• 제목/요약/키워드: Grade 91

검색결과 418건 처리시간 0.028초

병기 I, II 자궁 경부암에서 방사선치료 후 생존율 및 합병증 분석 (Survival and Complication Rate of Radiation Therapy in Stage I and II Carcinoma of Uterine Cervix)

  • 마선영;조흥래;손승창
    • Radiation Oncology Journal
    • /
    • 제13권4호
    • /
    • pp.349-357
    • /
    • 1995
  • 목적 : 수술을 시행 받지 않은 IB, IIA, IIB 자궁경부암 환자에서 외부 방사선 조사 및 강내조사 방법에 따른 생존율과 방광 및 직장 합병증 발생률을 분석하여 보고자 하였다. 방법 : 1984년 11월 부터 1993년 12월 까지 인제대학교 부산백병원 치료방사선과에서 근치적 방사선치료 또는 화학요법을 병행한 자궁경부암 병기 IB, IIA, IIB 환자 127명 중 추적 가능하였던 환자 107명을 대상으로 생존율을 후향적 분석하였고, 합병증은 91명에서 추적 가능하였다. 방사선 단독으로 치료 받은 환자가 86명, 보조적 화학요법을 받은 환자는 21명이었다. 대상 환자들의 추적 조사 기간은 3개월에서 118개월이었고 (중앙값, 47개월), 환자의 연령은 31세에서 76세까지 (중앙값, 56세) 분포를 보였다. FIGO 병기 IB기가 26명, IIA기가 40명, IIB기가 41명 이었다. 강내 방사선 조사는 저선량률 강내조사를 받은 군(80명)과 고선량률 강내조사를 받은 군(21명)으로 나누어 분석하였다. 저선량률 강내조사는 1회 시행받은 환자군(63명)과 2회로 나누어 시행받은 환자군(17명)을 비교하여 보았고, 저선량률 강내조사를 받은 환자 중에서 전골반 외부 조사선량에 따라 4500cGy 이하인 환자군(18명)과 4501cGy 이상인 환자군(62명)으로 나누어 분석하였다. 외부 조사선량이 5000cGy 이상인 환자 중에서 중심선 차폐(midline block)를 한 군(36명)과 하지 않은 군(31명)을 나누어 분석하였다. 결과 : 전체 환자의 5년생존율은 $69{\%}$였고, 병기별 5년생존율은 IB $92{\%}$, IIA $75{\%}$, IIB $53{\%}$로 나왔다. 직장 합병증은 Grade 1이 20명($22{\%}$), Grade 2가 22명($24{\%}$) 이었고, 방광 합병증은 Grade 1이 22명($24{\%}$), Grade 2가 17명($19{\%}$) 이었으며 수술을 요할 정도의 심각한 합병증은 없었다. 방광 및 직장 합병증이 나타났던 군에서 합병증이 없었던 군보다 방광 및 직장에 조사된 최대 방사선량(maximum dose)의 평균치가 높았던 것으로 나타났다 (최대 방광 조사선량 평균 : 7608cGy v 6960cGy (p<0.01), 최대 직장 조사선량 평균 : 7041cGy v 6269cGy (p<0.01)). 외부 조사선량이 4500cGy 이하인 군과 4501cGy 이상인 군에서 생존율과 방광 합병증 발생율은 통계적 차이가 없었으나 Grade 2 직장 합병증 발생율은 각각 $6.3{\%},\;25.5{\%}$ (p<0.05)로 4500cGy 이하인 군에서 낮은 것으로 나타났다. 고선량률 강내조사를 받은 군과 저선량률 강내 조사를 받은 군 사이에 생존율은 병기별 분석에서 유의한 차이가 없었으며, 합병증 발생률은 고선량률 강내조사 군에서 더 높게 나타났지만 Point A와 직장에 조사된 방사선량이 저선량률 강내조사 군에 비해 높아 고선량률 강내치료 자체가 합병증 발생률을 높인 인자로 볼 수는 없었다 (p<0.01). 저선량률 강내조사의 횟수에 따른 생존율이나 합병증 발생률의 차이는 없었다. 외부조사시 중심선 차폐 여부에 따른 생존율과 직장 합병증 발생률의 유의한 차이는 없었으나 방광 합병증 발생률은 중심선 차폐를 시행한 군에서 더 높았다 (p<0.05). 결론 : 병기 IB, IIA, IIB 자궁경부암에서 방사선 치료방법에 따른 생존율은 통계적으로 유의한 차이는 없었으며, 직장 합병증은 외부 조사선량이 4500cGy이하인 군에서 4501cGy 이상인 군에서보다 낮은 것으로 나타났고, 최대 방광 선량과 최대 직장 선량이 합병증 발생률과 유의한 상관관계를 보여, 향후 전골반 외부 조사선량이 4500cGy를 넘지 않도록 주의하여야 되겠고, 강내 치료 계획시 직장 및 방광 선량을 가능한 낮추도록 치료 선량을 결정해야 할 것이다.

