• Radiation Oncology Journal
• /
• v.14 no.1
• /
• pp.1-8
• /
• 1996

Purpose: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancer in terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. Materials and Methods: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to APr. 1993. Of these, twenty six patients were treated by conventional radio-therapy alone, and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The Patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of Primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The range of follow-up periods was 3-102 months and median was 20 months. The range of a9e was 33-79 years old and median was 58 years old. Results : Overall 3-year actuarial survival rate (3YSR) of all patients was $39\%$. The 3YSRS of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55, 33 and $32\%$, respectively The 3YSRS of Tl+2, T3+4 and No, N+ were 55, $18\%$ (p=0.005) and 43, $36\%$ (p>0.1), respectively. There was no difference in 3YSRS between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs $43\%$, p>0.1). According to the original site of primary tumor, the 3YSRS of tonsil (n=32), base of tongue (n=8), soft palate or uvula (n=6) and pharyngeal wall (n=1) were 36 38, 67 and $0\%$, respectively The Patients of soft palate or uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 Patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not Primary extension, but the difference was marginally significant statistically (24 vs $60\%$, p=0.08). On Cox multivariate analysis in entire patients with variables of age, T stage, N stage, total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy, only T stage was a significant Prognostic factor affecting 3YSR. Conclusion : The difference of 3YASRS of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal cancer, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multi-modal approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.

• Radiation Oncology Journal
• /
• v.21 no.2
• /
• pp.125-134
• /
• 2003

Purpose: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. Materials and Methods: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4$\~$6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. Results: The compliance to the current preoperative CRCT protocol was excellent, where 92.5$\%$ (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9$\%$), while resection was abandoned during laparotomy in two patients (5.7$\%$). Gross complete resection was peformed in 30 patients, gross incomplete resection was peformed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5$\%$ (15/33), and the complete resection rate with the negative resection margin 78.8$\%$ (26/33). During the CRCT course, grade 3 $\~$4 neutropenia developed in four patients (10.8$\%$). Local recurrence after surgical resection developed in 12.1$\%$ (4/33), and distant metastases after the preoperative CRCT start developed in 21.6$\%$ (8/37). The overall 3-years survival rate was 87$\%$. Conclusion: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.

• Radiation Oncology Journal
• /
• v.14 no.3
• /
• pp.221-228
• /
• 1996

Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the Patterns of failure in ovarian dysgerminoma retrospectively According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Materials and Methods : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY) Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy (group 2). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass (20) pelvic discomfort or pain (5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy/l-2weeks 1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease ($100\%$). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four Patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one Patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 Patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were $96.6\%$ (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation. So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). Conclusion : The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.

• The Journal of Korean Society for Radiation Therapy
• /
• v.29 no.1
• /
• pp.37-48
• /
• 2017

Purpose: The most basic conditions of radiation therapy is to prevent unnecessary exposure of normal tissue. The risk factors that are important o evaluate the dose emitted to the lung and heart from radiation therapy for breast cancer. Therefore, comparing the dose factors of a normal tissue according to the radion treatment position and Seeking an effective radiation treatment for breast cancer through the analysis of the correlation relationship. Materials and Methods: Computed tomography was conducted among 30 patients with left breast cancer in supine and prone position. Eclipse Treatment Planning System (Ver.11) was established by computerized treatment planning. Using the DVH compared the incident dose to normal tissue by position. Based on the result, Using the SPSS (ver.18) analyzed the dose in each normal tissue factors and Through the correlation analysis between variables, independent sample test examined the association. Finally The HI, CI value were compared Using the MIRADA RTx (ver. ad 1.6) in the supine, prone position Results: The results of computerized treatment planning of breast cancer in the supine position were V20, $16.5{\pm}2.6%$ and V30, $13.8{\pm}2.2%$ and Mean dose, $779.1{\pm}135.9cGy$ (absolute value). In the prone position it showed in the order $3.1{\pm}2.2%$, $1.8{\pm}1.7%$, $241.4{\pm}138.3cGy$. The prone position showed overall a lower dose. The average radiation dose 537.7 cGy less was exposured. In the case of heart, it showed that V30, $8.1{\pm}2.6%$ and $5.1{\pm}2.5%$, Mean dose, $594.9{\pm}225.3$ and $408{\pm}183.6cGy$ in the order supine, prone position. Results of statistical analysis, Cronbach's Alpha value of reliability analysis index is 0.563. The results of the correlation analysis between variables, position and dose factors of lung is about 0.89 or more, Which means a high correlation. For the heart, on the other hand it is less correlated to V30 (0.488), mean dose (0.418). Finally The results of independent samples t-test, position and dose factors of lung and heart were significantly higher in both the confidence level of 99 %. Conclusion: Radiation therapy is currently being developed state-of-the-art linear accelerator and a variety of treatment plan technology. The basic premise of the development think normal tissue protection around PTV. Of course, if you treat a breast cancer patient is in the prone position it take a lot of time and reproducibility of set-up problems. Nevertheless, As shown in the experiment results it is possible to reduce the dose to enter the lungs and the heart from the prone position. In conclusion, if a sufficient treatment time in the prone position and place correct confirmation will be more effective when the radiation treatment to patient.

