No abstract available.
Hodgkin Disease* ; Radiotherapy*

This study was done to provide basic data on prevention of breast cancer by identifying and analyzing risk factors for breast cancer in Korean women. The data were collected from three hospitals. The data from Jan. 1995 to Dec. 1997 was based on the patient recordings and personal contacts if possible. Data from 1998 to 1999 was collected from 280 inpatients and outpatients diagnosed as breast cancer. From this data, information about the risk factors of breast cancer could be acquired. The factors are scaled according to the degree of risk. Menstrual history, obstetrical history, family history, lactation period, life style were given 5 point, and body mass index was given 4 point. Using one-way ANOVA, the most important risk factors were identified and analyzed by multiple regression. The conclusion of this study are as follows: General factors which would show an effect on the results of the multiple regression included risk factors such as menstrual history, obstetrical history, lactation period, family history, and life style factors including mortal state, monthly income, educational level, job and age. Family history(R=0.481) was found to be the highest risk factor(23.1%) affecting breast cancer risk. The next factors were dying hair(R=0.603), drinking(R=0.846), body mass index(R=0.885), smoking(R= 0.916), age of menopause(R=0.937), pregnancy age of first full-term(R=0.957), eating vegetable(R=0.980) and the number of full term pregnancies in that order. The sum total(R=0.986) of all the above factors accounted for 97.3% of the risk of breast cancer for Korean women. In conclusion, it was found that family history and dyeing hair were the highest risk factors for breast cancer. It is recommended that those with a family history of breast cancer should have regular breast examinations, and those who often dye their hair should reconsider this practice.
Body Mass Index ; Breast ; Breast Neoplasms ; Eating ; Female ; Hair ; Humans ; Inpatients ; Korea* ; Lactation ; Learning* ; Life Style ; Nursing* ; Outpatients ; Pregnancy ; Risk Factors

This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionnaires. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows: 1. In population-sociological characteristics: in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics: Stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were "dully pain" as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91 subjects complained pain. And mean pain score was 287.1+/-116.1. The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. the duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91 subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary. Response of Analgesic after Medication was usually "moderate release". The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference: Whether subjects had been operated or not: (t=2.88, P=0.005), time of pain is (t=3.34, P=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, P=0.0008). In the pain level of diagnosis, Colon cancer was 353.3+/-81.7(F=2.34, P=0.049), the origin of pain, nerve pressure 316.3+/-98.5(F=2.44, P=0.045). In the complication, ascites and obstruction 324.9+/-96.8(T=2.60, P=0.04).
Anxiety ; Appetite ; Ascites ; Busan ; Colonic Neoplasms ; Diagnosis ; Female ; Humans ; Male ; Meals ; Morphine ; Nausea ; Neuralgia ; Nuclear Family ; Nursing ; Pain Management* ; Pain Measurement ; Surveys and Questionnaires ; Spouses ; Stomach Neoplasms

Among 238 patients Non-odgkin's lymphoma received radiotherapy at Yonsei Cancer center, Yonsei University Medical College, from 1970 to 1981, 30 patients presented with localized(Stage I & II) gastrointestinal lymphomas. Retrospective analysis of these 30 cases in an attempt to evaluate the influence of various prognostic factors and the effectiveness of therapy is presented. Overall 5 year survival rate of 30 cases of primary gastrointestinal lymphoma was 48%. Bulk of residual disease after initial surgery and stage were significant prognostic factors. Stage I with small residual disease treated with post-p irradiation achieved 100% 5 year survival rate. So above group is considered curable with surgery and post-p irradiation. 80% of Stage II with small residual disease showed 31.5% 5 year survival rate. Non of them died with local failure. So, we suggest that complete surgical resection of tumor mass should be attempted initially in the management of localized gastrointestinal lymphomas and systemic chemotherapy is needed in addition to post-p irradiation in the cases of Stage II and large residual disease after initial surgery.
Drug Therapy ; Humans ; Lymphoma* ; Radiotherapy ; Retrospective Studies ; Survival Rate

