본 논문에서는 직장암 환자를 대상으로 일반적 치료방식인 3차원입체조형치료법과 선형가속기 기반의 I MRT, 그리고 토모테라피를 이용한 IMRT의 치료계획을 각각 수립하여 직장암 환자에 대한 최적의 치료법 을 비교하고자 하였다. 치료법 비교 결과 종양조직에서는 처방선량의 95% 이상의 흡수선량을 만족시키고 있었으며 정상조직인 방광, 소장, 넙다리머리뼈의 정상조직의 합병증 발생율의 기준(V40, V30, V20, V10) 을 만족하였다. 다만, 3가지의 치료법에서 선량분포측면에서 가장 효율적인 치료법은 Tomotherapy기반의 I MRT였으며 가장 낮은 효율을 보인 치료법은 3DCRT였다. 직장암의 방사선 치료시 환자의 자세재현성, 개 인적인 신체환경 등을 고려하여 가장 적합한 치료방식을 적용한다면 환자의 예후와 삶의 질에 긍정적인 효과가 나타날 것으로 사료된다.

The aim of this study was to evaluate clinical outcomes of laparoscopic surgery for colorectal cancer within a learning period. A total of 86 consecutive patients who underwent laparoscopic resection for colorectal cancer between January 2010 and December 2011 were investigated retrospectively. The patients were sorted into the early and late group; 43 patients were included in each group. Patient’s clinicopathologic features, perioperative outcomes, morbidity, and mortality were evaluated. The two groups showed similar operative results in terms of operation time, conversion rate to open surgery (16% vs 7%, p=0.313), and the rate of postoperative complication (34.9% vs 37.2%, p=0.313). The most serious complication, anastomotic leak, developed in five and four patients in the early and late group, respectively. Hemoglobin change, which means blood loss indirectly was lower in late phase and was statistically significant (2.3g/dL vs. 1.7g/dL, p=0.007). No difference in TNM stage and number of retrieved lymph nodes (19.2±11.9 vs 18.7±12.7, p=0.847) was observed between the two groups. Laparoscopic surgery for colorectal cancer can be performed safely and effectively even during a learning period, if the operation is performed carefully.

Capecitabine is a prodrug of a 5-fluorouracil (5-FU) that is converted to 5-FU inside the tumor cells. Here, we report a case of 5-FU induced encephalopathy which was subsequently treated with capecitabine without any neurologic complication. A 76-year-old man with rectal adenocarcinoma received chemotherapy, which consisted of 5-FU, leucovorin and oxaliplatin after resection of the primary and metastatic masses. Confusion and agitation were observed during the 2nd cycle of chemotherapy and reappeared during 4th cycle. Both events were completely disappeared within a few days. Capecitabine was administered for 4 cycles without any neurologic toxicity. Capecitabine could be an alternative in patients experiencing 5-FU induced encephalopathy.