Effect of National Oral Health Screening Program on the Risk of Head and Neck Cancer: A Korean National Population-Based Study

위찬우,이효정,이재련,이혜진,권민정,정우진,엄근용 대한암학회 2022 Cancer Research and Treatment Vol.54 No.3

PurposePoor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC.Materials and MethodsData from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+.ResultsA total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877).ConclusionThe National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.

가로림만 저서다모류군집의 시·공간 분포 및 건강 상태

위찬우,이정호,신현출,Wi, Chan Woo,Lee, Jung Ho,Shin, Hyun Chool 한국해양학회 2014 바다 Vol.19 No.4

This study was carried out to estimate the benthic environments and polychaetous community in Garolim Bay, through five field surveys from April 2006 to April 2007. Garilim Bay is a semi-enclosed bay and composed of a biramous tidal channel and nearby wide tidal flats. Surface sediment in the inner bay was composed of fine grained particles whereas that in the mouth area of bay was of coarse grained ones. Benthic polychaete worms were the most dominant taxa occupying 65.1% of total benthic macrofauna. Species number was higher in the inner bay than mouth and outer area of bay, and in the bay higher on the tidal flat than channel area. Density was higher on the tidal flat than channel area. Dominant polychaetous species were Prionospio sp., Heteromastus filiformis, Lumbrineris longifolia and so on, which is known as opportunistic species. Prionospio sp. and H. filiformis inhabited mainly on the tidal flats in inner bay, while L. longifolia in the channel area and mouth of the bay. Cluster analysis and nMDS showed the typical inner-to-outward distribution of station groups, which indicated the sequential difference of the species composition of each station group. To assess the benthic healthiness of Garolim Bay by AMBI and BPI analysis, the benthic condition was analyzed from slightly polluted in the outer and mouth of the bay to moderately polluted in the inner bay. Assumed from dominant species composition and benthic healthiness condition, benthic environments of Garolim Bay was slightly unstable and disturbed and organic enrichment was currently underway by massed fisheries farms. 가로림만 저서다모류군집의 특성을 파악하기 위하여 2006년 4월부터 2007년 4월까지 5회에 걸쳐 현장조사를 실시하였다. 가로림만은 반폐쇄성 매만으로 2분지형의 수로를 통해 해수의 유출입이 일어나며 수로 주변으로 넓은 갯벌이 형성되어 있다. 저서다모류는 전체 대형저서동물군집중 개체수에 있어서 65.1%를 차지하는 우점 동물군이었다. 출현종수는 내만역이 만입구나 외해역에 비해, 그리고 갯벌 지역이 수로 지역에 비해 많은 편이었다. 서식밀도 역시 수로 지역보다 갯벌 지역에서 높았다. 주요 우점다모류는 기회주의종으로 잘 알려진 Prionospio sp., Heteromastus filiformis, Lumbrineris longifolia 등이었다. Prionospio sp.와 H. filiformis는 주로 내만역의 갯벌에 주로 서식하였고, 반면 L. longifolia는 수로지역과 만 입구역에 서식하였다. 집괴분석과 nMDS 분석 결과 정점군들은 내만역에서 외해쪽으로의 분포 경향을 보였으며, 이는 각 정점군의 종조성이 순차적으로 차이가 남을 의미한다. AMBI와 BPI를 이용하여 가로림만의 저서 환경 건강도를 평가한 결과 만 입구역에서는 약간 오염(slightly polluted)된 정도이었으나, 내만역으로 들어갈수록 중간정도의 오염(moderately polluted) 상태를 보여주었다. 우점종의 종조성과 저서건강도 상태를 고려해볼 때, 가로림만의 저서환경은 약간 불안정하고 교란이 진행되고 있는 상태이며, 대규모 양식장들로 인한 유기물오염이 현재 진행되고 있는 것으로 판단된다.

Interim Tumor Progression and Volumetric Changes of Surgical Cavities during the Surgery-to-Radiotherapy Interval in Anaplastic Gliomas: Implications for Additional Pre-radiotherapy Magnetic Resonance Imaging