  • PDF

초등학생의 스트레스요인, 대처방식, 어머니와의 의사소통 및 학교적응 (Stressor, Coping Style, Communication with Mother & School Adaptation in 6th Grade Elementary School Children)

  • 홍연란
    • Child Health Nursing Research
    • /
    • 제6권3호
    • /
    • pp.362-371
    • /
    • 2000
  • The purpose of this study was to examine the stressors, coping styles, communication with mother, school adaptation and predictors for school adaptation. The subjects of this study consisted of 354 children. They were 6th grade of elementary school in Taegu city. The periods of study was from march 10, to march 18, 2000. Data were analyzed by SAS computer programme. The results of this study were as follows: 1. The mean score for stressor was 39.91 in children(range 24-72). The higher stressor among three subgroups of stressor was mass media stressor. The degree of stressor revealed to be influenced significantly economic status. 2. The most frequently used coping style was problem-oriented coping style(M=18.94) in children. The degree of emotion-oriented coping style revealed to be influenced significantly family's atmosphere 3. The mean score for communication with mother was 72,44 in children(range 20- 100). The degree of communication with mother revealed to be influenced significantly sex, economic status, family' atmosphere. 4. The mean score for school adaptation was 62.48 in children(range 25-100). The higher school adaptation among five subgroup was rule dimension. The degree of school adaptation revealed to be influenced significantly sex, birth, mother's job, economic status, family's atmosphere. 5. School adaptation were positively correlated with communication with mother, problem- oriented coping style(r=0.40 p<0.001) (r=0.30 p<0.001). 6. School adaptation were negatively correlated with emotion-oriented coping style, stressor (r=-0.16 p<0.01)(r=-0.13 p<0.01). 7. Forward multiple regression analysis revealed that the most powerful predictor was the variable communication with mother accounted for 15.25% in school adaptation. All variables accounted for 25.55% in school adaptation. From the above results, it can be concluded that teaching mother about importance of communication, encouraging to use problem-oriented coping style is necessary to improve school adaptation in 6th grade elementary school children

  • PDF

Pattern analysis of lower limb magnetic resonance images in Korean patients with distal myopathy

  • Park, Hyung Jun;Shin, Ha Young;Kim, Seung Min;Park, Kee Duk;Choi, Young-Chul
    • Annals of Clinical Neurophysiology
    • /
    • 제21권2호
    • /
    • pp.79-86
    • /
    • 2019
  • Background: Magnetic resonance (MR) images are useful for diagnosing myopathy. The purpose of this study was to determine the usefulness of lower-limb MR images in Korean patients with distal myopathy. Methods: We reviewed medical records in the myopathy database from January 2002 to October 2016. We selected 21 patients from 91 unrelated families with distal myopathy: four with GNE myopathy, 11 with dysferlinopathy, and six with ADSSL1 myopathy. Results: Ten (48%) of the 21 patients were men. The ages of the participants at symptom onset and imaging were $19.2{\pm}9.5$ and $30.4{\pm}9.0$ years (mean${\pm}$standard deviation), respectively. Their grade on the modified Gardner-Medwin and Walton grade was $3.3{\pm}1.7$. The strength grade of the knee extensors was not correlated with the Mercuri scale for the quadriceps (r = -0.247, p = 0.115). However, the Medical Research Council grades of the knee flexors, ankle dorsiflexors, and ankle plantar flexors were significantly correlated with the Mercuri scale ratings of the knee flexors (r = -0.497, p = 0.001), tibialis anterior (r = -0.727, p < 0.001), and ankle plantar flexors (r = -0.620, p < 0.001), respectively. T1-weighted MR images showed characteristic fatty replacement patterns that were consistent with the causative genes. Unsupervised hierarchical clustering of the Mercuri scale showed that the main factors contributing to the dichotomy were the causative gene and the clinical severity. Conclusions: This study is the first to reveal the usefulness of lower-limb MR images in the differential diagnosis of distal myopathy in Korea.

Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young;Park, Seo Hee;Kim, Joohyung;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
    • /
    • 제51권3호
    • /
    • pp.163-178
    • /
    • 2021
  • Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

Genetic Parameter Estimates of Carcass Traits under National Scale Breeding Scheme for Beef Cattle

  • Do, ChangHee;Park, ByungHo;Kim, SiDong;Choi, TaeJung;Yang, BohSuk;Park, SuBong;Song, HyungJun
    • Asian-Australasian Journal of Animal Sciences
    • /
    • 제29권8호
    • /
    • pp.1083-1094
    • /
    • 2016
  • Carcass and price traits of 72,969 Hanwoo cows, bulls and steers aged 16 to 80 months at slaughter collected from 2002 to 2013 at 75 beef packing plants in Korea were analyzed to determine heritability, correlation and breeding value using the Multi-Trait restricted maximum likelihood (REML) animal model procedure. The traits included carcass measurements, scores and grades at 24 h postmortem and bid prices at auction. Relatively high heritability was found for maturity ($0.41{\pm}0.031$), while moderate heritability estimates were obtained for backfat thickness ($0.20{\pm}0.018$), longissimus muscle (LM) area ($0.23{\pm}0.020$), carcass weight ($0.28{\pm}0.019$), yield index ($0.20{\pm}0.018$), yield grade ($0.16{\pm}0.017$), marbling ($0.28{\pm}0.021$), texture ($0.14{\pm}0.016$), quality grade ($0.26{\pm}0.016$) and price/kg ($0.24{\pm}0.025$). Relatively low heritability estimates were observed for meat color ($0.06{\pm}0.013$) and fat color ($0.06{\pm}0.012$). Heritability estimates for most traits were lower than those in the literature. Genetic correlations of carcass measurements with characteristic scores or quality grade of carcass ranged from -0.27 to +0.21. Genetic correlations of yield grade with backfat thickness, LM area and carcass weight were 0.91, -0.43, and -0.09, respectively. Genetic correlations of quality grade with scores of marbling, meat color, fat color and texture were -0.99, 0.48, 0.47, and 0.98, respectively. Genetic correlations of price/kg with LM area, carcass weight, marbling, meat color, texture and maturity were 0.57, 0.64, 0.76, -0.41, -0.79, and -0.42, respectively. Genetic correlations of carcass price with LM area, carcass weight, marbling and texture were 0.61, 0.57, 0.64, and -0.73, respectively, with standard errors ranging from ${\pm}0.047$ to ${\pm}0.058$. The mean carcass weight breeding values increased by more than 8 kg, whereas the mean marbling scores decreased by approximately 0.2 from 2000 through 2009. Overall, the results suggest that genetic improvement of productivity and carcass quality could be obtained under the national scale breeding scheme of Korea for Hanwoo and that continuous efforts to improve the breeding scheme should be made to increase genetic progress.

코의 Angiocentric Immunoproliferative Lesions(AILs) (Angiocentric Immunoproliferative Lesions(AILs) in Nose)

  • 한지연;김재유;이연수;정수미;김민식;윤세철;김훈교;조승호;김병기;이경식;김동집
    • 대한두경부종양학회지
    • /
    • 제12권1호
    • /
    • pp.16-21
    • /
    • 1996
  • Lymphomatoid granulomatosis, polymorphic reticulosis, midline malignant reticulosis, or lethal midline granuloma have similar histologic features of an angiocentric and angiodestructive lymphoreticular proliferation representing the same nosologic entity. The term 'angiocentric immunoproliferative lesion' (AIL) was proposed by Jaffe, Costa, and Martin. The malignant potential of AILs is originally uncertain, but the facts that AILs have a relatively short survival, and most of them usually progress to an overt malignant lymphoma and survival is inversely proportional to the large, atypical lymphoreticular cells suggest that AILs are malignane. We experienced 17 AILs in nose during 16-year period and retrogradely analized them to recognize the problems in the diagnosis and to establish the further therapeutic strategies. The results were as follows; Twelve of total 17 patients who had diagnosed as histologic grade 1 and 2 had received radiation therapy as an initial treatment and the complete response rate was 91.7%(11/12), but 6 out of 11 had local recurrence and 5 had progress to overt maligant lymphoma within 2years. Three patients with the histologic grade 3 and 2 with unclear histologic grade had received CHOP chemotherapy and there was 1 case with complete response. Two patients with unclear histologic grade had been proved to be malignant histiocytosis by bone marrow biopsy during the clinical course. The overall duration of survival was 2 - 119 months and the 5-year survival rate was 71.9%. And the achievement of initial complete response was the most important prognostic factor of overall survival(P=0.006). Our results suggest that the treatment strategy according to the histologic grading scheme is efficient and more aggressive combination chemotherapy may be necessary to achieve complete response in patients with histologic grade III and II, because most of them progress to overt malignant lymphoma during its process.

