• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.75-79
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• 2012

Purpose: the study aimed to compare the quality of life (QOL) and radiotherapy complications among Chinese nasopharyngeal carcinoma (NPC) patients at different 3-dimensional conformal radiotherapy (3DCRT) stages adjusting for other variables. Methods: 511 NPC patients at different 3DCRT stages were enrolled. They were interviewed regarding SF-36, complications and socio-demographic variables and cancer- or treatment-related variables. Analysis of covariance (ANCOVA) based on SF-36, complications scores as dependent variables, 3DCRT stages as independent variables, and other variables as covariate were established. Results: The influencing factors of PCS included 3DCRT stages and age group. The influencing factors of MCS included 3DCRT stages and income. Most QOL scores of NPC patients were significantly associated with 3DCRT stage, after accounting for other variables. QOL scores of the patients receiving 3DCRT were the lowest, QOL scores of people after 3DCRT gradually increased. PCS scores of people greater than 5 years after 3DCRT was improved to or even better than the level before 3DCRT. The complications with significantly different scores of patients at different 3DCRT status included xerostomia, throat ache, hypogeusia, caries, hearing loss, snuffles. Conclusions: Clinicians should pay more attention to older NPC patients and patients with lower income. When patients receive 3DCRT, measures should be taken to reduce radiation injury to improve the patients' QOL.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.195-202
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• 1999

Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.547-552
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• 2013

To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.

• Radiation Oncology Journal
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• v.36 no.4
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• pp.276-284
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• 2018

Purpose: Traditionally, three-dimensional conformal radiation therapy (3D-CRT) is used for neoadjuvant chemoradiation in locally advanced rectal cancer. Intensity-modulated radiation therapy (IMRT) was later developed for more conformal dose distribution, with the potential for reduced toxicity across many disease sites. We sought to use the National Cancer Database (NCDB) to examine trends and predictors for IMRT use in rectal cancer. Materials and Methods: We queried the NCDB from 2004 to 2015 for patients with rectal adenocarcinoma treated with neoadjuvant concurrent chemoradiation to standard doses followed by surgical resection. Odds ratios were used to determine predictors of IMRT use. Univariable and multivariable Cox regressions were used to determine potential predictors of overall survival (OS). Propensity matching was used to account for any indication bias. Results: Among 21,490 eligible patients, 3,131 were treated with IMRT. IMRT use increased from 1% in 2004 to 22% in 2014. Predictors for IMRT use included increased N stage, higher comorbidity score, more recent year, treatment at an academic facility, increased income, and higher educational level. On propensity-adjusted, multivariable analysis, male gender, increased distance to facility, higher comorbidity score, IMRT technique, government insurance, African-American race, and non-metro location were predictive of worse OS. Of note, the complete response rate at time of surgery was 28% with non-IMRT and 21% with IMRT. Conclusion: IMRT use has steadily increased in the treatment of rectal cancer, but still remains only a fraction of overall treatment technique, more often reserved for higher disease burden.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.9-13
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• 2000

Objectives: To determine the tumor interstitial fluid pressure(TIFP) in patients with head and neck cancerand predict radiotherapy outcome.Materials and Methods: In 12 biopsy proven primary head and neck cancer patients with accessible by direct inspection and palpation, and of sufficient thickness(>1cm) to permit accurate needle placement, we measured TIFP at cervical lymph node before and during radiotherapy using a modified wick-in-needle technique. Tumor size was measured clinically and radiologically. Results: The mean preradiotherapy TIFP was 23.4mmHg. Preradiotherapy TIFP had significant relationship with tumor size(p=0.0009). Preradiotherapy TIFP was not different between complete response group and partial or less response group(p=0.114). Radiotherapy outcome was not different between group with above and group with below average TIFP(p=0.09). Conclusion: The mean TIFP was elevated with 23.4mmHg before radiation therapy. Preradiotherapy TIFP had significant relationship with tumor size. It is not definitive that TIFP could be prognostic indicator of radiation response.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.71-95
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• 1995

