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Concurrent Weekly Cisplatin and Radiation Therapy for High risk group of Uterine Cervical Cancer (국소적으로 진행된 자궁경부암에 대한 방사선 치료와 Cisplatin의 동시 병행요법의 치료 결과)

  • Suh Hyun Suk;Kang Seung Hee;Kim Ju Ree;Lee Eung Soo;Kim Yong Bong;Park Sung Kwan
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.213-217
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    • 1992
  • Locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate despite the advances in modern radiation therapy techniques. Combination of chemotherapy and radiation therapy demonstrated benefit in improving local control and possibly the overall survival. Twelve patients with advanced stages (Figo stage III, IV) or 11b with bulky tumors (>5 cm in diameter) were treated with combination of radiation therapy and concurrent weekly cisplatin between May of 1988 and September of 1991 at Inje University Paik Hospital. Cisplatin was administered in bolus injections of 50 mg at weekly intervals during the courses of radiation therapy. Median follow-up period was 34 months with ranges from 3 to 53 months. Eleven patients were evaluable for the estimation of response. Response was noted in all the 11 patients: complete response (CR) in 7 ($64\%$), partial response (PR) in 4 ($36\%$). Of the 7 patients with CR, all maintained local control, whereas only 1 of 4 with PR showed local control. Six of 7 with CR are alive disease free on the completion of follow-up. Eight of 11 patients ($73\%$) maintained local control in the pelvis. The median survival for CR patient is 27 months and 9 months for the PR patients. Analysis of survival by stage shows 11 b 4/5, III 2/3 and IV 1/3. Overall survival rate was $61\%$. Three patients recurred: 1 at local, 1 in distant site and 1 with local and distant site. Toxicity for the combination therapy was not excessive. These results are preliminary, but definitely encouraging in view of markedly improved response rate compared with the results of historical control group.

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Twice Daily Radiation Therapy Plus Concurrent Chemotherapy for Limited-Stage Small Cell Lung Cancer (국한성병기 소세포폐암에서 하루 두 번 분할조사와 동시 화학방사선치료)

  • Yeo Seung-Gu;Cho Moon-June;Kim Sun-Young;Kim Ki-Whan;Kim Jun-Sang
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.96-102
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    • 2006
  • Purpose: A retrospective study was performed to evaluate the efficiency and feasibility of twice daily radiation therapy plus concurrent chemotherapy for limited-stage small cell lung cancer in terms of treatment response, survival, patterns of failure, and acute toxicities. Materials and Methods: Between February 1993 and October 2002, 76 patients of histologically proven limited-stage small cell lung cancer (LS-SCLC) were treated with twice daily radiation therapy and concurrent chemotherapy. Male was in 84% (64/76), and median age was 57 years (range, 32-75 years). Thoracic radiation therapy consisted of 120 or 150 cGy per fraction, twice a day at least 6 hours apart, 5 days a week. Median total dose was 50.4 Gy (range, 45-51 Gy). Concurrent chemotherapy consisted of CAV ($cytoxan\;1000mg/m^2,\;adriamycin\;40mg/m^2,\;vincristine\;1mg/m^2$) alternating with PE ($cisplatin\;60mg/m^2,\;etoposide\;100mg/m^2$) or PE alone, every 3 weeks. The median cycle of chemotherapy was six (range, 1-9 cycle). Prophylactic cranial irradiation (PCI) was recommended to the patients who achieved a complete response (CR). PCI scheme was 25 Gy/10 fractions. Median follow up was 18 months (range, 1-136 months). Results: Overall response rate was 86%; complete response in 39 (52%) and partial response in 26 (34%) patients. The median overall survival was 23 months. One, two, and three year overall survival rate was 72%, 50% and 30%, respectively. In univariate analysis, the treatment response was revealed as a significant favorable prognostic factor for survival (p<0.001). Grade 3 or worse acute toxicities were leukopenia in 46 (61%), anemia in 5 (6%), thrombocytopenia in 10 (13%), esophagitis in 5 (6%), and pulmonary toxicity in 2 (2%) patients. Of 73 evaluable patients, 40 (55%) patients subsequently had disease progression. The most frequent first site of distant metastasis was brain. Conclusion: Twice daily radiation therapy plus concurrent chemotherapy produced favorable response and survival for LS-SCLC patients with tolerable toxicities. To improve the treatment response, which proved as a significant prognostic factor for survival, there should be further investigations about fractionation scheme, chemotherapy regimens and compatible chemoradiotherapy schedule.