  • PDF

초등학생의 부력 개념 형성과 인지 수준의 관계 (Elementary School Students형 Conceptions of Buoyance related with Cognitive Levels)

  • 권도현;권성기
    • 한국초등과학교육학회지:초등과학교육
    • /
    • 제19권1호
    • /
    • pp.131-143
    • /
    • 2000
  • The unit of a buoyant force included in the 7th national science curriculum for 6th grade students. On the contrary, it seldom that students' conception about buoyant phenomena is studied, even though there has been many studies of students' conceptions of basic science contents. The purpose of this study was to survey the elementary school students' conceptions of a buoyant force, to analyze their cognitive levels, and to explore the relationships between them. Sixth grade students (total numbers is 192) were selected .from 5 .lasses in two elementary schools in a local city of Kyungsangdo. They were asked to respond two kinds of test, which are the Logical Thinking Ability (GALT) to investigate students' cognitive levels and the Buoyant Force Questionnaire (BFQ). We developed BFQ test, based on the 7th national science curriculum for 6th grade and the previous researches of a buoyant force. We, qualitatively, analysed students' frequency of responses about a buoyant force and their types of explanation, and, quantitatively, analysed the relationships between cognitive levels and conceptions of a buoyant force with SPSS/ PC 7.0 programmes. The results of cognitive level showed that half of 6th grade students were in the concrete operational stage, 43.2% in the transitional stage, 6.8% in the formal stage. However, their sub-logical thinking abilities in a combinational, conservational, controlling variables, proportional, probability and correlational logic were very fluctuated from 91% to 8%. The results that only 4.8% of elementary students had correct conceptions of a buoyant force suggest that 6th grade students had great difficulties in understanding of that concept. Their difficulties would originated from the frequent common-sense explanations of a buoyant phenomena in terms of the weight or the unique properties or the contact area of an object or with/without air. Furthermore students' explanations, frequently, changed with context of problems of a buoyant force. Scheffe test of quantitative results that elementary students in the concrete level had 50.6% of concept formation in a buoyant force, the transitional level 54.5%, and in the formal operational level 62.8% showed significant differences of conceptions of a buoyant force with cognitive levels. Therefore the concrete operational elementary students had more difficulties of understanding of a buoyant force than the transitional and formal level, which is required to higher cognitive levels. This conclusion have implications that the unit of a buoyant force have to be presented with concrete activities for majority of students who are in concrete and transitional levels.

  • PDF

Development of On-line Quality Sorting System for Dried Oak Mushroom - 3rd Prototype-

