• Radiation Oncology Journal
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• v.36 no.2
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• pp.147-152
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• 2018

Purpose: To evaluate the treatment outcomes of adjuvant external beam radiation therapy (EBRT) and vaginal brachytherapy (VB) following radical hysterectomy in cervical cancer patients with involved vaginal resection margin (VRM). Materials and Methods: We retrospectively reviewed the medical records of 21 patients treated with postoperative EBRT and VB for positive VRM FIGO stage IB-IIA cervical cancer between 2003 and 2015. Concurrent platinum-based chemotherapy was administered to all patients. Results: The median whole pelvis EBRT dose was 50.4 Gy (range, 45 to 50.4 Gy). In the VB, the median dose per fraction, number of fractions, and total dose delivered were: 4 Gy (range, 3.0 to 4.0 Gy), 4 fractions (range, 3 to 5 fractions), and 16 Gy (range, 12 to 20 Gy), respectively. At a median follow-up of 46 months (range, 9 to 122 months), local recurrence was observed in 2 patients, and distant metastasis was present in 7 patients. All patients with local recurrence subsequently developed distant metastases. The 5-year local control, disease-free survival, and overall survival rates were 89.1%, 65.9%, and 62.9%, respectively. Of the 21 patients, 7 patients (33.3%) reported grade 2 acute toxicity; however, there were no grade 3 or higher acute adverse events. Grade 1-2 late toxicities were observed in 8 patients. Late grade 3 urinary toxicity was reported in 1 patient. Conclusions: Adjuvant EBRT and VB showed excellent local control and low toxicity in cervical cancer patients with positive VRM. Although limited by its retrospective nature, the findings from our study provide evidence supporting the use of additional VB in pathologically involved VRM.

• Imaging Science in Dentistry
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• v.46 no.4
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• pp.291-296
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• 2016

Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.

• 대한핵의학회:학술대회논문집
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• 2002.11a
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• pp.32.2-32.2
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• 2002

• The Korean Journal of Pain
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• v.10 no.2
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• pp.250-253
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• 1997

The perineum is comprised of diverse anatomic structures with mixed sympathetic and somatic innervation. The coccyx is innervated by the coccygeal nerves and branches of the fifth sacral root. Recently, ganglion impar block has been introduced as an alternative means of managing intractable pain of sympathetic origin, coccygodynia by trauma, tenesmus and perineal hyperhydrosis. We managed a 59-year-old female patient who had suffered from perineal pain by metastasis of cervical cancer. Approach to impar ganglion through the anococcygeal ligament was impossible because her coccyx was hyperflexed anteriorly by old fracture. But we could perform ganglion impar block successfully by approach through the separation of sacrum and coccyx.

• Journal of Veterinary Clinics
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• v.35 no.6
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• pp.308-310
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• 2018

A 17-year-old neutered male Miniature Pinscher dog presented with a mass on the left side of the submandibular region. Fine needle aspiration revealed malignant epithelial cells from the salivary gland but no evidence of metastasis was found on radiography, ultrasonography, or computed tomography. The cervical mass was surgically resected, and the histopathological examination confirmed adenocarcinoma of the mandibular salivary gland. Seven months after the initial diagnosis, the dog is alive without any clinical signs. This report describes the clinical findings, cytology, diagnostic imaging, and histopathological characteristics of a mandibular salivary gland adenocarcinoma in a Miniature Pinscher dog.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.191-199
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• 1996

Purpose : To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative radiotherapy for the uterine cervical cancer were analyzed retrospectively. Materials and Methods : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients ($3.4\%$) in stage Ib, 2 patients ($3.4\%$) in stage IIa, 31 patients ($52.5\%$) in stage IIb, 15 patients ($25.4\%$) in stage IIIb, 9 patients ($15.3\%$) in stage IV. External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR. A point dose of ICR was calculated to 30-43.66 Gy (median: 34.6 Gy). These techniques delivered total A Point dose of 80.4 to 109.8 Gy (median: 85 Gy). Patients had been followed up from 2 to 110 months (median: 61 months) Results : The overall 5-year survival rate & disease free survival rate were $55.9\%$ and $55.0\%$ respectively. According to FIGO stage, the 5-year survival rate for less than IIa, IIb, IIIb, IV were $75.0\%$, $74.8\%$, $26.7\%$, $33.3\%$, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage IIIa and above revealed $74.8\%$, $29.2\%$ respectively (P<0.005). According to the hemoglobin level during RT, the 5-rear survival rate of was $73.3\%$ for patients with Hg 10 gm/dL or higher, in contrast to $0\%$ for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5cm), the 5-year survival rates were $71.8\%$. The 5-rear survival rates for 18 patients with 5 cm or greater in tumor diameter were $22.2\%$ (p<0.005). The 5-year survival rate for Patient age of above 50 years and below were $65.3\%$ $34.2\%$ respectively (p<0.05). ECOG performance status. pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multivariate analysis showed the hemoglobin level during RT (P=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468). Total recurrence rate was $23.7\%$ local failure $15.2\%$ (9/59), distant metastasis $6.8\%$ (4/59), local and distant metastasis $1.7\%$ (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was $23.8\%$ (14/59) The late complication rate of colorectum and genitourinary tract were $15.3\%$ (9/59), $8.5\%$ (5/59), respectively: 10 patients ($17.0\%$) were grade 2, 3 Patients ($5.1\%$) were grade 3 and one patient ($1.7\%$) was grade 4. The late complications were radiation proctitis, rectal bleeding, radiation colitis, diarrhea and radiation cystitis in decreasing order. Conclusion : For improvement of therapeutic results, prospective randomized trials are recomended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.482-485
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• 2013

