불완전 방사선치료 환자의 분석

허승재,우홍균,안용찬,김대용,신경환,이규찬,정원아,김현주,Huh Seung Jae,Wu Hong Gyun,Ahn Yong Chan,Kim Dae Yong,Shin Kyung Hwan,Lee Kyu Chan,Chong Won A,Kim Hyun Joo The Korean Society for Radiation Oncology 1998 Radiation Oncology Journal Vol.16 No.3

목적 : 본 연구는 계획된 방사선치료의 과정 도중에 방사선치료를 완료하지 못하는 환자들의 빈도를 조사하고 그 이유를 분석하고자 하였다. 대상 및 방법 :삼성서울병원 치료방사선과에서 방사선치료를 받은 환자 중에서 1996년 4월부터 1997년 5월까지 방사선치료를 시행 받은 1,100명의 환자들을 대상으로 하였다. 대상 환자들 중에서 최초 계획 방사선량의 95$\%$ 이하를 받은 경우를 불완전 방사선치료로 정의하여 그 빈도와 이유를 조사하였다. 결과 : 불완전 방사선치료의 빈도는 1,100명 중 128명으로 12$\%$였다. 불완전 방사선치료 환자들의 운동수행능력은 전체 환자들에 비하여 불량하였으며, 방사선치료의 목적은 고식적 목적이 많았다. 불완전 방사선치료의 가장 흔한 이유는 환자의 거부였으며 이는 주로 환자의 방사선치료에 대한 불신과 경제적 부담 때문이었다. 결론 : 불완전 방사선치료의 빈도를 줄이기 위해서는 방사선치료의 임상적 적응 여부는 물론 환자의 사회 경제적인 여건을 잘 고려하여 방사선치료의 대상 환자를 선정하는 것이 요망되며 이는 특히 고식적 방사선치료의 경우에 더욱 중요하다고 할 수 있겠다. Purpose : This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. Materials and Methods : The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95$\%$ of initially planned radiation dose, and the reasons for incomplete radiation therapy. Results : One hundred and twenty eight patients (12$\%$) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally Poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Conclusion : Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting.

방사선 조사된 흰쥐에서 고단백식이와 레스베라트롤 첨가가 영양상태 및 면역기능 증진에 미치는 효과

김경옥(Kim Kyoung-Ok),전미선(Chun Mison),강승희(Kang Seunghee),김현숙(Kim Hyun-Sook) 韓國營養學會 2009 Journal of Nutrition and Health Vol.42 No.7

Most cancer patients are treated with surgery, chemotherapy or radiation as anticancer therapies. Especially in the case of radiation, these treatments produce adverse effects such as vomiting, weight loss, anorexia, normal cell damage and malabsorption. The major goal of this study was to determine the effect of irradiation on the nutritional and immune status in irradiated rats. A secondary goal was to determine the effectiveness of high protein diet (HP) and resveratrol (Res) in minimizing the adverse effects of radiation. Rats were divided into four groups: normal diet (NP), HP, NP + Res and HP + Res groups. Each group was further divided into subgroups that received radiation (RT group) and one that did not (non-RT group). Each diet was supplied from 12<SUP>th</SUP> day prior to irradiation treatment with irradiation dose of 17.5 Gy. The diets were continued until 10th day after radiation treatment and animals were sacrificed. The radiation treatment showed decreased body weight, serum protein and HDL levels and increased TG and LDL levels in nutritional status. HP, NP + Res and HP + Res groups reduced the level of serum LDL and TG in irradiated rats. NP + Res and HP + Res groups increased reduced albumin level of serum in RT group. In case of immune status, the radiation treat-ment showed decreased WBC, lymphocytes and increased neutrophil and eosinophil levels. The levels of serum IL-2 and IL-6 were significantly increased by radiation, however the cytokine levels decreased in all dietary treatment groups. These results showed that high protein diet and resveratrol supplementation seem to minimize the adverse effects of radiation on lipid nutritional status and inflammation response in the rat model.

초기 후두암의 치료

최건,채성원,박호정,정광윤,최종욱,Choi, Geon,Chae, Sung-Won,Park, Ho-Jung,Jung, Kwang-Yoon,Choi, Jong-Ouck 대한기관식도과학회 1998 大韓氣管食道科學會誌 Vol.4 No.1

Background: Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods: Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II:37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II:18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.

Optimization of treatment planning workflow and tumor coverage during daily adaptive magnetic resonance image guided radiation therapy (MR-IGRT) of pancreatic cancer

Olberg, Sven,Green, Olga,Cai, Bin,Yang, Deshan,Rodriguez, Vivian,Zhang, Hao,Kim, Jin Sung,Parikh, Parag J.,Mutic, Sasa,Park, Justin C. BioMed Central 2018 Radiation oncology Vol.13 No.-

