Postoperative External Beam Radiotherapy for Medulloblastoma

전하정,이명자,Chun, Ha-Chung,Lee, Myung-Za The Korean Society for Radiation Oncology 2000 Radiation Oncology Journal Vol.18 No.2

목적 : 수아세포종에 대한 수술 후 두개척수 방사선종양학 의학용어집에 따라 방사선치료의 효과를 평가하고 최적의 방사선치료 방법을 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1984년 5월부터 1998년 4월까지 본원 치료방사선과에서 두개척수 외부 방사선치료를 받은 43명의 수아세포종 환자를 후향적으로 분석하였다. 추적기간은 18개월에서 U개월이었으며 중앙추적기간은 47개월이었다. 남자는 27명이었고 여자는 16명으로서 남자와 여자의 비율은 1.7: 1이었다. 5명의 환자에서는 조직검사만을 시행하였고 14명에서는 육안적 완전절제술, 나머지 24명의 환자에서는 아절제술을 시행하였다. 모든 환자는 두개척수 방사선치료를 받았고, 39명의 환자는 최소 5,000 cGy의 방사선을 원발부위에 조사받았으며 40명의 환자는 최소 3,000cGy의 방사선을 척수에 조사받았다. 결과 : 대상환자 43명의 5년 및 7년 생존율은 67$\%$ 및 56$\%$이었고, 5년 및 7년 무병생존율은 각각 60$\%$ 및 51$\%$이었다. 원발병소의 국소제어율은 5년 및 7년에 각각 77$\%$ 및 67$\%$이었다. 육안적 완전절제술 및 아절제술을 시행받은 환자의 5년 생존율은 각각 76$\%$ 및 66$\%$이었으며 반면에 조직검사만을 시행받은 환자는 5년 생존율이 40$\%$에 불과 하였다. 총 18명의 재발환자 중 11명에서 원발부위가 재발부위이었으며 7명의 환자는 원발병소에서만 재발하였다. 4명의 환자는 척수에서, 3명의 환자는 원격전이만을 보였고 나머지 4명의 환자에서는 원발부위를 포함하여 여러부위에서 재발하는 양상을 나타내었다. 결론 : 수아세포종의 뇌척추 방사선치료는 유의한 치료 부작용이 없는 효과적인 치료요법이었다. 그러나 원발부위의 국소치료효과를 높이기 위하여 개선하여야 할 점이 있는 것으로 사료되며 이는 다분할조사, 정위적 방사선수술 및 삼차원 입체 조형치료 등 방사선요법의 기술적 발전으로 이루어 질 수 있을 것으로 생각된다. Purpose : This study was peformed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with modulloblastoma and to define the optimal radiotherapeutic regimen. Materials and Methods : We retrospectively analyzed the records of 43 patients with modulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to U months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received at least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. Results : The overall survival rates at 5 and 7 years for entire group of patients were 57$\%$ and 56$\%$, respectively. Corresponding disease free survival rates were 60$\%$ and 51$\%$, respectively, The rates of disease control in the posterior fossa were 77$\%$ and 67$\%$ at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76$\%$ and 66$\%$, respectively, In contrast, those patients who had biopsy alone had a 5 year survival rate of only 40$\%$. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Conclusion : Craniospinal irradiation for patients with moduiloblastoma is an effective adjuvant treatment without significant treatment related toxicitles. There is room for Improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hypefractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be evolved to improve the tumor control rate at primary site.

