• Title/Summary/Keyword: Cancer radiotherapy

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Concurrent Chemoradiotherapy Using Weekly Cisplatin with or without Daily Oral UFT in Nasopharyngeal Cancer (비인강암에서 저용량 시스플라틴$\pm$경구용 UFT를 이용한 동시항암방사선치료의 효과)

  • Ahn Jin-Hee;Chang Hye-Sook;Lee Sang-Wook;Park Jin-Hong;Kim Sang-Yoon;Nam Soon-Yuhl;Cho Kyung-Ja;Kim Woo-Kun;Lee Jung-Shin;Kim Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.184-191
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    • 2002
  • 연구방법 : 근치적 목적의 동시항암방사선치료를 시행받은 비인강암 환자들을 대상으로하여 치료 효과와 독성에 대한 후향적 분석을 시행하였다. 환자 및 방법 : 1993년 8월부터 1999년 3월까지 원격전이가 없는 50명의 비인강암 환자들이 방사선 치료기간 중 주 1회의 시스플라틴 $20mg/m^2$을 투여받았고, 1999년 4월부터 2000년 4월까지 20명의 환자가 상기 용량의 시스플라틴에 더하여 경구용 UFT300mg을 추가적으로 투여받았다. 총 70명 환자들의 임상기록과 병리 기록지를 검토하였다. 결 과: 연령의 중앙값은 47세 (범위 $18{\sim}76$)였고, 남자와 여자가 각각 53명과 17명 이었으며, 병기 II, III, IVA, IVB가 각각 23명, 14명, 15명, 18명이었다. 치료에 대한 반응율은 92.8%(95% C.I. $42{\sim}143%$)였고(완전반응 57명, 부분반응 8명), 총 34개월의 추적 관찰 기간 동안에 완전반응을 보인 57명 중 21명에서 재발(국소재발 5, 원격전이 11, 복합전이 5)을 하였다. 3년 무진행 생존율은 51.5%였으며 5년 생존율은 60.3%였다. 경구용 UFT의 추가적 사용은 주 1회 시스플라틴 항암치료에 비하여 반응율과 생존율 및 독성에 유의한 영향을 미치지 않았다. 결 론: 주 1회 저용량 시스플라틴$\pm$경구용 UFT를 이용한 동시항암방사선요법은 비인강암 환자의 치료에 있어서 비교적 적은 독성으로 높은 반응율을 나타내었으나, 향후 재발율을 감소시키기 위한 연구가 지속되어야 할 것으로 사료된다.

Adjuvant Chemotherapy after Surgical Resection for Small-Cell Carcinoma of Lung (소세포폐암에서 수술 후 복합화학요법의 성적)

  • Kim, Hak-Ryul;Jung, Jong-Hoon;Kim, Hwi-Jung;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.443-448
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    • 2004
  • Background : Small-cell carcinomas of lung have a tendency for rapid growth and early wide metastasis. Despite the high response rates of combination chemotherapy alone or with radiotherapy, the overall long-term survival rate is very disappointing. According to autopsy findings, the common cause of failure is local recurrence in the primary cancer site. Therefore, surgical resection with combined chemotherapy has recently been attempted for very early stage small-cell carcinomas of the lung. Methods : 10 patients (TNM I & II: 5 cases each) undergoing surgical resection for small-cell carcinomas of the lung were treated with adjuvant chemotherapy in an attempt to prolong survival. Of these, 9 patients received chemotherapy, and a retrospective study for survival undertaken (Kaplan-Meier analysis). Results : The median survival time was 26 months, and the 2- and 5-year survival rates were 68.6 and 46.7%, respectively. If the 1 patient not having undergone chemotherapy was excluded, the 2-, 5-year survival rates were 76.2 and 50.8%, respectively? No difference in the survival rate was seen between patients with TNM stages I and II. Conclusion : Adjuvant chemotherapy after surgical resection results in prolonged survival for patients with TNM stages I and II small-cell carcinomas of the lung.

