42 results on '"Jung Ho Im"'
Search Results
2. Assessment of deep learning-based auto-contouring on interobserver consistency in target volume and organs-at-risk delineation for breast cancer: Implications for RTQA program in a multi-institutional study
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Min Seo Choi, Jee Suk Chang, Kyubo Kim, Jin Hee Kim, Tae Hyung Kim, Sungmin Kim, Hyejung Cha, Oyeon Cho, Jin Hwa Choi, Myungsoo Kim, Juree Kim, Tae Gyu Kim, Seung-Gu Yeo, Ah Ram Chang, Sung-Ja Ahn, Jinhyun Choi, Ki Mun Kang, Jeanny Kwon, Taeryool Koo, Mi Young Kim, Seo Hee Choi, Bae Kwon Jeong, Bum-Sup Jang, In Young Jo, Hyebin Lee, Nalee Kim, Hae Jin Park, Jung Ho Im, Sea-Won Lee, Yeona Cho, Sun Young Lee, Ji Hyun Chang, Jaehee Chun, Eung Man Lee, Jin Sung Kim, Kyung Hwan Shin, and Yong Bae Kim
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RTQA ,Inter-observer variation ,Auto-contouring ,Breast cancer ,Deep learning ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Purpose: To quantify interobserver variation (IOV) in target volume and organs-at-risk (OAR) contouring across 31 institutions in breast cancer cases and to explore the clinical utility of deep learning (DL)-based auto-contouring in reducing potential IOV. Methods and materials: In phase 1, two breast cancer cases were randomly selected and distributed to multiple institutions for contouring six clinical target volumes (CTVs) and eight OAR. In Phase 2, auto-contour sets were generated using a previously published DL Breast segmentation model and were made available for all participants. The difference in IOV of submitted contours in phases 1 and 2 was investigated quantitatively using the Dice similarity coefficient (DSC) and Hausdorff distance (HD). The qualitative analysis involved using contour heat maps to visualize the extent and location of these variations and the required modification. Results: Over 800 pairwise comparisons were analysed for each structure in each case. Quantitative phase 2 metrics showed significant improvement in the mean DSC (from 0.69 to 0.77) and HD (from 34.9 to 17.9 mm). Quantitative analysis showed increased interobserver agreement in phase 2, specifically for CTV structures (5–19 %), leading to fewer manual adjustments. Underlying IOV differences causes were reported using a questionnaire and hierarchical clustering analysis based on the volume of CTVs. Conclusion: DL-based auto-contours improved the contour agreement for OARs and CTVs significantly, both qualitatively and quantitatively, suggesting its potential role in minimizing radiation therapy protocol deviation.
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- 2024
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3. Dummy run quality assurance study in the Korean Radiation Oncology Group 19 − 09 multi-institutional prospective cohort study of breast cancer
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Myeongsoo Kim, Boram Park, Haksoo Kim, Yeon-Joo Kim, Dong Ju Choi, Weonkuu Chung, Yeon Joo Kim, Hyun Soo Shin, Jung Ho Im, Chang-Ok Suh, Jin Hee Kim, Boram Ha, Mi Young Kim, Jongmoo Park, Jeongshim Lee, Sung-Ja Ahn, Sun Young Lee, Grace Kusumawidjaja, Faye Lim, Won Kyung Cho, Haeyoung Kim, Doo Ho Choi, and Won Park
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Breast neoplasms ,Radiotherapy ,Quality assurance ,Dummy run ,Dosimetric variations ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background The Korean Radiation Oncology Group (KROG) 19 − 09 prospective cohort study aims to determine the effect of regional nodal irradiation on regional recurrence rates in ypN0 breast cancer patients. Dosimetric variations between radiotherapy (RT) plans of participating institutions may affect the clinical outcome of the study. We performed this study to assess inter-institutional dosimetric variations by dummy run. Methods Twelve participating institutions created RT plans for four clinical scenarios using computed tomography images of two dummy cases. Based on a reference structure set, we analyzed dose-volume histograms after collecting the RT plans. Results We found variations in dose distribution between institutions, especially in the regional nodal areas. Whole breast and regional nodal irradiation (WBI + RNI) plans had lower inter-institutional agreement and similarity for 95% isodose lines than WBI plans. Fleiss’s kappa values, which were used to measure inter-institutional agreement for the 95% isodose lines, were 0.830 and 0.767 for the large and medium breast WBI plans, respectively, and 0.731 and 0.679 for the large and medium breast WBI + RNI plans, respectively. There were outliers in minimum dose delivered to 95% of the structure (D95%) of axillary level 1 among WBI plans and in D95% of the interpectoral region and axillary level 4 among WBI + RNI plans. Conclusion We found inter-institutional and inter-case variations in radiation dose delivered to target volumes and organs at risk. As KROG 19 − 09 is a prospective cohort study, we accepted the dosimetric variation among the different institutions. Actual patient RT plan data should be collected to achieve reliable KROG 19 − 09 study results.
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- 2022
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4. Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multi-institutional analysis (KROG 19-04)
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Sung Uk Lee, Jinsil Seong, Tae Hyun Kim, Jung Ho Im, Woo Chul Kim, Kyubo Kim, Hae Jin Park, Tae Gyu Kim, Youngkyong Kim, Bae Kwon Jeong, Jin Hee Kim, Byoung Hyuck Kim, and Taek-Keun Nam
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gallbladder cancer ,adjuvant treatment ,chemoradiotherapy ,locoregional recurrence-free survival ,overall survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Objective: The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC. Methods: A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III–IV). Results: In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III–IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05). Conclusions: CRT has value as adjuvant treatment for resected GBC with stage III–IV disease. Further study is needed for stage II disease with high-risk features.
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- 2022
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5. Impact of radiation dose on complications among women with breast cancer who underwent breast reconstruction and post-mastectomy radiotherapy: A multi-institutional validation study
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Seung Yeun Chung, Jee Suk Chang, Kyung Hwan Shin, Jin Ho Kim, Won Park, Haeyoung Kim, Kyubo Kim, Ik Jae Lee, Won Sup Yoon, Jihye Cha, Kyu-Chan Lee, Jin Hee Kim, Jin Hwa Choi, Sung-Ja Ahn, Boram Ha, Sun Young Lee, Dong Soo Lee, Jeongshim Lee, Sei One Shin, Sea-Won Lee, Jinhyun Choi, Mi Young Kim, Yeon Joo Kim, Jung Ho Im, Chang-Ok Suh, and Yong Bae Kim
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Breast cancer ,Breast reconstruction ,Major complication ,Radiation therapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Purpose: Emerging data suggest that higher radiation doses in post-mastectomy radiotherapy may be associated with an increased risk of reconstruction complications. This study aimed to validate previous findings regarding the impact of radiation dose on complications among women with breast cancer using a multi-center dataset. Methods: Fifteen institutions participated, and women with breast cancer who received radiotherapy after either autologous or prosthetic breast reconstruction were included. The primary endpoint was major post-radiation therapy complications requiring re-operation for explantation, flap failure, or bleeding control. Results: In total, 314 patients were included. Radiotherapy was performed using both conventional fractionation and hypofractionation in various schedules. The range of the radiation therapy dose in Equivalent Dose in 2 Gy fractions (EQD2; α/β = 3.5) varied from 43.4 to 71.0 Gy (median dose: 48.6 Gy). Boost radiation therapy was administered to 49 patients. Major post-radiation therapy complications were observed in 24 (7.6%) patients. In multivariate analysis, an increasing EQD2 per Gy (odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.26–1.98; p
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- 2021
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6. Impact of Denoising on Deep-Learning-Based Automatic Segmentation Framework for Breast Cancer Radiotherapy Planning
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Jung Ho Im, Ik Jae Lee, Yeonho Choi, Jiwon Sung, Jin Sook Ha, and Ho Lee
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radiation therapy ,contouring ,organs at risk ,deep-learning-based auto-segmentation ,denoiser ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Objective: This study aimed to investigate the segmentation accuracy of organs at risk (OARs) when denoised computed tomography (CT) images are used as input data for a deep-learning-based auto-segmentation framework. Methods: We used non-contrast enhanced planning CT scans from 40 patients with breast cancer. The heart, lungs, esophagus, spinal cord, and liver were manually delineated by two experienced radiation oncologists in a double-blind manner. The denoised CT images were used as input data for the AccuContourTM segmentation software to increase the signal difference between structures of interest and unwanted noise in non-contrast CT. The accuracy of the segmentation was assessed using the Dice similarity coefficient (DSC), and the results were compared with those of conventional deep-learning-based auto-segmentation without denoising. Results: The average DSC outcomes were higher than 0.80 for all OARs except for the esophagus. AccuContourTM-based and denoising-based auto-segmentation demonstrated comparable performance for the lungs and spinal cord but showed limited performance for the esophagus. Denoising-based auto-segmentation for the liver was minimal but had statistically significantly better DSC than AccuContourTM-based auto-segmentation (p < 0.05). Conclusions: Denoising-based auto-segmentation demonstrated satisfactory performance in automatic liver segmentation from non-contrast enhanced CT scans. Further external validation studies with larger cohorts are needed to verify the usefulness of denoising-based auto-segmentation.
