• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4935-4937
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• 2016

Objective: To compare dosimetric parameters of 3 dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) in terms of target coverage and doses to organs at risk (OAR) in the management of rectal carcinoma. Methods: In this prospective study, conducted between August 2014 and March 2016, all patients underwent CT simulation along with a bladder protocol and target contouring according to the Radiation Therapy Oncology Group (RTOG) guidelines. Two plans were made for each patient (3 DCRT and IMRT) for comparison of target coverage and OAR. Result: A total of 43 patients were recruited into this study. While there were no significant differences in mean Planning Target Volume (PTV) D95% and mean PTV D98% between 3 DCRT and IMRT, mean PTV D2% and mean PTV D50% were significantly higher in 3 DCRT plans. Compared to IMRT, 3 DCRT resulted in significantly higher volumes of hot spots, lower volumes of cold spots, and higher doses to the entire OAR. Conclusion: This study demonstrated that IMRT achieves superior normal tissue avoidance (bladder and bowel) compared to 3 DCRT, with comparable target dose coverage.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.390-393
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• 2011

We report an unusual case of angioedema induced by intravenous oxaliplatin in a patient with rectal cancer. Intravenous oxaliplatin was administered to the patient according to FOLFOX regimen (oxaliplatin/leucovorin/5-fluorouracil) for the management of his colorectal carcinoma. The patient had been on FOLFOX regimen for several months without reporting any adverse effects, but he experienced angioedema suddenly during his $9^{th}$ cycle of chemotherapy. Angioedema was observed about 2 hours after the initiation of oxaliplatin infusion. Oxaliplatin was stopped then the patient became stable. This case report demonstrates that intravenous oxaliplatin may induce angioedema several hours after the initiation of oxaliplatin infusion in later cycles of chemotherapy.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.349-357
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• 1995

Purpose : To analyze survival rate and late rectal and bladder complication for patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy Materials and Methods : Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patiens was 56 years (range 31-76). 26 patients were stage IB by FIGO classification, 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions And we evaluated the external radiation dose and midline shield. Results : Actuarial survival rate at 5 years was $92{\%}$ for stage IB, $75{\%}$ for stage IIA, $53{\%}$ for stage IIB and $69{\%}$ in all patients Grade 1 rectal complications were developed in 20 cases ($22{\%}$), grade 2 were in 22 cases ($24{\%}$). 22 cases ($24{\%}$) of grade 1 urinary complications and 17 cases ($19{\%}$) of grade 2 urinary complications were observed But no patient had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications (7608 cGy v 6960cGy. p<0.01) Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without rectal complications (7041cGy v 6269cGy, p<0.01). While there was no significant difference for survival rate or bladder complication incidence as a function of dose to whole pelvis, Grade 2 rectal complication incidence was significantly lower for the patients receiving less than 4500cGy ($6.3{\%}$ v $25.5{\%}$, p<0.05). There was no significant differance between HDR ICRT group and LDR ICRT group for survival rate according to stage, on the other hand complication incidence was higher in the HDR group than LDR group, This was maybe due to different prescription doses between HDR group and LDR group. Midline shield neither improved survival rate nor decreased complication rate. The number of insertion in LDR ICRT group did not affect on survival and compication rate. Conclusion : In stage I and II carcinoma of uterine cervix there was no significant differance for 5 year survival rate by radiation therapy technique. Rectal complication incidence was as a function of dose to whole pelvis and there were positive correlations of maximum dose of rectum and bladder and each complication incidence. So we recommand whole pelvis dose less than 4500cGy and maximum dose of rectum and bladder as low as possible.

• Journal of Ginseng Research
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• v.17 no.3
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• pp.196-202
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• 1993

A study was performed to compare the anticancer effects of Korean and Chinese red ginseng roots. The whole crude extracts or chloroform, methanol and acetone fractions of the crude extracts were added in the culture medium of three cancer cell lines, a mouse leukemia cell line ($P_{388}$), a human colon carcinoma cell line (HT-29) and a human rectal carcinoma cell line (HRT-18), to screen the growth inhibition effects. The results are summarized as follows : 1. Crude extracts of both Korean and Chinese red ginseng roots inhibited the proliferation of all the three cancer cell lines tested in a dose dependent manner. However, the growth inhibition effects of Korean red ginseng extracts were significantly greater than that of Chinese red ginseng. 2. An acetone fraction showed the greatest antiproliferative effects among the 11'hole crude extracts, chloroform, methanol and acetone fractions of the crude extracts. 3. These results suggest that the active antiproliferative components of the crude extracts are present mostly in the acetone fraction.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.35-41
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• 1998

The pulmonary metastasis and bony metastasis finally resulted from the malignant tumors as one of the inevitable problems. Among them, the bony metastasis, which frequently involved the vertebrae, pelvis, ribs, sternum, and skull, have had the frequencies over 30%. Metastasis to the distal part of the knee is rare. However, acrometastasis which occured in bones of the foot is even rarer(0.4%) and a late manifetation of a disseminated disease from the literature review. Acrometastasis should be considered in elderly patients with a history of the previous malignancy, complaint of foot pain and mass lesion. We are reporting one rectal carcinoma with acrometastasis to the second metatarsal bone.