An Ultrastructural Study on the Parotid Acinar Cells of X-irradiated Rats (X-선 조사를 받은 흰쥐 귀밑샘 샘포의 미세구조)

  • Yang, Nam-Gil;Park, In-Kyu;Ahn, E-Tay;Ko, Jeong-Sik;Park, Kyung-Ho;Kim, Jin-Gook
    • Applied Microscopy
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    • v.24 no.1
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    • pp.28-40
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    • 1994
  • Xerostomia and xerophthalmia are delicate or serous side effects, occuring when the radiotherapy is administered to the head and neck cancer patient. It is known that the cause of the above side effect is radiosensitivity of serous cells. In this study, the ultrastructural features of the parotid glands of the X-irradiated rats were observed. Sprague-Dawley rats weighing 200-250g each were anesthetized with sodium thiopental, and placed on the Mitsubishi linear accelerator. Only the head and neck areas of animals were exposured at the distance of 80cm, within the area of $30X30cm$, in the depth of 1cm, with the speed of 200R/min. Total doses applied were 3,000R or 6,000R depending on the experimental groups. Animals were sacrificed on the 6th hour, 2nd day and 6th day after the irradiation. Parotid glands were fixed in the 2.5% glutaraldehyde-1.5% paraformaldehyde solution, and followed by refixation in the 1% osmium tetroxide solution. Dehydrated blocks were embedded in araldite mixture, and ultrathin sections were cut. Sections were contrasted with the solution of uranyl acetate and lead citrate, and observed with JEM 100 CX-II electron microscope. The results were as follows: 1. Normal parotid acinar cells are two types; the light and the dark acinar cells. The light acinar cell contains dense secretory granules, whereas dark acinar cells contains granules of medium density with some darker spots within them, or other cells contain granules of medium density with darker rims. 2. Six hours after the irradiation, many acinar cells were degenerated showing variable stages of cytolytic bodies, light bodies, or dense degenerations. Within the acinar cell, Golgi apparatus and granular endoplasmic reticula were most severely altered elements. Granules showed more contrasting densities and irregularities. 3. Two days after the irradiation, some cytolytic bodies, and focal lucent degeneration of cytoplasm, and fine granular alteration of cytoplasmic matrix were pronounced. But other elements including secretory granules are rather looked unlatered. 4. Six days after the irradiation, most severe alterations were seen. Many intracellular canaliculi (or secretion figures), quanta of cytoplasm containing secretion antecedants, severely irregular luminal border, and again contrasting density of secretory granules showing tigroid spots or dense rims were noted. And myoepithelial degenerations were observed not uncommonly. 5. Irregular densities of secretory granules were interpreted as abnormal components of protein or carbohydrate portion are synthesized or abnormally metabolized under severe X-irradiation. 6. Myoepithelial degeneration and related alteration of nerve endings, etc., were suggested as the other causes of xerostomia following X-irradiation. 7. It is requested that radiation doses should be arranged, considering in mind not only the sensitivity of acinar cells but also the myoepithelial and neural functions.

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Therapeutic Effect of Oncolytic Herpes Simplex Virus on Induced Radioresistant Head and Neck Squamous Cell Carcinoma (방사선 치료에 내성이 유도된 두경부 편평세포암에 대한 종양살상 헤르페스 바이러스의 유전자 치료 효과)

  • Kim, Se-Heon;Choi, Eun-Chang;Lee, Jin-Seok;Chun, Je-Young;Byun, Hyung-Kwon;Song, Ki-Jae;Kim, Kwang-Moon
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.130-136
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    • 2006
  • Introduction : The sensitivity of tumor cells to radiotherapy is a critical determinant of local control and potential cure in advanced head and neck squamous cell carcinoma(HNSCC). The emergence of radioresistant tumor cells is an obstacle to cancer therapy. Most radioresistant cells have a higher proportion of cells in the Sphase of the cell cycle and a lower apoptotic fraction than radiosensitive cells. HSV replication is increased in cells that have higher S-phase fractions. NV1066 is an oncolytic herpes simplex virus type-1 mutant. We hypothesized that NV1066 replication and cytotoxicity are increased in radioresistant cells. The purpose of this study is to evaluate the antitumor efficacy of NV1066 to treat radioresistant HNSCC. Methods : Radioresistant cells were selected by treating five HNSCC cell lines with repeated conventional fractionated doses of radiation(2Gy/day), using a Cs-137 irradiator, up to a cumulative dose of 70Gy. Clonogenic cell survival and S-phase fractions were compared between radioresistant and parental radiosensitive cells. The two cell populations were then treated with NV1066 to examine viral replication, by the viral plaque assay and viral cytotoxicity. Results : Fractionated irradiation resulted in the selection of radioresistant cells. Radioresistant cells had a higher S-phase fraction(42.9%) compared to parental cells(26.2%). NV1066 replication in radioresistant cells was 7.4 times higher than in parental cells(p<0.01). Treatment with NV1066 resulted in increased cytotoxicity of 24.5% in radioresistant cells compared to parental cells(p<0.05). Conclusion : NV1066 showed increased viral replication and cytotoxicity in radioresistant HNSCC cell lines. These findings suggest a potential clinical application for this oncolytic viral therapy as treatment for radioresistant head and neck cancers.

