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Analysis of Treatment Failures in Early Uterine Cervical Cancer (조기 자궁경부 악성종양의 치료실패에 대한 분석)

  • Kim Joo-Young;Lee Kyu-Chan;Choi Hyung-Sun
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.285-291
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    • 1991
  • One hundred and twenty six patients with early uterine cervical cancer who had been treated at Departmen of Radiation Oncology of Korea University Hospital from Jan.1981 to Dec.1988 were analysed retrospectively by the treatment result and pattern of of failures. All patients had stage Ia to IIa disease and were grouped whether they had combination of operation and postop irradiation or radiation therapy alone. 1) Sixty six patients belonged to the combination treatment group and 60 patients to the radiation alone group. 2) Combination group consisted of $18.1\%$(12/66) stage Ia, $71.2\%$(47/66) stage Ib and $10.6\%$ (7/66) stage IIa patients. There were no stage Ia, 18.8$\%$(l1/60) stage Ib and 81.6$\%$(49/60) stage IIa patients for RT alone gronp. 3) There were total 23$\%$(29/126) treatment failures,13 patients in combination group and 16 patients in RT alone group. In 66 patients of combination group, they were found to have 5 locoregional failures, 7 distant failures and 1 at both sites. In 60 patients of RT alone group, 9 locoreginal failure and 7 distant failures occured. Eighty six percent (25/29) of total failures appeared within 18 month after completion of treatment. About 60$\%$ of the patients with regional recurrences which were located at pelvic side wall or pelvic lymph nodes paesented their recurrent disease after 1 year of completion of treatment, whereas same percent of distant failures appeared within 6 month. 5) In RT alone group, the first sites of distant failure were mostly para-aortic lymph node and/or left supraclavicular lymph node (71.4$\%$,5/7). In combination group, various sites such as inguinal lymph node, mediastinal lymph node, liver, lung and bone appeared first or at the same time with para-aortic and supraclavicular lymph node metastasis. 6) Logistic regression analysis was done for multivariate analysis of the factors contributing to locoregional and distant failures. In combination group, adequacy of the resection margin and the presence of positive pelvic node were found to be the most significant factors (p=0.0423 & 0.0060 respectively). In RT alone group, less than complete regression of the tumor at the end of treatment was the only significant contributing factor for the treatment failures (p=0.0013) with good liklihood ratio.

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Effects of Fractionated Stereotactic Radiotherapy for Primary Hepatocellular Carcinoma (원발성 간암의 분할 정위방사선치료 효과)

  • Choi Byeong Ock;Kang Ki Mun;Jang Hong Seok;Lee Snag-wook;Kang Young Nam;Chai Gyu Young;Choi Ihl Bhong
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.92-97
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    • 2005
  • Purpose : Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. in this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC. Materials and Methods : A retrospective analysis was peformed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was $2\~6.5$ cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was S or 10 Gy: each dose was prescribed based on the planning target volume and normalized to $85\~99\%$ isocenter dose. Patients were treated $3\~5$ times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was $\~55$ months (the median follow up period: 23 months). Results : The response rate was $50\%$ (12 patients), with 4 patients showing complete response ($20%$), 8 patients showing partial response ($40\%$), and 8 patients showing stable disease ($40\%$). The 1-year and 2-year survival rates were $70.0\%$ and $43.1\%$, respectively, and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were $65\%$ and $32.5\%$, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients ($60\%$), nausea/emesis in 8 patients ($40\%$), and transient liver function impairment in 6 patients ($30\%$). However, there was no treatment related death. Conclusion : The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC.

