Radiation Treatment of Esophageal Cancer

W.Y. Oh(오원용),C.O. Suh(서창옥),G.E. Kim(김귀언) 대한방사선종양학회 1985 Radiation Oncology Journal Vol.3 No.1

한국에서는 식도암의 임상적 관찰과 치료성적이 아직까지는 광범위하게 연구 및 보고되지 않았지만, 소화기계통에서 발생하는 악성종양 중에서는 비교적 적지 않은 것으로 알려져 있다. 의학적 지식, 진단적 설비, 방사선 치료의 적용, 외과적 수술의 진보, 그리고 최근의 화학요법의 재발 등과 같은 괄목할만한 향상에도 불구하고 예후는 극히 불량하여 5년 생존율이 10%이하로서, 과거에 비하여 크게 향상되지 않은 것으로 보고되고 있다. 이에 저자들은 1970년 1월부터 1980년 12월까지 만 11년 동안 식도암으로 진단되어 연세 암 센터에서 근치적 목적으로 방사선 치료를 받았던 63예에 대한 철저한 추적조사를 통하여 후향성 분석을 시행한 바 다음과 같은 결과를 얻었다. 1. 전 63예의 식도암 환자의 85.2%인 52예는 조직병리학적 소견에서 상피성세포암(Epidermoid Carcinoma)으로 확진되었다. 그리고 T1인 17예를 제외한 46예(73%)의 병변은 상당히 진행되였던 예들이였다. 2. 방사선 조사선량은 일일 일회 2Gys가 조사되였으며 총 조사선량 50~74Gys가 5~8주간에 조사되었다. 3. 전 63예중 28예에서 방사선 치료 후 1개월만에 식도조형상을 통하여 식도암에 대한 방사선치료 효과를 평가하여 본 결과, 완전관해는 7예였으며 나머지 15예는 부분적 관해, 그리고 6예는 변화가 없었다. 4. 전 63예의 3년, 5년 생존율은 11.8%, 8.8%였으며 그리고 T1인 17예의 3년, 5년 생존율은 24.7%, 20.8%였다. 63 patients who were irradiated with a goal of long term control among 101 patients with esophageal cancer seen during an 11 fears period between Jan, 1970 and Dec, 1980 at Yonsei Cancer Center in Seoul, Korea have retrospectively analysed. 52(82.5%) among the 63 Patients were confirmed to have epidermoid carcinoma in the histology. 46 cases(73.0%) except 17 cases of T_1, were locally or far advanced extension. Tumor dose of radical radiation in the management of esophageal cancer had delivered from 50 Gy to 74 Gys. 2 Gys daily fractions, between 5weeks and 8 weeks. After 1 month from the completion of radiation, 23 of the 63 patients had a repeat barium esophagogram for the assessment of tumor response, there had showed 7 cases of complete response and 15 cases of partial response. 45(71.4%) patients were followed up and the remaining 18 patients were lost to follow-up within 1 year after the completion of irradiation. Actuarial overall 3 and 5 years survival rate of all 63 Patients were 11.8f and 8.8%, respectively. The actuarial 3 and 5 years survival rates of 17 cases of T1, esophageal cancer were 24.7% and 20.8%. Statistically, there was no significant difference in survival rate according to tumor location (p>0.05). Radical Radiotherapy, Esophageal Cancer

두경부 선낭암의 생물학적 특성과 치료

오원용(W.Y.Oh),조관호(K.H.Cho),서창옥(C.O.Suh),김귀언(G.E.Kim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.2