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- 2022
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7. Combined High-Dose Radiotherapy with Sequential Gemcitabine-Cisplatin Based Chemotherapy Increase the Resectability and Survival in Locally Advanced Unresectable Intrahepatic Cholangiocarcinoma: A Multi-institutional Cohort Study.
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Jung Ho Im, Jeong Il Yu, Tae Hyun Kim, Tae Gyu Kim, Jun Won Kim, and Jinsil Seong
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PROPORTIONAL hazards models , *OVERALL survival , *PROGNOSIS , *MULTIVARIATE analysis , *CHEMORADIOTHERAPY - Abstract
Purpose: The locally advanced unresectable intrahepatic cholangiocarcinoma (ICC) has detrimental oncological outcomes. In this study, we aimed to investigate the efficacy of radiotherapy in patients with locally advanced unresectable ICC. Materials and Methods: Between 2001 and 2021, 116 patients were identified through medical record who underwent radiotherapy for locally advanced unresectable ICC. The resectability of ICC is determined by the multidisciplinary team at each institution. Overall survival (OS) were analyzed using the Kaplan-Meier method, and prognostic factors were analyzed using the Cox proportional hazards model. Results: The median equivalent radiotherapy dose in 2 Gy fractions (EQD2) was 52 Gy (range, 30 to 110 Gy). Forty-seven patients (40.5%) received sequential gemcitabine-cisplatin based chemotherapy (GEM-CIS CTx). Multivariate analysis identified two risk factors, EQD2 of = 60 Gy and application of sequential GEM-CIS CTx for OS. Patients were grouped by these two risk factors: group 1, EQD2 = 60 Gy with sequential GEM-CIS CTx (n=25); group 2, EQD2 < 60 Gy with sequential GEM-CIS CTx or fluoropyrimidine-based concurrent chemoradiotherapy (n=70); and group 3, radiotherapy alone (n=21). Curative resection was more frequently undergone in group 1 than in groups 2 or 3 (28% vs. 8.6% vs. 0%, respectively). Consequently, OS was significantly better in group 1 than in groups 2 and 3 (p < 0.05). Conclusion Combined high-dose radiotherapy with sequential GEM-CIS CTx improved oncologic outcomes in patients with locally advanced unresectable ICC. Further prospective studies are required to validate these findings. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Risk Factors for Distant Metastasis in Extrahepatic Bile Duct Cancer after Curative Resection (KROG 1814).
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Younghee Park, Tae Hyun Kim, Kyubo Kim, Jeong Il Yu, Wonguen Jung, Jinsil Seong, Woo Chul Kim, Jin Hwa Choi, Ah Ram Chang, Bae Kwon Jeong, Byoung Hyuck Kim, Tae Gyu Kim, Jin Hee Kim, Hae Jin Park, Hyun Soo Shin, Jung Ho Im, and Eui Kyu Chie
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CHOLANGIOCARCINOMA ,DISEASE risk factors ,LYMPHATIC metastasis ,METASTASIS ,BIOMEDICAL materials - Abstract
Purpose Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated. Materials and Methods Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated. Results After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors. Conclusion Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection. [ABSTRACT FROM AUTHOR]
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- 2024
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9. 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
10. Dummy run quality assurance study in the Korean Radiation Oncology Group 19 - 09 multi-institutional prospective cohort study of breast cancer
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Myeongsoo Kim, Boram Park, Haksoo Kim, Yeon-Joo Kim, Dong Ju Choi, Weonkuu Chung, Yeon Joo Kim, Hyun Soo Shin, Jung Ho Im, Chang-Ok Suh, Jin Hee Kim, Boram Ha, Mi Young Kim, Jongmoo Park, Jeongshim Lee, Sung-Ja Ahn, Sun Young Lee, Grace Kusumawidjaja, Faye Lim, Won Kyung Cho, Haeyoung Kim, Doo Ho Choi, and Won Park
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Oncology ,Axilla ,Republic of Korea ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,Breast Neoplasms ,Radiotherapy, Adjuvant ,Prospective Studies - Abstract
Background The Korean Radiation Oncology Group (KROG) 19 − 09 prospective cohort study aims to determine the effect of regional nodal irradiation on regional recurrence rates in ypN0 breast cancer patients. Dosimetric variations between radiotherapy (RT) plans of participating institutions may affect the clinical outcome of the study. We performed this study to assess inter-institutional dosimetric variations by dummy run. Methods Twelve participating institutions created RT plans for four clinical scenarios using computed tomography images of two dummy cases. Based on a reference structure set, we analyzed dose-volume histograms after collecting the RT plans. Results We found variations in dose distribution between institutions, especially in the regional nodal areas. Whole breast and regional nodal irradiation (WBI + RNI) plans had lower inter-institutional agreement and similarity for 95% isodose lines than WBI plans. Fleiss’s kappa values, which were used to measure inter-institutional agreement for the 95% isodose lines, were 0.830 and 0.767 for the large and medium breast WBI plans, respectively, and 0.731 and 0.679 for the large and medium breast WBI + RNI plans, respectively. There were outliers in minimum dose delivered to 95% of the structure (D95%) of axillary level 1 among WBI plans and in D95% of the interpectoral region and axillary level 4 among WBI + RNI plans. Conclusion We found inter-institutional and inter-case variations in radiation dose delivered to target volumes and organs at risk. As KROG 19 − 09 is a prospective cohort study, we accepted the dosimetric variation among the different institutions. Actual patient RT plan data should be collected to achieve reliable KROG 19 − 09 study results.
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- 2022
11. Use of lysates from pooled human mononuclear cells to activate CD3 T cells in humanized mice with low human cell engraftment efficiency
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A-Reum Han, Jeoung Eun Lee, Seung Young Ko, Hyun Soo Shin, Jung Ho Im, Ji Yoon Lee, and Dong Ryul Lee
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Epitopes ,Mice ,T-Lymphocytes ,Animals ,Humans ,Cell Biology ,General Medicine ,Lymphocytes ,Mice, SCID ,Spleen ,Developmental Biology - Abstract
In regenerative medicine, humanized mice (hu-mice) are extremely valuable for verifying the cross talk between immune cells and therapeutic cells. Given the highly dynamic nature of the activities of immune cells, the in vitro platform does not allow for screening of their exact interactions with different therapeutic cells. By contrast, hu-mice have been widely applied for in vivo studies, especially those on immune rejection. However, the full reconstitution of lymphoid lineage cells in hu-mice remains to be realized. In this study, we investigated whether lysates from healthy donor-derived pooled mononuclear cells (MNCs) can promote the increase of lymphoid lineage cells in hu-mice. The pooled MNC lysate treatment of hu-mice possessing a low proportion of CD45 cells resulted in significant increases in CD3 cells and CD45 cells with the RO phenotype. The diverse epitopes from the pooled MNC lysates significantly induced the proportion of lymphoid lineage cells in the thymus and spleen after therapeutic cells with mismatched HLAs were co-injected into the hu-mice. These findings demonstrate the technical benefits of using pooled MNC lysates for reconstituting lymphoid lineage cells in hu-mice, providing a valuable in vivo platform for investigating the cross talk between lymphoid immune cells and therapeutic cells.
