• 제목/요약/키워드: Cancer radiotherapy

검색결과 1,773건 처리시간 0.024초

위암 표준진료권고안 (Clinical Practice Guideline of Gastric Cancer in Korea)

  • 김재규
    • Journal of Digestive Cancer Research
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    • 제4권1호
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    • pp.10-16
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    • 2016
  • There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

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폐암의 방사선치료 결과 (Result of Radiation Therapy for the Lung Cancer)

  • 김주영;최명선;서원혁
    • Radiation Oncology Journal
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    • 제7권2호
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    • pp.213-225
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    • 1989
  • An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.

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Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

  • Ding, Xiu-Ping;Zhang, Jian;Li, Bao-Sheng;Li, Hong-Sheng;Wang, Zhong-Tang;Yi, Yan;Sun, Hong-Fu;Wang, Dong-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.319-323
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    • 2012
  • Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

전립선암에서 강도변조방사선치료 (Intensity Modulated Radiation Therapy)의 적용 (Application of Intensity Modulated Radiation Therapy (IMRT) in Prostate Cancer)

  • 박석원;오도훈;배훈식;조병철;박재홍;한승희
    • Radiation Oncology Journal
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    • 제20권1호
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    • pp.68-72
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    • 2002
  • 최근 들어 새로운 방사선치료법인 강도변조방사선치료가 많은 종류의 종양치료에 적용되어 치료에 따른 부작용을 줄이고 치료율을 향상시키려는 노력들이 이루어지고 있다. 특히 전립선암에서 강도변조방사선치료법을 적용하여 삼차원입체조형치료에 비해 향상된 선량분포와 이로 인한 주위 정상조직의 방사선량을 줄임으로써 더욱 많은 양의 방사선을 전립선에 투여할 수 있고 이로 인하여 치료율의 상승을 기대할 수 있게 되었다. 저자들은 강도변조방사선치료를 전립선암에 적용하였기에 이에 대한 문헌고찰과 함께 치료과정을 보고하고자 한다.

대장암환자 수술치료가 신체기능에 영향을 미치는 요인 (The Effect of Physical Function on Operative Treatment of Colorectal Cancer Patients)

  • 이성란
    • 한국산학기술학회논문지
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    • 제11권9호
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    • pp.3412-3416
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    • 2010
  • 본 연구의 목적은 대장암환자 수술치료가 신체기능에 영향을 미치는 요인을 규명하고자 시도되었다. 서울지역에 소재한 종합병원에 내원한 대장암 환자 110명을 대상으로 2009년 12월 15일부터 2010년 1월 30일까지 설문 및 면접조사를 실시하였다. 연구결과는 첫째, 수술치료 부작용은 복원술 후 보다 복원술 전 환자들에서 유의하게 높았다(t=5.284, p<0.001). 둘째, 성적만족은 수술 전이 수술 후 방사선 치료 환자들보다 유의하게 높은 것으로 나타났다(t=1.946, p<0.05). 셋째, 배뇨문제는 장루가 있는 경우가 장루가 없는 경우보다 유의하게 높은 불편감을 가진 것으로 나타났다(t=1.537, p<0.05). 결론적으로 대장암환자 수술치료의 신체기능을 향상하기 위해서는 기능상태 및 증상 불편감을 개선시킬 수 있는 중재프로그램의 개발이 필요하다.

초기 유방함의 근치적 방사선치료 (Radical Radiotherapy with Lumpectomy (wide excisional biopsy) for Early Breast Cancer -A Case Report and Review of Literature-)

  • 오원용;황인순
    • Radiation Oncology Journal
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    • 제6권2호
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    • pp.283-288
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    • 1988
  • 초기 유방암의 치료는 근치적 절제술이 오랫동안 주된 치료방법으로써 선택되어 왔으나, 근래에는 여성의 유방을 보존하고 미용효과를 기대할 수 있는 보조적 절제술 후 근치적 방사선치료법이 개발되어 지대한 관심과 상당한 논란이 거듭되어 왔다. 이러한 논란을 해결하기 위하여 그동안 세계적으로 많은 후향성 또는 전향성 분석을 시행하여 두 치료방법사이의 치료효과를 비교하여 본 결과, 국소치료율, 재발을, 그리고 생존율에 있어서 큰 차이를 보이지 않았다. 이와 같은 치료성적의 결과를 토대로 하여 최근에는 보조적 절제술 후 근치적 방사선치료법이 여성들의 유방을 보존하고 미용효과를 향상시킬 수 있을 뿐만 아니라 국소치료율, 재발율, 생존율도 근치적 절제술의 성적과 대동소이하므로 초기 유방암의 치료에 활발히 이용되기에 이르렀다. 본원에서도 이러한 추세에 따라서 보조적 절제술 후 근치적 방사선치료를 시행한 초기 유방암 1예를 보고하면서 아울러 많은 문헌고찰과 함께 향후 치료방침을 세우고자 한다.

