A Case of Langerhans Cell Histiocytosis with Hypothalamic Mass / 대한소아혈액종양학회지

A 14-month-old girl presented with petechial skin lesions and polydipsia was diagnosed as Langerhans cell histiocytosis (LCH) and responded fairly well to multiple chemotherapies using vincristine, cyclophosphamide, and prednisone. 3 years later, relapses were more common with short periods of remissions in spite of using more intensive therapy with vinblatine and etoposide. At age of 4.5, sudden weight gain and abnormal behavior led to MRI study and revealed an hypothalamic mass. Radiation of 1, 800 cGy was given to the mass and followed by a 75% decrease in measuring and remission of the obesity. Although, there was no evidence of tumor progression in the hypothalamus, she died of sepsis due to systemic progression of the disease at age of 5. LCH commonly present with the symptoms of diabetes insipidus, but hypothalamic mass is not common. We report this case with a brief review of literatures.

Results of Radiotherapy in Hypopharyngeal Cancer / 대한방사선종양학회지

PURPOSE: The aim of this study was to assess the effectiveness, survival rate and complications of radiation therapy and chemoradiation treatment in hypopharyngeal cancer. METHODS AND MATERIALS: From January 1984 to December 1999, 56 patients who had hypopharyngeal carcinoma treated with curative radiation therapy were retrospectively studied. Twenty four patients (42.9%) were treated with radiation therapy alone (Group I) and 32 (57.1%) treated with a combination of chemotherapy and radiation (Group II). Total radiation dose ranged from 40.5 to 83. 5 Gy (median 67.9 Gy). Radiotherapy was given with conventional technique in 9 patients (16.4%), with hyperfractionation I (1.15~1.2 Gy/fr., BID) in 26 (47.2%), hyperfractionation II (1.35 Gy/fr., BID) in 18 (32.7%), and accelerated fractionation (1.6 Gy/fr., BID) in 2 (3.6%). In chemotherapy, 5-FU (1,000 mg/m2 daily for 5 consecutive days) and cisplatin (100 mg/m2 on day 1) were administered in a cycle of 3 weeks interval, and a total of 1 to 3 cycles (average 2..3 cycles) were given prior to radiation therapy. Follow up duration was 1~195 months (median 28 months). RESULTS: Overall 2 and 5 year survival rates were 40.6% and 27.6%; 50.0% and 30.0% in Group I, and 36.4% and 26.3% in Group II, respectively. Complete local control rates in Group I and II were 70.0% and 67.7%, respectively. The response to radiotherapy and nodal stage were statistically significant prognostic factors. The complication rate was increased in Group II and was decreased in hyperfractionation. CONCLUSION: The response to radiotherapy and nodal stage were valid factors to indicate the degree of control over the hypopharyngeal cancer. The induction cisplatin, 5-Fu chemotherapy was not valid in terms of local control rate and survival rate, but did contribute to an increased complication rate. The use of hyperfractionation was valid to reduce the late radiation complications.

Smad6 Gene and Suppression of Radiation-Induced Apoptosis by Genistein in K562 cells / 대한방사선종양학회지

PURPOSE: The genes involved on the suppression of radiation-induced apoptosis by genistein in K562 leukemia cell line was investigated. MATERIALS AND METHODS: K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. Forx-ray irradiation and drug treatment, cultures were prepared at 2x105 cells/mL. The cells were irradiated with 10 Gy (Clinac 1800C, Varian, USA). Stock solutions of herbimycin A (HMA, Calbiochem, UK) and genistein (Calbiochem, UK) were prepared in dimethylsulfoxide (DMSO, Sigma, UK). After incubation at 37degreesC for 24 h, PCR-select cDNA subtractive hybridization, dot hybridization, DNA sequencing and Northern hybridization were examined. RESULTS: Smad6 gene was identified from the differentially expressed genes in K562 cells incubated with genistein which had been selected by PCR-select cDNA subtractive hybridization. The mRNA expression of Smad6 in K562 cells incubated with genistein was also higher than control group by Northern hybridization analysis. CONCLUSION: We have shown that Smad6 involved on the suppression of radiation-induced apoptosis by genistein in K562 leukemia cell line. It is plausible that the relationship between Smad6 and the suppression of radiation-induced apoptosis is essential for treatment development based on molecular targeting designed to modify radiation-induced apoptosis.

