Inhomogeneity correction in on-line dosimetry using transmission dose

Hong-Gyun Wu,Soon-Nyung Huh,Hyoung-Koo Lee,Sung-Whan Ha 대한방사선방어학회 1998 방사선방어학회지 Vol.23 No.3

Therapeutic effect of recombinant human epidermal growth factor (rhEGF) on mucositis in patients undergoing radiotherapy, with or without chemotherapy, for head and neck cancer : A double-blind placebo-controlled prospective phase 2 multi-institutional c

Wu, Hong Gyun,Song, Si Yeol,Kim, Yeon Sil,Oh, Young Taek,Lee, Chang Geol,Keum, Ki Chang,Ahn, Yong Chan,Lee, Sang-wook Wiley Subscription Services, Inc., A Wiley Company 2009 Cancer Vol.115 No.16

<B>BACKGROUND:</B><P>We evaluated the efficacy of topically applied human recombinant epidermal growth factor (rhEGF) for the treatment of oral mucositis induced by radiotherapy (RT), with or without chemotherapy, in patients with head and neck cancer.</P><B>METHODS:</B><P>Patients receiving definitive chemoradiotherapy, definitive RT, or postoperative RT to the oral cavity or oropharynx were recruited from 6 institutions and enrolled in a randomized, double-blind, placebo-controlled phase 2 trial. Patients were assigned to a placebo group or to 1 of 3 EGF-treatment groups (10, 50, or 100 μg/mL doses, delivered in a spray, twice daily). The grade of mucositis was evaluated using the Radiation Therapy Oncology Group (RTOG) scoring criteria. Responders to EGF were defined as having an RTOG grade of 2 or lower at the fourth- or fifth-week examinations during RT, but an enduring RTOG grade 2 for 2 weeks was an exception.</P><B>RESULTS:</B><P>Of the 113 patients included in the study, 28 received placebo and 29 received EGF at 10 μg/mL, 29 at 50 μg/mL, and 27 at 100 μg/mL. EGF significantly reduced the incidence of severe oral mucositis at the primary endpoint (a 64% response was observed with 50 μg/mL EGF vs a 37% response in the control group; P = .0246).</P><B>CONCLUSIONS:</B><P>The EGF oral spray may have potential benefit for oral mucositis in patients undergoing RT for head and neck cancer. Phase 3 studies are ongoing to confirm these results. Cancer 2009. © 2009 American Cancer Society.</P>

Development of the Algorithm for On-line Dosimetry System for High Energy Radiation Treatment

Hong Gyun Wu,Sung Whan Ha 대한방사선방어학회 1997 방사선방어학회지 Vol.22 No.3

Bioinformatics and Systems Biology : Differential expression of apoptosis-related genes in Lung cancer cell Lines determine the responsiveness to ionizing radiation

( Hong Gyun Wu ),( Sun Hye Jeong ),( Woong Yang Park ) 한국생화학분자생물학회 (구 한국생화학회) 2008 생화학분자생물학회 춘계학술발표논문집 Vol.2008 No.-

Signifcance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Eso phageal Carcinoma

우홍균(Hong-Gyun Wu),박찬일(Charn Il Park),하성환(Sung Whan Ha),김일한(Il Han Kim) 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.2

목 적 : 1997년에 개정된 AJCC 병기분류법에 의하면 흉부식도암의 쇄골상림프절전이는 원격전이로 분류된다. 연구자들은 다른 국소림프절전이와 쇄골상림프절전이의 임상적 양상의 차이에 대하여 연구하였다. 대상 및 방법 : 1979년 6월부터 1992년 12월 사이에 임상적으로 절제가 불가능한 식도암 환자 289명이 방사선치료를 받았다. 이 중 25명의 환자에서 쇄골상림프절전이가 관찰되었다. 쇄골상림프절의 임상적 중요성을 평가하기 위하여, 국소림프절전이 환자와 생존율 및 재발양상에 대한 결과를 비교 분석하였다. 결 과 : 쇄골상림프절전이 환자의 생존중앙치는 7개월이었으며 2년 및 5년 생존율은 각각 12.0% 및 4.0% 였다. 국소림프절전이 환자에서는 9개월, 17.0% 및 3.8% 였다. 두 군 사이에 통계적 유의성은 관찰할 수 없었다. 또한 재발양상에 있어서도 두 군 사이에 차이가 없었다. 결 론 : 본 연구의 결과 흉부식도에서 발생한 식도암에서 쇄골상림프절로의 전이는 현재의 분류인 원격전이이기 보다는 국소림프절전이로 분류되어야 할 것이며, 향후 이에 대한 다기관공동연구가 필요할 것이다. Background and Purpose : Involvement of supraclavicular lymph nodes (SCL) is considered distant metastas is for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional lymph node involvement. Materials and Methods :Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients , 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric lymph node pos itive patients to evaluate prognostic s ignificance of SCL involvement. Res ults :Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0% and 4.0% respectably. Corresponding features for regional node positive patients were 9 month, 17.0% and 3.8%. There was no s ignificant difference between two groups. There was also no difference in patterns of recurrence . Conclusion : Results of this analys is showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

