방사선조사와 Paclitaxel의 병합요법에 의한 신내막 과증식억제

장기육,승기배,강동헌,임상현,정해억,임효영,김태균,김연실,채장성,김재형,홍순조,윤세철,최규보 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.6

The Effect of Radiation Therapy on Oligodendrogliomas

Sei Chul Yoon(윤세철) , Sung Whan Kim(김성환) , Soo Mi Chung(정수미) , Hak Jun Gil(길학준) , Kyung Sub Shinn(신경섭) , Yong Whee Bahk(박용휘) , Joon Ki Kang(강준기) , Jin Un Song(송진언) 대한방사선종양학회 1991 Radiation Oncology Journal Vol.9 No.1

가톨릭의대 방사선치료실에서는 1983년 4월부터 1989년 4월 사이 6년 동안에 회돌기교종환자 21예를 외부방사선 치료하였다. 전예에 대하여, 연령 및 발병부위별 빈도와 임상증상과 CT 소견 그리고 추적 가능하였던 20예의 생존율에 관한 후향적 분석을 하여 다음과 같은 성적을 얻었다. 1. 전예는 원발성 뇌종양으로 방사선치료 하였던 환자 (246예)의 약 8%의 빈도를 보였으며, 연령 분포는 5~62세(중앙값 38세)이고, 남녀의 비는 13:8이었다. 2. 임상 주 증상은 두통 18예(86%), 뇌운동신경마비 12예(57%), 오심구토 7예 (33%), 경련 5예 (24%)등 순을 보였다. 3. 발병부위는 전두엽 10예 (48%), 두정엽 10예 (48%), 측두엽 7예 (33%), 후두엽 2예 (10%) 그리고 뇌간 및 소뇌가 각각 1예 (5%)씩 이었다. 4. 조직학적 진단은 정위다방향 조직생검이 3예(14%), 종양의 수술적 제거 (부분 전체제거)에 의함이 18예(86%)이었다. 전예에서 전뇌 및 소부위에 3960~6480cGy/5~8주 외부방사선 치료를 하였고, 6예(29%)에서는 항암약물 치료도 병행하였다. 5. CT음영은 저, 고, 혼합 및 등가음영이 각각 13(62%), 3(14%), 3(14%), 2(10%), 예씩 이었고, 낭성종괴 7예(33%), 괴사 및 출혈성 종괴가 각각 1예(5%)씩 이었다. 석회와 음영은 14예(67%)에서 관찰되었으며, 조영증강 유무는 9:12로 나타났다. 6. 평균생존기간은 38개월이었다. From April, 1983 through April, 1989, we have treated histologically proven 21 patients with oligodendroglioma using 6 MV linear accelerator at the Division of Radiation Therapy, Kangnam St. Mary's Hospital Catholic University Medical College. These are 8% of the irradiated 246 primary brain tumors during the same period. To investigate influencing factors on the survival of irradiated 21 patients with oligodendrog-lioma, we analyzed the cerebral location of the involvements, initial symptoms, CT findings and survival rates, retrospectively. One case was lost to follow up and excluded from survival data. Of the 21 patients, thirteen were male and 8 female. Ages raged from 5 to 68 years with a median age of 38 years. Radiation doses varied from 3960 cGy to 6480 cGy and were given for 5 to 8 weeks. All but one were supratentorial. The involvement of the frontal and parietal lobes were 10 (48%) patients in each and temporal lobe in 8 (38.1%) Histological diagnosis was made by stereotactic biopsy in 3 and postoperatively in 18. The type of surgery was divided into partial, subtotal and total resection in 7, 9 and 2 cases respectively. In 6 cases, chemotherapy was also tried during or after radiation therapy. Major presenting symptoms were headache, cerebral motor, nausea & vomiting and epilepsy in 18, 12, 7 and 5 respectively in decreasing order. In CT analysis, low density (62%), cystic mass (33%), calcifica-tion (66%) and positive contrast enhancement (42.8%) were observed as the highest frequency. Mean survival duration after radiation therapy was 38 months (K-M methods). We could not achieve statistically significant factors influencing on the survival rate after radiation therapy for oligodendrogliomas by one or two tail test.