The Analysis of Radiation Exposure of Hospital Radiation Workers / 대한방사선종양학회지

PURPOSE: This investigation was performed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. METHODS AND MATERIALS: The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. RESULTS: The average of yearly radiation exposure of 347 persons was 1.52+/-1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87+/-1.01 mSv/year, mean 1.22+/-0.69 mSv between 31 and 40 year old and mean 0.97+/-0.43 mSv/year over 41year old ( p<0.001). Men received mean 1.67+/-1.54 mSv/year were higher than women who received mean 1.13+/-0.61 mSv/year ( p<0.01). Radiation exposure in the department of nuclear medicine department in spite of low energy sources is higher than other departments that use radiations in hospital ( p<0.05). And the workers who received mean 3.69+/-1.81 mSv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department ( p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74+/-1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17+/-0.35 mSv/year and upper gastrointestinal room of mean 1.74+/-1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology ( p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75+/-1.17 mSv/year and mean 1.60+/-1.39 mSv/year than other people who work in radiation area in hospital ( p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. CONCLUSION: The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

The Frequency of Chromosomal Aberrations of Peripheral Lymphocytes according to Radiation Dose and Dose Rate / 대한방사선종양학회지

PURPOSE: It was studied that the relationship between radiation dose, dose rate and the frequency of chromosomal aberrations in peripheral lymphocytes. METHODS AND MATERIALS: Peripheral lymphocytes were irradiated in vitro with 6 MeV X-ray at dose ranges from 50 cGy to 800 cGy. The variations of the frequency of chromosomal aberrations were observed according to different radiation dose rate from 20 cGy/min to 400 cGy/min at constant total dose of 400 cGy which it was considered as factor to correct biological radiation dose measurement. RESULTS: The yields of lymphocytes with chromosomal aberrations (dicentric chromosome, ring chromosome, acentric fragment pairs) are 0% at 50 cGy, 9% at 100 cGy, 20% at 200 cGy, 27% at 300 cGy, 55% at 400 cGy, 88% at 600 cGy, and 100% at 800 cGy. The value of Ydr is 0.000 at 50 cGy, 0.093 at 100 cGy, 0.200 at 200 cGy, 0.364 at 300 cGy, 0.612 at 400 cGy, 2.040 at 600 cGy, and 2.846 at 800 cGy. The relationship between radiation (D) and the frequency of dicentric chromosomes and ring chromosomes (Ydr) can be expressed as Ydr=0.188x10-2/GyxD+0.422x10-4/Gy2xD2. The value of Qdr is 0.000 at 50 cGy, 1.000 at 100 cGy, 1.000 at 200 cGy, 1.333 at 300 cGy, 1.118 at 400 cGy, 2.318 at 600 cGy, and 2.846 at 800 cGy. When 400 cGy is irradiated with different dose rate each of 20, 40, 60, 80, 100, 160, 240, 320, and 400 cGy/min, Ydr is each of 0.982, 0.837, 0.860, 0.732, 0.763, 0.966, 0.909, 1.006, and 0.806, and Qdr is each of 1.839, 1.565, 1.654, 1.333, 1.381, 1.750, 1.6000, 1.710, and 1.318. CONCLUSION: There are not the significant variations of Ydr and Qdr values according to different dose rate. And so radiation damage is influenced by total exposed radiation doses and is influenced least of all by different dose rate when it is acute single exposure.

Radiation-induced Apoptosis is Differentially Modulated by PTK Inhibitors K562 Cells / 대한방사선종양학회지

