Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal Cavity

김수곤,박경란,이창걸,서창옥,김귀언,노준규,홍원표,김병수,류삼열,Kim Soo Kon,Park Kyung Ran,Lee Chang Gul,Suh Chang Ok,Kim Gwi Eon,Loh John J.K.,Hong Won Pyo,Kim Byung Soo,Ryu Samuel The Korean Society for Radiation Oncology 1987 Radiation Oncology Journal Vol.5 No.2

1970년부터 1980년까지 연세대학교 치료방사선과에서 방사선치료 받은 비강 및 부비동에 발생한 NHL환자 15예를 대상으로 후향성 분석을 하여 다음과 같은 결과를 얻었다. 1. 병기분포는 13예가 IE 2예가 IIE였고 TNM병기에 따르면 7예가 국소병변이 진행된 T3, T4 환자였다. 2. Overall 5년 생존율을 $25\%$, IE는 $28\%$, IIE는 $0\%$였다. 3. 병기별 치료실패율은 T1, T2는 $33\%(2/6),\; T3,\;T_4는\;86\%(6/7),\;IIE$에서는 $100\%(2/2)$였다. 4. 방사선 조사량이 55Gy 이상인 경우 $100\%$의 완전 관해율을 보였으며 55Gy이하인 경우 $73\%$의 완전 관해율을 보였다. 5. 비강 및 부비동의 NHL의 Ann Arbor병기 분류와 함께 TNM 병기도 예후에 중요한 요인이 될 것 같다. 6. 국소병변이 진행된 병기 T3, T4와 IIE 환자에서는 화학요법제의 병용치료가 필요할 것 같다. From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation.13 patients were stage It and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were $25\%,\;28\%$ for IE and $0\%$ for IIE. Total tumor dose varied from 40 to 68 Gy. $100\%$ complete response with a total tumor dose of more than 55 Gy and $73\%$ complete response with less than 55Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was $50\%$ as compared with $14\%$ for T3 and T4. Failure rate by stage was $33\%(2/6)$ for T1 and T2, $86\%(6/7)$ for T3 and T4, and $100\%$(2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tuner dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.

Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal Cavity

Soo Kon Kim(김수곤),Samuel Ryu(류삼열),Kyung Ran Park(박경란),Chang Gul Lee(이창걸),Chang Ok Suh(서창옥),Gwi Eon Kim(김귀언),John J.K. Loh(노준규),Byung Soo Kim(김병수),Won Pyo Hong(홍원표) 대한방사선종양학회 1987 Radiation Oncology Journal Vol.5 No.2

1970년부터 1980년까지 연세대학교 치료방사선과에서 방사선치료 받은 비강 및 부비동에 발생한 NHL 환자 15예를 대상으로 후향성 분석을 하여 다음과 같은 결과를 얻었다. 1. 병기분포는 13예가 IE 2예가 IIE였고 TNM병기에 따르면 7예가 국소병변이 진행된 T₃, T₄ 환자였다. 2. Overall 5년 생존율을 25%, IE는 28%, IIE는 0%였다. 3. 병기별 치료실패율은 T₁, T₂는 33%(2/6), T₃, T₄ 는 86%(6/7), IIE에서는 100%(2/2)였다. 4. 방사선 조사량이 55Gy 이상인 경우 1000%의 완전 관해율을 보였으며 55Gy이하인 경우 73%의 완전 관해율을 보였다. 5. 비강 및 부비동의 NHL의 Ann Arbor 병기 분류와 함께 TNM 병기도 예후에 중요한 요인이 될 것 같다. 6. 국소병변이 진행된 병기 T₃, T₄와 IIE 환자에서는 화학요법제의 병용치료가 필요할 것 같다. From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation.13 patients were stage It and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33%(2/6) for T1 and T2, 86%(6/7) for T3 and T4, and 100%(2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tuner dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.

소세포 폐암의 치료성적에 대한 고찰

김은화 ( Eun Hwa Kim ),이순형 ( Soon Hyoung Lee ),허원영 ( Won Young Huh ),김한식 ( Han Sik Kim ),조진웅 ( Jin Ung Jo ),김미애 ( Mee Ae Kim ),김상균 ( Sang Kyun Kim ),김귀완 ( Kwi Wan Kim ),정원규 ( Weon Kuu Chung ),김수곤 ( Soo K 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.3

후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발 : 예비 결과

정웅기(Woong-Ki Chung),김일한(Il-Han Kim),안성자(Sung-Ja Ahn),남택근(Taek-Keun Nam),오윤경(Yoon-Kyeong Oh),송주영(Ju-Young Song),나병식(Byung-Sik Nah),정경애(Gyung-Ai Chung),권형철(Hyoung-Cheol Kwon),김정수(Jung-Soo Kim),김수곤(Soo-K 대한방사선종양학회 2003 Radiation Oncology Journal Vol.21 No.4