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폐암으로 유발된 무기폐에 대한 방사선 치료의 효과 (Radiation Effect on Airway Obstruction from Lung Cancer)

  • 신세원;김성규;김명세
    • Journal of Yeungnam Medical Science
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    • 제6권2호
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    • pp.121-125
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    • 1989
  • 1986년 4월부터 1988년 12월까지 영남대학병원 치료 방사선과에 폐암으로 확진후 등록된 환자중 기관지정 검사상 지도 폐쇄의 소견이 있으며 흉부 X-선 사진상 현저한 폐음영이 있었던 환자 21명에 대한 방사선 치료 성적은 다음과 같다. 1. 71.4%의 환자(15/21)에서 임상 증상의 호전을 보였다. 2. 소세포성 암환자는 30GY/10 fractions의 선량에서도 100%의 증상 호전 및 흉부 X-선상 소견의 호전을 보였다. 3. 비소세포성 암환자에서 50GY이상 조사군 이 45GY이하 조사군 보다 우수한 성적을 보였다. 4. 병변의 위치와 무기폐의 호전정도는 무관하였다.

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Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States

  • Weiner, Joseph P.;Schwartz, David;Shao, Meng;Osborn, Virginia;Choi, Kwang;Schreiber, David
    • Radiation Oncology Journal
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    • 제35권2호
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    • pp.137-143
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    • 2017
  • Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was $725cGy{\times}5fractions$ (49.6%) followed by $700cGy{\times}5fractions$ (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently $700-725cGy{\times}5fractions$ appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

Upregulation and Clinicopathological Significance of Long Non-coding NEAT1 RNA in NSCLC Tissues

  • Pan, Lin-Jiang;Zhong, Teng-Fei;Tang, Rui-Xue;Li, Ping;Dang, Yi-Wu;Huang, Su-Ning;Chen, Gang
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2851-2855
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    • 2015
  • Background: Recent reports have shown that nuclear enriched abundant transcript 1 (NEAT1), a long noncoding RNA (lncRNA), contributes to the precise control of gene expression and is related to several human malignancies. However, limited data are available on the expression and function of NEAT1 in lung cancer. The major objective of the current study was to profile the expression and clinicopathological significance of NEAT1 in non-small cell lung cancers (NSCLCs). Materials and Methods: NEAT1 expression in 125 NSCLC cases and paired adjacent non-cancer tissues was assessed by real-time quantitative reverse transcription-PCR (qRT-PCR). Relationships between NEAT1 and clinicopathological factors were also investigated. Results: The relative level of NEAT1 was $6.98{\pm}3.74$ in NSCLC tissues, significantly elevated as compared to that of the adjacent non-cancer lung tissues ($4.83{\pm}2.98$, p<0.001). The area under curve (AUC) of high expression of NEAT1 to diagnose NSCLC was 0.684 (95% CI: 0.619~0.750, p<0.001). NEAT1 expression was positively correlated with patient age (r=-2.007, p=0.047), lymphatic metastasis (r=-2.731, p=0.007), vascular invasion (r=-3.617, p=0.001) and clinical TNM stage (r=-4.134, p<0.001). Conclusions: This study indicates that NEAT1 might be associated with oncogenesis and progression in NSCLC, and suggests application in molecular targeted therapy.

Soft-tissue Sarcomas in the Asia-Pacific Region: A Systematic Review

  • Ngan, Roger;Wang, Edward;Porter, David;Desai, Jayesh;Prayogo, Nugroho;Devi, Beena;Quek, Richard
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6821-6832
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    • 2013
  • Background: Soft-tissue sarcomas require tailored and multidisciplinary treatment and management. However, little is known about how sarcomas are treated and managed throughout the Asia-Pacific region. Materials and Methods: MEDLINE was systematically searched using prespecified criteria. Publications (previous 10 years) that reported tumour characteristics, treatment patterns, survival outcomes, and/or safety outcomes of patients with soft-tissue sarcoma were selected. Exclusion criteria were studies of patients <18 years of age; ${\leq}10$ patients; countries other than Australia, Hong Kong, Indonesia, Korea, Malaysia, New Zealand, Philippines, Singapore, Taiwan, or Thailand; >20% benign tumours; sarcomas located in bones or joints; gastrointestinal stromal tumour; Kaposi's sarcoma; or not reporting relevant outcomes. Results: Of the 1,822 publications retrieved, 35 (32 studies) were included. Nearly all patients (98%, 1,992/2,024; 31 studies) were treated with surgery, and more studies used adjuvant radiotherapy than chemotherapy (24 vs 17 studies). Survival outcomes and recurrence rates varied among the studies because of the different histotypes, sites, and disease stages assessed. Only 5 studies reported safety findings. Conclusions: These findings highlight the lack of specific data available about soft-tissue sarcomas in the Asia-Pacific region. Better efforts to understand how the sarcoma is managed and treated will help improve patient outcomes in the region.