Bilolgical behavior and treatment results of 33 patients with Adenoid Cystic Carcinoma (ACC) in the Head and Neck at Yonsei Cancer Center for 10 years between 1971 and 1980 were retrospectively analysed. Most common, primary site was minor salivary glands such as maxillary sinus, nasal cavity and base of tongue. The typical biological behavior of these tumors was very slowly in growth with long time of duration(mean 19 months) from 1 month to 10 years and more frequent of nerve invasion but rare invasion of neck nodes. Local control and failure pattern in the results of treatment, 16 of 17 patients with irradiation alone were seen complete or partial response but 5 cases of locoregional recurrence, 2 cases of failure of neck node and 4 cases of distant metastasis as lung and brain. On the other hand, among 10 cases of surgery and postoperative irradiation, 2 cases of locoregional failure and 3 cases of distant metastasis as lung and bone. 2 of 4 cases with surgery alone were recurred within primary site. Actuarial overall NED survival at 5 and 10 years were 52.6% and 42.8%, respectively. Survival rate of 10 patients with surgery and postoperative irradiation was more high than 17 patients of radiation alone. Therefore, we have known that surgery with postoperative adjunctive irradiation is most effective treatment modality of adenoid cystic carcinoma in the head and neck. Primary site, treatment modality and with or without nerve and bone invasion have influenced on prognosis.

상악동암의 방사선치료와 생존율

오원용(W Y Oh),김귀언(G E Kim),서창옥(C O Suh),노준규(J K oh),홍원표(W P Hong),김광문(K M Kim),이원상(W S Lee) 대한두경부종양학회 1987 대한두경부 종양학회지 Vol.3 No.1

Irradiated 88 patients of .Maxillary Sinus Carcinoma at Yonsei Cancer Center for 10years between 1971 and 1980 were retrospectively analysed. The majority of patients had very advanced disease (87.5% of T3 and T4) and 17% of cervical lymph node involvement. 80.6% of all patients were epidermoid type. In 44 cases (50%), irradiation alone was performed. 28 cases (32%) of postoperative radiation after incomplete surgery and the remaining 16 cases (18%) of postopera tive radiation after radical surgery were done. The majority of patients except 6 cases had irradiation a dose between 60Gy and 80Gy in 30-40 fractions over 6 -8 weeks. The actuarial overall 3 and 5 year survival rate were 362% and 26%, respectively. The actuarial 5 year survival rate for 44 cases of radiation alone group was 14.l %, The actuarial 5 year survival rate for 28 cases of incomplete surgery and postoperative radiation group and 16 cases of radical surgery and postoperative radiation group were 312% and 67.4% respectively. In the actuarial 5 year survival rate according to the stage, stage II, Ill and IV were 79.5%, 20.90% and 0%. In recent, for the improvement of survival rate of advanced Maxillary Sinus Carcinoma at Yonsei Cancer Center, combined multidisplinary or trimodal treatment modality have been applied and in near time the more excellent results expect to be analyse.

두경부에 국한된 Stage Ⅰ, Ⅱ, Non-Hodgkin's Lymphoma의 방사선치료

오원용(W.Y. Oh),서창옥(C.O. Suh),김귀언(G.E. Kim),김병수(B.S. Kim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.1

53 patients of previously untreated Stage Ⅰ&Ⅱ Non-Hodgkin's Lymphoma in head and neck treated with irradiation at Yonsei Cancer Center from January, 1970 to December, 1978 were retrospectively analyzed. 5year survival rate and 5 year disease free survival rate were 51.5% and 42%, Local control rate by irradiation was 92.4% with mainly 4000~6000 rads. 21 patients suffered relapses after radiotherapy, 4 cases recurred within irradiated area, 4 cases at contiguous site of irradiation field, and 13 cases recurred at distant area, more commonly below diaphragm. Most cases relapsed within 1 year 6 months after treatment. Optimum irradiation field for head and neck localized lymphoma, prognostic factors and usefulness of chemotherapy are also discussed.

비소세포 폐암의 방사선 치료

성진실(J.S. Seong) 오원용(W.Y.Oh),서창옥(C.O.Suh),김귀언(G.E.Kim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.2

131 patients of non-small cell cell lung cancer treated with irradiation at Yonssei Cancer Center from Jan. 1971 to Dec. 1980 were retrospectively analyzed. Overall 5 year survival rate was 7% in 117 cases, treated with radiotherapy alone and 33% in 14 Cases, treated with surgery & postoperative radiotherapy. Their median survival was 9.6 months in the former, while 11.1 months in the latter. The patients treated with radical aim achieved 10% in 5 YSR and with palliative aim, 0%. Also, survival according to histological calssification and staging was obtained. Treatment failure was monstly distant failure( 40 cases/ 49 cases), and within 6 months( 34 cases/ 49 cases)

