patients who were diagnosed with contact granuloma and treated with surgery from 2011 to July 2016 at Hanyang University hospital. Results: Of 14 patients, 9 (64.3%) were male and 5 (27.4%) were female. The mean age was 53.8 (${\pm}6.1$) years. The main symptoms were voice change followed by globus, dyspnea, and asymptomatic. Mean Reflux Finding Score (RFS) before surgery was 13.5 and mead Reflux Symptom Index (RSI) was 10.4. The causes of surgery were inadequate response to proton pump inhibitor (PPI) in 4 cases, airway obstruction with large granuloma in 8 cases, and differential diagnosis in 2 cases. Of 14 patients, recurrence occurred in 8 (53.3%) patients after surgery. In 8 recurrent cases, 5 patients showed complete remission and 3 patients showed partial remission with PPI medication. Conclusion: The role of surgery in the treatment of contact granuloma might be limited due to high recurrence rate.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.268-273
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• 2017

Purpose: We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. Materials and Methods: We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31-65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was $34.1cm^3$ (range, $6.8-83.2cm^3$), and fractionated radiation was administered to a total dose of 50-54 Gy with a daily dose of 2 Gy. Results: The median follow-up period was 6.8 years (range, 2.2-8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9-95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Conclusion: Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

• Progress in Medical Physics
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• v.26 no.4
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• pp.229-233
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• 2015

We retrospectively reviewed lung cancer patients who were treated with stereotactic ablative radiotherapy (SABR). We investigated the value of response evaluation after treatment by measuring the volume change of tumors on serial chest computed tomography (CT) examinations. The study included 11 consecutive patients with early-stage (T1-T2aN0M0) non-small cell lung cancer (NSCLC) who were treated with SABR. The median dose of SABR was 6,000 cGy (range 5,000~6,400) in five fractions. Sequential follow-up was performed with chest CT scans. Median follow-up time was 28 months. Radiologic measurement was performed on 51 CT scans with a median of 3 CT scans per patient. The median time to partial response ($T_{PR}$) was 3 months and median time to complete remission ($T_{CR}$) was 5 months. Overall response rate was 90.9% (10/11). Five patients had complete remission, five had partial response, and one patient developed progressive disease without response. On follow-up, three patients (27.2%) developed progressive disease after treatment. We evaluated the the response after SABR. Our data also showed the timing of response after SABR.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8855-8859
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• 2014

Purpose: To investigate the impact of hyperglycemia during inductive treatment on the prognosis of acute lymphocytic leukemia (ALL) in children. Materials and Methods: Clinical data of 159 ALL childhood cases were reviewed. The patients were divided into the hyperglycemia group (fasting $glucose{\geq}126mg/dl$ and/or random blood $glucose{\geq}200mg/dl$) and the euglycemia group according to the blood glucose values. The X2 test was performed to compare the complete remission rates of the two groups, and Kaplan-Meier and log-rank tests were performed to compare the 5-year overall and relapse-free survival. Results: The incidence of hyperglycemia in the $age{\geq}10-year-old$ group was higher than the younger-age group (P=0.009). Values in the interim- and high-risk groups were higher than the standard-risk group (P=0.028), while there was no significant difference between genders (P=0.056). The complete remission rates of the 2 groups demonstrated no significant difference (P=0.134), while the 5-year OS of the hyperglycemia group was lower than in the euglycemia group ($83.8{\pm}6.0%$ vs $94.9{\pm}2.4%$, P=0.014). The 5 -year RFS was significantly lower than the euglycemia group ($62.9{\pm}8.7%$) vs $80.2{\pm}9.1%$, P<0.001). Conclusions: Children with $age{\geq}10year$ old, and in the middle- and high-risk groups appear prone to complicating hyperglycemia during inductive chemotherapy, associated with lower 5-year OS and RFS.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4711-4715
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• 2013

Aim: The aim of this study was to evaluate acute adverse events and efficacy of three-dimensional intensitymodulated radiotherapy (IMRT) combined with endocrine therapy for intermediate and advanced prostate cancer. Methods: Sixty-seven patients were treated with three-dimensional IMRT combined with maximum androgen blockade. The correlation between radiation-induced rectal injury and clinical factors was further analyzed. Results: After treatment, 21 patients had complete remission (CR), 37 had partial remission (PR), and nine had stable disease (SD), with an overall response rate of 86.5%. The follow-up period ranged from 12.5 to 99.6 months. Thirty-nine patients had a follow-up time of ${\geq}$ five years. In this group, three-year and five-year overall survival rates were 89% and 89.5%, respectively; three-year and five-year progression-free survival rates were 72% and 63%. In univariate analyses, gross tumor volume was found to be prognostic for survival ($X^2$ = 5.70, P = 0.037). Rates of leucopenia and anemia were 91.1% and 89.5%, respectively. Two patients developed acute liver injury, and a majority of patients developed acute radiation proctitis and cystitis, mainly grade 1/2. Tumor volume before treatment was the only prognostic factor influencing the severity of acute radiation proctitis (P < 0.05). Conclusions: IMRT combined with endocrine therapy demonstrated promising efficacy and was well tolerated in patients with intermediate and advanced prostate cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1089-1092
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• 2013

