• Journal of Chest Surgery
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• 제22권2호
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• pp.357-363
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• 1989

We experienced very rare case of pulmonary blastoma in a 5 year old girl. She complained of right chest pain and productive cough for 3 months. With computerized tomography and echocardiography it is disclosed that huge mediastinal solid tumor is occupied to whole right thoracic cavity and compressed mediastinal structures to left and extended to left atrium. We removed the thoracic tumor and its extended intracardiac portion completely using the technique of intrapericardial pneumonectomy with cardiopulmonary bypass. Postoperatively the patient recovered without any problem and received adjuvant chemotherapy and radiotherapy. But she was succumbed 2 months later because of opportunistic pulmonary infection with pneumocystis carinii.

• Journal of Chest Surgery
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• 제45권5호
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• pp.345-347
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• 2012

We describe herein an extremely rare case of a recurrent primary pulmonary malignant fibrous histiocytoma 3 months after operation that occurred in a 55-year-old man who was treated with chemotherapy and radiotherapy successfully. Until now, 36 months later, the patient has shown no evidence of tumor recurrence. The clinical, radiographic, and pathologic features are reported here together with a brief review of the literature.

• Journal of Chest Surgery
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• 제54권6호
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• pp.539-542
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• 2021

Resection and reconstruction of the chest wall for the radical surgical treatment of malignant soft tissue tumors are currently considered a substantial challenge for thoracic surgeons. We present an unusual case of infantile fibrosarcoma with tropomyosin 3-neurotrophic receptor tyrosine kinase 1 fusion in a 13-year-old patient. The surgical treatment consisted of radical resection of the right posterior chest wall and reconstruction with the use of the STRATOS (Strasbourg Thoracic Osteosynthesis System) titanium rib bridge system. The patient had a favorable postoperative course and received respiratory-ventilatory rehabilitation, adjuvant therapy with chemotherapeutic agents, immunotherapy, and radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2359-2362
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• 2014

Background: To investigate the effects of double radiofrequency hyperthermia on Th1/Th2 cells in esophageal cancer patients treated with radiotherapy. Materials and Methods: 22 patients with esophageal cancer were divided into a radiotherapy group (10 cases) and a combined group (double radiofrequency hyperthermia combined with radiotherapy group, 12 cases). Both groups received conventional radiotherapy using a cobalt-60 therapy apparatus (TD60-66Gy/30-33F). Patients in the combined group also underwent double radiofrequency hyperthermia (2F/W, 8-10F). Before and after treatment, Th1, Th2, Tc1 and Tc2 cells in peripheral blood were determined with flow cytometry. Results: In the radiotherapy group, Th1 cell contents before and after radiotherapy were $17.5{\pm}5.26%$ and $9.69{\pm}4.86%$, respectively, with a significant difference (p<0.01). The Th1/Th2 ratio was significantly decreased from $28.2{\pm}14.3$ to $16.5{\pm}10.4 $(p<0.01). In the combined group, Th1 cell content before radiotherapy was $15.9{\pm}8.18%$, and it increased to $18.6{\pm}8.84$ after radiotherapy (p>0.05), the Th1/Th2 ratio decreasing from $38.4{\pm}36.3$ to $28.1{\pm}24.0$ (p>0.05). Changes in Th2, Tc1 and Tc2 cell levels were not significant in the two groups before and after therapy (p>0.05). Conclusions: Double radiofrequency hyperthermia can promote the conversion from Th2 to Th1 cells, and regulate the balance of Th1/Th2 cells.

• Tuberculosis and Respiratory Diseases
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• 제63권2호
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• pp.154-164
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• 2007

배경: Irinotecan hydrochloride는 topoisomerase I inhibitor로서 소세포 폐암에 효과적인 약제로 알려져 있다. Irinotecan은 cisplatin과 더불어 방사선감작물질로 작용하기도 한다. 본 연구는 이전에 치료받은 경험이 없는 제한성 병기의 소세포 폐암 환자에서 irinotecan과 cisplatin(IP)의 방사선 동시화학요법의 효과를 평가하기 위하여 시행되었다. 방법: 2002년 12월부터 2004년 11월까지 충남대학교 병원에서 새로이 제한성 병기의 소세포 폐암으로 진단된 24명의 환자들을 대상으로 하였다. Irinotecan $60mg/m^2$을 제 1일과 제 8일째 투여하였고 cisplatin $60mg/m^2$을 제 1일째 투여하였으며 매 3주 간격으로 시행되었다. 제 3차 항암화학요법을 시작하는 날과 동시에 과다 분할방사선 치료(twice-daily thoracic irradiation; 45 Gy total)을 시작하였다. 예방적 전 뇌 방사선 조사(Prophylactic cranial irradiation)가 방사선 동시화학요법이 끝난 후 완전반응(complete response)을 나타낸 환자에서 시행되었다. 제 2차 항암요법과 제 6차 항암요법이 끝난 후에 흉부 전산화 단층촬영과 기관지경 등을 통한 병기의 재평가가 이루어졌다. 결과: 병기의 재평가는 19명의 환자에게 이루어졌다. 중앙 추적관찰기간은 12.5개월이고 전체 99회의 항암치료가 시행되었다. 평균 한 환자당 5.2회의 항암치료가 시행되었다. 실제 용량강도는 cisplatin $19.6mg/m^2$/week과 irinotecan $38.2mg/m^2$/week이었다. 9명의 환자가 완전반응을 보였고 10명의 환자가 부분반응(partial response)을 보여서 전체 반응률은 95%였다. 3에서 4도의 혈액학적 독성은 백혈구 감소증(35% of cycles), 빈혈(7% of cycles), 혈소판 감소증(7% of cycles) 등으로 나타났다. 3에서 4도의 비 혈액학적 독성은 설사(5% of cycles)였다. 3에서 4도의 방사선 식도염(10% of patients)을 제외하고는 과다 분할 방사선 치료를 이용한 방사선 동시 화학요법의 기존의 방법과 독성 면에서는 큰 차이가 없었다. 치료와 관련된 사망은 관찰되지 않았다. 평가가 가능한 환자들에서 1년 생존율과 2년 생존율은 각각 89% (16/18)와 47% (9/18)였다. 결론: 3주 간격으로 시행된 irinotecan과 cisplatin을 이용한 과다분할 방사선 동시 요법은 제한성 병기의 소세포 폐암 환자에서 부작용은 높지 않으면서 효과적인 치료법으로 고려될 수 있을 것이다.