• Radiation Oncology Journal
• /
• v.19 no.3
• /
• pp.216-223
• /
• 2001

Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.

• MISULJARYO - National Museum of Korea Art Journal
• /
• v.98
• /
• pp.226-241
• /
• 2020

Located on the right side of the third floor of the State Hermitage Museum in St. Petersburg, the "Art of Central Asia" exhibition boasts the world's finest collection of artworks and artifacts from the Silk Road. Every item in the collection has been classified by region, and many of them were collected in the early twentieth century through archaeological surveys led by Russia's Pyotr Kozlov, Mikhail Berezovsky, and Sergey Oldenburg. Some of these artifacts have been presented around the world through special exhibitions held in Germany, France, the United Kingdom, the Netherlands, Korea, Japan, and elsewhere. The fruits of Russia's Silk Road expeditions were also on full display in the 2008 exhibition The Caves of One Thousand Buddhas - Russian Expeditions on the Silk Route on the Occasion of 190 Years of the Asiatic Museum, held at the Hermitage Museum. Published in 2018 by the Shanghai Chinese Classics Publishing House in collaboration with the Hermitage Museum, Kuche Art Relics Collected in Russia introduces the Hermitage's collection of artifacts from the Kuche (or Kucha) region. While the book focuses exclusively on artifacts excavated from the Kuche area, it also includes valuable on-site photos and sketches from the Russian expeditions, thus helping to enhance readers' overall understanding of the characteristics of Kuche art within the Buddhist art of Central Asia. The book was compiled by Dr. Kira Samosyuk, senior curator of the Oriental Department of the Hermitage Museum, who also wrote the main article and the artifact descriptions. Dr. Samosyuk is an internationally renowned scholar of Central Asian Buddhist art, with a particular expertise in the art of Khara-Khoto and Xi-yu. In her article "The Art of the Kuche Buddhist Temples," Dr. Samosyuk provides an overview of Russia's Silk Road expeditions, before introducing the historical development of Kuche in the Buddhist era and the aspects of Buddhism transmitted to Kuche. She describes the murals and clay sculptures in the Buddhist grottoes, giving important details on their themes and issues with estimating their dates, and also explains how the temples operated as places of worship. In conclusion, Dr. Samosyuk argues that the Kuche region, while continuously engaging with various peoples in China and the nomadic world, developed its own independent Buddhist culture incorporating elements of Gandara, Hellenistic, Persian, and Chinese art and culture. Finally, she states that the culture of the Kuche region had a profound influence not only on the Tarim Basin, but also on the Buddhist grottoes of Dunhuang and the central region of China. A considerable portion of Dr. Samosyuk's article addresses efforts to estimate the date of the grottoes in the Kuche region. After citing various scholars' views on the dates of the murals, she argues that the Kizil grottoes likely began prior to the fifth century, which is at least 100 years earlier than most current estimates. This conclusion is reached by comparing the iconography of the armor depicted in the murals with related materials excavated from the surrounding area (such as items of Sogdian art). However, efforts to date the Buddhist grottoes of Kuche must take many factors into consideration, such as the geological characteristics of the caves, the themes and styles of the Buddhist paintings, the types of pigments used, and the clothing, hairstyles, and ornamentation of the depicted figures. Moreover, such interdisciplinary data must be studied within the context of Kuche's relations with nearby cultures. Scientific methods such as radiocarbon dating could also be applied for supplementary materials. The preface of Kuche Art Relics Collected in Russia reveals that the catalog is the first volume covering the Hermitage Museum's collection of Kuche art, and that the next volume in the series will cover a large collection of mural fragments that were taken from Berlin during World War II. For many years, the whereabouts of these mural fragments were unknown to both the public and academia, but after restoration, the fragments were recently re-introduced to the public as part of the museum's permanent exhibition. We look forward to the next publication that focuses on these mural fragments, and also to future catalogs introducing the artifacts of Turpan and Khotan. Currently, fragments of the murals from the Kuche grottoes are scattered among various countries, including Russia, Germany, and Korea. With the publication of this catalog, it seems like an opportune time to publish a comprehensive catalog on the murals of the Kuche region, which represent a compelling mixture of East-West culture that reflects the overall characteristics of the region. A catalog that includes both the remaining murals of the Kizil grottoes and the fragments from different parts of the world could greatly enhance our understanding of the murals' original state. Such a book would hopefully include a more detailed and interdisciplinary discussion of the artifacts and murals, including scientific analyses of the pigments and other materials from the perspective of conservation science. With the ongoing rapid development in western China, the grotto murals are facing a serious crisis related to climate change and overcrowding in the oasis city of Xinjiang. To overcome this challenge, the cultural communities of China and other countries that possess advanced technology for conservation and restoration must begin working together to protect and restore the murals of the Silk Road grottoes. Moreover, centers for conservation science should be established to foster human resources and collect information. Compiling the data of Russian expeditions related to the grottoes of Kuche (among the results of Western archaeological surveys of the Silk Road in the early twentieth century), Kuche Art Relics Collected in Russia represents an important contribution to research on Kuche's Buddhist art and the Silk Road, which will only be enhanced by a future volume introducing the mural fragments from Germany. As the new authoritative source for academic research on the artworks and artifacts of the Kuche region, the book also lays the groundwork for new directions for future studies on the Silk Road. Finally, the book is also quite significant for employing a new editing system that improves its academic clarity and convenience. In conclusion, Dr. Kira Samosyuk, who planned the publication, deserves tremendous praise for taking the research of Silk Road art to new heights.

