• 대한핵의학회지
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• 제24권2호
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• pp.274-278
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• 1990

Metastases to the liver presents a common clinical problem in the management of patients with cole-rectal cancer, and are responsible for a high degree of morbidity and mortality associated with this malignancy. Unfortunately, attempts at preventing the development of liver metastases in "high risk" patients has so far been unsuccessful. Ongoing studies of adjuvant chemotherapy have not yet illustrated a significant increase in survival in patients receiving such therapy. The purpose of the study is to investigate the value of adjuvant radiotherapy given in the form of colloidal chromic phosphate P-32 suspension administered via portal vein after radical resection of the primary cancer, in preventing the growth of occult metastases in the liver. Twenty one patients (10 patients of treated group with 11 controls) were followed 18 months after operation. There was no significant change in the CBC and liver functions after administration of P-32 labeled colloidal chromic phosphate. The number of patients who showed local metastases at 18 months were 2 in the treated group and 3 in the control group. While liver metastases occurred in one patient at 6 months and in three at 12 months in the control group, there was no development of liver metastases by 12 months in the treated group. At 18 month follow-up CT scan one patient in the treated group showed a single nodule in the liver. In conclusion liver metastasis rate was lower in the patients who received colloidal P-32 chromic phosphate via portal vein after radical resection of the primary cole-rectal cancer.

• Tuberculosis and Respiratory Diseases
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• 제53권3호
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• pp.319-324
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• 2002

저자들은 장기간의 흡연력이 있는 60세 남성흡연자에서, 방사선소견상 다발성의 공동을 지니는 병변을 보여 흉부 전산화 단층촬영과 기관지 내시경을 통해 큰 공동을 형성한 원발성 폐암의 다발성 공동 형성 전이로 확진한 1예를 경험하였기에 문헌고찰과 함께 보고하였다.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.297-306
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• 2018

Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5081-5086
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• 2012

Background: The liver is one of the most common metastatic sites of breast cancer, hepatic metastases developing in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim of this study was to analyze the survival and clinical characteristics of patients with hepatic metastases from breast cancer of different molecular subtypes and to investigate the prognostic and predictive factors that effect clinical outcome. Methods: We retrospectively studied the charts of 104 patients with breast cancer hepatic metastases diagnosed at Sun Yat-sen University Cancer Center from December 1990 to June 2009. Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN). Prognostic factor correlations with clinical features and treatment approaches were assessed at the diagnosis of hepatic metastases. Results: The median survival time was 16.0 months, and the one-, two- three-, four-, five-year survival rates were 63.5%, 31.7%, 15.6%, 10.8%, and 5.4%, respectively. Median survival periods after hepatic metastases were 19.3 months (luminal A), 13.3 months (luminal B), 18.9 months (HER2-enriched), and 16.1 months (TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis, treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy could improve the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4 months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy did significantly better than the Luminal A group of patients treated without endocrine therapy (median survival of 48.9 vs. 13.8 months, P=0.003). Conclusions: Breast cancer subtypes were not associated with survival after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.

• 대한핵의학회지
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• 제34권2호
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• pp.107-118
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• 2000

목적: 분화성 갑상선암에서 방사성 옥소는 분화성 갑상선암의 수술 후 표준적 치료로 이용되고 있으나 현재까지 우리 나라에서의 I-131 치료에 대한 보고가 없어 폐 및 뼈전이를 가진 분화성 갑상선암 환자에서 I-131 치료 효과를 후향적으로 분석하였다. 대상 및 방법: 1984년에서 1998년 사이에 치료한 갑상선암 환자 760명 중 기능적 폐전이는 76명(10.0%)에서, 뼈전이는 20명(2.6%)에서 발견되었다. 이 중 폐전이 환자 53명과 뼈전이 환자 15명에서 치료 효과를 분석하였다. 폐나 뼈에 원격전이가 있는 환자에서 병리 소견상 여포상암이나 여포 변이를 동반한 유두상암이 차지하는 비율이 원격전이가 없는 환자와 비해 상대적으로 높았다. 결과: 방사성옥소 전신스캔에서 폐전이가 발견된 환자중 단순 흉부방사선검사에서 44%에서만 전이성 병변이 발견되었다. 폐전이 환자 53명 중 19명(35.8%)에서 I-131치료로 폐병변이 완전히 소실되었고, 22명(41.5%)에서는 폐병변의 감소를 보여 폐전이 환자의 77.3%에서 방사성옥소 치료에 좋은 반응을 보였다. 나머지 12명에서는 폐병변의 변화가 없거나 오히려 악화되었다. 폐병변이 완전히 소실된 19명 중 13명은 I-131 총치료 용량이 18.5 GBq 이하였다. 뼈전이는 15명의 43부위에서 발견되었고, 척추전이가 15부위로 가장 많았으며, 골반 전이는 8부위였다. 43개의 뼈전이 병소 중 I-131만으로 단독 치료한 29병소 중 14병소가 호전되었고, 15부위의 병소는 변화가 없거나 더 진행하였다. I-131와 수술 또는 외부 방사선 치료의 복합 치료를 병행한 14부위 중 수술 치료를 병행한 3부위에서 병변이 완전히 소실되었고, 11부위는 병변이 감소되었다. 결론: 우리나라 분화성 갑상선암 환자에서 폐전이는 방사성옥소로 비교적 잘 치료되었다. 그러나 뼈전이는 방사성옥소만으로는 치료 효과가 적어 수술이나 외부 방사선 치료를 병행하는 것이 필요하였다.

