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Re-Irradiation for Recurrent Gliomas: Treatment Outcomes and Prognostic Factors
이정심,조재호,장종희,서창옥 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.4
Purpose: The aim of this study was to evaluate the efficacy of re-irradiation in patients with recurrent gliomas and to identify subgroupsfor whom re-irradiation for recurrent gliomas is most beneficial. Materials and Methods: We retrospectively reviewed 36 patients with recurrent or progressive gliomas who received re-irradiationbetween January 1996 and December 2011. Re-irradiation was offered to recurrent glioma patients with good performance or at least 6 months had passed after initial radiotherapy (RT), with few exceptions. Results: Median doses of re-irradiation and initial RT were 45.0 Gy and 59.4 Gy, respectively. The median time interval between initial RT and re-irradiation was 30.5 months. Median overall survival (OS) and the 12-month OS rate were 11 months and 41.7%, respectively. In univariate analysis, Karnofsky performance status (KPS) ≥70 (p<0.001), re-irradiation dose ≥45 Gy (p=0.040), and longer time interval between initial RT and re-irradiation (p=0.040) were associated with improved OS. In multivariate analysis, KPS (p=0.030) and length of time interval between initial RT and re-irradiation (p=0.048) were important predictors of OS. A radiographicallysuspected mixture of radiation necrosis and progression after re-irradiation was seen in 5 patients. Conclusion: Re-irradiation in conjunction with surgery could be a salvage treatment for selected recurrent glioma patients with good performance status and recurrence over a long time.
First record of Androcorys pusillus (Orchidaceae) from Mt. Baekdu
이정심,김수남,김무열 한국식물분류학회 2013 식물 분류학회지 Vol.43 No.1
Androcorys pusillus (Ohwi & Fukuy.) Masam. (Orchidaceae) was first found from Mt. Baekdu of the Korean peninsular and was known to distribute from Taiwan and Japan. This species is distinguished from the related taxa by its denticulated sepal margin, petal width which is as broad as dorsal sepal, and larger bract size.
이정심,안성수,장종희,서창옥 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.2
Purpose: To evaluate the adequacy of retreatment, including hypofractionated re-irradiation (HFReRT), after surgery for recurrentglioblastoma (GBM) and related prognosticators of outcomes. Materials and Methods: From 2011 to 2014, 25 consecutive patients with recurrent (n=17) or secondary (n=7) disease underwent maximal surgery and subsequent HFReRT after meeting the following conditions: 1) confirmation of recurrent or secondary GBM after salvage surgery; 2) Karnofsky performance score (KPS) ≥60; and 3) interval of ≥12 months between initial radiotherapy and HFReRT. HFReRT was delivered using a simultaneous integrated boost technique, with total dose of 45 Gy in 15 fractions to the gross tumor volume (GTV) and 37.5 Gy in 15 fractions to the clinical target volume. Results: During a median follow-up of 13 months, the median progression-free and overall survival (OS) were 13 and 16 months, respectively. A better KPS (p=0.026), no involvement of the eloquent area at recurrence (p=0.030), and a smaller GTV (p=0.005) were associated with better OS. Additionally, OS differed significantly between risk groups stratified by the National Institutes of Health Recurrent GBM Scale (low-risk vs. high-risk, p=0.025). Radiologically suspected radiation necrosis (RN) was observed in 16 patients (64%) at a median of 9 months after HFReRT, and 8 patients developed grade 3 RN requiring hospitalization. Conclusion: HFReRT after maximal surgery prolonged survival in selected patients with recurrent GBM, especially those with small-sized recurrences in non-eloquent areas and good performance.
A new species of Daphne (Thymelaeaceae): D. jejudoensis M. Kim
이정심,이강협,소순구,최창학,김무열 한국식물분류학회 2013 식물 분류학회지 Vol.43 No.2
A new species, Daphne jejudoensis M. Kim, has been named and described from Seonheul, Jejudo Province, Korea. Daphne jejudoensis shares several characteristics (white calyx colors, long calyx tube, evergreen leaves, leathery leaf textures, etc.) with its related species D. kiusiana, but it is distinct from D. kiusiana which has a hairy calyx tube and lobes, short calyx lobes, oblanceolate leaves (with acute apex), and a different distribution (coastal region in Geojedo Is.) by having a glabrous calyx tube and lobes, long calyx lobes, elliptic leaves (with acuminate apex), and by its distribution (inland region in Jejudo Is.).