Locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy plus concurrent weekly cisplatin with or without neoadjuvant chemotherapy

Chan Woo Wee,Bhumsuk Keam,Dae Seog Heo,Myung-Whun Sung,Tae-Bin Won,Hong-Gyun Wu 대한방사선종양학회 2015 Radiation Oncology Journal Vol.33 No.2

Purpose: The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods: Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results: With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion: CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited.

Evaluation of variability in target volume delineation for newly diagnosed glioblastoma: a multi-institutional study from the Korean Radiation Oncology Group

Wee, Chan Woo,Sung, Wonmo,Kang, Hyun-Cheol,Cho, Kwan Ho,Han, Tae Jin,Jeong, Bae-Kwon,Jeong, Jae-Uk,Kim, Haeyoung,Kim, In Ah,Kim, Jin Hee,Kim, Sung Hwan,Kim, Suzy,Lee, Dong Soo,Lee, Me Yeon,Lim, Do Hoo BioMed Central 2015 Radiation oncology Vol.10 No.-

<P><B>Background</B></P><P>This study aimed for a collaborative evaluation of variability in the target volumes for glioblastoma, determined and contoured by different radiotherapy (RT) facilities in Korea.</P><P><B>Methods</B></P><P>Fifteen panels of radiation oncologists from independent institutions contoured the gross target volumes (GTVs) and clinical target volumes (CTVs) for 3-dimensional conformal RT or intensity-modulated RT on each simulation CT images, after scrutinizing the enhanced T1-weighted and T2-weighted-fluid-attenuated inversion recovery MR images of 9 different cases of glioblastoma. Degrees of contouring agreement were analyzed by the kappa statistics. Using the algorithm of simultaneous truth and performance level estimation (STAPLE), GTV<SUB>STAPLE</SUB> and CTV<SUB>STAPLE</SUB> contours were derived.</P><P><B>Results</B></P><P>Contour agreement was moderate (mean kappa 0.58) among the GTVs and was substantial (mean kappa 0.65) among the CTVs. However, each panels’ GTVs and modification of CTVs regarding anatomical structures varied. Three-fourth of contoured panels’ CTVs encompassed the peritumoral areas of T2-high signal intensity (T2-HSI). Nine of nine GTV<SUB>STAPLE</SUB> encompased the surgical cavity and the T1-enhanced lesions. Eight of nine CTV<SUB>STAPLE</SUB> encompassed the peritumoral T2-HSI area. The median MARGIN<SUB>90</SUB> and the median MARGIN<SUB>95</SUB> were 1.4 cm and 1.5 cm, respectively.</P><P><B>Conclusions</B></P><P>Moderate to substantial agreement existed in target volumes for 3-dimensional or intensity-modulated RT determined by radiation oncologists in Korea. According to the estimated consensus contours, the initial CTV encompassed the GTV with margin less than 2.0 cm and the whole peritumoral areas of T2-HSI. The findings of our study propose the need for further studies and modified guidelines.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1186/s13014-015-0439-z) contains supplementary material, which is available to authorized users.</P>

Korean Association for Clinical Oncology : Slide Session ; P-55 : Others ; Evaluation of the Target Volume Delineation in Patients with Glioblastoma: Multi-Institutional Study (Korean Radiation Oncology Group 13-18)

( Chan Woo Wee ),( Wonmo Sung ),( Hyun-Cheol Kang ),( Il Han Kim ),( Kwan Ho Cho ),( Taejin Han ),( Bae Gwon Jeong ),( Jae-Uk Jeong ),( Haeyoung Kim ),( In Ah Kim ),( Jin Hee Kim ),( Sung Hwan Kim ),( 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: To evaluate current practice and variability in contouring glioblastoma (GBL) gross target volume (GTV) and clinical target volume (CTV) among Korean radiation oncologists, eventually to establish a consensus guideline in the future. Methods: 9 representative cases of GBL differing in location, surgical extent, multiplicity, and midline crossing were chosen for the study. The MR images with simulation CT images from those cases were distributed to 15 radiation oncologists for GTV and CTV contouring. Contouring agreement was analyzed using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus and kappa statistics. The agreement interpretation was evaluated using Landis and Koch`s interpretation of strength of agreement. GTV95 and CTV95 contours were obtained by STAPLE algorithm at the confi dence level of 95%. Results: No near perfect agreement was seen in any of the 9 cases. Substantial agreement of CTV delineation was seen in all but 1 case. In contrast, moderate agreement was seen in majority of cases regarding GTV delineation with substantial agreement in only 3 cases. Of the 15 radiation oncologists, 53-100% included the T2HSI within the CTV in the 9 cases. The mean maximal distance from the GTV to the CTV ranged 1.42- 3.17cm (median, 2.18cm). T2HSI was included within the CTV95 in all 9 cases. Conclusions: Only substantial agreement of CTV delineation was seen in a group of experts. Although heterogeneity exists in the inclusion of T2HSI and margins from GTVs, it seems reasonable to include the whole T2HSI volume in the initial CTV according to the STAPLE algorithm. Future consensus guideline including descriptions of margin status, inclusion of T2HSI, and dose-fractionation for GTV and CTV delineation in GBL is warranted and should be made upon a discussion between brain tumor radiation oncologists.