Radiation Treatment of Esophageal Cancer

오원용,서창옥,김귀언,Oh W. Y.,Suh C. O.,Kim G. E. The Korean Society for Radiation Oncology 1985 Radiation Oncology Journal Vol.3 No.1

한국에서는 식도암의 임상적 관찰과 치료성적이 아직까지는 광범위하게 연구 및 보고되지 않았지만, 소화기계통에서 발생하는 악성종양 중에서는 비교적 적지 않은 것으로 알려져 있다. 의학적 지식, 진단적 설비, 방사선 치료의 적용, 외과적 수술의 진보, 그리고 최근의 화학요법의 재발 등과 같은 괄목할만한 향상에도 불구하고 예후는 극히 불량하여 5년 생존율이 10%이하로서, 과거에 비하여 크게 향상되지 않은 것으로 보고되고 있다. 이에 저자들은 1970년 1월부터 1980년 12월까지 만 11년 동안 식도암으로 진단되어 연세 암 센터에서 근치적 목적으로 방사선 치료를 받았던 63예에 대한 철저한 추적조사를 통하여 후향성 분석을 시행한 바 다음과 같은 결과를 얻었다. 1. 전 63예의 식도암 환자의 85.2%인 52예는 조직병리학적 소견에서 상피성세포암(Epidermoid Carcinoma)으로 확진되었다. 그리고 $T_1$인 17예를 제외한 46예73%의 병변은 상당히 진행되였던 예들이였다. 2. 방사선 조사선량은 일일 일회 2Gys가 조사되였으며 총 조사선량 $50{\sim}74Gys$가 $5{\sim}8$주간에 조사되었다. 3. 전 63예중 28예에서 방사선 치료 후 1개월만에 식도조형상을 통하여 식도암에 대한 방사선치료 효과를 평가하여 본 결과, 완전관해는 7예였으며 나머지 15예는 부분적 관해, 그리고 6예는 변화가 없었다. 4. 전 63예의 3년, 5년 생존율은 11.8%, 8.8%였으며 그리고 $T_1$인 17예의 3년, 5년 생존율은 24.7%, 20.8%였다. 63 patients who were irradiated with a goal of long term control among 101 patients with esophageal cancer seen during an 11 fears period between Jan, 1970 and Dec, 1980 at Yonsei Cancer Center in Seoul, Korea have retrospectively analysed. 52(82.5%) among the 63 Patients were confirmed to have epidermoid carcinoma in the histology. 46 cases(73.0%) except 17 cases of $T_1$, were locally or far advanced extension. Tumor dose of radical radiation in the management of esophageal cancer had delivered from 50 Gy to 74 Gys. 2 Gys daily fractions, between 5weeks and 8 weeks. After 1 month from the completion of radiation, 23 of the 63 patients had a repeat barium esophagogram for the assessment of tumor response, there had showed 7 cases of complete response and 15 cases of partial response. 45(71.4%) patients were followed up and the remaining 18 patients were lost to follow-up within 1 year after the completion of irradiation. Actuarial overall 3 and 5 years survival rate of all 63 Patients were 11.8% and 8.8%, respectively. The actuarial 3 and 5 years survival rates of 17 cases of $T_1$, esophageal cancer were 24.7% and 20.8%. Statistically, there was no significant difference in survival rate according to tumor location (p>0.05). Radical Radiotherapy, Esophageal Cancer

두경부에 국한된 Stage I, II, Non-Hodgkin's Lymphoma의 방사선치료

오원용,서창옥,김귀언,김병수,Oh W. Y.,Suh C. O.,Kim G. E.,Kim B. S. 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.1

53 patients of previously untreated Stage I&II Non-Hodgkin's Lymphoma in head and neck treated with irradiation at Yonsei Cancer Center from January, 1970 to December, 1978 were retrospectively analysed. 5 year survival rate and 5 year disease free survival rate were $51.5\%\;and\;42\%$. Local control rate by irradiation was $92.4\%$ with mainly $4,000\~6,000$ rads. 21 patients suffered relapses after radiotherapy, 4 cases recurred within irradiated area, 4 cases at contiguous site of irradiation field, and 13 cases recurred at distant area, more commonly below diaphragm. Most cases relapsed within 1 year 6 months after treatment. Optimum irradiation field for head and neck localized lymphoma, prognostic factors ana usefulness of chemotherapy are also discussed.