위찬우,김일한,박철기,김진욱 대한암학회 2020 Cancer Research and Treatment Vol.52 No.2

Purpose This study was designed to investigate the incidence of interim disease progression (IPD) and volumetric changes of the surgical cavity (SC) during the surgery-to-radiotherapy interval (SRI), and eventually assess the value of magnetic resonance imaging (MRI) at the time of radiotherapy (RT) planning in newly diagnosed anaplastic gliomas. Materials and Methods Among 195 anaplastic glioma patients who underwent RT, 121 were evaluable with two separate MRIs during SRI. The presence of IPD was determined using the updated Response Assessment in Neuro-Oncology size criteria. In 84 patients who underwent surgical resection, each SC was contoured by a radiation oncologist and the volumetric changes of the SCs were calculated between the two separate MRIs. Daily rate of change in the SC volume was calculated assuming an exponential and linear change. Results Five of 121 patients (4.13%) demonstrated IPD during SRI, and the incidence was significantly higher in patients undergoing biopsy (vs. surgical resection, 12.9% vs. 1.1%, p=0.015) and in patients with remnant contrast-enhancing tumor after surgery (15.8 vs. 2.0%, p=0.027). The mean daily rate of absolute change in SC was 1.06% (95% confidence interval [CI], 0.89 to 1.23) and 0.89% (95% CI, 0.77 to 1.02) according to the exponential and linear model, respectively. The expected mean volumetric change at 2 weeks were 16.64% (95% CI, 13.77 to 19.52) and 12.51% (95% CI, 10.77 to 14.26), respectively. Conclusion IPD during the SRI is rare in surgically resected anaplastic gliomas. However, pre-RT MRI is essential for accurate RT-target delineation and disease evaluation for patients initiating RT beyond postoperative 2 weeks and undergoing biopsy, respectively.

Locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy plus concurrent weekly cisplatin with or without neoadjuvant chemotherapy

위찬우,허대석,성명훈,우홍균,김범석,원태빈 대한방사선종양학회 2015 Radiation Oncology Journal Vol.33 No.2

Purpose: The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods: Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results: With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion: CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited.

Prediction of Pathologic Findings with MRI-Based Clinical Staging Using the Bayesian Network Modeling in Prostate Cancer: A Radiation Oncologist Perspective

위찬우,장범섭,김진호,정창욱,곽철,김현회,구자현,김승협,조정연,김상연 대한암학회 2022 Cancer Research and Treatment Vol.54 No.1

Purpose This study aimed to develop a model for predicting pathologic extracapsular extension (ECE) and seminal vesicle invasion (SVI) while integrating magnetic resonance imaging-based T-staging (cTMRI, cT1c-cT3b). Materials and Methods A total of 1,915 who underwent radical prostatectomy between 2006-2016 met the inclusion/exclusion criteria. We performed a multivariate logistic regression analysis as well as Bayesian network (BN) modeling based on possible confounding factors. The BN model was internally validated using 5-fold validation. Results According to the multivariate logistic regression analysis, initial prostate-specific antigen (iPSA) (β=0.050, p < 0.001), percentage of positive biopsy cores (PPC) (β=0.033, p < 0.001), both lobe involvement on biopsy (β=0.359, p=0.009), Gleason score (β=0.358, p < 0.001), and cTMRI (β=0.259, p < 0.001) were significant factors for ECE. For SVI, iPSA (β=0.037, p < 0.001), PPC (β=0.024, p < 0.001), Gleason score (β=0.753, p < 0.001), and cTMRI (β=0.507, p < 0.001) showed statistical significance. BN models to predict ECE and SVI were also successfully established. The overall area under the receiver operating characteristic curve (AUC)/accuracy of the BN models were 0.76/73.0% and 0.88/89.6% for ECE and SVI, respectively. According to internal comparison between the BN model and Roach formula, BN model had improved AUC values for predicting ECE (0.76 vs. 0.74, p=0.060) and SVI (0.88 vs. 0.84, p < 0.001). Conclusion Two models to predict pathologic ECE and SVI integrating cTMRI were established and installed on a separate website for public access to guide radiation oncologists.

Role of Radiotherapy in Metastatic Renal Cell Carcinomas: An Evolutionary Journey in a Misunderstood Histological Type

위찬우,조재호 대한비뇨기종양학회 2023 대한비뇨기종양학회지 Vol.21 No.3

Renal cell carcinoma (RCC) has traditionally been considered one of the most radioresistant tumors based on in vitro and clinical studies that utilized a low biologically effective dose. However, recent studies have suggested that administering a higher radiation dose to RCC can lead to satisfactory local control and potentially long-lasting disease control. Thanks to significant advances in radiotherapy technology, it is now feasible to deliver higher radiation doses to tumors while preserving the organs at risk. Furthermore, over the past decade, a crucial role of radiotherapy has emerged in metastatic cancers, both for symptom palliation and for the elimination of tumor niches. This review discusses the current evidence and future perspectives concerning the role of radiotherapy in metastatic RCC.

