322 results on '"Il Han Kim"'
Search Results
2. Supplementary Data from Targeting Epidermal Growth Factor Receptor–Associated Signaling Pathways in Non–Small Cell Lung Cancer Cells: Implication in Radiation Response
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In Ah Kim, Il Han Kim, Jae Sung Kim, Hong Gyun Wu, So Yeon Kim, Yun Kyeong Ryu, and Eun Jung Choi
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Supplementary Figures S1-S2.
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- 2023
3. Data from Histone Deacetylase Inhibitor–Mediated Radiosensitization of Human Cancer Cells: Class Differences and the Potential Influence of p53
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Gary D. Kao, Charn Il Park, Sung Whan Ha, Eui Kyu Chie, Hong Gyun Wu, Jae Sung Kim, Jin Ho Kim, Il Han Kim, Jin Hee Shin, and In Ah Kim
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Histone deacetylase inhibitors (HDI) are emerging as potentially useful components of the anticancer armamentarium and as useful tools to dissect mechanistic pathways. HDIs that globally inhibit histone deacetylases (HDAC) have radiosensitizing effects, but the relative contribution of specific HDAC classes remains unclear. Newly characterized HDIs are now available that preferentially inhibit specific HDAC classes, including SK7041 (inhibits class I HDACs) and splitomicin (inhibits class III HDACs). We investigated in human cancer cells the relative radiosensitizations that result from blocking specific HDAC classes. We found that trichostatin A (TSA; inhibitor of both class I and II HDACs) was the most effective radiosensitizer, followed by the class I inhibitor SK7041, whereas splitomicin (inhibitor of class III) had least effect. Interestingly, radiosensitization by TSA in cell lines expressing p53 was more pronounced than in isogenic lines lacking p53. Radiosensitization of cells expressing p53 by TSA was reduced by pifithrin-α, a small-molecule inhibitor of p53. In contrast, the radiosensitization by TSA of cells expressing low levels of p53 was enhanced by transfection of wild-type p53–expressing vector or pretreatment with leptomycin B, an inhibitor of nuclear export that increased intracellular levels of p53. These effects on radiosensitization were respectively muted or not seen in cells treated with SK7041 or splitomicin. To our knowledge, this may be among the first systematic investigations of the comparative anticancer effects of inhibiting specific classes of HDACs, with results suggesting differences in the degrees of radiosensitization, which in some cell lines may be influenced by p53 expression.
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- 2023
4. Supplementary Figures 1-2 from Histone Deacetylase Inhibitor–Mediated Radiosensitization of Human Cancer Cells: Class Differences and the Potential Influence of p53
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Gary D. Kao, Charn Il Park, Sung Whan Ha, Eui Kyu Chie, Hong Gyun Wu, Jae Sung Kim, Jin Ho Kim, Il Han Kim, Jin Hee Shin, and In Ah Kim
- Abstract
Supplementary Figures 1-2 from Histone Deacetylase Inhibitor–Mediated Radiosensitization of Human Cancer Cells: Class Differences and the Potential Influence of p53
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- 2023
5. Long-term outcomes of low-dose radiotherapy in Kasabach-Merritt syndrome
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Dowook Kim, Jung Yoon Choi, Kyung Taek Hong, Hyoung Jin Kang, Il Han Kim, and Joo Ho Lee
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Oncology ,Radiology, Nuclear Medicine and imaging - Abstract
Purpose: Reports on results of radiation therapy (RT) for Kasabach-Merritt syndrome (KMS) are limited. We performed a retrospective study to evaluate the response rates and late complications and to determine the adequate RT dose for patients with KMS patients.Materials and Methods: We studied 11 patients who received RT between October 1988 and September 2008 for KMS refractory to pharmacologic therapy. All patients had external hemangiomas and received the diagnosis of KMS within 12 months of birth. All 11 patients received steroids as the first-line therapy; eight patients additionally received interferon-α therapy, and one patient underwent surgery. Nine patients underwent single-course RT with a total dose of 4.5–8 Gy (1.5–2 Gy/fraction). Two patients received multiple courses of RT, with a cumulative total dose of 12 Gy (2 Gy/fraction) and 18Gy (1.5 Gy/fraction), respectively.Results: The median follow-up period was 156 months (interquartile range [IQR], 75 to 226 months). The median total dose of RT was 6 Gy, and all patients maintained complete remission until the last follow-up. An additional course of RT was performed for refractory cases or cases of local relapse after initial RT. Rapid platelet count increase after RT was seen in most patients, which returned to normalcy in a median of 20 days (IQR, 5 to 178 days). However, seven patients experienced radiation-related long-term complications.Conclusion: Low-dose RT is effective and yields rapid response in patients with KMS. However, given growth-related late complications, RT should be carefully considered.
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- 2022
6. Risk Stratification to Define the Role of Radiotherapy for Benign and Atypical Meningioma: A Recursive Partitioning Analysis
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Won Ick, Chang, Il-Han, Kim, Seung Hong, Choi, Tae Min, Kim, Soon-Tae, Lee, Jae Kyung, Won, Sung-Hye, Park, Min-Sung, Kim, Jin Wook, Kim, Yong Hwy, Kim, Chul-Kee, Park, and Joo Ho, Lee
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Meningeal Neoplasms ,Humans ,Radiotherapy, Adjuvant ,Surgery ,Neurology (clinical) ,Neoplasm Recurrence, Local ,Meningioma ,Prognosis ,Risk Assessment ,Retrospective Studies - Abstract
The role of adjuvant radiotherapy (RT) for benign or atypical meningioma is controversial.To identify prognostic factors and a subgroup that could be potentially indicated for adjuvant RT.A total of 336 patients with benign and 157 patients with atypical meningioma underwent surgical resection between January 2015 and December 2019. We retrospectively analyzed 407 patients who did not receive adjuvant RT to stratify risk groups for recurrence. A recursive partitioning analysis (RPA) with the prognostic factors for their failure-free survival (FFS) divided the patients into risk groups.The 3-year FFS with surgical resection only was 76.5%. Identified prognostic factors for FFS were skull base location, tumor size, brain invasion, a Ki-67 proliferation index of ≥5%, and subtotal resection. The RPA-classified patients were divided into 4 risk groups: very low, low, intermediate, and high, and their 3-year FFS were 98.9%, 78.5%, 59.8%, and 34.2%, respectively. Intermediate-risk and high-risk groups comprise the patients with meningioma of sizes ≥2 cm after subtotal resection or meningioma of sizes3 cm, located in the skull base or with brain invasion, respectively. After combining with patients treated with adjuvant RT, no FFS benefit was found in the very low-risk and low-risk groups after adjuvant RT, whereas significantly improved FFS was found in the intermediate-risk and high-risk groups (P.05).The RPA classification revealed a subgroup of patients who could be potentially indicated for adjuvant RT even after gross total resection or for whom adjuvant RT could be deferred.
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- 2022
7. The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-institutional Retrospective Study (KROG 18-11)
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Su Jeong Kang, Jong Hee Chang, Il Han Kim, In Ah Kim, Chang Ok Suh, Chan Woo Wee, Joo Ho Lee, Chul-Kee Park, Jung Ho Im, Do Hoon Lim, Sung Hwan Kim, Hong In Yoon, Jinhee Kim, Seung Hyuck Jeon, and Sung Hye Park
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Adult ,Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Solitary fibrous tumor ,Multivariate analysis ,Adolescent ,medicine.medical_treatment ,Urology ,Postoperative radiotherapy ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Port (medical) ,medicine ,Humans ,Postoperative ,Child ,Margin ,Aged ,Retrospective Studies ,Postoperative Care ,Hemangiopericytoma ,Radiotherapy ,Brain Neoplasms ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Intracranial ,Progression-Free Survival ,CNS cancer ,Radiation therapy ,030104 developmental biology ,Oncology ,Multicenter study ,Solitary Fibrous Tumors ,030220 oncology & carcinogenesis ,Original Article ,Female ,business - Abstract
Purpose This study aimed to evaluate the role of postoperative radiotherapy (PORT) in intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).Materials and Methods A total of 133 patients with histologically confirmed HPC were included from eight institutions. Gross total resection (GTR) and subtotal resection (STR) were performed in 86 and 47 patients, respectively. PORT was performed in 85 patients (64%). The prognostic effects of sex, age, performance, World Health Organization (WHO) grade, location, size, Ki-67, surgical extent, and PORT on local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were estimated by univariate and multivariate analyses.Results The 10-year PFS, and OS rates were 45%, and 71%, respectively. The multivariate analysis suggested that PORT significantly improved LC (p < 0.001) and PFS (p < 0.001). The PFS benefit of PORT was maintained in the subgroup of GTR (p=0.001), WHO grade II (p=0.001), or STR (p < 0.001). In the favorable subgroup of GTR and WHO grade II, PORT was also significantly related to better PFS (p=0.028). WHO grade III was significantly associated with poor DMFS (p=0.029). In the PORT subgroup, the 0-0.5 cm margin of the target volume showed an inferior LC to a large margin with 1.0-2.0 cm (p=0.021). Time-dependent Cox proportion analysis showed that distant failures were significantly associated with poor OS (p=0.003).Conclusion This multicenter study supports the role of PORT in disease control of intracranial SFT/HPC, irrespective of the surgical extent and grade. For LC, PORT should enclose the tumor bed with sufficient margin.
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- 2022
8. Outcomes of intracranial germinoma—A retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies
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Kyung-Nam Koh, Ru Xin Wong, Dong-Eun Lee, Jung Woo Han, Hwa Kyung Byun, Hong In Yoon, Dong-Seok Kim, Chuhl Joo Lyu, Hyoung Jin Kang, Kyung Taek Hong, Joo Ho Lee, Il Han Kim, Ji Hoon Phi, Seung-Ki Kim, Tai-Tong Wong, Hsin-Lun Lee, I-Chun Lai, Yu-Mei Kang, Young-Shin Ra, Seung Do Ahn, Ho Joon Im, Wen Shen Looi, Sharon Yin Yee Low, Enrica Ee Kar Tan, Hyun Jin Park, Sang Hoon Shin, Hiroshi Fuji, Chang-Ok Suh, Yi-Wei Chen, and Joo-Young Kim
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Salvage Therapy ,Cancer Research ,Oncology ,Brain Neoplasms ,Clinical Investigations ,Humans ,Germinoma ,Neurology (clinical) ,Pineal Gland ,Retrospective Studies - Abstract
Background This multinational study was conducted to report clinical presentations and treatment strategies in patients with intracranial germinomas across selected Asian centers, including failure patterns, risk factors, and outcomes. Methods A retrospective data collection and analysis of these patients, treated between 1995 and 2015 from eight healthcare institutions across four countries was undertaken. Results From the results, 418 patients were analyzed, with a median follow-up of 8.9 years; 79.9% of the patients were M0, and 87.6% had β-human chorionic gonadotropin values Conclusions Survival outcomes of patients with germinoma were excellent. Thus, the focus of treatment for intracranial germinoma should be on survivorship. Further studies are warranted to find the optimal intensity and volume of radiation, including the role of chemotherapy in the survival of patients with intracranial germinomas, considering age, primary tumor location, and extent of disease.