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- 2022
12. Impact of radiation dose on complications among women with breast cancer who underwent breast reconstruction and post-mastectomy radiotherapy: A multi-institutional validation study
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Kyung Hwan Shin, Yong Bae Kim, Jinhyun Choi, Sei One Shin, Jung Ho Im, Chang Ok Suh, Yeon Joo Kim, Haeyoung Kim, Sea Won Lee, Dong Soo Lee, Jee Suk Chang, Seung Yeun Chung, Ik Jae Lee, Jihye Cha, Kyu Chan Lee, Won Sup Yoon, Boram Ha, Sun Young Lee, Jeongshim Lee, Sung Ja Ahn, Jinhee Kim, Mi Young Kim, Won Soon Park, Jin Hwa Choi, Kyubo Kim, and Jin Ho Kim
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Adult ,medicine.medical_specialty ,Multivariate analysis ,EQD2, equivalent dose in 2 Gy fractions ,medicine.medical_treatment ,Mammaplasty ,Context (language use) ,Breast Neoplasms ,Major complication ,Radiation Dosage ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,PMRT, post-mastectomy radiotherapy ,OD, odds ratio ,Clinical endpoint ,Medicine ,Humans ,Breast reconstruction ,HER2, human epidermal growth factor receptor 2 ,030212 general & internal medicine ,Mastectomy ,Aged ,Retrospective Studies ,RT, Radiotherapy ,MROC, Mastectomy Reconstruction Outcomes Consortium ,business.industry ,General Medicine ,Odds ratio ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Confidence interval ,Radiation therapy ,CI, confidence interval ,Treatment Outcome ,030220 oncology & carcinogenesis ,Surgery ,Original Article ,Female ,Radiotherapy, Adjuvant ,Radiology ,Dose Fractionation, Radiation ,business - Abstract
Purpose Emerging data suggest that higher radiation doses in post-mastectomy radiotherapy may be associated with an increased risk of reconstruction complications. This study aimed to validate previous findings regarding the impact of radiation dose on complications among women with breast cancer using a multi-center dataset. Methods Fifteen institutions participated, and women with breast cancer who received radiotherapy after either autologous or prosthetic breast reconstruction were included. The primary endpoint was major post-radiation therapy complications requiring re-operation for explantation, flap failure, or bleeding control. Results In total, 314 patients were included. Radiotherapy was performed using both conventional fractionation and hypofractionation in various schedules. The range of the radiation therapy dose in Equivalent Dose in 2 Gy fractions (EQD2; α/β = 3.5) varied from 43.4 to 71.0 Gy (median dose: 48.6 Gy). Boost radiation therapy was administered to 49 patients. Major post-radiation therapy complications were observed in 24 (7.6%) patients. In multivariate analysis, an increasing EQD2 per Gy (odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.26–1.98; p, Highlights • Radiation dose is associated with the risk of breast reconstruction complications. • We conducted a retrospective multi-center observational study of 314 women in Korea. • Complication-related risk factors were identified using multivariate analysis. • Use of hypofractionated radiation therapy may improve breast reconstruction outcomes. • A prospective multi-center study is under way to further validate our findings.
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- 2021
13. 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, Hong In Yoon, and Chang-Ok Suh
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PROGNOSIS ,RADIOTHERAPY ,MIDDLE Ages ,FACTOR analysis ,GLIOMAS ,MAGNETIC resonance imaging - Abstract
Purpose This multicenter retrospective study aimed to investigate clinical, radiologic, and treatment-related factors affecting survival in patients with newly diagnosed diffuse intrinsic pontine glioma (DIPG) treated with radiotherapy. Materials and Methods Patients aged < 30 years who underwent radiotherapy as an initial treatment for DIPG between 2000 and 2018 were included; patients who did not undergo magnetic resonance imaging at diagnosis and those with pathologically diagnosed grade I glioma were excluded. We examined medical records of 162 patients collected from 10 participating centers in Korea. The patients’ clinical, radiological, molecular, and histopathologic characteristics, and treatment responses were evaluated to identify the prognosticators for DIPG and estimate survival outcomes. Results The median follow-up period was 10.8 months (interquartile range, 7.5 to 18.1). The 1- and 2-year overall survival (OS) rates were 53.5% and 19.0%, respectively, with a median OS of 13.1 months. Long-term survival rate (≥ 2 years) was 16.7%, and median OS was 43.6 months. Age (< 10 years), poor performance status, treatment before 2010, and post-radiotherapy necrosis were independently associated with poor OS in multivariate analysis. In patients with increased post-radiotherapy necrosis, the median OS estimates were 13.3 months and 11.4 months with and without bevacizumab, respectively (p=0.138). Conclusion Therapeutic strategy for DIPG has remained unchanged over time, and the associated prognosis remains poor. Our findings suggest that appropriate efforts are needed to reduce the occurrence of post-radiotherapy necrosis. Further well-designed clinical trials are recommended to improve the poor prognosis observed in DIPG patients. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multi-institutional analysis (KROG 19-04)
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Sung Uk, Lee, Jinsil, Seong, Tae Hyun, Kim, Jung Ho, Im, Woo Chul, Kim, Kyubo, Kim, Hae Jin, Park, Tae Gyu, Kim, Youngkyong, Kim, Bae Kwon, Jeong, Jin Hee, Kim, Byoung Hyuck, Kim, and Taek-Keun, Nam
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Cancer Research ,Oncology ,Humans ,Gallbladder Neoplasms ,Chemoradiotherapy, Adjuvant ,Combined Modality Therapy ,Neoplasm Staging - Abstract
Objective: The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC. Methods: A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III–IV). Results: In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III–IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05). Conclusions: CRT has value as adjuvant treatment for resected GBC with stage III–IV disease. Further study is needed for stage II disease with high-risk features.
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- 2021
15. 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
16. Role of adjuvant radiotherapy in extrahepatic bile duct cancer: A multicenter retrospective study (Korean Radiation Oncology Group 18-14)
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Joon Oh Park, Jinsil Seong, Bae Kwon Jeong, Sang Myung Woo, Eui Kyu Chie, Byoung Hyuck Kim, Woo Chul Kim, Jin Hwa Choi, Younghee Park, Tae Gyu Kim, Jung Ho Im, Do Youn Oh, Jung Il Yu, Kyubo Kim, Hae Jin Park, Jinhee Kim, Jin-Young Jang, Woojin Lee, Tae Hyun Kim, Jin Seok Heo, Wonguen Jung, and Hyun Soo Shin
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Perineural invasion ,Gastroenterology ,Bile Ducts, Extrahepatic ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,Bile duct ,business.industry ,Cancer ,Retrospective cohort study ,Chemoradiotherapy, Adjuvant ,Middle Aged ,medicine.disease ,Prognosis ,medicine.anatomical_structure ,Oncology ,Bile Duct Neoplasms ,Lymphatic Metastasis ,Resection margin ,Female ,Radiotherapy, Adjuvant ,Neoplasm Recurrence, Local ,business ,Chemoradiotherapy - Abstract
To evaluate the role of adjuvant radiotherapy (RT) after curative resection in patients with extrahepatic bile duct (EHBD) cancer.Between January 2000 and December 2015, 1475 patients with EHBD cancer who underwent curative resection were accrued from 14 institutions in Korea. Among these, 959 patients did not receive any adjuvant therapy (RT(-) group), while 516 underwent postoperative RT with or without chemotherapy (RT(+) group).The median age was 67 years. Nodal involvement was present in 482 patients (32.7%), and resection margin was involved in 293 patients (19.9%). RT(+) group had more patients with proximal tumours, advanced tumours, nodal involvement, perineural invasion, and involved resection margin than RT(-) group (all p 0.001). With a median follow-up of 36 months, there were 211 locoregional recurrences, 307 distant metastases and 322 combined locoregional and distant failures. On multivariate analysis incorporating age, tumour location, differentiation, pT classification, pN classification, perineural invasion and resection margin, adjuvant RT was associated with improved overall survival (hazard ratio, 0.74; 95% confidence interval, 0.63-0.86; p 0.001). When RT(+) group was separated into RT alone, concurrent chemoradiotherapy (CCRT) and CCRT followed by chemotherapy, the greatest benefit was observed in patients treated with CCRT followed by chemotherapy (hazard ratio, 0.52; 95% confidence interval, 0.41-0.68).Adjuvant RT combined with chemotherapy improved survival outcomes of resected EHBD cancer patients. Considering the greatest benefit observed in patients receiving CCRT followed by chemotherapy, a randomised controlled trial comparing chemotherapy alone and CCRT followed by chemotherapy is urgently needed.
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- 2021
17. Effect of Gold Nanoparticles on Dose Enhancement in Brachytherapy Using a Polymer Gel Dosimeter
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Jung Ho Im, Junchul Chun, Soo-Il Kwon, Seung Young Ko, Sei Kyung Chang, Hyun Soo Shin, and Jung Il Lee
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010302 applied physics ,Materials science ,Dosimeter ,Dose enhancement ,medicine.medical_treatment ,Brachytherapy ,General Physics and Astronomy ,02 engineering and technology ,021001 nanoscience & nanotechnology ,01 natural sciences ,Colloidal gold ,Treatment plan ,0103 physical sciences ,medicine ,Polymer gel ,0210 nano-technology ,Biomedical engineering - Abstract
The objective of the present study was to measure and evaluate the effect of gold nanoparticles (GNPs) on dose enhancement in brachytherapy with and 192Ir source using polymer gel dosimeters. To test the dose enhancement effect of GNPs during brachytherapy using 192Ir radioisotope, we used gamma rays in the same amount to irradiate gel dosimeters containing different concentrations and sizes of GNPs to measure their doses. Radiation was applied to 10 polymer gel dosimeters and control gel dosimeters that contained GNPs with different sizes (10 nm and 100 nm) and concentrations (0.1, 0.2, 0.3, 0.4, and 0.5 mM) under the same conditions. Dose enhancement factors (DEFs) were found to be 1.011, 1.014, 1.015, 1.026, and 1.029 when the concentrations of GNP were 0.1, 0.2, 0.3, 0.4, and 0.5 mM, respectively, with the size of the GNPs at 10 nm. When the GNP size was increased to 100 nm, the DEFs were 1.070, 1.088, 1.1890, 1.212, and 1.244 when concentrations of the GNPs were 0.1, 0.2, 0.3, 0.4, and 0.5 mM, respectively, showing dose enhancements higher than those of 10-nm-sized GNPs. When GNP size was 100 nm and its concentration was 0.3 mM or higher, the DEFs were higher than 1.15. The bigger the GNP size and the higher the concentration were, the larger the dose enhancement effect was. Such a dose enhancement effect of GNPs obtained in the present study can be utilized as basic data for clinical applications to enhance treatment effects. If such data are utilized in a treatment plan system, a treatment plan taking dose enhancement effect into account can be established at the planning stage.
