• Title/Summary/Keyword: death year

Search Result 930, Processing Time 0.031 seconds

Aortopulmonary Window (대동맥폐동맥창)

  • Kim Dong-Jin;Min Sun-Kyung;Kim Woong-Han;Lee Jeong-Sang;Kim Yong-Jin;Lee Jeong-Ryul
    • Journal of Chest Surgery
    • /
    • v.39 no.4 s.261
    • /
    • pp.275-280
    • /
    • 2006
  • Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

A Study on the Establishment Process and Design Conception of KoKwan Park in Modern Busan (근대 부산에서 고관공원의 성립과 설계 사상)

  • Kang, Youngjo
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.31 no.4
    • /
    • pp.22-32
    • /
    • 2013
  • This study aimed to reveal the establishment process and design concept of KoKwan park built in modern Busan, which is called three major park includes YongDuSan park and TaeJeong Park, by analyzing BusanIlbo published modern period in Busan and 'Busan' published modern Busan prefecture. In KoKwan, there was installed DuMoPo Waegwan. The Japanese residents built the cemetery and memorial stone for Tsunohe Heigo's sudden death in the KoKwan hill, who was an envoy dispatched by Tsusima prefecture, in order to enhance awareness of the old territory DuMoPo Waegwan. In 1916, the Japanese residents repaired ruined the place by rasing funds and donated to Busan prefecture. Busan prefecture went public this place as a park. Meanwhile, In order to commemorate the 50th anniversary of the opening of Busan port, Oike Chusuke's memorial statue was built in private house neiboring KoKwan park. He became the richest person in Busan while engaged in commerce and industry since he come to the Busan the year before the opening of Busan port. He donate garden site includes his statue and 10,000 Won for KoKwan park construction expenses to Busan prefecture Busan prefecture invite Oya Rejo, who was Osaka-Hu's landscape designer, to design the KoKwan park. He visited Busan and survey KoKwan park and other Busan's park and submitted the plan to Busan prefecture. His Plan for KoKwan includes shrine and Oike's statue, arboretum and greenhouses, children's play garden, etc. Oya's design concept of KoKwan park was analyzed as follows: the juxtaposition of the sacred and secular, the succession of present landscape context, the complement of parks content, the tool of nation-state formation. KoKwan park was completed with cost 20,000 won, insufficient budget compared with Oya's estimated amount. However, in this thesis, it was not cleared whether Busan prefecture built the park as it was. In 1945, after the independence, KoKwan Park was destroyed due to build Dong-gu Office, houses. The remained subjects from this study are to clarify the process the destruction of the park.

