Sixty-six patients with squamous cell carcinoma of the supraglottic larynx received irradiation with curative intent between 1979 and 1985 were retrospectively analysed. All patients had a minimum follow-up of 4 years. Of the entire group consisting of 73% T3 and T4 lesions and 58% lymph node metastases, a 5-year acturial survival rate was 31.3%. A 5-year acturial survival rates for stage II, III andIV were 60.7%, 46.7% and 13.5% respectively (p<0.05). Patients without lymphnode metastases had better survival rate than those with costive lymphnode metastases(54.8% vs 12.2%) (p<0.005). Surgical salvage rate was 4/7 (57%). Three patients developed distant metastases. Major complications requiring surgery were seen in 11% Radiation therapy alone with surgical salvage was an effective, voice preserving treatment for stage I, II and selected III carcinoma of the supraglottic carcinoma, however planned combined treatment with surgery and radiation therapy is advised for stage III andIV carcinoma of the supraglottic larynx with resectable neck disease.
Carcinoma, Squamous Cell* ; Follow-Up Studies ; Humans ; Larynx* ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate ; Voice

One hundred and ten patients with carcinoma of the nasopharynx were treated by radiation therapy in Deoartment of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1985. Among these, one hundred and five patients were treated with curative intent and 5 patients with palliative aim. Excluding 16 patients who did not receive a full coarse of radiation therapy, the remaining 89 patients were reviewed for this analysis. Minimum follow-up period of survivors was 36 months. Forty-three percent of the patients had T4 primary lesions and 72% had stage IV disease. The histology was squamous cell carcinoma in 46% of the patients. undifferentiated carcinoma in 49%, and lymphoepithelioma in 5%. Total radiation dose to the primary site averaged 6,500 cCY for T1, T2 lesions and 7,500 cCY for T3, T4 lesions. Neck node were given boost treatment to a maximum 7,500 cCY depending on the extent of disease. Early primary lesion(T1, T2) and neck nodes were successfully controlled in most cases when dose of greater than 6,500 cGy was delievered. Forty two patients(47%) had recurred, 16 of whom(38%) recurred at the primary site and 24(57%) developed distant metastases. Of these, 9 patients received re-irradiation with or without chemotherapy and local control was obtained in 2 patients(22%). Actuarial overall survival and disease-free survival rate was 42% and 38% at 5 years. T-stage and histotogic subtype were not correlated with survival. However, N-stage was related to survival significantly(p=0.043).
Carcinoma ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Nasopharynx ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Seoul ; Survivors

Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scale at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was 36%. Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical response by scoring scale were correlated with survival.
Brain Stem Neoplasms* ; Brain Stem* ; Brain* ; Cranial Nerves ; Diagnosis ; Drug Therapy ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiotherapy* ; Survival Rate

PURPOSE: To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. MATERIALS AND METHODS: We analyzed 77 previouly untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows : AJCC stage III-2, stage IV-75, Sixty-six patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and cisplatin (100 mg/m2, on Day 1), eleven patients received infusion of 5-FU (1000 mg/m2, on Day 1~5) and carboplatin (300 mg/m2, on Day 1), as neoadjuvant chemotherapy prior to radiation therapy. The median follow-up for surviving patients was 44 months. RESULTS: The overall chemotherapy response rates were 87%. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nausea/vomiting). The degree of radiation induced mucositis was not severe, and then patients developed Grade 2 mucositis. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year overall survival rates were 68% and the 5-year disease free survival rates were 65%. The 5-year freedom from distant metastasis rates were 82% and 5-year locoregional control rates were 75%. CONCLUSION: This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity.
Carboplatin ; Cisplatin ; Disease-Free Survival ; Drug Therapy* ; Fluorouracil ; Follow-Up Studies ; Freedom ; Humans ; Mucositis ; Neoplasm Metastasis ; Seoul ; Survival Rate