<P><B>Background</B></P><P>To simplify the adaptive treatment planning workflow while achieving the optimal tumor-dose coverage in pancreatic cancer patients undergoing daily adaptive magnetic resonance image guided radiation therapy (MR-IGRT).</P><P><B>Methods</B></P><P>In daily adaptive MR-IGRT, the plan objective function constructed during simulation is used for plan re-optimization throughout the course of treatment. In this study, we have constructed the initial objective functions using two methods for 16 pancreatic cancer patients treated with the ViewRay™ MR-IGRT system: 1) the conventional method that handles the stomach, duodenum, small bowel, and large bowel as separate organs at risk (OARs) and 2) the OAR grouping method. Using OAR grouping, a combined OAR structure that encompasses the portions of these four primary OARs within 3 cm of the planning target volume (PTV) is created. OAR grouping simulation plans were optimized such that the target coverage was comparable to the clinical simulation plan constructed in the conventional manner. In both cases, the initial objective function was then applied to each successive treatment fraction and the plan was re-optimized based on the patient’s daily anatomy. OAR grouping plans were compared to conventional plans at each fraction in terms of coverage of the PTV and the optimized PTV (PTV OPT), which is the result of the subtraction of overlapping OAR volumes with an additional margin from the PTV.</P><P><B>Results</B></P><P>Plan performance was enhanced across a majority of fractions using OAR grouping. The percentage of the volume of the PTV covered by 95% of the prescribed dose (D<SUB>95</SUB>) was improved by an average of 3.87 ± 4.29% while D<SUB>95</SUB> coverage of the PTV OPT increased by 3.98 ± 4.97%. Finally, D<SUB>100</SUB> coverage of the PTV demonstrated an average increase of 6.47 ± 7.16% and a maximum improvement of 20.19%.</P><P><B>Conclusions</B></P><P>In this study, our proposed OAR grouping plans generally outperformed conventional plans, especially when the conventional simulation plan favored or disregarded an OAR through the assignment of distinct weighting parameters relative to the other critical structures. OAR grouping simplifies the MR-IGRT adaptive treatment planning workflow at simulation while demonstrating improved coverage compared to delivered pancreatic cancer treatment plans in daily adaptive radiation therapy.</P>

Radiation recall dermatitis induced by tamoxifen during adjuvant breast cancer treatment

Jiyoung Rhee,MD,Gwi Eon Kim,MD,Chang Hyun Lee,MD,Jung-Mi Kwon,MD,Sang-Hoon Han,MD,Young Suk Kim,MD,Woo-Kun Kim,MD 대한방사선종양학회 2014 Radiation Oncology Journal Vol.32 No.4

Tamoxifen and radiotherapy are used in breast cancer treatment worldwide. Radiation recall dermatitis (RRD), induced by tamoxifen, has been rarely reported. Herein, we report a RRD case induced by tamoxifen. A 47-year-old woman had a right quadrantectomy and an axillary lymph node dissection due to breast cancer. The tumor was staged pT2N0; it was hormone receptor positive, and human epidermal growth factor receptor 2 negative. The patient received adjuvant chemotherapy followed by tamoxifen and radiotherapy. After 22 months of tamoxifen, the patient developed a localized heating sensation, tenderness, edema, and redness at the irradiated area of the right breast. The symptoms improved within 1 week without treatment. Three weeks later, however, the patient developed similar symptoms in the same area of the breast. She continued tamoxifen before and during dermatitis, and symptoms resolved within 1 week.

Treatment Outcomes and Quality of Life in Oropharyngeal Cancer after Surgery-based versus Radiation-based Treatment

김태욱,Hye-Youn Youm,Hayoung Byun,손영익,백정환 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.3

Objectives. Advances in reconstruction and conservative surgery and the importance of quality of life (QOL) encouraged this reevaluation of surgery-based treatments for oropharyngeal cancer. We tried to compare treatment outcome and QOL after surgery-based versus radiation-based treatment in oropharyngeal cancer. Methods. The 133 eligible patients were divided into surgery-based and radiotherapy (RT)-based treatment groups. Medical records were reviewed, and EORTC QLQ-C30 and HN65 questionnaires were completed for survivors. Three-year overall survivals, disease-free survivals, locoregional control rates, and QOL scores were compared between the two groups. Results. Demographic data and overall stages were not significantly different between the two groups, and all survival rates were non-significantly different, either. The scores for most QOL items were equivalent, however, for a few items,scores were significantly better in surgery-based group. Conclusion. The surgery-based group achieved equivalent treatment outcomes and slightly better QOL scores than the RT-based group. The results of this study suggest that surgery could still be considered as a first-line therapy for oropharyngeal cancer.

Radiation recall dermatitis induced by tamoxifen during adjuvant breast cancer treatment

Rhee, Jiyoung,Kim, Gwi Eon,Lee, Chang Hyun,Kwon, Jung-Mi,Han, Sang-Hoon,Kim, Young Suk,Kim, Woo-Kun The Korean Society for Radiation Oncology 2014 Radiation Oncology Journal Vol.32 No.4

Tamoxifen and radiotherapy are used in breast cancer treatment worldwide. Radiation recall dermatitis (RRD), induced by tamoxifen, has been rarely reported. Herein, we report a RRD case induced by tamoxifen. A 47-year-old woman had a right quadrantectomy and an axillary lymph node dissection due to breast cancer. The tumor was staged pT2N0; it was hormone receptor positive, and human epidermal growth factor receptor 2 negative. The patient received adjuvant chemotherapy followed by tamoxifen and radiotherapy. After 22 months of tamoxifen, the patient developed a localized heating sensation, tenderness, edema, and redness at the irradiated area of the right breast. The symptoms improved within 1 week without treatment. Three weeks later, however, the patient developed similar symptoms in the same area of the breast. She continued tamoxifen before and during dermatitis, and symptoms resolved within 1 week.

