Quantitative Analysis of DNA Single-strand Breaks in EL 4 cells and Mouse Spleen Lymphocytes after Irradiation

류성렬,조철구,고경환,박우윤,박영환,김성호,김태환,정인용,Yoo Seong Yul,Cho Chul Koo,Koh Kyung Hwan,Park Woo Yoon,Park Young Hwan,Kim Sung Ho,Kim Tae Hwan,Chung In Yong The Korean Society for Radiation Oncology 1990 Radiation Oncology Journal Vol.8 No.2

Filter elution 방법으로 EL 4백서 백혈병 세포 및 C57BL/6백서 유래의 비장 임파구에 대한 Co-60 $\gamma$ 선의 DNA single-strand breaks (SSB) 효과를 정량적으로 측정하였다. 임파구는 [${^3}H$]thymidine을 표지하기 위하여lipopolysaccharide (LPS, 20 $\mug/ml$)를 첨가하여 자극하고 부유 상태의 EL 4 세포 및 임파구를 $0^{\circ}C$에서 0 Gy, 1 Gy, 5 Gy, 10 Gy 또는 15 Gy조사하였으며, elution용액의 pH는 12.1로 하였다. $\gamma$ 선 조사에 따른 single-strand breaks의 수는 방사선 조사량에 따라 증가 하였으며 21 ml elution 양을 기준으로 한 strand scission factor (SSF)는 EL 4 세포에서 $0.01301\pm0.00096\;Gy^{-1}(n=5)$이었고, 임파구는 $0.01097\pm0.00091\;Gy^{-1}(n=5)$를 나타내므로 본 실험에서는 EL 4 세포가 정상 임파구에 비하여 방사선에 의한 DNA SSB가 민감함을 알 수 있었다(p<0.005). 본 연구 결과 DNA strand breaks의 측정법을 이용하여 방사선의 특성 및 생물학적 효과의 파악은 물론 나아가 기존의 방호제 및 새로운 약제의 DNA에 대한 효과를 판별할 수 있을 것이다. The filter elution technique was used to assay Co-60 $\gamma$ ray-induced DNA single-strand breaks(SSB) in EL 4 mouse leukemia cell and mouse spleen lymphocyte. The lymphocytes were stimulated with lipopolysaccharide (LPS, 20 $\mug/ml$) to label [${^3}H$] thymidine. EL 4 cells and lymphocytes in suspension were exposed at $0^{\circ}C$ to 0 Gy, 1 Gy, 5 Gy,10 Gy of Co-60 radiation and elution procedure was performed at PH 12.1. The number of DNA single-strand breaks increased with increasing doses of $\gamma$ rays. The strand scission factor (SSF) was estimated in each experiment (eluted volume 21 ml). The slope for EL 4 cells was $0.01301\pm0.00096\;Gy^{-1}(n=5)$ and the slope for lymphocytes was $0.01097\pm0.00091\;Gy^{-1}(n=5)$. The slopes were significantly different (P<0.005). Thus EL 4 cells were more sensitive to induction of DNA SSB by ionizing radiation than lymphocytes.

근접방사선조사에 의한 두경부암의 치료

류성렬,Yoo, Seong-Yul 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.3

치료선량의 증가와 주위 정상조직의 보호의 의미에서 근접치료의 효과는 입증되어 있다. 그러나 우리 나라에서는 아직 통상치료법으로 상용화가 되어 있지 않다. 저자는 저선량률 이리디움 근접조사치료의 임상적 경험을 바탕으로 두경부암에서의 근접조사치료의 역사, 사용되는 동위원소의 재원 및 특성, 시행 시 고려 하여야할 사항, 임상기술적인 문제, 방사선물리학적 문제 등을 검토하였고 저자의 임상 경험 185례의 치료성적을 분석하여 그 효과를 검증하였고 마지막으로 향후 발전방향을 제시하여 보았다. Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Seondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed.