Psammaplin A-Modified Novel Radiosensitizers for Human Lung Cancer and Glioblastoma Cells

Wee, Chan Woo,Kim, Jin Ho,Kim, Hak Jae,Kang, Hyun-Cheol,Suh, Soo Youn,Shin, Beom Soo,Ma, Eunsook,Kim, Il Han The Korean Association for Radiation Protection 2019 방사선방어학회지 Vol.44 No.1

Background: Psammaplin A (PsA) is a radiosensitizer whereas its clinical application is hampered by poor bioavailability. This study aimed to synthesize novel radiosensitizers using PsA as the lead compound. Materials and Methods: Eight homodimeric disulfides were synthesized from corresponding acid and cystamine dihydrochloride in N-hydroxysuccinimide and dicyclohexylcarbodiimide coupling conditions. One monomeric thiol analog was obtained by reduction of homodimeric disulfide with dithiothreitol. Clonogenic assay was used to measure cell survival after irradiation and drug treatment in human lung cancer (A549) and glioblastoma (U373MG) cells. Results and Discussion: Using the PsA backbone, nine compounds were synthesized. Eight compounds showed variable cytotoxicity with 50% inhibitory concentrations ranging $16.14{\mu}M$ to $150.10{\mu}M$ (A549), and $13.25{\mu}M$ to $50.15{\mu}M$ (U373MG). Four and six compounds radiosensitized A549 and U373MG cells, respectively. Two compounds that radiosensitized both cell lines were tested for its inhibitory effects on DNMT1. One of them was shown to significantly inhibit DNMT1 activity. Conclusion: Novel compounds with radiosensitizing activity were synthesized. These compounds have a great potential to serve as a basis for the development of future radiosensitizers. Further investigation is warranted for their clinical application.

Radiotherapy for Newly Diagnosed Glioblastoma in the Elderly: What Is the Standard?

Chan Woo Wee 대한뇌종양학회 2022 Brain Tumor Research and Treatment Vol.10 No.1

Nearly half of the patients with newly diagnosed glioblastomas are aged ≥65 years. Unfortunately, these elderly patients with glioblastoma (GBM-e) demonstrate detrimental survival. However, the opti- mal treatment for GBM-e after surgery remains controversial. Conventionally fractionated radiotherapy (CFRT) of 60 Gy, hypofractionated radiotherapy (HFRT), temozolomide (TMZ), or a combination of these treatments with or without tumor treating fields can be considered. Although evidence has indi- cated a non-inferiority of HFRT compared to CFRT in GBM-e treated with radiotherapy (RT) alone throughout the past, the optimal RT scheme (CFRT vs. HFRT), when combined with TMZ, has never been investigated in a prospective randomized fashion for GBM-e patients suitable for radiochemo- therapy. Several other issues make the treatment of GBM-e even more challenging. In this review, cur- rent evidence regarding RT in GBM-e, as well as issues that need to be addressed, is discussed.

Locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy plus concurrent weekly cisplatin with or without neoadjuvant chemotherapy

Wee, Chan Woo,Keam, Bhumsuk,Heo, Dae Seog,Sung, Myung-Whun,Won, Tae-Bin,Wu, Hong-Gyun The Korean Society for Radiation Oncology 2015 Radiation Oncology Journal Vol.33 No.2

Purpose: The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods: Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results: With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion: CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited.

Novel RG108-derived DNA-methyltransferase Inhibitor as a Radiosensitizer in Glioblastoma Cells

Chan Woo Wee,․Jin Ho Kim,Hak Jae Kim,Soo Youn Suh,Hyun-Cheol Kang,Beom Soo Shin,Eunsook Ma,Il Han Kim 대한방사선방어학회 2017 대한방사선방어학회 학술발표회 논문요약집 Vol.2017 No.11

폐경 호르몬요법에서 경구용 Levonorgestrel 투여 1년 후 유방 치밀도에 대한 효과

위찬우 ( Chan Woo Wee ),강민정 ( Min Jung Kang ),서경용 ( Kyoung Yong Seo ),최연현 ( Yeon Hyeon Choe ),민용기 ( Yong Ki Min ),이동윤 ( Dong Yun Lee ),최두석 ( Doo Seok Choi ),윤병구 ( Byung Koo Yoon ) 대한폐경학회 2011 대한폐경학회지 Vol.17 No.1