폐경 호르몬요법에서 경구용 Levonorgestrel 투여 1년 후 유방 치밀도에 대한 효과

위찬우 ( Chan Woo Wee ),강민정 ( Min Jung Kang ),서경용 ( Kyoung Yong Seo ),최연현 ( Yeon Hyeon Choe ),민용기 ( Yong Ki Min ),이동윤 ( Dong Yun Lee ),최두석 ( Doo Seok Choi ),윤병구 ( Byung Koo Yoon ) 대한폐경학회 2011 대한폐경학회지 Vol.17 No.1

연구목적: 한국 폐경여성에서 levonorgestrel (LNG)를 이용한 호르몬 치료의 유방 치밀도에 대한 영향을 평가하였다. 연구재료 및 방법: 후향적 연구로서, 이전에 호르몬치료 기왕력이 없는 58명을 대상으로 하였다. 23명에게 estadiol valerate (E)+LNG를 이용해 주기적으로 치료하였고, 25명의 비치료군을 대조군, 10명의 conjugated equine estrogen (CEE)+medroxyprogesterone acetate (MPA) 치료군을 양성 대조군으로 두었다. 이후 기저치와 1년 후 유방촬영을 시행하여 치밀도를 비교하였다. 치료 전후의 X선 유방촬영술상 유방 치밀도의 변화는 J-image 프로그램을 이용하여 평가하였다. 자료는 chi-square 분석 및 Fisher`s exact 분석법, 그리고 nalysis of variance (ANOVA)을 이용하여 분석하였다. 결 과: 세 군 간의 기저 임상적 특성에 차이는 없었다. 1년의 호르몬요법 후, breast imaging reporting and data system (BI-RADS) 기준에 따른 변화를 보았을 때 CEE+MPA 사용군 (77.8% [7/9])이, E + LNG 사용군 (12.5% [2/16])보다 유의하게 증가하였으나 (P=0.001), E+LNG 사용군과 비치료군 (5.3% [1/19])사이에 유의한 차이는 없었다 (P=0.446). 치밀도가 3단계인 환자만을 대상으로 한 분석에서도 E+LNG 사용군은 비치료군과 유방 치밀도 변화에 차이가 없었다. J-image 프로그램을 이용한 분석 결과도 유사한 결과를 보였다. 또한 회귀 분석 결과, 기저 치밀도와 호르몬요법후 치밀 면적의 변화 사이에는 상관 관계가 나타나지 않았다. 결론: 한국 폐경 여성에서 LNG를 이용한 호르몬요법은 유방 치밀도에 영향을 미치지 않는다. 향후 유방암 위험에 대한 추가 연구가 필요하다고 사료된다. Objectives: We evaluated changes in mammographic density (MMGD) after hormone therapy (HT) using levonorgestrel (LNG) in Korean postmenopausal women. Methods: In this retrospective study, 58 healthy postmenopausal women with no history of prior HT were included. Twenty-three women were given a cyclic regimen of estradiol valerate (E) 2 mg/day+LNG 0.075 mg/day and 25 untreated women served as a negative control and 10 women treated with continuous combined regimen of conjugated equine estrogen (CEE) 0.625 mg/day+medroxyprogesterone acetate (MPA) 2.5 mg/day as a positive control. Mammography was obtained at baseline and 1 year later, and MMGD was assessed. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher`s exact test. Results: There were no significant differences in baseline characteristics among three groups. After 1 year of HT, increase of BI-RADS grade in CEE+MPA group (7/9, 77.8%) was higher than in E+LNG group (2/16, 12.5%; P=0.001). But there was no difference between untreated group (1/19, 5.3%) and E+LNG group (2/16, 12.5%; P=0.446). In subgroup analysis of women with BI-RADS grade 3 at baseline, no significant difference. Changes in the proportion of dense areas assessed by the J-image program showed similar results. Regression analysis revealed that there was no correlation between baseline dense area and changes after HT in E+LNG group. Conclusion: HT using LNG did not influence MMGD in Korean postmenopausal women. Further study on breast cancer risk may be needed. (J Korean Soc Menopause 2011;17:27-33)

한국여성에서 폐경 후 Drospirenone 2 mg과 17-β-Estradiol 1 mg 투여의 혈압 및 체중에 대한 효과

신미영 ( Mi Young Shin ),위찬우 ( Chan Woo Wee ),주정경 ( Jung Kyung Joo ),강지현 ( Ji Hyun Kang ),주인숙 ( In Sook Ju ),서경용 ( Kyoung Young Seo ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.10

