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韓一病院에서 放射線照射(Cs^(137)遠隔照射, Radium 腔內照射)에 依한 子宮頸癌 治療(第2報)

Cs^(137) and Radium Radiation Terapy of Cancer of the Uterine Cervix in Hahnil Hospital (Ⅱ)

대한산부인과학회지 1966년 9권 11호 p.27 ~ 28
申雄浩 (  ) - 韓一病院 産婦人科

강영호 (  ) - 韓一病院 産婦人科
邕相吉 (  ) - 韓一病院 産婦人科

Abstract


In the ,first section(basic section) of this report, the physical characteristics and biologic effects of Cs´37 in comparison with Co60 and X-ray as the external irradiation therapy, and the advantages and the method of dosage calculation in use of TAO. (Tasaki, Arai, Otachi) applicator, the afterloading technic of Ra, as the internal irradiation therapy were discussed.
CS137 and Co60 are more excellent in their therapeutic effects than conventional x-ray.
Cs137 has longer half-life, less penumbra, ease in protection, and costs low for its installation, but hI.s lower energy level with less depth dose and dose rate.
In calculation of Ra dosage, two methods were adopted instead of mg. hr or mC. hr which were less valuable for accurate biologic effects. Unit of R (Roentgen) in bilateral : points A & points B was calculated.
In the second section (clinical section), 167 cases from 181 cases who were admitted and treated for the invasive cancer of the uterine cervix since July, 1962 till June, 1966 were studied about the clinical therapeutic effects after the irradiation therapy. Four cases with radical operation only and 10 cases with chemotherapy were excluded in this study.
The 167 cases were divided into group I (119 cases) in which subgroup A treated with Cs137 therapy only and subgroup B with Ra and Cs137 therapy were included, and group $ (48 cases) in which subgroup C (46 cases) with Cs137 therapy after radical operation and subgroup D (2 cases) with radical operation after the. irradiation therapy were included.
The following results were obtained;
1. The local lesions of the cervix were improved in about 80 per cent of cases. And the effect was better in subgroup B than in subgroup A.
2. The size of induration from the parametrial invasion was also decreased in about 70 per cent of cases.
3. Incidence of metastasis to the pelvic lymph nodes was 14.3 per cent in 28 cases of stage. I and 38.8 per cent in 18 cases of stage II.
. 4. Recurrences of the cervical cancer were detected in 23 cases, mostly within one year after radiation therapy. Most prevalent sites were the vaginal wall (16 cases) and pelvic cavity (12 cases). Eleven cases from them expired within one year and twelve cases were lost.
5. As radiation sickness, nausea, general weakness, anorexia, and headache were most, common. And they were most severe in 10 th to 15 th day after beginning of radiation therapy and then gradually subsided,
6. Erythema and/or dark pigmentation of the skin were common; but excoriation (5.4%), bulla (3.2%), and ulceration (3.2%) were rare
7. Other common complications during radiation therapy were disorders of the rectum (22 cases) and bladder disturbances (11 cases).
8. Survival rate:
(1) In group I: Two years after completion of radiation therapy, 70 cases (46.2%) from 149 cases were lost. Three years after completion of radiation therapy, 65 cases (58.6%) from 111 cases were lost. And their survival rates were uncertain.
(2) In subgroup C (with Cs137 therapy after radical operation): Two years survival rate in 44 cases, - two years after completion of radiation therapy (7 case were lost), was 84.6 per cent in the first stage and 55.6 per cent in the second stage. Three years survival rate in 33 cases, three years after completion of radiation therapy (10 cases were lost), was 63.2 per cent in the first stage and 50.0 per cent in the second stage.

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