Radiation Therapy of Testicular Seminoma

우홍균(Hong Gyun Wu),오도훈(Do Hoon Oh),하성환(Sung Whan Ha) 대한방사선종양학회 1994 Radiation Oncology Journal Vol.12 No.3

연구목적 : 고환의 정상피종은 방사선치료에 매우 민감한 종양으로서 초기 정상피종에 있어서 근치적 고환절제술 후 보조적 방사선치료로 좋은 결과를 얻을 수 있는 것으로 알려져 있다. 10년간 서울대학교병원 치료방사선과에서 치료를 받은 28명의 환자를 대상으로 치료성적의 분석을 실시하였다. 대상 및 방법 : 1980년 8월에서 1990년 2월까지 서울대학교병원에서 치료를 받은 고환 정상피종환자 32명을 대상으로 후향적 분석을 하였다. 27명의 환자는 근치적 고환절제술 후에 그리고 5명은 재발 후에 방사선치료를 받았는데 각군에서 2명씩을 불완전한 방사선치료로 연구대상에서 제외되었다. 고환절제술후 치료를 받은 환자들의 병기별 분포는 Ⅰ기 18명, ⅡA기 5명, ⅢB기 1명 ⅡC기 1명이었다. 재발 후 방사선치료를 받은 3명은 첫 진단시 병기를 알 수 없었다. 전체 환자 중 6명 환자에서 동측 고환, 2명에서 반대편 고환, 그리고 1명은 양측에서 잠복고환이 관찰되었다. 후복막 및 골반 임파절에 대한 방사선치료 선량의 중앙치는 2900cGy(1550-4550cGy)이었다. 종격동조사를 시행한 환자는 Ⅰ기 1명, ⅡA기 4명, ⅢB기 1명 그리고 재발된 환자가 1명이었다. 항암화학요법은 ⅡB기 1명, ⅡC기 1명, 재발된 1명에서 방사선치료 전에 시행되었다. 환자들의 중앙추적기간 104개월 (3-144개월)이다. 결과 : 전체 국소치유율은 5년에 1005를 보였고, Ⅰ기 환자 1명에서 종격동 전이로 인한 사망을 보여 생존율은 5년에 Ⅰ기 94.4%, Ⅱ기 100%, 그리고 재발한 경우에서 100%를 보였다. 결론 : 고환 정상피종에 있어서 방사선치료는 근치적 고환절제술 후의 보조적 목적뿐 아니라 국소적으로 재발한 경우에 있어서도 우수한 치료방법으로 생각된다. Purpose : Testicular seminomas are radiosensitive and adjuvant radiation therapy after orchiectomy results in long term survival in early stage diseases. Ten year results of radiation therapy after orchiectomy and results of definitive treatment of recurrent seminoma are presented. Materials and Methods : Between August 1980 and February 1990, 32 patients with testicular seminumas were treated at the Department of Therapeutic Radiology. Seoul National University Hospital. Twenty-seven patients received radiation therapy after orchiectomy and 5 patients for treatment of recurrent tumors. Two of postoperatively treated patients and 2 of recurrent patients wre excluded from the study because of incomplete treatment. Of the patients treated postoperatively. 18 were stage I, 5 were stage ⅡA, on was stage ⅡB, and one was stage ⅡC. There were 4 ipsilateral and 2 contralateral cryptorchids. Preoperatively, β-HCG levels were elevated in 5 patients. Median dose to pelvic and paraaortic lymph node area was 2900 cGy (1550-4550 cGy). One patients with stage Ⅰ, 4 with stage ⅡA, and 1 with stage ⅡB received prophylactic mediastinal irradiation. Two patients were treated with chemotherapy before radiation therapy. Median follow-up period was 104(3-144) months. Results : Local control rates were 100% at 5 years after orchiectomy. five year survival rates were 94.4% in Stage Ⅰ and 100% in Stage Ⅱ patients. One patient with stage Ⅰ disease died 3 months after surgery due to mediastinal metastasis.. All the 3 patients treated for recurrent disease are alive without disease. Conclusion : Postorchiectomy radiation to the pelvis and para-aortic area remains the treatment of choice for patient with early stage testicular seminoma. Radiation therapy is also an excellent treatment modality for recurrent seminoma.

