5-Fluorouracil 투여가 마우스공장 소낭선세포의 방사선조사 효과에 미치는 영향

허승재,박찬일,장선택 중앙대학교 의과대학 의과학연구소 1985 中央醫大誌 Vol.10 No.3

The interaction of radiation and 5-Fluorouracil(5-FU) on mouse jejunal crypt cells was studied using the microcolony survival assay. 150㎎/㎏ of 5-FU was injected intraperitoneally 15 minutes before irradiation and 6 hours after irradiation. Jejunal crypt cells of mouse survived more when 5-FU was given 15 minutes before irradiation than giving it 6 hours after irradiation. The mean lethal doses(Do) of each of irradiation alone group, 5-FU injection group of 15 minutes preceding irradiation, and 5-FU injection group of 6 hours postirradiation were, 135, 135, and 114 rad respectively. The dose effect factor of each of 5-FU injection groups of 15 minutes preceding irradiation and of 6 hours post irradiation were 1.13 and 1.27.

The role of radiation therapy in rectal cancer

Charn Il park 대한외과학회 1989 대한외과학회 학술대회 초록집 Vol.1989 No.11

A Study on Recovery from Potentially Lethal Damage Induced by γ-Irradiation in Plateau-phase vero Cells in vitro

Il Han Kim(김일한),Eun Kyung Choi(최은경),Sung Whan Ha(하성환),Charn Il Park(박찬일),Chang Yong Cha(차창룡) 대한방사선종양학회 1988 Radiation Oncology Journal Vol.6 No.1

방사선 조사후 발생한 잠재치사손상의 회복(PLDR)에 있어 조사선량 및 시간에 따른 환경변화가 회복의 동적양상에 미치는 영향을 Vero 세포계를 이용하여 실험하였다. 배양액을 교환시키지 않고 배양하여 평형기에 도달한 세포에 동물실험용 세시움 조사기로 1Gy~9Gy의 감마선을 조사하고 각 조사조건에서 0~6 및 24 시간동안 정치지킨 후 Agarose가 포함된 새로운 배양액에서 배양하였다. 16Gy를 조사한 동종의 세포를 feeder 세포로 첨가하여 배양액내의 전체세포수를 일정하게 한 조건에서 형성된 세포집락수에 따라 세포의 생존을 정하였다. 잠재치사손상의 회복은 2~4시간 정치후에 포화수준에 도달한 빠른 회복이었다. 방사선량이 증가함에 따라 회복속도는 증가하였고, 포화수준의 회복량도 증가하였다. Linear-quadratic model에 의한 ‘방사선량-생존분획’ 분석결과 잠채치사손상이 회복됨에 따라 일차 비활성계수 α는 급속히 감소하여 0에 접근하였고 이차 비활성계수 ß는 미미하게 증가하여 PLDR은 α로 표시되는 손상에 주로 영향을 주었다. Multitarget model에 따라 분석한 결과 Do는 변화가 없고 Dq가 증가하였다. 세포 생존분획이 높은 3 Gy 이하의 저선량 영역에서 dose modifying factor가 높아 잠재치사손상의 회복에 의한 영향이 저선량 영역에서 상대적으로 크게 나타났다. Recovery from potentially lethal damage (PLDR) after irradiation was studied in plateau-phase culture of Vero cells in vitro. Unfed plateau-phase cells were irradiated wth dose of 1 to 9 Gy using Cs-137 irradiator. Cells then were incubated again and left in situ for 0,1,2,3,4,5,6, and 24 hours and then were trypsinized, explanted, and subcultured in fresh RPMI-1640 media containing 0.33% agar. Cell survival was measured by colony forming ability. An adequate number of heavily irradiated Vero cells were added as feeder cells to make the total cell number constant in every culture dish. As the postirradiation in situ incubation time increased, surviving fraction increased by PLDR. The rate of PLDR was so rapid that increased surviving fraction reached saturation level at 2 to 4 hours after in situ incubation. As the radiation dose increased, the rate of PLDR fastened and the magnitude of increased surviving fraction at saturation level by PLDR also increased. In analysis of cell survival curve fitted to the linear-quadratic model, the linear inactivation coefficient (α) decreased largely and reached nearly to zero but the quadratic inactivation coefficient (ß) increased minimally by increment of postirradiation in situ incubation time. So PLDR mainly affected the damage expressed as α. In the multitarget model, significant change was not obtained in Do but in Dq Therefore, shoulder region in cell survival curve was mainly affected by PLDR and terminal slope was not influenced at all. And dose-modifying factor by PLDR was relatively higher in shoulder region, that is, in low dose area below 3 Gy.

