PURPOSE: Compared to conventional radiotherapy (RT), intensity-modulated radiotherapy (IMRT) significantly reduces the rate of treatment-induced late toxicities in head and neck cancer. However, a clear survival benefit of IMRT over conventional RT has not yet been shown. This study is among the first comparative study to compare the survival rates between conventional RT and helical tomotherapy in head and neck cancer. MATERIALS AND METHODS: From January 2008 to November 2011, 37 patients received conventional RT and 30 patients received helical tomotherapy for management of head and neck cancer. We retrospectively compared the survival rates between patients treated with conventional RT and helical tomotherapy, and analyzed the prognostic factors for survival. RESULTS: The 1- and 2-year locoregional recurrence-free survival rates were 61.2% and 58.1% for the conventional RT group, 89.3% and 80.3% for the helical tomotherapy group, respectively. The locoregional recurrence-free survival rates of the helical tomotherapy group were significantly higher than conventional RT group (p = 0.029). There were no significant differences in the overall and distant metastasis-free survival between the two groups. RT technique, tumor stage, and RT duration were significant prognostic factors for locoregional recurrence-free survival. CONCLUSION: This study showed the locoregional recurrence-free survival benefits of helical tomotherapy in the treatment of head and neck cancers.
Head ; Head and Neck Neoplasms ; Humans ; Neck ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate

From January 1981 to December 1989, total 42 patients with atelectasis from lung cancer were treated with radiation therapy at the Department of Therapeutic Radiology in Kyung Hee University Hospital. The reexpansion of atelectasis after radiotherapy of the lung was evaluated retrospectively, utilizing treatment records and follow-up chest radiographs. Of the patients with non-small cell carcinoma of the lung, the response rate was 62% (21/34). Patient with small cell carcinoma showed a 75% (6/8) response rate. There appears to be some evidence of a relationship of total tumor dose versus response of atelectasis; radiation dose over 40 gy (1337 ret), had a favorable effect on the rate of response compared with that below 40 gy (1297 ret), 70% (21/30) and 50% (6/12), respectively (p<0.01). Total response rate (partial and complete responses) of all patients was 64% (27/42). Franction size was not contributed to the difference of response rates between small fraction (180~200 cgy) and large fraction (300 cgy), 53% (14/22) and 65% (13/20), respectively. The results of this study suggest that radiation therapy has a definite positive role in management of atelectasis caused by lung cancer, especially in inoperable non-small cell carcinoma.
Carcinoma, Small Cell ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Pulmonary Atelectasis* ; Radiation Oncology ; Radiography, Thoracic ; Radiotherapy ; Retrospective Studies

PURPOSE: To evaluate protective mechanism of melatonin against radiation damage and its relationship with apoptosis in mouse jejunum. MATERIALS AND METHODS:' 168 mice were divided into 28 groups according to radiation dose and melatonin treatment. To analysis crypt survival, microcolony survival assay was done according to Withers an (l Elkind's method. To analysis apoptosis, TUNEL assay was done according to Labet-Moleur's method. RESULTS: Radiation protection effect of melatonin was demonstrated by crypt survival assay and its effect was stronger in high radiation dose area. Apoptosis index with 8 Gy irradiation was 18.4% in control group and 16.5% in melatonin treated group. After 18 Gy, apoptosis index was 17.2% in control group and 15.4% in melatonin treated group. Apoptosis index did not show statistically significant difference between melatonin treated group and control group. CONCLUSION: Melatonin shows clear protective effect in mouse jejunum against radiation damage but it.', protective effect seems not to be related with apoptosis protection effect.
Animals ; Apoptosis* ; Cell Survival* ; In Situ Nick-End Labeling ; Jejunum ; Melatonin* ; Mice* ; Radiation Protection

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients, 24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 patients). The actuarial overall and relapse free 5 year survival rate were 71.0%, 68.3% respectively. The survival rates by stage were 79.1% in stage I, and 61.2% in stage II. Treatment failure was noted in 18 of 64 patients (28.1%), locoregional failure in 8(12.5%), distant metastasis in 8(12.5%), paraaortic node metastasis in 1 and one patient had concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thickness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level, resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24(33.3%), 5000-5500 cGy+ICR 3/7(42.9%), 5000-5500 cGy external RT only group 3/33(9.1%). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose not improve results but only increases complication.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Pelvis ; Radiation Oncology ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms*