• Journal of Distribution Science
• /
• v.8 no.3
• /
• pp.17-26
• /
• 2010

Recently concerns have been raised due to the unbalanced supply of crops: the price of crops has been unstable and at one point the price went up so high that the word Agflation(agriculture+ inflation) was coined. Korea, in particular, is a small-sized country and needs to secure the stable supply of crops by investing in the produce importation at a national level. Investment in foreign produce importation is becoming more important as a measure for sufficient supply of crops, limited supply of domestic crops, weakened farming conditions worldwide, as well as recent changes in the use of crops due to the development of bio-fuels, influence of carbon emission on crops, the price increase in crops, and influx of foreign hot money. However, there are many problems with investing in foreign produce importation: lack of support from the government; lack of farming information and technology; difficulty in securing the capital; no immediate pay-off from the investment and insufficient management. Although foreign produce is originally more price-competitive than domestic produce, it loses its competiveness in the process of importation (due to high tariffs) and poor distribution system, which makes it difficult to sell in Korea. Therefore, investment in foreign produce importation is being questioned for feasibility; to make it possible, foreign produce must maintain the price-competitiveness. Especially, harvest of agricultural products depends on natural and geographical conditions of each country and those products have indigenous properties, so distribution system according to import and export of agricultural products should be treated more carefully than that of other industries. Distribution costs are differentiated into each item and include cost of sorting and wrapping, cost of wrapping materials, cost of domestic transport, cost of international transport and cost of clearing customs for import and export. So transporting and storing agricultural products generates considerable costs compared with other products. Also, due to upgrade of dietary life, needs for stability, taste and visible quality toward food including agricultural products are being raised and wrong way of storage causes decomposition of food and loss of freshness, making the storage more difficult than that in room temperature, so storage and transport in distribution of agricultural products needs specialty. In addition, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. However, existing distribution system of agricultural products is exposed to various problems including problems in distribution channel, making distribution and strategy for distribution and those problems are as follows. First, in case of investment in overseas agricultural industry, stable supply of the products is difficult because areas of production are dispersed widely and influenced by outer factors due to including overseas distribution channels. Also, at the aspect of quality, standardization of products is difficult, distribution system is quite complicated and unreasonable due to long distribution channels according to international trade and financial and institutional support is not enough. Especially, there are quite a lot of ineffective factors including multi level distribution process, dramatic gap between production cost and customer's cost, lack of physical distribution facilities and difficulties in storage and transport due to lack of wrapping containers. Besides, because import and export of agricultural products has been manages under the company's own distribution according to transaction contract between manufacturers and exporting company, efficiency is low due to excessive investment in fixed costs and lack of specialty in dealing with agricultural products causes fall of value of products, showing the limit to lose price-competitiveness. Especially, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. Second, among tangible and intangible services which promote the efficiency of the whole distribution, a function building distribution environment which includes distribution information, system for standard and inspection, distribution finance, system for diversification of risks, education and training, distribution administration and tax system is wanted. In general, such a function building distribution environment is difficult to be changed and supplement innovatively because its effect compared with investment does not appear immediately despite of its