목 적: 후두암 방사선 치료의 표준화를 위하여 후두암에 관한 기본적인 임상자료를 축적하고 필요한 조사항목을 결정하여 전국적인 웹 기반 데이터 베이스 시스템을 개발하고자 하였다. 대상 및 방법 : 1998년 1월부터 1999년 12월까지 호서호남 지역에서 후두암으로 진단되어 방사선치료를 받은 환자를 대상으로 임상적 분석을 시행하였다. 환자 선정 기준은 18세 이상이며 과거력상 타 장기의 암 진단 병력이 없고 후두에서 기원한 원발성 상피세포암으로 과거 후두에 대한 다른 질환으로 치료력이 없는 환자를 대상으로 하였다. 후두암에 관한 조사항목 개발은 대한 방사선 종양학회 호서호남지회 소속 병원의 전문의들이 합의하여 일차적으로 선정한 항목에 대하여 각 병원에서 자체적으로 조사하였다. 통계처리는 SPSS v10.0을 이용하였다. 결 과: 자료가 수집된 총 증례수는 45예이었다. 환자의 연령분포는 28~ 88세(중 앙값: 61)이었고 남녀비는 10대 1로 대부분 남자에 발생하였다. 원발부위는 성문암이 28예(62%), 성문상부암이 17예(38%)이었다.병리소견으로는 편평세포암이 대부분이었다(44/45, 98%). AJCC (1997년도)병기 I+II는, 성문암 28예 중 24예(86%)에 비해 성문상부암의 경우는 16예 중 8예(50%)이었다(p=0.002). 증상은 애성이 40예(89%)로 가장 많았다.진단은 간접후두경이 전체환자에서, 직접후두경검사는 43예(98%)에서 각각 시행되었다. 치료로서 성문암 28예와 성문상부암 17예 중,방사선 단독치료는 21예(75%), 6예(35%)에서 각각 시행되었다. 또한 수술요법과 방사선요법의 병용은 각각 5예(18%), 8예(47%)이었고, 항암화학요법과 방사선요법의 병용치료는 각각 2예(7%), 3예(18%)이었으나 두 원발 병소간에 병용치료 빈도의 유의한 차이는 없었다(p=0.20). 방사선 치료는 모두 선형가속기 6MVX-ray 를 이용하여 통상적 분할조사법으로 시행되었다. 분할선량은 성문암 환자의 86%에서 2.0 Gy를 사용한 반 면 성 문 상 부 암은 59%에서 1.8 Gy를 각각 사용하였다. 방사선단독치료를 완 료한 환자에서 원발 병소의 평균 총방사선량은 성문암에서 65.98 Gy, 성문상부암에서 70.15 Gy이었다. 수집된 자료를 기초로 후두암 방사선치료 형태 연구에 필요한 총 12개의 모듈과 90개의 항목을 개발하였다. 결 론: 본 연구에서는 후두암 데이터베이스시스템에 필요한 연구항목을 개발하였다. 향후 웹 기반데이터 베이스시스템을 완성하고 전국의 방사선치료 자료를 축적하여 후두암에 대한 한국형 방사선치료의 표준화 및 적정화를 기하고자 한다. Purpose In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a w eb-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data of patients who w e re treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 in the South-west area of Korea. Eligibility criteria of the patients are as follows : 18 years or older, currently diagnosed with primary epithelial carcin oma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologist who are members of Korean South west Radiation Oncology Group. SPSS v10.0 software was used for statistical analysis. Results Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years (median, 61). Laryngeal cancer occurred predominantly in males (10 1 s ex ratio). Twenty-eight patients (62%) had primary cancers in the glottis and 17 (38%) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98%). Twenty-four of 28 glottic cancer patients (86%) had AJCC (American Joint Committee on Cancer) stage I/II, b ut 50% (8/16) had in supraglottic cancer patients (p=0.02). Most patients (89%) had the symptom of hoarseness. Indirect laryngoscopy was done in all patients and direct laryngoscopy was performed in 43 (98%) patients. Twenty-one o f 28 (75%) glottic cancer cases and 6 of 17 (35%) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18%) glottic and 8 (47%) supraglottic patients. Chemotherapy and radiation was used in 2 (7%) glottic and 3 (18%) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6MV X-ray was used with conventional fractionation. The fraction size was 2 Gy in 80% of glottic cancer patients compared with 1.8 Gy in 59% of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 Gy and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items wer e developed for the study of the patterns of care in laryngeal cancer. Conclusion The study items for laryngeal cancer were developed. In the near future, a web system will be established based on the items investigated, and t h en a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radiotherapy.