Clinical Trial of Concomitant Thermo-Chemotherapy in Cernix Cancer Patients

Yoon, Sei-Chul,Park, Jong-Sup,Kim, Seung-Jo,Namkoong, Sung-Eun,Shinn, Kyung-Sub,Ryu, Yeon-Shil,Kim, Yeon-Shil,Jang, Hong-Seok,Chung, Su-Mi CATHOLIC MEDICAL CENTER 1996 Bulletin of the Clinical Research Institute Vol.21 No.1

The purpose of this study is to assess the clinical results of concomitant thermo-chemotherapy on twenty-eight patients with cervix cancer. A retrospective analysis was done for consecutive 28 patients with cervix cancer who have received concomitant thermo-chemotherapy from September 1993 to September 1994. Cisplatin-based combination chemotherapy was delivered in four arms: 1) cisplatin. 5-FU (cis-SFU) for 12 patients, 2) vincristine, bleomycine, cisplatin (VBP) for 11, 3) VP 16, cisplatin, (EP) for 3, 4) cyclophosphamide, adriamycine, cisplatin (CAP) for 2. Local hyperthermia was underwent with HEH-500C (Omron Co. Japan), and the heat sessions ranged from 1 to 12 times (median 4 times). After these treatments, 24 patients had another successive treatments (surgery, chemotherapy, or radiation therapy) in single or combination modalities. We analyzed local responses as a function of age, FIGO staging, histology of the tumor, Hb level, pelvic lymph node metastasis, types of chemotherapy and numbers of chemotherapy course and heat session. And we also evaluated ultimate pelvic disease control after another successive treatments as a function of above factors and local response after concomitant thermo-chemotherapy. In the analysis of local response following concomitant thermo-chemotherapy of 28 patients, there were complete response (CR) in 5 (18%), partial response (PR) in 16 (57%), pelvic failure(persistent disease or progression) in 7 (25%). Significant factors for local response were histology of the tumor, types of chemotherapy, numbers of chemotherapy course and heat session and Hb level (p<0.05). After these treatments, twenty-four patients had another treatments (surgery, chemotherapy, or radiation therapy) successively. Significant factors for ultimate pelvic disease control were FIGO staging, types of chemotherapy and local response after concomitant thermo-chemotherapy (p<0.05). Among 24 patients, 17 showed no evidence of disease (NED) and 7 had residual pelvic disease. All of 17 with NED underwent successive treatment including radical surgery. Treatment was tolerable. The most common complication of the concomitant thernumhemotherapy was hot spot on the skin (28/28), although 1˚ burn or fat necrosis was developed in 2 patients. Although numbers of chemotherapy course and heat session had significant correlation with local response, but they correlated poorly with ultimate pelvic disease control. In contrast, types of chemotherapy showed significant correlation with local control and ultimate pelvic disease control. FIGO staging and local response after initial treatments significantly correlated with ultimate pelvic disease control. Thus, subsequent treatments (especially radical surgery) after concomitant thermo-chemotherapy were important for ultimate patient outcome.

Role of Radiation Therapy for Locally Advanced Gastric Carcinoma Management

Sei Chul Yoon(윤세철),Yoon Kyeoung Oho(오윤경),Kyeong Sub Shinn(신경섭),Yong Whee Bahk(박용휘),In Chul Kim(김인철),Kyung Sik Lee(이경식) 대한방사선종양학회 1988 Radiation Oncology Journal Vol.6 No.1

가톨릭의대 강남성모병원 방사선치료실에서는 1983년 5월 부터 1987년 5월 사이 수술후 재발되거나 국소적으로 진행되어 절제 불가능한 위암환자 35예에 대하여 외부방사선치료를 실시하였다. 방사선치료는 6MV 선행가속기를 사용하여 매일 160~180cGy씩, 주 5회 분할 조사하여 총 4500~5500cGy를 시도 하였으며, 전예에서 Box Technique을 이용하였다. 방사선치료만을 실시하였던 3예를 제외한 전예에서 5-FU 또는 FAM 화학요법을 병행하였다. 1. 총 35예는 남자 25명 여자 10명이였으며 연령은 38세에서 80세사이에 (평균 56세) 분포하였다. 조직학적으로는 전 예가 선세포암이었다. 2. 수술후 재발되어 방사선치료하기까지의 기간은 수술후 1년 이내에 18(51%)명, 1~2년내 8(23%)명, 그리고 2~3년내에 5(14%)명이었다. 3. 방사선치료를 하게된 주된 증상으로는 통증 30명(86%), 종괴 29명(85%), 위장관폐쇄 11(31%)명 및 폐쇄성 황달이 9(26%)명이었다. 4. 이중상들의 방사선치료후 반응은 총치료선량에 따라 40~50Gy에서 14/16(88%), 50 Gy이상에서 8/10(80%), 30~40Gy에서 6/8(75%), 및 20~30Gy에서 8/15(53%)의 호전율을 관찰할 수 있었다. 5. 국소 진행된 위암환자의 방사선치료후 평균 생존율은 3.6개월이었으며 방사선치료에 의한 부작용으로서는 오심, 구토(46%), 설사(20%), 백혈구 감소증(17%), 그리고 빈혈 및 폐염(9%) 등의 순을 보였다. Thirty-five Patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy(RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed 14(40%) poorly differentiated, 12(34%) moderately differentiated, 3(9%) well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for 18 (51%), 1 to 2 years for 8 (23%) and 2 to 3 years for 5 (14%), respectively. The major symptoms to be treated were pain in 30 (86%), mass for 29(83%), obstruction for 11(31%) and jaundice for 9 (26%) patients. The response rate (patient number of positive respones/total patient number) according to treated radiation doses were observed as follows; 14/16(88%) for 40~50 Gy, 8/10 (80%) for over 50 Gy, 6/8 (75%) for 30~40 Gy and 8/15 (53%) for 20~30 Gy in decreasing order. The over all survival was 3.6 months and that of 5FU+RT, FAM+RT and RT along groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in 16 (46%), diarrhea in 7 (20%), leukopenia in 6 (17%) and anemia and intercurrent pneumonia in each 3 (9%) patients in decreasing order.