PURPOSE: Granisetron is a potent, the most selective 5-HT3 receptor antagonist and is reported to be effective in treatment of radiation-induced emesis. The antiemetic efficacy and safety of oral granisteron was evaluated in patients with receiving highly emetogenic treatment by conventional fractionated irradiation. MATERIAL AND METHODS: Patients with various cancers who were being treated with irradiation were accrued into the present study. The intensity of nausea was evaluated on first 24 hours and on day-7 by patients according to the degree of interference with normal daily life as followings; a) none; b) present but no interference with normal daily life (mild); c) interference with normal daily life (moderate); and d) bedridden because of nausea (severe). Non or mild state was considered to indicate successful treatment. The efficacy of antiemetic treatment was graded as follows; a) complete response; no vomiting, no worse than mild nausea and receive no rescue antiemetic therapy over the 24h period, b) major response; either one episode of vomiting or moderate/severe nausea or had received rescue medication over 24h period, or any combination of these, c) minor response; two to four episodes of vomiting over the 24h period, regardless of nausea and rescue medication, d) failure; more than four medication. The score of the most sympto m was recorded and the total score over 24 hours was summarized. The complete or major response was considered to indicate successful treatment. RESULTS: A total of 10 patients were enrolled into this study, and all were assessable for efficacy analysis. Total nausea control was achieved in 90% (9/10:none=60% plus mild=30%) of total patients after 7 days. The cotrol of vomiting by granisteron was noted in seven patients (70%) of complete response and three (30%) of major response with a hundred-percent successful treatment over 7 days. The minor response or treatment failure were not observed. No significant adverse events or toxicities from granisetron were recorded in patient receiving granisetron. CONCLUSION: We concluded that granisetron is a highly effective antiemetic agent in controlling radiotherapy-induced nausea or vomiting with a minimal toxicity profile.
Granisetron* ; Humans ; Nausea* ; Radiotherapy ; Receptors, Serotonin, 5-HT3 ; Treatment Failure ; Vomiting*

Using as assay for jejunal crypt stem cell survival, dose-response curves for the reproductive capacity of crypt stem cells mouse jejunum exposed to multifractionated gamma-ray irradiation(single, 2, 3, 4, 5, 6, 7, 8, 10,12, and 16 fractions) were analyzed and single-dose survival curve of these cells was constructed. The following conclusion were drawn: 1) Survival curves for higher numbers of dose fractions were displaced to higher dose, and characterized by increasingly shallower slopes. 2) The single-dose survival curve had broad shoulder, Dq=460 cGy, remaining near-exponential over initial dose range 0 to 300 cGy, with initial slope 1Do=474 cGy 3) At fractionated dose in the range of 180 to 450 cGy, the average recovered dose per fraction interval was approximately 50% of the dose per fraction. 4) The value of a/b ratio by using of linear regression analysis for the reciprocal dose plots was 8.3Gy which lied in the range of 6-14Gy for early-reacting tissues. 5) The linear-quadratic model for dose-response formula offers valid approximations for all doses to be used in radiotherapy, only two parameters to be determined, and considerable convenience in practical applications.
Animals ; Jejunum ; Linear Models ; Mice* ; Radiotherapy ; Shoulder ; Stem Cells

Forty-four patients with brain astrocytoma and glioblastoma were treated with surgical resection and postoperative radiation from January 1980 through May 1987. Four patients were lost to follow up, and in 40 patients sruvival time was evaluable. Three year actuarial sruvival rate was 66.7% in Grade I and II astrocytoma, 30% in Grade III, and 20.4% in glioblastoma multiforme patients. The prognostic factors affecting survival rate were histologic grade in all cases, age, and total radiation dose in Grade III and glioblastoma.
Astrocytoma* ; Brain ; Glioblastoma* ; Humans ; Lost to Follow-Up ; Survival Rate

Multicellul ar tumor spheroids of HeLa cells have been grown in a static culture system. Samples of spheroids were exposed for 2 h to graded concentration of sis-platinum and its analogue, carboplatin, and then response assayed by survival of clonogenic cells. The purpose of present experiment is to clarify the effectiveness of these platinum compounds and to evaluate intrinsic radiosensitivity of cells using spheroids of HeLa cells as an experimental in vitro model. Variations of the drug sensitivity of monolayers as well as spheroids were also evaluated in cell-survival curves. In cia-platinum concentration-survival cutie, there was a large shoulder extending as far as Cq=3.4 mM, after which there was exponential decrease in survival curve having a Co Value of 1.2 mu in spheroids. While the Co for the spheroids was essentially no significant change, but Cq value was larger than that of monolayers. This suggest that the effect of cis-platinum is greater in the monolayer with actively proliferaing cells than hypoxic one. In the carboplatin concentration-survival curves, the Co value of spheroids was 15.0 mM and the ratio with the Co from monolayer cell (32.5 mM) was 0.46, thus indicating that the spheroids had a greater sensitivity to carboplatin than monolayers. Therefore, the effect of carboplatin is mainly on the deeper layers of spheroids acting as hypoxic cell sensitizer. The enhanced effect was obtained for monolayer cells using combined X-ray and carboplatin treatment 2 hours before irradiation. The result shown in isobologram analysis for the level of surviving fraction at 0.01 indicated that the effect of two agents was truely supra-additive. From this experimental data, carboplatin has excited much recept interest as one of the most promising, since it is almost without nephrotoxicity and causes less gastrointestinal toxicity than cia-platinum. Interaction between carboplatin and radiation might play an important role for more effective local tumor control.
Carboplatin ; Cisplatin ; HeLa Cells* ; Humans ; Platinum Compounds ; Platinum* ; Radiation Tolerance ; Shoulder ; Spheroids, Cellular*