To be helpful to the treatment of pulmonary cancer with oriental medicine, we got clinical reports together and analyzed the data. The results were obtained as follows: 1. The treating methods could be summarized as three methods that were reinforcing vital energy, eliminating harmful Qi, and reinforcing vital energy with eliminating harmful Qi. The methods of reinforcing vital energy were supplementing Qi & Yin, increasing pahological heat & reinforcing kidney, augmenting Qi & blood, supplementing vital energy and strengthening fundermental energy, reinforcing spleen and increasing Qi, lubricate Yin and lung, and the other methods of eliminating harmful Qi were transforming pathological fluid and softening, clarifying heat and eliminating poison, dipersing lung and softening, toxicding and softening, guiding Qi and activating blood, clarifying heat and dispersing lung, guiding Qi and counteracting stress etc., and the methods of supplementing vital energy with eliminating poison were reinforcing spleen and transforming pathological fluid, increasing Qi and activating blood, supplementing Yin and clarifying heat, reinforcing spleen and dry the dampness, lubricating lung and transforming patholigical fluid and supplementing Qi and activating blood. 2. The oriental prescriptions used for pulmonary cancer were Chunkeum-Weekyungtang & Sohamhwingtang, Jinhayookgunjatang, Hyulboochukeotang, Bokbangkyogonamtang was reported to be effective in the treatment of metastasis. 3. Bokbangshinjingtang and haewool were applied for the complications of pulmonary cancer, Soshihotang for fever, hangamryung for tumor pain. Prunus ansu Komarov, Eriobotrya japonica Lirdley, Pyrrosiae lingua Farwel, Steomon japonica Miguel, Maximowiczia chinensis Ruprecht var, Morus bombycis Koidzumi for cough, Panax Pseudo-ginseng Wall. var, Bletilla striata Reichenbach f., Acacia catechu(兒茶) for hemoptysis, Lonicerae flos, Aspongopus chinensis(九香蟲) for chest pain, Cypsum Fibrosum, Gazella gutturosa, Scutellaria baicalensis Georgi, Gypsophila oldhamiana Miquel for fever, Lepidii semen descurainiae semen, Belamcanda chinensis D.C, Gnaphalium affine(佛耳草) for asthma. 4. For the reduction of side effect by chemotherapy and radiotherapy it was known that supplementing Qi was used chiefly for side effect of chemotherapy and augmenting Yin applied to side effect of radiotherapy. 5. The oriental presciptions were suggested for the side effect by chemotherapy and radiotherapy ; Sammaekaek(參麥液), Whaebokwontang(化瘀復元湯), Hwangjungomitang(黃精五味湯), Yukmijihwangtang(六味地黃湯), Hyangsayukgunjatang(香砂六君子湯), Samlyeekulsan for side effect by chemotherapy while Geumgweisingiwhan, Hwanglyentang(黃連湯), Hwanglyenhaedoktang(黃連解毒湯), Yangyeunchungpeitang(養陰淸肺湯), Idongtang(二冬湯), Jayeunkanghwatang(滋陰降火湯) for side effect by radiotherapy.

• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.489-502
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• 1997

Quality of life(QOL) and fatigue in cancer patients receiving the radiotherapy was assessed. The subjects were 46 cancer patients who daily attended the radiotherapy department. Assessment was done on four occassions : the first assessment was done on the treatment simulation visit, the second one was four weeks after treatment started, the third one at the completion of treatment and the last assessment was done between six and eight week following treatment. The results are as follows : The fatigue scores of the patients at each stage of assessment ranged from 5.49 points to 7.67 points and highest score was recorded at the third assessment that is, at the completion of treatment. The fatigue points showed an increase from the 1st. to 3rd. stage. However, at the 4th. stage, fatigue points decreased to the level at the first stage of assessment. QOL were assessed in three areas namely, physical, emotional and social /functional. The QOL scores in the physical area showed the highest score, followed by social /functional and emotional areas. The QOL scores decreased gradually to the third. stage of assessment thereafter recovered to the level of the first. stage. Correlation between QOL and fatigue scores during the treatment indicated that the level of QOL decreased as the level of fatigue increased. In particular, fatigue persisted after completion of the treatment and showed a significantly negative correlation with QOL. The present study strongly suggests that a strategy to restore the emotional well being level of the patient should be devised in order to improve QOL and reduce fatigue of patients receiving radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4233-4235
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• 2016