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- 2021
9. Long-Term Outcomes and Sequelae Analysis of Intracranial Germinoma: Need to Reduce the Extended-Field Radiotherapy Volume and Dose to Minimize Late Sequelae
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Kyung Taek Hong, Tae Min Kim, Hee Young Shin, Seung Hong Choi, Byung Kyu Cho, Kyu-Chang Wang, Seung-Ki Kim, Sung Hye Park, Joo Ho Lee, Keun Yong Eom, Soon-Tae Lee, Ji Hoon Phi, Hyoung Jin Kang, Chul-Kee Park, Dae Seog Heo, Jung Yoon Choi, and Il Han Kim
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Radiation toxicity ,Young Adult ,Intracranial Germinoma ,medicine ,Long term outcomes ,Radiation-induced neoplasms ,Humans ,Child ,Retrospective Studies ,Chemotherapy ,Radiotherapy ,Germinoma ,Brain Neoplasms ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Remission Induction ,Radiotherapy Dosage ,Middle Aged ,Prognosis ,medicine.disease ,CNS cancer ,Survival Rate ,Extended field radiotherapy ,Radiation therapy ,Oncology ,Child, Preschool ,Original Article ,Female ,Radiology ,Radiation-induced cancer ,business ,Craniospinal ,Follow-Up Studies - Abstract
Purpose We aimed to refine the radiotherapy (RT) volume and dose for intracranial germinoma considering recurrences and long-term toxicities.Materials and Methods Total 189 patients with intracranial germinoma were treated with RT alone (n=50) and RT with upfront chemotherapy (CRT) (n=139). All cases were confirmed histologically. RT fields comprised the extended-field and involved-field only for primary site. The extended-field, including craniospinal, whole brain (WB), and whole ventricle (WV) for cranial field, is followed by involved-field boost. The median follow-up duration was 115 months.Results The relapses developed in 13 patients (6.9%). For the extended-field, cranial RT dose down to 18 Gy exhibited no cranial recurrence in 34 patients. In CRT, 74 patients (56.5%) showed complete response to chemotherapy and no involved-field recurrence with low-dose RT of 30 Gy. WV RT with chemotherapy for the basal ganglia or thalamus germinoma showed no recurrence. Secondary malignancy developed in 10 patients (5.3%) with a latency of 20 years (range, 4 to 26 years) and caused mortalities in six. WB or craniospinal field rather than WV or involved-field significantly increased the rate of hormone deficiencies, and secondary malignancy. RT dose for extended-field correlated significantly with the rate of hormone deficiencies, secondary malignancy, and neurocognitive dysfunction.Conclusion De-intensifying extended-field rather than involved-field or total scheme of RT will be critical to decrease the late toxicities. Upfront chemotherapy could be beneficial for the patients with complete response to minimize the RT dose down to 30 Gy. Prospective trials focused on de-intensification of the extended-field RT are warranted.
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- 2021
10. Feasibility of low-dose radiotherapy for patients with stage I/II extranodal NK
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Jae Sik, Kim, Noorie, Choi, Il Han, Kim, Tae Min, Kim, Yoon Kyung, Jeon, and Ji Hyun, Chang
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To assess treatment outcomes in patients with stage I/II extranodal NK-/Between 1992 and 2018, 76 patients with early-stage ENKTCL-NT who achieved CR or partial response (PR) after induction chemotherapy received adjuvant RT. RT doses (using biologically equivalent doses in 2 Gy fractions [EQD2]) and rates of local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and cancer-specific survival (CSS) were determined.Median follow-up was 5.1 years (range, 0.5-20.8). The median RT dose was 45 Gy (range, 20-54). The 5-year LRFS, LRRFS, DMFS, PFS, and CSS rates were 82.7 %, 78.2 %, 81.1 %, 68.7 %, and 84.4 %, respectively. CR after induction chemotherapy was notably linked to better survival outcomes across each endpoint. Survival outcomes were not affected either by the administration of l-ASP or EQD2 40 Gy in patients displaying CR after l-ASP. Adverse events (AEs) ≥ Grade 2 were significantly reduced with EQD2 40 Gy, compared with EQD2 ≥ 40 Gy.Achieving CR after chemotherapy was the most predictive factor of survival outcomes in early-stage ENKTCL-NT. Decreasing RT doses in patients with CR after l-ASP appeared to minimize the occurrence of AE without compromising LRR risk; however, longer follow-ups and cautious application are warranted.
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- 2022
11. Adjuvant Radiotherapy Versus Surveillance for Grade 2 Intracranial Meningiomas: A Multi-Institutional Propensity Score-Matched Study
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Hwa Kyung Byun, Won Ick Chang, Joo Ho Lee, Chul-Kee Park, In Ah Kim, Chae-Yong Kim, Jaeho Cho, Eui Hyun Kim, Jong Hee Chang, Seok-Gu Kang, Ju Hyung Moon, Sang Hyung Lee, Jason Joon Bock Lee, Il Han Kim, Chang-Ok Suh, Chan Woo Wee, and Hong In Yoon
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Cancer Research ,Oncology - Abstract
PurposeWe aimed to compare the outcomes of adjuvant radiotherapy (ART) and surveillance in patients with grade 2 meningiomas (MNG2) who underwent surgical resection.Materials and MethodsData from four hospitals, in which patients aged ≥18 years underwent Simpson grade 1−4 surgical resection for newly diagnosed MNG2 between 1998 and 2018, were examined in this multicenter retrospective cohort study. Patients receiving ART with conventional fractionation were compared with those undergoing surveillance. Progression-free survival (PFS), progression/recurrence (P/R) were evaluated.ResultsThis study included 518 patients, 158 of whom received ART. The median follow-up duration was 64.9 months. In the total cohort, ART was independently associated with significantly improved PFS (HR, 0.35; 95% CI, 0.23–0.55; PConclusionsART significantly improved PFS and P/R in patients with MNG2, irrespective of the surgical extent, and can be recommended after gross total resection. A prognostic model may guide decision-making for the use of ART.
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- 2022
12. Outcomes of intracranial germinoma—a retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies
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Kyung-Nam Koh, Ru Xin Wong, Dong-Eun Lee, Jung Woo Han, Hwa Kyung Byun, Hong In Yoon, Dong-Seok Kim, Hyoung Jin Kang, Joo Ho Lee, Il Han Kim, Seung-Ki Kim, Tai-Tong Wong, Hsin-Lun Lee, Young-Shin Ra, Wen Shen Looi, Enrica Ee Kar Tan, Hiroshi Fuji, Chang-Ok Suh, Yi-Wei Chen, and Joo-Young Kim
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- 2022
13. Adjuvant radiotherapy versus surveillance for grade 2 intracranial meningiomas: a multicenter study
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Chan Woo Wee, Hwa Kyung Byun, Won Ick Chang, Il Han Kim, Joo Ho Lee, Chul-Kee Park, In Ah Kim, Chae-Yong Kim, Chang-Ok Suh, Jaeho Cho, Eui Hyun Kim, Jong Hee Chang, Seok-Gu Kang, Ju Hyung Moon, and Hong In Yoon
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- 2022
14. Different radiation responses induced by acquired gefitinib resistance in a non-small-cell lung cancer cell line
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Jinwook Kim, Tamrin Chowdhury, Hyojung Park, Sojin Kim, Chae Eun Lee, Chul-Kee Park, Jin Ho Kim, Il Han Kim, Bhumsuk Kim, Tae Min Kim, Ja-Lok Ku, and Ji Yeoun Lee
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- 2022
15. Interim Tumor Progression and Volumetric Changes of Surgical Cavities during the Surgery-to-Radiotherapy Interval in Anaplastic Gliomas: Implications for Additional Pre-radiotherapy Magnetic Resonance Imaging
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Chan Woo Wee, Jin Wook Kim, Chul-Kee Park, and Il Han Kim
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Radiosurgery ,Anaplastic glioma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Interim progression ,Biopsy ,Humans ,Medicine ,Radiation oncologist ,Aged ,Radiotherapy ,medicine.diagnostic_test ,Brain Neoplasms ,business.industry ,Incidence (epidemiology) ,Magnetic resonance imaging ,Glioma ,Middle Aged ,Magnetic Resonance Imaging ,Confidence interval ,Surgery ,Radiation therapy ,Oncology ,Tumor progression ,030220 oncology & carcinogenesis ,Disease Progression ,Surgical cavity ,Female ,Original Article ,business ,030217 neurology & neurosurgery - Abstract
PurposeThis study was designed to investigate the incidence of interim disease progression (IPD) and volumetric changes of the surgical cavity (SC) during the surgery-to-radiotherapy interval (SRI), and eventually assess the value of magnetic resonance imaging (MRI) at the time of radiotherapy (RT) planning in newly diagnosed anaplastic gliomas.Materials and MethodsAmong 195 anaplastic glioma patients who underwent RT, 121 were evaluable with two separate MRIs during SRI. The presence of IPD was determined using the updated Response Assessment in Neuro-Oncology size criteria. In 84 patients who underwent surgical resection, each SC was contoured by a radiation oncologist and the volumetric changes of the SCs were calculated between the two separate MRIs. Daily rate of change in the SC volume was calculated assuming an exponential and linear change.ResultsFive of 121 patients (4.13%) demonstrated IPD during SRI, and the incidence was significantly higher in patients undergoing biopsy (vs. surgical resection, 12.9% vs. 1.1%, p=0.015) and in patients with remnant contrast-enhancing tumor after surgery (15.8 vs. 2.0%, p=0.027). The mean daily rate of absolute change in SC was 1.06% (95% confidence interval [CI], 0.89 to 1.23) and 0.89% (95% CI, 0.77 to 1.02) according to the exponential and linear model, respectively. The expected mean volumetric change at 2 weeks were 16.64% (95% CI, 13.77 to 19.52) and 12.51% (95% CI, 10.77 to 14.26), respectively.ConclusionIPD during the SRI is rare in surgically resected anaplastic gliomas. However, pre-RT MRI is essential for accurate RT-target delineation and disease evaluation for patients initiating RT beyond postoperative 2 weeks and undergoing biopsy, respectively.
