담도암의 방사선치료

성진실,이익재 대한췌장담도학회 2005 대한췌담도학회지 Vol.10 No.2

구연 : 랫드 간장에서 프로테오믹스 분석에 의한 방사선 유도성 변화

성진실,김성희,안정희,박의철,윤종복 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.3(S)

배경/목적: 간암의 치료에 전리방사선의 이용이 확대되면서 그 효과 뿐만 아니라, 방사선에 의한 정상간의 손상에 대한 관심이 높아지고 있다. 방사선에 의한 간 손상은 방사선성 간염이 주요 독성으로 알려져 왔으나, 주로 결과론적인 형태나 기능적 변화에 제한적으로 알려져 있다. 최근 새로운 분자생물학적 연구 기법, 즉 high throughput 기술의 등장으로 이 분야에 대하여 새로운 접근의 연구가 필요하게 되었다. 본 연구에서는 방사선에 의한 정상 간의 변화를 프로테오믹스라는 신기술을 이용하여 기전적인 규명을 하고자 하였다. 대상과 방법 : 랫드에 25 Gy의 방사선을 조사한 후, 1시간부터 28일까지 간장을 채취하였다. 간장에서 추출된 단백질을 9-18%의 SDS gel에서 2D electrophoresis를 실시하고 PD Quest 2-D software를 이용하여 image를 분석하였다. 이 때 발현의 변화를 보이는 단백질을 trypsin으로 digestion 처리하여 MALDI-TOF로 측정한 후 이 data를 NCBI와 Swiss-prot database에서 단백질을 확인하였다. 결과: 최소 60개 이상의 단백질이 방사선조사 후 유의한 양적인 변화를 보였으며, 이 중 47개의 단백질을 동정하였다. 이들은 방사선에 의한 DNA 손상 신호전달계, 반응성 산소계 대사, 염증반응 등에 관련되는 일련의 물질들을 포함하고 있어, 방사선에 의한 간장의 반응이 분자 수준에서 매우 복잡하게 연계된다는 것을 알 수 있었다. 결론: 방사선에 의한 간 손상을 프로테오믹스 기술로 분석한 결과 다양한 종류의 단백질들이, 여러 가지의 분자 신호전달에 관여하는, 복합적인 현상이 관찰되었다. 이는 기존의 연구 시야를 확장시켜주는 동시에 손상에 대한 표적 물질을 인식하고 대처 방안을 개발하는 데 기초 자료로 이용될 수 있을 것으로 본다.

간암의 간외 전이에서 방사선 치료의 효과

성진실 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.5(S)

춘계학술대회 발표 : 포스터전시 ; 간경변증 동물모델에서 방사선에 대한 간손상의 프로테오믹스 분석

성진실,안정희,오해진,김원우,정숙인,백용한,한광협 대한간학회 2006 Clinical and Molecular Hepatology(대한간학회지) Vol.12 No.3(S)

Challenge and Hope in Radiotherapy of Hepatocellular Carcinoma

성진실 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.5

Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease. The tumor stage and underlying liver function are both major determinants of the treatment selection as well as prognosis in HCC patients, thus allowing no more than a 20% chance for potentially curative therapies. Radiotherapy technology has been evolved remarkably during the past decade, and radiation can be precisely delivered, thereby permitting higher doses to the tumour and reduced doses to surrounding normal tissues. There has been increasing interest in the merits of radiotherapy in HCC over the past few years, as indicated by a Pub Med search. Radiotherapy has been used as the definitive therapy with curative intent in early stage tumours. It has been used also in combination with TACE for intermediate stage tumours. In locally advanced tumours, radiotherapy has been combined with systemic agents. Despite its efficacy, radiotherapy has not yet been incorporated into the standard management guidelines of HCC. The lack of high evidence level data, especially randomized controlled trials, has posed an obstacle in including radiotherapy into the routine treatment schema of HCC. Therefore, well-designed prospective studies are strongly recommended using developing technology for radiotherapy alone or combination therapies. Also, many issues such as the optimal dose-fractionation, intra- or extrahepatic metastasis after radiotherapy, and radiation-induced hepatic dysfunction remain to be solved. In this review, current status of radiotherapy for HCC will be discussed with regard to technical consideration and combination strategy. The limitation and future perspectives will also be discussed. Hepatocellular carcinoma (HCC) is one of the most critical global health issues. With frequent association of viral liver disease, HCC is highly complex, harboring both cancer and chronic liver disease. The tumor stage and underlying liver function are both major determinants of the treatment selection as well as prognosis in HCC patients, thus allowing no more than a 20% chance for potentially curative therapies. Radiotherapy technology has been evolved remarkably during the past decade, and radiation can be precisely delivered, thereby permitting higher doses to the tumour and reduced doses to surrounding normal tissues. There has been increasing interest in the merits of radiotherapy in HCC over the past few years, as indicated by a Pub Med search. Radiotherapy has been used as the definitive therapy with curative intent in early stage tumours. It has been used also in combination with TACE for intermediate stage tumours. In locally advanced tumours, radiotherapy has been combined with systemic agents. Despite its efficacy, radiotherapy has not yet been incorporated into the standard management guidelines of HCC. The lack of high evidence level data, especially randomized controlled trials, has posed an obstacle in including radiotherapy into the routine treatment schema of HCC. Therefore, well-designed prospective studies are strongly recommended using developing technology for radiotherapy alone or combination therapies. Also, many issues such as the optimal dose-fractionation, intra- or extrahepatic metastasis after radiotherapy, and radiation-induced hepatic dysfunction remain to be solved. In this review, current status of radiotherapy for HCC will be discussed with regard to technical consideration and combination strategy. The limitation and future perspectives will also be discussed.

