Biomarkers indicating past exposure to radiation have not yet been entirely satisfactory. In this study, we validated several genes reported as radiation response genes, as biomarkers to detect past exposure to radiation in occupationally exposed workers, especially workers in the medical field. A total of 54 radiation workers in hospital were investigated for radiation exposure dose. Their average radiation dose of recent one year was 1.09 mSv ($\pm$1.63) with a 10.63 mSv ($\pm$12.91) cumulative dose. The results of the multiple regression analysis for the various variables indicate that the Hsc70 (P=0.0292) and ORAL (P=0.0045) may be candidate biomarkers for the recent 1 year radiation exposure in radiation workers, whereas AEN (P=0.0334) and PGAMI (P=0.0003) might be for cumulative exposure.
Song Mi Hee;Chung Eun Ji;Seong Jin Sil;Suh Chang Ok
Radiation Oncology Journal
/
v.10
no.2
/
pp.261-266
/
1992
We analyzed retrospectively the patients of granulocytic sarcoma treated with radiotherapy at the Department of Radiation Oncology, Yonsei University College of Medicine from Mar 1987 to Mar.1992 in an attempt to review our experience with irradiation of granulocytic sarcoma and to evaluate the treatment results for the radiation dose response. Fourteen lesions of granulocytic sarcoma in 9 patients were developed in variable clinical settings such as AML, CML and without leukemia. The involved lesions were bone, lymph node, soft tissue and skin in descending order of occurrence. All of the lesions in 9 patients were treated with external beam radiotherapy (Co-60 or electron beam). Both age distribution and clinical settings did not show any correlation with the response to treatment. The response to treatment seemed to be better for lesions in the bone than in other involved lesions. The majority received local irradiation of a total dose of more than 2000 cGy. Radiation dose of more than 2000 cGy showed excellent local control of $100\%$, (11/11), while local control decreased to $33\%$(1/3) with total dose less than 2000 cGy. In conclusion, local radiotherapy seems to be very effective for palliative or curative aim of granulocytic sarcoma, and a radiation dose more than 2000 cGy is highly recommended.
Purpose: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). Materials and Methods: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. Results: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. Conclusion: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.
$\underline{Purpose}$: We evaluated retrospectively the outcome of locally advanced non-small cell lung cancer patients treated with definitive radiotherapy to find out prognostic factros affecting survival. $\underline{Materials\;and\;Methods}$: 216 cases of stage IIIB non-small cell lung cancer were with treated radiotherapy at our Hospital between 1991 to 2002 and reviewed retrospectively. Cases were classified by mode of treatment and response to treatment. Patients showing complete response or partial response to treatment were included in the "response group", while those showing stable or progressive cancer were included in the "non-response group". $\underline{Results}$: 30 patients completed the planned radiotherapy treatments and 39 patients completed combined treatments or chemoradiotherapy. Median survival was 4.6 months for patients treated with radiotherapy and 9.9 months for those undergoing combined radiotherapy and chemotherapy. Survival rates for the first year were 13.3% with radiotherapy and 35.9% with chemoradiotherapy. In the second year, 3.3% of the radiotherapy patients survived and 20.5% of the patients receiving chemoradiotherapy survived. By the third year, 15.4% of the patients receiving the combined treatments survived. None of the patients treated with radiotherapy alone lived to the third year, however. Overall survival was significantly different between the radiotherapy patients and the combined chemoradiotherapy patients (p<0.001). In the response group, median survival was 7.2 months with radiotherapy and 16.5 months with combined therapy. In the non-response group, median survival was 4.4 months with radiotherapy and 6.7 months with combined treatments. Severe acute complications (grade 3) occurred in 2 cases using radiotherapy, and in 7 cases using combined therapy. $\underline{Conclusion}$: When the patients with stage IIIB non-small cell lung cancer received chemoradiotherapy, treatment response rate and overall survival was greater than with radiation alone.
Chang, Ji Hyun;Kim, Chae-Yong;Choi, Byung Se;Kim, Yu Jung;Kim, Jae Sung;Kim, In Ah
Journal of Korean Neurosurgical Society
/
v.55
no.1
/
pp.5-11
/
2014
Objective : We evaluated pseudoprogression (PsPD) following radiation therapy combined with concurrent temozolomide (TMZ), and we assessed pseudoresponse following anti-angiogenic therapy for patients with recurrent disease using the Response Assessment of the Neuro-Oncology Working Group. Methods : Patients who were pathologically confirmed as having high-grade glioma received radiotherapy with concurrent TMZ followed by adjuvant TMZ. Bevacizumab (Avastin) with CPT-11 were used as a salvage option for cases of radiologic progression. Magnetic resonance imaging (MRI) was routinely performed 1 month after concurrent radiochemotherapy (CRT) and every 3 months thereafter. For cases treated with the bevacizumab-containing regimen for progressive disease, MRI was performed every 2 months. Results : Of 55 patients, 21 (38%) showed radiologic progression within 4 weeks after CRT. Of these patients, 16 (29%) showed progression at second post-CRT MRI (etPD) and five (9%) showed improvement (PsPD). Seven of thirty-four initially non-progressed patients showed progression at the second post-CRT MRI (ltPD). No difference in survival was observed between the etPD and ltPD groups (p=0.595). Five (50%) of ten patients showed a radiological response after salvage bevacizumab therapy. Four of those patients exhibited rapid progression immediately after discontinuation of the drug (drug holiday). Conclusion : Twelve weeks following treatment could be the optimal timing to determine PsPD or true progression. MRI with gadolinium enhancement alone is not sufficient to characterize tumor response or growth. Clinical correlation with adequate follow-up duration and histopathologic validation may be helpful in discriminating PsPD from true progression.