Retinoblastoma

Il Han Kim(김일한),Jong Hoon Kim(김종훈),Charn Il Park(박찬일) 대한방사선종양학회 1990 Radiation Oncology Journal Vol.8 No.2

1980년 3월부터 1987년 8월까지 서울대학교 치료방사선과에서 망막아세포종으로 방사선 치료를 23예의 치료 성적을 보고한다. 20예의 편측성 종양에서, 13예는 안구적출수술후 방사선치료를, 2예는 방사선치료만, 5예는 안구적출후 동측 재발종양의 방사선치료를 받았다. 재발성 종양을 제외한 15예의 병기는 St. Jude Children's Research Hospital의 병기분류 기준에 의한 Ⅰ기(retinal)는 없고, Ⅱ기(gloval) 5예, Ⅲ기(orbital) 8예, Ⅳ(cranial or metastatic) 2예였다. 양측성 종양 3예는 생후 1개월 이내에 증상이 나타났고, 진행된 종양측은 안구적출술을 시행했으며 조기 종양측은(3예 모두 Ⅰ기)방사선 치료를 하였다. 시신경 절단부 또는 뇌척수액에서 종양 세포가 확인된 경우에는 항암화학치료를 병용하였다. 수술후 계획대로 방사선치료를 받은 12예의 5년 생존율은 82.2%이며, 국소재발 또는 원격전이는 없었으나, 2환아(Ⅲ기)의 진단시 무병상태였던 반대측 망막에서 종양이 속발하였다. 일차적 방사선 치료를 계획대로 받는 1예의 반대측 망막에서 종양이 속발하였다. 따라서 양측성 종양의 전반적 빈도는 33%였다. 재발성종양 5예의 치료성적은 매우 불량하여 생존율 20%였다. 양측선 종양 3예중 2예가 무병상태로 생존하고 있다. 방사선 치료후의 변화로는 안와 연조직 위축이 관찰되었다. 방사선 치료성적은 조기 병기 또는 종양의 크기가 작은 경우에 양호하여 조기 치료가 중요하며 진단후 치료가 지연되지 않도록 함이 중요하다. Radiotherapy result was analyzed in 23 children with retinoblastoma treated in Seoul National University Hospital from 1980 to 1987. Three (17%) had bilateral tumor at diagnosis. Among 20 children with unilateral retinoblastoma 13 children got radiotherapy after enucleation, 2 were treated with radiotherapy alone, and 5 were delivered with radiotherapy after relapse. Of 15 non-recurrent unilateral tumors, there were 5 stage Ⅱ children, 8 stage Ⅲ, and 2 stage Ⅳ by staging system proposed by St. Jude Children's Research Hospital. Chemotherapy was combined when resection margin of the optic nerve was positive or when malignant cell was found in CSF. Of 12 children who completed radiotherapy, local or distant failure was not found but 2 cases of relapse at the contralateral retina were observed. Their 5 year survival rate was 82.2%. Another case of contralateral relapse was detected in children who was treated with radiotherapy alone. Thus overall frequency of the bilateral disease was 33%. Prognosis of recurrent tumors were so poor that no cases of CR was obtained and that 3 year survival rate was 20%. Two of 3 bilateral cases at diagnosis were in NED status. Complication were sunken orbit only. Result of radiotherapy was so good in early stage or small bulk tumor that treatment delay after diagnosis must not be allowed.

Squamous Cell Carcinoma of the Supraglottic Larynx Treated with Radiation Therapy

Charn Il Park,Kwang Hyun Kim 대한방사선종양학회 1989 Radiation Oncology Journal Vol.7 No.1

Sixty-six patients with squamous cell carcinoma of the supraglottic larynx received irradiation with curative intent between 1979 and 1985 were retrospectively analysed. All patients had a minimum follow-up of 4 years. Of the entire group consisting of 73% T3 and T4 lesions and 58% lymph node metastases, a 5-year acturial survival rate was 31.3%. A 5-year acturial survival rates for stage Ⅱ, Ⅲ and Ⅳ were 60.7% respectively (p<0.05). Patients without lymphnode metastases had better survival rate than those with postive lymphnode metastases (54.8% vs 12.2%) (p<0.005). Surgical salvage rate w8s 4/7(57%). Three patients developed distant metastases. Major complications requiring surgery were seen in , Radiation therapy alone with surgical salvage was an effective, voice preserving treatment for stage Ⅰ, Ⅱ and selected Ⅲ carcinoma of the supraglottic carcinoma, however planned combined treatment with surgery and radiation therapy is advised for stage Ⅲ and Ⅳ carcinoma of the supraglottic larynx with resectable neck disease.