Radiation Therapy in Carcinoma of the Vulva A Review of Fifteen Patients

H.S. Lee(이형식),W.Y. Oh(오원용),C.O. Suh(서창옥),G.E. Kim(김귀언),C.K. Park(박찬규) 대한방사선종양학회 1985 Radiation Oncology Journal Vol.3 No.1

외음부에서 발생하는 악성종양은 부인과 영역의 악성종양 중에서는 드물게 발생하는 것으로 알려져 있으며 치료에 있어서도 수술 또는 방사선치료 단독의 경우보다는 수술 후 보조적으로 방사선 치료를 시행하는 것이 더 효과적이고 치료율도 높은 것으로 알려져 있다. 이에 1971년 1월부터 1985년 4월 사이에 연세대학교 의과대학 치료방사선과에서 외음부 악성 종양으로 진단되어 방사선 치료를 받았던 15예에 대하여 후향성 분석을 시행한 바 다음과 같은 결과를 얻었기에 보고하는 바이다. 1. 15예의 외음부 종양 환자 중 4예는 수술요법 시행 후 보조적요법의 방사선 치료를 받았으며, 1예는 수술전 방사선 치료를 받았고, 나머지 10예는 근치적 목적의 방사선 치료를 받았다. 2. 방사선치료만을 시행한 군과 방사선치료 및 수술요법을 병행한 군과의 국소제어율을 비교하여 본 결과, 전 15예의 국소제어율은 53%(8/15)였으며, 단지 방사선 치료만을 시행한 군에서는 40%(4/10), 방사선 치료 및 수술요법을 병행한 군에서는 80%(4/5)의 국소제어율을 보였다. 3. 치료 실패율은(국소적 잔존+국소재발 또는 원격전이) 단지 방사선 치료만을 시행한 군에서는 70%(7/10), 수술 후 방사선 치료를 시행한 군에서는40%(2/5)의 성적을 보였으며, 치료실패 호발부위는 원발병소(외음부)였다. This study analyzes fifteen patients who underwent a course of radiation therpy for their vulva cancer in the Department of Radiation Oncology, College of Medicine, Yonsei University from January, 1971 to April, 1985. Four patients had initial surgery for their vulva cancer and were subsequently treated by a course of adjuvant radiation therapy. Eleven patients were given radiation therapy as the initial course of therapy, and one of these was in adjuvant setting before radical surgery. Treatment in each instance was individuilzed and usually consisted of some components of external beam, brachytherapy, and/or electron beam therapy. Primary local control rate in all cases was 53%(8/15), 40%(4/10) in the radiation therapy alone group and 80%(4/5) in the radiation therapy combined with surgery group. Treatment failures were noted in 7/10 in the radiation therapy alone group and 2/5 in the radiation therapy combined with surgery group. The most common failure site was primary site failure(vulva).

Radiation Therapy in Malignant Tumors of the Parotid Gland

K.R. Park(박경란),W.Y. Oh(오원용),C.O. Suh(서창옥),G.E. Kim(김귀언),J.K. Loh(노준규),J.S. Park(박정수),J.S. Min(민진식) 대한방사선종양학회 1986 Radiation Oncology Journal Vol.4 No.1

