• Title/Summary/Keyword: Preoperative radiotherapy

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Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

  • Zhao, Yi-Bing;Wang, Jin-Hua;Chen, Xiao-Xiang;Wu, Yu-Zhong;Wu, Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1487-1489
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    • 2012
  • Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

Reconstruction with Anterolateral Thigh Perforator Free Flap in Patients with Merkel Cell Carcinoma: Report of Two Cases (멕켈 세포 암종 환자의 치험례: 전방 외측 대퇴부 천공지 유리 피판술을 이용한 재건)

  • Kim, Kyu-Nam;Kim, Tae-Gon;Kim, Hoon;Kang, Byoung-Su;Hong, Joon-Pio
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.31-34
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    • 2009
  • Purpose: Merkel cell carcinoma, also called neuroendocrine carcinoma, is a very rare type of skin cancer that develops as Merkel cells grow out of control. Merkel cell carcinoma is reported below 1% of whole skin neoplasms in the United States and is known that the 2-year survival rate is about 50~70%. The principles of treatment are wide excision of primary lesion with radiotherapy and/or chemotherapy that decrease the local recurrent rate. There has been no report of reconstruction with free flap after resection of Merkel cell carcinoma in Korea. Methods: We reconstructed the skin and soft tissue defect after wide excision of Merkel cell carcinoma with anterolateral thigh perforator free flap in two cases. No distant metastasis was found at the preoperative imaging work-up. In one case, preoperative chemotherapy was performed and the size of lesion was decreased. Results: There were no recurrence and significant complications. Functionally and aesthetically satisfactory results were obtained with reconstruction. Conclusion: Wide excision and reconstruction with anterolateral thigh perforator free flap for Merkel cell carcinoma patient is the first report in Korea. We regard this method as the treatment of choice in Merkel cell carcinoma.

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MALIGNANT FIBROUS HISTIOCYTOMA OF THE MAXILLA ; REPORT OF A CASE (상악골에 발생한 악성섬유성조직구종)

  • Ryu, Sun-Youl;Park, Suk-In;Lee, Jin-Hwan;Chung, Mu-Gang;Chung, Jong-Chull;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.117-123
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    • 1992
  • Malignant fibrous histiocytoma rarely occurs in the jaws. A case of malignant fibrous histiocytoma originated from the maxillary sinus is reported with review of literature. A 59-year-old woman visited the Chonnam University Hospital in March, 1990, with chief complaint of swelling and tenderness in the right cheek. Radiographic findings revealed wide destruction of the maxilla. The biopsy taken from the maxilla showed histopatholgic findings of malignant fibrous histiocytoma. Accordingly the patient received preoperative and postoperative anticancer chemotherapy by the modified CY-VA-DIC protocol of the Southwest Oncology Group (SWOG). Preoperative and postoperative radiotherapy were also given to her in total 40Gy of $^{60}Co$ And she underwent radical resection of the maxilla. No evidence of recurrence or metastasis was shown for 2-year period of postoperative follow up.

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Therapeutic Results of Radiotherapy in Rectal Carcinoma - Comparison of Sandwich Technique Radiotherapy with Postoperative Radiotherapy (직장암의 방사선 치료 결과 - Sandwich Technique 방사선 치료와 수술후 방사선 치료의 비교)

  • Huh Cil Cha;Suh Hyun Suk;Lee Hyuk Sang;Kim Re Hwe;Kim Chul Soo;Kim Hong Yong;Kim Sung Rok
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.25-31
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    • 1996
  • Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to Postoperative radiotherapy in resectable rectal cancer. Materials and Methods : Between January 1989 and Mar 1994, 60 patients with resectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital. Fifty one patients were available for analysis: 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with Postoperative radiotherapy. In sandwich technique radiotherapy(RT), Patients were treated with preoperative RT 1500 cGy/5fx, followed by immediate curative resection. Patients staged as Astler-Coiler B2, C were considered for postoperative RT with 2500-4500 cGy. in postoperative RT total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-Sweets was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich RT group and postoperative RT group were $60\%$ and $71\%$, respectively(p>0.05). The 5-rear disease free survival rates for each group were $63\%$. There was no difference in local failure rate between two groups($11\%$ versus $7\%$) Incidence of distant metastasis was $11\%$(2/20) in the sandwich technique RT group and $20\%$(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of Postoperative RT alone group but reduced distant metastasis compared to Postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT.

