Stage I and II Waldeyer's Ring and Sinonasal Non-Hodgkin's Lymphoma

표홍렬,김우철,서창옥,김귀언,김병수,노재경 대한두경부종양학회 1993 대한두경부종양학회 학술대회 논문집 Vol.1993 No.1

뇌종양 환자의 3차원 입체조형 치료를 위한뇌내 주요 부위의 모델치료계획의 개발

표홍렬,이상훈,김귀언,금기창,장세경,서창옥 대한방사선종양학회 2002 Radiation Oncology Journal Vol.20 No.1

경부 유건종(Desmoid Tumor)의 방사선치료

표홍렬(Hong Ryull Pyo),신현수(Hyun Soo Shin),김귀언(Gwi Eon Kim),박정수(Cheong Soo Park) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.1

A 66 years old female who had a huge desmoid tumor on her left neck was treated by partial excision and postoperative irradiation. Detailed summary of this rare tumor are included with a review of the literature about treatment modality including irradiation. We suggest that local irradiation is one of the effective treatment tools in the management of desmoid tumor, especially, in the case of unresectable or postoperative residual tumors on the neck.

동시 간 전이가 있는 직장암 환자에서 원발 부위에 대한 수술 후 보조 방사선 치료의 역할

표홍렬 (Hong Ryull Pyo),성진실 (Jin Sil Weong),신현수 (Hyun Soo Shin),이형식 (Hyung Sik Lee),김귀언 (Gwi Eon Kim),서창옥 (Chang Ok Suh),노준규 (Juhn Kyu Loh),김우철 (Woo Cheol Kim) 대한방사선종양학회 1993 Radiation Oncology Journal Vol.11 No.1

Among the patients with rectal cancer who entered Yonsei University Hospital for management from Jan. 1980 to Dec. 1990, we selected 23 subjects who were received surgical resection of tumor in rectum, and who proved to have liver metastasis during the diagnostic work-up, at the time of the operation, of within 3 months after starting definitive treatment. With those subjects, we investigated the role of radiation therapy by comparison of the treatment results of the patients without radiation therapy (S group) with those of the patients with radiation therapy to the primary site (S+R group). The local control rates of S group and S+R group were 64% and 89%, and 2-year survival rates were 50% and 78%, respectively. Although there was not statistically meaningful difference, local control rate and 2-year survival rate were higher in the group with radiation therapy to primary site than that without radiation therapy. The 2-year survival rates of the case with resection of the liver and the case without it were 636% and 58.3% respectively, which was not statistically significant. Also, the 2-year survival rate of the case with sustained local control was higher than that of the case with local failure, which was statistically significant (76.5% and 16.7%, p<0.005). From the above results, it is thought that radiation therapy to the primary site might improve the local control rate even in the patients with liver metastasis, which seems to be correlated to the higher survival rate.

선택적 Cyclooxygenase-2 억제제인 Celecoxib가 상이한 Cylooxygenase-2 발현량을 가진 인간 암세포주들에 대하여 유도하는 방사선 감수성 증진 작용

표홍렬(Hongryull Pyo),신유근(You Keun Shin),김현석(Hyun Seok Kim),성진실(Jinsil Seong),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim) 대한방사선종양학회 2003 Radiation Oncology Journal Vol.21 No.3