Purpose: There has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior. Materials and Methods: Medical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy. Results: No KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables. Conclusion: RT is effective in local control of NAKS resulting great response rate.
Background: To study the effect of parecoxib, a novel cyclooxygenase-2 selective inhibitor, on the radiation response of colorectal cancer (CRC) cells and its underlying mechanisms. Materials and Methods: Both in vitro colony formation and apoptosis assays as well as in vivo mouse xenograft experiments were used to explore the radiosensitizing effects of parecoxib in human HCT116 and HT29 CRC cells. Results: Parecoxib sensitized CRC cells to radiation in vitro with a sensitivity enhancement ratio of 1.32 for HCT116 cells and 1.15 for HT29 cells at a surviving fraction of 0.37. This effect was partially attributable to enhanced apoptosis induction by parecoxib combined with radiation, as illustrated using an in vitro apoptosis assays. Parecoxib augmented the tumor response of HCT116 xenografts to radiation, achieving growth delay more than 20 days and an enhancement factor of 1.53. In accordance with the in vitro results, parecoxib combined with radiation resulted in less proliferation and more apoptosis in tumors than radiation alone. Radiation monotherapy decreased microvessel density (MVD) and microvessel intensity (MVI), but increased the hypoxia level in xenografts. Parecoxib did not affect MVD, but it increased MVI and attenuated hypoxia. Conclusions: Parecoxib can effectively enhance radiation sensitivity in CRC cells through direct effects on tumor cells and indirect effects on tumor vasculature.
An electronic personal dosimeter(EPD) with hybrid type preamplifier adopting a semiconductor detector as a radiation detector has been developed, manufactured and test-evaluated. The radiation detection characteristics of this EPD has been performance-tested by using a reference photon radiation field. After several test-irradiations to a $^{137}Cs$ gamma radiation source the radiation detection sensitivity of this EPD appeared to be $3.8\;cps/Gy{\cdot}h^{-1}$. The linearity of radiation response was kept within 8% of the dose equivalent ranges of $10{\mu}Sv{\sim}4Sv$ and the angular dependence was under less than 4% in angles of ${\pm}60^{\circ}$. It was confirmed that the energy response range was in $60{\sim}1,250keV$ given in the ISO standard. This EPD satisfied the international criteria for the EPD in the mechanical and the environmental performance test for 9 test categories according to IEC 61526.
From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.
Kim, Jae-Won;Son, Hee-Young;Jeon, Sea-Yuong;Park, Jung-Je;Ahn, Seong-Ki;Kang, Ki-Mun;Kim, Jin-Pyeong
Korean Journal of Head & Neck Oncology
/
v.24
no.1
/
pp.26-32
/
2008
Purpose:Hypopharyngeal carcinoma is usually diagnosed as an advanced disease after an asymptomatic beginning, and it is related to a high frequency of lymph node metastases. An eventual negative outcome may occur not only because of possible locoregional failures but also for frequent distant metastases. Thus, the efficacy of induction chemotherapy followed by radiation therapy, with regards to the response, survival rate and complications for locally advanced hypopharyngeal carcinoma patients, was examined. Methods and Materials:Since July 1998 to February 2001, 18 patients having locally advanced hypopharyngeal carcinoma were treated with induction chemotherapy followed by radiation therapy, and the results were retrospectively analyzed. The regimen of the induction chemotherapy was the 5-flurouracil(5-FU, 1,000mg/$m^2$ daily for 5 consecutive days) and cisplatin(100mg/$m^2$ on day 1) combination at 3-week intervals for 2 cycles. The total radiation dose for the primary tumor and metastatic lymph nodes was 68.4-72.0Gy(median:70.2Gy) Results:The 3-year overall survival rate and disease free survival rate were 31.3% and 22.2%, respectively. In 6 patients(33.3%), preservation of the larynx for over 3 years was possible. After the induction chemotherapy and radiotherapy, a complete response was noted in 14 patients(77.8%), and a partial response in 4 patients (22.2%), with an overall response rate of 100%. Conclusion:Induction chemotherapy followed by radiation therapy is an effective treatment and larynx preservation rate was 33% in patients with locally advanced hypopharyngeal carcinoma in our report.
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