PURPOSE: The effect of PTK inhibitors (herbimycin A and genistein) on the induction of radiation-induce d apoptosis in Ph-positive K562 leukemia cell line was investigated. MATERIALS AND METHODS: K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. For 6 MV X-ray irradiation and drug treatment, cultures were initiated at 2x10' cells/mL. The cells were irradiated with 10 Gy. Stock solutions of herbimycin A and genistein were prepared in dimethyl sulphoxide (DMSO). After incubation at 37C for 0-48 h, the extent of apoptosis was determined using agarose gel electrophoresis and TUNEL assay. The progression of cells throughth the cel l cycle after irradiation and drug treatment was also determined with flow cytometry. Western blot analysis was used to monitor bcl-2, bcl-X and bax protein levels. RESULTS: Treatment with 10 Gy X-irradiation did not result in the induction of apoptosis. The HMA alone (500 nM) also failed to induce apoptosis. By contrast, incubation of K562 cells with HMA after irradiation resulted in a substantial induction of nuclear condensation and fragmentation by agarose gel electro-phoresis and TUNEL assay. Genistein failed to enhance the ability of X-irradiation to induce DN A fragmentation. Enhancement of apoptosis by H MA was not attributable to downregulation of the bcl-2 or bcl-X anti-apoptotic proteins. When the cells were irradiated and maintained with HMA, the percentage cf cells in G2/M phase decreased to 30-40% at 48 h. On the other hand, cells exposed to 10 Gy X-irradiation alone or maintained with genistein did not show marked cell cycle redistribution. CONCLUSION: We have shown that nanomolar concentrations of the PTK inhibitor HMA synergize with X-irradiation in inducing the apoptosis in Ph (+) K562 leukemia cell line. While, genistein, a PTK inhibitor which is not selective for p2 10""'' failed to enhance the radiation induced apoptosis in K562 cells. It is unlikely that the ability of HMA to enhance apoptosis in K562 cells is attributable to bcl-2 family. It is plausible that the relationship between cell cycle delays and cell death is essential for drug development based on molecular targeting designed to modify radiation-induced apoptosis.

Results of Radio-thermotherapy in Stage IIIb Uterine Cervical Cancer Local response, survival rate and analysis of prognostic factor / 대한암학회지

PURPOSE: This retrospective study was conducted to obtain local response and survival rates, and to analyze prognostic factors affecting survival of patients treated with radio-thermotherapy for stage IIIb uterine cervical cancer. MATERIALS AND METHODS: From May 1992 to Dec. 1996, 24 patients treated with radio-thermo therapy for stage IIIb uterine cervical cancer at department of Radiation Oncology in Kosin Medical College, Kosin University were enrolled. Radiotherapy used 6~10 MV linear accelerator was performed in whole pelvis with 4 portals box technique by conventional (180~200 cGy/ fraction, 5 fraction/week) method in 5 patients (20.8%) or hyperfractionated (120~135 cGy/fr., 2 fr./day, 10 fr./wk) in 19 patients (79.2%). Total dose of A-point was 67~112 Gy (median: 77.27 Gy). Hyperthermia used 8 MHz radiofrequency capacitive heating device was applied in pelvic area with 2~3 sessions per wk. Each course started within 15 to 20 minutes after radio therapy and took 40 to 60 minutes. Local progression free (LPFS), disease free (DFS) and overall (OS) rates were calculated in survival analysis. Statistics was calculated by Kaplan-Meier Method in survival and Log-rank test in statistical significance. Multivariate analysis for prognostic factor was applied to Cox Regression model. Follow-up duration was 6~82 months (median: 25 months). RESULTS: Overall local response rate was 95.8% (45.8% in CR/50.0% in PR). Five year LPFS, DFS, OS were 48.6%, 31.7%, 67.1%, respectively. In univariate analysis, an age was the signi ficant prognostic factor in terms of OS (p=0.03), but was insignificant in LPFS and DFS. In multivariate analysis, none of evaluated factors are important in LPFS, DFS or OS. CONCLUSION: Radio-thermotherapy for stage IIIb uterine cervical cancer did not increase 5 year LPFS, DFS and OS in spite of higher local response rate. Age was the only significant factor for OS in univariate analysis.