이하선 악성종양의 치료는 근치적 수술이 주된 치료법으로 알려져 왔으나 이하선이 해부학적으로 주위의 근육, 골조직, 혈관, 신경등과 밀접하게 부착되어 있어 피막 및 주위 조직의 침윤이 있거나 조직학적으로 high grade tumor, 임파절 전이가 있는 경우 등에서 광범위한 근치적 수술로도 종양을 완전히 제거하기가 어렵고 수술 후 국소재발이 빈번한 것으로 알려져 있다. 수술만으로는 국소재발율이 상당히 높은 데도 북구하고 이 종양이 방사선치료에 반응하지 않는 것으로 잘못 인식되어져와서 수술후 방사선치료를 시행해 오지 않다가 근래에 와서 수술후 방사선치료가 실시되었고 수술만 시행한 경우에서보다 국소재발율이 현저히 감소한 것으로 보고되고 있어 현재는 방사선치료가 치료 결과를 향상시키는 중요한 치료방법으로 인식되고 있다. 이에 저자들은 1970년 1월부터 1982년 12월 사이 연세대학교 의과대학 연세암센터, 치료방사선과에서 이하선암으로 치료를 받은 31예를 대상으로 후향적 추적조사를 통하여 치료방법과 치료실패 양상을 분석하여 향후 치료방법의 실정과 치료 결과의 향상을 위하여 본 연구를 실시하였다. From 1970 to 1982, thirty one patients with malignant tumors of the parotid gland were treated with radiation therapy at department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center. Indication for radiotherapy were as follows: 1) when there were microscopic or gross residual diseases (6 patients), 2) when the patients considered to have high risk factors (15 patients), 3) when the tumor found to be inoperable (6 patients), 4) when there was recurrence after surgery (4 patients). Most patients were treated with a total of 5,000 to 6,500cGy in 5 to 6 weeks except when there were gross diseases, in which patients received slightly higher dose up to 7,000 cGy in 7 weeks. Locoregional failure rate was 43% in patients with microscopic or gross residual disease and high risk factors (postoperative radiotherapy group) and 20 in patients with inoperable tumor and recurrence after surgery (Primary radiotherapy group). There was no difference in the failure rates amen!1 the various histological types. Eight patients failed distantly, Severe complications appeared only in 2 patients irradiated for inoperable advanced diseases.

子宮頸部癌 腔內 放射線 照射裝置에 依한 直腸 및 膀胱의 被曝線量 評價

추성실(S.S.Chu),오원용(W.Y.Oh),서창옥(C.O.Suh),김귀언(G.E.Kim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.2

The intrauterine irradiation is essential to achieve adequate tumor dose to central tumor mass of uterine malignancy in radiotherapy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The simulation radiogram and medical records of 203 patients who were treated with intrauterine irradiation from Feb. 1983 to Oct 1983, were critically analized. The physical parameters to include distances between lateral walls of vaginal fornices, longitudinal and lateral angles of tandem applicator to the body axis, the distance from the external os of uterine cervix to the central axis of ovoids were measured for low dose rate irradiation system and high dose rate remote control afterloading system. The radiation doses and dose distributions within cervical area including interesting points and bladder, rectum, according to sources arrangement and location of applicator, were estimated with personal computer. Followings were summary of study results; 1. In distances between lateral walls of vaginal fornices, the low dose rate system showed as 4~7 cm width and high dose rate system showed as 5~6 cm. 2. In horizontal angulation of tandem to body axis, the low dose rate system revealed mid position 64.6%, left deviation 19/2% and right deviation 16.2%. 3. In longitudinal angulation of tandem to body axis, the mid position was 11.8% and anterior angulation 88.2% in low dose rate system but in high dose rate system, anterior angulation was 98.5%. 4. Down ward displacement of ovoids below external os was only 3% in low dose rate system and 66.7% in high dose rate system. 5. Inradiation source arrangement, the most activites of tandem and ovoid were 35 by 30 in low dose rate system but 50 by 40 in high dose rate system. 6. In low and high dose rate system, the total doses and TDF were 80, 70 Gy and 141, 123, including 40 Gy external irradiation. 7. The doses and TDF in interesting points Co, B, sere 98, 47 Gy and 230, 73 in high dose rate system but in low dose rate system, 125, 52 Gy and 262, 75 respectively. 8. Doses and TDF in bladder and rectum were 70, 68 Gy and 124, 120 in low dose rate system, but in high dose rate system, 58, 64 Gy and 98, 110 respectively, and then grades of injuries in bladder and rectum were 25, 30% and 18, 23% respectively.