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- 2020
16. Reduced-dose whole-brain radiotherapy with tumor bed boost after upfront high-dose methotrexate for primary central nervous system lymphoma
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Chul-Kee Park, Joo Ho Lee, Ji Hyun Chang, Tae Hoon Lee, Byoung Hyuck Kim, Tae Min Kim, Chan Woo Wee, Sung-Joon Ye, and Il Han Kim
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Clinical Investigation ,Adverse effect ,Non-Hodgkin lymphoma ,Chemotherapy ,Adverse effects ,business.industry ,Neurotoxicity ,Primary central nervous system lymphoma ,Retrospective cohort study ,medicine.disease ,Primary tumor ,Radiation therapy ,Central nervous system ,Cranial irradiation ,030220 oncology & carcinogenesis ,Original Article ,Methotrexate ,business ,medicine.drug - Abstract
Purpose This retrospective study compares higher-dose whole-brain radiotherapy (hdWBRT) with reduced-dose WBRT (rdWBRT) in terms of clinical efficacy and toxicity profile in patients treated for primary central nervous system lymphoma (PCNSL). Materials and methods Radiotherapy followed by high-dose methotrexate (HD-MTX)-based chemotherapy was administered to immunocompetent patients with histologically confirmed PCNSL between 2000 and 2016. Response to chemotherapy was taken into account when prescribing the radiation dose to the whole brain and primary tumor bed. The whole brain dose was ≤23.4 Gy for rdWBRT (n = 20) and >23.4 Gy for hdWBRT (n = 68). Patients manifesting cognitive disturbance, memory impairment and dysarthria were considered to have neurotoxicity. A median follow-up was 3.62 years. Results The 3-year overall survival (OS) and progression-free survival (PFS) were 70.0% and 48.9% with rdWBRT, and 63.2% and 43.2% with hdWBRT. The 3-year OS and PFS among patients with partial response (n = 45) after chemotherapy were 77.8% and 53.3% with rdWBRT, and 58.3% and 45.8% with hdWBRT (p > 0.05). Among patients with complete response achieved during follow-up, the 3-year freedom from neurotoxicity (FFNT) rate was 94.1% with rdWBRT and 62.4% with hdWBRT. Among patients aged ≥60 years, the 3-year FFNT rate was 87.5% with rdWBRT and 39.1% with hdWBRT (p = 0.49). Neurotoxicity was not observed after rdWBRT in patients aged below 60 years. Conclusion rdWBRT with tumor bed boost combined with upfront HD-MTX is less neurotoxic and results in effective survival as higher-dose radiotherapy even in partial response after chemotherapy.
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- 2020
17. Suggestions for Escaping the Dark Ages for Pediatric Diffuse Intrinsic Pontine Glioma Treated with Radiotherapy: Analysis of Prognostic Factors from the National Multicenter Study
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Hyun Ju Kim, Joo Ho Lee, Youngkyong Kim, Do Hoon Lim, Shin-Hyung Park, Seung Do Ahn, In Ah Kim, Jung Ho Im, Jae Wook Chung, Joo-Young Kim, Il Han Kim, Chang-Ok Suh, and Hong In Yoon
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Cancer Research ,Oncology - Abstract
Purpose This multicenter retrospective study aimed to investigate prognostic factors for survival, encompassing clinical and radiologic features and treatments, in newly diagnosed diffuse intrinsic pontine glioma (DIPG) patients treated with radiotherapy. Methods Patients
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- 2021
18. RADT-32. ADJUVANT RADIOTHERAPY VERSUS SURVEILLANCE FOR GRADE 2 INTRACRANIAL MENINGIOMAS: A MULTICENTER STUDY
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Hwa Kyung Byun, Won Ick Chang, Il Han Kim, Joo Ho Lee, Chul-Kee Park, In Ah Kim, Chae-Yong Kim, Chang-Ok Suh, Jaeho Cho, Eui Hyun Kim, Jong Hee Chang, Seok-Gu Kang, Ju Hyung Moon, Hong In Yoon, and Chan Woo Wee
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Cancer Research ,Oncology ,Neurology (clinical) - Abstract
BACKGROUND To compare the outcomes between adjuvant radiotherapy (ART) and surveillance in patients with grade 2 intracranial meningiomas (MNG2s) after surgical resection.Materials and METHODS This multicenter study included 518 patients with newly diagnosed MNG2 who underwent resection between 1998–2018. Patients receiving ART with conventional fractionation (n = 158) were compared with those undergoing surveillance (n = 360). Progression-free survival (PFS) and progression/recurrence (P/R) rates were evaluated. Propensity score matching was performed to adjust for covariables (n = 43 in each group). RESULTS The median follow-up was 64.9 months. The median ART dose was 60 Gy in 30 fractions. Patients receiving ART had larger tumors (median, 5.0 vs. 4.5 cm, P < 0.001) and less frequent gross total resection (69.6% vs. 85.3%, P < 0.001). In multivariable analysis, ART was associated with significantly improved PFS (HR, 0.34; 95% CI, 0.22–0.53; P< 0.001) and P/R (HR, 0.29; 95% CI, 0.18–0.46; P< 0.001). In the propensity score matched cohort, the 5-year PFS rates were 80.8% vs 57.7% (P = 0.020) in the ART and surveillance group, respectively. Even in patients receiving gross total resection, the 5-year PFS (85.0% vs. 64.7%; HR, 0.50; 95% CI, 0.27–0.91; P = 0.023) and P/R rates (15.2% vs. 32.0%; HR, 0.50; 95% CI, 0.25–0.96; P = 0.038) were significantly improved by ART. Using recursive partitioning analysis in patients undergoing surveillance, we classified patients to low-, intermediate-, or high-risk of P/R based on surgical extent, tumor size, and Ki-67 index. The 5-year P/R rates in the low-, intermediate-, and high-risk groups were 18.6%, 37.9%, and 65.3%, respectively. CONCLUSION ART significantly improved PFS and P/R in MNG2s irrespective of surgical extent and should be recommended after both gross total and partial resection. A recursive partitioning analysis model for P/R may guide clinicians for decision making in resected MNG2s.
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- 2022
19. Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma: Prospective multicenter cohort study
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Chang Ok Suh, Hyeon Jin Park, Keon Hee Yoo, Kyung Duk Park, Dong Seok Kim, Dong Soo Lee, Il Han Kim, Joo Young Kim, Jung Woo Han, Nack Gyun Chung, and Do Hoon Lim
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medicine.medical_specialty ,Chemotherapy ,Germinoma ,business.industry ,medicine.medical_treatment ,Retrospective cohort study ,Hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Disseminated disease ,Radiology ,Prospective cohort study ,business ,Survival rate ,Neoadjuvant therapy - Abstract
Purpose To assess the efficacy of upfront chemotherapy followed by response-adapted reduced-dose/reduced-volume radiotherapy (RT) for intracranial germinoma. Materials and methods Ninety-one patients from five institutions were registered in the KSPNO G051/G081 Protocol. Germinomas were classified as solitary or multiple/disseminated diseases, and upfront chemotherapy was administered. For all patients with multiple or disseminated disease, and patients with partial response after chemotherapy, 19.5–24 Gy of craniospinal irradiation plus 10.8–19.8 Gy of tumor bed boost were planned. For patients with complete response (CR), reduced-dose RT (30.6 Gy) was planned, along with a reduced field for solitary lesions. Results The median patient age was 14 (range, 3–30) years. Sixty-five patients (71.4%) had a solitary lesion. The median follow-up duration was 67.9 (range, 6.6–119.3) months. Recurrence was not observed in 32 patients in the protocol compliant group. Four patients (4.4%) in the protocol non-compliant group experienced relapse after CR and one patient died of the disease. The 5-year and 7-year overall survival rates were 98.8% and 98.8%, while the corresponding event-free survival rates were 96.6% and 93.8%, respectively. All three patients with basal ganglia germinomas who were treated with local RT experienced recurrence outside the RT field. Among the 23 patients with pineal or suprasellar lesions who received whole-ventricle RT, there was no recurrence. Conclusions Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.
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- 2019
20. Cumulative Light Intensity of Automotive Glass: A Comparative Study on Combination of Optical Filter for Accelerated Weathering Test
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Il Han Kim, Chang Hwan Kim, In-Soo Han, and Eun Hee Jo
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Sunlight ,Spectral power distribution ,business.industry ,020209 energy ,Automotive industry ,Weathering ,02 engineering and technology ,Test method ,Light intensity ,020303 mechanical engineering & transports ,0203 mechanical engineering ,Automotive Engineering ,0202 electrical engineering, electronic engineering, information engineering ,Curve fitting ,Environmental science ,Optical filter ,business ,Remote sensing - Abstract
The aim of this study was to establish a test method with improved reliability and reproducibility for the accelerated weathering test of automotive interior materials. For this purpose, this study measured the spectral power distribution (SPD) of the glass used in actual vehicles in the oceanic climate region of South Korea (Seosan) and in the desert climate region of North America (California Proving Ground). In addition, the SPD was measured according to the position of automotive interior parts, and cumulative light intensity was calculated using the curve fitting method. Results showed that the measured light intensity varied according to the position of interior parts because of numerous variables such as the type of glass, angle of sunlight, and frames of vehicles. We investigated the cumulative light intensity of the solar glass used in this study and the glass of other manufacturers, and the obtained data were incorporated into a data base (DB). Understanding the optical characteristics of filters is important accelerated weathering tests (Xenon). Therefore, we compared the SPD and cumulative light intensity of each filter combination and actual automotive glass to confirm the suitability of the filters for weathering tests.
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- 2019
21. Clinical Outcomes of Isolated Regional Lymph Node Recurrence in Patients With Malignant Cutaneous Melanoma
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Byoung Hyuck Kim, Cheol Lee, Young A Kim, Suzy Kim, Il Han Kim, and Jeanny Kwon
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Adult ,Male ,Vascular Endothelial Growth Factor A ,Cancer Research ,medicine.medical_specialty ,Skin Neoplasms ,Time Factors ,Multivariate analysis ,Adolescent ,Databases, Factual ,Gastroenterology ,Young Adult ,Risk Factors ,Internal medicine ,Biomarkers, Tumor ,medicine ,Malignant Cutaneous Melanoma ,Humans ,In patient ,Phosphorylation ,Melanoma ,Lymph node ,First Recurrence ,Aged ,Retrospective Studies ,Patterns of failure ,Ribosomal Protein S6 ,business.industry ,Forkhead Transcription Factors ,General Medicine ,Middle Aged ,medicine.disease ,Progression-Free Survival ,medicine.anatomical_structure ,Oncology ,Lymphatic Metastasis ,Disease Progression ,Lymph Node Excision ,Female ,Lymph ,business ,Proto-Oncogene Proteins c-akt - Abstract
BACKGROUND/AIM Regional lymph node recurrence (RLNR) is the most common pattern of recurrence within 2 years from the diagnosis of patients with non-metastatic malignant cutaneous melanoma. However, isolated RLNR without distant metastasis has been rarely studied. PATIENTS AND METHODS Forty patients with isolated RLNR as a first recurrence were analyzed retrospectively. The clinical outcomes and prognostic impact of clinicopathologic parameters were analyzed. Immunostaining for FOXP3, VEGF, pAKT, and pS6 was also performed. RESULTS The median disease-free interval from first diagnosis to isolated RLNR and post-recurrence recurrence-free survival (pRFS) were 12 months and 7.2 months, respectively. Distant failure was the most common pattern of failure after isolated RLNR (67.5%). The number of initially harvested lymph nodes (LN) >7 and LN ratio >22.2% at the time of recurrence were prognosticators for pRFS in multivariate analysis. None of the tested biomarkers were significantly related to prognosis. The 5-year post-recurrence overall survival rate was 84.9%. CONCLUSION Most patients with isolated RLNR will experience a second failure within months, especially distantly. The number of initially harvested LNs and LN ratio at the time of recurrence could predict pRFS.