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- 2019
18. Clinical safety and efficacy of salvage reirradiation for upper abdominal malignancies
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Jason Joon Bock Lee, Seo Hee Choi, Jinsil Seong, and Jung Ho Im
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Adult ,Male ,medicine.medical_specialty ,Duodenum ,medicine.medical_treatment ,Re-Irradiation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Aged, 80 and over ,Salvage Therapy ,Univariate analysis ,medicine.diagnostic_test ,business.industry ,Prior Radiotherapy ,Radiotherapy Planning, Computer-Assisted ,Medical record ,Radiotherapy Dosage ,Middle Aged ,Endoscopy ,Gross tumor volume ,Survival Rate ,Radiation therapy ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,Abdominal Neoplasms ,030220 oncology & carcinogenesis ,Retreatment ,Clinical safety ,Female ,Patient Safety ,Radiology ,business - Abstract
Reirradiation has the potential to provide effective local control of upper abdominal malignancies. This study aimed to evaluate the safety and efficacy of reirradiation for upper abdominal malignancies.A total of 42 patients with a history of prior radiotherapy (RT) received reirradiation for abdominal malignancies between 2005 and 2017. Each patient's medical records, contours, and dose distribution for both RT courses were reviewed. The median dose of the prior RT was 50.0 Gy (range, 30.0-60.0 Gy) and the median dose of reirradiation was 45.0 Gy (range, 15.0-75.0 Gy).With a median follow-up of 10.9 months, the median infield-failure-free survival (IFFS) rate was 9.2 months. Gross tumor volume (GTV) significantly related to IFFS in both the univariate (p = 0.009) and multivariate analyses (p = 0.024), and patients with a GTV of60.0 mL had an improved IFFS (p = 0.001). Four patients experienced ≥grade 3 late toxicities. In the retrospective dose reconstruction analysis in these patients, the cumulative dose to the most exposed 2 cc (D2cc) of the duodenum was60.0 Gy (range, 60.1-73.7 Gy). In the univariate analysis, the D2cc of the duodenum and a preexisting duodenal ulcer identified using endoscopy prior to reirradiation significantly correlated with late severe toxicity (p = 0.021 and 0.017, respectively).Reirradiation for upper abdominal malignancies could be safely performed for patients without preexisting gastrointestinal morbidity unless the duodenum received excessive radiation doses. Reirradiation could also provide substantial IFFS, especially for patients with a GTV of60.0 mL.ZIELSETZUNG: Eine Rebestrahlung hat das Potenzial, bösartige Tumore im oberen Abdominalbereich lokal zu kontrollieren. Diese Studie dient dem Zweck, festzustellen, ob eine Rebestrahlung in diesem Bereich sicher und effizient ist.Insgesamt 42 Patienten mit einer Vorgeschichte von Bestrahlungen erhielten zwischen 2005 und 2017 eine Rebestrahlung für bösartige Tumore im oberen Abdominalbereich. Die medizinische Krankenakte, die Umrisse der Tumore und die Bestrahlungsdosen von beiden Behandlungen wurden bewertet. Der Mittelwert der ersten Bestrahlung lag bei 50,0 Gy (Spanne 30,0–60,0 Gy), der Mittelwert der Rebestrahlung betrug 45,0 Gy (Spanne 15,0–75,0 Gy).Mit einer Durchschnittszeit von 10,9 Monaten lag die Durchschnittsrate des Infield-Failure-Free-Bereichs (IFFS) bei 9,2 Monaten. Das Gesamtvolumen des Tumors (GTV) zeigte große Wirkung in Verbindung mit IFFS, in der univariaten (p = 0,009) sowie in der multivariaten Analyse (p = 0,024). Patienten mit einem GTV von60,0 ml hatten einen verbesserten IFFS (p = 0,001). Vier Patienten erlitten im Verlauf eine verzögerte Toxizität ≥Grad 3. Bei der retrospektiven Analyse der Dosen dieser Patienten stellte sich heraus, dass die kumulative Dosis der am meisten exponierten 2 cc (D2cc) des Duodenums60,0 Gy betrug (Spanne 60,1–73,7 Gy). In der univariaten Analyse zeigte sich, dass der D2cc-Gehalt des Duodenums und ein prädisponierter Duodenalulkus, der vor der Rebestrahlung mittels Endoskopie identifiziert wurde, direkt mit einer verzögerten Toxizität (jeweils p = 0,021 bzw. 0,017) in Verbindung gebracht werden konnte.Eine Rebestrahlung bei bösartigen Tumoren im oberen Abdominalbereich kann bei Patienten, bei denen keine prädisponierte gastrointestinale Erkrankung vorliegt, sicher durchgeführt werden, es sei denn, das Duodenum erhielt exzessive Bestrahlungsdosen. Rebestrahlung kann zudem auch erheblich zu IFFS beitragen, vor allem bei Patienten mit einem GTV von60,0 ml.
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- 2019
19. The Korean Society for Neuro-Oncology (KSNO) Guideline for Antiepileptic Drug Usage of Brain Tumor: Version 2021.1
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Yun Sik Dho, Kyung Hwan Kim, Jin Mo Cho, Young Zoon Kim, Wan Soo Yoon, Kihwan Hwang, Ho Sung Kim, Jae-Sung Park, Min Sung Kim, Chul-Kee Park, Youn Soo Lee, Youngbeom Seo, Myung Hoon Han, Chan Woo Wee, Se Hoon Kim, Minho Lee, Jangsup Moon, Ho Shin Gwak, Je Beom Hong, Jung Ho Im, Jong Hee Chang, Se-Hoon Lee, Kyoung Su Sung, Hong In Yoon, Do Hoon Lim, Young Il Kim, Jin Ho Song, and Ji Eun Park
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Drug ,Pediatrics ,medicine.medical_specialty ,media_common.quotation_subject ,Neuro oncology ,Brain tumor ,MEDLINE ,Antiepileptic drug ,Guideline ,Brain tumors ,03 medical and health sciences ,0302 clinical medicine ,Korean Society for Neuro-Oncology ,Medicine ,In patient ,Medical prescription ,General Environmental Science ,media_common ,Practice ,business.industry ,medicine.disease ,030220 oncology & carcinogenesis ,General Earth and Planetary Sciences ,Original Article ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019. METHODS The Working Group was composed of 27 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords. RESULTS The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naive patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naive patients with one early postoperative seizure (
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- 2021
20. Functional recovery by colon organoid transplantation in a mouse model of radiation proctitis
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Hyun Soo Shin, Mi Sun Kim, Dong-Youn Hwang, Jee Hyun Kim, Jongman Yoo, Hyemi Jeon, Seung Young Ko, Jae-Hwi Seo, Woo Hee Choi, Taegyu Lim, Jun-Hyeok Park, Jung Ho Im, Enoch Park, Ji Su Ko, Sang Yun Jeong, JooHyun Jee, Woo Ram Kim, Jung Il Lee, and Kyung-jin Lee
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Pathology ,medicine.medical_specialty ,Radiation proctitis ,Colon ,Biophysics ,Bioengineering ,02 engineering and technology ,Regenerative medicine ,Biomaterials ,03 medical and health sciences ,Mice ,Organoid ,Medicine ,Animals ,Proctitis ,Intestinal Mucosa ,Fibrin glue ,Radiation Injuries ,030304 developmental biology ,0303 health sciences ,business.industry ,Regeneration (biology) ,LGR5 ,021001 nanoscience & nanotechnology ,medicine.disease ,digestive system diseases ,Transplantation ,Organoids ,Mechanics of Materials ,Ceramics and Composites ,Stem cell ,0210 nano-technology ,business - Abstract
Radiation proctitis is the collateral damage that occurs to healthy cells during radiation treatment of pelvic malignancies. Conservative treatment of radiation proctitis can mitigate inflammatory symptoms, but, to date, no therapeutic options are available for direct recovery of the damaged colonic epithelium. The present study assessed the ability of colon organoid-based regeneration to treat radiation proctitis. Radiation proctitis was induced in mice by irradiating their recta, followed by enema-based transplantation of mouse colon organoids. The transplanted colon organoids were found to successfully engraft onto the damaged rectal mucosa of the irradiated mice, reconstituting epithelial structure and integrity. Lgr5+ stem cells were shown to be pivotal to colon organoid mediated regeneration. Endoscopic examination showed the efficacy of localized transplantation of colon organoids with fibrin glue to irradiated sites. These findings provide useful insights into the use of colon organoid-based regenerative therapy for the treatment of radiation proctitis.
