• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.30-35
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• 2002

Objective: To determine the effectiveness and toxicity of chemoradiation therapy in nasopharyngeal carcinoma by comparing with radiation therapy alone. Materials and Methods: Between October 1989 and July 2000, One hundred eleven patients with newly diagnosed and histologically proven nasopharyngeal carcinoma treated in Department of Radiation Oncology, Asan Medical Center were retrospectively reviewed. Forty-five patients were treated with radiation therapy alone (Group I) and 66 patients were treated with radiation therapy and concurrent cisplatin (Group II). Cisplatin was administered once a week, on the first day of each successive week of treatment, starting on day 1 of radiation therapy and given as a intravenous bolus at a dose of $20mg/m^2$ of body-surface area. Radiation therapy was given in doses of 1.8Gy, once a day, 5 days per week with 4MV or 6 MV photons. Initial field was received a total of 60Gy and a primary tumor and enlarged lymph nodes were boosted with an high dose intracavitory brachytherapy and 3D conformal therapy. Results: The complete response rate was 86.7% in Group I, and was 90.9% in Group II. The 5 year overall survival rate for Group I was 60% and for Group II was 45% (p=0.2520). The 5 year disease free survival rate was 52% versus 45%, respectively (p=0.7507). The median follow up was 44 months versus 34 months, respectively. Conclusion: Analysis of the III patients showed no significant difference in disease free survival and overall survival in two treatment group. This retrospective analysis did not demonstrate benefit with concurrent chemoradiation using cisplatin at a dose of $20mg/m^2$ of body-surface area in treatment result than radiation alone.

• Radiation Oncology Journal
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• v.26 no.3
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• pp.149-159
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• 2008

Purpose: To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial cancer, pelvic control, and overall survival rate was free of severe toxicity when pelvic radiation therapy or vaginal brachytherapy was performed. In the high-risk group, pelvic control rate was excellent, but the survival rate was poor due to distant metastases, in spite of the pelvic radiation therapy. The combined modality of chemotherapy and radiation therapy is recommended for high-risk groups. For the intermediate-risk group, a prospective randomized study is required to compare the efficacy between whole pelvic radiation therapy and vaginal brachytherapy.

• Polymer(Korea)
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• v.36 no.2
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• pp.124-130
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• 2012

The uniform nanofibers of poly(L-lactide-$co$-${\varepsilon}$-caprolactone) (PLCL) with different contents of marine collagen (MC) were successfully prepared by electrospinning method. The effects of the major parameters in electrospinning process such as tip to target distance (TTD), voltage, nozzle size and flow rate on the average diameter of the electrospun nanofiber were investigated in generating composite nanofiber. The diameter and morphology of the nanofibers were confirmed by a scanning electron microscopy (SEM). Also, we measured a water contact angle to determine the surface wettability of the nanofibers. The average diameter of the nanofibers decreased as the value of TTD, MC contents, and voltages increased in comparison with that of pristine PLCL nanofiber. In contrast, the diameter of the nanofibers increased as the flow rate and inner diameter of nozzle increased in comparison with that of pristine PLCL. In addition, the hydrophilicity of the nanofiber and attachment of MG-63 cells on the sheets increased as incorporated collagen contents increased. Therefore, the marine collagen would be a potential material to enhance cellular interactivity of synthetic materials by mimicking the natural tissue.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.245-249
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• 2003

A primary malignant melanoma of the vagina is a very rare gynecological malignant tumor. Its clinical behavior is more aggressive than that of cutaneous and vulvar melanomas. We present a case of a large sized primary melanoma of the lower third of the vagina, with a cervical lesion, in a 58-year-old postmenopausal woman. The patient was treated with conventional external radiation therapy and intracavitary radiotherapy (ICR), without surgical treatment. Although the primary lesion showed a partial response, the patient died of extensive metastases, which were found 4.5 months after the initial diagnosis. We suggest that shortening the treatment period, such as hypofractionated radiation therapy and surgical removal, and various systemic therapies for preventing early distant metastasis, are appropriate treatments for a primary malignant melanoma of the vagina, with a large tumor size.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.129-136
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• 2017