  • 김철수;김기동;조기현;이정택;김진현
    • Agricultural and Biosystems Engineering
    • /
    • 제4권1호
    • /
    • pp.8-15
    • /
    • 2003
  • In Korea, quality evaluation of dried oak mushrooms are done first by classifying them into more than 10 different categories based on the state of opening of the cap, surface pattern, and colors. And mushrooms of each category are further classified into 3 or 4 groups based on its shape and size, resulting into total 30 to 40 different grades. Quality evaluation and sorting based on the external visual features are usually done manually. Since visual features of mushroom affecting quality grades are distributed over the entire surface of the mushroom, both front (cap) and back (stem and gill) surfaces should be inspected thoroughly. In fact, it is almost impossible for human to inspect every mushroom, especially when they are fed continuously via conveyor. In this paper, considering real time on-line system implementation, image processing algorithms utilizing artificial neural network have been developed for the quality grading of a mushroom. The neural network based image processing utilized the raw gray value image of fed mushrooms captured by the camera without any complex image processing such as feature enhancement and extraction to identify the feeding state and to grade the quality of a mushroom. Developed algorithms were implemented to the prototype on-line grading and sorting system. The prototype was developed to simplify the system requirement and the overall mechanism. The system was composed of automatic devices for mushroom feeding and handling, a set of computer vision system with lighting chamber, one chip microprocessor based controller, and pneumatic actuators. The proposed grading scheme was tested using the prototype. Network training for the feeding state recognition and grading was done using static images. 200 samples (20 grade levels and 10 per each grade) were used for training. 300 samples (20 grade levels and 15 per each grade) were used to validate the trained network. By changing orientation of each sample, 600 data sets were made for the test and the trained network showed around 91 % of the grading accuracy. Though image processing itself required approximately less than 0.3 second depending on a mushroom, because of the actuating device and control response, average 0.6 to 0.7 second was required for grading and sorting of a mushroom resulting into the processing capability of 5,000/hr to 6,000/hr.

  • PDF

자궁경부암의 고선량률 근접치료 : 분할선량에 따른 결과 비교 (High-Dose-Rate Brachytherapy for Uterine Cervical Cancer : The Results of Different Fractionation Regimen)

  • 윤원섭;김태현;양대식;최명선;김철용
    • Radiation Oncology Journal
    • /
    • 제20권3호
    • /
    • pp.228-236
    • /
    • 2002
  • 목적 : 자궁경부암의 고선량률 근접치료는 각 기관마다 분할선량이 매우 다양하게 사용되고 있고 각 분할선량에 따른 치료 결과가 임상적으로 비교된 적이 적었던 바 저자들은 자궁경부암 환자에서 고선량률 근접치료의 분할선량에 따른 국소제어율과 합병증 발생을 비교하여 적정한 분할선량에 대해 알아보고자 하였다. 대상 및 방법 : 1992년 11월부터 1998년 3월까지 자궁경부암으로 진단 후 방사선치료를 시행한 224명을 대상으로 하였다. A군은 122명(수술 후 방사선치료 67명, 근치적 방사선치료 55명)으로 외부방사선 치료 후 고선량률 근접치료의 분할선량을 line-A (선원으로부터 반경 2 cm를 이은 등량선)에 3 Gy를 주당 3회씩 $6\~10$회 조사한 군이었고 B군는 102명(수술 후 방사선치료 49명, 근치적 방사선치료 53명)으로 외부방사선 치료가 시행된 후 분할선량을 line-A에 4 또는 4.5 Gy를 주당 2회씩 $6\~8$회 조사한 군이었다. 외부방사선치료는 10 MV X-선을 이용하여 전골반부에 $45\~54\;Gy$ (중앙값 54 Gy)를 조사하였다. 고선량률 근접치료는 이리디움(iridium)-192를 사용하였다. 합병증은 RTOG morbidity grading system에 따라 grade 1에서 5까지 나누어서 평가하였다. 결과 : A군과 B군의 5년 국소제어율은 각각 $80\%,\;84\%$였고(p=0.4523) B군에서 더 높은 국소제어율을 보였다. 근치적 방사선치료군에서는 A군과 B군의 5년 국소제어율이 각각 $62.9\%,\;76.9\%$ (p=0.2557), 수술 후 방사선치료군에서는 A군과 B군의 5년 국소제어율이 각각 $91.7\%,\;91.6\%$ (p=0.8867)였다. A군에서는 22명$(18.0\%)$에서 합병증이 발생하였고 B군에서는 30명$(29.4\%)$에서 합병증이 발생하였다. 방광에 대한 합병증은 A군에서 12명$(9.8\%)$이 발생하였고 grade 3 이상이 2명이었다. B군에서는 15명$(14.7\%)$에서 합병증이 발생하였으며 grade 3이상이 3명이었다. 직장에 대한 합병증은 A군에서 12명$(9.8\%)$에서 발생하였고 grade 3 이상이 1명이었고 B군에서는 22명$(21.6\%)$에서 발생하였고 grade 3 이상이 10명이었다. 합병증에 대한 단일변량분석에서 고선량률 근접치료의 분할 선량이 작으면 전체 합병증(0=0.0405), 직장의 합병증(0=0.0147), 방광의 합병증(0=0.115)이 감소하였고 수술 후 방사선치료군(p=0.0860) 및 근치적방사선치료군(0=0.0370)에서도 분할선량이 작으면 합병증은 감소하였다. 결론 : 근치적 방사선치료 시 고선량률 근접치료의 적절한 분할선량에 대한 평가는 환자의 병기, 예후인자 등을 고려한 다양한 분할선량에 대한 세분화한 연구가 더 필요할 것이다. 수술 후 방사선치료 시 고선량률 근접치료의 분할선량은 국소제어에 영향을 미치지 않았고 합병증에 대해선 분할선량이 커지면 다소 증가하는 면을 보여 분할선량을 3 Gy로 주 3회 시행하는 것이 하나의 치료 방법이 될 수 있을 것이다.