The RBE of Fractionated Fast Neutron on Walker 256 Carcinosarcoma with KCCH-Cyclotron

류성렬,고경환,조철구,박찬일,강위생,Yoo, Seong-Yul,Koh, Kyoung-Hwan,Cho, Chul-Koo,Park, Charn-Il,Kang, Wee-Saing The Korean Society for Radiation Oncology 1987 Radiation Oncology Journal Vol.5 No.2

원자력병원 싸이클로트론으로 발생되는 고에너지 속중성자선의 생물학적효과에 대한 연구의 일환으로 RBE를 측정하였다. 대상은 Walker 256 carcinosacoma 및 정상조직으로 마우스 위장관 및 골수를 이용하였고 단일 및 분할조사에 대한 반응을 관찰하였다. 마우스 공장소낭선세포의 단일전신조사에 의한 RBE는 2.8이었다. 단일조사시 이식암 Walker 250의 TCD 50에 대한 RBE, 마우스 골수 및 위장관의 RBE는 각각 1.9, 1.9, 1.5이었다. 분할조사시 Walker 256의 RBE는 분할횟수의 증가에 따라 감소하였고 1회 분할조사량의 증가에 따라 증가하였다. For evaluation of biological effect of $p^+(50.5MeV)$ Be neutron beam produced by Korea Cancer Center Hospital (KCCH) cyclotron the RBE had been measured in experimental tumor Walker 256 carcinosarcoma as well as normal tissue, mouse intestine and bone marrow, in single and fractionated irradiation. As pilot study, the RBE had been measured for the mouse jejunal crypt cells in single whole body irradiation of which the result was 2.8. The obtained RBE values of TCD 50 of Walker 256 tumor, bone marrow and intestine En single irraiation were 1.9, 1.9 and 1.5 respectively. In fractionated irradiation, the RBE value of tumor Walker 256 was decreased as increasing of fraction number and increased as increaing of fraction size.

Dosimetric Characteristics of the KCCH Neutron Therapy Facility

류성렬,노성우,정현우,조철구,고경환,박주식,줄리 인마,Yoo Seong Yul,Noh Sung Woo,Chung Hyun Woo,Cho Chul Koo,Koh Kyoung Hwan,Bak Joo Shik,Eenmaa Juri The Korean Society for Radiation Oncology 1988 Radiation Oncology Journal Vol.6 No.1

한국에너지연구소 원자력병원 싸이클로트론에 의해 생산되는 중성자를 임상에 적용시키기 위해, 이의 물리적 특성을 알기 위하여 방사선선량 측정실험을 시행하였다. 여기서 얻은 결과를 외국의 다른 치료기관에서 얻은 데이타와 비교 분석하였다. 중심축 선상의 심부선량백분율, build-up곡선, open과 쐐기등선량 곡선의 값이 4MV와 6MV X-ray값의 중간에 위치하였다. 최대선량의 build-up은 피부아래 1.35cm에 위치했으며 입사 선량은 약 $40\%$였다. 출력인자는 $6\times6cm$의 조사야에서 0.894, $30\times30cm$의 조사야에서는 1.187이었다. 중성자선의 X-ray오염도는 $10\times10cm$ 조사야에서 심부 2cm에서 $4.9\%$였다. For the physical characterization of neutron beam, dosimetric measurements had been performed to obtain physical data of KCCH cyclotron-produced neutrons for clinical use. The results are presented and compared with the data of other institutions from the literatures. The central axis percent depth dose, build-up curves and open and wedge isodose curve values are intermediate between that of a 4 and 6 MV X-rays. The build-up level of maximum dose was at 1.35cm and entrance dose was approximately $40\%$. Flatness of the beam was $9\%$ at Dmax and less $than{\pm}3\%$ at the depth of $80\%$ isodose line. Penumbra begond the $20\%$ line is wider than corresponding photon beam. The output factors ranged 0.894 for $6\times6cm$ field to 1.187 for $30\times30cm$ field. Gamma contamination of neutron beam was $4.9\%$ at 2 cm depth in $10\times10cm$ field.

