Journal of Yeungnam Medical Science

Review article

Radiation Oncology
Radiation therapy in the treatment of pancreatoblastoma: a narrative review: Atsuto Katano; J Yeungnam Med Sci. 2025;42:37. Published online June 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.37

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Abstract PDF: Pancreatoblastoma is an extremely rare pediatric pancreatic tumor that primarily affects children <10 years of age, with a mean age of onset of 5 years. Risk factors such as vascular and lymph node involvement often lead to incomplete resection, necessitating a multidisciplinary approach. Despite these strategies, the role of radiotherapy in the management of pancreatoblastoma remains unclear. A quantitative literature search of the PubMed database was performed to identify relevant case reports and series that explicitly documented the use of radiotherapy for pancreatoblastoma. The search covered the period from January 1986 to November 2024. Of the 36 records retrieved, seven case reports comprising eight patients fulfilled the inclusion criteria. Six patients underwent radiotherapy at the primary tumor site with external beam therapy doses ranging from 36 to 46.2 Gy. Intraoperative radiotherapy was also administered in two cases, with doses of 15 and 20 Gy. Additionally, stereotactic radiotherapy was administered to two patients with intracranial metastases, demonstrating its effectiveness in managing brain metastases. Although the role of radiotherapy in pancreatoblastoma remains ambiguous, it demonstrates promise in cases of incomplete resection, recurrence, or non-resectable disease. However, pediatric patients require careful consideration because of potential long-term side effects. Further research is required to optimize radiotherapy protocols and integrate emerging therapies.

Original article

Radiation Oncology
Clinical performance of FractionLab in patient-specific quality assurance for intensity-modulated radiotherapy: a retrospective study: Se An Oh, Sung Yeop Kim, Jaehyeon Park, Jae Won Park, Ji Woon Yea; J Yeungnam Med Sci. 2022;39(2):108-115. Published online September 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01123

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Background
This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT).
Methods
The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and BrainLAB) between June 2019 and March 2021. We analyzed the multileaf collimator (MLC) DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm–1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm).
Results
The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1 (95.5%–100%) and 97.5% (92.3%–99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm–0.9%/0.9 mm).
Conclusion
This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

Citations

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Impact of Multileaf Collimator Width and Normal Tissue Objective on Radiation Dose Distribution in Stereotactic Radiosurgery Using HyperArc for Single Brain Lesions
Se An Oh, Jae Won Park, Ji Woon Yea, Jaehyeon Park, Yoon Young Jo
Current Oncology.2025; 32(5): 272. CrossRef
Clinical Performance of FractionLab Using Log Files for Patient-Specific Quality Assurance in Stereotactic Radiosurgery Using Truebeam Equipped with HyperArc
Ji Young Bae, Sung Yeop Kim, Jae Won Park, Jaehyeon Park, Ji Woon Yea, Yoon Young Jo, Se An Oh
Progress in Medical Physics.2025; 36(2): 27. CrossRef

Case report

Radiology, Radiotherapy & Diagnostic Imaging
Stent graft treatment of an ilioenteric fistula secondary to radiotherapy: a case report: Joo Yeon Jang, Ung Bae Jeon, Jin Hyeok Kim, Tae Un Kim, Jae Yeon Hwang, Hwa Seong Ryu; J Yeungnam Med Sci. 2022;39(1):77-80. Published online July 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01053

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Abstract PDF

Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

Citations

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Resection of sigmoid cancer with bladder invasion using laparoscopic combined with a cystoscopic holmium laser: an innovative surgical procedure
Ronghua Wu, Cong Xu, Xing Liu, Weihua Fu, Yujia Chen, Jingzhen Zhu, Guangsheng Du
Lasers in Medical Science.2023;[Epub] CrossRef

Review article

Radiation Oncology
Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma: Jongmoo Park, Jae Won Park, Min Kyu Kang; Yeungnam Univ J Med. 2019;36(3):192-200. Published online August 12, 2019; DOI: https://doi.org/10.12701/yujm.2019.00269

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Abstract PDF

Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

Citations

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Quantification of dose accumulation using deformable image registration: Application in re‐irradiation of liver metastases using robotic radiosurgery
Ahamed Badusha Mohamed Yoosuf, Mohd Zahri Abdul Aziz, Mohd Syahir Mansoor, Gokula Kumar Appalanaido, Salem Alshehri, Mamdouh Alqathami
Journal of Applied Clinical Medical Physics.2025;[Epub] CrossRef
Radiation therapy, radiosurgery, chemotherapy and targeted therapies for metastatic spine tumors: WFNS Spine committee recommendations
Vashisht Sekar, Jamie Walsh, Luke H. Pearson, Ori Barzilai, Salman Sharif, Mehmet Zileli
Neurosurgical Review.2024;[Epub] CrossRef
Dosimetric Comparison Study Between Free Breathing and Breath Hold Techniques in Patients Treated by Liver-Directed Stereotactic Body Radiation Therapy
Atsuto Katano, Tomoyuki Noyama, Kosuke Morishima, Yuki Nozawa, Hideomi Yamashita
Cureus.2023;[Epub] CrossRef
The role of stereotactic body radiotherapy (SBRT) in the treatment of recurrent / progressive lung lesions after primary treatment
H. Demir, S. Özdemir, N. Işık, G. Yaprak
International Journal of Radiation Research.2023; 21(4): 727. CrossRef
Gastric Fistula After MR-Guided Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma
Sarah Goodchild, Matthew N. Mills, Russell F. Palm, Sarah E. Hoffe, Jessica M. Frakes
Applied Radiation Oncology.2023; 12(4): 40. CrossRef
MRI features of treated hepatocellular carcinoma following locoregional therapy: a pictorial review
Mohanned Alnammi, Jeremy Wortman, Jaclyn Therrien, Jalil Afnan
Abdominal Radiology.2022; 47(7): 2299. CrossRef
Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis
Shan Jin, Shisheng Tan, Wen Peng, Ying Jiang, Chunshan Luo
World Journal of Surgical Oncology.2020;[Epub] CrossRef

Original articles

Pathology and Forensic Medicine
What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?: Sol-Min Kim, Ghilsuk Yoon, An Na Seo; Yeungnam Univ J Med. 2019;36(2):124-135. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00157

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Abstract PDF

Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Citations

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Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy
Tuba Kurt Catal, Günay Can, İsmai̇l Demi̇rel, Sefi̇ka Ergen, Di̇dem Öksüz
Oncology Letters.2025; 29(5): 1. CrossRef
Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection
Mohamed I Fahim, Fady Shafeik, Rasha M Allam, Marina Asaad, Mohammad Taher
Cureus.2025;[Epub] CrossRef
Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

Obstetrics, Gynecology, and Reproductive Medicine
Clinical significance of lymph node size in locally advanced cervical cancer treated with concurrent chemoradiotherapy: Jinju Oh, Ki Ho Seol, Youn Seok Choi, Jeong Won Lee, Jin Young Bae; Yeungnam Univ J Med. 2019;36(2):115-123. Published online February 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00143

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Abstract PDF

Background
This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT).
Methods
A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed.
Results
The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the in-field para-aortic LN failure rate (p=0.024). The pelvic and para-aortic LN size (≥10 mm) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ≥10 mm).
Conclusion
A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.

Citations

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Lokal fortgeschrittenes Zervixkarzinom - evidenzbasierte Standards und Perspektiven
Tanja N. Fehm, Emely Cathrin Dreher, Camila Hoyos Banchon, Jan Haussmann, Juliane Hörner-Rieber, Frederic Dietzel
Frauenheilkunde up2date.2026; 20(02): 129. CrossRef
Clinical outcomes of external radiotherapy boost versus no boost to radiologically positive lymph nodes in FIGO stage IIIC cervical cancer
Karthik S. Rishi, K. Harshita, Pilli Spandana, Pradeep Kumar Reddy Donapati, P.S. Hari, G.V. Giri
International Journal of Gynecological Cancer.2025; 35(10): 102030. CrossRef
Therapeutic effects of surgical debulking of metastatic lymph nodes in cervical cancer IIICr: a trial protocol for a phase III, multicenter, randomized controlled study (KGOG1047/DEBULK trial)
Bo Seong Yun, Kwang-Beom Lee, Keun Ho Lee, Ha Kyun Chang, Joo-Young Kim, Myong Cheol Lim, Chel Hun Choi, Hanbyoul Cho, Dae-Yeon Kim, Yun Hwan Kim, Joong Sub Choi, Chae Hyeong Lee, Jae-Weon Kim, Sang Wun Kim, Yong Bae Kim, Chi-Heum Cho, Dae Gy Hong, Yong J
Journal of Gynecologic Oncology.2024;[Epub] CrossRef
Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report
Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla
World Journal of Clinical Cases.2024; 12(10): 1851. CrossRef
RECIST 1.1 versus clinico-radiological response assessment for locally advanced cervical cancer: implications on interpreting survival outcomes of future trials
Mayuri Charnalia, Supriya Chopra, Jaahid Mulani, Palak Popat, Sushmita Rath, Maarten Thomeer, Prachi Mittal, Ankita Gupta, Ingrid Boere, Sudeep Gupta, Remi A Nout
International Journal of Gynecological Cancer.2024; 34(6): 817. CrossRef
Efficacy of lymph node dissection on stage IIICr of cervical cancer before CCRT: study protocol for a phase III, randomized controlled clinical trial (CQGOG0103)
Misi He, Mingfang Guo, Qi Zhou, Ying Tang, Lin Zhong, Qing Liu, Xiaomei Fan, Xiwa Zhao, Xiang Zhang, Gang Chen, Yuanming Shen, Qin Xu, Xiaojun Chen, Yuancheng Li, Dongling Zou
Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Stadializarea clinică şi chirurgicală a pacientelor cu cancer de col uterin – studiu retrospectiv privind corelaţiile dintre diagnosticul iniţial, opţiunile de tratament şi rezultatele histopatologice
Mihai-Cristian Dumitraşcu, Adina-Elena Nenciu, Cătălin George Nenciu, Carmen Ursu, Andreea Ilieşiu, Alexandru Baroş, Diana Secară, Monica Mihaela Cîrstoiu
Ginecologia.ro.2023; 1(39): 30. CrossRef
Treatment of bulky lymph nodes in locally advanced cervical cancer: boosting versus debulking
Ester Paulien Olthof, Hans Wenzel, Jacobus van der Velden, Anje M Spijkerboer, Ruud Bekkers, Jogchum J Beltman, Hans W Nijman, Brigitte Slangen, Ramon Smolders, Nienke van Trommel, Petra L M Zusterzeel, Ronald Zweemer, Lukas J A Stalpers, Maaike van der A
International Journal of Gynecological Cancer.2022; 32(7): 861. CrossRef
Targetability of cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT) for patients receiving radiation therapy
Lifei Zhu, Yi Huang, Dao Lam, H. Michael Gach, Imran Zoberi, Dennis E. Hallahan, Perry W. Grigsby, Hong Chen, Michael B. Altman
International Journal of Hyperthermia.2021; 38(1): 498. CrossRef
Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study
Simone Marnitz, Audrey Tieko Tsunoda, Peter Martus, Marcelo Vieira, Renato Jose Affonso Junior, João Nunes, Volker Budach, Hermann Hertel, Alexander Mustea, Jalid Sehouli, Jens-Peter Scharf, Uwe Ulrich, Andreas Ebert, Iris Piwonski, Christhardt Kohler
International Journal of Gynecological Cancer.2020; 30(12): 1855. CrossRef

Radiation Oncology
Non–coplanar whole brain radiotherapy is an effective modality for parotid sparing: Jaehyeon Park, Jae Won Park, Ji Woon Yea; Yeungnam Univ J Med. 2019;36(1):36-42. Published online January 3, 2019; DOI: https://doi.org/10.12701/yujm.2019.00087

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Abstract PDF

Background
The purpose of this study was to evaluate the efficacy and feasibility of non–coplanar whole brain radiotherapy (NC–WBRT) for parotid sparing.
Methods
Fifteen cases, previously treated with WBRT were selected. NC–WBRT plans were generated. The beam arrangement for the non–coplanar plans consisted of superior anterior, right, and left beams. After generation of the non–coplanar plans a field–in–field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC–WBRT plans were subsequently compared with the previously generated bilateral WBRT (B–WBRT) plans. A field–in–field technique was also used with the B–WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.
Results
The mean dose to the parotid gland for the two different plans were 16.2 Gy with B–WBRT and 13.7 Gy with NC–WBRT (p<0.05). In the NC–WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B–WBRT plan. The Dmax of the lens was also lower by 10% with NC–WBRT.
Conclusion
The use of NC–WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose–volume parameters of the parotid gland.

