• Title/Summary/Keyword: Radiation medicine

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Why Do Patients Drop Out During Radiation Therapy? - Analyses of Incompletely Treated Patients - (불완전 방사선치료 환자의 분석)

  • Huh Seung Jae;Wu Hong Gyun;Ahn Yong Chan;Kim Dae Yong;Shin Kyung Hwan;Lee Kyu Chan;Chong Won A;Kim Hyun Joo
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.347-350
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    • 1998
  • Purpose : This study is to see how much proportion of the patients receiving radiation therapy drop out during radiation therapy and to analyze the reason for the incomplete treatment. Materials and Methods : The base population of this study was 1,100 patients with registration numbers 901 through 2,000 at Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea. Authors investigated the incidence of incomplete radiation therapy, which was defined as less than 95$\%$ of initially planned radiation dose, and the reasons for incomplete radiation therapy. Results : One hundred and twenty eight patients (12$\%$) did not complete the planned radiation therapy. The performance status of the incompletely treated patients was generally Poorer than that of the base population, and the aim of radiation therapy was more commonly palliative. The most common reason for not completing the planned treatment was the patients' refusal of further radiation therapy because of the distrust of radiation therapy and/or the poor economic status. Conclusion : Careful case selection for radiation therapy with consideration of the socioeconomic status of the patients in addition to the clinical indication would be necessary for the reduction of incomplete treatment, especially in the palliative setting.

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Parotid gland sparing effect by computed tomography-based modified lower field margin in whole brain radiotherapy

  • Cho, Oyeon;Chun, Mison;Park, Sung Ho;Oh, Young-Taek;Kim, Mi-Hwa;Park, Hae-Jin;Nam, Sang Soo;Heo, Jaesung;Noh, O Kyu
    • Radiation Oncology Journal
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    • v.31 no.1
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    • pp.12-17
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    • 2013
  • Purpose: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. Materials and Methods: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Results: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands ${\geq}20$ Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. Conclusion: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.

Postoperative radiation therapy following the incomplete resection of a non-small cell lung cancer

  • Park, Jaehyeon;Song, Si Yeol;Kim, Su Ssan;Kim, Sang-We;Kim, Woo Sung;Park, Seung-Il;Kim, Dong Kwan;Kim, Yong-Hee;Park, Jongmoo;Lee, Sang-Wook;Kim, Jong Hoon;Ahn, Seung Do;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.32 no.2
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    • pp.70-76
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    • 2014
  • Purpose: To review the results of postoperative radiation therapy (PORT) for residual non-small cell lung cancer (NSCLC) following surgical resection and evaluate multiple clinicopathologic prognostic factors. Materials and Methods: A total of 58 patients, who completed scheduled PORT for positive resection margin, among 658 patients treated with PORT from January 2001 to November 2011 were retrospectively analyzed. Radiation therapy was started at 4 to 6 weeks after surgery. Chemotherapy was also administered to 35 patients, either sequentially or concurrently with PORT. Results: The median age of patients was 63 years (range, 40 to 82 years). The postoperative pathological stage I NSCLC was diagnosed in 10 (17.2%), stage II in 18 (31.0%), and stage III in 30 patients (51.7%). Squamous cell carcinoma was identified in 43, adenocarcinoma in 10, large cell in 1, others in 4 patients. Microscopic residual disease (R1) was diagnosed in 55 patients (94.8%), and the remaining three patients were diagnosed with gross residual disease (R2). The median dose of PORT was 59.4 Gy (range, 50.0 to 64.8 Gy). Chemotherapy was administered to 35 patients (60%), and the median follow-up time was 22.0 months (range, 6.0 to 84.0 months). The 3-year locoregional relapse-free survival and distant metastasis-free survival rates were 82.1% and 52.9%, respectively. The median overall survival was 23.8 months (range, 6.0 to 84.1 months), and the 3-year overall survival rate was 58.2%. Chemotherapy did not influence the failure pattern or survival outcome. Conclusion: PORT is an effective modality for improving local tumor control in incompletely resected NSCLC patients. Major failure pattern was distant metastasis despite chemotherapy.