• Journal of Gastric Cancer
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• 제9권1호
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• pp.14-17
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• 2009

대장암이나 타 장기 암의 간전이 경우 간 절제는 비교적 좋은 결과를 가지는 치료 방법으로 보고되고 있으나, 위암의 간전이에 대한 치료로 절제 수술의 역할과 생존율에 대한 효과는 연구가 많지 않은 실정이다. 위암의 수술 전 진단 때나 수술 후 추적 검사 중 진단된 간전이의 경우 많은 예에서 다발성 전이, 좌, 우엽에 전이, 간외 전이, 복막 파종이나 다발성 림프절 전이 양상으로 절제 수술의 적응이 되지 못하는 악성 경로를 가지는 경우가 많다. 그러나 몇몇 보고에서는 수술 적응 대상 환자가 적으나 간절제 치료로 좋은 결과를 보고하는 경우도 있어 제한된 간전이 환자에 대한 맞춤 치료의 영역은 있다고 하였다. 위암의 간전이 절제 예에 대한 보고를 종합하여 보면 간전이 병소가 진단되는 시기가 예후에 중요하여 동시성으로 전이가 진단된 경우가 나쁘며, 절제연이 10 mm 이상 유지 될 때 좋은 결과를 보고하였다. 반면 전이 병소의 개수는 생존율 검사에서 통계학적 의미는 없는 것으로 보고 되었다. 또한 충분한 절제연을 확보하면서 해부학적 구역 절제 이상의 수술이 시행된 경우와 이시성 간전이가 좋은 생존율을 보이는 것으로 보고되었다. 또한 간 절제 수술 후 가장 많은 재발 병소는 역시 간으로, 재발 시 대부분 2년 내 사망을 초래하여 절제 후 보조항암화학요법 치료도 중요하다.

• 대한의용생체공학회:의공학회지
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• 제42권3호
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• pp.71-79
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• 2021

Currently, the naked eyes-based diagnosis of bone metastases on CT images relies on qualitative assessment. For this reason, there is a great need for a state-of-the-art approach that can assess and follow-up the bone metastases with quantitative biomarker. Radiomics can be used as a biomarker for objective lesion assessment by extracting quantitative numerical values from digital medical images. In this study, therefore, we evaluated the clinical applicability of non-invasive and objective bone metastases computer-aided diagnosis using radiomics-based biomarkers in CT. We employed a total of 21 approaches consist of three-classifiers and seven-feature selection methods to predict bone metastases and select biomarkers. We extracted three-dimensional features from the CT that three groups consisted of osteoblastic, osteolytic, and normal-healthy vertebral bodies. For evaluation, we compared the prediction results of the classifiers with the medical staff's diagnosis results. As a result of the three-class-classification performance evaluation, we demonstrated that the combination of the random forest classifier and the sequential backward selection feature selection approach reached AUC of 0.74 on average. Moreover, we confirmed that 90-percentile, kurtosis, and energy were the features that contributed high in the classification of bone metastases in this approach. We expect that selected quantitative features will be helpful as biomarkers in improving the patient's survival and quality of life.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6381-6384
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• 2015

Background: The purpose of this retrospectively study was to examine the effectiveness and tolerability of a radiotherapy technique for the palliation of symptomatic liver metastases. Materials and Methods: Twentyseven patients with liver metastases were enrolled and received targeted whole liver irradiation consisting of mean 1, 8 Gy in five to twelve fractions to a total mean dose 17Gy. Symptoms at baseline were hepatic pain (26 patients), lost of weight (6), lack of appetite (2), and night sweats (1). Seventeen patients (63%) had failed previous treatment with chemotherapy and/or high-dose steroids. Results: Individual symptom response rates were 100% at 4 weeks. Partial or complete global symptomatic responses were noted in 11 patients (40%) after 2 months. After 3 months, 8 patients (28%) reported loss of pain. The treatment was well tolerated with one patient (3%) experiencing grade 3 toxicity (one vomiting and one diarrhoea). Overall the median survival time was 4.9 months (range 1 - 14 months). One year survival was 39%. Conclusions: This is simple and well-tolerated treatment but to achieve good palliation effects we should carefully selected patients whose conventional treatment does not bring good analgesic control.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1995-1997
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• 2012

Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.