The Role of Fas in Radiation Induced Apoptosis in vivo (방사선에 의한 Apoptosis에서 Fas의 역할)

  • Kim, Sung-Hee;Seong, Jin-Sil;Seong, Je-Kyung
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.246-252
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    • 2002
  • Purpose : It has been recognized that interaction of the Fas : Fas ligand plays an important role in radiation-induced apoptosis. The purpose of this study was to investigate the role of Fas mutation in radiation-induced apoptosis in vivo. Materials and Method : Mice with mutations in Fas, $MRL/Mpj-Fas^{Ipr}$, and its normal control, MRL/Mpj, were used in this study. Eight-week old male mice were given whole body radiation. After irradiation, the mice were killed and their spleens were collected at different time intervals. Tissue samples were stained with hematoxylin-eosin and the numbers of apoptotic cells were scored. Regulating molecules of apoptosis including p53, Bcl-2, Bax, $Bcl-X_L,\;and\;Bcl-X_S$ were also analyzed by Western blotting. Results : At 25 Gy irradiation, the level of apoptosis reached the peak value at 8 hr after radiation and recovered to the normal value at 24 hr after radiation in MRL/Mpj mice. In contrast, the peak apoptosis level appeared at 4 hr after radiation in $MRL/Mpj-Fas^{Ipr}$. At 8 hr after radiation, the levels of apoptosis in MRL/Mpj mice and $MRL/Mpj-Fas^{Ipr}$ mice were $52.3{\pm}7.8\%\;and\;8.0{\pm}8.6\%$, respectively (p<0.05). The expression of apoptosis regulating molecules, p53, $Bcl-X_L\;and\;Bcl-X_S$, increased in MRL/Mpj mice in response to radiation; p53 with a peak level of 3-fold at 8 h, $Bcl-X_L$ with a peak level of 3.3-fold at 12 h, and $Bcl-X_S$ with a peak level of 3-fold at 12 h after 25 Gy radiation. Bcl-2 and Bax did not show significant change in MRL/Mpj mice. However in $MRL/Mpj-Fas^{Ipr}$ mice, the expression levels of p53, Bcl-2, Bax, $BCl-X_L\;and\;BCl-X_S$ showed no significant change. Conclusion : The level of radiation-induced apoptosis was lower in Fas mutated mice, Ipr, than in control mice. This seemed to be related to the lack of radiation-induced p53 activation in the Ipr mice. This result suggests that Fas plays an important role in radiation-induced apoptosis in vivo.

Significance of Apoptotic Cell Death after $\gamma-Irradiation$ (방사선 조사에 의한 세포사에 있어서 세포고사의 의미)

  • Wu H.G.;Kim I.H.
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.252-258
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    • 2001
  • Purpose : The objectives of this study are to investigate the significance of apoptotic death compared to total cell death after $\gamma-ray$ irradiation in human H&N cancer cell lines and to find out correlation between apoptosis and radiation sensitivity. Materials and method : Head and neck cancer cell lines (PCI-1, PCI-13, and SNU-1066), leukemia cell line (CCRF-CEM), and fibroblast cell line (LM217) as a normal control were used for this study. Cells were irradiated using Cs-137 animal experiment irradiator. Total cell death was measured by clonogenic assay. Annexin-V staining was used to detect the fraction of apoptotic death. Results : Surviving fraction at 2 Gy (SF2) were 0.741, 0.544, 0.313, 0.302, and 0.100 for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217 cell lines, respectively. Apoptosis was detected in all cell lines. Apoptotic index reached peak value at 72 hours after irradiation in head and neck cancer cell lines, and that was at 24 hours in CCRF-CEM and LM217. Total cell death increased exponentially with increasing radiation dose from 0 Gy to 8 Gy, but the change was minimal in apoptotic index. Apoptotic fractions at 2 Gy were $46\%,\;48\%,\;46\%,\;24\%,\;and\;19\%$ and at 6 Gy were $20\%,\;33\%,\;35\%,\;17\%,\;and\;20\%$ for PCI-1, PCI-13, SNU-1066, CCRF-CEM, and LM217, respectively. The radioresistant cell lines showed more higher apoptotic fraction at 2 Gy, but there was not such correlation at 6 Gy. Conclusion : All cell lines used in this study showed apoptosis after irradiation, but time course of apoptosis was different from that of leukemia cell line and normal fibroblast cell line. Reproductive cell death was more important mode of cell death than apoptotic death in all cell lines used in this study. But there was correlation between apoptotic fraction and radiation sensitivity at 2 Gy.

