No abstract available.
Meningioma* ; Radiosurgery*

During the period between March 1983 and December 1990, 74 patients with esophageal carcinoma(EC) were treated with radiation therapy(RT) at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Of these, 6 patients were lost to follow-up, and 13 patients were interrupted. So the remaining 55 patients were analyzed, retrospectively. 32 patients were irradiated with curative aim, 12 patients with palliative intent, 10 patients postoperatively, and 1 patient pre- and post-operatively. Among these 55 patients, 28 patients were treated with chemoradiation modality, and 27 patients with RT alone. All patients were followed for a minimum of 20 months or Hntil death. of 32 patients irradiated by curative aim, 22 patients(69%) showed partial remission (PR), 6 patients(19%) complete remission(CR). Overall mean survival and two-year survival rate were 15.6 months and 22%. With respect to sex, age, pathologic differentiation, tumor location, tumor size, stage, RT aim, RT response, RT dose, use of chemotherapy and functional categories(FC) of dysphagia at initiation of RT and at finishing RT : Tumor size, stage, RT response had great influences on prognosis and FC at finishing RT had a slight influence on prognosis. Especially, the mean survival and 2-year survival rate in patients with postoperative RT were 24.7 months and 63%, which could be compared with 29.1 months and 43% in radically treated patients with CR. And the mean survival duration and 2-year survival rate in patients irradiated with doses more than 60 Gy were 22.4 months and 29%, and 50~60 Gy were 12.2 months and 12%, respectively. However, no significant difference was shown statistically. Among 12 patients treated with palliative intent, 9 patients (75%) had good improvement in dysphagia and the mean duration of palliative response was 10.6 months.
Deglutition Disorders ; Drug Therapy ; Humans ; Lost to Follow-Up ; Prognosis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: Granulocyte-colony stimulating factor (G-CSF) has been widely used to treat neutropenia caused by chemotherapy or radiotherapy. The efficacy of recombinant human hematopoietic growth factors in improving oral mucositis after chemotherapy or radiotherapy has been recently demonstrated in some clinical studies. This study was designed to determine whether G-CSF can modify the radiation injury of the intestinal mucosa in mice. MATERIALS AND METHODS: One hundred and five BALB/c mice weighing 20 grams were divided into nine subgroups including G-CSF alone group (I : 10 microgram/kg or II : 100 microgram/kg), radiation alone group (7.5 or 12 Gy on the whole body), combination group with G-CSF and radiation (G-CSF I or II plus 7.5 Gy, G-CSF I or II plus 12 Gy), and control group. Radiation was administered with a 6 MV linear accelerator (Mevatron Siemens) with a dose rate of 3 Gy/min on day 0. G-CSF was injected subcutaneously for 3 days, once a day, from day -2 to day 0. Each group was sacrificed on the day 1, day 3, and day 7. The mucosal changes of jejunum were evaluated microscopically by crypt count per circumference, villi length, and histologic damage grading. RESULTS: In both G-CSF I and II groups, crypt counts, villi length, and histologic damage scores were not significantly different from those of the control one (p>0.05). The 7.5 Gy and 12 Gy radiation alone groups showed significantly lower crypt counts and higher histologic damage scores compared with those of control one (p<0.05). The groups exposed to 7.5 Gy radiation plus G-CSF I or II showed significantly higher crypt counts and lower histologic damage scores on the day 3, and lower histologic damage scores on the day 7 compared with those of the 7.5 Gy radiation alone one (p<0.05). The 12 Gy radiation plus G-CSF I or II group did not show significant difference in crypt counts and histologic damage scores compared with those of the 12 Gy radiation alone one (p>0,05). Most of the mice in 12 Gy radiation with or without G-CSF group showed intestinal death within 5 days. CONCLUSION: These results suggest that G-CSF may protect the jejunal mucosa from the acute radiation damage following within the tolerable ranges of whole body irradiation in mice.