Lung cancer is the leading cause of cancer deaths. Non-small cell lung cancer constitutes approximately 75% of lung cancers, and 40% will present as advanced stage IIIa or IIIb, which are ineffectively treated by primary surgery. Radiation of a primary tumor, and the regional lymphatics, has been the traditional treatment for an unresectable locally advanced disease, but few patients achieved a complete response. Due to the limited benefits provided by radiation therapy, we explored the use of combined chemoradiotherapy in patients with locally advanced, unresectable NSCLC. Combined chemoradiotherapy appears to have improved the outcome of patients with locally advanced unresectable stage III NSCLC, with a median survival of 13 to 14 months, with 5 year survival rates as high as 15 to 20%, nearly three times that reported with radiation therapy alone. Various agents have been used either sequentially or concomitantly in clinical trials of combined chemoradiotherapy for NSCLC. The interactions of chemotherapy and radiation therapy are complex, and Texanes interact with radiation at many levels. Cell-cycle synchronization, through mitotic arrest, has been consistently shown to play a major role in radiation enhancement, but increased apoptosis and tumor reoxygenation may be additional mechanisms. Clearly, the interaction is multifactorial, and the dominant mechanism may be affected by specific settings, which include drug exposure and concentration, tumor type and radiation dosimetry. Recent studies have demonstrated that shorter, high-dose, radiotherapy schedules cause a statistically significant increase in the control of a local tumor in NSCLC. Radiation dose escalation, utilizing conventional fractionation techniques, would be likely to cause prohibitive toxicity. Threedimensional conformal radiation therapy (3-DCRT) has the potential to deliver high dose radiation >70 Gy), with minimal under-dosing and concomitant relative sparing of normal tissues. This technical demonstration of the enhanced therapeutic ratio is used as the basis for the evolving clinical utilization of 3-DCRT for NSCLC. Preliminary experience of the technique has resulted in promising survival rates, following three-dimensional conformal radiation therapy alone, for locally advanced NSCLC. A greater follow-up and experience will help determine its late toxicity, maximum dose and efficacy of dose escalation. Strategies should be developed to integrate this modality into combined treatments for locally advanced NSCLC. Biotechnological developments within the last decade have resulted in the identification of important biological and biophysiological pathways in lung carcinogenesis, and new agents are being developed to target difficult levels of these important pathways. Preclinical and clinical studies using these specific targeted therapies in lung cancer have been very promising. Targeted therapies in lung cancer, and the potential of combining these agents with chemotherapy and radiotherapy, are under investigation.
Apoptosis ; Appointments and Schedules ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Radiometry ; Radiotherapy* ; Survival Rate

No astract is available
Radiosurgery*

CNS prophylaxis with 18 or 24 Gy cranial irradiation plus intrathecal methotrexate was given to 134 childhood acute lymphoblastic leukemia patients who had got bone marrow remission(M1) after remission induction chemotherapy from August 1979 to December 1986. The rate of initial total CNS relapse was 14.2%(19/134), the rate of isolated CNS relapse was 5.2%(7/134), and the rate of CNS relapse concomittantly combined with bone marrow relapse or testicular relapse was 9%(12/134). Male sex or older age was accociated with higher CNS relapes and the initial peripheral leukocyte count over 50,000/ul had higher relapse rate. Relapse with radiation dose of 18 Gy was somewhat lower than that with 24 Gy. Within 4 years after CNS prophylaxis occurred 89% of the total CNS relapses, 100% of the isolated CNS relapses, and 83% of the combined CNS relapses. Adjusted to exposed cases to risk of CNS relapse, the total CNS relapse rate was 11.9% during maintenance chemotherapy and 4.9% after maintenance chemotherapy.
Bone Marrow ; Child* ; Cranial Irradiation* ; Drug Therapy ; Humans ; Leukocyte Count ; Maintenance Chemotherapy ; Male ; Methotrexate ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Remission Induction

BACKGROUND AND PURPOSE: Involvement of supraclavicular lymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional lymph node involvement. MATERIALS AND METHODS: Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric lymph node positive patients to evaluate prognostic significance of SCL involvement. RESULTS: Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0% and 4.0% respectably. Corresponding features for regional node positive patients were 9 month, 17.0% and 3.8%. There was no significant difference between two groups. There was also no difference in patterns of recurrence. CONCLUSION: Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.
Classification ; Esophageal Neoplasms ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Recurrence ; Survival Rate