Improved Breast Irradiation Techniques Using Multistatic Fields or Three Dimensional Universal Compensators (Multistatic Field또는 3차원 공용보상체를 사용한 유방의 방사선 조사법의 평가)

  • Han Youngyih;Cho Jae Ho;Park Hee Chul;Chu Sung Sil;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.24-33
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    • 2002
  • Purpose : In order to improve dose homogeneity and to reduce acute toxicity in tangential whole breast radiotherapy, we evaluated two treatment techniques using multiple static fields or universal compensators. Materials and Methods : 1) Multistatic field technique : Using a three dimensional radiation treatment planning system, Adac Pinnacle 4.0, we accomplished a conventional wedged tangential plan. Examining the isodose distributions, a third field which blocked overdose regions was designed and an opposing field was created by using an automatic function of RTPS. Weighting of the beams was tuned until an ideal dose distribution was obtained. Another pair of beams were added when the dose homogeneity was not satisfactory. 2) Universal compensator technique : The breast shapes and sizes were obtained from the CT images of 20 patients who received whole breast radiation therapy at our institution. The data obtained were averaged and a pair of universal physical compensators were designed for the averaged data. DII (Dose Inhomogeneity Index : percentage volume of PTV outside $95\~105\%$ of the prescribed dose) $D_{max}$ (the maximum point dose in the PTV) and isodose distributions for each technique were compared. Results : The multistatic field technique was found to be superior to the conventional technique, reducing the mean value of DII by $14.6\%$ (p value<0.000) and the $D_{max}$ by $4.7\%$ (p value<0.000). The universal compensator was not significantly superior to the conventional technique since it decreased $D_{max}$ by $0.3\%$ (p value=0.867) and reduced DII by $3.7\%$ (p value=0.260). However, it decreased the value of DII by maximum $18\%$ when patients' breast shapes fitted in with the compensator geometry. Conclusion : The multistatic field technique is effective for improving dose homogeneity for whole breast radiation therapy and is applicable to all patients, whereas the use of universal compensators is effective only in patients whose breast shapes fit inwith the universal compensator geometry, and thus has limited applicability.

Probabilities of Pulmonary and Cardiac Complications and Radiographic Parameters in Breast Cancer Radiotherapy (유방암의 방사선치료에서 방사선학적 지표에 따른 폐 및 심장의 부작용 확률)

  • Noh, O-Kyu;Park, Sung-Ho;Ahn, Seung-Do;Choi, Eun-Kyung;Lee, Sang-Wook;Song, Si-Yeol;Yoon, Sang-Min;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.28 no.1
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    • pp.23-31
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    • 2010
  • Purpose: To evaluate the relationship between the normal tissue complication probability (NTCP) of 3-dimensional (3-D) radiotherapy and the radiographic parameters of 2-dimensional (2-D) radiotherapy such as central lung distance (CLD) and maximal heart distance (MHD). Materials and Methods: We analyzed 110 patients who were treated with postoperative radiotherapy for breast cancer. A two-field tangential technique, a three-field technique, and the reverse hockey stick method were used. The radiation dose administered to whole breast or the chest wall was 50.4 Gy, whereas a 45 Gy was administered to the supraclavicular field. The NTCPs of the heart and lung were calculated by the modified Lyman model and the relative seriality model. Results: For all patients, the NTCPs of radiation-induced pneumonitis and cardiac mortality were 0.5% and 0.7%, respectively. The NTCP of radiation-induced pneumonitis was higher in patients treated with the reverse hockey stick method than in those treated by other two techniques (0.0%, 0.0%, 3.1%, p<0.001). The NTCP of radiation-induced pneumonitis increased with CLD. The NTCP of cardiac mortality increased with MHD ($R^2=0.808$). Conclusion: We found a close correlation between the NTCP of 3-D radiotherapy and 2-D radiographic parameters. Our results are useful to reanalyze the previous 2-D based clinical reports about breast radiation therapy complications as a viewpoint of NTCP.