necessity. Especially, in case of distribution of agricultural products, as a function of collecting and distributing is performed individually through various channels, the importance of distribution information and standardization is getting more focus due to the problem of repetition of work and lack of specialty. Also, efficient management of distribution is quite difficult due to lack of professionals in distribution, so support to professional education is needed. Third, though effort to keep self-sufficiency ratio of staple food, rice is regarded as important at the government level, level of dependency on overseas of others crops is high. Therefore, plan for stable securing food resources aside from staple food is also necessary. Especially, governmental organizations of agricultural products distribution in Korea are production-centered and have unreasonable structure whose function at the aspect of distribution and consumption is quite insufficient. And development of new distribution channels which can deal with changes in distribution environment and they do not achieve actual results of strategy for distribution due to non-positive strategy for price distribution. That is, it implies the possibility that base for supply will become vulnerable because it does not mediate appropriate interests on total distribution channels such as manufacturers, wholesale dealers and vendors by emphasizing consumer protection excessively in the distribution of agricultural products. Therefore, this study examined fundamental concept and actual situation for our investment to overseas agriculture, drew necessities, considerations, problems, etc. of overseas agricultural investment and suggested improvements at the level of distribution for price competitiveness of agricultural products cultivated in overseas under five aspects; government's indirect support, distribution's modernization and distribution information function's strengthening, government's political support for distribution facility, transportation route, load and unloading works' improvement, price competitiveness' securing, professional manpower's cultivation by education and training, etc. Here are some suggestions for foreign produce importation. First, the government should conduct a survey on the current distribution channels and analyze the situation to establish a measure for long-term development plans. By providing each agricultural area with a guideline for planning appropriate production of crops, the government can help farmers be ready for importation, and prevent them from producing same crops all at the same time. Government can sign an MOU with the foreign government and promote the importation so that the development of agricultural resources can be stable and steady. Second, the government can establish a strategy for an effective distribution system by providing farmers and agriculture-related workers with the distribution information such as price, production, demand, market structure and location, feature of each crop, and etc. In order for such distribution system to become feasible, the government needs to reconstruct the current distribution system, designate a public organization for providing distribution information and set the criteria for level of produce quality, trade units, and package units. Third, the government should provide financial support and a policy to seek an efficient distribution channel for foreign produce to be delivered fresh: the government should expand distribution facilities (for selecting, packaging, storing, and processing) and transportation vehicles while modernizing old facilities. There should be another policy to improve the efficiency of unloading, and to lower the cost of distribution. Fourth, it is necessary to enact a new law covering exceptional cases for importing produce in order to maintain the price competitiveness; currently the high tariffs is keeping the imported produce from being distributed domestically. However, the new adjustment should be made carefully within the WTO regulations since it can create a problem from giving preferential tariffs. The government can also simplify the distribution channels in order to reduce the cost in the distribution process. Fifth, the government should educate distributors to raise the efficiency and to modernize the distribution system. It is necessary to develop human resources by educating people regarding the foreign agricultural environment, the produce quality, management skills, and by introducing some successful cases in advanced countries.