PURPOSE: The purpose of this study was to identify the predictors influencing on resilience in adolescents with cancer. METHODS: The participants consisted of 107 parents and 107 adolescents who aged ten and eighteen diagnosed with cancer more than six months and currently receiving outpatient treatment or further management after off-therapy. Data was collected using self-report questionnaires and analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. RESULTS: Resilience was significantly different by religion (t=2.472, p=.045) and number of cancer treatment regimens (F=3.155, p=.047). Family problem-solving communication was also significant by number of cancer treatment regimens (F=3.582, p=.031). The higher social support showed the stronger family hardiness and the better family problem-solving communication. In addition, a positive relationship was found between Family Hardiness Index (FHI) (r=.193, p=.046), Family Problem Solving Communication (FPSC) (r=.226, p=.019) and resilience of adolescents with cancer. FPSC (beta=.356, p=.045) and religion (beta=.441, p=.002) were predictive factors at ages 10-12, FHI (beta=.509, p=.029) and FPSC (beta=.503, p=.037) were predictive factors at ages 13-15 on resilience of adolescents with cancer that explained 16.0% and 24.3% respectively. CONCLUSION: The findings suggest that nursing interventions should focus on enhancing family resilience and resilience of adolescents with cancer.
Adolescent ; Aged ; Humans ; Outpatients ; Parents ; Problem Solving ; Surveys and Questionnaires

Two cases of primary malignant lymphoma of the brain and six cases of secondary CNS lymphoma seen at Yonsei cancer center, radiotherapy department for recent 4 years are presented. Primary lymphomas revealed single tumor mass on corpus callosum area and secondary lymphoma were intracranial (3 cases) or leptomeningeal type (3 cases). Histology of primary lymphoma were reticulum cell sarcoma and secondary lymphomas were either diffuse histiocytic or diffuse poorly differentiated lymphocytic lymphoma. All patients showed good response to radiation. Two patients with primary CNS lymphoma and two of six secondary CNS lymphoma are alive after radiotherapy (34, 31, 26, 12 months). But the prognosis of secondary CNS lymphoma is grave, because of progressive systemic disease. Incidence, risk factors, diagnosis and therapeutic management of CNS involvement are also discussed.
Brain ; Corpus Callosum ; Diagnosis ; Humans ; Incidence ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Prognosis ; Radiotherapy ; Risk Factors

PURPOSE: We tried to find the patients characteristics of parasternal recunence, to classify the parasternal recunence according to the radiological and clinical features, and to evaluate the efficacy of local radiotherapy. MATERIALS AND METHODS: Between August 1987 and April 1997, twenty one patients with parastemal recurrence of breast cancer after surgery with or without adjuvant chemotherapy were treated with radiotherapy. Age distribution at initial operation was ranged from 31 to 79 years(median 48 years). Sixteen(76.2%) cancers were in the right breast and five(23.8%) were in the left. The pathologic types were infiltrative ductal carcinoma in 18 patients and medullary carcinoma in 3 patients. Eight patients had stage I, three had stage IIa, six had stage IIb, one had stage IIIa diseases and we had no information about the initial stage of the other 3 patients. Parasternal recurrence were diagnosed by biopsy in 7 patients, and the other 14 recurrences were diagnosed by clinical and radiologic findings such as chest CT, whole body bone scan. All the patients were treated with radiation for the parasternal recurrent tumors. In addition, five patients also received chemotherapy(FAC or Taxol based protocol) and one patient also received partial resection before radiotherapy. Radiotherapy was delivered with Co-60 gamma-ray or 4~6 MV X-ray or electron beam to both supraclavicular lymph nodes and parasternal areas with total doses of 3000~6480 cGy(median 6100 cGy). RESULTS: The range of interval between curative resection and parasternal recurrence were 4~110 months(median 34 months). The main symptoms of the parasternal recurrence were a painless mass(n=10). The duration of symptom before diagnosis ranged from one to 36 months(median 7 months). Among 21, five patients(23.8%) presented distant metastses at the diagnosis of parasternal recurrences. The parasternal recurrences were classified into three groups according to radiologic and clinical findings; the recurrent tumors originated from sternum and invaded into adjacent tissues(Group 1, n=5), tumors originated from intemal mammary lymph nodes and invaded into sternum or parasternal tissues(Group 2, n=6), tumors originated from medial chest wall and invaded into sternum or parasternal tissues(Group 3, n=10). In nineteen patients(19/21; 90.5%) there was complete response of parasternal recurrence following radiotherapy. Although the follow up period was relatively short(3~78 montbs, median 14 months), there were no local recurrence in radiation field in 19 patients with complete response. Among the 16 patients without distant metastases at diagnosis of parasternal recurrence, nine patients were alive without any evidence of disease. CONCLUSION: Chest CT scan is necessary and effective in patients with parastemal discomfort, pain, swelling or palpable mass after mastectomy. And we found that radiotherapy was very effective for the local treatment of parasternal recunence in terms of symptom palliation and local control of tumor. Although we classified the parasternal recurrence into three groups, we could not reach any conclusive results because of short follow up duration and insufficient patients number.
Age Distribution ; Biopsy ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Medullary ; Chemotherapy, Adjuvant ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy ; Neoplasm Metastasis ; Paclitaxel ; Radiotherapy ; Recurrence* ; Sternum ; Thoracic Wall ; Tomography, X-Ray Computed