Background: Whole brain radiotherapy (WBRT) and stereotactic radiosurgery were frequently used to palliate patients with brain metastases. It remains controversial which modality or combination of therapy is superior especially in the setting of limited number of brain metastases. The availability of newer medical therapy that improves survival highlighted the importance of reducing long term radiation toxicity associated with WBRT. In this study, we aim to demonstrate the hippocampal sparing technique with whole brain and integrated simultaneous boost Materials and Methods: Planning data from 10 patients with 1-5 brain metastases treated with SRS were identified. Based on the contouring guideline from RTOG atlas, we identified and contoured the hippocampus with 5mm isocentric expansion to form the hippocampal avoidance structure. The plan was to deliver hippocampal sparing whole brain radiotherapy (HSWBRT) of 30 Gy in 10 fractions and simultaneous boost to metastatic lesions of 30 Gy in 10 fractions each. Results: The PTV, hippocampus and hippocampal avoidance volumes ranges between 1.00 - 39.00 cc., 2.50 - 5.30 cc and 26.47 - 36.30 cc respectively. The mean hippocampus dose for the HSWBRT and HSWBRT and SIB plans was 8.06 Gy and 12.47 respectively. The max dose of optic nerve, optic chiasm and brainstem were kept below acceptable range of 37.5 Gy. Conclusions: The findings from this dosimetric study demonstrated the feasibility and safety of treating limited brain metastases with HSWBRT and SIB. It is possible to achieve the best of both worlds by combining HSWBRT and SIB to achieve maximal local intracranial control while maintaining as low a dose as possible to the hippocampus thereby preserving memory and quality of life.

• Radiation Oncology Journal
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• v.31 no.3
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• pp.147-154
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• 2013

Purpose: To evaluate the role of salvage radiotherapy (RT) for the treatment of regional lymph node recurrence (RLNR) after radical surgery in advanced gastric cancer. Materials and Methods: We retrospectively analyzed medical records of 26 patients who underwent salvage treatment after diagnosis of RLNR between 2006 and 2011. Patients with peritoneal seeding or distant metastasis were excluded. Eighteen patients received RT with or without chemotherapy and the other 8 did chemotherapy only without RT. A three-dimensional conformal RT was performed with median dose of 56 Gy (range, 44 to 60 Gy). Sixteen patients had fluoropyrimidine-based chemotherapy, 5 did taxane-based chemotherapy, and irinotecan was applied in 4. Results: With a median follow-up of 20 months (range, 5 to 57 months), median overall survival (OS) and progression-free survival (PFS) after diagnosis of RLNR were 29 months and 12 months in the entire patients, respectively. Radiotherapy (p = 0.007) and disease-free interval (p = 0.033) were statistically significant factors for OS in multivariate analysis. Median OS was 36 months in patients who received RT and 16 months in those who did not. Furthermore, delivery of RT (p < 0.001), complete remission after salvage treatment (p = 0.040) and performance status (p = 0.023) were associated with a significantly better PFS. Gastrointestinal toxicities from RT were mild in most patients. Conclusion: Salvage RT combined with systemic chemotherapy may be an effective treatment managing RLNR from advanced gastric cancer.

• Radiation Oncology Journal
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• v.31 no.1
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• pp.18-24
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• 2013

Purpose: The purpose of this study was to assess the clinical outcomes of hypofractionated radiotherapy (HFRT) with three-dimensional conformal technique for medically inoperable patients with early stage non-small-cell lung cancer (NSCLC) and to evaluate prognostic factors. Materials and Methods: We performed a retrospective review of 26 patients who underwent HFRT for early stage NSCLC between September 2005 and August 2011. Only clinical stage T1-3N0 was included. The median RT dose was 70 Gy (range, 60 to 72 Gy) and the median biologically equivalent dose (BED) was 94.5 Gy (range, 78.0 to 100.8 Gy). In 84.6% of patients, 4 Gy per fraction was used. Neoadjuvant chemotherapy with paclitaxel and cisplatin was given to 2 of 26 patients. Results: The median follow-up time for surviving patients was 21 months (range, 13 to 49 months). The overall response rate was 53.9%, and the initial local control rate was 100%. The median survival duration was 27.8 months. Rates of 2-year overall survival, progression-free survival (PFS), local control (LC), and locoregional-free survival (LRFS) were 54.3%, 61.1%, 74.6%, and 61.9%, respectively. Multivariate analysis showed that BED (>90 vs. ${\leq}90$ Gy) was an independent prognostic factor influencing PFS, LC, and LRFS. Severe toxicities over grade 3 were not observed. Conclusion: Radical HFRT can yield satisfactory disease control with acceptable rates of toxicities in medically inoperable patients with early stage NSCLC. HFRT is a viable alternative for clinics and patients ineligible for stereotactic ablative radiotherapy. BED over 90 Gy and 4 Gy per fraction might be appropriate for HFRT.