Status of Medical Exposure in Korea

SEI-CHUL YOON,IL-HAN KIM,SUNG-HOON KIM,HYUCK-JOO KIM 대한방사선방어학회 2010 방사선방어학회지 Vol.35 No.3

Effect of Micrwave Hyperthermia in Radiotherapy of Human Malignant Tumors : An Analysis of Clinical Response of 42 Patients

Yoon, Sei-Chul,Oh, Yoon-Kyeong,Gil, Hak-Jun,Chung, Su-Mi,Shinn, Kyung-Sub,Bahk, Yong-Whee Catholic Medical Center 1987 Bulletin of the Clinical Research Institute Vol.15 No.-

Status of Medical Exposure in Korea

Yoon, Sei-Chul,Kim, Il-Han,Kim, Sung-Hoon,Kim, Hyuck-Joo The Korean Association for Radiation Protection 2010 방사선방어학회지 Vol.35 No.3

Medical use of radiation is increasing in recent times and its influence on the population creates almost the same amount of annual natural background radiation in industrialized countries in particular. Thus, medical radiation has become a social issue. This paper is a brief report on the status of medical exposure in Korea by way of consulting from the radiation-related medical societies in Korea.

The Effect of Simulation on Recurrence after Breast- Conserving Surgery and Radiotherapy: Preliminary Results

Ji-Yoon Kim,Yeon-Sil Kim,Mi-Ryung Ryu,Sung-Whan Kim,Chul-Seung Kay,Sei-Chul Yoon,Woo-Chan Park,Byung-Joo Song,Se-Jeong Oh,Sang-Seol Jung,Jong-Man Won,Seung-Nam Kim,Su-Mi Chung 대한암학회 2006 Cancer Research and Treatment Vol.38 No.1

Purpose: To evaluate the effect of the simulation method on recurrence among the patients who received radiotherapy after breast-conserving surgery (BCS) for early breast carcinoma.Methods and Materials: Between 1995 and 2000, 70 patients with stage I-II breast carcinoma underwent breast-conserving surgery and adjuvant radiotherapy. Twenty nine patients (41.4%) were simulated with the 2D contour-based method (September 1995 to August 1997) and 41 patients (58.6%) were simulated with the 3D CT-based method (September 1997 to February 2000). To analyze the effect of the simulation method, the patient and treatment characteristics were compared.Results: The characteristics were similar for the patients between the 2D contour-based simulation group and the 3D CT-based simulation group. During a median follow-up period of 75 months, 4 (13.8%) of 29 patients who were treated with 2D simulation and 1 (2.4%) of 41 patients who were treated with 3D simulation group developed treatment failure. The five-year survival rates were 89.2% and 95.1% between the 2D and 3D simulation groups (p=0.196). The five-year disease free survival (DFS) rates were 86.2% and 97.5% between the 2D and 3D simulation groups (p=0.0636). On univariate analysis, age 〉 40 (p= 0.0226) and the number of dissected axillary lymph node ≥ 10 (p=0.0435) were independent predictors of improved 5-year DFS. Conclusions: Although our data showed marginal significance for the DFS between the two groups, it is insufficient, due to the small number of patients in our study, to prove whether 3D CT-based simulation might improve the DFS and reduce the risk of recurrence when compared with 2D contour-based simulation. Further study is needed with a larger group of patients. (Cancer Res Treat. 2006;38:40-47)

뇌하수체선종

윤세철(Sei Chul Yoon),권형철(Hyung Chul Kwon),오윤경(Yoon Kyeong Oh),박용휘(Yong Whee Bahk),손호영(Ho Young Son),강준기(Joon Ki Kang),송진언(Jin Un Song) 대한방사선종양학회 1985 Radiation Oncology Journal Vol.3 No.1

Twenty-four cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic Medical College. Of 24 cases of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analysed the alteration of the endocrinologic tests, neurologic abnormalities, major clinical symptoms, endocrinologic changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra· and para-sellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormone -secreting tumors, 3 ACTH-secreting tumors consisting of one Cushing's disease and two Nelson's syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but one lost case. 6. Two of 4 growth hormone·secreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.