비인강암의 병합요법 (Combined Modality Treatment in Nasopharyngeal Carcinoma)

  • 윤상모;김재철;박인규
    • Radiation Oncology Journal
    • /
    • 제19권2호
    • /
    • pp.100-106
    • /
    • 2001
  • 목적 : 국소 진행된 비인강암으로 유도 화학요법 혹은 동시 화학요법 및 방사선 치료를 받은 환자들의 부작용 및 단기 생존율을 비교하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 1989년 10월부터 1998년 5월까지, 비인강암으로 진단받고 유도 화학요법 혹은 동시 화학요법 및 방사선 치료를 받은 62명의 환자들을 대상으로 후향적 분석을 시행하였다. 유도 화학요법군은 50명, 동시 화학요법군은 12명이었다. 나이, 성, 전신 수행능력, 조직학적 유형 등은 양군에서 비교적 고르게 분포하였다. 병기 분포는, 유도 화학요법군의 경우 IIB가 $32\%$, III가 $30\%$, 그리고 IV가 $38\%$였으며, 동시 화학요법군은 각각 50, 33.3, $16.7\%$였다. 양군에서 화학요법 약제는 CF (cisplatin and 5-FU)였고, 약제 투여 방법은 동일하였다. Cisplatin $100\;mg/m^2$을 day 1에, 5-FU $1,000\;mg/m^2$을 day $2\~6$에 각각 정맥투여하였으며 3주 간격으로 반복하였다. 방사선 치료 종료시까지 시행된 화학요법의 횟수는 양군 모두 테$1\~3$회(중앙값 2회)였다. 방사선 치료는 양군 모두 일일선량 $1.8\~2.0\;Gy$를 주 5회 조사하였다. 총 방사선량은, 유도 화학요법군의 경우 $69.4\~86\;Gy$ (중앙 선량 73.4 Gy), 동시 화학요법군은 $69.4\~75.4\;Gy$ (중앙 선량 70.8 Gy)였다. 추적기간은, 유도 화학요법군의 경우 $9\~l16$개월(중앙값 40.5개월), 동시 화학요법군은 $14\~29$개월(중앙값 21개월)이었다. 결과 : 전체 환자에서 2년 생존율은 $78.7\%$였다. 치료 방법별 2년 전체 생존율은, 유도 화학요법군이 $77\%$, 동시 화학요법군은 $87\%$였으며(p>0.05), 2년 무병 생존율은 각각 $56\%$$81\%$였다(p>0.05). 최종 치료에 대한 완전 관해율은 $75.5\%$$91.7\%$로 동시 화학요법군에서 높았으나 통계학적 유의성은 없었다. 방사선 치료시 grade $3\~4$의 혈액학적 독성은 양군에서 차이가 없었고, grade 2의 백혈구 감소가 동시 화학요법군에서 많았다 $(18\%\;vs\;66.7\%)$. Grade $3\~4$의 점막염은 동시 화학요법군에서 많았다$(4.0\%\;vs\;33.3\%)$. 전체적으로 grade $3\~4$의 급성 부작용이 동시 화학요법군에서 빈번하였고$(6.0\%\;vs\;41.7\%,\;p=0.005)$, 부작용으로 사망한 경우는 없었다. 결론 : 국소 진행된 비인강암에서 동시 화학요법을 시행함으로써 치료의 반응율과 2년 무병 생존율이 향상되는 경향을 보였으나, 통계학적 의의는 없었다. 따라서, 좀더 많은 대조군과 장기 추적관찰이 요구된다.

  • PDF