농업 활동에 의한 대기오염물질의 배출 특성

전하정,송명기,유근혜,오세호,최서영,고동훈,정혜지,배민석 한국대기환경학회 2023 한국대기환경학회 학술대회논문집 Vol.2023 No.10

Role of Postoperative Radiation Therapyin the Management of Cervical Cancer

전하정,이명자 대한방사선종양학회 2004 Radiation Oncology Journal Vol.22 No.4

External Beam Radiotherapy for Primary Spinal Cord Tumors

전하정,Chun, Ha-Chung The Korean Society for Radiation Oncology 1989 Radiation Oncology Journal Vol.7 No.2

1969년부터 1983년까지 버지니아 의대부속병원에서 방사선 치료를 받은 34예의 원발성 척수암중, 조직검사 또는 아절제술을 시행한 후 수술후 방사선 요법으로 치료받은 32예 (Astrocytoma 16, ependymoma 16)에 대한 치료실적을 보고하고자 한다. 29예에서는 $45\~55Gy$를 5내지 6주간에 조사 받았으며 나머지 3예에서는 40Gy이하의 선량을 조사받았다. 50Gy 이상 조사된 6예는 모두 척수가 조사야에 포함되었다. 본 연구의 최저 추적 기간은 5년이었다. 방사선 치료 실패 후 재수술로 치료된 3예를 포함하여, 모든 예에서 생존율은 5년과 10년에서 각각 $73\%\;와\;50\%$이었다. 각각의 투병생존율은 $60\%\;와\;32\%$이었다. 45Gy 이상의 선량을 받은 29예에서는 5년 무병생존이 $63\%$이었다. 13예에서 치료실패를 경험했으며 치료실패는 조사야에서만 관찰되었다. Ependymoma가 astrocytoma보다 통계적으로 유의하게 무병생존율이 높았다 $(45\%\;:\; 89\%(p<0.05))$, 원발부위에 있어 경추가 포함된 예에서 그렇지 않은 예보다 생존율이 저하되었다. 원발부위의 cauda equina포함여부는 예후에 영향이 없었다. 최고 20년간 추적결과 방사선 치료에 의한 신경성 합병증은 관찰되지 않았다. 본 연구는 원발성 척수암의 치료에 있어서 방사선 치료가 안전하고 효과적임을 확인하였다. Of 34 evaluated patients with primary spinal cord tumors, 32 were irradiated at our institution between 1969 and 1983. The results are reported of 32 patients, 16 with ependymoma and 16 with astrocytoma, who were treated with post-operative external beam radiotherapy following biopsy or subtotal resection Twenty-nine patients received $45\~55Gy$ megavoltage beam irradiation in $5\~6$ weeks and the remaining three patients received less than 40Gy. Spinal cord was in the irradiated field for six patients who received more than 50Gy. The minimum follow-up was five years. Five and ten year acturaial survival rates for entire group of patients were $73\%(22/30)\;and\;50\%(8/16)$, including three patients who were salvaged by surgery after radiation failures. Corresponding five and ten year relapse free survival rates were $60\%(18/30)\;and\;32\%(6/19)$, respectively. Of the 29 patients who recived more than 45Gy, relapse free survival at five years was $63\%(17/27)$. Treatment failed in 13 patients and all of those failures were in the irradiated portal. Patients with ependymomas have significantly better relapse free survival than those with astrocytomas, $80\%\;vs.\;40\%$ (p<0.05). There was significant difference in survival between patients with tumors involving the cervical spine and those with tumors in the other loactions, $45\%$ vs. $89\%(p<0.05)$. There was no significant differnece in survival between patients with cauda equina tumors and those with tumors at spinal cord, $100\%\;vs.\;68\%(p>0.05)$. No radiotherapy related neurological deficit was noted with a maximum 20 year follow-up. This study confirms that external beam radiotherapy is a safe and effective treatment modality for primary spinal cord tumors.

