Clinical Benefit of Hepatic Arterial Infusion Concurrent Chemoradiotherapy in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

윤홍인,송기준,이익재,김도영,한광협,성진실 대한암학회 2016 Cancer Research and Treatment Vol.48 No.1

Purpose The aim of this study was to evaluate whether hepatic arterial infusion concurrent chemora- diotherapy (CCRT) could improve overall survival (OS) in patients with locally advanced hepatocellular carcinoma (LAHCC). Materials and Methods Two databases were reviewed from Yonsei Cancer Center (YCC) and Korean Liver Cancer Study Group (KLCSG) nationwide multi-center hepatocellular carcinoma (HCC) cohort. The CCRT group included 106 patients, with stage III-IV, Child-Pugh classification A, Eastern Cooperative Oncology Group performance status 0 or 1, who underwent definitive CCRT as the initial treatment at YCC. We used propensity score matching to adjust for seven clinical factors, including age, tumor size, TNM stage by the Liver Cancer Study Group of Japan, T stage, Barcelona Clinic Liver Cancer (BCLC) staging system, etiology of HCC, and portal vein invasion, which all differed significantly in the two databases. From the KLCSG cohort enrolled at 32 institutions, 106 patients for the non-CCRT group were defined. Results After propensity score matching, all patient characteristics were balanced between the two groups. The CCRT group had better OS (median, 11.4) than the non-CCRT group (6.6 months, p=0.02). In multivariate analyses for all patients, CCRT (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.11 to 1.97; p=0.007), tumor size (HR, 1.08; 95% CI, 1.04 to 1.12; p < 0.001), and BCLC stage (HR, 0.54; 95% CI, 0.36 to 0.8; p=0.003) were inde- pendent prognostic factors for OS. Conclusion CCRT showed better OS for LAHCC patients. In LAHCC patients with a good performance and normal liver function, CCRT could be a feasible treatment option. All of these findings need to be validated in prospective clinical trials.

Overexpression of SOX2 Is Associated with Better Overall Survival in Squamous Cell Lung Cancer Patients Treated with Adjuvant Radiotherapy

윤홍인,박규현,이은정,금기창,이창걸,김철훈,김용배 대한암학회 2016 Cancer Research and Treatment Vol.48 No.2

Purpose The purpose of this study is to investigate the prognostic significance of SOX2 gene amplification and expression in patients with American Joint Committee on Cancer stage III lung squamous cell carcinoma (SCC) who underwent surgery followed by adjuvant radiotherapy. Materials and Methods Pathological specimens were obtained from 33 patients with stage III lung SCC treated with surgery followed by adjuvant radiotherapy between 1996 and 2008. SOX2 gene amplification and protein expression were analyzed using fluorescent in situ hybridization and immunohistochemistry, respectively. Patients were divided into two groups according to their SOX2 gene amplification and protein expression status. Kaplan-Meier estimates and a Cox proportional hazards model were used to identify the prognostic factors affecting patient survival. Results The median follow-up period for surviving patients was 58 months (range, 5 to 102 months). SOX2 gene amplification was observed in 22 patients and protein overexpression in 26 patients. SOX2 overexpression showed significant association with SOX2 gene amplification (p=0.002). In multivariate analysis, SOX2 overexpression was a significant prognostic factor for overall survival (OS) (hazard ratios [HR], 0.1; 95% confidence interval [CI], 0.002 to 0.5; p=0.005) and disease-free survival (DFS) (HR, 0.15; 95% CI, 0.04 to 0.65; p=0.01). Age (HR, 0.33; 95% CI, 0.11 to 0.98; p=0.046) and total radiation dose (HR, 0.13; 95% CI, 0.02 to 0.7; p=0.02) were the independent prognostic factors for OS and DFS. Patients with SOX2 amplification did not show a longer OS (p=0.95) and DFS (p=0.48). Conclusion Our data suggested that SOX2 overexpression could be used as a positive prognostic factor in patients with stage III lung SCC receiving adjuvant radiotherapy.

High Radiation Dose to the Fornix Causes Symptomatic Radiation Necrosis in Patients with Anaplastic Oligodendroglioma

윤홍인,장종희,김태형,조재호,강석구,문주형,서창옥,박예원 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.1