Objective: To evaluate effects of Drospirenone 2 mg (DRSP) with 17-β-Estradiol 1 mg (E2) on blood pressure (BP) and body weight in postmenopausal Korean women. Methods: BP and body weight were measured at baseline and 3 months of the treatment. We compared the change in BP and body weight between normotensive (group 1, control) and high-normotensive (group 2) group during treatment. And we compared the change in BP and body weight between hypertensive group receiving anti-hypertensive with (group 3) and without (group 4, control) DRSP/E2 during treatment. Results: The mean systolic BP/diastolic BP of group 1 was not significantly decreased from baseline (116.9/75.0 mmHg) after treatment with DRSP/E2 for 3 months (116.1/73.2 mmHg) (P<0.152/P=0.088), however that of group 2 was significantly decreased from baseline (128.8/81.8 mmHg) after treatment with DRSP/E2 for 3 months (126.2/79.3 mmHg) (P<0.001/P=0.002). The mean systolic BP/diastolic BP of group 3 was significantly decreased from baseline (133.5/82.5 mmHg) after treatment with DRSP/E2 for 3 months (129.3/77.9 mmHg) (P<0.001/P<0.001), and that of group 4 was also significantly decreased from baseline (133.2/80.7 mmHg) after treatment with DRSP/E2 for 3 months (131.0/78.3 mmHg) (P=0.002/P<0.001). However change in the mean systolic BP/diastolic BP of group 3 was greater than that of group 4 (P=0.041/P=0.024). There was no weight change in all four groups. Conclusion: The use of DRSP/E2 showed a tendency to decrease the BP of high-normotensive or above in postmenopausal Korean women, and hypertensive patients receiving anti-hypertensive showed greater decline in BP. However there was no statistical significance in body weight change.

키토산 함유 주사형 지지체가 성체 줄기세포 분화 중 골 형성 유전자 변화에 미치는 영향

정창호 ( Chang Ho Jeong ),위찬우 ( Chanwoo Wee ),고성균 ( Sung Kyun Ko ),정병훈 ( Byunghoon Jeong ),장철원 ( Cheolwon Jang ),임원봉 ( Wonbong Lim ) 한국키틴키토산학회 2024 한국키틴키토산학회지 Vol.29 No.1

Several injectable materials have been applied for bone substitute in bone defect however, nothing has achieved acceptance in clinic. This study was carried out to investigate whether chitosan-alginate gel/mesenchymal stem cell composites are potentially injectable substitute materials for bone remodeling. The chitosan-alginate gel/mesenchymal stem cell composites were implanted in the bone defect lesion of rat calvaria to investigate the mRNA expressions of implanted mesenchymal stem cells. The implantation of chitosan-alginate gel/mesenchymal stem cell promoted the expression of collagen type 1 in bone defect lesion and induced the growth of osteoblast cells, thereby promoting new bone formation. In addition, the new bone formation process was improved by increasing the expression of Col13a1, Tnn, Fignl1, and Chad, which are related to the growth and differentiation of osteoblasts, and decreasing the expression of MMP13, which is related to the differentiation of osteoclasts. The present study suggests that chitosan-alginate gel/mesenchymal stem cell composites could be a useful tool for treatment of bone defect as a bone substitute.

Clinical Outcomes of Postoperative Radiotherapy Following Radical Prostatectomy in Patients with Localized Prostate Cancer: A Multicenter Retrospective Study (KROG 18-01) of a Korean Population

이성욱,조관호,박원,조원경,김재성,위찬우,김영석,김진호,남택근,조재호,정송미,김영경,심수정,최영민,김준상 대한암학회 2020 Cancer Research and Treatment Vol.52 No.1

Purpose The purpose of this study was to investigate the clinical outcomes of postoperative radiotherapy (PORT) patients who underwent radical prostatectomy for localized prostate cancer. Materials and Methods Localized prostate cancer patients who received PORT after radical prostatectomy between 2001 and 2012 were identified retrospectively in a multi-institutional database. In total, 1,117 patients in 19 institutions were included. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ! nadir+2 after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA regardless of its value. Results Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasisfree survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT. Pre-PORT PSA " 0.5 ng/ml and Gleason’s score " 7 predicted favorable clinical outcomes, with 10-year OS rates of 92.5% and 94.1%, respectively. The 10-year OS rate was 82.7% for patients with a PSA > 1.0 ng/mL and 86.0% for patients with a Gleason score of 8-10. The addition of longterm ADT (! 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ! T3b. Conclusion Clinical outcomes of PORT in a Korean prostate cancer population were very similar to those in Western countries. Lower Gleason score and serum PSA level at the time of PORT were significantly associated with favorable outcomes. Addition of long-term ADT (! 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ! T3b.