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- 2020
21. RADT-35. 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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Woo Chul Kim, Woong-Ki Chung, Hong In Yoon, Young Zoon Kim, Shin-Hyung Park, Jong Hee Chang, Chae-Yong Kim, Jinhee Kim, Il Han Kim, In Ah Kim, Chang Ok Suh, Tae-Young Jung, Kwan Ho Cho, Chan Woo Wee, Chul-Kee Park, Jung Ho Im, Ho Shin Gwak, Do-Hyun Nam, Sung Hwan Kim, and Do Hoon Lim
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Clinical Radiotherapy ,Cancer Research ,medicine.medical_specialty ,Oncology ,business.industry ,Postoperative radiotherapy ,Medicine ,Intracranial ependymoma ,Neurology (clinical) ,Radiology ,Who grade ,business - Abstract
BACKGROUND To evaluate the impact of adjuvant postoperative radiotherapy (PORT) in adult WHO grade II–III intracranial ependymoma (IEPN). METHODS 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. RESULTS 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. CONCLUSION 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
22. Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multiinstitutional analysis (KROG 19-04).
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Sung Uk Lee, Jinsil Seong, Tae Hyun Kim, Jung Ho Im, Woo Chul Kim, Kyubo Kim, Hae Jin Park, Tae Gyu Kim, Youngkyong Kim, Bae Kwon Jeong, Jin Hee Kim, Byoung Hyuck Kim, and Taek-Keun Nam
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CHEMORADIOTHERAPY ,ADJUVANT chemotherapy ,GALLBLADDER ,RECTAL cancer ,OVERALL survival ,RANDOMIZED controlled trials ,TUMOR classification - Abstract
Objective: The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC. Methods: A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III-IV). Results: In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III-IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05). Conclusions: CRT has value as adjuvant treatment for resected GBC with stage III-IV disease. Further study is needed for stage II disease with high-risk features. [ABSTRACT FROM AUTHOR]
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- 2022
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23. Clinical outcomes of hypofractionated radiotherapy for thyroid-associated ophthalmopathy
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Sang Min Lee, Helen Lew, Hyun Soo Shin, and Jung Ho Im
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Hypofractionated Radiotherapy ,medicine.medical_specialty ,business.industry ,Orbital radiotherapy ,General Medicine ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,030221 ophthalmology & optometry ,medicine ,Radiology ,business ,Thyroid-Associated Ophthalmopathy ,Original Research - Abstract
Objective: To evaluate the safety and effectiveness of hypofractionated orbital radiotherapy applied in the treatment of thyroid-associated ophthalmopathy (TAO) patients. Methods: Between 2014 and 2018, we retrospectively reviewed the cases of 28 patients with TAO. All patients underwent radiotherapy on both retroocular tissues and received an oral steroid. Patients were divided into two treatment groups: 14 patients received conventional fractionated radiotherapy (20 Gy in 10 fractions), and the second group of 14 patients received hypofractionated radiotherapy (20 Gy in five fractions). The clinical activity score (CAS), NOSPECS (No physical signs or symptoms, Only signs, Soft tissue involvement, Proptosis, Extraocular muscle signs, Corneal involvement, and Sight loss) classification, Hess screen test and binocular single vision (BSV) were evaluated to determine the response to treatment before and at 1 month after radiotherapy. Results: There were no significant differences in any of the variables between the two treatment groups. In both groups, the CAS and NOSPECS score decreased significantly, and the range of extraocular muscle motility in Hess screen test and BSV improved significantly after radiotherapy (p < 0.05). There were no significant differences in CAS, NOSPECS score, Hess screen test or BSV between the two groups. No radiation-related, acute severe toxicity was observed. Conclusion: Hypofractionated radiotherapy for TAO produced a comparable clinical outcome to that of conventional fractionated radiotherapy. Further case accumulation and long-term follow-up are required to determine if late toxicity occurs and to confirm efficacy. Advances in knowledge: This is the first study to show that the efficacy and risk of adverse events are comparable between hypofractionated radiotherapy and conventional radiotherapy in the treatment of TAO.
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- 2020
24. 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
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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
25. The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-institutional Retrospective Study (KROG 18-11).
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Joo Ho Lee, Seung Hyuck Jeon, Chul-Kee Park, Sung-Hye Park, Hong In Yoon, Jong Hee Chang, Chang-Ok Suh, Su Jeong Kang, Do Hoon Lim, In Ah Kim, Jin Hee Kim, Jung Ho Im, Sung-Hwan Kim, Chan Woo Wee, and Il Han Kim
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MULTIVARIATE analysis ,PROGRESSION-free survival ,UNIVARIATE analysis ,OVERALL survival ,RETROSPECTIVE studies - 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. [ABSTRACT FROM AUTHOR]
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- 2022
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26. Prognostic factors and patterns of loco-regional failure in patients with R0 resected gallbladder cancer
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Ho Kyoung Hwang, Chang Moo Kang, Woo Jung Lee, Jung Ho Im, and Jinsil Seong
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medicine.medical_specialty ,Multivariate analysis ,Lymphovascular invasion ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Overall survival ,Humans ,In patient ,Risk factor ,Gallbladder cancer ,Therapeutic strategy ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Hepatology ,Proportional hazards model ,business.industry ,medicine.disease ,Prognosis ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Gallbladder Neoplasms ,Neoplasm Recurrence, Local ,business - Abstract
Background In this study, risk factors for loco-regional recurrence in curative R0 resected gallbladder adenocarcinoma were investigated. Methods Patients with gallbladder adenocarcinoma with curative R0 resections between 2000 and 2016 were retrospectively reviewed. Loco-regional failure-free survival (LRFFS) and overall survival (OS) were analyzed using the Kaplan–Meier method; prognostic factors were analyzed using the Cox proportional hazards model. Based on the identified risk factors, patients were grouped for further analysis. Results A total of 272 patients were included for analysis; overall, 5-year LRFFS and OS were 83% and 81%, respectively. On multivariate analysis, 3 risk factors for LRFFS were identified; lymphovascular invasion, T3, and N1, by which patients were grouped; group 1 for 0 factor, group 2 for 1 factor and group 3 for 2 to 3 factors. The 5-year LRFFS in groups 1, 2, and 3 were 94%, 73%, and 40%, and the 5-year OS in groups 1, 2, and 3 were 90%, 75%, and 47%, respectively. LRFFS and OS differed significantly among groups (p Conclusion In patients with R0 resected gallbladder cancer, the presence of >1 risk factor increased the risk of loco-regional recurrence. Additional therapeutic strategy for these patients needs further consideration.
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- 2019
27. Risk factors associated with locoregional failure and estimation of survival after curative resection for patients with distal bile duct cancer
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Dong Ki Lee, Jun Won Kim, Ik Jae Lee, Dong Sup Yoon, Joon Seong Park, and Jung Ho Im
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Adult ,Male ,0301 basic medicine ,Curative resection ,medicine.medical_specialty ,Multivariate analysis ,lcsh:Medicine ,Article ,Bile duct cancer ,03 medical and health sciences ,0302 clinical medicine ,Carcinoembryonic antigen ,Bile Ducts, Extrahepatic ,Risk Factors ,Biomarkers, Tumor ,medicine ,Humans ,Treatment Failure ,Risk factor ,Stage (cooking) ,lcsh:Science ,Aged ,Aged, 80 and over ,Multidisciplinary ,biology ,business.industry ,lcsh:R ,Middle Aged ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Surgery ,030104 developmental biology ,Bile Duct Neoplasms ,biology.protein ,Resection margin ,T-stage ,Female ,Radiotherapy, Adjuvant ,lcsh:Q ,Neoplasm Recurrence, Local ,business ,030217 neurology & neurosurgery - Abstract
Our aim was to identify the risk factors associated with locoregional recurrence in resected distal bile duct cancer (DBDC), and to determine the subgroup that may benefit from adjuvant radiotherapy. Between 2001 and 2013, we retrospectively analyzed 93 patients with DBDC who had undergone curative resection. Patients who received adjuvant radiotherapy were excluded. The 3-year locoregional failure-free survival (LRFFS) and overall survival (OS) rates for all patients were 50.7%, and 53.2%, respectively. On multivariate analysis, the preoperative carcinoembryonic antigen (CEA) level, resection margin, histologic grade, T stage, and N stage were significant prognostic factors for LRFFS. Locoregional recurrence was observed in more than 78% of the patients who underwent R1 resection and were node-positive, and the 3-year LRFFS rate was 19.3%. The 3-year LRFFS rate was 46.9% in the patients who underwent R0 resection and were node-negative with more than 2 risk factors (preoperative CEA level ≥ 5 ng/mL, poorly differentiated histologic grade, and T3 stage). On multivariate analysis for OS, patients with more than 2 risk factors showed a 7-fold higher risk of death, compared with patients with 1 or no risk factor. The important risk factors of locoregional failure in patients with DBDC who underwent resection were R1 resection and positive lymph nodes. Adjuvant radiotherapy should be considered for these patients to improve the oncologic outcomes. Patients undergoing selective R0 resection and those with node-negative status and multiple locoregional failure risk factors may benefit from adjuvant radiotherapy.