This case report describes the increment of regulatory T cells in thyroid carcinoma of a mixed breed dog compared with normal dogs. A mixed breed dog was referred for a submandibular mass and hyperthermia. Right cervical mass was detected during the physical examination and radiography identified right cervical mass suspected thyroid gland. Accurate location and size of mass was confirmed using computed tomography and 3D reconstructed images. After confirmation of mass, surgical resection was performed and evaluation of regulatory T cells in blood of this patient was performed using flow cytometric assay. The percentage of regulatory T cells was 38.28% of all CD4 (+)/CD25 (+) T cells. This result was higher than median percentage of regulatory T cells of healthy 8 beagles ($7.66{\pm}1.65%$ (p<0.01) of all CD4 (+)/CD25 (+) T cells). And masses were confirmed as giant cell thyroid carcinoma based on histopathologic examination. After surgical resection of cervical mass was performed, the owner didn't want chemotherapy. Seven days later, cervical mass came out again. And CBC showed severe leukocytosis (WBC $47.6{\times}10^3/{\mu}L$) and non-regenerative anemia (PCV 21%). Suspected pulmonic metastasis regions became more severe. Finally the dog died of severe anemia and respiratory disorder.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.55-61
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• 1995

Purpose : Despite a development of therapeutic machines and advance in modern radiation therapy techniques, locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate, Combination of chemotherapy and radiotherapy demonstrated benefit in improving local control and possibly the overall survival. Our study was performed to evaluate effect of concurrent chemoradiation on locally advanced uterine cervical cancer. Methods and Materials : Twenty six patients with locally advanced stage(FIGO stage IIB with ${\geq}5cm$ in diameter, III, IVA) were treated with combination of radiation therapy and concurrent cisplatinum between May of 1988 and September of 1993 at our hospital. Radiation therapy consisted of external irradiaton and 1-2 sessions of intracavitary irradiation. Cisplatinum was administered in bolus injection of 25mg/$m^2$ at weekly intervals during the course of external radiation therapy. Results : Of the 26 Patients, twenty-five patients were evaluable for estimation of response. Median follow-up period was 25 months with ranges from 3 to 73 months. Stage IIB, III, and IVA were 16, 5, 4 patients, respectively, Twenty patients were squamous cell carcinoma. Response was noted in all 25 patients: complete response(CR) in 17/25($68\%$), Partial response(PR) in 8/25($32\%$). Of the 24 patients except one who died of sepsis at 3 months follow-up, seventeen patients($70.8\%$) maintained local control in the pelvis: 16/17($94.1\%$) in CR, 1/17($14.3\%$) in PR. Fourteen of the 17 patients with CR are alive disease free on the completion of follow-up. Median survival is 28 months for CR and 15 months for PR. Analysis of 5-year survival by stage shows 11/16($59.8\%$) in IIB, 3/5($60.0\%$) in III, and 1/4($25.0\%$) in IVA. Overall 5-year survival rate was $55.2\%$. Ten patients recurred: 4 at locoregional, 3 in distant metastasis and 3 with locoregional and distant site. Toxicity by addition of cisplatinum was not excessive. Conclusion : Although the result of this study was obtained from small number of patients, it is rather encouraging in view of markedly improved response rate compared with the results of historical group.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.182-191
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• 2018

Purpose: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. Materials and Methods: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and disease-specific survival (DSS) rates were calculated by the Kaplan-Meier method. Results: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. Conclusion: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.544-550
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• 2010

Purpose: The result of all malignant neoplasms including oral cancer is decided by long-term prognosis. However, until now, there are only a few reports about long-term prognosis of cancer secluded in the oral cavity. So, we investigated all patients that visited our clinic for oral squamous cell carcinoma (SCCa) for the last 10 years. From this survey, we hope to find important factors that influence prognosis of the disease. Patients and Methods: A retrospective study was performed for patients that visited the oral oncology clinic for oral cancers from Jan. 2001 to Feb. 2010. We selected the patients that were diagnosed with SCCa and received curative treatment. In these patients, we investigated basic epidemiology, smoking history, body mass index, recurrence rate, treatment methods, pathologic data and 5-yr survival rate. Results: There was a total of 185 patients (115 males, 70 females and mean age: 57.3 years) that visited the oral oncology clinic for oral SCCa. Areas of primary lesion were tongue (105 cases, 57%), lower gum (19 cases, 10%), floor of mouth (16 caess, 8%), retromolar trigone (12 cases, 6.5%), and buccal cheek (11 cases, 6%). Other involved areas were upper gum, palate, lip, and salivary glands-of 1 case each. The overall 5-year survival rate was 63.7%. The factors that influenced prognosis of the disease were stage of the disease, status of differentiation, recurrence, metastasis of cervical lymph node and age. Conclusion: The factors that influence prognosis of disease are stage of the disease, status of differentiation, recurrence, metastasis of cervical lymph node and age. To point out a current trend, the mean age of patients that developed oral cancer was lower than that of before. Secondly, the prevalence of oral cancer in non-smoker are on the rise. Thus, further studies on etiology and epidemiology should be done.