No absract available.
Follow-Up Studies* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Three dimensional conformal radiotherapy planning is being used widely for the treatment of patients with brain tumor. However, it takes much time to develop an optimal treatment plan, therefore, it is difficult to apply this technique to all patients. To increase the efficiency of this technique, we need to develop standard radiotherapy plans for each site of the brain. Therefore we developed several 3 dimensional conformal radiotherapy plans (3D plans) for tumors at each site of brain, compared them with each other, and with 2 dimensional radiotherapy plans. Finally model plans for each site of the brain were decided. MATERIALS AND METHODS: Imaginary tumors, with sizes commonly observed in the clinic, were designed for each site of the brain and drawn on CT images. The planning target volumes (PTVs) were as follows; temporal tumor-5.7x8.2x7.6 cm, suprasellar tumor-3x4x4.1 cm, thalamic tumor-3.1x5.9x3.7 cm, frontoparietal tumor-5.5x7x5.5 cm, and occipitoparietal tumor-5x5.5x5 cm. Plans using parallel opposed 2 portals and/or 3 portals including fronto-vertex and 2 lateral fields were developed manually as the conventional 2D plans, and 3D noncoplanar conformal plans were developed using beam's eye view and the automatic block drawing tool. Total tumor dose was 54 Gy for a suprasellar tumor, 59.4 Gy and 72 Gy for the other tumors. All dose plans (including 2D plans) were calculated using 3D plan software. Developed plans were compared with each other using dose-volume histograms (DVH), normal tissue complication probabilities (NTCP) and variable dose statistic values (minimum, maximum and mean dose, D5, V83, V85 and V95). Finally a best radiotherapy plan for each site of brain was selected. RESULTS: 1) Temporal tumor; NTCPs and DVHs of the normal tissue of all 3D plans were superior to 2D plans and this trend was more definite when total dose was escalated to 72 Gy (NTCPs of normal brain 2D plans : 27%, 8% 3D plans : 1%, 1%). Various dose statistic values did not show any consistent trend. A 3D plan using 3 noncoplanar portals was selected as a model radiotherapy plan. 2) Suprasellar tumor; NTCPs of all 3D plans and 2D plans did not show significant difference because the total dose of this tumor was only 54 Gy. DVHs of normal brain and brainstem were significantly different for different plans. D5, V85, V95 and mean values showed some consistent trend that was compatible with DVH. All 3D plans were superior to 2D plans even when 3 portals (fronto-vertex and 2 lateral fields) were used for 2D plans. A 3D plan using 7 portals was worse than plans using fewer portals. A 3D plan using 5 noncoplanar portals was selected as a model plan. 3) Thalamic tumor; NTCPs of all 3D plans were lower than the 2D plans when the total dose was elevated to 72 Gy. DVHs of normal tissues showed similar results. V83, V85, V95 showed some consistent differences between plans but not between 3D plans. 3D plans using 5 noncoplanar portals were selected as a model plan. 4) Parietal (fronto- and occipito-) tumors; all NTCPs of the normal brain in 3D plans were lower than in 2D plans. DVH also showed the same results. V83, V85, V95 showed consistent trends with NTCP and DVH. 3D plans using 5 portals for frontoparietal tumor and 6 portals for occipitoparietal tumor were selected as model plans. CONCLUSION: NTCP and DVH showed reasonable differences between plans and were thought to be useful for comparing plans. All 3D plans were superior to 2D plans. Best 3D plans were selected for tumors in each site of brain using NTCP, DVH and finally by the planner's decision.
Brain Neoplasms* ; Brain Stem ; Brain* ; Humans ; Rabeprazole ; Radiotherapy ; Radiotherapy, Conformal*

PURPOSE: The purpose of this study was to identify whether individualized distraction intervention using a smart phone affected pre-op anxiety of children. METHODS: This was a nonequivalent control group pre-post test quasi-experimental design. The participants were 30 children in the experimental group and 30 in the control group. In experimental group, a smart phone individualized distraction intervention was given to children from the reception area to the operation room. RESULTS: For heart rate, there were no statistically significant differences between the experimental group and control group. In the behavioral anxiety response, there were statistically significant differences between the experimental group and control group (t=-3.11, p=.003). CONCLUSION: The finding suggest that, for pre-op children, the individualized distraction intervention using a smart phone had some significance as a nursing intervention having a positive impact. Such interventions can help pediatric nurses to relieve pre-op anxiety and improve health of children in their care.
Anxiety* ; Child ; Evaluation Studies as Topic ; Heart Rate ; Humans ; Nursing ; Smartphone