유방암의 방사선치료

全河禎 대한의학협회 1992 대한의학협회지 Vol.35 No.4

P300 숨긴정보검사에서 순열 검증의 정확도

전하정,손진훈,엄진섭 한국인지및생물심리학회 2020 한국심리학회지 인지 및 생물 Vol.32 No.1

The purpose of this study is to show the P300 amplitude of probe stimulus is overestimated more than that of irrelevant stimulus because of the difference of the number of trials between two stimuli in the P300-based concealed information test, and to demonstrate that the type 1 error rate of bootstrap method is higher than the significance level, but that of permutation test is the same as the significance level. The type 1 error rate and the statistical power of bootstrap method and permutation test were estimated by using Monte Carlo study in the case of using 30 Hz, 10 Hz, or 5 Hz low-pass filter, and using P300 peak amplitude or P300 mean amplitude of 100 ms interval. As a result, despite using low-pass filter or P300 mean amplitude of 100 ms interval, the extent of overestimation for the P300 amplitude of probe stimulus was greater at least about 1 ㎶ than that of irrelevant stimulus. For this reason the type 1 error rate of bootstrap method was higher than the significance level. However, the type 1 error rate of permutation test was the same as the significance level. The power of permutation test was highest when 5 Hz low-pass filter and P300 means amplitude of 100 ms interval were used. The results of this study can be used in all cases where the P300 amplitudes of two stimuli with different number of trials are compared. 본 연구의 목적은 P300 숨긴정보검사에서 저역통과필터나 100 ms 구간의 P300 평균전위를 사용하더라도 관련자극과 무관련자극의 시행수 차이로 인하여 관련자극의 P300 진폭이 과대추정된다는 것을 밝히고, 부트스트랩 방법의 1 종 오류율은 유의수준보다 크게 나타나지만 순열 검증의 1 종 오류율은 적절하게 통제된다는 것을 증명하는 것이다. 몬테 카를로 연구를 이용하여 30 Hz, 10 Hz, 또는 5 Hz 저역통과필터를 사용하는 경우와 P300 정점 또는 100 ms 구간의 P300 평균전위를 사용하는 경우에 부트스트랩 방법과 순열 검증의 1 종 오류율과 통계적 검증력을 산출하였다. 연구 결과, 저역통과필터를 사용하거나 100 ms 구간의 P300 평균전위를 사용하여도 관련자극의 P300 진폭이 과대추정되는 정도가 무관련자극의 P300 진폭이 과대추정되는 정도보다 약 1 ㎶ 이상 더 컸다. 이로 인하여 부트스트랩 방법의 1 종 오류율은 유의수준보다 더 높게 나타났다. 그러나 순열 검증의 1 종 오류율은 유의수준과 동일하였다. 순열 검증의 검증력은 5 Hz의 저역통과필터를 사용하고 100 ms 구간의 P300 평균전위를 사용하는 경우에 가장 높았다. 본 연구결과는 P300 숨긴정보검사 뿐만 아니라 시행수가 서로 다른 자극의 P300 진폭을 비교하는 모든 경우에도 활용될 수 있을 것이다.

Results of Radiation Therapy for Squamous Cell Carcinoma of the Esophagus

전하정,이명자 대한방사선종양학회 2009 Radiation Oncology Journal Vol.27 No.1

Purpose: This study was designed to evaluate the effectiveness and prognostic factors for patients treated with postoperative radiation therapy following surgery or with radiation therapy alone for squamous cell carcinoma of the esophagus. Materials and Methods: We retrospectively analyzed 132 esophageal cancer patients treated with postoperative radiation therapy following surgery or patients who were treated with radiation therapy alone at our institution from 1989 to 2006. Thirty-five patients had stage II disease, 88 patients had stage III disease and nine patients had stage IV disease. Tumors were located at the upper esophagus in 18 patients, the mid esophagus in 81 patients and the distal esophagus in 33 patients. Sixty patients were treated with radiation therapy alone and 72 patients were treated with postoperative radiation therapy following surgery. Eight patients received a dose less than 40 Gy and 78 patients received a dose of 40 to 50 Gy. The remaining 46 patients received a dose of 50 to 60 Gy. The majority of patients who underwent postoperative radiation therapy received a dose of 45 Gy. Results: Actuarial survival rates for all of the patients at two years and five years were 24% and 5%, respectively. The median survival time was 11 months. Survival rates for patients who underwent postoperative RT at two years and five years were 29% and 8%, respectively. The corresponding survival rates for patients who received radiation alone were 18% and 2%, respectively. Survival rates at two years and five years were 43% and 15% for stage II disease, 22% and 2% for stage III disease and 0% and 0% for stage IV disease, respectively; these findings were statistically significant. Two-year survival rates for patients with upper, middle and distal esophageal cancer were 19, 29% and 22%, respectively. Although there was a trend of slightly better survival for middle esophageal tumors, this finding was not statistically significant. Complete response to radiation was achieved in 13 patients (22%) and partial response to radiation was achieved in 40 patients (67%) who received radiation alone. No response to radiation was noted in seven patients (12%). A statistically significant difference in survival rates was seen between patients that had a complete response and patients that had a partial response. Two-year survival rates for patients that had a complete response versus patients that had a partial response were 31% and 17%, respectively. There were no survivors for patients with no response as determined at two-year follow-up. Conclusion: We conclude that radiation therapy is an effective treatment for esophageal cancer. Stage and response to radiation therapy were noted to be prognostic factors. A more effective treatment modality is needed to improve long term survival because of the relatively dismal prognosis for this tumor