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Characteristics of Si Floating Gate Nonvolatile Memory Based on Schottky Barrier Tunneling Transistor (쇼트키 장벽 관통 트랜지스터 구조를 적용한 실리콘 나노점 부유 게이트 비휘발성 메모리 특성)

  • Son, Dae-Ho;Kim, Eun-Kyeom;Kim, Jeong-Ho;Lee, Kyung-Su;Yim, Tae-Kyung;An, Seung-Man;Won, Sung-Hwan;Sok, Jung-Hyun;Hong, Wan-Shick;Kim, Tae-You;Jang, Moon-Gyu;Park, Kyoung-Wan
    • Journal of the Korean Vacuum Society
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    • v.18 no.4
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    • pp.302-309
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    • 2009
  • We fabricated a Si nano floating gate memory with Schottky barrier tunneling transistor structure. The device was consisted of Schottky barriers of Er-silicide at source/drain and Si nanoclusters in the gate stack formed by LPCVD-digital gas feeding method. Transistor operations due to the Schottky barrier tunneling were observed under small gate bias < 2V. The nonvolatile memory properties were investigated by measuring the threshold voltage shift along the gate bias voltage and time. We obtained the 10/50 mseconds for write/erase times and the memory window of $\sim5V$ under ${\pm}20\;V$ write/erase voltages. However, the memory window decreased to 0.4V after 104seconds, which was attributed to the Er-related defects in the tunneling oxide layer. Good write/erase endurance was maintained until $10^3$ write/erase times. However, the threshold voltages moved upward, and the memory window became small after more write/erase operations. Defects in the LPCVD control oxide were discussed for the endurance results. The experimental results point to the possibility of a Si nano floating gate memory with Schottky barrier tunneling transistor structure for Si nanoscale nonvolatile memory device.

Development of a High Heat Load Test Facility KoHLT-1 for a Testing of Nuclear Fusion Reactor Components (핵융합로부품 시험을 위한 고열부하 시험시설 KoHLT-1 구축)

  • Bae, Young-Dug;Kim, Suk-Kwon;Lee, Dong-Won;Shin, Hee-Yun;Hong, Bong-Guen
    • Journal of the Korean Vacuum Society
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    • v.18 no.4
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    • pp.318-330
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    • 2009
  • A high heat flux test facility using a graphite heating panel was constructed and is presently in operation at Korea Atomic Energy Research Institute, which is called KoHLT-1. Its major purpose is to carry out a thermal cycle test to verify the integrity of a HIP (hot isostatic pressing) bonded Be mockups which were fabricated for developing HIP joining technology to bond different metals, i.e., Be-to-CuCrZr and CuCrZr-to-SS316L, for the ITER (International Thermonuclear Experimental Reactor) first wall. The KoHLT-1 consists of a graphite heating panel, a box-type test chamber with water-cooling jackets, an electrical DC power supply, a water-cooling system, an evacuation system, an He gas system, and some diagnostics, which are equipped in an authorized laboratory with a special ventilation system for the Be treatment. The graphite heater is placed between two mockups, and the gap distance between the heater and the mockup is adjusted to $2{\sim}3\;mm$. We designed and fabricated several graphite heating panels to have various heating areas depending on the tested mockups, and to have the electrical resistances of $0.2{\sim}0.5$ ohms during high temperature operation. The heater is connected to an electrical DC power supply of 100 V/400 A. The heat flux is easily controlled by the pre-programmed control system which consists of a personal computer and a multi function module. The heat fluxes on the two mockups are deduced from the flow rate and the coolant inlet/out temperatures by a calorimetric method. We have carried out the thermal cycle tests of various Be mockups, and the reliability of the KoHLT-1 for long time operation at a high heat flux was verified, and its broad applicability is promising.

