• Title/Summary/Keyword: stage IV

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Primary Orbital Lymphoma : A Retrospective Analysis of Results of Radiation Therapy (원발성 안와 림프종의 방사선치료 성적에 관한 후향적 분석)

  • Kim Sussan;Ahn Seung Do;Chang Hyesook;Kim Kyoung Ju;Lee Sang-wook;Choi Eun Kyung;Kim Jong Hoon;Huh Jooryung;Suh Cheol Won;Kim Sung Bae
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.139-146
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    • 2002
  • Purpose : This study evaluated the treatment outcomes, patterns of failure, and treatment related complications of primary lymphoma patients who received definitive radiation therapy. Materials and Methods : A retrospective analysis was undertaken for 31 patients with primary orbital lymphoma at the Asan Medical Center between February 1991 and April 2001. There were 18 males and 13 females with ages ranging from 3 to 73 years (median, 44 years). The involved sites were 9 conjunctivae, 12 eyelids and 10 other orbits. The histological types were 28 MALT lymphomas (low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type), 1 diffuse large B-cell lymphoma, 1 anaplastic large cell lymphoma and 1 lymphoblastic lymphoma. The Ann Arbor stages were all IE $(100\%)$. Ann Arbor stage III or IV patients were excluded from this study, Bilateral orbital involvement occurred in 6 cases. Radiation therapy was given with one anterior port of high energy electrons $(6\~16\;MeV)$ for the lesions located at the anterior structures like the conjunctivae or eyelids. Lesions with a posterior extension or other orbital lesions were treated with 4 or 6 MeV photons with appropriately arranged portals. In particular, lens blocks composed of lead alloy were used in conjunctival or eyelid lesions. Twelve patients received chemotherapy. The median follow-up period was 53 months. Results : The 5-year overall, cause-specific, and disease-free survival was $91\%,\;96\%,\;and\;80\%$, respectively. The complete response rate 6 months after radiation therapy was $100\%$. Local recurrences were observed in 2 patients at 16 and 18 months after completion of radiation treatment. They were salvaged with additional radiation therapy. Two patients developed distant metastases. A MALT lymphoma patient with a lung relapse was successfully salvaged with radiotherapy, but the other lymphoblastic lymphoma patient with bone marrow relapse expired. There were no severe complications but 5 patients developed radiation-induced cataracts and 2 patients developed dry eye. Conclusion : Most primary orbital lymphomas consisted of MALT lymphomas. Radiation therapy was a successful treatment modality for orbital lymphoma without any severe complications. In cases of local relapses, radiation therapy is also a very successful salvage treatment modality.

A Prospective Randomized Trial Comparing the Seciuence of Adiuvant Chemotherapy and Radiotherapy following Curative Resection of Stage II, III Rectal Cancer (직장암의 근치적 수술 루 방사선치료와 화학요법의 순서에 대한 고찰 -전향적 무작위 3상 임상연구 중간 결과 보고-)

  • Kim Kyoung Ju;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook;Ahn Seung Do;Lee Je Hwan;Kim Jin Cheon;Yu Chang Sik
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.17-25
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    • 2000
  • Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

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Studies on the ecological variations of rice plant under the different seasonal cultures -I. Variations of the various agronomic characteristics of rice plant under the different seasonal cultures- (재배시기 이동에 의한 수도의 생태변이에 관한 연구 -I. 재배시기 이동에 의한 수도의 실용제형질의 변이-)