Adaptive Response to ionizing Radiation Induced by Low Doses of Gamma Rays in Human Lymphoblastoid Cell Lines

성진실,서창옥,김귀언,Seong, Jin-Sil,Suh, Chang-Ok,Kim, Gwi-Eon The Korean Society for Radiation Oncology 1994 대한방사선종양학회지 Vol.12 No.1

When cells are exposed to low doses of a mutagenic or clastogenic agents. they often become less sensitive to the effects of a higher dose administered subsequently. Such adaptive responses were first described in Escherichia coli and mammalian cells to low doses of an alkylating agent. Since most of the studies have been carried out with human lymphocytes, it is urgently necessary to study this effect in different cellular systems. Its relation with inherent cellular radiosensitivity and underlying mechanism also remain to be answered. In this study, adaptive response by 1 cGy of gamma rays was investigated in three human lymphoblastoid cell lines which were derived from ataxia telangiectasia homozygote, ataxia telangiectasia heterozygote, and normal individual. Experiments were carried out by delivering 1 cGy followed by 50 cGy of gamma radiation and chromatid breaks were scored as an endpoint. The results indicate that prior exposure to 1 cGy of gamma rays reduces the number of chromatid breaks induced by subsequent higher dose (50 cGy), The expression of this adaptive response was similar among three cell lines despite of their different radiosensitivity. When 3-aminobenzamide, an inhibitor of poly (ADP-ribose) polymerase, was added after 50 cGy, adaptive responses were abolished in all the tested cell lines. Therefore it is suggested that the adaptive response can be observed in human lymphoblastoid cell lines, which was first documented through this study. The expression of adaptive response was similar among the cell lines regardless of their radiosensitivity. The elimination of the adaptive response by 3-aminobenzamide is consistent with the proposal that this adaptive response is the result of the induction of a certain chromosomal repair mechanism.

편도선 암의 방사선 치료

성진실,김수곤,서창옥,김귀언,노준규,Seong J. S.,Kim S. G.,Suh C. O.,Kim G. E.,Loh J. K. The Korean Society for Radiation Oncology 1986 Radiation Oncology Journal Vol.4 No.1

1971년 1월부터 1980년 12월까지 연세암센터에서 방사선치료를 받은 36예의 편도선암 환자군을 대상으로 후향성 분석을 통해 임상적 고찰 및 치료결과를 살펴 보았다. 환자의 $75\%$는 초진시 이미 진행된 병기에 속하였고, 청부 임파절 전이율은 $64\%$였다. 환자의 $19\%$에서는 양측성 경부 임파절 전이가 있었다. 3년 국소치유율은 $T_1$에서 $88\%$, $T_2$에서 $46\%$, $T_3$에서 $25\%$였고 $T_4$에서는 $11\%$에 불과했다. 경부 임파절 전이의 치유율은 $N_0\;와\;N_1$인 경우가 $87\%$였고 $N_2\;와\;N_3$에서 $16\%$로서 뚜렷한 차이를 보였다. 원발병소와 경부 임파절 전이의 정도가 심할수록 예후가 좋지 않았고 전 환자의 3년 국소치유율은 $42\%$였다. Thirty-six patients with carcinoma of the tonsillar region treated with radical radiotherapy at Yonsei Cancer Center between Jan. 1971 and Dec. 1980 were retrospectively reviewed. The purpose of this study is to evaluate the clinical characteristics and the treatment results. Seventy-five per cent of patients were in advanced stage when they were first seen. Incidence of nodal involvement at the time of initial presentation was $64\%$. Bilateral nodal involvement was found in $19\%$ of cases. Three-year local control rates for T1, T2, T3, and T4 were $88\%,\;46\%,\;25\%,\;and\;11\%$, respectively. Advanced neck nodes were poorly controlled $(N1\;70\%,\;N2\;20\%,\;N3\;12\%)$. The prognosis is mainly affected by the status of the primary and neck nodes Overall three-year local control rate was $42\%$.

암치료에서 방사선 치료의 새로운 시도

성진실 대한외과학회 2002 대한외과학회 학술대회 초록집 Vol.2002 No.10

담낭암의 방사선 치료

성진실 대한췌담도학회 2004 대한췌담도학회지 Vol.9 No.1

춘계학술대회 : 구연 ; 간암 : 진행성 간암에 대한 방사선 요법의 pattern of care study -진행성 간암의 표준 치료지침 개발을 위한 대한 간암 연구회 공동 임상 연구-

성진실,심수정,임도훈,김태현,김종훈,장홍석,김미숙,지의규,김진희,남택근,이형식,한철주 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.3(S)