성문암 방사선치료 15년 성적

류성렬(Seong Yul Yoo),고경환(Kyoung Hwan Koh),서성희(Sung Hee Suh),김진용(Chin Yong Kim),심윤상(Youn Sang Shim) 대한방사선종양학회 1985 Radiation Oncology Journal Vol.3 No.1

To assess the result of radiation therapy for fifteen years experience, a total of 81 cases of pathologically proven vocal cord cancer had been analysed according to patient survival retrospectively. All the patients had been treated with radiation therapy using Co-60 teletherapy unit in curative aim. The results are as follows ; 1. According to AJCC staging, (ive year survival rate was 75.0% in stage I, 73.1% in stage II, 36.0% in stage III, and 20.0% in stage IV. 2. According to T-staging, five year survival rate was 75.0% in T1, 73.1% in T2, 24.3% in T3, and 25.0% in T4. 3. According to nodal status, five year survival rate was 59.4% in negative node group and 14.2% in positive group. 4. According to the histologic grade, the better in differentiation, the more in number of cases and the better in prognosis. 5. In summary, five year actuarial survival rate was 55.5% and ten year survival rate was 49.8% and ten year survivors totalled 12 cases.

타액선 종양의 방사선치료

류성렬(Seong Yul Yoo) 대한두경부종양학회 1993 대한두경부 종양학회지 Vol.9 No.1

Surgery has been known to be traditional treatment modality for the malignant salivary gland tumor. the tumors being considered as radioresistant. However. reviews of the literature have shown a high recurrence rate. especially in advanced and/or high grade tumors. The retrospective data suggests that conservative surgery with adjunctive radiation therapy is justified in view of the enhanced locoregional control. In inoperable and recurrent tumor. definitive radiotherapy can achieve 30-40 3 of average 5 year survival rate, but in early stage, local control and survival rate could be raised more than 80 3. This results shown to be aggressive radiotherapy can replace surgical management for the selected cases of small sized tumor. Neutron therapv is another option for curative treatment of malignant salivary gland tumors.

수술불능 및 재발성 직장암에 대한 중성자선 치료

류성렬 (Seong Yul Yoo),고경환 (Kyoung Hwan Koh),조철구 (Chul Koo Cho),박우윤 (Woo Yun Park),윤형근 (Hyong Geun Yun),심재원 (Jae Won Shim) 대한방사선종양학회 1993 Radiation Oncology Journal Vol.11 No.1

Total of 53 patients of unresectable and recurrent rectal cancer treated with neutron beam during the period from Oct. 1987 to Apr. 1992 were analyzed. Dose fractionation for the neutron only group was 1.5 Gy per fraction, 3 fraction per week, 21 Gy/4¹/₂ wks for 42 patients out of 53 (76%). Neutron only but modified fractionation schedule (10% more or less of total dose) was applied for 9 patients, and mixed beam (neutron boost) was for 4 patients. Complete tumor response was obtained in 40 patients (76% response rate). Local control rate was 28 out of 53 (53%). Statistically significant better prognostic factors for local control were age below 49 years old (15/22, 68%) than above 50 years old (13.31, 42%), male (20/32, 63%) than female (8/21, 38%), tumor size less than 5 cm and non-metastatic (16/24, 67%) than size more than 5 cm or metastatic (12/29, 41%). Major complication had developed in 7 patients (13%). Two year overall survival rate by Kaplan-Meier method was 30%, but it was rised to, 47% when the tumor was less than 5 cm non-metastatic.

근접방사선조사에 의한 두경부암의 치료

류성렬(Seong Yul Yoo) 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.2

치료선량의 증가와 주위 정상조직의 보호의 의미에서 근접치료의 효과는 입증되어 있다. 그러나 우리나라에서는 아직 통상치료법으로 상용화가 되어 있지 않다. 저자는 저선량률 이리디움 근접조사치료의 임상적 경험을 바탕으로 두경부암에서의 근접조사치료의 역사, 사용되는 동위원소의 제원 및 특성, 시행 시 고려하여야할 사항, 임상기술적인 문제, 방사선물리학적 문제 등을 검토하였고 저자의 임상 경험 185례의 치료성적을 분석하여 그 효과를 검증하였고 마지막으로 향후 발전방향을 제시하여 보았다. Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrene. Seondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the fu ture prospect of brachytherapy of head and neck cancer is discussed.