Safety Simulation of Therapeutic I-131 Capsule Using GEANT4 (GEANT4를 이용한 치료용 I-131 캡슐의 안정성 시뮬레이션)

  • Jeong, Yeong-Hwan;Kim, Byung-Cheol;Sim, Cheol-Min;Seo, Han-Kyung;Gwon, Yong-Ju;Han, Dong-Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.57-61
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    • 2014
  • Purpose Iodine (I-131) is one of the most widely used radioactive isotopes for therapeutic in the field of nuclear medicine. Therapeutic I-131 capsule is made out of lead to shield high energy radiation. Accurate dosimetry is necessarily required to perform safe and effective work for relative workers. The Monte Carlo method is known as a method to predict the absorbed dose distribution most accurately in radiation therapy and many researchers constantly attempt to apply this method to the dose calculation of radiotherapy recently. This paper aims to calculate distance dependent and activity dependent therapeutic I-131 capsule using GEANT4. Materials and Methods Therapeutic capsules was implemented on the basis of the design drawings. The simulated dose was determined by generating of gamma rays of energy to more than 364 keV. The simulated dose from the capsule at the distance of 10 cm and 100 cm was measured and calculated in the model of water phantom. The simulated dose were separately calculated for each position of each detector. Results According to the domestic regulation on radiation safety, the dose at 10 cm and 100 cm away from the surface of therapeutic I-131 capsule should not exceed 2.0 mSv/h and 0.02 mSv/h, respectively. The simulated doses turned out to be less than the limit, satisfying the domestic regulation. Conclusion These simulation results may serve as useful data in the prediction of hands dose absorbed by I-131 capsule handling. GEANT4 is considered that it will be effectively used in order to check the radiation dose.

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Quality Assurance of Multileaf Collimator Using Electronic Portal Imaging (전자포탈영상을 이용한 다엽시준기의 정도관리)

  • ;Jason W Sohn
    • Progress in Medical Physics
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    • v.14 no.3
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    • pp.151-160
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    • 2003
  • The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

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Development of a Korean Adult Female Voxel Phantom, VKH-Woman, Based on Serially Sectioned Color Slice Images (고해상도 연속절단면 컬러해부영상을 이용한 한국인 성인여성 복셀팬텀 VKH-Woman 개발)

  • Jeong, Jong Hwi;Yeom, Yoen Soo;Han, Min Cheol;Kim, Chan Hyeong;Ham, Bo Kyoung;Hwang, Sung Bae;Kim, Seong Hoon;Lee, Dong-Myung
    • Progress in Medical Physics
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    • v.23 no.3
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    • pp.199-208
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    • 2012
  • The computational human phantom including major radiation sensitive organs at risk (OARs) can be used in the field of radiotherapy, such as the variation of secondary cancer risks caused by the radiation therapy and the effective dose evaluation in diagnostic radiology. The present study developed a Korean adult female voxel phantom, VKH-Woman, based on serially sectioned color slice images of Korean female cadaver. The height and weight of the developed female voxel phantom are 160 cm and 52.72 kg, respectively that are virtually close to those of reference Korean female (161 cm and 54 kg). The female phantom consists of a total of 39 organs, including 27 organs recommended in the ICRP 103 publication for the effective dose calculations. The female phantom composes of $261{\times}109{\times}825$ voxels (=23,470,425 voxels) and the voxel resolution is $1.976{\times}1.976{\times}2.0619mm^3$ in the x, y, and z directions. The VHK-Woman is provided as both ASCII and Binary data formats to be conveniently implemented in Monte Carlo codes.