Reduction of Patient Dose in Radiation Therapy for the Brain Tumors by Using 2-Dimensional Vertex or Oblique Vertex Beam Technique

Il Han Kim,Eui Kyu Chie,Charn Il Park 대한방사선방어학회 2003 방사선방어학회지 Vol.28 No.3

Medulloblastoma: Radiotherapy Result with Emphasis on Radiation Dose and Methods of Craniospinal Treatment

김일한(Il Han Kim),하성환(Sung Whan Ha),박찬일(Charn Il Park),조병규(Byung-Kyu Cho) 대한방사선종양학회 1988 Radiation Oncology Journal Vol.6 No.2

1979년부터 1984년까지 서울대학교병원 치료방사선과에서 수아세포종으로 전중추신경계 방사선치료를 받은 25예의 치료성적을 분석하였다. 수술시 중앙절제는 조직생검에 2예, 부분절제가 18예, 완전절제가 5예였다. 전중추신경계 방사선치료는 15예가 orthogonal법에 의하여 원발병소 및 후두와에 55Gy, 전외에 40Gy, 전척수에 30Gy를 주로 조사받았으며, 10예는 AP:PA법으로 원발병소 및 후두와의 50Gy, 전뇌에 40~45Gy, 전척수에 36Gy를 주로 조사받았다. 치료직후 84%(21/25)의 완전관해 상태가 관찰되었으나 완전관해 21예중 10예가 재발하여 56%의 치료실패율을 얻었다. 치료실패 14예중 13예는 후두와에 종양잔존 또는 재발 소견이 있어 11예는 후두와의 단독 실패, 1예는 후두와의 실패와 광범위의 뇌실벽 침윤, 다른 1예는 후두와의 실패와 경부 임피적 전이 양상을 보였다. 척수강만에서의 재발이 1예에서 관찰되었다. 전체 25예의 3년 및 5년 생존율은 75%였으며, 무병생존율은 각각 58% 및 36%였다. 후두와 선량이 55Gy인 예가 50Gy인 예보다 5년 무병생존율이 월등하였고(62%:17%, p<0.05), orthogonal법으로 치료받은 예가 AP:PA법으로 치료받은 예보다 양호하였으며 (87%:12%, p<0.05), 종양이 완전절제된 예가 부분절제된 예보다 양호하였다.(56%:30%, p<0.05), 재차 방사선치료의 성적은 불량하였다. 치료후 중증의 후유증은 관찰되지 않았다. 따라서 최대의 치료 결과를 얻기 위하여는, 수술적으로 종양을 가능한 완전히 절제한 후 orthogonal법으로 후두와의 55Gy를 조사해야 할 것이다. 그러나 전뇌 및 전척수에 대한 방사선량을 30Gy 이하로 감소시켜도 무방할 것인가는 단정할 수 없다. 이는 앞으로 관찰기간이 더 경과한 이후에 판단할 수 있겠고 또한 방사선치료전에 전지주막하의 종양범위를 명확히 확인할 것이 요구된다. Twenty five patients with histologically proven medulloblastoma received craniospinal radiotherapy (CSRT) at the Seoul National University Hospital from 1979 to 1984. The extent of tumor removal was biopsy only in 2 patients, partial in 18, and near total in 5. With orthogonal technique of CSRT, mainly 55Gy was delivered to the posterior fossa (PF), 40Gy to whole brain (WB), and 30Gy to whole spine (WS). And with AP: PA technique, 50Gy to PF, 45-50Gy to WB, and 36 Gy to WS. Complete remission was obtained in 84% of patients. Among 21 CR's 10 failures were observed, thus total failure rate was 56% (14/25). Of 14 faiure 13 had the primary failure, 11 failed in primary site alone, 1 failure was combined with ventricular seeding, and another 1 was combined with neck node metastasis. There was 1 isolated spinal failure. Actuarial overall survival rates at 3 and 5 years were 75% and 54%, and disease-free survival rates were 58% and 36%, respectively. Better 5 year disease-free survival was noted in patients with 55 Gy to the posterior fossa than those with 50Gy (62% vs 17%, p<0.05), in patients treated with orthogonal technique than those treated with AP:PA technique (87% vs 12%, p<0.05), and in patients with near total removal than those with partial or less removal of tumor (56% vs 30% N.S.) Re-irradiation was not satisfactory. No severe late sequelae was noted among the survivors. For the higher control of medulloblastoma, dose to posterior fossa should be at least 55Gy with orthogonal CSRT to small tumor burden. And dose reduction in the subarachnoidal spaces might be safe, but optimal dose to the subarchnoidal spaces should be determined by the thorough tumor staging before radiotherapy.

