• Radiation Oncology Journal
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• v.15 no.4
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• pp.357-367
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• 1997

Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.257-262
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• 2008

Purpose: Oral mucositis induced by radiotherapy to the head and neck area, is a common acute complication and is considered as the most severe symptom for cancer patients in the early stages of treatment. This study was proposed to establish the oral mucositis mouse model induced by a single dose of radiation for the facility of testing therapeutic candidates which can be used for the oral mucositis treatments. Materials and Methods: Fifty-five BALB/c mice were divided into four groups: control, 16 Gy, 18 Gy, and 20 Gy. Oral mucositis was induced by a single dose of radiation to the head and neck using 6 MV x-Ray from linear accelerator. After irradiation, body weight and physical abnormalities were checked daily. Tongue tissues from all groups were taken on days 1, 2, 3, 5, 7, 9, and 14, respectively and H&E staining was conducted to examine morphological changes. Results: Body weight dramatically decreased after day 5 in all irradiated mice. In the 16 Gy treatment group, body weight was recovered on day 14. The histology data showed that the thickness of the epithelial cell layer was decreased by the accumulated time after radiation treatment, up to day 9. Severe ulceration was revealed on day 9. Conclusion: A single dose of 16 Gy is sufficient dose to induce oral mucositis in Balb/C mice. Significant changes were observed in the Balb/C mice on days 7 and 9 after radiation. It is suggested that this mouse model might be a useful standard tool for studying oral mucositis induced by radiation.

• Radiation Oncology Journal
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• v.23 no.2
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• pp.106-110
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• 2005

Purpose : Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. Materials and Methods : From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at Kyung Hee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. Results : There was a tendency of frequent bleeding for the Patients younger than 11 (p=0.051) but there was also a tendency for more improvement in this group (p=0.057). The number of joint bleedings was related with joint pain (p=0.012) and joint swelling (p=0.033) but not with the Arbold-Hilgartner stage (p=0.739), cartilage destruction (p=0.718) and synovial hypertrophy (p=0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy (p=0.017). Conclusion : Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.

• Radiation Oncology Journal
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• v.28 no.2
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• pp.64-70
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• 2010

Purpose: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. Materials and Methods: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. Results: The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Conclusion: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.35-41
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• 1998

Purpose : To investigate the role of adjuvant chemoradiotherapy in adenocarcinoma of the rectum, we retrospectively compared the treatment results between postoperative adjuvant radiotherapy alone and combined chemoradiotherapy. Material and Methods : From October 1989 to May 1994, 141 patients with rectal carcinoma were treated by postoperative adjuvant therapy in Yonsei Cancer Center. Sixty eight patients were treated by radiation therapy alone. Seventy three patients were treated by combined chemoradiotherapy. Radiation therapy was delivered with 10 MV linear accelerator, 180cGy fraction/5 days per week. Total radiation doses were 5400cGy in the postoperative radiotherapy alone group. Three to twelve cycles of Fluorouracil(mean dose $393.9mg/m^2$) with Leucovorin($20mg/m^2$) and 5040cGy of radiation were delivered in the combined chemoradiotherapy group. Third and 4th cycle of chemotherapy were administrated during the radiation treatment in the combined group. The median follow up was 38 months with a range of 3 to 81 months. Results : The 5 year overall survival rate of radiation alone group and combined group were $60.1\%$ and $66.3\%$, respectively. The 5 year disease free survival rate of radiation aione group and combined group were $54.2\%$ and $65.5\%$, respectively There was no significant difference of overall survival and disease free survival between RT alone group and combined group(p<0.05). But the 5 year Local failure free survival rate of combined group was significantly better than radiotherapy alone group($05.8\%\;vs.\;50.3\%.\;p=0.04$). Conclusion : There was no significant difference in overall survival, disease free survival, and distant metastasis free survival between postoperative adjuvant radiotheray alone group and combinded chemoradiotherapy group. Only the Local failure free survival rate was superior in the combined treatment group. These results confirm the radiosensitizing effect of the chemotherapeutic agent in the combined chemoradiotherapy treatment.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.100-107
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• 1999

Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.