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- 2019
28. The Korean Society for Neuro-Oncology (KSNO) Guideline for Adult Diffuse Midline Glioma: Version 2021.1
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Kyung Hwan Kim, Yun Sik Dho, Jin Mo Cho, Chan Woo Wee, Kyoung Su Sung, Min Sung Kim, Hong In Yoon, Young Zoon Kim, Jong Hee Chang, Kihwan Hwang, Jangsup Moon, Ho Shin Gwak, Jae-Sung Park, Myung Hoon Han, Je Beom Hong, Se Hoon Kim, Chul-Kee Park, Wan Soo Yoon, Ji Eun Park, Youn Soo Lee, Do Hoon Lim, Seo Hee Choi, Young Il Kim, Jin Ho Song, Jung Ho Im, Minho Lee, Se-Hoon Lee, Youngbeom Seo, and Ho Sung Kim
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Guideline ,03 medical and health sciences ,0302 clinical medicine ,Glioma ,Korean Society for Neuro-Oncology ,Biopsy ,medicine ,General Environmental Science ,Practice ,Chemotherapy ,Temozolomide ,medicine.diagnostic_test ,business.industry ,Diffuse midline glioma ,medicine.disease ,Radiation therapy ,030220 oncology & carcinogenesis ,General Earth and Planetary Sciences ,Original Article ,Neurosurgery ,Radiology ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019. Methods The Working Group was composed of 27 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As 'diffuse midline glioma' was recently defined, and there was no international guideline, trials and guidelines of 'diffuse intrinsic pontine glioma' or 'brain stem glioma' were thoroughly reviewed first. Results The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma's protocol is recommended. Conclusion The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.
- Published
- 2021
29. A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage
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Jung Ho Im, Myung Hoon Han, Ho Sung Kim, Yun Sik Dho, Jae-Sung Park, Young Il Kim, Jin Ho Song, Youn Soo Lee, Wan Soo Yoon, Chan Woo Wee, Youngbeom Seo, Jin Mo Cho, Hong In Yoon, Do Hoon Lim, Je Beom Hong, Young Zoon Kim, Jong Hee Chang, Chul-Kee Park, Sung Kwon Kim, Jangsup Moon, Se-Hoon Lee, Kyoung Su Sung, Ji Eun Park, Kyung Hwan Kim, Kihwan Hwang, Ho Shin Gwak, and Se Hoon Kim
- Subjects
medicine.medical_specialty ,Practice patterns ,Antiepileptic drugs ,Antiepileptic drug ,Brain tumor ,Brain tumors ,Steroids, Guideline Working Group ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Korean Society for Neuro-Oncology ,medicine ,General Environmental Science ,business.industry ,Questionnaire ,Perioperative ,Guideline ,medicine.disease ,030220 oncology & carcinogenesis ,Emergency medicine ,General Earth and Planetary Sciences ,Original Article ,Levetiracetam ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background The Guideline Working Group of the Korean Society for Neuro-Oncology (KSNO) conducted a nationwide questionnaire survey for diverse queries faced in the treatment of brain tumors. As part I of the survey, the aim of this study is to evaluate national patterns of clinical practice about antiepileptic drug (AED) and steroid usage for management of brain tumors. Methods A web-based survey was sent to all members of the KSNO by email. The survey included 9 questions of AED usage and 5 questions of steroid usage for brain tumor patients. All questions were developed by consensus of the Guideline Working Group. Results The overall response rate was 12.8% (54/423). Regarding AED usage, the majority of respondents (95.2%) routinely prescribed prophylactic AEDs for patients with seizure at the peri/postoperative period. However, as many as 72.8% of respondents prescribed AED routinely for seizure-naïve patients, and others prescribed AED as the case may be. The duration of AED prophylaxis showed wide variance according to the epilepsy status and the location of tumor. Levetiracetam (82.9%) was the most preferred AED for epilepsy prophylaxis. Regarding steroid usage, 90.5% of respondents use steroids in perioperative period, including 34.2% of them as a routine manner. Presence of peritumoral edema (90.9%) was considered as the most important factor determining steroid usage followed by degree of clinical symptoms (60.6%). More than half of respondents (51.2%) replied to discontinue the steroids within a week after surgery if there are no specific medical conditions, while 7.3% preferred slow tapering up to a month after surgery. Conclusion The survey demonstrated the prevailing practice patterns on AED and steroid usage in neuro-oncologic field among members of the KSNO. This information provides a point of reference for establishing a practical guideline in the management of brain tumor patients.
- Published
- 2020
30. Adjuvant Radiotherapy and Chemotherapy Offer a Recurrence and Survival Benefit in Patients with Resected Perihilar Cholangiocarcinoma
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Jinsil Seong, Hye Jin Choi, Gi Hong Choi, Woo Jung Lee, Jung Ho Im, Seung Woo Park, Dai Hoon Han, and Seungmin Bang
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0301 basic medicine ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Adjuvant therapy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Prospective cohort study ,Aged ,Retrospective Studies ,Chemotherapy ,Radiation ,business.industry ,General Medicine ,Chemoradiotherapy, Adjuvant ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Survival Analysis ,Radiation therapy ,Biliary Tract Surgical Procedures ,030104 developmental biology ,Treatment Outcome ,Bile Duct Neoplasms ,Oncology ,030220 oncology & carcinogenesis ,Resection margin ,Adenocarcinoma ,Female ,Neoplasm Recurrence, Local ,business ,Adjuvant ,Chemoradiotherapy ,Follow-Up Studies ,Klatskin Tumor - Abstract
The objective of this study was to investigate the benefits of adjuvant treatment for patients with resected perihilar cholangiocarcinoma (PHC). Between 2001 and 2017, 196 patients with PHC adenocarcinoma underwent curative resection. The patients were divided into four groups according to adjuvant treatment type: surgery alone (S; N = 90), surgery with chemotherapy (S+CTx; N = 67), surgery with radiotherapy (S+RTx; N = 18), and surgery with chemoradiotherapy (S+ CRTx; N = 21). The median follow-up duration of the surviving patients was 58 months. The 5-year rate of overall survival (OS) was 32%. In multivariate analysis, receiving S+CTx and S+CRTx were significant prognostic factors for OS. In subgroup analyses of the R1 resection patients, the S+CRTx group showed better OS than the S group (p
- Published
- 2019
31. Surgery Alone Versus Surgery Followed by Chemotherapy and Radiotherapy in Resected Extrahepatic Bile Duct Cancer: Treatment Outcome Analysis of 336 Patients
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Kyung Sik Kim, Jinsil Seong, Dong Sup Yoon, Kyung Ran Park, Joon Seong Park, Ik Jae Lee, Woo Jung Lee, and Jung Ho Im
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Survival ,medicine.medical_treatment ,Treatment outcome ,Extrahepatic bile duct cancer ,Cholangiocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Bile Ducts, Extrahepatic ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,business.industry ,Middle Aged ,Survival Analysis ,Surgery ,Radiation therapy ,Biliary Tract Neoplasms ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Original Article ,Female ,Adjuvant radiotherapy ,Drug therapy ,business ,Adjuvant ,Chemoradiotherapy - Abstract
PURPOSE This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. MATERIALS AND METHODS A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). RESULTS The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). CONCLUSION Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients.
