PURPOSE: To evaluate the predictive value of the early response of 18F-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. RESULTS: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of SUVmax (%DeltaSUVmax) were larger in responder group than in non-responder group (55.7% +/- 15.6% vs. 23.1% +/- 19.0%, p = 0.01). The percent changes of SUVmean (%DeltaSUVmean) were also larger in responder group than in non-responder group (54.4% +/- 15.9% vs. 22.3% +/- 23.0%, p = 0.01). The percent changes of MTV (%DeltaMTV) or TLG (%DeltaTLG) had no correlation with the tumor response after treatment. All the 7 patients (100%) with %DeltaSUVmax > or = 50% had PR, but only 2 out of 6 patients (33%) with %DeltaSUVmax < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with %DeltaSUVmean > or = 50% had PR, but only 3 out of 7 patients (43%) with %DeltaSUVmean < 50% had PR after CCRT (p = 0.026). CONCLUSION: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Glycolysis ; Humans ; Lung Neoplasms ; Positron-Emission Tomography ; Tumor Burden

We report four cases of spontaneous intracranial hypotension that were investigated by radionuclide cisternography Tc-99m-diethylenetriamine pentaacetic acid radionuclide cisternography of all our patients showed direct sign of cerebrospinal fluid leakage as well as indirect signs of less activity than expected over the cerebral convexities and rapid appearance of bladder activity. The headache of all patients was eventually controlled with bed rest and hydration.
Bed Rest ; Cerebrospinal Fluid ; Headache ; Humans ; Intracranial Hypotension* ; Urinary Bladder

PURPOSE: Flavopiridol enhanced radiation-induced apoptosis of cancer cells in our previous in vitro study. The purpose of this study was to assess if flavopiridol could enhance the radioresponse of mouse mammary tumors in vivo. MATERIALS AND METHODS: Balb/c mice bearing EMT-6 murine mammary carcinoma were treated with flavopiridol only, radiation only, or both for 7 days. Flavopiridol was administered 2.5 mg/kg twice a day intraperitoneally (IP). Radiation was delivered at a 4 Gy/fraction at 24-h intervals for a total dose of 28 Gy. Tumor volume was measured and compared among the different treatment groups to evaluate the in vivo radiosensitizing effect of flavopiridol. Tumors were removed from the mice 20 days after treatment, and TUNEL and Immunohistochemical stainings were performed. RESULTS: Significant tumor growth delay was observed in the radiation only and combined treatment groups, when compared with the control group. However, there was no significant difference between the tumor growth curves of the control and flavopiridol only group or between the radiation only and combination treatment group. Apoptotic cells of different treatment groups were detected by terminal deoxynucleotidyl transferase-medicated nick end labeling (TUNEL) staining. The expressions of Ku70 in tumor tissues from the different groups were analyzed by immunohistochemistry. Similarly, no significant difference was found between the apoptotic rate or Ku70 expression among the different treatment groups. CONCLUSION: Flavopiridol did not show evidence of enhancing the radioresponse of mouse mammary tumors in this study.
Animals ; Apoptosis ; Flavonoids ; Immunohistochemistry ; In Situ Nick-End Labeling ; Mice ; Piperidines ; Radiation-Sensitizing Agents ; Tumor Burden ; Ursidae

Purpose: To assess the effect of gold nanoparticles (GNPs) on enhancing radiation doses in brachytherapy and evaluate their potential as radiosensitizers. Methods: A Monte Carlo simulation was conducted to determine the radiation dose enhancement factor (DEF) of GNPs in brachytherapy using Iridium-192 (¹⁹²Ir) or Iodine-125 (¹²⁵I). The simulations compared the depth-dose curves of ¹⁹²Ir and ¹²⁵I in both water and tissue phantoms. A spherical tumor model with a radius of 3.5 cm surrounded by normal tissue was used for DEF calculation.The radioactive source was positioned at the center of the tumor and the DEF was calculated for GNP concentrations of 7, 18, and 30 mg/g present only in the tumor tissue. Results: The differences in depth doses between the water and tissue phantoms were more noticeable for ¹⁹²Ir than for ¹²⁵I. For ¹⁹²Ir, the DEF of the GNPs ranged from 1.6 to 2.8, depending on the concentration of GNP. For ¹²⁵I, the DEF was less than 1. Conclusions GNPs were confirmed to enhance the radiation dose in brachytherapy when using 192 Ir.