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- 2019
22. Clinical observation of lymphopenia in patients with newly diagnosed glioblastoma
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Woo Jin Kim, Il Han Kim, Seung Hong Choi, Tae Min Kim, Soon-Tae Lee, Chan Young Ock, Yun Sik Dho, Chul-Kee Park, and Jin Wook Kim
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,Lymphocyte ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Lymphopenia ,White blood cell ,Internal medicine ,medicine ,Humans ,Clinical significance ,Aged ,Retrospective Studies ,Aged, 80 and over ,Temozolomide ,Brain Neoplasms ,business.industry ,Retrospective cohort study ,Common Terminology Criteria for Adverse Events ,Chemoradiotherapy ,Middle Aged ,Prognosis ,Survival Rate ,Regimen ,medicine.anatomical_structure ,Neurology ,Oncology ,030220 oncology & carcinogenesis ,Absolute neutrophil count ,Female ,Neurology (clinical) ,Glioblastoma ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,medicine.drug - Abstract
Lymphopenia in patients with glioblastoma (GBM) is related to treatment as well as disease progression. This retrospective study investigated the prevalence, influencing factors, recoverability, and clinical significance of lymphopenia in GBM patients treated with concomitant chemoradiotherapy (CCRT). A total of 219 patients with newly diagnosed GBM who had received at least 3 cycles of adjuvant temozolomide (TMZ) followed by CCRT with TMZ were enrolled. Serial data on complete blood cell counts, including differential cell counts, were collected just before a new phase and before every treatment cycle of the regimen. Relationships between white blood cell (WBC) variable changes and treatment modalities as well as survival were analyzed. Lymphopenia was classified using the definition of the Common Terminology Criteria for Adverse Events version 5.0. A total of 92 patients (42.0%) showed decreased levels of lymphocytes (
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- 2019
23. Appraisal of re-irradiation for the recurrent glioblastoma in the era of MGMT promotor methylation
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Il Han Kim
- Subjects
Oncology ,Re-Irradiation ,medicine.medical_specialty ,Methyltransferase ,Temozolomide ,Bevacizumab ,Cumulative dose ,business.industry ,Review Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Tolerability ,030220 oncology & carcinogenesis ,Internal medicine ,Recurrent glioblastoma ,medicine ,Re-irradiation ,Radiology, Nuclear Medicine and imaging ,MGMT ,Adverse effect ,business ,medicine.drug - Abstract
Despite recent innovation in treatment techniques and subsequently improved outcomes, the majority of glioblastoma (GBL) have relapses, especially in locoregional areas. Local re-irradiation (re-RT) has been established as a feasible option for recurrent GBL of all ages with safety, tolerability, and effectiveness both in survival and quality of life regardless of fractionation schedule. To keep adverse effects under acceptable range, cumulative dose limit in equivalent dose at 2 Gy fractions by the linear-quadratic model at α/β = 2 for normal brain tissue (EQD2) with narrow margin should be observed and single/hypofractionated re-RT should be undertaken very carefully to recurrent tumor with large volume or adjacent to the brainstem. Promising outcome of re-operation (re-Op) plus re-RT (re-Op/RT) need to be validated and result from re-RT with temozolomide/bevacizumab (TMZ/BV) or new strategy is expected. Development of new-concept prognostic scoring or risk group is required to select patients properly and make use of predictive biomarkers such as O(6)-methylguanine-DNA methyltransferase (MGMT) promotor methylation that influence outcomes of re-RT, re-Op/RT, or re-RT with TMZ/BV.
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- 2019
24. Survival outcomes after adjuvant radiotherapy for aggressive fibromatosis depend on time frame and nuclear β-catenin
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Hak Jae Kim, Il Han Kim, Kyung Chul Moon, Jae Sik Kim, Me-Yeon Lee, Han-Soo Kim, Seung Geun Song, and Ilkyu Han
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medicine.medical_specialty ,medicine.medical_treatment ,Clinical Investigations ,Aggressive fibromatosis ,Urology ,Beta catenin ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Statistical significance ,medicine ,Radiology, Nuclear Medicine and imaging ,Progression-free survival ,Risk factor ,Univariate analysis ,business.industry ,Retrospective cohort study ,Debulking ,medicine.disease ,Immunohistochemistry ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Original Article ,Adjuvant radiotherapy ,business - Abstract
Purpose To identify prognostic factors influencing progression-free survival (PFS) of aggressive fibromatosis (AF) after postoperative radiotherapy (PORT) and assess correlations between immunohistochemistry (IHC) features of β-catenin/smooth muscle actin (SMA) and PFS. Materials and Methods Records of 37 patients with AF treated by PORT from 1984 to 2015 were retrospectively reviewed. Fifteen patients underwent wide excision for AF and 22 patients received debulking operation. The median total dose of PORT was 59.4 Gy. IHC staining results of β-catenin and SMA were available for 11 and 12 patients, respectively. Results The median follow-up duration was 105.9 months. Five-year PFS rate was 70.9%. Tumor size or margin status was not related to PFS in univariate analysis (p = 0.197 and p = 0.716, respectively). Multivariate analysis showed that increased interval from surgery to PORT (>5.7 weeks) was a marginal risk factor for PFS (p = 0.054). Administration of PORT at the initial diagnosis resulted in significantly improved PFS compared to deferring PORT after recurrence (p = 0.045). Patient with both risk factors of deferring PORT after recurrence and interval from surgery to PORT >5.7 weeks had significantly lower 5-year PFS than patients without risk factor (34.1% vs. 100.0%; p = 0.012). Nuclear β-catenin intensity tended to inversely correlate with 5-year PFS, although it did not reach statistical significance (62.5% at low vs. 100.0% at high; p = 0.260). SMA intensity was not related to PFS (p = 0.700). Conclusion PORT should be performed immediately after surgery irrespective of margin status or tumor size especially in recurrent case. Nuclear β-catenin staining intensity of IHC might correlate with local recurrence.
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- 2019
25. Psammaplin A-Modified Novel Radiosensitizers for Human Lung Cancer and Glioblastoma Cells
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Jin Ho Kim, Soo Youn Suh, Il Han Kim, Eunsook Ma, Chan Woo Wee, Beom Soo Shin, Hyun-Cheol Kang, and Hak Jae Kim
- Subjects
chemistry.chemical_classification ,Radiosensitizer ,Radiation ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Pharmacology ,Dithiothreitol ,chemistry.chemical_compound ,chemistry ,Cell culture ,Cystamine ,Thiol ,Radiology, Nuclear Medicine and imaging ,Clonogenic assay ,Cytotoxicity ,Lead compound - Abstract
Background: Psammaplin A (PsA) is a radiosensitizer whereas its clinical application is hampered by poor bioavailability. This study aimed to synthesize novel radiosensitizers using PsA as the lead compound. Materials and Methods: Eight homodimeric disulfides were synthesized from corresponding acid and cystamine dihydrochloride in N-hydroxysuccinimide and dicyclohexylcarbodiimide coupling conditions. One monomeric thiol analog was obtained by reduction of homodimeric disulfide with dithiothreitol. Clonogenic assay was used to measure cell survival after irradiation and drug treatment in human lung cancer (A549) and glioblastoma (U373MG) cells. Results and Discussion: Using the PsA backbone, nine compounds were synthesized. Eight compounds showed variable cytotoxicity with 50% inhibitory concentrations ranging 16.14 μM to 150.10 μM (A549), and 13.25 μM to 50.15 μM (U373MG). Four and six compounds radiosensitized A549 and U373MG cells, respectively. Two compounds that radiosensitized both cell lines were tested for its inhibitory effects on DNMT1. One of them was shown to significantly inhibit DNMT1 activity. Conclusion: Novel compounds with radiosensitizing activity were synthesized. These compounds have a great potential to serve as a basis for the development of future radiosensitizers. Further investigation is warranted for their clinical application.
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- 2019
26. Newly Synthesized DNA Methyltransferase Inhibitors as Radiosensitizers for Human Lung Cancer and Glioblastoma Cells
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Hak Jae Kim, Il Han Kim, Eunsook Ma, Chan Woo Wee, Hyun-Cheol Kang, Jin Ho Kim, Soo Youn Suh, and Beom Soo Shin
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DNA (Cytosine-5-)-Methyltransferase 1 ,Cancer Research ,Radiosensitizer ,Radiation-Sensitizing Agents ,Lung Neoplasms ,Cell Survival ,DNA Methyltransferase Inhibitor ,Down-Regulation ,DNA methyltransferase ,Pharmacokinetics ,Cell Line, Tumor ,medicine ,Humans ,Enzyme Inhibitors ,Clonogenic assay ,Cytotoxicity ,Lung cancer ,Cell Proliferation ,Molecular Structure ,Chemistry ,Brain Neoplasms ,General Medicine ,Chemoradiotherapy ,medicine.disease ,Gene Expression Regulation, Neoplastic ,Oncology ,A549 Cells ,DNMT1 ,Cancer research ,Glioblastoma - Abstract
BACKGROUND/AIM Improvement of the efficacy of radiotherapy for lung cancer and glioblastoma is urgently needed. MATERIALS AND METHODS We synthesized several novel DNA methyltransferase inhibitors and evaluated their potentials as possible radiosensitizers. Eleven non-nucleoside compounds were synthesized and evaluated along with one known compound using human lung cancer (A549) and glioblastoma (U373MG) cells. Cytotoxicity and radiosensitizing effects were evaluated using clonogenic assay. Sensitizer enhancement ratios at a survival fraction of 0.5 were calculated, and statistical analysis was performed using the ratio paired t-test. The inhibitory effects of three selected compounds on the activity of DNA methyltransferase 1 (DNMT1) and the pharmacokinetic profiles were analyzed. RESULTS All twelve compounds demonstrated various levels of cytotoxicity. Of the twelve compounds, eleven and eight compounds radiosensitized A549 and U373MG cells, respectively, with at least marginal significance (p
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- 2020
27. Time-Sequential Change in Immune-Related Gene Expression After Irradiation in Glioblastoma: Next-Generation Sequencing Analysis
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Kye Hwa Lee, Chul-Kee Park, Hak Jae Kim, Juyeon Yu, Il Han Kim, Kwangsoo Kim, Jin Ho Kim, Soo Yeon Seo, Myung Seon Song, Junjeong Choi, and Yi Jun Kim
- Subjects
Medicine (General) ,Immune-related signals ,QH301-705.5 ,medicine.medical_treatment ,T cell ,Biology ,General Biochemistry, Genetics and Molecular Biology ,R5-920 ,Immune system ,Antigen ,Interferon ,medicine ,Biology (General) ,U87 ,Radiotherapy ,Immunotherapy ,Articles ,medicine.anatomical_structure ,Cell culture ,Cancer cell ,Cancer research ,Next-generation sequencing ,Animal Science and Zoology ,Glioblastoma ,Transcriptome ,medicine.drug ,Research Article - Abstract
The time-sequential change in immune-related gene expression of the glioblastoma cell line after irradiation was evaluated to speculate the effect of combined immunotherapy with radiotherapy. The U373 MG glioblastoma cell line was irradiated with 6 Gy single dose. Next-generation sequencing (NGS) transcriptome data was generated before irradiation (control), and at 6, 24, and 48 hours post-irradiation. Immune-related pathways were analyzed at each time period. The same analyses were also performed for A549 lung cancer and U87 MG glioblastoma cell lines. Western blotting confirmed the programmed death-ligand 1 (PD-L1) expression levels over time. In the U373 MG cell line, neutrophil-mediated immunity, type I interferon signaling, antigen cross-presentation to T cell, and interferon-γ signals began to increase significantly at 24 hours and were upregulated until 48 hours after irradiation. The results were similar to those of the A549 and U87 MG cell lines. Without T cell infiltration, PD-L1 did not increase even with upregulated interferon-γ signaling in cancer cells. In conclusions, In the glioblastoma cell line, immune-related signals were significantly upregulated at 24 hours after irradiation. Therefore, the time interval between daily radiotherapy might not be enough to expect full immune responses by combined immune checkpoint inhibitors and newly infiltrating immune cells after irradiation.