두경부암의 근접방사선 치료

류성렬(Seong Yul Yoo) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.1

Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. The main characteristics of brachytherapy are delivering of higher dose to target volume shortening of total treatment period and sparing of normal tissue. Recent development of iridium ribbons for low dose rate implant provides improvement of technology of brachytherapy in terms of safety and efficiency. High dose rate method. on the other hand, is effective to avoid unnecessary expoure of medical personnel.

Correlation Between Response to Induction Chemotherapy and Subsequent Radiotherapy in Previously Untreated Patients with Squamous Cell Carcinomas of the Head and Neck

박우윤,류성렬,고경환,조철구,박영환,심윤상,오경균,이용식,Park Woo Yoon,Yoo Seong Yul,Koh Kyoung Hwan,Cho Chul Koo,Park Young Hwan,Shim Youn Sang,Oh Kyung Kyoon,Lee Yong Sik The Korean Society for Radiation Oncology 1990 Radiation Oncology Journal Vol.8 No.2

유도화학요법과 방사선치료후 종양 관해의 상호 관련성을 파악하고자 1986년부터 1989년까지 원자력병원에서 소정의 충분한 유도화학요법과 근치적 방사선치료를 받은 국소적으로 진행된 두경부 악성종양 환자 60예에 대한 후향적 분석을 시도하였다. 유도화학요법은 CDDP를 기본으로한 복합요법을 2 내지 3회 시행한바, 20예에서 Bleomycin+CDDP(BP), 37예에서 5-FU+CDDP(FP), 그리고 3예에서 BP/FP의 교대요법을 시행하였으며, 방사선은 병소에 따라서 65 Gy 내지 75 Gy 또는 그이상을 조사하였다. 유도화학요법에 의한 종양의 관해율은원발병소에서는 $80\%$(48/60), 경부임파절에서는 $79\%$(31/39)였으며, 약제, T-병기, 그리고 N-병기에 의한 통계적 유의성은 관찰되지 않았다. 방사선조사 6개월후 원발부위에서는 $67\%$(40/60)의 완전관해를, 경부임파절에서는 $77\%$(30/39)의 완전관해를 보인바, 이를 유도화학요법에 의한 관해 유무에 따른 차이를 분석한 결과 원발부위에서는 유도화학요법에 의한 관해(완전관해 또는 부분 관해)를 얻었던 48예중 39예에서 완전관해를 얻었으나($81\%$), 관해를 얻지못한 12예에서는 1예에서만이 방사선 치료에 의해 완전관해를 얻을 수 있었으며 ($8\%$) (p<0.0005), 경부임파절에서는 유도화학요법에 의해 관해를 얻었던 32예중 28예에서 완전관해를 얻은 반면 ($90\%$), 관해를 얻지 못한 8예에서는 2예에서만이 방사선 치료에 의해 완전관해를 얻을 수 있었던바($25\%$) (p<0.001), 모두 통계적으로 유의한 차이를 보였다. 한편 이를 원발부위, T-병기 그리고 N-병기에 따라 분석해본 결과, 특히 T-병기중 T3, 4에서는 유의한 차이가 관찰되었으나(p<0.0005), T1, 2에서는 유의한 차이가 관찰 되지 않았다(0.3<p), 따라서 유도화학요법과 방사선치료에 의한 종양의 관해 정도는 대체적으로 상호연관성이 관찰되고 있으나, 초기 병변에서는 이러한 현상이 관찰되지 않는바 유도화학요법에 의해 관해가 없더라도 방사선 치료에 의해 완전관해를 얻을 수 있을 것이다. To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course ($2\~3$ cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administeredd with CDDP+Bleomycin (BP) in 20, CDDP+5-FU (FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was giver conventionally with a dose of 65 to 75 Gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were $80\%$ for the tumors and $879\%$ for the nodes whereas complete reponse rates were $12\%\;and\;13\%$, respectively. Six months after radiotherapy $67\%$ of the tumors and $77\%$ of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy,39 ($81\%$) and 28 ($90\%$), respectively, achieved complete response after radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p<0.0005 in tumor, p<0.0001 in node). By reanalyzing according to disease subsets (i.e. primary site, T-stage, N-stage) this relationship was not observed at T1-T2 disease (p>0.3). Therefore the tumor or node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-T2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in $T_1-T_2$ tumors.