뇌수막종에서 선형가속기를 이용한 방사선수술 효과

계철승(Chul Seung Kay),윤세철(Sei Chul Yoon),정수미(Su Mi Chung),유미령(Mi Ryung Ryu),김연실(Yeon Sil Kim),서태석(Tae Suk Suh),최규호(Kyuho Choi),손병철(Byung Chul Son),김문찬(Moon Chan Kim) 대한방사선종양학회 2001 Radiation Oncology Journal Vol.19 No.2

목 적 :뇌수막종 환자들을 대상으로 선형가속기를 이용한 방사선수술을 시행한 결과에 대하여 환자의 임상적 증상과 방사선학적 추적검사를 통해 그 효과를 알아보고자 하였다. 대상 및 방법 : 1988년 7월부터 1998년 8월까지 20명의 뇌수막종 환자들을 대상으로 6 MV 선형가속기를 이용하여 방사선수술을 시행하였다. 20명의 환자들 중 4명(20%)은 남성, 16명(80%)은 여성이었으며, 평균연령은 51세(22∼78세)였다. 종양의 뇌내 위치는 측시상동 부위(parasagittal area)와 접형골 부위(sphenoid wing)가 8례(40%)로 가장 많았다. 방사선 수술 전에 시행한 신경외과적 수술의 횟수를 보면 1회 시행한 경우가 11례, 2회가 2례, 3회 시행한 경우가 1례였으며, 수술을 시행하지 않고 방사선수술만을 시행한 경우는 6례였다. 종양의 평균 부피는 5.72 cm3 (0.78∼15.1 cm3)였으며, 2차 시준기(secondary collimator)의 지름의 중간 값은 2 cm (1∼3 cm)이었다. 종양변연부의 평균조사량은 19.6 Gy (9∼30 Gy)였다. 추적관찰기간은 2.5∼109개월로 중앙값은 53개월이었다. 결 과 :방사선학적 검사와 신경학적 검사상 모두 반응률은 95%였다. 방사선추적검사상 종양의 부피가 줄어든 경우는 5례(25%), 종양의 부피에 변화가 없는 경우는 14례(70%), 그리고 종양의 부피가 증가된 경우가 1례(5%)였다. 종양의 부피가 증가된 1례를 제외한 19명의 환자중, 4명의 환자에서 추적 영상 검사상 중심부괴사의 소견이 보였다. 임상적 증상의 호전여부에 따른 신경학적인 검사상 증상의 호전이 있었던 경우는 9명(45%), 증상의 변화가 없었던 경우는 10명(50%)였다. 증상이 악화되었던 1명(5%)의 환자는 수술을 시행하여, 방사선 괴사의 소견을 보였다. 결 론 :뇌수막종 환자들에서 선형가속기를 이용한 방사선수술은 부작용 없이 시행할 수 있는 효과적인 치료법으로 생각된다. Purpose : To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas , we retrospectively analyzed the results of clinical and follow up CT/MRI studies . Methods and Materials : From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients , four (20%) were ma le and 16 (80%) were female. Mean age was 51 years old (22∼78 years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing a rea. RS was done for primary treatment in 6 (30%), postoperative res idual les ions in 11 (55%) a nd regrowth after surgery in 3 (15%). Mean tumor volume was 5.72 cm3 (0.78∼15.1 cm3) and secondary collimator s ize was 2.04 cm (1∼3 cm). The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy (9∼30 Gy) which was 40∼90% of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. Results : By the follow up imaging studies , the tumor volume was reduced in 5 cases (25%), arrested growth in 14 cases (70%), and increased s ize in 1 case (15%). Among these respons ive and stable 19 patients by imaging studies , there showed loss of contrast enhancement after CT/MRI in four patients . In clinical response, nine (45%) patients were cons idered improved condition, 10 (50%) patients were stable and one (5%) was worsened to be operated. This partly resulted in necros is after surgery. Conclusion : The overall control rate of meningiomas with linac based RS was 95% by both imaging follow- up and clinical evaluation. With this results , linac based RS is cons idered safe a nd effective treatment method for meningioma.