Results of Hyperthermic Treatment Combiced with Radiotherapy/Chemotherapy in Locally Advanced Inoperable Gastric Cancer / 대한암학회지

PURPOSE: This retrospective study is conducted to evaluate the local response rate, survival rate, median survival times and complication of hyperthermic treatment combined with radiotherapy/chemotherapy in locally advanced inoperable gastric cancer. MATERIALS AND METHODS: One hundred and twenty-seven patients treated with hyperthermia from April, 1992 to December, 1994 were enrolled. Among 127 patients, 13(10.2%) were treated with thermo-radiotherapy(Group I), 4(3.1%) were treated with thermo-radio-chemotherapy(Group II) and 110(86.6%) were treated with thermo-chemotherapy (Group III). Hyperfractionated radiotherapy(135 cGy/fr., 2 times/day) using 6-MV X-ray Linac was delivered with total doses of 40.5~67.5 Gy(median: 45 Gy). Chemotherapy by FI(5-FU+ Interferon) or EAP(Etoposide+ Adriamycin+ Cisplatin) regimens was administered. Hyperthermia using 8-MHz RF(radiofrequency) capacitive heating eqiupment (CANCERMIA GHT-8) was applied with interval of 2 times/week, 40~60 minutes /session within 10~15 minutes following radiation, and was simultaneously done with chemotherapy. The estimation of local response was used computed tomography and endoscopy, and was divided into complete response(CR), partial response(PR), and no response(NR). The survival rate was calculated by Kaplan-Meier method. RESULTS: Overall local response rate(CR+ PR) was 68.5% with 6.3% in CR and 62.2% in PR. The local response rates by treatment modality were 92.3% (CR: 15.4%, PR: 76.9%) in Group I, 100%(CR: 75.0%, PR: 25.0%) in Group II and 64.5%(CR: 2.7%, PR: 61.8%) in Group III. There was statistically significant difference(p=0.0001). The overall 1 and 2 years survival rates with median survival time(MST) were 20.5%, 7.1% with 9 months, respectively. The overall 1 and 2 years survival rates(with MST) by treatment modality were 7.7%, 0%(7 months) in Group I, 50.0%, 0%(9 months) in Group II and 20.9%, 8.2%(6 months) in Group III. There was no statistically significant difference. The incidence of side effect by heating was 3.1%(4 patients) and the most serious side effect was subcutaneous fat necrosis in anterior abdominal wall. CONCLUSION: From this study we concluded that hyperthermic treatment combined with radiotherapy/chemotherapy may increase the local response rate in locally advanced inoperable gastric cancer.

Results of Radiation Therapy in Stage III Uterine Cevical Cancer / 대한치료방사선과학회지

PURPOSE: The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. MATERIALS AND METHODS: From January 1980 through December 1985, 227 patients with stage II uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients(31.7%) were stage IIIa, and 155 patients(68.3%) were stage IIIb according to FIGO classification. Age distribution was 32-71 years(median: 62 years). Sixty nine patients(95.8%) in stage IIIa and 150 patients(96.8%) in stage IIIb were squamous cell carcinoma. Pelvic lymphnode metastasis at initial diagnosis was 8 patients (11.1%) in stage IIIa and 29 patients(18.7%) in stage IIIb. Among 72 patients with stage IIIa, 36 patients(50%) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr). And 36 patients(50%) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with Cs137 sources, and among 155 patients with stage IIIb, 80 patients(51.6%) were treated with external radiation therapy alone and 75 patients(48.4%) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median : 78.5 Gy) and 65-125.5 Gy (median :83.5 Gy). Survival rate was calculated by life-table method. RESULTS: Complete response rates were 58.3% (42 patients) in state IIIa and 56.1%(87 patients) in stage Iiib. Overall 5 year survival rates were 57% in stage IIIa and 40% in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were 64%, 40% in group treated in combination of external radiation and ICR, and 50%, 40% in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were 90%, 66% in responder group, and 10%, 7% in non-responder group (p<0.01). There were statistically no significances of 5 year survival rate by total radiation doses and external radiation doses (40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatement failures rates were 40.3%(29 patients) in stage IIIa and 57.4%(89 patients) in stage IIIb, 17 patients (23.6%) in stage IIIa and 46 patients (29.7%) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa(50%) and Iib(50%), Serious complicaton rates were higher in group received externl radiaton doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Seious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of deah was cachexia due to locoregional failure in both stage IIIa(34.7%) and IIIb(43.9%). CONCLUSION: From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy tho whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.