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- 2020
28. Treatment outcome and long-term follow-up of central nervous system germ cell tumor using upfront chemotherapy with subsequent photon or proton radiation therapy: a single tertiary center experience of 127 patients
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Hyoung Jin Kang, Hee Young Shin, Kyung Taek Hong, Ji Hoon Phi, Sung Hye Park, Jung Yoon Choi, Da Hye Lee, Bo Kyung Kim, Seung-Ki Kim, Hong Yul An, Il Han Kim, Joo-Young Kim, and Jung Eun Cheon
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Adolescent ,Cyclophosphamide ,medicine.medical_treatment ,lcsh:RC254-282 ,Secondary malignant neoplasm ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Germ cell tumor ,Genetics ,medicine ,Humans ,Child ,Etoposide ,Retrospective Studies ,Chemotherapy ,Germinoma ,Brain Neoplasms ,business.industry ,Neoplasms, Germ Cell and Embryonal ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Intracranial ,Proton therapy ,Carboplatin ,Treatment Outcome ,030104 developmental biology ,chemistry ,Central nervous system ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,Germ cell tumors ,business ,Complication ,Research Article ,Follow-Up Studies ,medicine.drug - Abstract
Background Central nervous system germ cell tumors (CNS GCTs) are a heterogeneous group of brain tumors, which are more common in Asian countries. There have been different therapeutic strategies in treating germinoma and non-germinomatous germ cell tumors (NGGCT), depending on prognosis. Moreover, long-term follow up should be emphasized due to higher late complication rates. Here, we investigated long-term outcomes and complication profiles of 127 CNS GCT patients who received uniform upfront chemotherapy. Methods We retrospectively evaluated outcomes of CNS GCT patients treated in Seoul National University Children’s Hospital from August 2004 to April 2019. Patients were classified as low risk (LR) or high risk (HR) based on pathologic diagnosis and tumor markers. Most patients received upfront systemic chemotherapy with carboplatin, cyclophosphamide, etoposide, and/or bleomycin, followed by either proton or photon radiation therapy according to patients’ choice. Results The median age at diagnosis was 11.9 (range, 3.8–25.1) years, and 54.3% of patients were LR. Photon and proton radiation therapy were administered to 73.2 and 25.2% of patients, respectively. In both LR and HR groups, there were no significant differences in survival between photon and proton radiation therapy. The 10-year relapse incidences were 9.3 and 5.6% in the LR and HR groups, respectively. All recurrences, except one, were local relapse. Six secondary malignancies occurred; the 10-year incidences of secondary malignancy were 2.2 and 7.6% in the LR and HR groups, respectively. The 10-year overall survival rates were 98.3 ± 1.7 and 91.8 ± 3.9% in the LR and HR groups, respectively. In a subgroup analysis of HR group, pathologically diagnosed NGGCT patients (n = 20) showed worse 10-year EFS (65.9 ± 11.9%, p p = 0.024) rates compared to other HR patients who were not pathologically diagnosed or were confirmed as germinoma with elevated tumor markers. All mortalities were related to disease progression or secondary malignancy. Conclusion The strategy of treating CNS GCTs with upfront chemotherapy according to risk groups resulted in good clinical outcomes and acceptable relapse incidence. However, further modification in the definition of the HR group is needed to reduce long-term complications.
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- 2020
29. Machine Learning Model to Predict Pseudoprogression Versus Progression in Glioblastoma Using MRI: A Multi-Institutional Study (KROG 18-07)
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Ju Hye Lee, Kwan Ho Cho, Seung Hong Choi, Do Hoon Lim, Bum Sup Jang, Il Han Kim, S.H. Park, Jinhee Kim, Leonard Sunwoo, Seung Hyuck Jeon, In Ah Kim, Andrew J. Park, and Ji Hyun Chang
- Subjects
Cancer Research ,Computer science ,Calibration (statistics) ,pseudoprogression ,Machine learning ,computer.software_genre ,lcsh:RC254-282 ,Cross-validation ,Article ,03 medical and health sciences ,0302 clinical medicine ,Radiation oncology ,medicine ,Pseudoprogression ,radiotherapy ,business.industry ,Deep learning ,glioblastoma ,Concurrent chemoradiation ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,machine learning ,Oncology ,030220 oncology & carcinogenesis ,Hyperparameter optimization ,Artificial intelligence ,business ,computer ,030217 neurology & neurosurgery ,Glioblastoma - Abstract
Some patients with glioblastoma show a worsening presentation in imaging after concurrent chemoradiation, even when they receive gross total resection. Previously, we showed the feasibility of a machine learning model to predict pseudoprogression (PsPD) versus progressive disease (PD) in glioblastoma patients. The previous model was based on the dataset from two institutions (termed as the Seoul National University Hospital (SNUH) dataset, N = 78). To test this model in a larger dataset, we collected cases from multiple institutions that raised the problem of PsPD vs. PD diagnosis in clinics (Korean Radiation Oncology Group (KROG) dataset, N = 104). The dataset was composed of brain MR images and clinical information. We tested the previous model in the KROG dataset, however, that model showed limited performance. After hyperparameter optimization, we developed a deep learning model based on the whole dataset (N = 182). The 10-fold cross validation revealed that the micro-average area under the precision-recall curve (AUPRC) was 0.86. The calibration model was constructed to estimate the interpretable probability directly from the model output. After calibration, the final model offers clinical probability in a web-user interface.
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- 2020
30. Correction to: Chemoradiation in elderly patients with glioblastoma from the multi‑institutional GBM‑molRPA cohort: is short‑course radiotherapy enough or is it a matter of selection?
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Woong Ki Chung, In Ah Kim, Sung Hwan Kim, Nalee Kim, Chan Woo Wee, Young-Taek Oh, Jong Hee Chang, Chae-Yong Kim, Il Han Kim, Do Hoon Lim, Chang Ok Suh, Do-Hyun Nam, and Chul-Kee Park
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Neuro oncology ,medicine.disease ,Neurology ,Internal medicine ,Cohort ,medicine ,Neurology (clinical) ,business ,Selection (genetic algorithm) ,Short course radiotherapy ,Glioblastoma - Abstract
The name of author Do Hoon Lim was incorrect in the initial online publication. The original article has been corrected.
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- 2020
31. Postoperative radiotherapy for WHO grade II-III intracranial ependymoma in adults: An intergroup collaborative study (KROG 18-06/KNOG 18-01)
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Jong Hee Chang, Kwan Ho Cho, Sung Hwan Kim, Chae-Yong Kim, Tae Young Jung, S.H. Park, Woong Ki Chung, Do-Hyun Nam, Chul-Kee Park, Ho Shin Gwak, Jinhee Kim, Chan Woo Wee, Young Zoon Kim, Woo Chul Kim, In Ah Kim, Chang Ok Suh, Jung Ho Im, Do Hoon Lim, Hong In Yoon, and Il Han Kim
- Subjects
Ependymoma ,Adult ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Postoperative radiotherapy ,World Health Organization ,Gastroenterology ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Hematology ,medicine.disease ,Prognosis ,Primary tumor ,Radiation therapy ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Radiotherapy, Adjuvant ,business ,Adjuvant - Abstract
To evaluate the impact of adjuvant postoperative radiotherapy (PORT) in adult WHO grade II-III intracranial ependymoma (IEPN).A total of 172 pathologically confirmed adult grade II-III IEPN patients from 12 institutions were eligible. Of them, 106 (61.6%) and 66 (38.4%) patients were grade II and III, respectively. For grade II and III IEPNs, 51 (48.1%) and 59 (89.4%) patients received PORT, respectively. The median dose to the primary tumor bed was 54.0 Gy and 59.4 Gy for grade II and III patients, respectively. The prognostic impact of sex, age, performance, WHO grade, location, size, surgical extent, and PORT on local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated by univariate and multivariate analysis.The median follow-up period for survivors was 88.1 months. The 5-/10-year LC, PFS, and OS rates were 64.8%/54.0%, 56.4%/44.8%, and 76.6%/71.0%, respectively. On multivariate analysis, adjuvant PORT significantly improved LC (P = 0.002), PFS (P = 0.002), and OS (P = 0.043). Older age (P 0.001), WHO grade III (P 0.001), larger tumor size (P = 0.004), and lesser surgical extent (P 0.001) were also negative factors for OS. Adjuvant PORT also improved LC (P = 0.010), PFS (P = 0.007), and OS (P = 0.069) on multivariate analysis for grade II IEPNs.This multicenter retrospective study supports the role of adjuvant PORT in terms of disease control and survival in adult grade II-III IEPNs. Prospective randomized trials focused on individualized treatment based on molecular subtypes is warranted.
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- 2020
32. Chemoradiation in elderly patients with glioblastoma from the multi-institutional GBM-molRPA cohort: is short-course radiotherapy enough or is it a matter of selection?
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In Ah Kim, Young-Taek Oh, Chan Woo Wee, Do Hoon Lim, Sung Hwan Kim, Jong Hee Chang, Chae-Yong Kim, Nalee Kim, Il Han Kim, Chang Ok Suh, Chul-Kee Park, Woong Ki Chung, and Do-Hyun Nam
- Subjects
Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Temozolomide ,Humans ,Short course ,Antineoplastic Agents, Alkylating ,Selection (genetic algorithm) ,Short course radiotherapy ,Aged ,Aged, 80 and over ,business.industry ,Brain Neoplasms ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Radiation therapy ,Treatment Outcome ,Neurology ,030220 oncology & carcinogenesis ,Cohort ,Female ,Neurology (clinical) ,business ,Glioblastoma ,030217 neurology & neurosurgery ,MathematicsofComputing_DISCRETEMATHEMATICS - Abstract
The optimal radiotherapy regimen in elderly patients with glioblastoma treated by chemoradiation needs to be addressed. We provide the results of a comparison between conventionally fractionated standard radiotherapy (CRT) and short-course radiotherapy (SRT) in those patients treated by temozolomide-based chemoradiation.Patients aged 65 years or older from the GBM-molRPA cohort were included. Patients who were planned for a ≥ 6-week or ≤ 4-week radiotherapy were regarded as being treated by CRT or SRT, respectively. The median RT dose in the CRT and SRT group was 60 Gy in 30 fractions and 45 Gy in 15 fractions, respectively.A total of 260 and 134 patients aged older than 65 and 70 years were identified, respectively. CRT- and SRT-based chemoradiation was applied for 192 (73.8%) and 68 (26.2%) patients, respectively. Compared to SRT, CRT significantly improved MS from 13.2 to 17.6 months and 13.3 to 16.4 months in patients older than 65 years (P 0.001) and 70 years (P = 0.002), respectively. Statistical significance remained after adjusting for age, performance status, surgical extent, and MGMT promoter methylation in both age groups. The benefit was clear in all subgroup analyses for patients with Karnofsky performance score 70-100, Karnofsky performance score ≤ 60, gross total resection, biopsy, methylated MGMT promoter, and unmethylated MGMT promoter (all P 0.05).CRT significantly improved survival compared to SRT in elderly glioblastoma patients treated with chemoradiation in selected patients amenable for chemoradiation. This study is hypothesis-generating and a prospective randomized trial is urgently warranted.