연구목적: 한국 폐경여성에서 levonorgestrel (LNG)를 이용한 호르몬 치료의 유방 치밀도에 대한 영향을 평가하였다. 연구재료 및 방법: 후향적 연구로서, 이전에 호르몬치료 기왕력이 없는 58명을 대상으로 하였다. 23명에게 estadiol valerate (E)+LNG를 이용해 주기적으로 치료하였고, 25명의 비치료군을 대조군, 10명의 conjugated equine estrogen (CEE)+medroxyprogesterone acetate (MPA) 치료군을 양성 대조군으로 두었다. 이후 기저치와 1년 후 유방촬영을 시행하여 치밀도를 비교하였다. 치료 전후의 X선 유방촬영술상 유방 치밀도의 변화는 J-image 프로그램을 이용하여 평가하였다. 자료는 chi-square 분석 및 Fisher`s exact 분석법, 그리고 nalysis of variance (ANOVA)을 이용하여 분석하였다. 결 과: 세 군 간의 기저 임상적 특성에 차이는 없었다. 1년의 호르몬요법 후, breast imaging reporting and data system (BI-RADS) 기준에 따른 변화를 보았을 때 CEE+MPA 사용군 (77.8% [7/9])이, E + LNG 사용군 (12.5% [2/16])보다 유의하게 증가하였으나 (P=0.001), E+LNG 사용군과 비치료군 (5.3% [1/19])사이에 유의한 차이는 없었다 (P=0.446). 치밀도가 3단계인 환자만을 대상으로 한 분석에서도 E+LNG 사용군은 비치료군과 유방 치밀도 변화에 차이가 없었다. J-image 프로그램을 이용한 분석 결과도 유사한 결과를 보였다. 또한 회귀 분석 결과, 기저 치밀도와 호르몬요법후 치밀 면적의 변화 사이에는 상관 관계가 나타나지 않았다. 결론: 한국 폐경 여성에서 LNG를 이용한 호르몬요법은 유방 치밀도에 영향을 미치지 않는다. 향후 유방암 위험에 대한 추가 연구가 필요하다고 사료된다. Objectives: We evaluated changes in mammographic density (MMGD) after hormone therapy (HT) using levonorgestrel (LNG) in Korean postmenopausal women. Methods: In this retrospective study, 58 healthy postmenopausal women with no history of prior HT were included. Twenty-three women were given a cyclic regimen of estradiol valerate (E) 2 mg/day+LNG 0.075 mg/day and 25 untreated women served as a negative control and 10 women treated with continuous combined regimen of conjugated equine estrogen (CEE) 0.625 mg/day+medroxyprogesterone acetate (MPA) 2.5 mg/day as a positive control. Mammography was obtained at baseline and 1 year later, and MMGD was assessed. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher`s exact test. Results: There were no significant differences in baseline characteristics among three groups. After 1 year of HT, increase of BI-RADS grade in CEE+MPA group (7/9, 77.8%) was higher than in E+LNG group (2/16, 12.5%; P=0.001). But there was no difference between untreated group (1/19, 5.3%) and E+LNG group (2/16, 12.5%; P=0.446). In subgroup analysis of women with BI-RADS grade 3 at baseline, no significant difference. Changes in the proportion of dense areas assessed by the J-image program showed similar results. Regression analysis revealed that there was no correlation between baseline dense area and changes after HT in E+LNG group. Conclusion: HT using LNG did not influence MMGD in Korean postmenopausal women. Further study on breast cancer risk may be needed. (J Korean Soc Menopause 2011;17:27-33)

자발성 피막 파열을 일으킨 안상부 기형종 : 증례보고 Case Report

위성찬,김재휴,김수한,강삼석,이제혁,우정현,정상우 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11

A case of spontaneously ruptured suprasellar teratoma, diagnosed preoperatively by computerized tomography(CT) and magnetic resonance image(MRI), is presented. The patient, a 51-year-old man was hospitalized for headache and focal seizure of left upper extremity since 5 days before admission. The CT scan showed an ill-defined hypodense mass in the suprasellar region and multiple small hypodense lesions in the subarachnoid space and cisterns, which were not enhanced by contrast media. The multiple small lesions in the cisterns seemingly derived from the ruptured tumor showed high signal intensity on T₁WI MRI. During operation the ruptured materials were confirmed to be fat globules and the arachnoid membrane was severely thickened and adhesed

Importance of taxonomic research for biodiversity of Korea

Hur, Wee-Haeng,Park, Chan-Ho,Min, Gi-Sik,Hyun, Chang-Woo,Bae, Eun Hee,Lee, Jeong Hyun,Jung, Eun-Hee,Yoo, Jung-Sun,Suh, Min Hwan The National Institute of Biological Resources 2016 Journal of species research Vol.5 No.3

In 2012, the NIBR started publishing the Journal of Species Research (JSR) as an international specialized journal of biological taxonomy focusing on taxonomic research. JSR Volume 5 Number 3, to be published in October 2016, has been planned as a 'Special Edition on New and Unrecorded Species of Invertebrates in Korea', and so it consists of the reports of 149 new and unrecorded invertebrate species (including protozoa) discovered in Korea. In future, the JSR should further accelerate the use of such methods to generate valid data for new species and effectively support the compilation of 'National List of Species of Korea'. In this way, it will contribute significantly to enrich for biodiversity in Korea.