Background: Elderly patients with acute myeloid leukemia (AML) have a poor outcome because of co-morbidities, poor tolerance to intensive chemotherapy and inherently more resistant disease. Clofarabine is a second generation nucleoside analogue which has shown promising activity in elderly patients with AML. This study was conducted to review the outcome of treatment with clofarabine in a group of such patients. Methods: The records of 5 elderly patients who were diagnosed to have AML and treated with clofarabine over a 12 month period were reviewed retrospectively. Results: There were 2 female and 3 male patients with a median age of 68 years (range 65-82). At the time of treatment, 2 patients had newly diagnosed AML not considered suitable for intensive therapy, while 3 patients had partial or no response to conventional chemotherapy. The overall response rate was 100%, all patients achieving a complete remission. Induction and consolidation were well tolerated. All patients developed neutropenia with a median duration of 20 days (range 17-42). One patient developed hand and foot syndrome and a generalized rash but recovered. There was no mortality and all patients remained in remission after a median follow-up of 5.2 months (Range 3-10). Conclusion: Clofarabine (alone or in combination) is active in elderly AML patients with an acceptable safety profile and should be considered a potential option in this group.

• Clinical and Experimental Pediatrics
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• v.55 no.3
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• pp.100-106
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• 2012

Purpose: The survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete remission (CR). Methods: Fifty-three ALL patients (42 men, 79%) who received HSCT in second CR from August 1991 to February 2009 were included (26 sibling donor HSCTs, 49%; 42 bone marrow transplantations, 79%). Study endpoints included cumulative incidence of acute and chronic graft-versus-host disease (GVHD), relapse, 1-year transplant-related mortality (TRM), disease-free survival (DFS), and overall survival (OS). Results: Cumulative incidences of acute GVHD (grade 2 or above) and chronic GVHD were 45.3% and 28.5%, respectively. The estimated 5-year DFS and OS for the cohort was $45.2{\pm}6.8%$ and $48.3{\pm}7%$, respectively. Only donor type, i.e., sibling versus unrelated, showed significant correlation with DFS in multivariate analysis ($p$=0.010). The rates of relapse and 1 year TRM were $28.9{\pm}6.4%$ and $26.4{\pm}6.1%$, respectively, and unrelated donor HSCT ($p$=0.002) and HLA mismatch ($p$=0.022) were significantly correlated with increased TRM in univariate analysis. Conclusion: In this single institution study spanning more than 17 years, sibling donor HSCT was the only factor predicting a favorable result in multivariate analysis, possibly due to increased TRM resulting from unrelated donor HSCT.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.123-129
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• 1997

Purpose : The Childhood Steroid Resistant Nephrotic Syndrome (SRNS) has a poor prognosis and there has been no effective therapy against SRNS of children. In 1990, Mendoza have reported that methylprednisolone pulse therapy was effective against SRNS of children. But in 1992, Waldo have reported that methylprednisolone pulse therapy was not as effective as in the report of Mendoza. So, retrospectively, we have studied 20 korean children with SRNS to evaluate the effect of methylprednisolone pulse therapy, Methods : Mothylprednisolone pulse therapy were given to 20 korean children with SRNS who admitted to Seoul National University Hospital from 1990 to 1995 and follow up was done Results : 1) During methylprednisolone pulse therapy, remission of nephrotic syndrome was induced in 45% of patients. 2) during follow up after the end of methylprednisolone pulse therapy, remission of nephrotic syndrome was maintained in 45% of patients. 3) 25% of patients has progressed to chronic renal failure. Conclusion : We think that the methylprednisolone pulse therapy is a effective therapy against SRNS of children with the 45%, remission rate of of SRNS in Korean Children

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.47-53
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• 2011

Purpose : Concurrent chemoradiotherapy(CCRT) with 3 weekly cisplatin is the standard treatment of locally advanced head and neck cancer(HNC). The aim is to evaluate the efficacy and toxicities of low-dose weekly cisplatin-based CCRT, which was devised to reduce the toxicity of CCRT. Method : We retrospectively analyzed HNC patients who received low-dose weekly cisplatin-based CCRT between 2008 and 2010. Cisplatin 35mg/$m^2$ was weekly given to all patients during radiotherapy. The efficacy was evaluated by the degree of clinical response, treatment failure and survival. The toxicity was evaluated by hematologic toxicities and oral mucositis. Results : A total of 27 patients were analyzed and median age was 59(range 31-81). The ratio of administered dose of radiotherapy and cisplatin to planned dose were 0.98 and 0.93, respectively. Complete remission and partial remission were 73% and 23%, respectively. Treatment failure was observed in 8(30%) patients. 1-year survival rate and 1-year disease free survival rate were 82% and 59%, respectively. Overall survival and progression-free survival did not reach median time. Grade 3/4 anemia, neutropenia, thrombocytopenia and oral mucositis were observed in 11%, 19%, 7% and 32% of patients, respectively. In terms of administered cycles, however, only 1-3% of grade 3/4 hematologic toxicities occurred among total 190 cycles. Severe oral mucositis were statistically associated with old age(p=0.003). Treatment failure had no statistical relation with age, pathology, primary site and stage. Conclusion : Low-dose weekly cisplatin-based CCRT seemed to deliver enough dose of cisplatin and to show low drop-out rate and good efficacy with low hematologic toxicities.