Purpose: To assess the effect of gold nanoparticles (GNPs) on enhancing radiation doses in brachytherapy and evaluate their potential as radiosensitizers. Methods: A Monte Carlo simulation was conducted to determine the radiation dose enhancement factor (DEF) of GNPs in brachytherapy using Iridium-192 (¹⁹²Ir) or Iodine-125 (¹²⁵I). The simulations compared the depth-dose curves of ¹⁹²Ir and ¹²⁵I in both water and tissue phantoms. A spherical tumor model with a radius of 3.5 cm surrounded by normal tissue was used for DEF calculation.The radioactive source was positioned at the center of the tumor and the DEF was calculated for GNP concentrations of 7, 18, and 30 mg/g present only in the tumor tissue. Results: The differences in depth doses between the water and tissue phantoms were more noticeable for ¹⁹²Ir than for ¹²⁵I. For ¹⁹²Ir, the DEF of the GNPs ranged from 1.6 to 2.8, depending on the concentration of GNP. For ¹²⁵I, the DEF was less than 1. Conclusions GNPs were confirmed to enhance the radiation dose in brachytherapy when using 192 Ir.

Purpose: To assess the effect of gold nanoparticles (GNPs) on enhancing radiation doses in brachytherapy and evaluate their potential as radiosensitizers. Methods: A Monte Carlo simulation was conducted to determine the radiation dose enhancement factor (DEF) of GNPs in brachytherapy using Iridium-192 (¹⁹²Ir) or Iodine-125 (¹²⁵I). The simulations compared the depth-dose curves of ¹⁹²Ir and ¹²⁵I in both water and tissue phantoms. A spherical tumor model with a radius of 3.5 cm surrounded by normal tissue was used for DEF calculation.The radioactive source was positioned at the center of the tumor and the DEF was calculated for GNP concentrations of 7, 18, and 30 mg/g present only in the tumor tissue. Results: The differences in depth doses between the water and tissue phantoms were more noticeable for ¹⁹²Ir than for ¹²⁵I. For ¹⁹²Ir, the DEF of the GNPs ranged from 1.6 to 2.8, depending on the concentration of GNP. For ¹²⁵I, the DEF was less than 1. Conclusions GNPs were confirmed to enhance the radiation dose in brachytherapy when using 192 Ir.

Purpose: To assess the effect of gold nanoparticles (GNPs) on enhancing radiation doses in brachytherapy and evaluate their potential as radiosensitizers. Methods: A Monte Carlo simulation was conducted to determine the radiation dose enhancement factor (DEF) of GNPs in brachytherapy using Iridium-192 (¹⁹²Ir) or Iodine-125 (¹²⁵I). The simulations compared the depth-dose curves of ¹⁹²Ir and ¹²⁵I in both water and tissue phantoms. A spherical tumor model with a radius of 3.5 cm surrounded by normal tissue was used for DEF calculation.The radioactive source was positioned at the center of the tumor and the DEF was calculated for GNP concentrations of 7, 18, and 30 mg/g present only in the tumor tissue. Results: The differences in depth doses between the water and tissue phantoms were more noticeable for ¹⁹²Ir than for ¹²⁵I. For ¹⁹²Ir, the DEF of the GNPs ranged from 1.6 to 2.8, depending on the concentration of GNP. For ¹²⁵I, the DEF was less than 1. Conclusions GNPs were confirmed to enhance the radiation dose in brachytherapy when using 192 Ir.