A Comparative Study of Radiation Therapy Planning between Volumetric-Modulated Arc Therapy and Three-Dimensional Conformal Radiotherapy in Nasopharyngeal Cancer (비인두암의 방사선치료 시 삼차원입체조형 치료기법과 용적세기조절회전치료기법의 비교연구)

  • Kim, Ji-Sung;Lee, Seok-Ho;Lee, Seung-Heon;Kim, Hye-Young;Choi, Jin-Ho;Lee, Kyu-Chan;Kim, Dong-Young
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.171-177
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    • 2010
  • 연구목적 : 비인두암 환자들을 대상으로 방사선치료 시 삼차원입체조형치료기법과 용적세기조절회전치료기법을 비교하고 이하선을 포함한 정상조직 보호에 있어 그 차이점을 알아 보고자 본 연구를 시행하였다. 대상 및 방법 : 비인두암 환자 5명을 대상으로 치료계획용 CT(computed tomography)를 시행 후 삼차원입체조형방사선치료계획 과 용적세기조절회전치료계획을 시행하였다. 이를 바탕으로 얻은 선량분포, conformity index(CI) 그리고 선량체적 히스토그램을 통해 손상위험장기(organ at risk)와 계획용표적체적(planning target volume)을 비교 분석하였다. 결 과 : 분석결과 이하선에 조사되는 평균선량이 용적세기조절회전치료계획에서는 43.9%로 삼차원입체조형치료계획에서의 89.4% 보다 유의하게(p=0.043) 감소하였다. 계획용표적체적 conformity index의 경우 용적세기조절회전치료계획 (CI=1.06)에서 삼차원입체조형치료계획(CI=2.55) 보다 유의하게(p=0.043) 향상된 결과를 보였다. 결 론 : 비인두암 환자에서 용적세기조절회전 치료계획 시 삼차원입체조형치료계획 보다 유의하게 이하선에 평균선량이 줄었고 계획용 표적체적에 대한 conformity도 유의하게 향상되는 결과를 보였다. 본 연구가 적은 수의 환자를 대상으로 하였으나 용적세기조절회전치료기법을 시행 시 구강건조증의 발생을 줄일 수 있을 것으로 기대된다. 향후 더 많은 환자군을 대상으로 한 임상연구가 필요할 것으로 사료된다.

Hemopoietic and Radioprotective Effects of Several Herbs on Murine Splenocytes and Bone Marrow Cells (수(數) 종(種) 한약재(韓藥材)가 생쥐의 골수(骨髓) 및 비장세포(脾臟細胞)의 조혈촉진(造血促進)과 방사선(放射線) 방어(防禦)에 미치는 영향)