우리나라 농촌지역의 출산조절행태 및 출산조절행위의 결정요인 분석

  • Chung, Kyung-Hee;Han, Seung-Hyun;Bang, Sook
    • Korea journal of population studies
    • /
    • v.11 no.2
    • /
    • pp.33-53
    • /
    • 1988
  • This study aimed at developing a desirable family planning policy and strategy by examining the current status of family planning practice in rural Korea and by indentifying the crucial factors which affect fertility control behavior. For this purpose, an analytical study was conducted, using the survey data collected in July 1985, on an interview basis, on 1, 440 married women living in the Soyi, Wonnam and Maingdong townships of Eumseong County(in North Chungcheong Province). This study population has the typical characteristics of rural areas, and the results of the analysis can be summarized as follows: 1. In regard to the demographic characteristics of the study population : their average age at marriage was 23.7, they had an average of 2.6 children( 1.3 boys, 1.3 girls) :10% experienced the death of their child (ren) :14% had spontaneous abortion(s) :4% weathered stillbirth(s) :35% went through induced abortion (s) : and 5.5% were currently pregnant. The average of their ideal numbers of children was 2.2, while 44% felt that they must have a son. 2. Looking at the contact rate with medical & health institutions, over the past 1 year, the visit rate to health subcenters was 43.7%, while 26.9% visited the (county) health center :59.6% had been to private clinics : and 41.5% went to the Soonchunhyang - Eumsung hospital : thus showing a relatively high rate of accessibility. 3. The utilization rate of family planning services was 76.5%, with tubectomy being the most prominent method at 52.3%, while the informants were health workers in 54.2% of the acceptors. Of the 8.4% who discontinued the use of contraceptive methods, only 26% did so due to want for pregnancy, natural infertility (meno - pause), or other reasons, while the remaining 74% stopped usage on account of side effects, failure in the methods themselves, and inconvenience of use, thus pointing to a situation where the proper choice of family planning methods have not yet been made. It can be noted that there is a strong motivation for early birth stopping as 35.3% practice family planning even with only one child, of which 38.3% have had sterilization operations. According to results of a multiple regression analysis, among the variables affecting contraception usage the most significant variable was the number of sons. 4. 34.8% experienced induced abortions. It was shown as a result of multiple regression analysis that the number of children and attitudes toward induced abortions extensively affected their frequency of abortions conducted. 5. In the regard to the relation between family planning and induced abortions, 33.7% of the women used both, while 52.0% of them used only the former(family planning), with only 1.4 % utilizing solely the latter(abortion), and 12.9% totally abstaining from fertility regulation : again, the discriminant analysis indicated that the choice of family planning and/or induced abortion was determined by the number of children and attitudes toward induced abortion. In view of the above mentioned results, the following are some comments and suggestions concerning problems related to the current family planning policies, in Korea : 1. It is difficult to expect a further quantitative expansion in family planning program operations, as there has been an excessive supply of target-oriented sterilization operations on women. From a maternal and child health care point of view, it will be desirable to have a diversification of service points in the future where family planning methods may be properly chosen, so that choices of methods which suit the mothers' characteristics and tastes may be made by the individuals themselves by strengthening their quality of family planning information services. 2. Along with the strengthening of the qualitative improvement of family planning services policies must be implemented to effectively promote the moral (ethical) deterrents to induced abortions and to preference for sons. From a maternal care standpoint, the social permissive norm toward induced abortion must be modified, and the bias towards son must be analyzed as the women with more daughters have a lower rate of family planning acceptance. Such changes in attitudes, however, can not be hoped to be accomplished with ad hoc policies, but will only be possible when an enhancement of the women's status(within the society) is brought about in a long - term perspective.

  • PDF

Ecological Characteristics of Termite(Reticulitermes speratus kyushuensis) for Preservation of Wooden Cultural Heritage (목조문화재의 보존을 위한 한국산 흰개미의 생태적 특성 연구)

  • Lee, Kyu-Shik;Jeong, So-Young
    • Korean Journal of Heritage: History & Science
    • /
    • v.37
    • /
    • pp.327-348
    • /
    • 2004
  • In this study, after analyzing several local climate characteristics of South Korea, I validated distribution, invasion, foraging, underground activities, attack season as ecological characteristics and also temperature, relative humidity, and tree species as preference characteristics of Korean termites (Reticulitermes speratus kyushuensis Morimoto). Especially, southern part of the Korean peninsula is a suitable area for inhabitation and motion of termites holding same ecological characteristic like R. speratus kyushuensis. Busan is a neighboring district at field distribution north limiting temperature of Coptotermes formosanus Shiraki and Chuncheon is a passing area through the Korean Peninsula of field distribution north limiting temperature of Reticulitermes speratus Kolbe. The termite attack of wood devices was about 34.5% for 3 years in the forest of Jongmyo. Although the attack rate of termite increased each year, the detection rate decreased and the missing rate was high by degrees. I confirmed a foraging habits which is a part of termite colony was a role of continuous decomposition and another was a role of new food hunt as experimental results. The foraging termites were found under ground at Jongmyo in Seoul from April to November in the 2001 and the most active period was on July and August. The termite invasion rate of bait station increased in every monitoring. Through the increasing attack rate of bait station during 2nd monitoring (November, 2000) and 3rd monitoring(March, 2001), I confirmed that termites moved into the deep underground in winter, and were working continuously to forage. R. speratus kyushuensis inhabiting at the Korean Peninsula is a species which has food consumption rate with higher temperature. The termite revealed the greatest amount of food(filter paper) at $30^{\circ}C$(90% RH), but showed increasing death rate at over $32^{\circ}C$. Also, survival rate of this termite was 97% at 84% RH($30^{\circ}C$), but killed 100% at 52% RH($30^{\circ}C$) and 70% RH($30^{\circ}C$). For wood feeding, this was observed the preference in a pine tree(Pinus densiflora) above all others. Survival of termites was high(87%) at a pine tree, but low(13.5%) at a paulownia tree(Paulownia coreana). In this study, I presented the biological characteristic of termite(R. speratus kyushuensis Morimoto) and confirmed the deterioration degree of termite on wooden cultural heritage in Korea. Depending on climate and soil temperature, each area in the southern part of the Korea Peninsula, has some different active period and different distribution of R. speratus kyushensis. With these results, I expect that this report helps to prepare the integrated pest management(IPM) of the termite on wooden cultural heritage in Korea, and it may help to reduce the economical loss from termite damage in Korea.