  • Hyun-Ok Choi
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.3
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    • pp.1-40
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    • 1965
  • To measure variations in some of the important agronomic characteristics of rice varieties under shifting of seedling dates, this study has been carried out at the Paddy Crop Division of Crop Experiment Station(then Agricultural Experiment Station) in Suwon for the period of three years 1958 to 1960. The varieties used in this study were Kwansan, Suwon #82, Mojo, Paltal and Chokwang, which have the different agronomic characteristics such as earliness and plant type. Seeds of each variety were sown at 14 different dates in 10-day interval starting on March 2. The seedlings were grown on seed bed for 30, 40, 50, 60, 70 and 80 days, respectively. The results of this study are as follows: A. Heading dates. 1. As the seeding date was delayed, the heading dates was almost proportionally delayed. The degree of delay was higher in early varieties and lower in late varieties and the longer the seedling stage, the more delayed the heading date. 2. Number of days to heading was proportionally lessened as seeding was delayed in all the varieties but the magnitude varied depending upon variety. In other words, the required period for heading in case of late planting was much shortened in late variety compared with early one. Within a variety, the number of days to heading was less shortened as the seedling stage was prolonged. Early variety reached earlier than late variety to the marginal date for the maximum shortening of days to heading and the longer the seeding stage, the limitted date came earlier. There was a certain limit in seeding date for shortening of days to heading as seeding was delayed, and days to heading were rather prolonged due to cold weather when seeded later than that date. 3. In linear regression equation, Y=a+bx obtained from the seeding dates and the number of days to heading, the coefficient b(shortening rate of days to heading) was closely correlated with the average number of days to heading. That is, the period from seeding to heading was more shortened in late variety than early one as seeding was delayed. 4. To the extent that the seedling stage is not so long and there is a linear relationship between delay of seeding and shortening of days to heading, it might be possible to predict heading date of a rice variety to be sown any date by using the linear regression obtained from variation of heading dates under the various seeding dates of the same variety. 5. It was found out that there was a close correlation between the numbers of days to heading in ordinary culture and the other ones. When a rice variety was planted during the period from the late part of March to the middle of June and the seedling ages were within 30 to 50 days, it could be possible to estimate heading date of the variety under late or early culture with the related data of ordinary culture. B. Maturing date. 6. Within (he marginal date for maturation of rice variety, maturing date was proportionally delayed as heading was delayed. Of course, the degree of delay depended upon varieties and seedling ages. The average air temperature (Y) during the ripening period of rice variety was getting lower as the heading date. (X) was delayed. Though there was a difference among varieties, in general, a linear regression equation(y=25.53-0.182X) could be obtained as far as heading date were within August 1 to September 13. 7. Depending upon earliness of a rice variety, the average air temperature during the ripening period were greatly different. Early variety underwent under 28$^{\circ}C$ in maximum while late variety matured under as low as 22$^{\circ}C$. 8. There was a highly significant correlation between the average air temperature (X) during the ripening period, and number of day (Y) for the maturation. And the relationship could be expressed as y=82.30-1.55X. When the average air temperature during the period was within the range of 18$^{\circ}C$ to 28$^{\circ}C$, the ripening period was shortened by 1.55 days with increase of 1$^{\circ}C$. Considering varieties, Kwansan was the highest in shortening the maturing period by 2.24 days and Suwon #82 was the lowest showing 0.78 days. It is certain that ripening of rice variety is accelerated at Suwon as the average air temperature increases within the range of 18$^{\circ}C$ to 28$^{\circ}C$. 9. Between number of days to heading (X) related to seeding dates and the accumulated average air temperature (Y) during the ripening period, a positive correlation was obtained. However, there was a little difference in the accumulated average air temperature during the ripening period even seeding dates were shifted to a certain extent. C. Culm- and ear-lengths. 10. In general all the varieties didn't show much variation in their culm-lengths in case of relatively early seeding but they trended to decrease the lengths as seeding was delayed. The magnitude of decreasing varied from young seedlings to old ones. Young seedlings which were seeded during May 21 to June 10 didn't decrease their culm-lengths, while seedlings old as 80 days decreased the length though under ordinary culture. 11. Variation in ear-length of rice varieties show the same trend as the culm-length subjected to the different seeding dates. When rice seedlings aged from 30 to 40 days, the ear-length remained constant but rice plants older than 40 days obviously decreased their ear-lengths. D. Number of panicles per hill. 12. The number of panicles per hill decreased up to a certain dates as seeding was delayed and then again increased the panicles due to the development of numerous tillers at the upper internodes. The seeding date to reach to the least number of panicles of rice variety depended upon the seedling ages. Thirty- to 40-day seedlings which were seeded during May 31 to June 10 developed the lowest number of panicles and 70- to 80-day seedlings sown for the period from April 11 to April 21 reached already to the minimum number of panicles. E. Number of rachillae. 13. To a certain seeding date, the number of rachillae didn't show any variation due to delay of seeding but it decreased remarkably when seeded later than the marginal date. 14. Variation in number of rachillae depended upon seedling ages. For example, 30- to 40-day old seedlings which, were originally seeded after May 31 started to decrease the rachillae. On the other hand, 80-day old seedlings which, were seeded on May 1 showed a tendency to decrease rachillae and the rice plant sown on May 31 could develop narrowly 3 or 4 panicles. F. Defective grain and 1.000-grain weights. 15. Under delay of the seeding dates, weight of the defective grains gradually increased till a certain date and then suddenly increased. These relationships could be expressed with two different linear regressions. 16. If it was assumed that the marginal date for ripening was the cross point of these two lines, the date seemed. closely related with seedling ages. The date was June 10- in 30- to 40-day old seedlings but that of 70- to 80-day old seedlings was May 1. Accordingly, the marginal date for ripening was getting earlier as the seedling stage was prolonged. 17. The 1.000-grain weight in ordinary culture was the heaviest and it decreased in both early and late cultures. G. Straw and rough rice weights. 18. Regardless of earliness of variety, rice plants under early culture which were seeded before March 22 or April 1 did not show much variation in straw weight due to seedling ages but in ordinary culture it gradually decreased and the degree was became greater in late culture. 19. Relationship between seeding dates (X) and grain weight related to varieties and seedling ages, could be expressed as a parabola analogous to a line (Y=77.28-7.44X$_1$-1.00lX$_2$). That is, grain yield didn't vary in early culture but it started to decrease when seeded later than a certain date, as seeding was delayed. The variation was much greater in cases of late planting and prolongation of seedling age. 20. Generally speaking, the relationship between grain yield (Y) and number of days to heading (X) was described with linear regression. However, the early varieties were the highest yielders within the range of 60 to 110, days to heading but the late variety greatly decreased its yield since it grows normally only under late culture. The grain yield, on the whole, didn't increase as number of days to heading exceeded more than 140 days.