Why Do Pat ients Drop Out During Radiat ion Therapy?

허승재(Seung Jae Huh),우홍균(Hong Gyun Wu),안용찬(Yong Chan Ahn),김용대(Dae Yong Kim),신경환(Kyung Hwan Shin),이규찬(Kyu Chan Lee),정원아(Won A Chong),김현주(Hyun Joo Kim) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.3

목 적 : 본 연구는 계획된 방사선치료의 과정 도중에 방사선치료를 완료하지 못하는 환자들의 빈도를 조사하고 그 이유를 분석하고자 하였다. 대상 및 방법 : 삼성서울병원 치료방사선과에서 방사선치료를 받은 환자 중에서 1996년 4월부터 1997년 5월까지 방사선치료를 시행 받은 1,100명의 환자들을 대상으로 하였다. 대상 환자들 중에서 최초 계획 방사선량의 95% 이하를 받은 경우를 불완전 방사선치료로 정의하여 그 빈도와 이유를 조사하였다. 결 과 : 불완전 방사선치료의 빈도는 1,100명 중 128명으로 12%였다. 불완전 방사선치료 환자들의 운동수행능력은 전체 환자들에 비하여 불량하였으며, 방사선치료의 목적은 고식적 목적이 많았다. 불완전 방사선치료의 가장 흔한 이유는 환자의 거부였으며 이는 주로 환자의 방사선치료에 대한 불신과 경제적 부담 때문이었다. 결 론 : 불완전 방사선치료의 빈도를 줄이기 위해서는 방사선치료의 임상적 적응 여부는 물론 환자의 사회 경제적인 여건을 잘 고려하여 방사선치료의 대상 환자를 선정하는 것이 요망되며 이는 특히 고식적 방사선치료의 경우에 더욱 중요하다고 할 수 있겠다. Purpose : This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. Materials and Methods : The base population of this study was 1,100 patients with registration numbers 901th ro ugh 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors inves-tigated the incidence of incomplete radiation therapy, which was defined as less than 95% of initially planned radiation d ose, and the reasons for incomplete radiation therapy. Results : One hundred and twenty eight patients(12%) did not complete the planned radiation therapy. The perfo rmance status of the incompletely treated patients was generally poorer than that of the base population, and the aim of radiation therapy was more commonly palliative . The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status . Conclusion : Careful case selection for radiation therapy with consideration of the socio economic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatme nt, especially in the palliative setting.

Metastatic bone disease: current concepts of clinicopathophysiology and modern surgical treatment

Frassica,D A,Frassica,F J,Sim,F H 가톨릭중앙의료원 가톨릭암센터 1997 암심포지움 Vol.- No.1

Metastatases to bone are a common problem confronting both the orthopaedic oncologist and cancer specialists. Early diagnosis requires a knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells in via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that is durable and functional. Non-operative treatment is utilised for small lesions (less than 25 percent of the cortical diameter). Radiotherapy (generally 3000 cGy in ten fractions), patient education (to avoid excessive torsional loads), and systemic chemotherapy or hormonal therapy are the mainstays of non-operative treatment. The indications for surgical treatment include: (1) lesions greater than 50 percent the diameter of the cortex, (2) permeative lesions in high stress areas (subtrochanteric region of the hip, mid-femoral diaphysis, mid humeral metaphysis), and (3) lesions in which pain persists following external beam irradiation. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. A knowledge of the pathogenesis and pathophysiology aids the clinician in making an early diagnosis.

가루깍지벌레에 대한 이온화에너지 처리 살충 효과

고성현 ( Sung Hyun Ko ),권기면 ( Gi Myon Kwon ),전용호 ( Yong Ho Jeon ),정철의 ( Chul Eui Jung ) 한국토양동물학회 2013 한국토양동물학회지 Vol.17 No.1

Since 2004, methyl bromide which is the most potent chemical fumiant applied in quarantine pest control began banned in many countries. Gamma radiation has proved as a technically feasible alternative to the conventional method of chemical control of many fresh fruits and vegetables in quarantine. We tested the effects of gamma radiation on the life stages of comstock mealybug. In the first trial, eggs, nymphs and adults were irradiated with increasing dose of gamma radiation (0, 50, 200, 400, 800 Gy). Then the second trial was made at 0, 200, 400, 1000, 2000 Gy. All experiments were conducted in the temperature controlled room at 25±1℃, 65±10% RH. Eggs were susceptible at all treatments. However mortality of nymphs and adults were shown only in high dose treatments (<1000 Gy). Further research on nymphal development and adult fecundity is required to fully understand the effect of the gamma radiation on the comstock mealybug.