A Study on the Meaning of Zelkova serrata as a Medium of Place Memory - Focused on the Natives of the Village and the Migrant of Keangnam Apartment in Dogok-dong - (장소기억의 매개로서 느티나무의 의미 고찰 - 역말 원주민과 도곡동 경남아파트 이주민을 중심으로 -)

  • Hamm, Yeon-Su;Sung, Jong-Sang
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.39 no.3
    • /
    • pp.42-55
    • /
    • 2021
  • This study investigated the memories of the natives and the migrants who had been living with the 760-year-old Zelkova serrata located in the Keangnam Apartment Complex in Dogok 1-dong. Place memory is a newly illuminated concept since the 1980s, and is also used as a new research methodology for studying and recording multi-layered memories left in a place based on feelings and traces of vivid memories. The urban development of Gangnam, which began in the 1970s, quickly changed rural to apartment complexes. The natives of Yeokmal were scattered throughout the country, and new migrants moved in. In the process, zelkova serrata was managed in different ways from time to time, and residents also establish relationship in different ways. Natives used to take a rest in the tree or swing at Dan-o, and recognized it as a place to receive the god during the village ritual. In other words, they shared the entire process of life and death and were given various roles depending on the lives of the residents. It is also a direct experience that was experienced in detail and a place where collective memories of residents are melted. On the other hand, with the construction of Keangnam Apartment, the management of zelkova tree has become stricter, making it impossible for migrants to access. Migrants have come to enjoy zelkova serrata visually, and the annual Yeokmal Traditional Festival makes common memories in the city. In addition, many people personified trees and received mental comfort. In addition, the nature of the old big tree was highlighted in the background of the city, and the symbol of "uniqueness and speciality" was newly formed, which led to the formation of pride and attachment. Through the memories of the two subjects' zelkova tree, we were able to examine the memories of the tree value, and management of protected tree in the city.

Implication and Its Meaning Contact of Gwangje-jeong's Place Transmission (광제정(光霽亭) 장소 전승의 함의와 의미맥락)

