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

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

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

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

In order to clarify the effect of radiation on the mouse jejunal crypt cells by combined administration of adriamycin and radiation and also to evaluate the enhancing effect of adriamycin, the authors performed this study by delivering single irradiation of 1,000 to 1,600 rad to the whole abdomen of mice by cobalt-60 teletherapy unit. In combination with adriyamycin treatment groups, the drug was administered as single dose of 10 mg/kg either 2 hours before or 4 hours after graded single dose, 900 to 1,400 rad, of irradiation. The authors studied the quantitative changes of intestinal crypt cells by microcolony survival assay technique and the morphological changes of small intestinal villi by scanning electron microscope in mice following to combined therapy with adriamycin and irradiation. The average number of jejunal crypts per circumference was 130+/-6 in control group. The mean lethal dose(Do) of each irradiation alone and combined therapy groups 2 hours before and 4 hours after irradiation, were 160, 170, and 170 rad in cell survival curves, respectively. The dose effect factor(DEF) of adriamycin in each groups of pre-irradiation and post-irradiation were 1.19 and 1.26, respectively. The conical shaped villi were noted on 1,200 rad in irradiation alone group and 1,000 rad in combined groups. For the proper clinical application we must be careful of the radiation injury to small bowel when the anticancer chemotherapy and radiation injury to small bowel when the anticancer chemotherapy and radiation therapy to the abdomen and pelvic area are used as combined therapeutic modality.
Abdomen ; Animals ; Cell Survival ; Doxorubicin* ; Drug Therapy ; Mice* ; Microscopy, Electron, Scanning ; Radiation Injuries

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

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*