Phytotoxic Effect of Herbicides on Upland Crops and Weeds (밭작물(作物) 및 잡초(雜草)에 대한 제초제(除草劑)의 약해(藥害) 약효(藥效))

  • Ryang, H.S.;Chun, J.C.;Yim, J.H.
    • Korean Journal of Weed Science
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    • v.4 no.1
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    • pp.69-78
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    • 1984
  • This study was conducted to select herbicides effective for upland crops and to investigate the cause of crop injury in peanut cultivated with mulching. Crop such as radish (Raphanus acanthiformis Moor.), Chinese cabbage (Brassica raps L.), soybean (Glycine max Merr.), Peanut (Archis hypogaea L.), and marsh mallow (Malva olitoria Nakai) were tolerant to napropamide [2-(${\alpha}$-naphthoxy)-N, N-diethylpropionamide], alachlor [2-chloro-2', 6'-diethyl-N-(methoxymethyl) acetanilide], trifluralin (${\alpha},{\alpha},{\alpha}$-trifluoro-2, 6-dinitro-N, N-dipropylp-toluidine) and nitrofen (2,4-dichlorophenyl-p-nitrophenylether). Napropamide, diphenamide (N, N-dimethyl-2, 2-diphenylacetamide) and alachlor were safe for red pepper (Capsicum annuum L.), eggplant (Solanum melongena L. and tomato (Lycopersicon esculentum Mill.), while trifluralin, nitrofen and chlonitrofen (2,4,6-trichlorophenyl-4-nitrophenyl ether) could be used for water melon (Citrullus battich Forsk.), carrot (Daucus carota L.) and lettuce (Lactuca scariola L.) without crop injury. Out of nine major weed species studied, Capsella bursa-pastoris Medicus was the most resistant species to the herbicides tested. Napropamide and alachlor could not control P. hydropiper, while P. oleracea and C. album were tolerant to diphenamide :and alachlor, respectively. Urea herbicides such as methabenzthiazuron [3-(2-benzothiazolyl)-1,3-dimethylurea], linuron [3-(3, 4-dichlorophenyl~l-methoxy-i-methyl urea], and isoproturon [3-(4-isopropylphenyl) -1, 1-dimethylurea]gave a great injury to the crops studied. The weeding effect was greater for broadleaf weeds than for grasses. Isoproturon and linuron provided good selectivity for marsh mallow and carrot, respectively. In peanut, the crop injury caused by Four herbicides studied was greater when cultivated with mulching than when cultivated without mulching. With dinitroaniline herbicides the crop injury decreased as the gaseous herbicide was removed out of mulching. Alachlor gave little phytotoxicity to peanut grown under mulching condition and nitralin [4-(methylsuphonyl)-2, 6-dinitro-N, N-dipropylaniline] showed less toxicity to the peanut than pendimenthalin (3,4-dimethyl-2, 6-dinitro-N-1-ethyl propylaniline) and trifluralin.

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Cytotoxicity of COX-2 Inhibitor (Nimesulide) in Non-small Cell Lung Cancer Cell Line (비소세포폐암 세포주에서 COX-2억제제(Nimesulide)의 세포독성)

  • Park Chan Beom;Jeon Hyun Woo;Jin Ung;Cho Kyu Do;Kim Chi Kyung;Wang Young-Pil
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.263-270
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    • 2005
  • In recent years, a combination of two demographic phenomena, an increased number of older people in the population and an increase in the incidence of lung cancer with age, has made it mandatory to develop therapeutic modalities with less toxicity for the treatment of inoperable elderly patients with lung cancer. Therefore, we investigated the correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Material and Method: Immunohistochemical staining of COX-2 was performed. After exposure of Nimesulide, XTT analysis, FACS analysis and Hoechst staining were carried out. Result: COX-2 protein was expressed in non-treated A549 cells strongly, but not in H1299. Cytotoxicity of Nimesulide against A549 cell and H1299 cell were similar and $IC_{50}$ of Nimesulide in both cell lines were $70.9{\mu}M$ in A549 cell line and $56.5{\mu}M$ in H1299 cell line respectively. FACS analysis showed $G_0/G_1$ arrest in both cell lines and the S phase cell fraction was decreased. Morphologic assessment of apoptosis by Hoechst 33258 staining, many apoptotic cells were detected in both cell lines. Conclusion: Selective COX-2 inhibitor, Nimesulide, can inhibit the proliferation of non-small cell lung cancer cell lines in vitro. Inhibitory effect of Nimesulide are induction of apoptosis and $G_0/G_1$ arrest. There is no correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Therefore, highly selective COX-2 inhibitors such as Nimesulide can be expected to lead to even greater efficacy of their use as adjuncts to various anticancer angents and radiation therapy for the treatment of high-risk patients.