Animals ; Drug Therapy ; Granulocyte Colony-Stimulating Factor ; Humans ; Intercellular Signaling Peptides and Proteins ; Intestinal Mucosa ; Jejunum ; Mice* ; Mucous Membrane* ; Neutropenia ; Particle Accelerators ; Radiation Dosage ; Radiation Injuries ; Radiotherapy ; Stomatitis ; Whole-Body Irradiation

From March 1983 through January 1990, two hundred sixty six patients with non-mall cell lung cancer were treated with external radiation therapy at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A retrospective analysis was performed on eligible 116 patients who had been treated with radiation dose over 40 Gy and had been able to be followed up. There were 104 men and 12 women. The age ranged form 33 years to 80 years (median; 53 years). Median follow up period was 18.8 months ranging from 2 months to 78 months. According to AJC staging system, there were 18(15.5%) patients in stage II, 79(68.1%) patients in stage III and 19(16.4%) patients in stage IV. The pathologic classification showed 72(62.8%) squamous cell carcinomas, 16(13.8%) unknown histology. In Karnofsky performance status, six(5.2%) patients were in rage below 50, 12(10.4%) patients between 50 and 60, 46(39.6%) patients between 60 and 70, 51(44.0%) patients between 70 and 80 and only one (0.8%) patients was in the range over 80. Sixty (51.7%) patients were treated with radiation therapy (RT) alone. Thirty three (28.4%) patients were treated in combination RT and chemotherapy, twenty three(19.8%) patients were treated with surgery followed by postoperative adjuvant RT, and of 23 patients above, five(4.3%) patients, were treated with postoperative RT and chemotherapy. Overall response according to follow-up chest X-ray and chest CT scans was noted in 92.5% at post RT 3 months. We observed that overall survival rates at 1 year were 38.9% in stage II, 20.8% in stage III, and 11.5% in stage IV, and 2 year overall survival rates were 11.1% in stage II, 20.8% in stage III and 10.5% in stage IV, respectively. We evaluated the performance status, radiation dose, age, type of histology, and the combination of chemotherapy and/or surgery to see the influence on the results following radiation therapy as prognostic factors. Of these factors, only performance status and response after radiation therapy showed statistical significance (p<0.05).
Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Classification ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Karnofsky Performance Status ; Lung Neoplasms ; Male ; Radiation Oncology ; Rage ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To improve the treatment results of locally advanced nonsmallcell lung cancer (NSCLC) patient, we treated those paients with regional hyperthermia combined with radiotherapy. And we conducted a retrospective analysis of the results. METHODS AND MATERIALS: Thirty two nonsmall cell lung cancer patients treated at the Department of Radiation Oncology, St. Mary's hospital. Catholic University Medical College were the base of this analysis. Fourteen patients of above them were treated with hyperthermia and radiotherapy of more than 3000 cGy in radiation dose. Radiofrequency capacitive hyperthermia was administered twice weekly, immediately after radiotherapy. Total sessions of hyperthermia ranged from 3 to 13 times (mean 7,8). Eighteen patient received an external radiation therapy alone. Median radiation dose was 5580 cGy (range, 3000-7000 cGy) in fraction of 180-300 cGy, 5 fractions per week. RESULTS: The results of themoradiotherapy group (HTRT group) were compared with radiation alone group (RT group). There were no complete response (CR) and 12 partial responses (PR) (CR rate 0%, response rate 85.7%) in HTRT group, whereas there were 2 CRs, 8 PRs and 8 no responses (CR rate 11.1%, response rate 55.6%) in RT group. There was significant differece in local response rate of the tumors between RT group and HTRT group (p<0.05). Overall 2 year survival rate and mean survival were 7.1% and 10.5 months for HTRT group, and 0% 8.1 months for RT group. However, by the number of hyperthermia, in cases with more than or equal to 10 sessions of hyperthermia, there were significant improvement in 2 year survival rate and mean survival (40.0% and 18.2 months) compared with those in cases with less than 10 sessions of hyperhtemia (7.4% and 7.4 months) (p<0.05). CONCLUSION: Thermoradiotherapy in locally advanced NSCLC patients increased their response rate but not 2 year survival and mean survival, therefore thermoradiotherpy with enough number of hyperthermia is suggested that may be one of the effective palliative treatments of those patients. And in cases with more than 10 sessions of hyperthermai, there showed improved 2 year survival rate and mean survival. But the number of the cases was small, further study in this aspect is required.