목 적: Cyclooxygenase-2 (COX-2)를 과발현하는 A549 인간폐암세포주와 발현하지 않는 MCF-7 인간 유방암 세포주에서 선택적 COX-2 억제제인 celecoxib의 방사선 감수성 증진 작용을 관찰하고자 하였다. 대상 및 방법 : A549 세포와 MCF-7 세포에 대해서 방사선 혹은 방사선과 celecoxib를 병용 투여한 후에 clonogenic radiationsurvival실험을 시행하였다.같은 실험을 각각 10%와 1%의 FBS를 포함한 배지에서 반복하였다.각 세포에 방사선과 celecoxib를 동시 혹은 단독 투여한 후에 각 실험 그룹의 세포사멸을 측정하였다. 결 과: 약물 투여기간 동안 10%의 혈청을 포함한 배지조건에서 배양된 A549 세포에서는, 3 0μM과 50μM 농도의celecoxib가 투여된 상태에서 surviving fraction=0.1에서의 Radiation enhancement ratio (RER)가 각각 1.58과 1.81로 celecoxib가 A549 세포의 방사선 감수성을 증가시켰다. 이러한 방사선 감수성의 증가는 세포를 1%의 혈청을 포함한 배지에서 배양하였을때는 소실되었다. MCF-7 세포에서는 10%와 1% 혈청을 포함한 각각의 배지조건 하에서 celecoxib에 의한 방사선 감수성의 변화가 관찰되지 않았다. A549와 MCF-7 세포의 각 그룹에서 세포사멸을 측정한 결과 celecoxib와 방사선이 병용 투여되었을 때 유도되는 세포사멸은 상호 상승적이지 않은 것으로 나타났다. 결 론: COX-2 선택적 억제제인 celecoxib는 COX-2를 과발현하는 A549 세포에서 선택적으로 방사선 감수성을 증진시켰으며, 저 농도의 혈청을 포함한 배지조건에서는 이러한 효과가 소실되었다. COX-2를 발현하지 않는 MCF-7 세포주에서는 celecoxib에 의해서 방사선 감수성이 변화되지 않았으며, 이러한 celecoxib의 방사선 감수성 증진 작용 기전에 세포 사멸은 관여하지 않는 것으로 보인다. Purpose To investigate the modulation of radiosensitivity by celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, on cancer cells over-and under-expressing COX-2. Materials and Methods: A clonogenic radiation survival analysis was performed on A549 human lung and MCF-7 human breast cancer cell lines incubated in both 1 and 10% fetal bovine serum (FBS) containing media. The apoptosis in both cell lines was measured after treatment w ith radiation and/or celecoxib. Results Celecoxib enhanced the radiation sensitivity of the A 5 49 cells in the medium containing the 10% FBS, with radiation enhancement ratios of 1.58 and 1.81 respectively, at surviving fractions of 0.1, with 30M and 50M celecoxib. This enhanced radiosensitivity disappeared in the medium containing the 1% FBS. Celecox ib did not change the radiation sensitivity of the MCF-7 cells in either media. The induction of apoptosis by celecoxib and radiation was not synergistic in either cell line. Conclusion Celecoxib, a selective COX-2 inhibitor, preferentially enhanced the effect of radiation on COX-2 over-expressing cancer cells compared to the cells with a low expression, and this effect disappeared on incubation of the cells during drug treatment in the medium with suboptimal serum concentration. Apoptosis did not appear to be the underlying mechanism of this radiation enhancement effect due to celecoxib on the A549 cells. These findings suggest radiosensitization by a selective COX-2 inhibitor is COX-2 dependent.

국한성 두경부 비호지킨스 림프종 환자에서의 다방면치료

표홍렬(Hong Ryull Pyo),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim),노재경(Jae Kyung Rho) 대한방사선종양학회 1995 Radiation Oncology Journal Vol.13 No.2

Purpose : Traditionally the patients with early stage non-hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined. Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage Ⅰ and Ⅱ non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods : 159 patients with stage Ⅰ and Ⅱ non-Hodgkin's lymphoma localized to the head and neck were treated at out hospital from January. 1979 to December. 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region and received prescribed radiation dose and/or more than 2 cycles of chemotherapy were selected to analyze the outcomes according to the treatment methods (radiotherapy alone, chemotherapy alone, and combined treatment with radiotherapy and chemotherapy). Results : Five year overall actuarial survival of the patients whose primary site was Waldeyer's ring was 62.5% and that of the patients whose primary site was nodal region was 53.8%. There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy, chemotherapy, and combined treatment was 92%, 83%, 94% respectively, and 5 year relapse free survival was 49.9%, 52.4%, 58.5% respectively (statistically not significant). In the patients with stage Ⅰ, 3 year relapse free survival of chemotherapy alone group was 75% and superior to other treatment groups. In the patients with stage Ⅱ, combined treatment group revealed the best result with 60.1% of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the patients who were treated by combined modality was analyzed and the sequence of primary chmotherapy+radiotherapy+maintenance chemotherapy showed the best result (3 year relapse free survival was 79.1%). There was no significant survival difference between BACOP regimen and CHOP regimen. REsponse to treatment was only one significant (p<0.005) prognostic factor on univariate analysis and age and mass size was marginally significant (p<0.1). On multivariate analysis age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion : In summary, the patients, who have non-Hodgkin's lymphoma fo the head and neck with stage Ⅰ and mass size smaller than 10cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