  • Lee, Neung-Gi;Choe, Seung-Hun;An, Gyu-Seok
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.3 no.1
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    • pp.29-48
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    • 1997
  • Astragalus membranaceus Bunge (黃?), Atractylodes macrocephala Loidz (白朮), Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子), Ligustrum lucidum Ail (女貞子) are Herbs that are frequently used in a lot of prescriptions to reduce the side effects of anti-cancer therapies, especially like chemotherapy and radiotherapy. The radioprotective and hemopoietic effects of these Herbs on BALB/c splenocytes and bone marrow cells are measured. In order to evaluate the Hemopoietic effects, Thymidine uptakes and secretion of colony stimulating factors(CSFs) of splenocytes and myelocytes treated with herbs were measured. Radioprotective effects were accessed by the method of immunocompetence of murine lymphocytes cultured with herbs before irradiation and with LPS, ConA after irradiation. The results are as follows. 1. The orders of Proliferative effects of herbs on splenocytes were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus membranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸). Lycium chinense Mill (枸杞子) and Ligustrum lucidum Ait (女貞子), the lowest of all. At Optimal concentration, the proliferation ratios of herb-treated splenocytes compared to non-treated ones were like these. Atractylodes macrocephala Loidz (白朮) 44.3, Astragalus membranaceus Bunge (黃?) 17.7, Angelica sinensis(Oliv) Kiels (當歸) 10, Lycium chinense Mill (枸杞子) 6.4, Ligustrum lucidum Ait (女貞子) 2.0.(p<0.05) 2. When splenocytes were cultured during different periods, Atractylodes. macrocephala Loidz (白朮) and Astragalus membranaceus Bunge (黃?) showed the higest proliferation on 3th day, Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) on 4th day,(p<0.05) and Ligustrum lucidum Ait (女貞子) until 5th day but with no significant increase. 3. The orders of Proliferative effects of herbs on Bone Marrow(BM) cells were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus memhranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) and Ligustrum lucidum Ait (女貞子), the lowest of all too. At Optimal concentration, the proliferation ratios of herb-treated BM cells compared to non-treated ones were like these. Atractylodes macrocephala Loidz (白朮) 21.7, Astragalus membranaceus Bunge (黃?) 9.9, Angelica sinensis(Oliv) Kiels (當歸) 4.9, Lycium chinense Mill (枸杞子) 2.3, Ligustrum lucidum Ait (女貞子) 1.4(p<0.05). 4. The secretion ratio of colony stimulating factors(CSFs) of each herb-treated group, compared to control, was Atractylodes macrocephala Loidz (白朮) 9.4, Astragalus membranaceus Bunge (黃?) 9.0, Angelica sinensis(Oliv) Kiels (當歸) 4.4, Lycium chinense Mill (枸杞子) 3.8 (p<0.05) but no significant increase in Ligustrum lucidum Ait (女貞子). 5. The mitogen(ConA, LPS) stimulated-lymphocytes cultured with each herb before irradiation of 1-3 Gy showed more enhanced proliferation than control(p<0.05). When compared to each non-irradiated group of all groups, the orders of percentage increase of irradiated group were Atractylodes macrocephala Loidz (白朮), the higest of all, Astragalus membranaceus Bunge (黃?), Angelica sinensis(Oliv) Kiels (當歸), Ligustrum lucidum Ait (女貞子), Lycium chinense Mill (枸杞子). Each percentage showed significant enhancement compared to control group(p<0.05). According to the results, Atractylcdes macrocephala Loidz (白朮), Astragalus membranaceus Bunge (黃?) are suggested to be the most effective hemopoietic and radioprotective herbs, and Angelica sinensis(Oliv) Kiels (當歸), Lycium chinense Mill (枸杞子) the next, but Ligustrum lucidum Ait (女貞子) showed lower effects than expected.

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Immunomodulatory Effects of Aureobasidium pullulans SM-2001 Exopolymers on Cyclophosphamide-Treated Mice

  • Yoon, Hyun-Soo;Kim, Joo-Wan;Cho, Hyung-Rae;Moon, Seung-Bae;Shin, Hyun-Dong;Yang, Kun-Ju;Lee, Hyeung-Sik;Kwon, Young-Sam;Ku, Sae-Kwang
    • Journal of Microbiology and Biotechnology
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    • v.20 no.2
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    • pp.438-445
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    • 2010
  • The immunomodulatory effects of Aureohasidium pullulans SM-2001 exopolymers containing $\beta$-1,3/1,6-glucan were evaluated in cyclophosphamide (CPA)-treated mice. To induce immunosuppression, 150 and 110 mg/kg of CPA were intraperitoneally injected 3 days and 1 day, respectively, before beginning administration of the test material. Exopolymers were delivered subcutaneously or orally, four times, in a volume of 10 ml/kg at 12-h intervals beginning 24 h after the second CPA treatment. Changes in thymus and spleen weights, splenic amounts of tumor necrosis factor (TNF)-$\alpha$, interleukin (IL)-$1{\beta}$, and IL-10, and numbers of CD3+, CD4+, CD8+, and TNF-$\alpha+$ thymus and spleen cells were monitored in CPA-treated mice. As a result of CPA treatment, dramatic decreases in the number of CD3+, CD4+, CD8+, and TNF-$\alpha+$ cells were detected in the thymus and spleen, along with decreases in thymus and spleen weights. In addition, splenic TNF-$\alpha$, IL-$1{\beta}$, and IL-10 contents were also decreased on observation with flow cytometry. However, oral and subcutaneous treatments with exopolymers effectively reduced the immunosuppressive changes induced by CPA. Therefore, it is concluded that exopolymers of A. pullulans SM-2001 can effectively prevent immunosuppression through, at least partially, the recruitment of T cells and TNF-$\alpha+$ cells or enhancement of their activity, and can provide an effective component of prevention or treatment regimens for immunosuppression related to cancer, sepsis, and high-dose chemotherapy or radiotherapy.