Experimental Comparison and Analysis of Measurement Results Using Various Flow Meters (유량측정 기기별 측정성과에 대한 실험적 비교분석)

  • Lee, Jae-Hyug;Lee, Suk-Ho;Jung, Sung-Won;Kim, Tae-Woong
    • Journal of Wetlands Research
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    • v.12 no.1
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    • pp.95-103
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    • 2010
  • Discharge data examine the process of hydrologic cycle and used significantly in water resource planning and irrigation and flood control planning. However, it needs lots of time and money to get the discharge data. So discharge rating curve is usually used in converting discharge data. Therefore reliability of discharge rating curve absolutely depends on quality of discharge data. Many engineers who study hydrologic engineering make high quality discharge data to develop reliable discharge rating curve. And they carry out research on standard and method of discharge measurement, and equipment improvement. Now various flow meters are utilized to make discharge data in Korea. However, accuracy of equipment and experimental research data from measurement are not enough. In this paper, constant discharge flowed through standard concrete channel, and the velocity is measured using various flow meters. Also Discharge is calculated by measured data to compare and analyze. The equipment for the experiment is Price AA(USGS Type AA Current meter), flow meter, ADC, C2 small current meter, flow tracker, Electromagnetic current meter. The discharge got form various flow meters which are widely used for discharge measurement. The various depths of water were examined and compared such as 0.30 m, 0.35 m, 0.40 m, 0.45 m, 0.50 m, 0.55 m. The experiment progresses a round-measurement on 6-case. Wading measurement(one point method : the 60 % height in surface of the water) was applied to improve creditability and accuracy among measurement methods. USGS Type AA current Meter, Flow Meter, ADC, C2 Small Current meter got the certificate of quality guaranteed. So the results of experiment were used to compare discharge. The Results showed the difference based on USGS Type AA current Meter at average discharge and velocity. Electromagnetic current meter made differences over $\pm$ 10 % and Flow Meter made differences under $\pm$ 10 %. Also ADC, Flow Meter, C2 Small Current meter made differences under $\pm$ 5 %.

Efficacy of Small Bowel Displacement System in Post-Operative Pelvic Radiation Therapy of Rectal Cancer (소장 용적 측정을 통한 직장암의 수술 후 방사선치료 시 사용하는 소장 전위 장치(Small Bowel Displacement System : SBDS) 의 효용성 검토)

  • Ahn Yong Chan;Lim Do Hoon;Kim Moon Kyung;Wu Hong Gyun;Kim Dae Yong;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.63-69
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    • 1998
  • Purpose : This study is to evaluate the efficacy of small bowel displacement system(SBDS) in post-operative pelvic radiation therapy(RT) of rectal cancer patients by measurement of small bowel volume included in the radiation fields receiving therapeutic dose. Materials and Method : Ten consecutive new rectal cancer patients referred to the department of Radiation Oncology of Samsung Medical Center in May of 1997 were included in this study. All patients were asked to drink $Castrographin^(R)$ before simulation and were laid prone for conventional simulation and CT scans with and without SBDS. The volume of opacified small bowel on CT scans, which was to be included in the radiation fields receiving therapeutic dose, was measured using Picture archiving and communication system (PACS). Results : The average small bowel volumes with and without SBDS were 176.0ml(5.2-415.6ml) and 185.1ml(54.5-434.2ml), respectively The changes of small bowel volume with SBDS compared to those without SBDS were more than $10\%$ decrease in three, less than 10% decrease in two, less than $10\%$ increase in three, and more than $10\%$ increase in two patients. Conclusion : No significant advantage of using SBDS in post-operative pelvic RT for rectal cancer patients has been shown by small bowel volume measurement using CT scan considering additional effort and time needed for simulation and treatment setup.

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A Study of a Non-commercial 3D Planning System, Plunc for Clinical Applicability (비 상업용 3차원 치료계획시스템인 Plunc의 임상적용 가능성에 대한 연구)

