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Treatment outcome of hepatic re-irradiation in patients with hepatocellular carcinoma
설승원,유정일,박희철,임도훈,오동렬,노재명,조원경,백승운 대한방사선종양학회 2015 Radiation Oncology Journal Vol.33 No.4
Purpose: We evaluated the efficacy and toxicity of repeated high dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with unresectable hepatocellular carcinoma. Materials and Methods: Between 1998 and 2011, 45 patients received hepatic re-irradiation with high dose 3D-CRT in Samsung Medical Center. After excluding two ineligible patients, 43 patients were retrospectively reviewed. RT was delivered with palliative or salvage intent, and equivalent dose of 2 Gy fractions for α/β = 10 Gy ranged from 31.25 Gy10 to 93.75 Gy10 (median, 44 Gy10). Tumor response and toxicity were evaluated based on the modified Response Evaluation Criteria in Solid Tumors criteria and the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. Results: The median follow-up duration was 11.2 months (range, 4.1 to 58.3 months). An objective tumor response rate was 62.8%. The tumor response rates were 81.0% and 45.5% in patients receiving ≥45 Gy10 and <45 Gy10, respectively (p = 0.016). The median overall survival (OS) of all patients was 11.2 months. The OS was significantly affected by the Child-Pugh class as 14.2 months vs. 6.1 months (Child-Pugh A vs. B, p < 0.001), and modified Union for International Cancer Control (UICC) T stage as 15.6 months vs. 8.3 months (T1–3 vs. T4, p = 0.004), respectively. Grade III toxicities were developed in two patients, both of whom received ≥50 Gy10. Conclusion: Hepatic re-irradiation may be an effective and tolerable treatment for patients who are not eligible for further local treatment modalities, especially in patients with Child-Pugh A and T1–3.
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불확실성에 대한 인내력 부족과 정서 통제감이 걱정에 영향을 미치는 기제: 문제 해결 지향의 매개효과를 중심으로
설승원,오경자 한국임상심리학회 2008 Korean Journal of Clinical Psychology Vol.27 No.1
The purpose of this study was to investigate the effects of intolerance of uncertainty and perceived emotion controllability on worry, and identify the role of problem orientation as mediator variable. Also, gender effect on the role of problem orientation was examined. The sample consisted of 143 female and 166 male university students who completed the questionnaire about intolerance of uncertainty, perceived emotion controllability, problem orientation and worry. The results were as follows. First, the structural equation model analyzing the partial mediating effect of problem orientation on the influence of intolerance of uncertainty and perceived emotion controllability on worry fit in total group. Problem orientation mediated the paths from both intolerance of uncertainty and perceived emotion controllability to worry. In addition, the direct paths from both intolerance of uncertainty and perceived emotion controllability was also significant. Second, gender differences were observed in the model when data were analysed separately for the male and female group. In male group, problem orientation mediated the path from perceived emotion controllability to worry, but path from intolerance of uncertainty to problem orientation was not significant. In case of intolerance of uncertainty, only the direct path to worry was significant. On the other hand, in female group, problem orientation mediated paths from both intolerance of uncertainty and perceived emotion controllability to worry. In addition, the direct path from emotion controllability to worry was also significant. Implications and limitations of this study were discussed along with the suggestions for future research.
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김성혁,신동진,정욱진,설승원 대한신경과학회 2011 대한신경과학회지 Vol.29 No.2
Background: There has been proposing reports that the autonomic nervous system (ANS) is involved in the pathophysiological mechanism of migraine. However, previous reports suggesting ANS dysfunction during migraine attack was not consistent and were focused mainly on comparison between migraine patients in interictal period and normal controls. The current study is designed to evaluate quantitative evidence of ANS dysfunction by comparing patients in ictal period with those in interictal period. Methods: We prospectively included 30 migraineurs in ictal period and 30 migraineurs in interictal period from August 2008 to August 2009. Sympathetic function was evaluated by blood pressure response to standing and isometric exercise. Parasympathetic function was evaluated by heart rate response to deep breathing, standing and the Valsalva maneuver. Results: In orthostatic test, falling of systolic blood pressure (SBP) after standing was prominent in ictal group. Although both groups showed elevation of diastolic blood pressure (DBP) after standing, the change was smaller in ictal group than intercital group. Elevation of DBP after isometric exercise was lower in ictal group without statistical significance. Results of parasympathetic function test were not significantly different between ictal and interictal patients. Conclusions: This study suggests that subjects with migraine had sympathetic hypofunction during migraine attack.
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노재명,하상윤,안용찬,오동렬,설승원,오영륜,한정호 대한암학회 2015 Cancer Research and Treatment Vol.47 No.3
Purpose The purpose of this study is to assess the clinicopathologic features, treatment outcomes, and role of adjuvant radiation therapy (RT) in cervical thymic neoplasm involving the thyroid gland or neck. Materials and Methods The medical and pathologic records of eight patients with cervical thymic neoplasm were reviewed retrospectively. All patients underwent surgical resection, including thyroidectomy or mass excision. Adjuvant RT was added in five patients with adverse clinicopathologic features. The radiation doses ranged from 54 Gy/27 fractions to 66 Gy/30 fractions delivered to the primary tumor bed and pathologically involved regional lymphatics using a 3-dimensional conformal technique. Results Eight cases of cervical thymic neoplasm included three patients with carcinoma showing thymus-like differentiation (CASTLE) and five with ectopic cervical thymoma. The histologic subtypes of ectopic cervical thymoma patients were World Health Organization (WHO) type B3 thymoma in one, WHO type B1 thymoma in two, WHO type AB thymoma in one, and metaplastic thymoma in one, respectively. The median age was 57 years (range, 40 to 76 years). Five patients received adjuvant RT: three with CASTLE; one with WHO type B3; and one with WHO type AB with local invasiveness. After a median follow-up period of 49 months (range, 11 to 203 months), no recurrence had been observed, regardless of adjuvant RT. Conclusion Adjuvant RT after surgical resection might be worthwhile in patients with CASTLE and ectopic cervical thymoma with WHO type B2-C and/or extraparenchymal extension, as similarly indicated for primary thymic epithelial tumors. A longer follow-up period may be needed in order to validate this strategy.
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