- Published
- 2020
33. Artifact-free CT images for electron beam therapy using a patient-specific non metallic shield
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Jong In Park, Il Han Kim, Sangmin Lee, and Sung-Joon Ye
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Scanner ,Materials science ,Monte Carlo method ,Biophysics ,General Physics and Astronomy ,Shields ,Electrons ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Radiation Protection ,law ,Shield ,Lens, Crystalline ,Dosimetry ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiation treatment planning ,General Medicine ,Lens (optics) ,Metals ,030220 oncology & carcinogenesis ,Electron Beam Therapy ,Tomography, X-Ray Computed ,Monte Carlo Method ,Biomedical engineering - Abstract
Patient's CT images taken with metallic shields for radiotherapy suffer from artifacts. Furthermore, the treatment planning system (TPS) has a limitation on accurate dose calculations for high density materials. In this study, a Monte Carlo (MC)-based method was developed to accurately evaluate the dosimetric effect of the metallic shield. Two patients with a commercial tungsten shield of lens and two patients with a custom-made lead shield of lip were chosen to produce their non-metallic dummy shields using 3D scanner and printer. With these dummy shields, we generated artifact-free CT images. The maximum CT number allowed in TPS was assigned to metallic shields. MC simulations with real material information were carried out. In addition, clinically relevant dose-volumetric parameters were calculated for the comparison between MC and TPS. Relative dosimetry was performed using radiochromic films. The dose reductions below metallic structures were shown on MC dose distributions, but not evident on TPS dose distributions. The differences in dose-volumetric parameters of PTV between TPS and MC for eye shield cases were not clearly shown. However, the mean dose of lens from TPS and MC was different. The MC results were in superior agreement with measured data in relative dosimetry. The lens dose could be overestimated by TPS. The differences in dose-volumetric parameters of PTV between TPS and MC were generally larger in lip cases than in eye cases. The developed method is useful in predicting the realistic dose distributions around the organs blocked by the metallic shields.
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- 2019
34. Survival gain with re-Op/RT for recurred high-grade gliomas depends upon risk groups
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Jin Wook Kim, Tae Min Kim, Soon-Tae Lee, Seung Hong Choi, Sung Hye Park, Chul-Kee Park, Seok Joo Chun, and Il Han Kim
- Subjects
Adult ,Male ,Reoperation ,Oncology ,Re-Irradiation ,medicine.medical_specialty ,medicine.medical_treatment ,Brain tumor ,Methylation ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Glioma ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Progression-free survival ,Promoter Regions, Genetic ,DNA Modification Methylases ,Aged ,Retrospective Studies ,Chemotherapy ,Brain Neoplasms ,business.industry ,Tumor Suppressor Proteins ,Standard treatment ,Retrospective cohort study ,Hematology ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Radiation therapy ,DNA Repair Enzymes ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Retreatment ,Female ,Radiotherapy, Adjuvant ,Neoplasm Recurrence, Local ,business ,030217 neurology & neurosurgery - Abstract
Introduction A majority of high-grade gliomas relapse despite combined surgery, radiotherapy and chemotherapy. There is no consensus on standard treatment for recurrent high-grade gliomas, or defined efficacy of adjuvant re-RT after re-Op. This retrospective study evaluated the benefit and safety of re-RT after re-Op (re-Op/RT). Materials and methods A total of 84 patients with recurrent high-grade gliomas who underwent reoperation from 2009 to 2015 were analyzed. All patients received neurosurgical intervention and adjuvant radiotherapy previously before recurrence. At recurrence and after reoperation, treatment options were discussed in multidisciplinary clinic or brain tumor joint conference. For re-RT, cumulative EQD2 (equivalent dose in 2 Gy fractions at α/β = 2) was below 106.9 Gy. Result Median progression free survival (PFS) was 6.5 months; 3.5 months with re-Op, 9.0 months with re-Op/RT (p = 0.025). Age 50, WHO grade IV, and unmethylated promoter of MGMT) were significantly associated with poor OS in multivariate analysis. Benefit of re-RT in both OS and PFS was established in patients carrying 2 or more risk factors. During re-RT, 4 patients (8%) had grade 2 or higher toxicity, and 3 patients (6%) did not complete re-RT. No radionecrosis was observed. Conclusion Re-RT after re-Op was tolerable with a cumulative median EQD2 of 99.3 Gy and resulted in clear benefit in PFS and marginal gain in OS. Survival gain with re-Op/RT was more prominent in patients with two or more risk factors (age ≥50, WHO pathologic grade IV, unmethylated MGMT promoter), and needs to be validated.
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- 2018
35. The predictive value of serum myeloma protein in solitary plasmacytoma
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Keun-Yong Eom, Won Ick Chang, Han-Soo Kim, Hyeon Kang Koh, Il Han Kim, and Sung-Soo Yoon
- Subjects
medicine.medical_specialty ,Myeloma protein ,medicine.medical_treatment ,Clinical Investigations ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Risk factor ,Not evaluated ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Area under the curve ,medicine.disease ,Radiation therapy ,Oncology ,030220 oncology & carcinogenesis ,Serum protein electrophoresis ,Plasmacytoma ,Original Article ,business ,Solitary plasmacytoma - Abstract
Purpose To identify the clinical usefulness of serum M protein and to establish a rationale for regular follow-up with serum protein electrophoresis in solitary plasmacytoma. Materials and methods Sixty-nine patients with solitary plasmacytoma and solitary plasmacytoma with minimal marrow involvement according to the International Myeloma Working Group criteria were retrospectively reviewed. Results At a median follow-up of 6.2 years, 5-year local control (LC), 5-year multiple myeloma-free survival (MMFS), 5-year failure-free survival (FFS), and 5-year overall survival (OS) were 82.6%, 44.1%, 41.8%, and 85.1%, respectively. Among the patients whose initial serum M protein was present or not evaluated, 37.3% of patients showed disappearance of serum M protein after various treatment. MMFS of these patients were comparable to non-secretory plasmacytoma with undetectable levels of M protein, and significantly better than patients with persistent M protein. Increase of serum M protein ≥0.1 g/dL was most predictive of treatment failure with area under the curve of 0.731. Conclusion Patients who eventually showed persistence of serum M protein after treatment showed worse MMFS and FFS compared to those whose serum M protein disappeared or who had initially non-secretory disease. The increase of serum M protein level ≥0.1 g/dL from current nadir was predictive of treatment failure. Therefore, regular follow-up with serum M protein is highly recommended especially unless the patient had initially non-secretory disease.
- Published
- 2019
36. Effects of Tumor Microenvironmental Factors on DNA Methylation and Radiation Sensitivity in A549 Human Lung Adenocarcinoma
- Author
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Seoyeon Bok, Jung-Min Oh, Young Eun Kim, Il Han Kim, Hak Jae Kim, Chan-Ju Lee, G-One Ahn, Beom-Ju Hong, Seong-Uk Jeon, and Dong-Young Park
- Subjects
Tumor microenvironment ,Radiation ,Chemistry ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,medicine.disease ,Human lung ,Radiation sensitivity ,medicine.anatomical_structure ,DNA methylation ,Gene expression ,medicine ,Cancer research ,Adenocarcinoma ,Radiology, Nuclear Medicine and imaging ,Radiosensitivity - Published
- 2018
37. Multi-institutional study of treatment patterns in Korean patients with WHO grade II gliomas: KNOG 15-02 and KROG 16-04 intergroup study
- Author
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Young-il Kim, Shin Jung, Sung Hwan Kim, Jeongshim Lee, Woo Chul Kim, Chul-Kee Park, El Kim, Taeryool Koo, Jong Hee Chang, Chae-Yong Kim, Il Han Kim, Hong Seok Jang, Chang-Ki Hong, Eun Young Kim, Ho Shin Gwak, Ik Jae Lee, Jinhee Kim, Yong Kil Hong, In Ah Kim, Semie Hong, Ho Jun Seol, Do Hoon Lim, and Kwan Ho Cho
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Oligoastrocytoma ,medicine.medical_treatment ,Procarbazine ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Practice Patterns, Physicians' ,Aged ,Retrospective Studies ,Cerebral Cortex ,Chemotherapy ,Temozolomide ,Brain Neoplasms ,business.industry ,Glioma ,Lomustine ,Middle Aged ,medicine.disease ,Survival Analysis ,Radiation therapy ,Regimen ,Treatment Outcome ,Neurology ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,Oligodendroglioma ,Neoplasm Grading ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
We performed this study to identify the treatment patterns of patients with low-grade gliomas (LGG) in Korea. A total of 555 patients diagnosed as WHO grade II gliomas between 2000 and 2010 at 14 Korean institutions were included. The patients were divided into four adjuvant treatment groups: adjuvant fractionated radiotherapy (RT, N = 204), adjuvant chemotherapy (N = 20), adjuvant fractionated RT and chemotherapy (N = 65), and non-adjuvant treatment (N = 266) groups. We examined differences among the groups and validated patient/tumor characteristics associated with the adjuvant treatments. Astrocytoma was diagnosed in 210 patients (38%), oligoastrocytoma in 85 patients (15%), and oligodendroglioma in 260 patients (47%). Gross total resection was performed in 200 patients (36%), subtotal resection in 153 (28%), partial resection in 71 patients (13%), and biopsy in 131 patients (24%). RT was most commonly applied as an adjuvant treatment. The use of chemotherapy with or without RT decreased after 2008 (from 38 to 4%). The major chemotherapeutic regimen was procarbazine, lomustine, and vincristine (PCV); however, the proportion of temozolomide increased since 2005 (up to 69%). Patient/tumor characteristics related with RT were male gender, non-seizure, multiple lobes involvement, and non-gross total resection. Chemotherapy was associated with non-gross total resection and non-astrocytoma. A preference for RT and increased use of temozolomide was evident in the treatment pattern of LGG. The extent of resection was associated with a decision to perform RT and chemotherapy. To establish a robust guideline for LGG, further studies including molecular information are needed.