- Published
- 2015
32. Role of Radiotherapy in the Multimodal Treatment of Ewing Sarcoma Family Tumors
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Chang Ok Suh, Chuhl Joo Lyu, Yun-Han Lee, Yunseon Choi, Jung Ho Im, Do Hoon Lim, and Soo Hyun Lee
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Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Urology ,Antineoplastic Agents ,Bone Neoplasms ,Sarcoma, Ewing ,Young Adult ,Internal medicine ,medicine ,Humans ,Combined Modality Therapy ,Young adult ,Child ,Neoadjuvant therapy ,Retrospective Studies ,Chemotherapy ,Radiotherapy ,business.industry ,Infant ,Retrospective cohort study ,Tumor burden ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,Radiation therapy ,Treatment Outcome ,Child, Preschool ,Female ,Original Article ,Surgery ,Sarcoma ,Neoplasm Recurrence, Local ,business ,Ewing sarcoma ,Progressive disease - Abstract
Purpose The aim of this study was to evaluate the role of radiotherapy (RT) in the management of Ewing sarcoma family tumors (ESFT). Materials and Methods Retrospective analysiswas performed on 91 patientswith localized ESFT treated from 1988 to 2012. Primary tumor size was ≥ 8 cm in 33 patients. Surgery, RT, and combined surgery with RT were applied in 37, 15, and 33 patients, respectively. Results Median follow-up was 43.8 months. Forty-three patients (47.3%) showed recurrence or progressive disease. Twelve patients (13.2%) showed local failure after initial treatment. Thirty-nine patients (42.9%) experienced distant metastases. The 5-year overall survival (OS), progression-free survival, and local control (LC) were 60.5%, 58.2%, and 85.1%, respectively. According to treatment, 5-year LCwas 64.8% with RT and 90.2% with combined surgery and RT (p=0.052). Prognostic factors for OS were tumor size (≥ 8 cm, p < 0.001) and surgical resection (p < 0.001). In large tumors (≥ 8 cm), combined surgery and RT produced better LC compared to RT (p=0.033). However, in smaller tumors (< 8 cm), RT without surgery resulted in a similar LC rate as RT with surgery (p=0.374). Conclusion RT used for patients with unfavorable risk factors resulted in worse outcome than for patientswho received surgery. Smallertumors could be controlled locallywith chemotherapy and RT. For large tumors, combined surgery and RT is needed. Proper selection of local treatment modality, RT, surgery, or both is crucial in the management of ESFT.
- Published
- 2015
33. Recurrence patterns after maximal surgical resection and postoperative radiotherapy in anaplastic gliomas according to the new 2016 WHO classification
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Se Hoon Kim, Junjeong Choi, Jong Hee Chang, Jaeho Cho, Je Beom Hong, Chang Ok Suh, and Jung Ho Im
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Surgical resection ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Anaplastic oligodendroglioma ,Postoperative radiotherapy ,Planning target volume ,lcsh:Medicine ,Article ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,lcsh:Science ,Aged ,Retrospective Studies ,Multidisciplinary ,business.industry ,Incidence ,lcsh:R ,Glioma ,Middle Aged ,medicine.disease ,Prognosis ,Gross Total Resection ,Radiation therapy ,Treatment Outcome ,030220 oncology & carcinogenesis ,lcsh:Q ,Female ,Radiology ,Neoplasm Recurrence, Local ,Who classification ,business ,030217 neurology & neurosurgery ,Anaplastic astrocytoma ,Follow-Up Studies - Abstract
We assessed the appropriateness of current radiotherapy volume for WHO grade III gliomas. The records of 73 patients with WHO grade III gliomas who received postoperative radiotherapy between 2001 and 2013 were retrospectively reviewed. Based on the 2016 WHO classification, 25/73 (34.2%) patients had anaplastic oligodendroglioma (AO), IDH-mutant and 1p/19q-codeleted; 11/73 (15.1%) patients had anaplastic astrocytoma, IDH-mutant; and 37/73 (50.7%) patients had anaplastic astrocytoma, IDH-wildtype. The extent of resection (EOR) was total in 43 patients (58.9%). The median follow-up time was 84 months. The 5-year overall survival was 65.4%. Of 31 patients with documented recurrences, 20 (64.5%) had infield gross tumor volume (GTV) failure, six (19.4%) had clinical target volume (CTV)/marginal failure, and five (16.1%) had outfield failure/seeding. In 13 recurrences among 43 patients who underwent gross total resection (GTR), six (46.2%) had infield CTV/marginal failure. However, among 30 patients for whom GTR was not conducted, infield GTV failure was dominant (77.8%). Seventeen patients with AO, IDH-mutant and 1p/19q-codeleted who underwent GTR experienced no recurrence. In conclusion, maximal surgical resection and postoperative radiotherapy resulted in a favorable prognosis, especially in patients with GTR, IDH mutation, and 1p/19q codeletion. Patterns of failure differed by EOR.
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- 2017
34. Postoperative radiotherapy dose correlates with locoregional control in patients with extra-hepatic bile duct cancer
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Jeongshim Lee, Jun Sung Park, Kyung Sik Kim, Yong Bae Kim, Jung Ho Im, Jinsil Seong, Dong Sup Yoon, Ik Jae Lee, and Woo Jung Lee
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Pathology ,medicine.medical_specialty ,business.industry ,Radiotherapy dosage ,Postoperative radiotherapy ,Perineural invasion ,Bile Duct Neoplasm ,medicine.disease ,Hepatic bile ,Bile duct cancer ,Surgery ,Oncology ,medicine ,Resection margin ,T-stage ,Bile duct neoplasms ,Radiology, Nuclear Medicine and imaging ,In patient ,Original Article ,Clinical Investigation ,Adjuvant radiotherapy ,business - Abstract
Purpose To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. Materials and methods Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). Results The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (≥50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). Conclusion In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.
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- 2014
35. Radiotherapeutic strategies for hepatocellular carcinoma with portal vein tumour thrombosis in a hepatitis B endemic area
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Jun Won Kim, Hee Chul Park, Jeong Il Yu, Hong Seok Jang, Sang Min Yoon, Jong Hoon Kim, Inkyung Jung, Jung Ho Im, Won Sup Yoon, Jinsil Seong, Jinhee Kim, Taek Keun Nam, Mi Sook Kim, Kyubo Kim, and Tae Hyun Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Radiation Dosage ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,medicine ,Combined Modality Therapy ,Humans ,Propensity Score ,Survival rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,Venous Thrombosis ,Korea ,Hepatology ,business.industry ,Portal Vein ,Liver Neoplasms ,Retrospective cohort study ,Hepatitis B ,Middle Aged ,medicine.disease ,Thrombosis ,Radiation therapy ,Survival Rate ,Venous thrombosis ,Logistic Models ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Multivariate Analysis ,030211 gastroenterology & hepatology ,Female ,Radiology ,business - Abstract
BACKGROUND & AIMS This nationwide, multicenter study investigated treatment outcomes as well as the optimal radiotherapeutic strategy in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT). METHODS We retrospectively reviewed the records of 985 patients who received radiotherapy (RT) for PVTT. The median equivalent RT dose was 48.75 Gy. Combined treatment, defined as liver-directed treatments performed within a month of RT, was administered to 657 patients (66.7%). The PVTT and primary tumour were irradiated in 413 patients (41.9%), and PVTT only was targeted in 572 patients (58.1%). RESULTS The response rate of the PVTT was 51.8%, and RT responders had a significantly longer survival than non-responders (15.2 vs. 6.9 months). Equivalent RT dose and combined treatment predicted response of PVTT. The median overall survival (OS) was 10.2 months. Multivariate analysis revealed the equivalent RT dose ˃45 Gy and combined treatment as significant positive factors for OS. In the propensity score matching analysis, the combined treatment group had better OS than the no combined treatment group, whereas the OS of the PVTT + primary tumour group did not differ significantly from that of the PVTT only group. CONCLUSION The equivalent RT dose ˃45 Gy, given in combination with other treatments, provided better PVTT control and OS. The optimal RT volume is suggested for either PVTT + primary or PVTT only. Taken together, multimodal treatment with equivalent RT dose higher than 45 Gy is recommended for patients with HCC and PVTT.