Carcinoma, Non-Small-Cell Lung* ; Fever ; Humans ; Lung Neoplasms ; Palliative Care ; Radiation Oncology ; Radiotherapy ; Retrospective Studies ; Survival Rate

PURPOSE: To improve the therapeutic results of postoperative recurrent disease and inoperable disease of stomach cancer, we used the thermoradiotherapy. We conducted a retrospective analysis of the results and compared between the results of hyperthermia before radiotherapy and those of hyperthermia after radiotherapy. MATERIALS AND METHODS: From july 1994 to november 1996, we treated twenty patients of locally advanced stomach cancer and recurrent stomach cancer with thermoradiotherapy. We divided those patients into two groups : hyperthermia before radiotherapy group (PreRT group : 13 patients) and hyperthermia after radiotherapy group (PostRT group : 7 patients). We performed radiation therapy to the total tumor dose of 3000-5040cGy in fraction of 180-300cGy and 5 fractions per week. Hyperthermia was performed with 8 MHz radiofrequency apparatus. We treated those patients everyday for thirty minutes within ten minutes before radiation therapy in PreRT group, and 1-2 sessions per week for 40-60 minutes within ten minutes after radiation therapy in PostRT group. RESULTS: Overall response rate was 33.3%. This response rate was appeared same in both groups. Mean survival and 1 year survival rate were 10.3 months and 16.5%. In PreRT group, mean survival and 1 year survival rate were 6.8 months and 9.0%, and in PostRT group, mean survival and 1 year survival rate were 7.7 months and 34%. There were no statistical significant difference between the prognostic factors and therapeutic results. CONCLUSION: The thermoradiotherapy was safe treatment method in advanced and recurrent gastric cancer when compared with other treatment. Because the number of patients we treated was small and the follow up period was short, we were not able to draw any conclusions about therapeutic efficacy of sequence of radiation therapy and hyperthermia Therefore, further clinical trial of thermoradiotherapy for stomach cancer appear to be warranted.
Fever* ; Follow-Up Studies ; Humans ; Radiotherapy ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Survival Rate

PURPOSE: To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. METHODS AND MATERIALS: From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four (20%) were male and 16 (80%) were female. Mean age was 51 years old (22~78 years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 (30%), postoperative residual lesions in 11 (55%) and regrowth after surgery in 3 (15%). Mean tumor volume was 5.72 cm3 (0.78~15.1 cm3) and secondary collimator size was 2.04 cm (1~3 cm). The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy (9~30 Gy) which was 40~90% of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. RESULTS: By the follow up imaging studies, the tumor volume was reduced in 5 cases (25%), arrested growth in 14 cases (70%), and increased size in 1 case (15%). Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine (45%) patients were considered improved condition, 10 (50%) patients were stable and one (5%) was worsened to be operated. This partly resulted in necrosis after surgery. CONCLUSION: The overall control rate of meningiomas with linac based RS was 95% by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.