This study is the retrospective evaluation of ninety-six patients with biopsy-proven carcinoma of nasopharynx treated with radiotherapy at Yonsei University, College of Medicine, radiation Oncology from January 1971 to December 1985. Patient's age ranged from 15 to 71 years with a median age of 49 years. Fifty-two point five percent of local control and 47.5% of actuarial 5 year survival were achieved with radical radiotherapy. Five year survival rate for Stage I & II, III and IV were 75.0%, 74.6% and 41.4%, respectively. Distant metastasis rate was related with N stage (N1 12.5%, N1 0%, N2 23.5%, N3 32.1%) and histologic type (lymphoepithelioma 41.7%, squamous cell carcinoma 6.5%) but not with T stage. Thirty-one of sixty-seven patient covered adequate radiation field received induction chemotherapy. However induction chemotherapy dose not appear to improve over all survival.
Carcinoma, Squamous Cell ; Humans ; Induction Chemotherapy ; Nasopharynx ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: To investigate the presence of adaptive response by low dose radiation in murine tumors in relation to radiation induced apoptosis as well as related mechanism. MATERIALS AND METHODS: Syngeneic murine tumors, OCa-I and HCa-I, were given 0.05 Gy pretreatment followed by therapeutic dose of 25 Gy radiation. Induction of apoptosis was analyzed for each treatment group. Regulating molecules of apoptosis, p53, Bcl-2, Bax, Bcl-X, were also analyzed by Western blotting. RESULTS: In 0.05 Gy pretreatment group of OCa-I, 25 Gy-induced apoptosis per 1000 cells was 229, which was estimated at 30% lower level than the expected (p<0.05). In contrast, this reduction in radiation induced apoptosis was not seen in HCa-I. In the expression of apoptosis regulating molecules, p53 increased in both tumors in response to radiation. Bcl-2 and Bax did not show significant change in both tumors however, the expression of Bcl-2 surpassed that of Bax in 0.05 Gy pretreatment group of OCa-I. Bcl-X was not expressed in OCa-I. In HCa-I, Bcl-X showed increased expression even with 0.05 Gy. CONCLUSION: Adaptive response by low dose radiation is shown in one murine tumor, OCa-I, in relation to radiation induced apoptosis. Apoptosis regulating molecules including Bcl-2/Bax and Bcl-X, appear to related. This study shows an evidence that adaptive response is present, but not a generalized phenomenon in vivo.
Apoptosis* ; Blotting, Western ; Radiation Dosage

A total of 20 patients(male : female=10:10, adult : children=8:12) with brainstem tumors had been received radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between 1980 and 1990. Thirteen of 20 patients were treated with conventional radiation therapy (before 1989, 180~200 cGy per fraction, 5 days a week, total dose 4680~5400 cGy), and seven patients were treated with hypefractionated radiation therapy(in 1990, 100 cGy per fraction, twice daily 10 fractions a week, total dose 7200 cGy). Median follow up periods for conventional radiation therapy group and hyperfractionated radiation therapy group were 39 months and 10 months, respectively. Four of 20 Patients had histopathologic diagnosis prior to treatment ; 3 cases were low grade astrocytoma and 1 case was high grade astrocytoma. Overall 2-year actuarial survival rate was 30%. The prognosis of patients with a longer duration of symptom and sign was better(60% vs 12%), and the adult(52%) was better than children(14%). There was no significant difference between the focal(29%) and diffuse(20%) type. The initial clinical response was better in the hyperfractionated radiation therapy group. Because of the relatively small number of Patients and short follow up Period in hyPerFractionated radiation therapy group, there was no comparison between two group.
Adult ; Astrocytoma ; Brain Stem Neoplasms* ; Brain Stem* ; Diagnosis ; Follow-Up Studies ; Humans ; Prognosis ; Radiation Oncology ; Survival Rate

PURPOSE: Traditionally the patients with early stage non-Hodgkin's lymphoma of he head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined. Therfore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Serverance Hospital. MATERIALS AND METHODS: 159 patients with stage I and II non-hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy, were selected to analyze the outcomes according to the treatment methods (radiotherapy alone, chemotherapy alone, and combined treatment with radiotherapy and chemotherapy). RESULTS: Five year overall actuarial survival of the patients whose primary site was Waldeyer's ring was 62.5%, and that of the patients whose primary site was nodal region was 53.8%. There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy, chemotherapy, and combined treatment was 92%, 83%, 94% respectively, and 5 year relapse free survival was 49.9%, 52.4%, 58.5% respectively (statistically no significant). In the patients with stage I, 3 year relapse free survival of chemotherapy alone group was 75% and superior to other treatment groups. In the patients with stage II, combined treatment group revealed the best result with 60.1% of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy shoed the best result (3 year relapse free survival was 79.1%). There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p<0.005) prognostic factor on univariate analysis and age and mass size was marginally significant (p<0.01). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. CONCLUSION: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller that 10cm , can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.
Appointments and Schedules ; Drug Therapy ; Head* ; Humans ; Lymphoma, Non-Hodgkin* ; Maintenance Chemotherapy ; Multivariate Analysis ; Neck* ; Radiotherapy ; Recurrence ; Retrospective Studies

No abstract available.
Paclitaxel* ; Radioimmunoassay*

No abstract available.

No abstract available.