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

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

A retrospective study of 53 patients suffering from non-small cell carcinoma of lung with brain metastases is presented. They were treated in the Department of Therapeutic Radiology of Kyung Hee University Hospital from 1983 to 1990. There were 37 male and 16 female patients. The age range was 39 to 85 years (median=59). The most common histologic cell type of tumor was adenocarcinoma (50.9%), followed by squamous cell carcinoma and large cell carcinoma. All patients were treated with whole-brain photon irradiation(WBI) using lateral opposing fields. The overall median survival time was 5 months. Age, sex, histologic type, and initial performance status were not prognostically important. The most important prognostic factors were the response to radiotherapy and the presence of brain metastases alone. Lncreasing the dose of radiotherapy to the main bulk of tumor may improve the symptom-free survival or overall survival in patients who present with brain metastases as the sole site of extrathoracic disease.
Adenocarcinoma ; Brain ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Female ; Humans ; Lung* ; Male ; Neoplasm Metastasis* ; Radiation Oncology ; Radiotherapy ; Retrospective Studies

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*

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

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

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*