聲門上部癌의 治療成績

朴贊一(Charn Il Park),金光顯(Kwang Hyun Kim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.1

From March of 1979 through December of 1982, 84 patients with supraglottic carcinoma were seen and evaluated in the Department of Therapeutic Radiology, Seoul National University Hospital. Of these, 58 patients were treated with a curative intent by employing either radiotherapy alone or a combined approach of radiotherapy plus surgery. Sixteen patients refused to complete the treatment program. Seventy-three per cent of patients had T3 and T4 lesions and 63% of patients had lymph node metastasis at the time of diagnosis. Actuarial recurrence-free survival at 3 year was : Stage Ⅰ~Ⅱ 62%, Stage Ⅲ 54%, Stage Ⅳ 18%. For T1-2, T3 and T4 lesions, the actuarial recurrence free survival at 3 years were 50%, 34% and 9% respectively. Of 39 patients with treatment failure, 29 patients (78%) had uncontrol or ultimate recurrence at the primary site while 9 patients having lymph node recurrence, 14 patients(21%) had lymph node recurrence, and 5 patients had distant metastasis. It is suggested that planned combined radiotherapy is indicated for advanced but resectable supraglottic carcinoma.

超音波를 利用한 溫熱療法時 溫度分布에 關한 硏究

朴贊一(Charn Il Park),高京煥(Kyeong Whan Koh),河星煥(Sung Whan Ha) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.1

Temperature homogeniety and stationary temperature is the most important thermometric considerations for the clinical use of hyperthermia. A thermal mapping was done in a phantom with thermocouple during hyperthermia which was induced by 1.0 MHz, 0.7~0.8 watts/㎠ ultrasound and unfocused 2.5 cm-diameter transducer. The results were as follows 1. Effective heating range(42.5℃±0.5℃) were obtained 3 cm in width and 4 cm in depth from surface of phantom and temperature distribution was relatively uniform. 2. There was little heating effect more than 2 cm away from transducer axis and more than 5cm in depth. 3. There was hot spots(more than 43℃) in 2.0±0.5 cm depth from transducer along transducer axis.

Radiotherapy Result of Brain Stem Tumors

김일한(Il Han Kim),양미경(Mi Gyoung Yang),박찬일(Charn Il Park) 대한방사선종양학회 1989 Radiation Oncology Journal Vol.7 No.2

1979년부터 1987년까지 뇌간 종양 환자 25명이 방사선 치료를 받았다. 6예는 조직학적으로, 19예는 이학적 및 신경학적 진찰, CT 및 MRI 등에 의하여 임상적으로 진단하였다. 18예는 근치적 목적의 방사선 치료를 , 6예는 수술 후 방사선 치료를, 1예는 방사선 치료후 항암제병용요법 등을 각각 받았다. 방사선 치료는 통상적 분할치료법에 의하여 50~55Gy를 조사였다. 치료 완료후 두달째 임상적 scoring scale에 따른 완전관해는 없었고, 부분관해 16예(64%), 무변화 2예, 종양진행 4예가 각각 관찰되었다. 생명표법에 의한 1,2,3년 생존율은 각각 56%, 40%, 36%였으며, 연령, 진단당신 전신상태, 뇌신경 장애정도, 조영제 투입후 시행한 뇌단층 촬영 소견, scoring scale에 의한 임상적 관해 양상 등의 요인이 생존율에 유의한 영향을 주는 예후인자였다. Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scare at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was 36%. Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical response by scoring scale were correlated with survival.