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- 2016
36. Response to Is radiotherapy the best option for treating hepatocellular carcinoma with PVTT?
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Tae Hyun Kim, Jun Won Kim, Hee Chul Park, Kyubo Kim, Jung Ho Im, Jinhee Kim, Won Sup Yoon, Sang Min Yoon, Mi Sook Kim, Taek Keun Nam, Jeong Il Yu, Inkyung Jung, Hong Seok Jang, Jong Hoon Kim, and Jinsil Seong
- Subjects
Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hepatology ,Portal Vein ,business.industry ,medicine.medical_treatment ,Liver Neoplasms ,Portal vein ,MEDLINE ,medicine.disease ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,Carcinoma ,medicine ,Humans ,030211 gastroenterology & hepatology ,Chemoembolization, Therapeutic ,business - Published
- 2017
37. Tailored radiotherapeutic strategies for disseminated uterine cervical cancer patients
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Hong In Yoon, Gwi Eon Kim, Eun Ji Nam, Ki Chang Keum, Ga Won Yim, Sunghoon Kim, Jung Ho Im, Yong Bae Kim, Young Tae Kim, and Sang Wun Kim
- Subjects
Adult ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Lymphatic metastasis ,Uterine Cervical Neoplasms ,Adenocarcinoma ,Disseminated uterine cervical neoplasms ,Metastasis ,Internal medicine ,medicine ,Carcinoma ,Humans ,Chemotherapy ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Small Cell ,Survival rate ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,Radiotherapy ,business.industry ,Research ,Radiotherapy Dosage ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Radiation therapy ,Radiology Nuclear Medicine and imaging ,Visceral organ metastasis ,Carcinoma, Squamous Cell ,Female ,business ,Follow-Up Studies - Abstract
Background To investigate the role of radiotherapy (RT) in and to suggest radiotherapeutic strategies for patients presenting with disseminated cervical cancer. Methods We retrospectively analyzed 50 patients diagnosed as the disseminated cervical cancer with distant lymph nodal or visceral organ metastasis between September 1980 and August 2012. Patients were divided into two subgroups according to visceral organ metastasis: 35 patients diagnosed with distant lymph node metastasis only (group A) and 15 patients with visceral organ metastasis (group B). All patients received external beam RT to the pelvis (median dose 45 Gy) and high-dose rate intracavitary RT (median dose 30 Gy). Thirty-nine patients (78%) received chemotherapy. Results Median follow-up time was 74 months. The 5-year pelvic control rate (PCR) was 85.8%, and the progression-free survival (PFS), and overall survival (OS) rates were 28.7%, and 36.2%, respectively. The major treatment failure was systemic progression (32 patients, 64%). The 5-year PCRs in groups A and B were 87.4% and 74.7%, respectively (p > 0.05). Meanwhile, PFS and OS rates for group A were significantly better than those for group B (35.3% vs. 13.3%, p = 0.010; and 46.3% vs. 13.3%, p = 0.009, respectively). Conclusion Our data revealed considerable prognostic heterogeneity in disseminated cervical cancer. Even though a high PCR was achieved in patients treated with definitive RT, survival outcomes were dependent on progression of visceral organ metastasis. Therefore, personalized RT and chemotherapy treatment strategies according to the presence of visceral organ metastasis in disseminated cervical cancer patients may help improve clinical outcomes.
- Published
- 2015
38. Surgery Alone Versus Surgery Followed by Chemotherapy and Radiotherapy in Resected Extrahepatic Bile Duct Cancer: Treatment Outcome Analysis of 336 Patients.
- Author
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Jung Ho Im, Jinsil Seong, Ik Jae Lee, Joon Seong Park, Dong Sup Yoon, Kyung Sik Kim, Woo Jung Lee, and Kyung Ran Park
- Subjects
- *
CANCER chemotherapy , *RADIOTHERAPY , *CHOLANGIOCARCINOMA , *HEALTH outcome assessment , *ADJUVANT treatment of cancer , *THERAPEUTICS , *PATIENTS - Abstract
Purpose This study analyzed the outcomes of patients with resected extrahepatic bile duct cancer (EHBDC) in order to clarify the role of adjuvant treatments in these patients. Materials and Methods A total of 336 patients with EHBDC who underwent curative resection between 2001 and 2010 were analyzed retrospectively. The treatment types were as follows: surgery alone (n=168), surgery with chemotherapy (CTx, n=90), surgery with radiotherapy (RT) alone (n=29), and surgery with chemoradiotherapy (CRT, n=49). Results The median follow-up period was 63 months. The 5-year rates of locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for all patients were 56.5%, 59.7%, 36.6%, and 42.0%, respectively. In multivariate analysis, surgery with RT and CRT was a significant prognostic factor for LRFFS, and surgery with CTx was a significant prognostic factor for DMFS, and surgery with CTx, RT, and CRT was a significant prognostic factor for PFS (p < 0.05). Surgery with CTx and CRT showed association with superior OS (p < 0.05), and surgery with RT had marginal significance (p=0.078). In multivariate analysis of the R1 resection patients, surgery with CRT showed significant association with OS (p < 0.05). Conclusion Adjuvant RT and CTx may be helpful in improving clinical outcomes of patients with resected EHBDC who have a high risk of disease recurrence, particularly R1 resection patients. Conduct of additional prospective, larger-scale studies will be required in order to confirm the benefit of adjuvant RT and CTx in these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
39. Role of Radiotherapy in the Multimodal Treatment of Ewing Sarcoma Family Tumors.
- Author
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Yunseon Choi, Do Hoon Lim, Soo Hyun Lee, Chuhl Joo Lyu, Jung Ho Im, Yun-Han Lee, and Chang-Ok Suh
- Subjects
EWING'S sarcoma ,OSTEOSARCOMA ,RADIOTHERAPY ,BONE tumors ,CANCER treatment - Abstract
Purpose The aim of this study was to evaluate the role of radiotherapy (RT) in the management of Ewing sarcoma family tumors (ESFT). Materials and Methods Retrospective analysis was performed on 91 patients with localized ESFT treated from 1988 to 2012. Primary tumor size was ≥ 8 cm in 33 patients. Surgery, RT, and combined surgery with RT were applied in 37, 15, and 33 patients, respectively. Results Median follow-up was 43.8 months. Forty-three patients (47.3%) showed recurrence or progressive disease. Twelve patients (13.2%) showed local failure after initial treatment. Thirty-nine patients (42.9%) experienced distant metastases. The 5-year overall survival (OS), progression-free survival, and local control (LC) were 60.5%, 58.2%, and 85.1%, respectively. According to treatment, 5-year LC was 64.8% with RT and 90.2% with combined surgery and RT (p=0.052). Prognostic factors for OS were tumor size (≥ 8 cm, p < 0.001) and surgical resection (p < 0.001). In large tumors (≥ 8 cm), combined surgery and RT produced better LC compared to RT (p=0.033). However, in smaller tumors (< 8 cm), RT without surgery resulted in a similar LC rate as RT with surgery (p=0.374). Conclusion RT used for patients with unfavorable risk factors resulted in worse outcome than for patients who received surgery. Smaller tumors could be controlled locally with chemotherapy and RT. For large tumors, combined surgery and RT is needed. Proper selection of local treatment modality, RT, surgery, or both is crucial in the management of ESFT. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
40. Ontology-Enabled Knowledge Management in Environmental Regulations and Incentive Policies: The ERIPAD System
- Author
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Oh, Seog-Chan, primary, Zhao, Xiang, additional, Biller, Stephan R., additional, Lee, Kisup, additional, Jung, Ho-Im, additional, Sohn, Mye, additional, and Lee, Heesang, additional
- Published
- 2010
- Full Text
- View/download PDF
41. Tailored radiotherapeutic strategies for disseminated uterine cervical cancer patients.
- Author
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Jung Ho Im, Hong In Yoon, Sunghoon Kim, Eun Ji Nam, Sang Wun Kim, Ga Won Yim, Ki Chang Keum, Young Tae Kim, Gwi Eon Kim, and Yong Bae Kim
- Subjects
- *
RADIOTHERAPY , *CERVICAL cancer treatment , *LYMPH nodes , *METASTASIS , *PROGNOSTIC tests , *CANCER chemotherapy - Abstract
Background: To investigate the role of radiotherapy (RT) in and to suggest radiotherapeutic strategies for patients presenting with disseminated cervical cancer. Methods: We retrospectively analyzed 50 patients diagnosed as the disseminated cervical cancer with distant lymph nodal or visceral organ metastasis between September 1980 and August 2012. Patients were divided into two subgroups according to visceral organ metastasis: 35 patients diagnosed with distant lymph node metastasis only (group A) and 15 patients with visceral organ metastasis (group B). All patients received external beam RT to the pelvis (median dose 45 Gy) and high-dose rate intracavitary RT (median dose 30 Gy). Thirty-nine patients (78%) received chemotherapy. Results: Median follow-up time was 74 months. The 5-year pelvic control rate (PCR) was 85.8%, and the progression-free survival (PFS), and overall survival (OS) rates were 28.7%, and 36.2%, respectively. The major treatment failure was systemic progression (32 patients, 64%). The 5-year PCRs in groups A and B were 87.4% and 74.7%, respectively (p > 0.05). Meanwhile, PFS and OS rates for group A were significantly better than those for group B (35.3% vs. 13.3%, p = 0.010; and 46.3% vs. 13.3%, p = 0.009, respectively). Conclusion: Our data revealed considerable prognostic heterogeneity in disseminated cervical cancer. Even though a high PCR was achieved in patients treated with definitive RT, survival outcomes were dependent on progression of visceral organ metastasis. Therefore, personalized RT and chemotherapy treatment strategies according to the presence of visceral organ metastasis in disseminated cervical cancer patients may help improve clinical outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
42. Postoperative radiotherapy dose correlates with locoregional control in patients with extra-hepatic bile duct cancer.
- Author
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Jung Ho Im, Jinsil Seong, Jeongshim Lee, Yong Bae Kim, Ik Jae Lee, Jun Sung Park, Dong Sup Yoon, Kyung Sik Kim, and Woo Jung Lee
- Subjects
- *
RADIOTHERAPY , *CHOLANGIOCARCINOMA , *PALLIATIVE treatment , *THERAPEUTICS ,BILE duct surgery - Abstract
Purpose: To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival. Materials and Methods: Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%). Results: The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (≥ 50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively). Conclusion: In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
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