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- 저자 : 이미조(Mi Jo Lee) (검색결과 3 건)
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초기 성문암 환자에서 소분할조사법의 방사선 치료 결과와 예후 인자
이미조(Mi Jo Lee),김헌정(Hun Jung Kim),김우철(Woo Chul Kim),노준규(Jun Gou Loh) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2
Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.
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김성진(Sung Jin Kim),이미조(Mi Jo Lee),윤선민(Seon Min Youn) 대한방사선종양학회 2011 Radiation Oncology Journal Vol.29 No.2
목적: 본원에서 시행된 세기조절방사선치료(IMRT) 환자의 질환별 정도관리(QA) 결과를 통해 오차의 원인과 정도를 확인하고 오차를 줄일 수 있는 개선점을 찾아 임상에 적용하고자 한다. 대상 및 방법: IMRT를 시행한 환자 50명(두경부, 28명; 유방, 14명; 골반부, 8명)에 대한 질환별 QA 결과를 분석하였다. 각각의 경우에 대해 film을 이용하여 gamma index를 구하였고, 이온함을 이용한 점 선량을 측정하여 치료계획 시스템의 선량과 비교분석하였다. 결과: 점 선량 측정에서는 50명의 환자 중 45명의 환자는 치료 계획된 선량과 측정된 선량의 오차가 ±3% 이내로 오차를 보였다. 최대 오차는 3.6%, 전체 평균 오차 0.17% (SD=2.25%)의 오차율을 보였다. 질환별로 살펴보면 두 경부 - 0.13% (SD=1.93%), 유방 -0.26% (SD=2.79%), 골반부의 경우 -0.24% (SD=2.44%)의 오차율을 보였다. 상대선량 측정에서는 측정된 필름의 Gamma index distance to agreement (DTA) - dose difference (DD) 3 ㎜-3%의 기준에서 두경부 6%, 유방 10%, 골반부 6%의 오차를 보였다. 등선량곡선 90% 이상의 영역에서는 두경부2%, 유방 1%, 골반부 0%의 오차를 보였다. 결론: 치료 위치에 따른 오차의 원인과 개선점을 파악하여 보다 양질의 IMRT를 구축하기 위한 기반을 다질 필요가 있을 것으로 생각한다. Purpose: To analyze our quality assurance (QA) data for intensity modulated radiation therapy (IMRT) according to treatment site and to possibly improve QA for IMRT in Hospital. Materials and Methods: We performed QA on 50 patients (head and neck, 28 patients; Breast, 14 patients; Pelvis, 8 patients) for IMRT. The calculated dose from RTP was compared with the measured value film, gamma index, and ionization chamber for dose measurement in each case. Results: The point dose measurement results in 45 of 50 patients showed good agreement with the calculation dose (±3%). The largest error measured thus far has been 3.60%, with a mean of only −0.17% (SD, 2.25%). Each treatment site showed an error rate of −0.13% (SD, 1.93%) for head and neck cases, −0.26% (SD, 2.79%) for breast cases, and −0.24% (SD, 2.44%) for pelvis cases. The gamma index verified with the error rate of head and neck cases (6%), breast (10%), and pelvis (6%), which corresponded to a tolerance of 3 ㎜ (3% for the head and neck, 2%, for the breast 1% for the pelvis, and 0% in the region where the isodose curve was greater than 90%. Conclusion: We recognize the cause of errors for each treatment site of IMRT QA and so we maximize our efforts to reduce error and increase accuracy.
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김우철(Woo Chul Kim),이돈행(Don Haeng Lee),이건영(Keon Young Lee),이미조(Mi Jo Lee),김헌정(HunJung Kim),이석호(Suk Ho Lee),노준규(John JK Loh) 대한방사선종양학회 2003 Radiation Oncology Journal Vol.21 No.2
목 적: 간외 담도암에서 수술단독군과 수술 후 방사선치료가 시행된 군의 비교를 통하여 방사선치료의 역할을 알아보고자 한다. 대상 및 방법: 1997년 1월부터 2000년 12월까지 인하대 병원에서 근치적 절제술을 받은 41명의 간외 담도암 환자를 대상으로 하였다.이 중 22명의 환자는 수술 단독으로 치료 되었고(1군) 19명의 환자는 수술 후 방사선치료가 시행 되었다(2군). 수술은 완전절제가 시행된 경우가 1군에서는 11명(50%)이었고 2군에서는 7명(36.8%)이었다.나머지 환자는 절제연양성으로 현미경 적미세종양이 남아있었다.두 군 간에병기,수술방법,병리소견등의 분포의 차이는 없었다. 방사선치료는 10MV X-ray를 이용하여 45˜54Gy(중앙값: 50.4 Gy)를 원발종양과 주변 림프절에 조사하였다. 결 과: 1군에서는 국소실패한 환자가 12명(54.5%)인 반면 2군에서는 3명(15.8%)으로 수술단독군에서 국소실패율이 의미있게 높게 나타났으며(p=0.010), 1군에서 국소실패한 12명 중7명이 절제연 양성군에서 발생하였고 2군에서는 국소실패한 3명 모두가 절제연 양성에서 발생하여 완전 절제군보다 절제연 양성군에서 국소실패가 월등히 높았다.1군과 2군의 3년전체 생존율은 각각 38.3%, 38.9%이었고 3년 무병 생존율은 각각 18.8%와 26.3%로 통계학적 차이를 보이지 않았다. 그러나 절제연 양성인 환자에서는 3년 생존율이 24.2%와 36.4%로 방사선 치료군에서 좋았고(p=0.06) 절제연 양성인 환자의 3년 무병생존율은 18.2%와 25.0%로 통계학적으로도 의미 있게 방사선 치료군이 좋았다(p=0.04). 결 론:간외 담도암 환자에서 수술 후 방사선치료는 국소제어율을 높이며,특히 절제연이 양성인 환자에서는 생존율을 향상시킬 수 있을 것으로 생각한다. Purpose: The goal of this study was to determine the role of postoperative radiation therapy in extrahepatic bile duct cancers. Materials and Methods: Between 1997 and 2001, 41 patients with extrahepatic bile duct cancer having undergone surgical resection were retrospectively analyzed. Of the 41 patients, 22 were treated by surgeryalone(GroupI) with remaining 19 treated by surgery and postoperative radiation therapy(Group II). A gross total surgical resection with pathologically negative margins was performed in 11 of the patients (50%) in Group I, and in 7 of the patients (36.8%) in Group II. There were no significant differences in the disease stage, surgical procedure or pathological characteristics of the two groups. The patients in group II received 45˜54 Gy(median:50.4Gy)ofexternal beam radiation therapy to the tumor bed and draining nodal area. Results: The local failure rate was significantly higher in group I (54.5%) than in group II (15.8%)(p=0.010). Of the 12failed patients in Group Iand the 3 failed patients in group II,7 and 3 had a positive resection margin. The overall 3-year survival rates were 38.3 and 38.9% and the 3-year disease free survival rates were 18.8 and 26.3% in groups I andII,respectively. However, the patients with positive resection margins who received adjuvant radiation therapy had higher 3-year overall survival rates than those with surgery alone (36.4% vs. 24.2%, p=0.06), and 3-year disease free survival rate was significantly higher in the group II patients who had positive margins compared with those in group I (25.0% vs. 18.2%, p=0.04). Conclusion: Post operative adjuvant radiation therapy appeared to reduce the incidence of localfailure in patients with extrahepatic bile duct cancer, and might improve the survival rate in the patients with positive resection margins.
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