  • Rho, Jae-Hyun;Lee, Suk-Woo;Lee Jung-Han;Jung, Kyung-Suk;Kim, Young-Suk
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.29 no.3
    • /
    • pp.40-51
    • /
    • 2011
  • The purpose of the study was to understand the symbol and locational meanings in building and relocating Gwangje-jeong(光霽亭) through the analysis and interpretation on the construction background, history, the location and its characteristics. Concerning physical environment, human activities, the symbol and meanings of the formal Gwangje-jeong site and the present location, the study was concluded about the site and its meaning of tradition as following. Gwangje, the name of the pavilion, represents the fidelity of Maedang(梅堂) Yangdon(楊墩) who refused as Seonbee(a man of virtue) to be tainted with the corrupt world, which was related with the situation at that time. It implies Maedang's feeling of realizing Noojeongjeyong(樓亭題詠) of Gwangje-jeong along with the high spirit of Gwangpoongjewol(光風霽月). According to the record about rebuilding Gwangje-jeong, Maedang was the very person who planted plum flowers at the pavilion and put up the tablet of its name, Gwangje. Even after his death, Gwangje-jeong was the symbol indicating Yangdon, given the triple high ground and the planting of plum flowers. Also, Sookho(宿虎) town at the entrance of Gwangje-jeong and Bokhoam(伏虎巖: a rock) at the right side of the pavilion signifies the location for praising Maedang Yangdon, and the Yangjipha's Oensi(五言詩: five words verse) engraved on the rock gives a good description about the place, Agyesa that worshiped Yangdon. As Agye-Sa(阿溪祠) where Yangdon was worshiped and praised had been abolished in the 5th year under the Kojong's reign(1868), the spirit praising Maedang had finally been used for the relocation of Gwangje-jeong. Despite the relocation of Gwangje-jeong, the old Gwangje-jeong site has remained at least for 359years at Hucheonli, and its surroundings have maintained the name 'Gwangje' as the front place name morpheme, for example, 'Gwangje-jeong,' 'Gwangje Town,' 'Gwangje Bridge' and 'Gwangje Creek,' for symbolizing the praising of Maedang. Gwangje-jeong, as the center place of solidarity among Namwon Yang's family clan, has been able to maintain its symbol and meanings in spite of relocation, mainly because of the fellowship among the descendants, family clan and alumni who respected virtuous achievements of ancestors and shared the agony of the time. In addition, the symbolism has been preserved since the spirit of Gwangpoonjewol of Yangdon and his high character were cherished along with the spirit of Bongseon(奉先) that inherited and kept virtuous achievements of ancestors.

Changes in the Incantations of the Daesoon Faith: Focusing on Historical Facts (대순 신앙의 주문 변화 -고증을 중심으로-)

  • Park Sang-kyu
    • Journal of the Daesoon Academy of Sciences
    • /
    • v.44
    • /
    • pp.1-52
    • /
    • 2023
  • Incantations are reflected in the fundamentals of the Daesoon faith system and are, thus, key to its understanding. Jeungsan, the yeonwon (fountainhead, 淵源) of the Daesoon faith, created new incantations or transformed existing ones that had been used in old religious traditions such as Buddhism and Daoism. However, there has been no in-depth academic research on Jeungsan's incantations until now. This study aims to academically clarify the incantatory archetypes of Jeungsan's incantations based on documents published until the 1970s. Jeungsan's incantations are then compared to those of Mugeuk-do (Limitless Dao) in the 1920s and Taegeuk-do (Great-Ultimate Dao) in the 1950s. Jeongsan's transformed incantations are analyzed through this process. Jeongsan reflected the faith system in Jeungsan's incantations during the period of Mugeuk-do. He transformed the incantations to achieve his goal and realize his wishes by arranging terms that referred to himself before the optative words of the incantations. Jeongsan made several changes to the incantations in the 1950s. First, the majority of incantations used in Mugeuk-do were discarded. This meant making partial changes to the faith system by reflecting awareness because the corresponding incantations were no longer necessary as the Degree Number calibrated by Jeungsan had been realized. Second, Jeongsan organized the incantations in use and institutionalized their instructions. This reflected the essential doctrinal system of the Daesoon faith, namely the completion of the true dharma by Jeongsan. Considering this doctrine, that is, the Fifty Year Holy Work (五十年工夫), the true dharma can be presumed to have been realized before the death of Jeongsan. Accordingly, the institutionalizing and organizing of the incantations were indispensable until the mid-to-late 1950s. Jeongsan, the founder of the Daesoon order, posited himself as the successor of religious orthodox lineage and as the figure who would complete the true dharma by realizing the Degree Number calibrated by Jeungsan. Therefore, Jeongsan interpreted Jeungsan's incantations to be a rough sketch of the Daesoon faith system that had been drawn for him in advance by Jeungsan. Accordingly, Jeongsan transformed Jeungsan's incantations and used them to realize the Degree Number, which Jeungsan had planned. Simultaneously, Jeongsan declared that he would fulfill the Degree Number and establish the true dharma by changing those incantations.