• The Journal of Korean Society for Radiation Therapy
• /
• v.27 no.2
• /
• pp.157-166
• /
• 2015

Purpose : Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. Results : If the target error is a sine curve breathing form, the size of the target of the movement is in response to the 5 mm, 10 mm, 20 mm, respectively, of the average $1.14{\pm}0.13mm$, $1.05{\pm}0.20mm$, with $2.37{\pm}0.17mm$, suddenly for it is variations in breathing, respective average $1.87{\pm}0.19mm$, $2.15{\pm}0.21mm$, and analyzed with $2.44{\pm}0.26mm$. If the correlation error can be defined by the length of the displacement vector in the target track is a sinusoidal breathing mode, the size of the target of the movement in response to 5 mm, 10 mm, 20 mm, respective average $0.84{\pm}0.01mm$, $0.70{\pm}0.13mm$, with $1.63{\pm}0.10mm$, if it is a variant of sudden breathing respective average $0.97{\pm}0.06mm$, $1.44{\pm}0.11mm$, and analyzed with $1.98{\pm}0.10mm$. The larger the correlation error values in both the both the respiratory form, the target error value is large. If the motion size of the target of the sine curve breathing form is greater than or equal to 20 mm, was measured at 1.5 mm or more is a recommendation value of both cyber knife manufacturer of both error value. Conclusion : There is a tendency that the correlation error value between about target error value magnitude of the target motion is large is increased, the error value becomes large in variation of rapid respiration than breathing the form of a sine curve. The more the shape of the breathing large movements regular shape of sine curves target accuracy of the tumor tracking system can be judged to be reduced. Using the algorithm of Cyber-Knife tumor tracking system, when there is a change in the sudden unpredictable respiratory due patient coughing during treatment enforcement is to stop the treatment, it is assumed to carry out the internal target validation process again, it is necessary to readjust the form of respiration. Patients under treatment is determined to be able to improve the treatment of accuracy to induce the observed form of regular breathing and put like to see the goggles monitor capable of the respiratory form of the person.

• Journal of the Korean association of regional geographers
• /
• v.3 no.2
• /
• pp.37-87
• /
• 1997