Terra 및 Aqua MODIS 위성자료를 활용한 동남아시아의 AOD 특징 분석

전하정,이나현,구자호,박상서 한국기상학회 2023 한국기상학회 학술대회 논문집 Vol.2023 No.11

Terra 및 Aqua MODIS 위성자료를 활용한 동남아시아의 AOD 특징 분석

전하정,이나현,구자호,박상서 한국기상학회 2023 한국기상학회 학술대회 논문집 Vol.2023 No.10

간외 담도계암에서 방사선치료의 역할

전하정,이명자 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.2

The purpose of this study is to evaluate the effectiveness and tolerance of external beam radiotherapy for carcinoma of the extrahepatic biliary system(EHBS) including gallbladder (GB) and extrahepatic bile ducts (EHBD) and to define the role of radiotherapy for theses tumors. We retrospectively analyzed the records of 64 patients with carcinoma of the EHBS treated with external beam radiotherapy at our institution between April, 1986 and July, 1999. Thity four patients had GB cancers and remaining 30 patients did EHBD cancers. Of those 34 GB cancers, 3 had Stage Ⅱ, 18 did Stage Ⅲ and 13 did Stage Ⅳ disease, respectively. Male to female ratio was 16 to 18. Twenty two patients underwent radical surgery with cuartive intent and 12 patients did biopsy and bypass surgery alone. All of these patients except for 5 patients were treated with 4500 cGy or higher doses postoperatively. Follow up periods ranged from 11 to 92 months. Of those 20 EHBD cancers, one had Stage Ⅰ, 3 did StageⅡ, 15 did StageⅢ and 11 did Stage Ⅳ disease, respectively. Male to fecale ratio was 24 to 6. Twenty four patients underwent Whipple's procedure or resection and drainage with curative aim and remaing 6 patients did bypass surgery alone. Postoperatively 24 patients were irradiated with 4500 cGy or higher doses and 6 patients with 3180 to 4140 cGy. Follow up periods ranged from 8 to 62 months. Overall median survival time of patients with GB cancer was 12 months. Median survival time for patients with Stage Ⅲ and Ⅳ disease were 14 months and 5 months, respectively. Corresponding two year survival rates were 31% and 17%, respectively. Those who underwent surgery with curative intent showed significantly better survival at 12 months than those who underwent bypass surgery alone(65% vs 14%). None of the patients died of treatment related complications. Median survival time for entire group of 30 patients with EHBD cancers was 10 months. Median survival time for 15 Stage Ⅲ disease and 11 Stage Ⅳ disease were 10 and 7 months, respectively. Survival rates at 9 month for patients treated with radical surgery and bypass alone were 63% and 0%, respectively. Postoperative external beam radiotherapy for carcinoma of the extrahepatic biliary system is well tolerated and might improve survival of patients, especially those with resectable lesions with microscopic or gross residual disease after surgery.