Female ; Follow-Up Studies ; Humans ; Male ; Meningioma* ; Middle Aged ; Necrosis ; Particle Accelerators ; Radiosurgery* ; Retrospective Studies ; Tumor Burden

PURPOSE: To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. MATERIALS AND METHODS: Between October 1983 and July 1996, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five (84.9%) patients had squamous cell carcinoma, seven (13.2%) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients (77.4%) and pelvic side wall in 12 patients (22.6%). Recurrent tumor size was devided into two groups : less than 3 cm in 43 patients (81.1%) and more than 3 cm in 10 patients (18.9%). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients (34%) or intracavitary irradiation in 24 patients (45.3%). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. RESULTS: Overall response rate was 66% (35/53). Among them, six patients (17.1%) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months). Therefore overall recurrence rate was 45.3%. Overall five-year actuarial survival rate was 78.9% and distant failure rate was 10% (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 (20%) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. CONCLUSION: Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Hysterectomy ; Korea ; Pelvis ; Pulmonary Embolism ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Skin Manifestations ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate the effectiveness of external radiation therapy and the prognostic factors, we retrospectively analyzed therapeutic results of malignant extrahepatic biliary obstruction (EHBO). METHODS AND MATERIALS: We analyzed the results of the external radiation therapy in 59 patients of inoperable malignant EHBO who had been treated with more than 10 Gy of external radiation therapy from April 1984 to December 1996. There were 21 stomach cancer (35.6%), 12 pancreas cancer (20.3%), 15 extrahepatic biliary cancer (18.6%) and 11 another cancer (18.6%). Their pathologies were confirmed in 31 patients (52.5%). They divided into 27 adenocarcinoma and 4 nonadenocarcinoma. Their chief complaints were jaundice in 47 patients (79.7%) and abdominal pain in 15 patients (49.2%). Twelve patients had slightly increased bilirubin level in liver function test without jaundice. We treated twenty four patients (40.6%) with percutaneous transhepatic biliary drainage (PTBD) and 32 patients (54%) with systemic chemotherapy (CT). We performed external radiation therapy (ERT) upto 10.8~55.8 Gy (median 37.8 Gy) with palliative aim. RESULTS: Overall median survival duration was 7.80+/-1.15 months. The response rates of jaundice were 81.8% in PTBD group and 66.7% in non-PTBD group without statistical significance. The improving rate of jaundice was not significantly different in decreased ratio of total bilirubin level. But abdominal pain was more decreased in CT group than non-CT group (P<0.05). The significant prognostic factors were high performance status (Karnofski Performance Status >70), total radiation dose more than 35 Gy and good response of pain after therapy. There were increased in bacterial cholagitis in PTBD group and gastrointestinal complications in CT group. CONCLUSION: External radiotheapy could improve jaundice and abdominal pain in malignant EHBO patients. Overall survival duration was prolonged in patients with higher performance status and patients who had been treated with more than 35 Gy of total radiation dose. In the future, we expect not only better palliative role but also the prolongation of survival of using the ERT combined with other treatment method. But to achieve certain conclusion, we need futher study consisted with many kinds of treatment methods including new technologies in RT.
Abdominal Pain ; Adenocarcinoma ; Bilirubin ; Drainage ; Drug Therapy ; Humans ; Jaundice ; Liver Function Tests ; Pancreatic Neoplasms ; Pathology ; Radiotherapy ; Retrospective Studies ; Stomach Neoplasms

PURPOSE: The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. MATERIAL AND METHODS: Between March 1983 and June 1994, 60 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patints with median follow up duration 50 months (range 6- 162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58%) was the most frequent site of occurrence followed by trunk (20%) and head and neck (12 %). Histologically malignant fibrous histiocytoma (23%), liposarcoma (17%), malignant schwannoma (12%) constitute 52% of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42%) received chemotherapy with various regimen in the postoperative period. RESULTS: Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48%) of local recurrence. Four patients (7%) developed simultaneous local recurrence and distant metastasis and 8 patients (13%) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head andneck primary. This feature is likely explanation for the decreased local control rate. Five of 29 patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 %, 36.6% respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). CONCLUSION: Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.
Disease-Free Survival ; Drug Therapy ; Extremities ; Female ; Follow-Up Studies ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Liposarcoma ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Neurilemmoma ; Postoperative Period ; Recurrence ; Retrospective Studies ; Sarcoma* ; Survival Rate