Purpose: The concentration of capecitabine peaks at 1-2 hours after administration. We therefore assumed that proper timing of capecitabine administration and radiotherapy would maximize radiosensitization and influence survival among patients with locally advanced rectal cancer. Materials and Methods: We retrospectively reviewed 223 patients with locally advanced rectal cancer who underwent preoperative chemoradiation, followed by surgery from January 2002 to May 2006. All patients underwent pelvic radiotherapy (50 Gy/25 fractions) and received capecitabine twice daily at 12-hour intervals ($1,650mg/m^2/day$). Patients were divided into two groups according to the time interval between capecitabine intake and radiotherapy. Patients who took capecitabine 1 hour before radiotherapy were classified as Group A (n = 109); all others were classified as Group B (n = 114). Results: The median follow-up period was 72 months (range, 7 to 149 months). Although Group A had a significantly higher rate of good responses (44% vs. 25%; p = 0.005), the 5-year local recurrence-free survival rates of 93% in Group A and 97% in Group B did not differ significantly (p = 0.519). The 5-year disease-free survival and overall survival rates were also comparable between the groups. Conclusions: Despite the better pathological response in Group A, the time interval between capecitabine and radiotherapy administration did not have a significant effect on survivals. Further evaluations are needed to clarify the interaction of these treatment modalities.

• Tuberculosis and Respiratory Diseases
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• v.73 no.6
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• pp.325-330
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• 2012

High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8591-8594
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• 2014

Background: Lung cancer is the most common cancer in males worldwide. The principal mode of treatment in the early stage of non-small cell lung cancer (NSCLC) is surgery. However, five-year survival is only about 15% for all stages. The aim is to investigate the effect of daily low dose cisplatin concurrently with radiation therapy in advanced NSCLC patients with poor performance status. Materials and Methods: Ten patients diagnosed as inoperable Stage IIIB NSCLC with comorbid disease were assessed retrospectively in Bezmialem Vakif University, Faculty of Medicine, Department of Radiation Oncology, between 2011 to 2013. ECOG performance status was between 3 and 4. Cisplatin was administered at $6mg/m^2$ daily, for 5 days a week concurrently with radiotherapy using 160-200 cGy daily fractions, 54 Gy being the lowest and 63 Gy being the highest dose. Results: Complete response at the primary tumour site was obtained in 20% patients. Grade I esophagitis was seen 70 percent of patients, and the grade II haematological toxicity rate was 20 %. Median survival time was 7 months. Conclusions: Median survival time was reasonable, despite the patients ECOG performance status of 3-4, which is similar to groups even without comorbid disorders in comparison to other published papers in the literature. Acceptable toxicity, high response rates and quality of life of patients are the other favourable features.

• Molecules and Cells
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• v.24 no.2
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• pp.255-260
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• 2007

Bone marrow (BM) derived mesenchymal stem cells (MSC) are pluripotent cells which can differentiate into osteogenic, adipogenic and other lineages. In spite of the broad interest, the information about the changes in BM cell composition, in particularly about the variation of MSC number and their properties in relation to the age of the donor is still controversial. The aim of this study was to investigate the age associated changes in variations of BM cell composition, phenotype and differentiation capacities of MSC using a rat model. Cell populations were characterized by flow cytometry using light scattering parameters, DNA content and a set of monoclonal antibodies. Single cell analysis was performed by conventional fluorescent microscopy. In vitro culture of MSC was established and their phenotype and capability for in vitro differentiation into osteogenic and adipogenic cells was shown. Age related changes in tibiae and femurs, amount of BM tissue, BM cell composition, proportions of separated MSC and yield of MSC in 2 weeks of in vitro culture were found. At the same time, neither change in phenotype no in differentiation capacities of MSC was registered. Age-related changes of the number of MSC should be taken into account whenever MSC are intended to be used for investigations.

• Radiation Oncology Journal
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• v.30 no.4
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• pp.218-225
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• 2012

Purpose: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. Materials and Methods: Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. Results: The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response ($V2R{\geq}0.4$). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with $V2R{\geq}0.4$ (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). Conclusion: Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.34-40
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• 2003

Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.