The Effect of Employment Types of Middle and Old Age Group of Wage Earner on Life Satisfaction (중·노년층 임금근로자의 고용형태에 따른 삶의 만족도)

  • Lee, Seo-yeong;Song, Hee-kyong
    • 한국노년학
    • /
    • v.39 no.3
    • /
    • pp.517-529
    • /
    • 2019
  • The study was conducted on the impact of employment types middle and old age group of wage earner on life satisfaction and analyzed by dividing it into variables in the employment types and demographic characteristics. Based on the data for the 12th year of the Korea Welfare Panel Study, 1,244 respondents who answered that the main types of economic activities were 'full-time, temporary, daily wage earners' or 'self-help labor, public labor, and elderly empolyment program in public sector.' among 4,341 people over 55 years of age under the age of 75 as of 2017 standard. The survey covered 1,244 people. By age group, 826 people aged 55-64 (middle-age group) and 418 people aged 65-74(old-age group). Middle age group showed that education level, spouse, health condition, beneficiaries of basic livelihood and average monthly income variables were the factors that influence the satisfaction of life. But The type of employment did not significantly affect. Old age group showed that the higher education level, in spouse with-living or spouse death, the better health condition is perceived, the less experience of beneficiaries of basic livelihood, the higher average monthly income, the more satisfied life is. The survey also found that old-aged people who participate in "self-help labor, public labor, and elderly employment program in public sector" are also found to be more satisfied with their lives. According to these results, policy for the old age group should be focused on hunting and expanding of employment program in public sector for the elderly. In order to boost life satisfaction of the elderly, more intensive vocational education and employment training should be provided.

The First North Korean Painting in the Collection of the National Museum of Korea: Myogilsang on Diamond Mountain by Seon-u Yeong (국립중앙박물관 소장 산률(山律) 선우영(鮮于英) 필(筆) <금강산 묘길상도>)