It is well known that intracavitary radiotherapy (ICR), either alone or in combination with external-beam radiotherapy (EBRT) is an essential component of the radiation treatment of uterine cervical cancer. Although low-dose-rate (LDR) brachytherapy has been successfully applied to the management of such patients, several radiation oncologists have experience of using high-dose-rate (HDR) brachytherapy with promising clinical results over the past 4 decades. However, there has been a considerable reluctance by radiation oncologists and gynecologists in North America to employ the HDR remote afterloading technique instead of the more firmly established LDR treatment modality. In contrast, the HDR-ICR system is rapidly gaining acceptance in Korea since the introduction of the Ralstron, remotely controlled afterloading system using HDR Co-60 sources, at the Yonsei Cancer Center in 1979. According to brachytherapy statistics reported by the Korean Society of Therapeutic Radiology and Oncology, in 1997, brachytherapy was performed upon 1,758 Korean patients with uterine cervical cancer, of whom approximately 83% received HDR brachytherapy. In this review, we present our experiences of HDR-ICR for the treatment of uterine cervical cancer. In addition, we discuss the controversial points, which are raised by those considering the use of HDR-ICR for uterine cervical cancer; these issues include physical and radiobiological considerations, and the prospect of future technical improvements.
Brachytherapy/*methods ; Cervix Neoplasms/*radiotherapy ; Dose Fractionation ; Female ; Human ; Radiotherapy Planning, Computer-Assisted

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.
Adenocarcinoma/radiotherapy ; Adenocarcinoma/mortality ; Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use+ACo- ; Antineoplastic Agents, Combined/adverse effects ; Carboplatin/administration +ACY- dosage ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/drug therapy ; Cervix Neoplasms/radiotherapy+ACo- ; Cervix Neoplasms/mortality ; Cervix Neoplasms/drug therapy ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration +ACY- dosage ; Combined Modality Therapy ; Comparative Study ; Cyclophosphamide/administration +ACY- dosage ; Doxorubicin/administration +ACY- dosage ; Female ; Fluorouracil/administration +ACY- dosage ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/epidemiology ; Hematologic Diseases/etiology ; Hematologic Diseases/epidemiology ; Hepatitis, Toxic/etiology ; Hepatitis, Toxic/epidemiology ; Human ; Kidney Diseases/epidemiology ; Kidney Diseases/chemically induced ; Korea/epidemiology ; Life Tables ; Lymphatic Metastasis ; Middle Age ; Particle Accelerators ; Radiotherapy, High-Energy+ACo-/adverse effects ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.
Adenocarcinoma/radiotherapy ; Adenocarcinoma/mortality ; Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use+ACo- ; Antineoplastic Agents, Combined/adverse effects ; Carboplatin/administration +ACY- dosage ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/drug therapy ; Cervix Neoplasms/radiotherapy+ACo- ; Cervix Neoplasms/mortality ; Cervix Neoplasms/drug therapy ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration +ACY- dosage ; Combined Modality Therapy ; Comparative Study ; Cyclophosphamide/administration +ACY- dosage ; Doxorubicin/administration +ACY- dosage ; Female ; Fluorouracil/administration +ACY- dosage ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/epidemiology ; Hematologic Diseases/etiology ; Hematologic Diseases/epidemiology ; Hepatitis, Toxic/etiology ; Hepatitis, Toxic/epidemiology ; Human ; Kidney Diseases/epidemiology ; Kidney Diseases/chemically induced ; Korea/epidemiology ; Life Tables ; Lymphatic Metastasis ; Middle Age ; Particle Accelerators ; Radiotherapy, High-Energy+ACo-/adverse effects ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome