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초록보기

Purpose: To assess the efficacy of the use of accelerated hyperfractionated radiotherapy (AHRT) for locally

advanced uterine cervix cancers.

Materials and Methods: Between May 2000 and September 2002, 179 patients were identified with FIGO

stage IIB, IIIB, and IVA cancers. Of the 179 patients, 45 patients were treated with AHRT (AHRT group) and

134 patients were treated with conventional radiotherapy (CRT group), respectively. Patients undergoing the

AHRT regimen received a dose of 30 Gy in 20 fractions (1.5 Gy×2 fractions/day) to the whole pelvis.

Subsequently, with a midline block, we administered a parametrial boost with a dose of 20 Gy using 2 Gy

fractions. Patients also received two courses of low-dose-rate brachytherapy, up to a total dose of 85∼90

Gy to point A. In the CRT group of patients, the total dose to point A was 85∼90 Gy. The overall treatment

duration was a median of 37 and 66 days for patients that received AHRT and CRT, respectively. Statistical

analysis was calculated by use of the Kaplan-Meier method, the log-rank test, and Chi-squared test.

Results: For patients that received cisplatin-based concurrent chemotherapy and radiotherapy, the local control

rate at 5 years was 100% and 79.2% for the AHRT and CRT group of patients, respectively (p=0.028).

The 5-year survival rate for patients with a stage IIB bulky tumor was 82.6% and 62.1% for the AHRT group

and CRT group, respectively (p=0.040). There was no statistically significant difference for severe late toxicity

between the two groups (p=0.561).

Conclusion: In this study, we observed that treatment with AHRT with concurrent chemotherapy allows a significant

advantage of local control and survival for locally advanced uterine cervix cancers.

목 적: 이 연구의 목적은 국소진행된 자궁경부암에서의 가속과분할 방사선치료의 효용성을 평가하기 위함이다.

대상 및 방법: 2000년 5월부터 2002년 9월 사이에 자궁경부암 병기 IIB, IIIB, IVA로 가속과분할 방사선치료를 받은 환

자 45명과 같은 기간 동안 고식적 방사선치료를 받은 병기 IIB, IIIB, IVA 환자 134명이 비교 분석되었다. 가속과분할 방

사선치료는 전골반에 대하여 총 30 Gy의 방사선을 1.5 Gy씩 하루 2회, 총 10일에 나누어 조사하였다. 전골반 조사 후

중심 차폐하여 자궁주위 조직에 대하여 총 20 Gy의 방사선을 2 Gy씩 하루 1회, 총 10일에 나누어 조사하였다. 외부방

사선치료가 끝난 후 Cs-137을 이용한 저선량 근접치료를 Point A 기준 55∼60 Gy의 방사선치료를 2회 시행하여, Point

A 기준 총 85∼90 Gy의 방사선 선량이 주어지도록 치료하였다. 고식적 방사선치료 또한 Point A 기준 총 85~90 Gy의

방사선 선량이 주어지도록 치료하였다. 총 치료기간은 가속과분할 치료군의 경우 중앙값이 37일이었으며, 고식적 치료

군은 중앙값 66일이었다. 통계적 분석은 Kaplan-Meyer 법, log-rank test, 그리고 Chi-square test를 통해 이루어졌다.

결 과: 항암치료를 시행했던 환자군에서, 5년 국소제어율은 각각 100.0%와 79.2%로 가속과분할 치료군이 고식적 치

료군에 비해 통계적으로 유의하게 우수한 성적을 보였고(p=0.028), 5년 생존율은 병기 IIB의 큰 종양군에서 가속과분할

치료군이 82.6%으로 고식적 치료군의 62.1%에 비해 통계적으로 유의하게 우수한 성적을 보였다(p=0.074). 두 군간에

있어서 방사선치료로 인한 후기 합병증의 차이는 없었다(p=0.561).

결 론: 항암치료와 동반된 가속과분할 방사선치료는 국소진행된 자궁경부암에서 생존율 및 국소제어율을 높이는데 효

과가 있을 것으로 판단된다.

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기사명 저자명 페이지 원문 목차
Management of regional lymph nodes in localizaed vulvar carcinoma Won Il Jang ;Hong-gyun Wu ;Charn Il Park ;Sung Whan Ha ;Hyo Pyo Lee ;Soon Beom Kang ;Yong Sang Song pp.1-9

A comparison of clinical outcomes for breast-conserving treatment and mastectomy for early breast cancer Jae Myoung Noh ;Won Park ;Seung Jae Huh ;Doo Ho Choi ;Jung Hyun Yang ;Seok Jin Nam ;Jeong Han Kim ;Y pp.10-16

식도의 편평상피세포암 환자에서 외부방사선치료의 결과 장지영 pp.17-23

Accelerated hyperfractionated radiotherapy for locally advanced uterine cervix cancers Young Seok Seo ;Chul Koo Cho ;Seong Yul Yoo ;Mi Sook Kim ;Kang Mo Yang ;Hyung Jun Yoo ;Chul Won Choi pp.24-34

세기조절방사선치료(IMRT)로 치료한 비소세포폐암 환자에서의 방사선 폐렴 김명세 pp.35-44

45세 이하의 유방암환자에서 조직미세배열법을 이용한 면역조직화학적 생체표지자의 역할 김은석 ;최두호 ;진소영 ;이동화 ;박희숙 ;이민혁 ;원종호 ;김용호 ;이규택 ; pp.45-55

국소진행된 직장암에서 cathepsin D와 p53 발현의 임상적 의의 김준상 ;이생금 ;김진만 ;조문준 pp.56-64

젊은 한국인 유방암 환자에서 BRCA1/2 돌연변이와 호르몬 수용체, HER-2 상태에 관한 연구 최두호 ;진소영 ;이동화 ;김은석 ;김용호 pp.65-73

참고문헌 (42건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Jae-Gab P. Cancer Incidence of Korea 1999-2001. Seoul, Republic of Korea; Ministry of Health and Welfare, 2005:157 미소장
2 Effect of tumor size on the prognosis of carcinoma of the uterine cervix treated with irradiation alone. 네이버 미소장
3 Fletcher GH. Cancer of the uterine cervix. janeway lecture, 1970. Am J Roentgenol Radium Ther Nucl Med 1971;111: 225-242 미소장
4 Radiation alone in the treatment of cancer of the uterine cervix: Analysis of pelvic failure and dose response relationship 네이버 미소장
5 Kil WJ, Chun MS, Kang SH, et al. Rdiotherapy results in stage IIB uterine cervix cancer. J Korean Soc Ther Radiol Oncol 2001;19:345-352 미소장
6 Mini-colpostats in the treatment of carcinoma of the uterine cervix 네이버 미소장
7 Carcinoma of the cervix, stage III. Results of radiation therapy. 네이버 미소장
8 Rectal complications in patients with carcinoma of the cervix treated with concomitant cisplatin and external beam irradiation with high dose rate brachytherapy: A dosimetric analysis 네이버 미소장
9 Bladder and rectal complications following radiotherapy for cervix cancer. 네이버 미소장
10 Biologic basis for altered fractionation schemes. 네이버 미소장
11 A new isoeffect curve for change in dose per fraction 네이버 미소장
12 Radiation induced renal damage in mice: Influence of fraction size 네이버 미소장
13 Ang KK, Howard D. Altered fractionation schedules. In: Perez CA, Brady LW, eds. Principles and Practice of Radiation Oncology. 4th ed. Philadelphia, PA: Lippincott Co. 2004:337-356 미소장
14 Saunders MI, Dische S. Continuous, hyperfractionated, accelerated radiotherapy (CHART) in non-small cell carcinoma of the bronchus. Int J Radiat Oncol Biol Phys 1990;19:1211- 1215 미소장
15 Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial 네이버 미소장
16 Suit HD. The american society of therapeutic radiologists presidential address: October 1981. potential for improving survival rates for the cancer patient by increasing the efficacy of treatment of the primary lesion. Cancer 1982;50:1227-1234 미소장
17 Fletcher GH. Squamous cell carcinoma of the uterine cervix: treatment technique according to size of the cervical lesion and extension. 1980 18. Leibel S, Bauer M, Wasserman T, et al. Radiotherapy with or without misonidazole for patients with stage IIIB or stage IVA squamous cell carcinoma of the uterine cervix: preliminary report of a radiation therapy oncology group randomized trial. Int J Radiat Oncol Biol Phys 1987;13:541-549 미소장
18 Hydroxyurea: A radiation potentiator in carcinoma of the uterine cervix: A randomized double-blind study 네이버 미소장
19 Preliminary results of concurrent radiotherapy and chemotherapy in advanced cervical carcinoma: a phase I-II prospective intergroup NCOG-RTOG Study. 네이버 미소장
20 Split-course versus continuous pelvis irradiation in carcinoma of the uterine cervix: A prospective randomized clinical trial of the radiation therapy oncology group 네이버 미소장
21 Neutron therapy in cervical cancer: Results of a phase III RTOG study 네이버 미소장
22 Sequential study on the effect of the addition of hyperbaric oxygen on the 5 year survival rates of carcinoma of the cervix treated with conventional fractional irradiations. 네이버 미소장
23 Carcinoma of the cervix: Results of a hyperbaric oxygen trial associated with the use of the cathetron 네이버 미소장
24 Withers HR, Taylor JM, Maciejewski B. The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 1988;27:131-146 미소장
25 The effect of treatment duration in the local control of cervix cancer 네이버 미소장
26 Perez CA, Grigsby PW, Castro-Vita H, Lockett MA. Carcinoma of the uterine cervix. I. impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy. Int J Radiat Oncol Biol Phys 1995;32:1275-1288 미소장
27 Twice-daily fractionation of external irradiation with brachytherapy in bulky carcinoma of the cervix. Phase I/II study of the Radiation Therapy Oncology Group 88-05. 네이버 미소장
28 Accelerated hyperfractionated radiotherapy for locally advanced cervix cancer 네이버 미소장
29 Tumor Size, Irradiation Dose, and Long-Term Outcome of Carcinoma of Uterine Cervix 네이버 미소장
30 Changes in the rate of repopulation during multifraction irradiation of mouse skin. 네이버 미소장
31 Loss of local control with prolongation in radiotherapy 네이버 미소장
32 Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. 네이버 미소장
33 Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. 네이버 미소장
34 Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer 네이버 미소장
35 Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. 네이버 미소장
36 Cisplatin, Radiation, and Adjuvant Hysterectomy Compared with Radiation and Adjuvant Hysterectomy for Bulky Stage IB Cervical Carcinoma 네이버 미소장
37 Modified partial hyperfractionation in radiotherapy for bulky uterine cervical cancer: reduction of overall treatment time 네이버 미소장
38 Randomized comparison of weekly cisplatin or protracted venous infusion of fluorouracil in combination with pelvic radiation in advanced cervix cancer: a gynecologic oncology group study. 네이버 미소장
39 Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial (RTOG) 90-01. 네이버 미소장
40 Results of a phase II trial of concurrent chemoradiation in the treatment of locally advanced carcinoma of uterine cervix: an experience from India. 네이버 미소장
41 Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix 네이버 미소장
42 Radiotherapy with or without misonidazole for patients with stage IIIB or stage IVA squamous cell carcinoma of the uterine cervix: preliminary report of a Radiation Therapy Oncology Group randomized trial. 네이버 미소장

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