- Published
- 2018
38. Differentiation of High-Grade from Low-Grade Astrocytoma: Improvement in Diagnostic Accuracy and Reliability of Pharmacokinetic Parameters from DCE MR Imaging by Using Arterial Input Functions Obtained from DSC MR Imaging
- Author
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Koung Mi Kang, Sung Hye You, Seung Hong Choi, Chul-Ho Sohn, Hye Jeong Choi, Roh Eul Yoo, Sung Hye Park, Jae Kyung Won, Chul-Kee Park, Tae Jin Yun, Ji-Hoon Kim, Tae Min Kim, Il Han Kim, and Soon-Tae Lee
- Subjects
Adult ,Male ,Low grade astrocytoma ,Diagnostic accuracy ,Astrocytoma ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Pharmacokinetics ,Image Processing, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,skin and connective tissue diseases ,Reliability (statistics) ,Aged ,Retrospective Studies ,Aged, 80 and over ,Brain Neoplasms ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Mr imaging ,ROC Curve ,Female ,Neoplasm Grading ,biological phenomena, cell phenomena, and immunity ,business ,Nuclear medicine ,Magnetic Resonance Angiography ,030217 neurology & neurosurgery - Abstract
Dynamic contrast-enhanced (DCE) MR imaging pharmacokinetic parameters derived by using arterial input functions (AIFs) at dynamic susceptibility-contrast imaging showed better diagnostic performance and reliability for differentiating high-grade from low-grade astrocytoma than those derived by using AIFs at DCE MR imaging alone.
- Published
- 2018
39. Performance Evaluation of Weighing Precipitation Gauge by Developed Test Facility
- Author
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Il-han Kim, Sung-teak Hong, Ho-Hyun Lee, Gi-hyun Yoo, Gang-Wook Shin, and Jong-rib Kim
- Subjects
Test facility ,Rain gauge ,Meteorology ,Environmental science ,Precipitation ,Gauge (firearms) - Published
- 2018
40. Efficacy of adjuvant radiotherapy in the intracranial hemangiopericytoma
- Author
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Sun Ha Paek, Chul-Kee Park, Sung Hye Park, Jin Wook Kim, Seung Hyuck Jeon, and Il Han Kim
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Treatment outcome ,Radiosurgery ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Survival analysis ,Aged ,Retrospective Studies ,Hemangiopericytoma ,Adjuvant radiotherapy ,Brain Neoplasms ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Survival Analysis ,Tumor Burden ,Radiation therapy ,Treatment Outcome ,Neurology ,Oncology ,030220 oncology & carcinogenesis ,Female ,Radiotherapy, Adjuvant ,Dose Fractionation, Radiation ,Neurology (clinical) ,Radiology ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Adjuvant ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40). The median follow-up period was 50 months (range 3–216 months). The local recurrence was defined as intracranial relapse within 15 mm and regional recurrence as beyond 15 mm from the margin of surgical bed. The 10-year overall survival (OS) and progression-free survival (PFS) were 69.9 and 34.4%, respectively. The 10-year local, regional, and distant failure-free rates were 56.6, 88.2, and 73.3%, respectively. Local tumor control was better with GTR followed by RT than GTR alone (p = 0.056), while there was no difference in OS. Local tumor control and OS after STR plus RT were equivalent to those after GTR alone. There were no differences in distant metastasis-free survival (DMFS) among GTR plus RT, GTR alone, and STR plus RT. Tumor volume > 40 cm3 was associated with poor PFS (p = 0.024). The local tumor recurrence was reduced by adjuvant RT after surgery. But OS or DMFS was not improved with adjuvant RT. PFS was better in the tumor with small volume at diagnosis.
- Published
- 2018
41. Recursive partitioning analysis for disease progression in adult intracranial ependymoma patients
- Author
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Tae Min Kim, Chul-Kee Park, Sang Hyung Lee, Dong Gyu Kim, Yong Hwy Kim, Il Han Kim, Sang Woo Song, Jin Wook Kim, Yun Sik Dho, Soon-Tae Lee, Sung Hye Park, Seung Hong Choi, Hee-Won Jung, and Sun Ha Paek
- Subjects
Adult ,Male ,Ependymoma ,Oncology ,medicine.medical_specialty ,Prognostic variable ,Recursive partitioning ,Complete resection ,Disease-Free Survival ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physiology (medical) ,Internal medicine ,Humans ,Medicine ,Survival analysis ,Aged ,business.industry ,Disease progression ,Univariate ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Surgery ,Neurology ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Disease Progression ,Female ,Neurology (clinical) ,business ,Adult intracranial ependymoma ,030217 neurology & neurosurgery - Abstract
Intracranial ependymomas are rare tumors in adults. Although recent advancements from demographic, clinical, and biological studies provide new perspectives on this rare tumor, they are not yet widely applied in clinical practice. Currently, most ependymoma patients are treated in the same way: via surgical resection with adjuvant radiation therapy. However, it is reasonable to apply more aggressive treatment for high-risk patients. From this point of view, we performed a study to investigate risk grouping for disease progression of intracranial ependymomas in adults. A total of 53 patients were included in this study. Data were extracted for patient and tumor characteristics, extent of resection, progression-free survival (PFS), and overall survival. Prognostic variables from univariate and multivariate survival analyses were included in a recursive partitioning analysis for the hierarchical risk grouping of the estimated PFS. Three risk groups were defined based on the clinical prognostic factors. Survival analysis showed significant differences in mean PFS between the different groups: 160.5±22.1months in the complete resection group, 100.4±36.8months in the incomplete-resection and intraventricular-location group, and 23.5±6.9months in the incomplete-resection and extraventricular-location group (p0.001). The risk of disease progression in adult intracranial ependymoma patients could be stratified by degree of resection and tumor location. In clinical practice, this result could provide useful information, such as when "second-look" surgery should be performed or whether small tumors invading the fourth ventricle floor should be resected at the expense of neurological deficit.
- Published
- 2017
42. PO-1077 Population-based study on the association between autoimmune disease and lymphoma in Korea
- Author
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Juree Kim, Ji Hyun Chang, J.M. Byun, and Il Han Kim
- Subjects
Population based study ,Autoimmune disease ,Oncology ,business.industry ,Immunology ,medicine ,Radiology, Nuclear Medicine and imaging ,Hematology ,medicine.disease ,business ,Lymphoma - Published
- 2021
43. Population-based study on the association between autoimmune disease and lymphoma: National Health Insurance Service-National Sample Cohort 2002–2015 in Korea
- Author
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Ji Hyun Chang, Ja Min Byun, Il Han Kim, and Jin Soo Kim
- Subjects
Adult ,Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Helicobacter pylori infection ,Lymphoma ,National Health Programs ,Carcinogenesis ,Immunology ,Ethnic group ,Autoimmune Diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Immunology and Allergy ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Autoimmune disease ,Radiation ,business.industry ,Incidence ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Population based study ,030104 developmental biology ,Oncology ,National health insurance ,Cohort ,Female ,business ,Follow-Up Studies - Abstract
We aimed to evaluate the association between autoimmune disease (AID) and lymphoma incidence in the Korean population. We also aimed to compare the overall survival (OS) in patients with AID-associated lymphoma (AAL) with that in patients with lymphoma without AID.We used National Sample Cohort 2002-2015 provided by National Health Insurance Service. Among 1,011,638 patients, 994,496 were recruited for the final cohort: 130,987 patients (13.2%) in the AID group and 863,509 (86.8%) in control. Lymphoma was diagnosed in 1162 patients and 322 patients with accompanying AID, irrespective of the time point of diagnosis, were defined as AAL. Of those, patients who experienced lymphoma development at least one year after AID diagnosis were defined as post-AID lymphoma (N = 155).The median follow-up duration was 13.7 years. AAL accounted for 0.03% of total and 27.7% of lymphoma cases. AID patients experienced more Epstein-Barr virus (0.02 vs. 0.01%, P = 0.027) or Helicobacter pylori infection (63.9 vs. 41.4%, P 0.001) than the control group did. AID was associated with a 1.45-fold increased risk of lymphoma. The median time interval from AID to AAL was 10.9 months. The risk of lymphoma increased in the order of: psoriasis (adjusted odds ratio [AOR] 1.61), systemic lupus erythematosus (AOR 3.99), multiple sclerosis (AOR 4.52), and sarcoidosis (AOR 26.37). Sjogren syndrome was not related to lymphoma in this cohort. The 5-year OS in AAL was not different from that in lymphoma patients without AID (60.9 vs. 61.5%, P = 0.970).The association patterns in AAL in Korean population were different from those of Western countries. Further studies on lymphomatogenesis from distinct baseline characteristics (e.g. chronic infection status) would elucidate the difference based on race and ethnicity.
- Published
- 2021
44. Troubled Peace and The Memory of Ancestors’ River : The Memory and Experience of The Local People within the Civilian Control Line in Kyunggi Province
- Author
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Il-han Kim and 동국대학교 북한학연구소 DMZ평화센터
- Subjects
Oral history ,History ,Ethnology ,General Medicine - Published
- 2017
45. Role of radiation therapy in primary central nervous system lymphoma
- Author
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Il Han Kim, Chang Ok Suh, Tae Min Kim, Semie Hong, In Ah Kim, Do Hoon Lim, Jaeho Cho, Woo Chul Kim, Dongryul Oh, Jinhee Kim, Ki Mun Kang, Hyeon Kang Koh, Bae Kwon Jeong, and Woong Ki Chung
- Subjects
Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lymphoma ,medicine.medical_treatment ,Salvage therapy ,Kaplan-Meier Estimate ,Disease-Free Survival ,Central Nervous System Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Median follow-up ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Combined Modality Therapy ,Proportional Hazards Models ,Retrospective Studies ,Salvage Therapy ,Chemotherapy ,Radiotherapy ,business.industry ,Primary central nervous system lymphoma ,Radiotherapy Dosage ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Radiation therapy ,Treatment Outcome ,Neurology ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
We analyzed patterns of care and outcomes for patients with primary central nervous system lymphoma (PCNSL) in this multi-institutional retrospective study. Between January 2000 and December 2011, 220 patients with PCNSL received radiotherapy (RT). Among these patients, 26 patients received RT alone; 179 patients were treated with chemotherapy and radiotherapy; the rest of the patients (N = 15) initially underwent chemotherapy alone, then received RT as a salvage treatment. Most of the patients (N = 188) received methotrexate-based chemotherapy. The median follow up duration was 38 months (range 3-179 months). The median RT dose and whole brain RT (WBRT) dose were 45.0 Gy (range 20.0-59.4) and 30.6 Gy (range 18.0-45.0), respectively. Seventy-seven (35%) patients received WBRT alone, and 143 patients (65%) underwent WBRT plus boost RT. Total RT dose and WBRT dose decreased during the study period. The median survival was 64 months and actuarial 5-year overall survival was 51.4%. In multivariate analysis, age (P
- Published
- 2017
46. Loss of Pericytes in Radiation Necrosis after Glioblastoma Treatments
- Author
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Ji Yeon Bae, Tae Min Kim, Sung Hye Park, Kon Chu, Il Han Kim, Soon-Tae Lee, Youngbeom Seo, Jin Wook Kim, Seung Hong Choi, and Chul-Kee Park
- Subjects
Male ,0301 basic medicine ,CD31 ,Pathology ,medicine.medical_specialty ,RHOA ,Vascular smooth muscle ,Angiogenesis ,medicine.medical_treatment ,Neuroscience (miscellaneous) ,Brain tumor ,Biology ,Receptor, Platelet-Derived Growth Factor beta ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,medicine ,Humans ,Aged ,Brain Neoplasms ,Growth factor ,Brain ,Middle Aged ,medicine.disease ,Actins ,030104 developmental biology ,medicine.anatomical_structure ,Neurology ,Immunology ,biology.protein ,Female ,Pericyte ,Glioblastoma ,Pericytes ,Astrocyte - Abstract
Radiation necrosis (RN) in brain tumor patients is often symptomatic, persistent without immediate resolution, and confused with tumor recurrence. Cerebral vascular pericytes are essential for endothelial function, vascular integrity, and angiogenesis. In this study, we showed that the loss of pericytes is involved in the pathogenesis of RN. From a brain tumor tissue repository, we identified three patients since 2011 with pathologically confirmed RN after the standard treatment for glioblastoma (GBM). The RN and their preradiation GBM tissues were serially processed for Western blotting using cell-type-specific antibodies against endothelial (CD31, active RhoA), pericyte [platelet-derived growth factor receptor-beta (PDGFR-β)], alpha-smooth muscle actin (α-SMA), astrocyte (GFAP), myelin sheath protein (MBP), and microglial markers (Iba1). Normal brain tissues from a brain bank were used as normal controls. The expressions of PDGFR-β and α-SMA were remarkably reduced in the RN, compared to those of GBM. However, the levels of CD31 or RhoA were not different between the two groups, which suggest that there was no change in the number of endothelial cells or their cytoskeletal assembly. The RN tissues showed a decreased ratio of pericyte/endothelial markers and an increased level of Iba1 compared to the GBM and even to the normal brain. The levels of GFAP and MBP were not changed in the RN. In the histopathology, the RN tissues showed a loss of markers (PDGFR-β), whereas the GBM tissues had abundant expression of the markers. The loss of pericytes and vascular smooth muscle cells, and the unsupported endothelial cells might be the cause of the leaky blood-brain barrier and tissue necrosis.