Identification of Specific Gene Modules in Mouse Lung Tissue Exposed to Cigarette Smoke

  • Xing, Yong-Hua;Zhang, Jun-Ling;Lu, Lu;Li, De-Guan;Wang, Yue-Ying;Huang, Song;Li, Cheng-Cheng;Zhang, Zhu-Bo;Li, Jian-Guo;Xu, Guo-Shun;Meng, Ai-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4251-4256
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    • 2015
  • Background: Exposure to cigarette may affect human health and increase risk of a wide range of diseases including pulmonary diseases, such as chronic obstructive pulmonary disease (COPD), asthma, lung fibrosis and lung cancer. However, the molecular mechanisms of pathogenesis induced by cigarettes still remain obscure even with extensive studies. With systemic view, we attempted to identify the specific gene modules that might relate to injury caused by cigarette smoke and identify hub genes for potential therapeutic targets or biomarkers from specific gene modules. Materials and Methods: The dataset GSE18344 was downloaded from the Gene Expression Omnibus (GEO) and divided into mouse cigarette smoke exposure and control groups. Subsequently, weighted gene co-expression network analysis (WGCNA) was used to construct a gene co-expression network for each group and detected specific gene modules of cigarette smoke exposure by comparison. Results: A total of ten specific gene modules were identified only in the cigarette smoke exposure group but not in the control group. Seven hub genes were identified as well, including Fip1l1, Anp32a, Acsl4, Evl, Sdc1, Arap3 and Cd52. Conclusions: Specific gene modules may provide better understanding of molecular mechanisms, and hub genes are potential candidates of therapeutic targets that may possible improve development of novel treatment approaches.

Development of the DVH management software for the biologically-guided evaluation of radiotherapy plan

  • Kim, Bo-Kyong;Park, Hee-Chul;Oh, Dong-Ryul;Shin, Eun-Hyuk;Ahn, Yong-Chan;Kim, Jin-Sung;Han, Young-Yih
    • Radiation Oncology Journal
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    • v.30 no.1
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    • pp.43-48
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    • 2012
  • Purpose: To develop the dose volume histogram (DVH) management software which guides the evaluation of radiotherapy (RT) plan of a new case according to the biological consequences of the DVHs from the previously treated patients. Materials and Methods: We determined the radiation pneumonitis (RP) as an biological response parameter in order to develop DVH management software. We retrospectively reviewed the medical records of lung cancer patients treated with curative 3-dimensional conformal radiation therapy (3D-CRT). The biological event was defined as RP of the Radiation Therapy Oncology Group (RTOG) grade III or more. Results: The DVH management software consisted of three parts (pre-existing DVH database, graphical tool, and $Pinnacle^3$ script). The pre-existing DVH data were retrieved from 128 patients. RP events were tagged to the specific DVH data through retrospective review of patients' medical records. The graphical tool was developed to present the complication histogram derived from the preexisting database (DVH and RP) and was implemented into the radiation treatment planning (RTP) system, $Pinnacle^3$ v8.0 (Phillips Healthcare). The software was designed for the pre-existing database to be updated easily by tagging the specific DVH data with the new incidence of RP events at the time of patients' follow-up. Conclusion: We developed the DVH management software as an effective tool to incorporate the phenomenological consequences derived from the pre-existing database in the evaluation of a new RT plan. It can be used not only for lung cancer patients but also for the other disease site with different toxicity parameters.

Metaplastic Breast Carcinoma: a Heterogeneous Disease

  • Gultekin, Melis;Eren, Gulnihan;Babacan, Taner;Yildiz, Ferah;Altundag, Kadri;Guler, Nilufer;Ozisik, Yavuz;Yazici, Gozde;Hurmuz, Pervin;Gurkaynak, Murat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2851-2856
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    • 2014
  • The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

Hepatic Hemangiomas: Spectrum of US Appearances on Gray-scale, Power Doppler, and Contrast-Enhanced US

  • Kyoung Won Kim;Tae Kyoung Kim;Joon Koo Han;Ah Young Kim;Hyun Ju Lee;Seong Ho Park;Young Hoon Kim;Byung Ihn Choi
    • Korean Journal of Radiology
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    • v.1 no.4
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    • pp.191-197
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    • 2000
  • Because US plays a key role in the initial evaluation of hepatic hemangiomas, knowledge of the entire spectrum of US appearances of these tumors is important. Most hemangiomas have a distinctive US appearance, and even with those with atypical appearances on conventional gray-scale US, specific diagnoses can be made using pulse-inversion harmonic US with contrast agents. In this essay, we review the spectrum of US appearances of hepatic hemangiomas on conventional gray-scale, power Doppler, and pulse-inversion harmonic US with contrast agents.

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