Purpose: Surgery, radiotherapy (RT), and chemotherapy have prolonged the survival of patients with anaplastic oligodendroglio ma. However, whether RT induces long-term toxicity remains unknown. We analyzed the relationship between the RT dose to the fornix and symptomatic radiation necrosis (SRN). Materials and Methods: A total of 67 patients treated between 2009 and 2019 were analyzed. SRN was defined according to the following three criteria: 1) radiographic findings, 2) symptoms attributable to the lesion, and 3) treatment resulting in symptom improvement. Various contours, including the fornix, were delineated. Univariate and multivariate analyses of the relationship between RT dose and SRN, as well as receiver operating characteristic curve analysis for cut-off values, were performed. Results: The most common location was the frontal lobe (n=40, 60%). Gross total resection was performed in 38 patients (57%), and 42 patients (63%) received procarbazine, lomustine, and vincristine chemotherapy. With a median follow-up of 42 months, the me dian overall and progression-free survival was 74 months. Sixteen patients (24%) developed SRN. In multivariate analysis, age and maximum dose to the fornix were associated with the development of SRN. The cut-off values for the maximum dose to the fornix and age were 59 Gy (equivalent dose delivered in 2 Gy fractions) and 46 years, respectively. The rate of SRN was higher in patients whose maximum dose to the fornix was >59 Gy (13% vs. 43%, p=0.005). Conclusion: The maximum dose to the fornix was a significant factor for SRN development. While fornix sparing may help main tain neurocognitive function, additional studies are needed.

The Clinical Usefulness of 18F-Fluorodeoxyglucose Positron Emission Tomography (PET) to Predict Oncologic Outcomes and PET-Based Radiotherapeutic Considerations in Locally Advanced Nasopharyngeal Carcinoma

윤홍인,김경환,이정심,노윤호,윤미진,조병철,이창걸,금기창 대한암학회 2016 Cancer Research and Treatment Vol.48 No.3

Purpose We investigated 18F-fluorodeoxyglucose positron emission tomography (PET)-derived parameters as prognostic indices for disease progression and survival in locally advanced nasopharyngeal carcinoma (NPC) and the effect of high-dose radiotherapy for a subpopulation with PET-based poor prognoses. Materials and Methods Ninety-seven stage III and Iva-b NPC patients who underwent definitive treatment and PET were reviewed. For each primary, nodal, and whole tumor, maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) were evaluated. Results Based on the C-index (0.666) and incremental area under the curve (0.669), the whole tumor TLG was the most useful predictor for progression-free survival (PFS); the whole tumor TLG cut-off value showing the best predictive performance was 322.7. In multivariate analysis, whole tumor TLG was a significant prognostic factor for PFS (hazard ratio [HR], 0.3; 95% confidence interval [CI], 0.14 to 0.65; p=0.002) and OS (HR, 0.29; 95% CI, 0.11 to 0.79; p=0.02). Patients with low whole tumor TLG showed the higher 5-year PFS in the subgroup for only patients receiving intensity modulated radiotherapy (77.4% vs. 53.0%, p=0.01). In the subgroup of patients with high whole tumor TLG, patients receiving an EQD2 ! 70 Gy showed significantly greater complete remission rates (71.4% vs. 33.3%, p=0.03) and higher 5-year OS (74.7% vs. 19.6%, p=0.02). Conclusion Our findings demonstrated that whole tumor TLG could be an independent prognostic factor and high-dose radiotherapy could improve outcomes for NPC showing high whole tumor TLG.

포스터전시 : 간세포암종에서 방사선치료로 인한 간독성 예측인자로서 ICG-R15 검사의 임상적 유용성 (초)

윤홍인,금웅섭,이익재,김자경,한광협,성진실 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.3(S)

광섬유 브래그 격자를 이용한 광섬유 레이저 장거리 스트레인 센서 ( Multiplexed Strain Sensor For Long-Distance Remote Sensing Using Fiber Grating-Tuned Fiber Laser Scheme )

윤홍,권서원,이상배,최상삼,김성철,강성철,이병호 한국통신학회 1998 한국통신학회 기타 간행물 Vol.- No.-

랜덤 ECU ID 기반 블록체인 활용한 차량용 네트워크 보안성 강화 방안

윤홍 한국정보처리학회 2022 정보처리학회지 Vol.29 No.4

직장암 환자의 골반 방사선치료에서 벨리보드 하위 경계 위치 변화의 영향

윤홍인(Hong In Yoon),정윤선(Yoonsun Chung),김주호(Joo Ho Kim),박효국(Hyo Kuk Park),이상규(Sang Kyu Lee),김영석(Young Suk Kim),최윤선(Yunseon Choi),김미선(Misun Kim),이하윤(Hayoon Lee),장지석(Jeesuk Chang),차혜정(Hyejung Cha),성진실(Jins 대한방사선종양학회 2010 Radiation Oncology Journal Vol.28 No.4