- Published
- 2017
47. Effects of Adjuvant Radiotherapy in Patients With Synovial Sarcoma
- Author
-
Junghwan Park, Han-Soo Kim, Ilkyu Han, Sanghyuk Song, Suzy Kim, Hak Jae Kim, and Il Han Kim
- Subjects
Male ,Cancer Research ,Lung Neoplasms ,Neoplasm, Residual ,medicine.medical_treatment ,Gastroenterology ,Postoperative Complications ,0302 clinical medicine ,030212 general & internal medicine ,Child ,Margins of Excision ,Radiotherapy Dosage ,Middle Aged ,Synovial sarcoma ,Survival Rate ,Treatment Outcome ,Oncology ,Child, Preschool ,030220 oncology & carcinogenesis ,Resection margin ,Female ,Sarcoma ,Radiodermatitis ,Adjuvant ,Adult ,medicine.medical_specialty ,Mitotic index ,Adolescent ,Pleural Neoplasms ,Bone Neoplasms ,Disease-Free Survival ,Sarcoma, Synovial ,Young Adult ,03 medical and health sciences ,Internal medicine ,Mitotic Index ,medicine ,Humans ,Survival rate ,Aged ,Retrospective Studies ,business.industry ,Extremities ,Retrospective cohort study ,medicine.disease ,Surgery ,Radiation therapy ,Radiotherapy, Adjuvant ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
To analyze the treatment outcomes and the effects of adjuvant radiotherapy (RT) in patients with synovial sarcoma (SS). The medical records of 103 patients treated with definitive surgery for SS, with/without RT, from August 1982 to July 2013 were reviewed retrospectively. The median age of the patients was 33 years (range, 5 to 72 y). The most frequent tumor location was the extremities (79 patients, 77%). Seventy-five patients (73%) received adjuvant RT and 26 (25%) did not. The median dose of adjuvant RT was 61.2 Gy (range, 45 to 66.6 Gy). The median follow-up period was 5.4 years (range, 0.2 to 31.0 y). The 5- and 10-year overall survival rates were 77 % and 65%, respectively. The progression-free survival (PFS) rates at 5 and 10 years were 52% and 43%, respectively. The most common site of initial failure was the lung (24 patients), followed by local recurrence (14 patients). The 5-year local-recurrence-free survival (LRFS) and distant-metastasis-free survival (DMFS) rates were 80% and 63%, respectively. On multivariate analysis, a mitosis count of
- Published
- 2017
48. Treatment of pediatric average-risk medulloblastoma using craniospinal irradiation less than 2500 cGy and chemotherapy: single center experience in Korea
- Author
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Ji Won Lee, Seung-Ki Kim, Jong Hyung Yoon, Kyu-Chang Wang, Hyoung Jin Kang, Hee Young Shin, Hyery Kim, Il Han Kim, Kyung Duk Park, and Sung Hye Park
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Single Center ,Risk Assessment ,Disease-Free Survival ,Craniospinal Irradiation ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Republic of Korea ,medicine ,Humans ,Neoplasm Invasiveness ,Cerebellar Neoplasms ,Child ,Neoplasm Staging ,Retrospective Studies ,Medulloblastoma ,Average risk ,Chemotherapy ,Adjuvant radiotherapy ,business.industry ,Large cell ,Standard treatment ,Dose-Response Relationship, Radiation ,Radiotherapy Dosage ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Survival Analysis ,Surgery ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,business ,030217 neurology & neurosurgery - Abstract
Although craniospinal irradiation (CSI) of 2340 cGy plus tumor booster with chemotherapy have been established as a standard treatment of childhood average-risk (AvR) medulloblastoma (MBL) in Western counties, there are a few recent reports in outcomes of AvR MBL using this strategy in Korean and other Asian children. We investigated the outcome of the Korean children with AvR MBL who were treated with CSI
- Published
- 2017
49. Underexpression of HOXA11 Is Associated with Treatment Resistance and Poor Prognosis in Glioblastoma
- Author
-
Young Bem Se, Hyun Goo Woo, Chul-Kee Park, Yong Hwy Kim, Sung Hye Park, Jin Wook Kim, Il Han Kim, Yun Sik Dho, Dong Gyu Kim, Seung Hong Choi, Soon-Tae Lee, Hak Jae Kim, Ja Eun Kim, Shin Hyuk Kang, Ji-Young Kim, Tae Min Kim, Seung Hyun Kim, and Se-Hyuk Kim
- Subjects
0301 basic medicine ,Cancer Research ,Cell Survival ,Down-Regulation ,Treatment resistance ,Homeobox genes ,Transcriptome ,03 medical and health sciences ,0302 clinical medicine ,Cell Line, Tumor ,medicine ,Humans ,Gene Regulatory Networks ,Hox gene ,Homeodomain Proteins ,Temozolomide ,Brain Neoplasms ,business.industry ,Microarray analysis techniques ,Gene Expression Profiling ,Cancer ,Prognosis ,medicine.disease ,HOXA11 ,Gene Expression Regulation, Neoplastic ,Gene expression profiling ,030104 developmental biology ,Oncology ,Drug Resistance, Neoplasm ,Gene Knockdown Techniques ,030220 oncology & carcinogenesis ,Cancer research ,Homeobox ,RNA Interference ,Original Article ,Glioblastoma ,business ,TXNIP ,Follow-Up Studies ,medicine.drug - Abstract
Purpose Homeobox (HOX) genes are essential developmental regulators that should normally be in the silenced state in an adult brain. The aberrant expression of HOX genes has been associated with the prognosis of many cancer types, including glioblastoma (GBM). This study examined the identity and role of HOX genes affecting GBM prognosis and treatment resistance. Materials and methods The full series of HOX genes of five pairs of initial and recurrent human GBM samples were screened by microarray analysis to determine the most plausible candidate responsible for GBM prognosis. Another 20 newly diagnosed GBM samples were used for prognostic validation. In vitro experiments were performed to confirm the role of HOX in treatment resistance. Mediators involved in HOX gene regulation were searched using differentially expressed gene analysis, gene set enrichment tests, and network analysis. Results The underexpression of HOXA11 was identified as a consistent signature for a poor prognosis among the HOX genes. The overall survival of the GBM patients indicated a significantly favorable prognosis in patients with high HOXA11 expression (31±15.3 months) compared to the prognoses in thosewith low HOXA11 expression (18±7.3 months, p=0.03). When HOXA11 was suppressed in the GBM cell lines, the anticancer effect of radiotherapy and/or temozolomide declined. In addition, five candidate mediators (TGFBR2, CRIM1, TXNIP, DPYSL2, and CRMP1) that may confer an oncologic effect after HOXA11 suppression were identified. Conclusion The treatment resistance induced by the underexpression of HOXA11 can contribute to a poor prognosis in GBM. Further investigation will be needed to confirm the value of HOXA11 as a potential target for overcoming the treatment resistance by developing chemo- or radiosensitizers.
- Published
- 2017
50. Post-bevacizumab Clinical Outcomes and the Impact of Early Discontinuation of Bevacizumab in Patients with Recurrent Malignant Glioma
- Author
-
Dae Seog Heo, Chae-Yong Kim, Dong Wan Kim, Yongjun Cha, Yu Jung Kim, In Ah Kim, Jee Hyun Kim, Tae Min Kim, Se-Hoon Lee, Eun-Hee Kim, Seung Hong Choi, Byung Se Choi, Chul-Kee Park, and Il Han Kim
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Time Factors ,Bevacizumab ,Population ,Angiogenesis Inhibitors ,Kaplan-Meier Estimate ,Irinotecan ,Young Adult ,03 medical and health sciences ,High-grade glioma ,Antineoplastic Agents, Immunological ,0302 clinical medicine ,Internal medicine ,Glioma ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Combined Modality Therapy ,Young adult ,education ,Aged ,education.field_of_study ,business.industry ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Discontinuation ,Treatment Outcome ,Oncology ,Tumor progression ,030220 oncology & carcinogenesis ,Original Article ,Camptothecin ,Female ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Glioblastoma ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,medicine.drug - Abstract
Purpose Bevacizumab±irinotecan is effective for treatment of recurrent malignant gliomas. However, the optimal duration of treatment has not been established. Materials and methods Ninety-four consecutive patients with recurrent malignant glioma who were treated with bevacizumab at our institutions were identified. Patients who continued bevacizumab until tumor progression were enrolled in a late discontinuation (LD) group, while those who stopped bevacizumab before tumor progression were enrolled in an early discontinuation (ED) group. Landmark analyses were performed at weeks 9, 18, and 26 for comparison of patient survival between the two groups. Results Among 89 assessable patients, 62 (69.7%) and 27 (30.3%) patients were categorized as the LD and ED groups, respectively. According to landmark analysis, survival times from weeks 9, 18, and 26 were not significantly different between the two groups in the overall population. However, the LD group showed a trend toward increased survival compared to the ED group among responders. In the ED group, the median time from discontinuation to disease progression was 11.4 weeks, and none of the patients showed a definite rebound phenomenon. Similar median survival times after disease progression were observed between groups (14.4 weeks vs. 15.7 weeks, p=0.251). Of 83 patients, 38 (45.8%) received further therapy at progression, and those who received further therapy showed longer survival in both the LD and ED groups. Conclusion In recurrent malignant glioma, duration of bevacizumab was not associated with survival time in the overall population. However, ED of bevacizumab in responding patients might be associated with decreased survival.
- Published
- 2017
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