  • Cho, Byung-Chul;Oh, Do-Hoon;Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.71-79
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    • 1998
  • Purpose : The objective of this study is to introduce our installation of a non-commercial 3D Planning system, Plunc and confirm it's clinical applicability in various treatment situations. Materials and Methods : We obtained source codes of Plunc, offered by University of North Carolina and installed them on a Pentium Pro 200MHz (128MB RAM, Millenium VGA) with Linux operating system. To examine accuracy of dose distributions calculated by Plunc, we input beam data of 6MV Photon of our linear accelerator(Siemens MXE 6740) including tissue-maximum ratio, scatter-maximum ratio, attenuation coefficients and shapes of wedge filters. After then, we compared values of dose distributions(Percent depth dose; PDD, dose profiles with and without wedge filters, oblique incident beam, and dose distributions under air-gap) calculated by Plunc with measured values. Results : Plunc operated in almost real time except spending about 10 seconds in full volume dose distribution and dose-volume histogram(DVH) on the PC described above. As compared with measurements for irradiations of 90-cm 550 and 10-cm depth isocenter, the PDD curves calculated by Plunc did not exceed $1\%$ of inaccuracies except buildup region. For dose profiles with and without wedge filter, the calculated ones are accurate within $2\%$ except low-dose region outside irradiations where Plunc showed $5\%$ of dose reduction. For the oblique incident beam, it showed a good agreement except low dose region below $30\%$ of isocenter dose. In the case of dose distribution under air-gap, there was $5\%$ errors of the central-axis dose. Conclusion : By comparing photon dose calculations using the Plunc with measurements, we confirmed that Plunc showed acceptable accuracies about $2-5\%$ in typical treatment situations which was comparable to commercial planning systems using correction-based a1gorithms. Plunc does not have a function for electron beam planning up to the present. However, it is possible to implement electron dose calculation modules or more accurate photon dose calculation into the Plunc system. Plunc is shown to be useful to clear many limitations of 2D planning systems in clinics where a commercial 3D planning system is not available.

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Expression of Cell Cycle Related Genes in HL60 Cells Undergoing Apoptosis by X-irradiation (HL60 세포주에서 방사선 조사에 의한 Apoptosis와 세포 주기 관련 유전자의 발현 변화)

  • Kim, Jin-Hee;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.377-388
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    • 1998
  • Purpose : To evaluate changes in expression of cell cycle related genes during apoptosis induced in HL60 cells by X-irradiation to understand molecular biologic aspects in mechanism of radiation therapy. Material and Methods : HL-60 cell line (promyelocytic leukemia cell line) was grown in culture media and irradiated with 8 Gr by linear accelerator (6 MV X-ray). At various times after irradiation, ranging from 3 to 48 hours were analyzed apoptotic DNA fragmentation assay for apoptosis and by western blot analysis and semi-quantitative RT-PCR for expression of cell cycle related genes (cyclin A, cyclin B, cyclin C, cyclin Dl, cyclin E, cdc2, CDK2, CDK4, $p16^{INK4a}$, $p21^{WAF1}$, $p27^{KIP1}$, E2F, PCNA and Rb). Results : X-irradiation (8 Gy) induced apoptosis in HL-60 cell line. Cycline A protein increased after reaching its peak 48 h after radiation delivery and cyclin E, E2F, CDK2 and RB protein increased then decreased after radiation. Radiation induced up-regulation of the expression of E2F is due to mostly increase of Phosphorylated retinoblastoma proteins (ppRb). Cyclin Dl, PCNA, CDC2, CDK4 and $p16^{INK4a}$ protein underwent no significant change at any times after irradiation. There was not detected $p21^{WAF1}$ and $p27^{KIP1}$ protein. Cyclin A, B, C mRNA decreased immediately after radiation and then increased at 12 h after radiation. Cyclin Dl mRNA increased immediately and then decreased at 48 h after radiation. After radiation, cyclin E mRNA decreased with the lapse of time. CDK2 mRNA decreased at 3h and increased at eh after radiation. CDK4 mRNA rapidly increased at 6 to 12 h after radiation. There was no change of expression of $p16^{INK4a}$ and not detected in expressin of $p21^{WAF1}$ and $p27^{KIP1}$ mRNA. Conclusion : We suggest that entry into S phase may contribute to apoptosis of HL60 cells induced by irradiation. Increase of ppRb and decrease of pRb protein are related with radiation induced auoptosis of HL60 cells and tosis of HL60 cells induced by irradiation. Increase of ppRb and decrease of PRb protein are related with radiation induced apoptosis of HL60 cells and this may be associated with induction of E2F and cyclinE/CDK2. These results support that $p21^{WAF1}$ and $p27^{KIP1}$ are not related with radiation induced-apoptosis.

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