• Radiation Oncology Journal
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• v.27 no.2
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• pp.64-70
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• 2009

Purpose: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. Materials and Methods: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/$m^2$). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/$m^2$) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. Results: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. Conclusion: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.2
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• pp.217-221
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• 2000

Solid and papillary epithelial neoplasm of the pancreas is an uncommon low-grade malignant tumor found predominantly in young females. It is rare in childhood. The origin of the tumor is probably from a multipotential stem cell of the pancreas. Neoplasm usually behave like a very low grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. We report a case of solid and papillary epithelial neoplasm of the pancreas in a 14 year -old girl who presented with intermittent abdominal pain and abdominal mass. CT scan shows a large, about $7{\times}6\;cm$ sized, well-marginated hypodense round mass in the head of the pancreas with some ill defined enhancing solid internal portion. She had taken complete excision of the pancereatic mass and Roux-en-Y pancreaticojejunostomy and histologically comfirmed solid and papillary epithelial neoplasm of the pancreas. A brief review of literature was made.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.331-335
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• 1993

From January 1981 to December 1991, forty patients with localized advanced carcinoma of the pancreas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. The treatment protocol consisted of two split course external radiation therapy with each 2000 cGy over two weeks separated by two week rest period. Intravenous 5-fluorouracil (5-FU) was administered on the first three days of each radiotherapy course. Twenty three of these patients were treated by maintenance 5-FU or FAM (5-FU, adriamycin, mitomycin) chemotherapy. Median survival was 9 months and the 2-year survival rate was $10.0\%.$ Good prognostic indicators were good performance status, palliative bypass surgery and tumor located in the head of pancreas.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.213-218
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• 2007

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1-and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2-and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

• Journal of the Korean Society of Radiology
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• v.85 no.4
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• pp.795-800
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• 2024

Intraductal papillary mucinous neoplasm (IPMN) is a tumor originating from pancreatic ductal epithelial cells, leading to excessive mucus secretion and dilation of the pancreatic duct. Pathologically, IPMNs display a wide range of dysplasia, ranging from low-grade dysplasia to invasive carcinoma. Invasion into surrounding organs, especially into spleen, is rare and has not been reported in Korean journals. Worldwide, only two cases have been reported. Here, the authors report their experience with a rare case of IPMN in the pancreas that invaded the spleen.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.89-98
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• 1998

The search for tumor-avid agents for use in nuclear medicine imaging is an ongoing field of importance. The purpose of this study was to determine the affinity for radio labeled vitamin $B_{12}$ by a wide histologic variety of tumor types in mice. Seventeen different types of tumor were grown subcutaneously in female Balb/C or Balb nu/nu(nude) mice. When the tumors reached about 1 cm in diameter, mice were injected intraperitoneally with $^{57}Co$-vitamin $B_{12}$. Twenty-four hours later, the mice were sacrificed. Organs and tissues were removed, weighed, and activity per mg determined by gamma counter. Values represented cpm/mg tissue that was normalized to 20 grams body weight for each mouse. A wide variety of tumor types showed significant uptake and concentration of $^{57}Co$-vitamin $B_{12}$, as evidenced by tumor:tissue activity ratios. For many tissues of great importance in terms of background(bone, muscle, blood), the tumor:tissue activity ratios of uptake were high. These data strongly suggest that further efforts to evaluate the utility of radio labeled adducts of vitamin $B_{12}$ for clinical use in oncologic imaging are warranted.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.64-69
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• 2014

Among exocrine pancreatic tumors, adenosquamous carcinoma is a rare, aggressive subtype with a poor prognosis and a high potential for metastases compared with its more conventional glandular counterpart, adenocarcinoma of the pancreas. We herein describe the imaging findings of pancreatic adenosquamous cell carcinoma with solitary liver metastasis showing different imaging features and also review the previous literature to recognize characteristic imaging features of pancreatic adenosquamous cell carcinoma.

• Radiation Oncology Journal
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• v.4 no.2
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• pp.141-145
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• 1986

From January,1981 to December,1985,22 patients with locally unresectable carcinoma of the pancreas were treated in the Department of Therapeutic Radiology, Seoul National University Hospital. Radiation was given in two spl it courses; each consisting of 2000 cGy over two weeks sepatated by two-week rest period. 5-FU was administered on the first three days of each radiation therapy course. FAM (5-fluorouracil, adriamycin, mitomycin) was administered for maintenance chemotherapy. For pain control, complete relief was obtained in $22\% (4/18)$ of patients and partial relief in 39% (7/18). Median survival was 31 weeks. Pretreatment performance status was the only statistically significant prognostic factor.

• Journal of Gastric Cancer
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• v.8 no.2
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• pp.104-109
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• 2008

Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.204-209
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• 2008

Purpose: The goal of this study was to review the clinicopathologic characteristics of neuroendocrine tumor (NET) of the stomach. Materials and Methods: We retrospectively reviewed the medical records of 13 patients who were diagnosed with neuroendocrine tumor from January 1999 to August 2007 at Kosin Medical Center; 4,159 gastric cancer patients were treated surgically during the same time. The average follow up period was 14.3 months. Results: The majority of 13 patients were men (male-female ratio: 11:2) and the average age of patients with NET was 59.4 years (range: 42~72 years). The presenting symptoms were mostly epigastric pain and soreness. The tumor was limited to the mucosa or submucosa in two cases, and the tumor extended beyond the muscle layer in 11 cases. The mean size of the tumor was 7.0 cm, ranging from 0.7 cm to 15 cm. The type of the NEC (according to the WHO classification) was type 3 for eight patients, type 4 for four patients and type 1 for one patient. Regional lymph node metastasis was noted in 11 patients. Four cases showed recurrence of disease and the site of recurrence included liver in two patients, multiple organs (including the peritoneum and lung) in one patient and multiple organs (including liver, pancreas and duodenum) in one patient. The recurrent cases were type 3 and type 4 and the average survival period of the recurrent patients was 12.8 months. Conclusion: The majority of neuroendocrine tumors of the stomach were at an advanced stage at the time of diagnosis. These tumors frequently recurred in the liver and they have a poor prognosis.