Citations

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Dosimetric optimization for dynamic mixed beam arc therapy (DYMBARC)
Chengchen Zhu, Gian Guyer, Jenny Bertholet, Silvan Mueller, Hannes A. Loebner, Werner Volken, Julius Arnold, Daniel M. Aebersold, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser
Medical Physics.2025; 52(1): 489. CrossRef
Organs in plain sight—parotid gland doses in short-course palliative whole-brain radiotherapy
Maheshkumar N. Upasani, Prashantkumar Shinde, Rameshwar Veer
Supportive Care in Cancer.2025;[Epub] CrossRef
Dosimetric analysis of different whole brain radiotherapy treatment planning methods: three types of 3-dimensional versus hippocampal avoidant
Jonathan Robert Gabriel, Angela Mariah Locke, Brian William Miller, Jared Rex Robbins
Radiation Oncology Journal.2025; 43(2): 63. CrossRef
DiffRecon: Diffusion-based CT reconstruction with cross-modal deformable fusion for DR-guided non-coplanar radiotherapy
Jiawei Sun, Nannan Cao, Hui Bi, Liugang Gao, Kai Xie, Tao Lin, Jianfeng Sui, Xinye Ni
Computers in Biology and Medicine.2024; 179: 108868. CrossRef
Technical note: Feasibility of gating for dynamic trajectory radiotherapy – Mechanical accuracy and dosimetric performance
Hannes A. Loebner, Daniel Frauchiger, Silvan Mueller, Gian Guyer, Paul‐Henry Mackeprang, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser, Jenny Bertholet
Medical Physics.2023; 50(10): 6535. CrossRef
Impact of the gradient in gantry‐table rotation on dynamic trajectory radiotherapy plan quality
Hannes A. Loebner, Silvan Mueller, Werner Volken, Philipp Wallimann, Daniel M. Aebersold, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser
Medical Physics.2023; 50(11): 7104. CrossRef
Retrospective analysis of portal dosimetry pre-treatment quality assurance of intracranial SRS/SRT VMAT treatment plans
Ernest Osei, Sarah Graves, Johnson Darko
Journal of Radiotherapy in Practice.2022; 21(4): 540. CrossRef
Application of piecewise VMAT technique to whole-brain radiotherapy with simultaneous integrated boost for multiple metastases
Yuan Xu, Yingjie Xu, Kuo Men, Jianping Xiao, Jianrong Dai
Radiation Oncology.2022;[Epub] CrossRef
Setup uncertainties and appropriate setup margins in the head-tilted supine position of whole-brain radiotherapy (WBRT)
Jae Won Park, Ji Woon Yea, Jaehyeon Park, Se An Oh, Ngie Min Ung
PLOS ONE.2022; 17(8): e0271077. CrossRef
Examination of the best head tilt angle to reduce the parotid gland dose maintaining a safe level of lens dose in whole‐brain radiotherapy using the four‐field box technique
Hidetoshi Shimizu, Koji Sasaki, Takahiro Aoyama, Hiroyuki Tachibana, Hiroshi Tanaka, Yutaro Koide, Tohru Iwata, Tomoki Kitagawa, Takeshi Kodaira
Journal of Applied Clinical Medical Physics.2021; 22(2): 49. CrossRef
Noncoplanar Versus Coplanar Intensity-Modulated Radiation Therapy (IMRT) for Protection of the Lip and Buccal Mucosa
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Whole brain radiotherapy using four-field box technique with tilting baseplate for parotid gland sparing
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Case Report

Gastroenterology and Hepatology
A Case of Metastatic Hepatocellular Carcinoma of the Orbit.: Young Joo Yang, Seung Hyeon Bae, Il Young Jang, Mi Jung Jun, Ji Won Jung, Ji Hyun An, Ju Hyun Shim; Yeungnam Univ J Med. 2013;30(2):152-155. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.152

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Abstract PDF: Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Review Article

Radiation Oncology
Role of Radiation Therapy in Treatment of Stomach Cancers: Sang Mo Yun, Myung Se Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S245-251. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S245

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Abstract PDF: Although occasionally used as a therapeutic modality, radiotherapy was not a routine part of the treatment of stomach cancer. As a single modality, preoperative radiotherapy showed some benefit, but this was not confirmed in radomized trial. In recent neoadjuvant trials, radiotherapy is usually given concurrently with chemotherapy, and pathologic complete response rates was about 30%. There were small studies of radiotherapy as an adjuvant, either alone or with chemotherapy, but the randomized studies using postoperative radiotherapy alone did not show a survival benefit. The results of intergroup gastric adjuvant trial(INT 0116) were presented in May 2000 at American Society of Clinical Oncology. In that report, postoperative concurrent chemoradiotherapy showed survival benefit. INT 0116 has established postoperative chemoradiotherapy as the standard care for high risk patients with resected stomach cancer. But, INT 0116 had several weak points including lack of standardized nodal dissection and delivery rates of treatments. So, Asian and European investigators did not agree. Korean study showed benefit of postoperative chemoradiotherapy after D2 dissection, but this study was not randomized. Recently, Korean investigators started randomized trial of chemoradiotherapy in D2 dissected patients. This trial may give answer to us about the benefit of postoperative chemoradiotherapy in resected stomach cancer.