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Survey on Radiotherpv Protocols for the Rectal Cancers Among the Korean Radiation Oncologists in 2002 for the Development of the Patterns of Care Study of Radiation Therapy (방사선치료 Patterns of Care Study 개발을 위한 2002년 한국 방사선종양학과 전문의들의 직장암 방사선치료 원칙 조사연구)

  • Kim, Jong-Hoon;Kim, Dae-Yong;Kim, Young-Ho;Kim, Woo-Chul;Kim, Chul-Yong;Sung, Jin-Shil;Son, Seung-Chang;Shin, Hyun-Su;An, Young-Chan;Oh, Do-Hum;Oh, One-Yong;Yu, Mi-Ryung;Yu, Hung-Jun
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.44-65
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    • 2003
  • Purpose : To conduct nationwide surgery on the principles In radiotherapy for rectal center, and develop the framework of a database of Korean Patterns of Care Study. Materials and Methods : A consensus committee was established to develop a tool for measuring the Patterns in radiotherapy Protocols for rectal cancer. The Panel was composed of radiation oncologists from 18 hospitals in Seoul Wetropolltan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eliglblllty criteria, 2) 20 Items for staging work-ups and prognostic factors, 3) 7 Items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) S radiotherapy treatment pians, 7) 4 physicalilaboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncoioglsts In charge of gastrolntestlnal malignancies in all hospitals (48 hospitals) In Korea to which 30 replies were received (63$\%$). Results : Most of the surrey Items were replied to without no major between the repliers, but with the fellowing items only 50$\%$ of repliers were in agreement : 1) Indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations. Conclusions : The Items where considerable disaggrement was shown among the radiation oncologists seemed to make no serious difference In the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These Items can be used for a basic database for the Patterns of Care Study, which will survey the practical radiotherapy Patterns for rectal cancer in Korea.

Carbohydrate Antigen 19-9 Levels Associated with Pathological Responses to Preoperative Chemoradiotherapy in Rectal Cancer

  • Yeo, Seung-Gu;Kim, Dae Yong;Kim, Tae Hyun;Kim, Sun Young;Baek, Ji Yeon;Chang, Hee Jin;Park, Ji Won;Oh, Jae Hwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5383-5387
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    • 2014
  • Purpose: To investigate whether pretreatment serum carbohydrate antigen 19-9 (CA 19-9) levels are associated with pathological responses to preoperative chemoradiotherapy (CRT) in patients with rectal cancer. Materials and Methods: In total, 260 patients with locally advanced rectal cancer (cT3-4NanyM0) who underwent preoperative CRT and radical surgery were analyzed retrospectively. CRT consisted of 50.4 Gy pelvic radiotherapy and concurrent chemotherapy. Radical surgery was performed at a median of 7 weeks after CRT completion. Pathological CRT response criteria included downstaging (ypStage 0-I) and ypT0-1. A discrimination threshold of CA 19-9 level was determined using a receiver operating characteristics analysis. Results: The median CA 19-9 level was 8.0 (1.0-648.0) U/mL. Downstaging occurred in 94 (36.2%) patients and ypT0-1 in 50 (19.2%). The calculated optimal threshold CA 19-9 level was 10.2 U/mL for downstaging and 9.0 U/mL for ypT0-1. On multivariate analysis, CA 19-9 (${\leq}9.0U/mL$) was significantly associated with downstaging (odds ratio, 2.089; 95% confidence interval, 1.189-3.669; P=0.010) or ypT0-1 (OR, 2.207; 95%CI, 1.079-4.512; P=0.030), independent of clinical stage or carcinoembryonic antigen. Conclusions: This study firstly showed a significant association of pretreatment serum CA 19-9 levels with pathological CRT responses of rectal cancer. The CA 19-9 level is suggested to be valuable in predicting CRT responses of rectal cancer cases before treatment.

Alveolar Soft Part Sarcoma (포상 연부 육종)

  • Shin, Kyoo-Ho;Hahn, Soo-Bong;Park, Hong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.220-225
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    • 1995
  • Alveolar soft part sarcoma, named by Christopherson in 1952, is a very rare soft tissue sarcoma. It reportedly accounts for 0.5 to 1.0% of all soft tissue sarcoma and no established treatment principle assists it. The relative lack of symptoms makes it easily overlooked and consequently early diagnosis is frequently impossible. Often, the metastasis to the lung or the brain is the first manifestation of the disease. In some cases wide excision is not performed because it is misdiagnosed as a benign tumor. Authors experienced 7 cases of alveolar soft part sarcoma in 20 years and found the ultimate prognosis grave and the treatment not promising. Therefore, the authors recommend the following; 1. Early diagnosis and early treatment are important for successful management of alveolar soft part sarcoma. 2. Preoperative incisional biopsy is necessary for pathologic diagnosis. 3. The recommended treatment modality is a combination of wide excision, chemotherapy and radiotherapy.