Results of Radiotherapy in Nasopharyngeal Cancer / 대한치료방사선과학회지

PURPOSE: The aim of this study was to assess the effectiveness, survival rate and complication of radiation therapy in nasopharyngeal cancer. MATERIALS AND METHODS: From January 1980 to May 1989, Fifty Patients who had nasopharyngeal carcinoma treated with curative radiation therapy at Kosin Medical Center were retrospectively studied. Thirty seven patients(74%) were treated with radiation therapy alone(Group I) and 13 patients (26%) treated with combination fo chemotherapy and radiation(Group II). Age distribution was 16-75 years(median:45.8 years). In histologic type, squamous cell carcinoma was in 30 patients(60%), undifferentiated carcinoma in 17 patinets(34%), and lymphoepithelioma in 3 patients(6%). According to AJCC staging system, 4 patinets(8%) were in T1, 13 patients(2%) in T2, 20 patients(40%) in T3, 13 patients(26%) in T4 and 7 patients(14%) in N0, 6 patients(12%) in N1, 23 patients(46%) in N2, 14 patients (28%) in N3. Total radiaton dose ranges were 5250-9200 cGy(median : 7355 cGy) in Group I and 5360-8400 cGy(median :6758cGy) in Group II. Radiotherapy on 4-6MV linear accelerator and/or 6-12MeV electron in boost radiation was given with conventional thechnique to 26 patinets(52%), with hyperfractionation(115-120cGy/fr., 2times/day) to 16 patients(32%), with accelerated fractionation(160cGy/fr., 2 times/day) to 8 patients(16%). In Chemotherapy, 5 FU 1000mg daily for 5 consecutive days, pepleomycin 10mg on days 1 and 3, and cisplatin 100mg on day 1 were administered with 3 weeks interval, total 1 to 3 cycles(average 1.8cycles) prior to radiation therapy. Follow up duration was 6-140 months(mean:58 months). Statistics was calculated with Chi-square and Fisher's exact test. RESULTS: Complete local control rates in Group I and II were 75.7%, 69.2%. Overall 5 year survival rates in Group I and II were 56.8%, 30.8%. Five year survival rates by histologic type in Group I and II were 52.2, 14.3% in squamous cell carcinoma an d 54.5%, 50% in undifferentiated carcinoma. Survival rates in Group I were superior to those of Group II though there were not statistically significant. In both group, survival rates seem to be increased according to increasing total dose of radiation up to 7500cGy, but not increased beyond it. There were not statistically significant differences in survival rates by age, , stage, and radiation tehchniques in both group. Twenty four patients (48%) experienced treatment failures. Complications were found in 12 patients(24%). The most common one was osteomyelitis(4 patients, 33.3%) involving mandible (3 patients) and maxilla(1patient). CONCLUSION: Chemotherapy in combination with radiotherapy was found to be not effective to nasopharyngeal cancer and the survival rate was also inferior to that of radiation alone group though it was statistically not significant due to small population in chemotherapy combined group.

The Study of Tissue Dose Perturbation by Air Cavity with 6MV Photon Beam / 대한치료방사선과학회지

PURPOSE: To determine the perturbation effect in the tissue downstream from surface layers of lesions located in the air/tumor-tissue interface of larynx using 6MV photon beam. MATERIALS AND METHODS: Thermoluminescent dosimeters(TLDs). Were embedded at 3 measurement locations in slab no.7 of a humanoid phantom and exposed to forward and backward direction using various field sizes(4X4cm2 - 15X15 cm2). RESULTS: At the air/tissue interface, forward dose perturbation factor(FDPF) is about 1.085 with 4X4 cm2, 1.05 with 7X7 cm2, 1.048 with 10X10cm2, and 1.041 with 15X15cm2. Backscatter dose perturbation factor(BDPF) is about 0.99 with 4X4cm2, 0.981 with 7X7cm2, 0.956 with 10X10cm2 and 0.97 with 15X15cm2 . CONCLUSION: FDPF is greater as field size is smaller. And FDPF is smaller as the distance is further from the air/tissue interface.