Original Articles

Gastroenterology and Hepatology
The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma.: Jong Ryul Eun, Kyo Won Choi, Heon Ju Lee, Mung Se Kim; Yeungnam Univ J Med. 2000;17(2):137-145. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.137

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Abstract PDF: BACKGROUND
Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

Radiation Oncology
Treatment Planning Correction Using MRI in the Radiotherapy of Cervical Cancer.: Se One Shin, Kil Ho Cho, Chan Won Park; Yeungnam Univ J Med. 1995;12(2):203-209. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.203

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Abstract PDF: PURPOSE: To evaluate the role of MRI in the management of cervical cancer treated by conventional four-field whole pelvic irradiation. METHOD AND MATERIAL: Between 1993-march and 1994-february, 20 patients(4 Stage I B, 3 Stage U A, 13 Stage U B) with invasive cervical cancer were eligible for evaluation of accuracy of conventionally designed lateral treatment field without MRI determination. RESULTS: 5 out of 20 Patients had inadequate margin without MRI. The position of uterine fundus was more important than cervix in correction of field size and the center of treatment field. CONCLUSION: This Preliminary date show MRI determination of uterine position prior to radiotherapy planning is essential in the case of four-field whole pelvic irradiation technique.

Radiation Oncology
Radiation therapy of nasopharyngeal cancers.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1992;9(2):312-320. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.312

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Abstract PDF: Radiotherapeutically, nasopharyngeal caner is an important disease in Korea. Because of its blind anatomic location, early detection is relatively uncommon. Clinically, most of cases are locally advanced and nodal involvements are common. Recently better understanding of nature of the disease and improvement of radio – therapy technique permit better treatment result, including locoregional control and survival rate, and minimal normal tissue damages comparing with previously published date. We analyzed 31 patients of pathologically proven and previously untreated naso – pharyngeal carcinoma with different treatment techniques, retrospectively. Minimal and maximal follow up period of the survivor is 6 months and 68 months, respectively. Thirteen patients with squamous cell carcinoma are included in this analysis. The median age is 49 years (range from 20 to 64 years). Twenty two patients are stage III. Eleven patients are treated with radiotherapy alone and 20 are treated with combined modalities treatment. The degree of response after radiotherapy are categorized by 3-classes, i,e. complete response, partial response. In spite of similarities of complete response rate and 1-year survival rate between two different treatment techniques, those patients with undifferentiated carcinoma appear to benefit from the adjuvant chemotherapy. In addition, systemic failure is more suggest that adjuvant therapy in the radiotherapeutic management of nasopharyngeal cancer needs additional research according to histologic types and future extensive clinical trials.

Radiation Oncology
Palliative effect of radiation therapy in management of symptomatic osseous metastases: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1992;9(1):102-109. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.102

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Abstract PDF: Bone metastases represent an important and frequent clinical problem in patients with advanced cancers. Especially, painful bone metastases are common features in these patients. Radiotherapy is an effective tool for palliative aim of painful metastatic osseous lesions. Various treatment results have been previously reported. The present retrospective study was aimed to evaluate the efficacy of palliative irradiation on pain relief, with the goal of selecting appropriate irradiation dose schedule. Radiotherapy consisted of 5 times a week with a various fractional dose between 180 and 400cGy. The response of pain relief and the survival time after completion of radiotherapy are related to total dose and most of the patients have shown a similar response by the end of radiotherapy. The higher dose and the more aggressive multimodality treatment, the better pain control and the longer survival time.

Radiation Oncology
A study of dose distribution in postoperative radiotherapy in uterine cervical cancer.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1991;8(1):166-177. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.166

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Abstract PDF: Uterine cervical cancer is the most common malignancy in Korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications cannot be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analyzed to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that out treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

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