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Clinical Application of Serum CEA, SCC, Cyfra21-1, and TPA in Lung Cancer (폐암환자에서 혈청 CEA, SCC, Cyfra21-1, TPA-M 측정의 의의)

  • Lee, Jun-Ho;Kim, Kyung-Chan;Lee, Sang-Jun;Lee, Jong-Kook;Jo, Sung-Jae;Kwon, Kun-Young;Han, Sung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.785-795
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    • 1997
  • Background : Tumor markers have been used in diagnosis, predicting the extent of disease, monitoring recurrence after therapy and prediction of prognosis. But the utility of markers in lung cancer has been limited by low sensitivity and specificity. TPA-M is recently developed marker using combined monoclonal antibody of Cytokeratin 8, 18, and 19. This study was conducted to evaluate the efficacy of new tumor marker, TPA-M by comparing the estabilished markers SCC, CEA, Cyfra21-1 in lung cancer. Method : An immunoradiometric assay of serum CEA, sec, Cyfra21-1, and TPA-M was performed in 49 pathologically confirmed lung cancer patients who visited Keimyung University Hospital from April 1996 to August 1996, and 29 benign lung diseases. Commercially available kits, Ab bead CEA (Eiken) to CEA, SCC RIA BEAD (DAINABOT) to SCC, CA2H (TFB) to Cyfra2H. and TPA-M (DAIICHI) to TPA-M were used for this study. Results : The mean serum values of lung cancer group and control group were $10.05{\pm}38.39{\mu}/L$, $1.59{\pm}0.94{\mu}/L$ in CEA, $3.04{\pm}5.79{\mu}/L$, $1.58{\pm}2.85{\mu}/L$ in SCC, $8.27{\pm}11.96{\mu}/L$, $1.77{\pm}2.72{\mu}/L$ in Cyfra21-1, and $132.02{\pm}209.35\;U/L$, $45.86{\pm}75.86\;U/L$ in TPA-M respectively. Serum values of Cyfra21-1 and TPA-M in lung cancer group were higher than control group (p<0.05). Using cutoff value recommended by the manufactures, that is $2.5{\mu}/L$ in CEA, $3.0{\mu}/L$ in Cyfra21-1, 70.0 U/L in TPA-M, and $2.0{\mu}/L$ in SCC, sensitivity and specificity of lung cancer were 33.3%, 78.6% in CEA, 50.0%, 89.7% in Cyfra21-1, 52.3%, 89.7% in TPA-M, 23.8%, 89.3% in SCC. Sensitivity and specificity of nonsmall cell lung cancer were 36.1%, 78.1% in CEA, 50.1%, 89.7% in Cyfra21-1, 53.1%, 89.7% in TPA-M, 33.8%, 89.3% in SCC. Sensitivity and specificity of small cell lung cancer were 25.0%, 78.5% in CEA, 50.0%, 89.6% in Cyfra21-1, 50.0%, 89.6% in TPA-M, 0%, 89.2% in SCC. Cutoff value according to ROC(Receiver operating characteristics) curve was $1.25{\mu}/L$ in CEA, $1.5{\mu}/L$ in Cyfra2-1, 35 U/L in TPA-M, $0.6{\mu}/L$ in SCC. With this cutoff value, sensitivity, specificity, accuracy and kappa index of Cyfra21-1 and TPA-M were better than CEA and SCC. SCC only was related with statistic significance to TNM stages, dividing to operable stages(TNM stage I to IIIA) and inoperable stages (IIIB and IV) (p<0.05). But no tumor markers showed any correlation with significance with tumor size(p>0.05). Conclusion : Serum TPA-M and Cyfra21-1 shows higher sensitivity and specificity than CEA and SCC in overall lung cancer and nonsmall cell lung cancer those were confirmed pathologically. SCC has higher specificity in nonsmall cell lung cancer. And the level of serum sec are signiticantly related with TNM staging.

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