국소 진행된 직장암의 수술 전 화학방사선 요법 치료 후 종양반응 분석: 종양체적 변화와 병리조직학적 병기하강과의 상관관계 분석

김남규,표홍렬,백승혁,이강영,손승국,조장환,라선영,정현철 대한대장항문학회 2004 Annals of Coloproctolgy Vol.20 No.5

Purpose: Preoperative chemoradiation treatment (CCRT) for locally advanced rectal cancer has been known to be safe and effective. The aim of study is to find any correlation between tumor volume reduction and histopathologic downstaging in locally advanced rectal cancer by preoperative CCRT. Methods: A total of 16 patients of rectal cancer were selected. They had been T3,4 N (+) preoperatively staged by using a transrectal ultrasonography and pelvic MRI. Radiation was given, a total of 5,040 cGy over 5 weeks, and systemic chemotherapy was also given 5 FU 450 mg/m2 and leucovorin 20 mg/m2 concurrently intravenously during the first and the fifth week of CCRT. Surgery was done 4∼6 weeks after completion of CCRT. A 3D CT image was obtained with AcQsim PQ 5000 3D(Philips, USA). Tumor volume was measured before and after CCRT. Results: The type of operative procedures were abdominoperineal resection 7, low anterior resection 5, coloanal anastomosis 3 and Hartmann operation 1. Volume reduction was ranged from 14.6% to 84.4%. Over a 50% tumor volume reductions were in 9 patients (56.2%). Pathologic complete remission was observed in 2 patients (12.5%), who showed 72% and 58.5% tumor volume reductions. Patients showing pT and/or pN downstaging patients (N=9) had a 55.9% tumor reductions (14.6∼84.4%), and patients showing no pT and/or pN downstaging (N=7) had 51.8% volume reduction (24.7∼ 79%). Conclusions: Preoeperative CCRT has been thought to be able to decrease tumor size and volume and to increase respectability. However, among our 9 patients who showed over 50% tumor volume reductions, 3 patients did not show any T and N downstaging, which is really important for long-term oncologic outcomes.

침윤성 방광암의 치료

이강현,표홍렬,정세일 대한비뇨기종양학회 2005 대한비뇨기종양학회지 Vol.3 No.2

Salvage Concurrent Chemo-radiation Therapy for Loco-regional Recurrence Following Curative Surgery of Non-small Cell Lung Cancer

이경화,안용찬,표홍렬,노재명,박승규,김태규,이언주,남희림,이혜빈,선종무,안진석,안명주,박근칠 대한암학회 2019 Cancer Research and Treatment Vol.51 No.2

Purpose This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer. Materials and Methods Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume (CTV) was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course. Results The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade  3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) ( 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV ( 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs.  1 year; HR, 0.489) were significantly favorable factors for OS. Conclusion The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED10, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

Risk Factors and Patterns of Locoregional Recurrence After Radical Nephrectomy for Locally Advanced Renal Cell Carcinoma

유규상,박원,표홍렬,정병창,전황균,강민용,서성일,전성수,이현무,최한용,박병관,김찬교,박성윤,권기영 대한암학회 2022 Cancer Research and Treatment Vol.54 No.1

Purpose We aimed to investigate the risk factors and patterns of locoregional recurrence (LRR) after radical nephrectomy (RN) in patients with locally advanced renal cell carcinoma (RCC). Materials and Methods We retrospectively analyzed 245 patients who underwent RN for non-metastatic pT3-4 RCC from January 2006 to January 2016. We analyzed the risk factors associated with poor locoregional control using Cox regression. Anatomical mapping was performed on reference computed tomography scans showing intact kidneys. Results The median follow-up duration was 56 months (range, 1 to 128 months). Tumor extension to renal vessels or the inferior vena cava (IVC) and Fuhrman’s nuclear grade IV were identified as independent risk factors of LRR. The 5-year actuarial LRR rates in groups with no risk factor, one risk factor, and two risk factors were 2.3%, 19.8%, and 30.8%, respectively (p < 0.001). The locations of LRR were distributed as follows: aortocaval area (n=2), paraaortic area (n=4), retrocaval area (n=5), and tumor bed (n=11). No LRR was observed above the celiac axis (CA) or under the inferior mesenteric artery (IMA). Conclusion Tumor extension to renal vessels or the IVC and Fuhrman’s nuclear grade IV were the independent risk factors associated with LRR after RN for pT3-4 RCC. The locations of LRR after RN for RCC were distributed in the tumor bed and regional lymphatic area from the bifurcation of the CA to that of the IMA.