PURPOSE: Metastatic cancer to the brain is a major problem for the patients with bronchogenic carcinoma, and most of these patients have a limited survival expectancy. To increase tumor control and/or to decrease late morbidity with possible shortening in over-all treatment period, multiple daily fraction technique for brain metastasis was performed. The author represented the results of accelerated fractionation radiotherapy in patients with brain metastases from non-small cell lung cancer. MATERIALS AND METHODS: Twenty-six patients with brain metastases from non-small cell lung cancer between 1991 and 1993 received brain radiotherapy with a total dose of 48 Gy, at 2 Gy per fraction, twice a day with a interfractional period of 6 hours, and delivered 5 days a week. The whole brain was treated to 40 Gy and boost dose escalated to 8 Gy for single metastatic lesion by reduced field. Twenty-four of the 26 patients completed the radiotherapy. Radiotherapy was interrupted in two patients suggesting progressive intracerebral disease. RESULTS: This radiotherapy regimen appears to be comparable to the conventional schema in relief from symptoms. Three of the 24 patients experienced nausea and or vomiting during the course of treatment because of acute irradiation toxicity. The author observed no excessive toxicity with escalating dose of irradiation. An increment in median survival, although not statistically significant (p>0.05), was noted with escalating doses(48 Gy) of accelerated fractionation (7 months) compared to conventional treatment(4.5 months). Median survival also increased in patients with brain solitary metastasis(9 months) compared to multiple extrathoracic sites(4 months), and in patients with good performance status(9 months versus 3.5 months), they were statistically significant(p<0.01). CONCLUSION: The increment in survival in patients with good prognostic factors such as controlled primary lesion, metastasis in brain only, and good performance status appeared encouraging. Based on these results, a multi-institutional prospective randomized trial should be initiated to compare the twice-a-day and one-a-day radiotherapy schemes on patients with brain metastasis with careful consideration for the patients' quality of life.
Brain* ; Carcinoma, Bronchogenic ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung* ; Nausea ; Neoplasm Metastasis* ; Quality of Life ; Radiotherapy ; Vomiting

From 1982 to 1991, sixteen patients with primary on-Hodgkin's lymphoma of the central nervous system (CNS) were seen at Kyung Hee University Hospital. The most common subtypes were large, noncleaved cell lymphoma and immunoblastic lymphoma of B cells. Lesions most commolnly involved were the parietal lobes and/or deep nuclei. Positive cerebrospinal fluid cytology was rare at initial presentation. Sixteen patients were treated with surgical biopsy or resection followed by whole brain radiotherapy at a median dose of 40 Gy(range=30-50 Gy) with variable boost doses. Of 16 patients who underwent surgery and postoperative radiotherapy, fourteen patients died between 2 and 49 months following treatment, and two are alive with no evidence of disease at 8 and 22 months. The 1-and 2-year survival rates were 55.6% and 34.7% respectively with 12 months of median survival. Patterns of failure were analyzed in eleven patients of total 16 patients. Failure at the original site of involvement was uncommon after radiotherapy treatment. In contrast, failure in the brain at sites other than those originally involved was common in spite of the use of whole brain irradiation. Failure occurred in the brain 11/16(68.7%), in spinal axis 4/16(25.0%). The age, sex. Location of involvement within CNS, numbers of lesion, or radiation dose did not influence on survival. The authors conclude that primary CNS lymphoma is a locally aggressive disease that is poorly controlled with conventional radiation therapy. The limitation of current therapy for this disease are discussed, and certain promising modality should be made in regarding the management of future patients with this disease.
Axis, Cervical Vertebra ; B-Lymphocytes ; Biopsy ; Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Parietal Lobe ; Radiotherapy ; Survival Rate