1)후각신경아세포종의 치료 및 결과

우홍균(Hong-Gyun Wu),김일한(Il Han Kim) 대한방사선종양학회 2000 Radiation Oncology Journal Vol.18 No.3

목 적 : 후각신경아세포종은 매우 드물고 치료 방법의 결정이 어려운 종양이다. 이 연구에서는 본 병원에서 시행한 후각신경아세포종의 여러 가지 치료방법을 정리하고 최근에 발표된 문헌들을 고찰하고자 하였다. 대상 및 방법 : 1979년 6월부터 1997년 4월 사이에 서울대학교병원에서 후각신경아세포종으로 진단을 받고 치료를 받은 20명의 환자를 대상으로 하였다. 14명의 남자와 6명의 여자가 포함되었다. 최초 진단 시 연령은 13세부터 77세까지였으며 중앙값은 24세였다. 20명중 14명은 Kadish 병기 C였다. 환자 개개인에 따라서 수술과 방사선치료, 항암화학요법의 다양한조합이 시행되었다. 이러한 조합으로는 수술과 수술 후 방사선치료 및 수술 후 항암화학요법 2예, 수술과 수술 후 방사선치료 6예, 수술전 항암화학요법과 수술 1예, 수술과 수술 후 항암화학요법 1예, 수술 단독만 시행 2예, 방사선치료전 화학요법과 방사선치료 3예, 방사선치료 및 방사선치료 후 항암화학요법 1예, 방사선치료 단독 3예, 모든 치료를 거부한 1예가 포함되었다. 결 과 : 추적 기간은 2개월부터 204개월사이로 중앙값은 40개월이었다. 5년 생존율과 10년 생존율은 각각 20%와 10%였 다. 4명의 환자가 자료 분석의 시점까지 생존해 있었으며 이 4명중 한명은 근치적 수술과 수술 후 방사선치료 및 수술 후항암화학요법으로 치료를 받았으며 2명은 근치적 수술과 수술 후 방사선치료, 그리고 나머지 한명은 근치적 수술만 시행 받았다. 결 론 : 후각신경아세포종의 치료에는 첫 진단 시에 근치적 수술과 수술 전 또는 수술 후 보조적 방사선치료와 항암화학요법을 병용하는 접근이 필요할 것이다. 환자수가 적은 제한이 있으나 본 연구에서는 근치적 수술 등 국소조절의 중요성이 강조되었다. Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating physician to practice with a consistent protocol. This study is performed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from 13 to 77 years with median of 24 years. Fifteen of 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+ postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadjuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of olfactory neuroblastoma.

초기 성문암 환자에서의 소분할 조사법을 이용한 방사선치료

우홍균(Hong Gyun Wu),홍세미(Semie Hong),신성수(Seong Soo Shin),박찬일(Charn Il Park) 대한방사선종양학회 2001 Radiation Oncology Journal Vol.19 No.4

목적: 초기 성문암의 방사선치료에 있어 소분할 치료(hygofractionated radiation therapy)의 용이성과 그 부작용의 정도를 파악하고자 하였다. 대상 및 방법: 1999년 2월부터 2000년 2월까지 서울대학교 병원 치료방사선과에 내원하여 조직학적으로 확진된 Ⅰ,Ⅱ 병기의 초기 성문암환자는 20명을 대상으로 전향적 연구를 진행하였다. 환자군의 성별분포는 18명이 남자, 2명이 여자였으며 연령의 중앙값은 59세였다. 병기의 분포는 T1aN0-16명, T1bN0-1명, T2n0 3명이었다. 18명의 환자는 후두미세수술을 통한 조직생검을 시행하였으며 2명의 환자는 레이저 절제술을 시행받았다. 모든 환자는 근치적 방사선치료를 2.5Gy의 분할조사선량으로 총 60 Gy의 방사선을 24회 분할하여 시행받았다. 치료 기간의 중앙값은 36일 이었다(범위31~45일). 결과: 방사선치료 기간 중 금성 반응으로 치료를 중단한 환자는 없었다. 주된 급성 부작용은 식도염과 애성이였으며 치료 후에는 호전되었다. RTOG grade 3의 식도염으로 인한 연하통을 보인 환자가 1례에서 있었고, 6례에서 grade 3의 애성을 보였다. 방사선치료에 대한 반응은 치료 종료 1개월 후에 판정하고 모든 환자에서 완전관해를 보였다. 20명의 환자 중 3명에서 재발이 관찰되었는데, 2례는 방사선치료 후 10개월과 13개월의 시점에서 국소재발이 관찰되었고, 1례 방사선치료 후 2개월의 시점에서 경부 림프절에서의 재발이 관찰되었고 4개월 후 원격전이가 관찰되었다. 결론: 소분할 방사선치료는 시행상의 큰 어려움 없이 진행되었으며 질병에 관해에 효과적인 것으로 나타났다. 하지만 방사선치료기간의 단축이 종양의 치료결과에 미치는 영향과 만성 부작용을 파악하기 위해서 보다 오랜 기간의 추적 관찰이 필요할 것으로 생각된다. Purpose: This study was performed for the evaluation of the feasibility and toxictiy of hypofractionated radiation therapy for early glottic cancer Methods and Materials: From February 1999 to February 2000, 20 patients with histologically confirmed Stage Ⅰ,Ⅱ glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as follows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy(2.5 Gy per fraction, 24 fractons, total 60 Gy). Median duration of teratment was 36days (range 31~45 days). Results: Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia (5%), six cases of grade 3 hoarseness (30%). Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy Conclusion: This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer. But longer follow up time would be required to assess the long0term disease control and the late complication by shortening radiation therapy duration.

Feasibility and safety of neck level IB-sparing radiotherapy in nasopharyngeal cancer: a long-term single institution analysis

Dowook Kim(Dowook Kim),Bhumsuk Keam(Bhumsuk Keam),Soon-Hyun Ahn(Soon-Hyun Ahn),Chang Heon Choi(Chang Heon Choi),Hong-Gyun Wu(Hong-Gyun Wu) 대한방사선종양학회 2022 Radiation Oncology Journal Vol.40 No.4

Purpose: Nasopharyngeal cancer (NPC) has a higher prevalence of regional nodal metastasis than other head and neck cancers; however, level IB lymph node involvement is rare. We evaluated the safety and feasibility of level IB-sparing radiotherapy (RT) for NPC patients. Materials and Methods: We retrospectively reviewed 236 patients with NPC who underwent definitive intensity-modulated RT with or without chemotherapy between 2004 and 2018. Of them, 212 received IB-sparing RT, and 24 received non-IB-sparing RT. We conducted a propensity score matching analysis to compare treatment outcomes according to IB-sparing status. In addition, dosimetric analysis of the salivary glands was performed to identify the relationship between xerostomia and the IB-sparing RT. Results: The median follow-up duration was 78 months (range, 7 to 194 months). Local, regional, and distant recurrences were observed in 11.9%, 6.8%, and 16.1% of patients, respectively. Of the 16 patients with regional recurrence, 14 underwent IB-sparing RT. The most common site categorization of regional recurrence was level II (75%), followed by retropharyngeal lymph nodes (43.8%); however, there was no recurrence at level IB. In the matched cohorts, IB-sparing RT was not significantly related to treatment outcomes. However, IB-sparing RT patients received a significantly lower mean ipsilateral and contralateral submandibular glands doses (all, p < 0.001) and had a lower incidence of chronic xerostomia compared with non-IB-sparing RT patients (p = 0.006). Conclusion: Our results demonstrated that IB-sparing RT is sufficiently safe and feasible for treating NPC. To reduce the occurrence of xerostomia, IB-sparing RT should be considered without compromising target coverage.

Enhancement of Radiation Effects by Flavopiridol in Uterine Cervix Cancer Cells

김수지,Hong-Gyun Wu,신진희,Hye Jin Park,김인아,김일한 대한암학회 2005 Cancer Research and Treatment Vol.37 No.3

Purpose: To determine the effects of combinations of radiation and flavopiridol, an inhibitor of cyclin-dependent kinases and global transcription, in a human uterine cervix cancer cell line.Materials and Methods: Human uterine cervix cancer cells (HeLa), cultured to the mid-log phase, were exposed to X-rays, flavopiridol, and combinations of X-rays and flavopiridol in various sequences. The end point in this study was the clonogenic survival, which was measured via clonogenic assays. In order to determine the intrinsic cytotoxicity of flavopiridol, 0, 5, 12.5, 25, 37.5, 50 and 100 nM of flavopiridol were added to cell culture media. In the combination treatment, four different schedules of flavopiridol and irradiation combinations were tested:treatment of flavopiridol for 24 hours followed by irradiation, simultaneous administration of flavopiridol and irradiation, and irradiation followed by flavopiridol (for 24 hours) at intervals of 6 and 24 hours. The fraction of cells surviving after the combination treatment with 2 Gy of radiation (SF2) was compared with that of the fraction of cells surviving after treatment with irradiation alone.Results: The cytotoxicity of flavopiridol was found to be dose-dependent, with an IC50 of 80 nM. No cytotoxic enhancements were observed when flavopiridol and radiation were administered simultaneously. Flavopiridol, administered either 24 hours before or 6 hours after irradiation, exerted no sensitizing effects on the cells. Only one protocol resulted in a radiosensitizing effect: the administration of flavopiridol 24 hours after irradiation.Conclusion: Flavopiridol enhanced the effects of radiation on a uterine cervix cancer cell line in vitro, and this enhancement was both sequence- and time-dependent