Sympathectomy, as an emerging treatment method for cardiovascular diseases, has received extensive attention in recent years. Stereotactic radiotherapy (SRT), a precise and noninvasive therapeutic technique, has gradually been introduced into interventions targeting the sympathetic nervous system and has shown promising prospects in the management of cardiovascular conditions. Using three-dimensional imaging, SRT can accurately localize sympathetic ganglia and deliver high-energy radiation to disrupt nerve fibers, thereby achieving effects similar to conventional sympathectomy while reducing surgery-related complications and shortening recovery time. It also offers the advantages of being noninvasive and causing fewer adverse effects, and thus holds potential as an alternative to traditional approaches in the future. The integration of SRT with sympathectomy opens new avenues for the treatment of cardiovascular diseases and presents broad clinical application prospects.
Radiosurgery/methods* ; Cardiovascular Diseases/radiotherapy* ; Humans ; Imaging, Three-Dimensional ; Ganglionectomy/methods* ; Ganglia, Sympathetic/radiation effects* ; Blood Vessels/physiopathology* ; Heart/physiopathology*

PURPOSE: This study aimed to identify risk factors that have significant interaction with radiation exposure to the heart, and thus to determine candidates for heart-sparing radiotherapy (RT) among women with left breast cancer. METHODS: We identified 4,333 patients who received adjuvant RT following breast-conserving surgery for ductal carcinoma in situ or invasive breast cancer from 1996 to 2010. Incidence rates of cardiovascular disease were compared between left-sided and right-sided RT, and stratified by age and risk factors such as body mass index (BMI), smoking, hyperlipidemia, hypertension, diabetes, administration of anthracycline, and trastuzumab. RESULTS: In all patients, the cumulative incidence of cardiovascular disease was greater in patients treated with left-sided RT than in those treated with right-sided RT, but the difference was not significant (p=0.428). Smoking (hazard ratio [HR], 5.991; 95% confidence interval [CI], 2.109–17.022; p=0.002) and hyperlipidemia (HR, 5.567; 95% CI, 3.235–9.580; p<0.001) were the most powerful risk factors for cardiovascular disease. There was no significant factor that further increased the risk of cardiovascular disease after left breast RT compared to right breast RT. CONCLUSION: Although hyperlipidemia and smoking are risk factors for cardiovascular disease, they have not been proven to increase the risk of RT-related cardiovascular disease in Korean women.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Cardiotoxicity ; Cardiovascular Diseases ; Female ; Heart ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Mastectomy, Segmental ; Radiation Exposure ; Radiotherapy* ; Risk Factors ; Smoke ; Smoking ; Trastuzumab

PURPOSE: To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. MATERIALS AND METHODS: A retrospective review was performed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 69 Gy. No patients were lost to follow-up. RESULTS: The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and 21%, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and 25%, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was 43%. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented 78% of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm (0% vs 36%). Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 (25% vs 26%, p>0.05). CONCLUSION: Radiation therapy alone is an effective and safe treatment for early stage non-small cell lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cardiovascular Diseases ; Cause of Death ; Disease-Free Survival ; Disulfiram ; Humans ; Karnofsky Performance Status ; Lost to Follow-Up ; Lung* ; Male ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure

INTRODUCTION: Stapled anastomosis in the rectal cancer surgery has been already proven as a safe technique, maintaing secure suture and saving times compared to handsewn anastomosis. With the advancement of stapling device, the incidence of anastomotic leakage has decreased significantly. However, developement of anastomotic stricture has become a major postoperative complication. PURPOSE: An analysis of the clinical features and the predisposing factors of anastomotic stricture was made to identify its pathogenesis and to determine adequate procedure. METHODS: We analyzed 49 patients (8.1%) with the rectal stricture among 608 patients, undergone stapled anastomosis for the rectal cancer surgery at Asan Medical Center from Jan 1993 to Dec 1998. Rectal stricture was defined when index finger or colonoscope could not pass the anastomotic site (high grade), or could pass with difficulty(low grade). RESULTS: Underlying general diseases, e.g., DM, hypertension and cardiovascular disease was associated more frequently in patients with anastomotic stricture (20.4%) than patients without (10.8%) (P<0.05). The rate of postoperative major complications in patients with stricture was 22.4%, while that of anastomotic leakage was 6.1%. Development of anastomotic stricture was not associated with operative methods, age, anastomosis level, and postoperative radiotherapy. In patients with stricture, 34 patients (69.4%) were asymptomatic, and 15 patients were symptomatic. In treating symptomatic rectal stricture, only five patients performed dilation manually or by the Hegar dilator. CONCLUSIONS: Rectal stricture after stapled anastomosis might be associated with underlying diseases, and correlated with prolonged sanguinous drainage and ileus. Meticulous management of underlying disease and complete hemostasis during operation appear to be important to reduce the rate of rectal stricture.
Anastomotic Leak ; Cardiovascular Diseases ; Causality ; Chungcheongnam-do ; Colonoscopes ; Constriction, Pathologic* ; Drainage ; Fingers ; Hemostasis ; Humans ; Hypertension ; Ileus ; Incidence ; Postoperative Complications ; Radiotherapy ; Rectal Neoplasms ; Sutures