  • Yi, Song-mi
    • MISULJARYO - National Museum of Korea Art Journal
    • /
    • v.97
    • /
    • pp.87-104
    • /
    • 2020
  • Myogilsang on Diamond Mountain, signed and dated (2000) by Seon-u Yeong (1946-2009), is the first work by a North Korean artist to enter the collection of the National Museum of Korea (fig. 1a). The donor acquired the painting directly from the artist in Pyeongyang in 2006. In consequence, there are no issues with the painting's authenticity.This painting is the largest among all existing Korean paintings, whether contemporary or from the Joseon Dynasty, to depict this iconography (see chart 1. A Chronological List of Korean Myogilsang Paintings.) It is ink and color on paper, measures 130.2 × 56.2 centimeters, and is in a hanging scroll format. Since this essay is intended as a brief introduction of the painting and not in-depth research into it, I will simply examine the following four areas: 1. Seon-u Yeong's background; 2. The location and the traditional appellation of the rock-cut image known as Myogilsang; 3. The iconography of the image; and 4) A comparative analysis of Seon-u Yeong's painting in light of other paintings on the same theme. Finally, I will present two more of his works to broaden the understanding of Seon-u Yeong as a painter. 1. Seon-u Yeong: According to the donor, who met Seon-u at his workshop in the Cheollima Jejakso (Flying Horse Workshop) three years before the artist's death, he was an individual of few words but displayed a firm commitment to art. His preference for subjects such as Korean landscapes rather than motifs of socialist realism such as revolutionary leaders is demonstrated by the fact that, relative to his North Korean contemporaries, he seems to have produced more paintings of the former. In recent years, Seon-u Yeong has been well publicized in Korea through three special exhibitions (2012 through 2019). He graduated from Pyeongyang College of Fine Arts in 1969 and joined the Central Fine Arts Production Workshop focusing on oil painting. In 1973 he entered the Joseon Painting Production Workshop and began creating traditional Korean paintings in ink and color. His paintings are characterized by intense colors and fine details. The fact that his mother was an accomplished embroidery specialist may have influenced on Seon-u's choice to use intense colors in his paintings. By 1992, he had become a painter representing the Democratic People's Republic of Korea with several titles such as Artist of Merit, People's Artist, and more. About 60 of his paintings have been designated as National Treasures of the DPRK. 2. The Myogilsang rock-cut image is located in the Manpok-dong Valley in the inner Geumgangsan Mountain area. It is a high-relief image about 15 meters tall cut into a niche under 40 meters of a rock cliff. It is the largest of all the rock-cut images of the Goryeo period. This image is often known as "Mahayeon Myogilsang," Mahayeon (Mahayana) being the name of a small temple deep in the Manpokdong Valley (See fig. 3a & 3b). On the right side of the image, there is an intaglio inscription of three Chinese characters by the famous scholar-official and calligrapher Yun Sa-guk (1728-1709) reading "妙吉祥"myogilsang (fig. 4a, 4b). 3. The iconography: "Myogilsang" is another name for the Bhodhisattva Mañjuśrī. The Chinese pronunciation of Myogilsang is "miaojixiang," which is similar in pronunciation to Mañjuśrī. Therefore, we can suggest a 妙吉祥 ↔ Mañjuśrī formula for the translation and transliteration of the term. Even though the image was given a traditional name, the mudra presented by the two hands in the image calls for a closer examination. They show the making of a circle by joining the thumb with the ring finger (fig. 6). If the left land pointed downward, this mudra would conventionally be considered "lower class: lower life," one of the nine mudras of the Amitabha. However, in this image the left hand is placed across its abdomen at an almost 90-degree angle to the right hand (fig. 6). This can be interpreted as a combination of the "fear not" and the "preaching" mudras (see note 10, D. Saunders). I was also advised by the noted Buddhist art specialist Professor Kim Jeong-heui (of Won'gwang University) to presume that this is the "preaching" mudra. Therefore, I have tentatively concluded that this Myogilsang is an image of the Shakyamuni offering the preaching mudra. There is no such combination of hand gestures in any other Goryeo-period images. The closest I could identify is the Beopjusa Rock-cut Buddha (fig. 7) from around the same time. 4. Comparative analysis: As seen in , except for the two contemporary paintings, all others on this chart are in ink or ink and light color. Also, none of them included the fact that the image is under a 40-meter cliff. In addition, the Joseon-period paintings all depicted the rock-cut image as if it were a human figure, using soft brushstrokes and rounded forms. None of these paintings accurately rendered the mudra from the image as did Seon-u. Only his painting depicts the natural setting of the image under the cliff along with a realistic rendering of the image. However, by painting the tall cliff in dark green and by eliminating elements on either side of the rock-cut image, the artist was able to create an almost surreal atmosphere surrounding the image. Herein lies the uniqueness of Seon-u Yeong's version. The left side of Seon-u's 2007 work Mount Geumgang (fig. 8) lives up to his reputation as a painter who depicts forms (rocks in this case) in minute detail, but in the right half of the composition it also shows his skill at presenting a sense of space. In contrast, Wave (fig. 9), a work completed one year before his death, displays his faithfulness to the traditions of ink painting. Even based on only three paintings by Seon-u Yeong, it seems possible to assess his versatility in both traditional ink and color mediums.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
    • /
    • v.15 no.1
    • /
    • pp.27-36
    • /
    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

  • PDF