목 적: 방광압박도구(bladder compression device) 추가에 따른 벨리보드(belly board) 하위 경계의 위치 변화에 따라 조사체적(irradiated volume) 내의 각 장기의 체적 차이 및 선량체적히스토그람을 분석하여 벨리보드의 하위 경계의 위치가 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 2010년 5월부터 2010년 9월까지 직장암으로 수술 전이나 후에 방사선치료를 위해 벨리보드만 사용하여 전산화 단층촬영을 시행한 경우와 방광압박도구를 추가하여 전산화 단층촬영을 재 시행한 10명을 대상으로 후향적으로 분석하였다. 환자의 중앙나이는 64세(범위, 45∼75세)로 조직학적으로 선암 진단을 받고, 수술 전 혹은 후에 동시항암화학방사선요법을 시행받았다. 방광압박도구 사용 전후 각 체적과 조사체적비의 평균비교 및 복강과 골반강의 조사체적의 합과 소장의 체적비와 방광의 체적비 간의 상관관계를 분석하였다. 결 과: 방광압박도구 추가 후 벨리보드 하위 경계는 치골결합 부위에서 허리엉치관절 부위 상방으로 올라갔다. 방광압박도구 사용 후 소장의 조사체적은 174.3±89.5 mL로 사용 전 조사체적 373.3±145.0 mL보다 유의하게 감소하였고 (p=0.001), 복부골반강(abdominopelvic cavity)의 조사체적도 사용 전보다 유의하게 감소하였다(1,282.6±218.7 mL vs. 1,571.9±158 mL, p<0.001). 방광압박도구 사용 전과 후의 치료체적 안의 방광 체적은 사용 후가 전보다 유의하게 증가하였다(222.9±117.9 mL vs. 153.7±95.5 mL, p<0.001). 방광압박도구 사용 후 복부골반강 대 방광의 조사체적비는 33.5±14.7%로 사용 전 조사체적비인 27.5±13.1%보다 유의하게 증가하였고(<0.001),복부골반강 대 소장의 조사체적비는 방광압박도구 사용 후 유의하게 감소하였다(13.9±7.6% vs. 24.2±10.2%, p<0.001). 결 론: 방광압박도구를 추가함으로 인해 벨리보드의 하위 경계를 허리엉치관절 부위 상방으로 올리는 것이 복부골반강 내 방광의 체적을 증가시켜 소장의 조사체적을 감소시킬 수 있음을 확인할 수 있었다. Purpose: We investigated the effect of location changes in the inferior border of the belly board (BB) aperture by adding a bladder compression device (BCD). Materials and Methods: We respectively reviewed data from 10 rectal cancer patients with a median age 64 years (range, 45∼75) and who underwent computed tomography (CT) simulation with the use of BB to receive pelvic radiotherapy between May and September 2010. A CT simulation was again performed with the addition of BCD since small bowel (SB) within the irradiated volume limited boost irradiation of 5.4 Gy using the cone down technique after 45 Gy. The addition of BCD made the inferior border of BB move from symphysis pubis to the lumbosacral junction (LSJ). Results: Following the addition of BCD, the irradiated volumes of SB and the abdominopelvic cavity (APC) significantly decreased (174.3±89.5 mL vs. 373.3±145.0 mL, p=0.001, 1282.6±218.7 mL vs. 1571.9±158 mL, p<0.001, respectively). Bladder volume within the treated volume increased with BCD (222.9±117.9 mL vs. 153.7±95.5 mL, p<0.001). The ratio of irradiated bladder volume to APC volume with BCD (33.5±14.7%) increased considerably compared to patients without a BCD (27.5±13.1%) (p<0.001), and the ratio of irradiated SB to APC volume decreased significantly with BCD (13.9±7.6% vs. 24.2±10.2%, p<0.001). The ratios of the irradiated SB volumeand irradiated bladder volume to APC volume negatively correlated (p=0.001). Conclusion: This study demonstrated that the addition of BCD, which made the inferior border of BB move up to the LSJ, increased the ratio of the bladder to APC volume and as a result, decreased the irradiated volume of SB.

PZT-stretcher를 이용한 파장가변 광섬유 DFB레이져

윤홍,조규만,이상배,김상혁,최상삼,Yun, Hong,Jo, Gyu-Man,Lee, Sang-Bae,Kim, Sang-Hyeok,Choe, Sang-Sam 한국광산업진흥회 2000 광산업정보 Vol.1 No.-

대 용량 메모리 기술 및 동향

윤홍일,김창현,황창규 한국전기전자재료학회 2000 전기전자재료 Vol.13 No.12

Over the years of decades, the memory technology has progressed a long, marble way. As we have evidenced from the Intel's 1Kb DRAM in 1970 to the Gigabit era of 2000's, the road further ahead towards the Terabit era will be unfolded. The technology once perceived inconceivable is in realization today, and similarly roadblocks as we know of today mayvecome trivial issues for tomorrow. For the inquiring mind, the question is how the "puzzle"of tomorrow's memory technology is pieced-in today. The process will take place both in evolutionary and revolutionary ways. Among these, note-worthy are the changes in DRAM architecture and the cell process technology. In this paper, some technical approaches will be discussed to bring these aspects into a general overview and a per-spective with possibilities for the new memory technology will be presented.presented.