• Journal of Korean Neurosurgical Society
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• 제39권5호
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• pp.385-388
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• 2006

An Intramedullary subependymoma of the spinal cord is a rare tumor with only 43 reported cases in the literature. Most of them are reported to be localized within the cervical spinal cord. We report a rare case of a thoracic spine intramedullary subependymoma in a 37-year-old female who presented with back pain and radiating leg pain. Subtotal resection and post-operative radiotherapy were performed. Subependymomas developing in the spinal cord are benign with a low proliferative potential. Complete resection of the tumor appears to be the optimal method for a complete cure. However aggressive surgery may cause severe neurological deficit. Therefore, if severe neurological deficits are expected after complete removal, a partial removal and postoperative radiation therapy is an alternative method for treatment in selected cases. A large-scale randomized study is mandatory to clarify the effectiveness of radiotherapy and to establish the recurrence rate and prognosis with respect to the surgical removal of these tumors.

• Journal of Chest Surgery
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• 제54권3호
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• pp.228-231
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• 2021

Herein, we report a case in which thoracomyoplasty was performed to manage chronic postlobectomy empyema (PLE). A 54-year-old male patient with a surgical history of right upper lobectomy and thymectomy 35 years previously who had undergone adjuvant radiotherapy presented with purulent discharge on the anterior chest wall. The patient was diagnosed with chronic PLE with ascending infection and concurrent osteonecrosis of the parasternum. Proper drainage was performed for local infection control and the dead spaces were successfully closed with muscle flaps. There have been no complications to date.

• Journal of Chest Surgery
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• 제19권3호
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• pp.484-488
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• 1986

Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.903-915
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• 1996

Background: Combination chemotherapy is now considered to be the cornerstone of small cell lung cancer (SCLC). management but the optimal management of limited SCLC is not well defined. The role of thoracic radiotherapy (TRT) is less well established. Recent meta-analyses reports revealed that TRT combined with chemotherapy produce "good" local control and prolonged survival. But other reports that survival was not changed. The liming, dose, volume and fractionation for TRT with the combined chemotherapy of SCLC remains unsettled. In this study, we analyzed the effects according to the timing of thoracic radiotherapy in limited SCLC. Method: All fifty one patients received cytoxan, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(VPP) every 3 weeks for 6 cycles were randomized prospectively into two groups: concurrent and sequential. 27 patients received 4500cGy in 30 fractions(twice daily 150cGy fractional dose) over 3 weeks 10 the primary site concurrent with the first cycle of VPP(concurrent gorup). 24 patients received 4000 to 5000cGy over 5 or 6 weeks after completion of sixth cycles of chemotherapy(sequential group). Results: 1. Response rates and response duration : Response rates were not significantly different between two groups(p=0.13). But response duration was superior in the concurrent group(p=0.03). 2. Survival duration was nor different between two groups(p=0.33). 3. Local control rate was superior in the concurrent group(p=0.00). 4. Side effects and toxicities: Hematologic toxicities, especially leukopenia, infection and frequency of radiation esophagitis were higher in the concurrent group (p=0.00, 0.03, 0.03). Conclusion: The concurrent use of TRT with chemotherapy failed to improve the survival of limited stage SCLC patients compared with the sequential use of TRT but response duration and local control rate were superior in the concurrent group. Frequency of radiation esophagitis, life threatening hematologic toxicities and infection were more frequent in the concurrent group than sequential group. So, the selection of an optimal schedule of chemotherapy combined with TRT that would lead to a major increase in survival with minimal toxicity is remained to be validated in large scale study in the future.

• Journal of Chest Surgery
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• 제47권2호
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• pp.197-199
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• 2014

Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.