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Weight Changes according to the Period of Chemotherapy Treatments for Breast Cancer (유방암 환자의 화학요법 치료시기에 따른 체중변화)

  • Park, Yun Hee;Yoo, Kyung Hee
    • Journal of Korean Biological Nursing Science
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    • v.18 no.2
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    • pp.94-101
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    • 2016
  • Purpose: This study aimed to evaluate weight changes in women during the period of TAC (docetaxel-doxorubicin-cyclophosphamide) chemotherapy after breast surgery and the differences in weight changes by disease characteristics among Korean women with breast cancer. Methods: The design of this study was retrospective survey research. The subjects of this study were 130 patients with fully completed TAC chemotherapy between January 2012 and April 2015. Body weight before their operation, and at 3 weeks, 6 weeks, 9 weeks, 12 weeks, 15 weeks, and 18 weeks after surgery, as well as general and disease characteristics, were reviewed via their medical charts. Results: The mean age of the patients was 51.2 years. The preoperative (baseline) mean weight was $59.4{\pm}8.44$. Significant weight losses were observed in the initial (1st 3 week) period of TAC chemotherapy compared to the baseline and significant weight losses were observed with the exception of the period 6 weeks after breast surgery. There were significant differences in mean weight changes according to the stage of breast cancer, radiotherapy, and hormone therapy among disease characteristics. Conclusion: It is necessary to study weight changes after breast surgery for the long periods of TAC chemotherapy. Through the accumulated results of studies, nursing programs for breast cancer patients must be developed for the prevention of weight gain in the periods of TAC chemotherapy.

Multimodal Treatment of Esophageal Cancer (식도암의 다원적 치료)

  • 조건현
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.707-714
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    • 1990
  • Despite of mortality and morbidity rates that are higher than other forms of therapy, surgical resection has been mainstay for the treatment of esophageal cancer because of a prompt completeness as well as a high possibility of cure. But a substantial numbers of patients are unsuitable for surgical treatment and those undergoing resection have still poor long term survival rate. With hopes of improving long term survival, we have attempted multimodal approach, composed of preoperative induction chemotherapy utilizing Cisplatin and 5 \ulcornerFU, surgery and postoperative loco-regional radiotherapy for the treatment of esophageal cancer since 1985. During the period of 1967 \ulcorner1985, 27 patients[group A] were treated by surgery only and during recent 5 years 28 patients[group B] by multimodal treatment, Clinical review and comparison between the two groups were as follows: l. Applied surgical procedures were hand-sewn esophagogastrostomy, esophagocologastrostomy and esophagojejunostomy in group A. In group B, only esophagogastrostomy was underwent using stapler mainly. 2. Incidence of peri and postoperative complication showed no remarkable differences between the two groups, but the occurrences of leakage from the anastomotic site were 5[19% ] out of group A and 1[4%] out of group B. 3. The response rate to induction chemotherapy was 36% in group B, 4. The number of local cancer recurrence at the site of anastomosis was 6[22%] out of group A, whereas 2[7%] out of group B. 5. Postoperative I year and 2 year survival were 61%, 15% in group A and 75%, 42% in group B.

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Leiomyosarcoma of the Posterior Mediastinum Extending into the Adjacent Spinal Canal

  • Lee, Deok-Heon;Park, Chang-Kwon;Keum, Dong-Yoon;Kim, Jae-Bum;Hwang, Il-Seon
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.192-195
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    • 2012
  • Leiomyosarcoma of the mediastinum and primary leiomyosarcoma of the spine are exceedingly rare. In most cases, spinal leiomyosarcoma is metastatic. In this report, we describe the case of a 58-year-old man who presented with a large leiomyosarcoma of the posterior mediastinum that extended into the adjacent spinal canal. The tumor was completely resected from the mediastinum, but only subtotally removed from the spinal canal because the spinal mass had tightly invaded the spinal cord. Because the patient's postoperative condition was poor, no adjuvant radiotherapy or chemotherapy was administered. He expired 3 months after the surgery due to relapse; the spinal and mediastinal tumor remained at the preoperative size.