• Journal of the Korean Society of Radiology
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• v.85 no.2
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• pp.409-414
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• 2024

Hepatoid adenocarcinoma (HAC) is a rare form of adenocarcinoma that is diagnosed based on immuno-histochemical findings reminiscent of hepatocellular carcinoma (HCC). The clinical characteristics of HAC include increased levels of serum alpha-fetoprotein and a poor prognosis due to early liver metastasis. In particular, diagnosing liver metastasis of HAC can be challenging owing to radiological findings similar to those of HCC. Although HAC can occur in various organs, the stomach is the most common site. We present the case of a 64-year-old femalewho presented with multiple tumors in the liver. During subsequent examination, rectal cancer was identified and diagnosed as HAC through a biopsy. Herein, we report this case along with a literature review.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3941-3944
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• 2013

Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.396-404
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• 2002

Purpose : Many papers support a correlation between rectal complications and rectal doses in uterine cervical cancer patients treated with radical radiotherapy. In vivo dosimetry in the rectum following the ICRU report 38 contributes to the quality assurance in HDR brachytherapy, especially in minimizing side effects. This study compares the rectal doses calculated in the radiation treatment planning system to that measured with a silicon diode the in vivo dosimetry system. Methods : Nine patients, with a uterine cervical carcinoma, treated with Iridium-192 high dose rate brachytherapy between June 2001 and Feb. 2002, were retrospectively analysed. Six to eight-fractions of high dose rate (HDR)-intracavitary radiotherapy (ICR) were delivered two times per week, with a total dose of $28\~32\;Gy$ to point A. In 44 applications, to the 9 patients, the measured rectal doses were analyzed and compared with the calculated rectal doses using the radiation treatment planning system. Using graphic approximation methods, in conjunction with localization radiographs, the expected dose values at the detector points of an intrarectal semiconductor dosimeter, were calculated. Results : There were significant differences between the calculated rectal doses, based on the simulation radiographs, and the calculated rectal doses, based on the radiographs in each fraction of the HDR ICR. Also, there were significant differences between the calculated and measured rectal doses based on the in-vivo diode dosimetry system. The rectal reference point on the anteroposterior line drawn through the lower end of the uterine sources, according to ICRU 38 report, received the maximum rectal doses in only 2 out of the nine patients $(22.2\%)$. Conclusion : In HDR ICR planning for conical cancer, optimization of the dose to the rectum by the computer-assisted planning system, using radiographs in simulation, is improper. This study showed that in vivo rectal dosimetry, using a diode detector during the HDR ICR, could have a useful role in quality control for HDR brachytherapy in cervical carcinomas. The importance of individual dosimeters for each HDR ICR is clear. In some departments that do not have the in vivo dosimetry system, the radiation oncologist has to find, from lateral fluoroscopic findings, the location of the rectal marker before each fractionated HDR brachytherapy, which is a necessary and important step of HDR brachytherapy for cervical cancer.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.44-50
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• 2006

Puroose: This study evaluated the late rectal complications in cervix cancer patients following treatment with external beam radiotherapy (EBRT) and high dose rate intracavitary radiation (HDR ICR). The factors affecting the risk of developing late rectal complications and its incidence were analyzed and discussed. Materials and Methods: The records of 105 patients with cervix cancer who were treated with radical radiotherapy using HDR ICR between July, 1995 and December, 2001 were retrospectively reviewed. The median dose of EBRT was 50.4Gy $(41.4{\sim}56.4 Gy)$ with a daily fraction size of 1.8Gy. A total of $5{\sim}7$ (median: 6) fractions of HDR ICR were given twice weekly with a fraction size of $4{\sim}5 Gy$ (median: 4Gy) to A point using an Ir (Iridium)-192 source. The median dose of ICR was 24 Gy $(20{\sim}35 Gy)$. During HDR ICR, the rectal dose was measured in vivo by a semiconductor dosimeter. The median follow-up period was 32 months, ranging from 5 to 84 months. Results: Of the 105 patients, 12 patients (11%) developed late rectal complications: 7 patients with grade 1 or 2, 4 patients with grade 3 and 1 patient with grade 4. Rectal bleeding was the most frequent chief complaint. The complications usually began to occur $5{\sim}32$ (median: 12) months after the completion of radiotherapy. Multivariate analysis revealed that the measured cumulative rectal BED over 115 Gy3 (Deq over 69 Gy) and the depth (D) of a 5 Gy isodose volume more than 50 mm were the independent predictors for late rectal complications. Conclusion: With evaluating the cumulative rectal BED and the depth of a 5 Gy isodose volume as predictors, we can individualize treatment planning to reduce the probability of late rectal complications.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.226-228
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• 1996

Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. The pain is usually spasmodic in nature and most commonly encountered in patients with carcinoma of the rectum or other pelvic organs. In 1988, Bristowand Foster reported that patients with severe spasmodic painful tenesmus were relieved with chemical sympathectomy. In 1990, Plancarte introduced block of Ganglion impar. This technique is proposed as an alternative means of managing localized perineal pain of sympathetic origin. Ganglion impar block was performed on a 54-year-old female patient when analgesic or psychotropic drugs failed to control the symptoms of post-traumatic severe spasmodic painful tenesmus. Postoperatively, patient was free of tenesmoid pain for only 7 days. We then performed neurotomy by RF lesion generator which provided complete pain relief.