Isolated Lung Perfusion with Cisplatin in Rabbit - evaluation of pharmacokinetics and long term pathologic changes of the lung- (가토에서 Cisplatin을 사용한 분리 폐 관류 -약리학적 변화 및 폐의 장기적 병리학적 변화에 관한 연구-)

  • 김관민;김진국;한정호
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.613-620
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    • 1999
  • Background: Recently, regional or isolated organ perfusion is being studied again as a drug administration modality which is able to reduce systemic toxicity while delivering high-dose chemotherapeutic agents. This research was planned to evaluate the pharmacokinetics and long-term pathologic changes of the lung in isolated lung perfusion (ILP) with cisplatin. Material and Method: Twenty-five New Zealand white rabbits were divided into 2 groups (Group I: 10, Group II: 15). The groups were then subdivided into 2 and 3 subgroups of 5 rabbits. In group I, tissue samples of the lung and kidney, and systemic blood for platinum concentration measurement were taken 30 minutes after systemic intravenous infusion of cisplatin (5 mg/kg) and isolated lung perfusion in each 5 rabbits. In 2 subgroups of group II, lung tissues for pathologic exams were taken 30 minutes and 1 week after ILP in each 5 rabbits, which received 10% pentastarch solution only and cisplatin, respectively. In the other subgroups, lung biopsy was undertaken 4 weeks after ILP with cisplatin. Result: When cisplatin was infused via systemic vein, the platinum concentration in the lung, kidney and plasma were 1.50${\pm}$0.43 $\mu\textrm{g}$/g, 7.65${\pm}$2.49 $\mu\textrm{g}$/g, 1.19${\pm}$0.03 $\mu\textrm{g}$/ml, respectively. However, the platinum concentration in the lung was about 50 times higher (75.43${\pm}$11.47 $\mu\textrm{g}$/g) than that of intravenous infusion group, and those in the kidney and plasma were decreased (1.30${\pm}$ 0.35 $\mu\textrm{g}$/g, 0.13${\pm}$0.02 $\mu\textrm{g}$/ml) when cisplatin was introduced through ILP. Pathologic change in the treated lung with ILP was characterized by the medial hypertrophy of the pulmonary arterioles and interstitial eosinophilic infiltration, which was not dependent on cisplatin

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Antimutagenic Effects of Korean Bamboo Trees and Inhibitory Effect of Hepatic Toxicity of Bamboo Extracts Coated Rice (한국산 대나무의 항돌연변이 효과 및 대나무 코팅쌀의 간 독성 억제효과)

  • Lee, Min-Ja;Kim, Eun-Young;Jeong, Keun-Ok;Park, Kun-Young;Moon, Gap-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.8
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    • pp.1279-1285
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    • 2004
  • To evaluate the antimutagenic effect and hepato protective of bamboo trees and bamboo byproduct, hot-water extracts from four kinds of bamboo [wang-dae (Phyllostachys bambusoides S. et Z.), som-dae (Phyllostachys nigra var. henonis), maengjong-juk (Phyllostachys pubescens) and o-juk (Phyllostachys nigra Munro)] and maengjong-juk extract coated rice were evaluated for antimutagenicity by Ames test using Salmonella typhimurium TA100. Bamboo extracts showed strong antimutagenic activity in the Ames test which MNNG was used as mutagen in the absence and presence of S9 mix. Maengjong-juk extract coated rice diet suppressed the loss of body weight significantly. Food intake was increased in maengjong-juk extract coated rice supplemented group but showed no significant differences between control and maengjong-juk extract coated rice diet groups. Food efficiency of maengjong-juk extract coated rice supplemented group was significantly higher than that of the control group. Liver weight was significantly increased by maengjong-juk extract coated rice diet administration. Plasma GOT & GPT activities of rabbit were significantly suppressed in maengjong-juk extract coated rice supplemented group. These results suggest that bamboo trees extracts and maengjong-juk extract coated rice are bioavailable resource on treatment of cardiovascular disease, such as atherosclerosis and hypercholesterolemia.