As a results of researches on the cultivation processes and settlement developments on the Mangyoung river valley as a whole could be have four 'Space-Time Continuity' through a [Origin-Destination] theory model. On a initial phases of cultivation, the cultivation process has been begun at mountain slopes and tributory plains in upper part of river-basin from Koryo Dynasty to early Chosun Dynasty. At first, indigenous peasants burned forests on the mountain slopes for making 'dryfield' for a cereal crops. Following population increase more stable food supply is necessary facets of life inducing a change production method into a 'wetfield' in tributory plains matching the population increase. First sedentary agriculture maybe initiated at this mountain slopes and tributory plains on upper part of river basin through a burning cultivation methods. Mountain slopes and tributory plains are become a Origin area in cultivation processes. It expanded from up to down through the valleys with 'a bits of land' fashion in a steady pace like a terraced fields expanded with bit by bit of land to downward. They expanded their land to the middle part of river basin in mid period of Chosun Dynasty with dike construction techniques on the river bank. Lower part of river cultivated with embankment building techniques in 1920s and then naturally expanded to the tidal marshes on the estuaries and river inlets of coastal areas. 'Pioneer fringes' are consolidated at there in modern times. Changes in landscapes are appeared it's own characters with each periods of time. Followings are results of study through the Mangyoung river valley as a whole. (1) Mountain slopes and tributory plains on the upper part of river are cultivated 'dryfields' by indigenous peasants with Burning cultivation methods at first and developed sedentary settlements at the edges of mountain slopes and on the river terrace near the fields. They formed a kind of 'periphery-located cluster type' of settlement. This type of settlement are become a prominant type in upper part of river basin. 'Dryfields' has been changed into a 'wetfields' at the narrow tributory plains by increasing population pressure in later time. These wetfields are supplied water by Weir and Ponds Irrigation System(제언수리방법). Streams on the tributory plains has been attracted wetfields besides of it and formed a [water+land] complex on it. 'Wetfields' are expanded from up to downward with a terraced land pattern(adder like pattern, 붕전) according to the gradient of valley. These periphery located settlements are formed a intimate ecological linkage with several sets of surroundings. Inner villages are expanded to Outer villages according to the expansion of arable lands into downward. (2) Mountain slopes and tributory plains expanded its territory to the alluvial deposited plains on the middle part of river valley with a urgent need of new land by population increase. This part of alluvial plains are cultivated mainly in mid period of Chosun Dynasty. Irrigation methods are changed into a Dike Construction Irrigation method(천방수리방법) for the control of floods. It has a trend to change the subjectives of cultivation from community-oriented one who constructed Bochang along tributories making rice paddies to local government authorities who could be gather large sums of capitals, techniques and labours for the big dike construction affairs. Settlements are advanced in the midst of plains avoiding friction of distances and formed a 'Centrallocated cluster type' of settlements. There occured a hierarchical structures of settlements in ranks and sizes according merits of water supply and transportation convenience at the broad plains. Big towns are developed at there. It strengthened a more prominant [water+land] complex along the canals. Ecological linkages between settlements and surroundings are shaded out into a tiny one in this area. (3) It is very necessary to get a modern technology of flood control at the rivers that have a large volume of water and broad width. The alluvial plains are remained in a wilderness phase until a technical level reached a large artificial levee construction ability that could protect the arable land from flood. Until that time on most of alluvial land at the lower part of river are remained a wilderness of overgrown with reeds in lacks of techniques to build a large-scale artificial levee along the riverbank. Cultivation processes are progressed in a large scale one by Japanese agricultural companies with [River Rennovation Project] of central government in 1920s. Large scale artificial levees are constructed along the riverbank. Subjectives of cultivation are changed from Korean peasants to Japanese agricultural companies and Korean peasants fell down as a tenant in a colonial situation of that time in Korea. They could not have any voices in planning of spatial structure and decreased their role in planning. Newly cultivated lands are reflected company's intensions, objectives and perspectives for achieving their goals for the sake of colonial power. Newly cultivated lands are planned into a regular Rectangular Block settings of rice paddies and implanted a large scale Bureaucratic-oriented Irrigation System on the cultivated plains. Every settlements are located in the midst of rice paddies with a Central located Cluster type of settlements. [water+land] complex along the canal system are more strengthened. Cultivated space has a characters of [I-IT] landscapes. (4) Artificial levees are connected into a coastal emnankment for a reclamation of broad tidal marshes on the estuaries and inlets of rivers in the colonial times. Subjectives of reclamation are enlarged into a big agricultural companies that could be acted a role as a big cultivator. After that time on most of reclamation project of tidal marshes are controlled by these agricultural companies formed by mostly Japanese capitalists. Reclaimed lands on the estuaries and river inlets are under hands of agricultural companies and all the spatial structures are formed by their intensions, objectives and perspectives. They constructed a Unit Farming Area for the sake of companies. Spatial structures are planned in a regular one with broad arable land for the rice production of rectangular blocks, regular canal systems and tank reservoir for the irrigation water supply into reclaimed lands. There developed a 'Central-located linear type' of settlements in midst of reclaimed land. These settlements are settled in a detail program upon this newly reclaimed land at once with a master plan and they have planned patterns in their distribution, building materials, location, and form. Ecological linkage between Newly settled settlemrnts and its surroundings are lost its colours and became a more artificial one by human-centred environment. [I-IT] landscapes are become more prominant. This region is a destination area of [Origin-Destination] theory model and formed a 'Pioneer Fringe'. It is a kind of pioneer front that could advance or retreat discontinously by physical conditions and socio-cultural conditions of that region.

• Radiation Oncology Journal
• /
• v.16 no.4
• /
• pp.409-423
• /
• 1998

Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.