The Study of Tissue Dose Perturbation by Air Cavity with 6MV Photon Beam / 대한치료방사선과학회지

PURPOSE: To determine the perturbation effect in the tissue downstream from surface layers of lesions located in the air/tumor-tissue interface of larynx using 6MV photon beam. MATERIALS AND METHODS: Thermoluminescent dosimeters(TLDs). Were embedded at 3 measurement locations in slab no.7 of a humanoid phantom and exposed to forward and backward direction using various field sizes(4X4cm2 - 15X15 cm2). RESULTS: At the air/tissue interface, forward dose perturbation factor(FDPF) is about 1.085 with 4X4 cm2, 1.05 with 7X7 cm2, 1.048 with 10X10cm2, and 1.041 with 15X15cm2. Backscatter dose perturbation factor(BDPF) is about 0.99 with 4X4cm2, 0.981 with 7X7cm2, 0.956 with 10X10cm2 and 0.97 with 15X15cm2 . CONCLUSION: FDPF is greater as field size is smaller. And FDPF is smaller as the distance is further from the air/tissue interface.

Dosimetric Consideration of the Lung Block in the Mantle Field / 대한치료방사선과학회지

PURPOSE: To evaluate the dose under lung block as a function of depth and the effectiveness of a block as a function of block width. MATERIALS AND METHODS: Field size of mantle field was 22.8 x 32.4 cm2 . Dose distribution of the mantle field was measured with two dimensional water phantom system. To analyze the effectiveness of the lung block, central axis plane, 5cm off-axis plane, and 10cm off-axis plane were studied. RESULTS: The dose under the lung block was recorded with maximum at the depth between , 5cm and 10cm . In the central axis plane, dosimetric block width was 10-15% les than physical block width. In the 5cm off-axis plane. Dosimetric block width was 4-9% less than physical block width. In the 10cm off-axis plane, dosimetric block width was 2% less than physical block width. CONCLUSION: Depth dependence of the dose under the lung block was founded. Also, block width dependence of the lung block was founded. To induce the accurate relation between the physical block width and the "effective" block width, it needs more detailed understanding of the variables involved.

Radiotherapy of Carcinoma of Maxillary Antrum / 대한치료방사선과학회지

Seventy-nine patients with carcinoma of maxillary antrum treated at the department of therapeutic radiology, Kosin Medical Center, between June 1980 and December 1986 were analyzed retrospectively for survival rate and treatment failure. Forty-three patients were treated with radiotherapy alone and thirty-six patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32%, patients that were treated with radiotherapy alone had a 5-year survival rate of 23%, and patients who were treated with combination of surgery and radiotherapy had a 5-year survival rate of 42%. 54 patients(68.4%) failed to be cured. Among these 54 patients, 37 patients(68.5%) had only locoregional failure, 16 patients(29.6%) had locoregional failure and distant metastases and 1 patient had only distant metastasis. From above study combination of surgery and radiotherapy might be a better treatment modality for carcinoma of the maxillary antrum.

Analysis of Radiotherapy Associated Factors in Stage IIb Carcinoma of Uterine Cervix / 대한치료방사선과학회지

331 patients of stage IIb uterine cervix cancer treated by radiation alone at Kosin Medical Center between June 1980 and Dec. 1985 were analysed to determine parameters of radiotherapy associated to disease states. Survival rate was highest among the reported (82.8% for crude and 82.4% for disease free survival). Pelvic control rate in 6 weeks after the end of radiotherapy was 93.6% in the patients treated with ICR following total pelvic radiation and 71.6% with small field additional external irradiation. 5 year survival rate in those who achieved pelvic control was 98. 9% and 12.9% in those who had pelvic failure and/or metastasis after radiation. The survival rate figured maximal 88.5% with dosage of 7500~8500 cgy to point A with acceptable incidence of complications (4.9%) but without increasing survival above it and minimal 74.1% with dosage of less than 6500 cgy. The treatment failure was counted 18.7% (62 of 331 patients): Local failure 72. 6% ( 45 of 62 patients), locoregional failure 3.2% (2 of 62 patients) and distant failure 24% (15 of 62 patients). Late complications were found In 50 patients (15.1%) and 42% of them was rectal bleeding and stenosis. The dose of 8500 cgy to point A was found to be critical for complication and 70% of complications occurred above it and was more serious one such as fistula. Rectal complications were developed above rectal dose 6500 cgy and bladder complication above bladder dose 7500 cgy. Major cause of death was cachexia due to locoregional failure (73.7% of death), next was due to metastasis to lung, liver and bone, and only 3 patients died of complication of intestinal perforations and obstruction. In conclusion higher external radiation dose for a bulky uterine cervix and barrel shaped uterus was essential for local control.