The Clinical Investigation of Drug Intoxication in the North-Youngseo District of Kangwon Province (강원 영서 북부 지역의 약물 중독 실태)

  • Ok, Taek-Gun;Cho, Jun-Hwi;Park, Chan-Woo;Kim, Sung-Eun;Choi, Ki-Hoon;Bae, Ji-Hoon;Seo, Jeong-Yeul;Chung, Jae-Bong;Ahn, Hee-Cheol;Ahn, Moo-Eob;You, Ki-Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.83-89
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    • 2004
  • Acute poisoning is one of the diseases which need the most fastest emergency measures at the very beginning. However, at present, The Korea doesn't manage the toxication all over the country, and in particular, there is no guide to medical cure paying due regard to the traits of each area. This paper focused on the issue that the necessary data in preparing the facilities for the treatment of the poisoned patients and materials for medical treatment including antidote would have to be collected, after finding the special features of the symptoms by searching the present conditions of the poisoning in small towns next to farm villages in the North area of Youngseo, Kangwon province. This study was based on the questionnaires from 111 patients who were carried into the emergency room by the poisoning in two university hospitals of the North area of Youngseo, Kangwon, for one year, 2002. Upon investigation, the patients(111) visiting emergency room by the acute poisoning during the research period was found to be 0.37 percent of all patients(30,085) visiting emergency room. Among them, the most high percentage was given in their twenties and thirties at the rate of $39.6\%$, and the ratio($40.5\%$) of the poisoned patients after their fifties was much higher than a research($10\%$) of other areas. Many poisoned patients came to their rescue in an emergency room generally in spring and in winter, from 7 a.m. to 3 p.m. Agricultural chemical of the toxic materials had a majority at a ratio of $57.7\%$, and paraquat of the agricultural chemicals was found to have a lot of toxicity by $31.7\%$. As the trace of the toxication, the oral poisoning was common by $89.2\%$, and $55.9\%$ in the case of operating gastric lavage and nasogastric irrigation, but only $14.4\%$ for prescribing antidote. The mortality of the acute poisoned patients was $17.2\%$, and the toxication by paraquat held a majority. As a result, the acute poisoning of the North area in Youngseo, Kangwon had both of the characteristics of the rural and the city, and the patients over their fifties by the population aging had more attack of the disease than other regions. Also, with the high ratio of the toxication by the agricultural chemicals, especially, the lethal agricultural chemical was used frequently. Therefore, these dangerous situations need to find the ways to cope with.

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Effect of Green Tea on Tissue Distribution and Deposition of 14C-Benzo[a]pyrene in Rats (흰쥐에서 녹차의 섭취가 14C-Benzo[a]pyrene의 조직 분배 및 잔류에 미치는 영향)

  • Kim, Ju-Yeon;Noh, Sang-K.
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.6
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    • pp.818-823
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    • 2011
  • Recently, we showed that green tea extract (GTE) markedly lowers the intestinal absorption of $^{14}C$-benzo[a]pyrene ($^{14}C$-BaP) and enhances its secretion into the biliary route, suggesting a protective role for GTE against body burden. These findings indicate that green tea could be used as an effective dietary means against the toxicity of BaP. The present study, therefore, was designed to investigate if green tea intake could affect the tissue distribution and deposition of $^{14}C$-BaP in rats. Male Sprague-Dawley rats had free access to a nutritionally adequate AIN-93G diet and deionized water. At ~340 g of weight, the rats were injected intraperitoneally with 27.4 kBq of [4-$^{14}C$]-BaP and 5.0 mg of BaP dissolved in $300\;{\mu}L$ of olive oil and then assigned randomly to the following two groups: one group (GTE) of rats was fed the AIN-93G diet with GTE via drinking water at approx. 4.7 mg of catechins/d, whereas the other was fed the same diet but without GTE (control). At 4 wk of dietary treatment with GTE, animals were euthanized and heart, liver, brain, spleen, kidney, retroperitoneal fat, testis, and epididymal fat were collected, weighed, and analyzed for tissue $^{14}C$-BaP. Both the control and GTE groups continuously gained weight throughout the study, but there was no significant difference between the groups. No significant differences were observed in the weights of heart, liver, brain, spleen, kidney, retroperitoneal fat, testis, and epididymal fat. However, the radioactivities of $^{14}C$-BaP, expressed in dpm/g, were significantly lower in the heart, liver, brain, spleen, and epididymal fat of rats receiving GTE as compared to their respective controls. These data indicate that green tea intake markedly lowers tissue accumulation of $^{14}C$-BaP. Taken together, these findings suggest that the decreased tissue levels of BaP by GTE intake may be associated with lowered intestinal absorption of BaP and its enhanced secretion into the bile.