Purpose: To assess the effect of gold nanoparticles (GNPs) on enhancing radiation doses in brachytherapy and evaluate their potential as radiosensitizers. Methods: A Monte Carlo simulation was conducted to determine the radiation dose enhancement factor (DEF) of GNPs in brachytherapy using Iridium-192 (¹⁹²Ir) or Iodine-125 (¹²⁵I). The simulations compared the depth-dose curves of ¹⁹²Ir and ¹²⁵I in both water and tissue phantoms. A spherical tumor model with a radius of 3.5 cm surrounded by normal tissue was used for DEF calculation.The radioactive source was positioned at the center of the tumor and the DEF was calculated for GNP concentrations of 7, 18, and 30 mg/g present only in the tumor tissue. Results: The differences in depth doses between the water and tissue phantoms were more noticeable for ¹⁹²Ir than for ¹²⁵I. For ¹⁹²Ir, the DEF of the GNPs ranged from 1.6 to 2.8, depending on the concentration of GNP. For ¹²⁵I, the DEF was less than 1. Conclusions GNPs were confirmed to enhance the radiation dose in brachytherapy when using 192 Ir.

PURPOSE: The role of radiotherapy (RT) was largely deserted after the introduction of platinum-based chemotherapy, but still survival rates are disappointingly low. This study focuses on assessing the clinical efficacy of RT in relation to chemotherapy resistance. MATERIALS AND METHODS: From October 2002 to January 2015, 44 patients were diagnosed with epithelial ovarian cancer (EOC) and treated with palliative RT for persistent or recurrent EOC. All patients received initial treatment with optimal debulking surgery and adjuvant platinum-based chemotherapy. The biologically effective dose (BED) was calculated with α/β set at 10. Ninety-four sites were treated with RT with a median BED of 50.7 Gy (range 28.0 to 79.2 Gy). The primary end-point was the in-field local control (LC) interval, defined as the time interval from the date RT was completed to the date any progressive or newly recurring disease within the RT field was detected on radiographic imaging. RESULTS: The median follow-up duration was 52.3 months (range 7.7 to 179.0 months). The 1-year and 2-year in-field LC rates were 66.0% and 55.0%, respectively. Comparisons of percent change of in-field tumor response showed similar distribution of responses among chemoresistant and chemosensitive tumors. On multivariate analysis of predictive factors for in-field LC analyzed by sites treated, BED ≥ 50 Gy (hazard ratio, 0.4; confidence interval, 0.2–0.9; p = 0.025) showed better outcomes. CONCLUSION: Regardless of resistance to platinum-based chemotherapy, RT can be a feasible treatment modality for patients with persistent of recurrent EOC. The specific role of RT using updated approaches needs to be reassessed.
Drug Therapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Ovarian Neoplasms* ; Palliative Care ; Radiotherapy ; Survival Rate ; Treatment Outcome

PURPOSE: To see the relationship between the response to chemotherapy and the final outcome of neoadjuvant chemotherapy and radiotherapy in patients with locally advanced hypopharyngeal cancer. METHODS AND MATERIALS: A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadjuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75%) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. RESULTS: The overall 2-year and 5-year survival rates are 65.6% and 43.0%, respectively. 5-year local control rate is 34%. Organ preservation for more than five years is achieved in 12 patients (38%). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR); the response rate was 75% (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60% for CR to chemotherapy group, 35.1% for PR to chemotherapy group, and 50% for NR to chemotherapy group, respectively ( p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3% vs. 14.7%, p< 0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). CONCLUSION: In this study, there were only five patients who achieved CR after neoadjuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.
Bleomycin ; Chemoradiotherapy ; Cisplatin ; Drug Therapy* ; Fluorouracil ; Humans ; Hypopharyngeal Neoplasms* ; Organ Preservation ; Particle Accelerators ; Radiotherapy* ; Retrospective Studies ; Seoul ; Survival Rate