• Radiation Oncology Journal
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• v.29 no.1
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• pp.36-43
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• 2011

Purpose: To evaluate the effectiveness of radiation therapy (RT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to analyze the prognostic factors. Materials and Methods: From December 2004 to April 2009, 70 patients who had HCC with PVTT were treated with RT at Keimyung University Dongsan Medical Center. Nineteen patients whose total dose was below 30 Gy and one patient who underwent liver transplantation were excluded. The remaining 50 patients (45 males, 5 females; median age 55 years) were analyzed. According to the LCSGJ TNM stage, there were 27 patients (54.0%) with stage III and 23 (46.0%) with stage IV. Total dose of 30~54 Gy was administered (median 45). Thirty patients (60.0%) were treated with concurrent chemoradiation therapy (CCRT). The median follow-up duration was from 13.5 months (range, 3 to 70 months). Results: The median survival time from the start of RT was 9 months. One-year and 2-year overall survival rates were 24.9% and 11.2%, respectively. At the follow-up time, three patients (6.0%) displayed no evidence of disease. Seven patients (14.0%) were alive with disease, and 40 (80.0%) patients had expired due to disease progression. CCRT was associated with worse survival than RT alone (p=0.034), Response to RT (p=0.037), CLIP stage (p=0.017), and TNM stage (p=0.041) were statistically significant prognostic factors. There was no radiation-induced liver disease. Conclusion: RT is an effective and safe modality for HCC with PVTT. Further studies such as prospective randomized trials are needed to confirm the role of RT for HCC with PVTT.

• Radiation Oncology Journal
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• v.1 no.1
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• pp.25-28
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• 1983

Anterior and posterior parallel opposed field technique covering entire neck is desirable for elimination of junctional problems in treating upper neck with bilateral parallel opposed fields and lower neck with anterior one field. For good dose distribution in neck, dose in build-up region should be high for anterior field and should be low for posterior field. And so, with 10 MV X-ray, lead absorber was used for anterior field only. The adequate thickness of lead absorber, absorber-skin separation, width of central cord block for posterior field and anterior & posterior field weight were studied using film dosimery. The results are as follows. 1. As the thickness of the lead absorber increased the dose in build-up region increased. 2. As the absorber-skin separation decreased the dose in build-up region increased. 3. The adequate thickness of lead absorber was around 5.6mm. 4. The adequate absorber-skin separation was around 5cm. 5. The adequate posterior cord block width was 3cm. 6. 4:1 weighting for anterior and posterior field was adequate. And so with this technique, adequate dose distribution could be made as well as elimination junction problems.

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.75-81
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• 1996

When high energy photon beam is incident upon an air cavity interface the effect of ionization build-up observed . This phenomenon is resulting from the surface layers of the lesions are significant deficiency of electrons reaching the layers because of the replacement, of solid scattering material by the air cavity, that is lack of electronic equilibrium. Measurement have been made in an acrylic phantom with a parallel plate chamber and high energy photon beams, CO-60, 4MV, 6MV and 10MV X-rays have been investigated. The result of our study show that a significant effect was measured and was determined to be very dependent on field size, air cavity dimension and photon energy. The reductions were much larger for 10MV beam, underdosage at the interface was 12, 12.2, 16.9 and $20.6\%$ for the CO-60, 4MV, 6MV and 10MV, respectively. It was found that this non-equilibrium effect at the interface is more severe for the higher energy beams than that of lower energy beams and the larger cavity dimensions the larger beam reductions occur. This problem is of clinical concern when lesions such as carcinoma beyond air cavities are irradiated, such as larynx, glottic and the patients with maxillectomy and ethmoidectomy and so forth.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.149-153
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• 1984

Postoperative radiotherapy of breast cancer makes it possible to reduce loco-regional recurrence of breast cancer. The treatment technique, which can reduce the low-dose region at the junction and lung, is required. To produce proper dose distribution of internal mammary chain and chest wall, authors tried to find the method to expose $^{60}Co\;\gamma-ray$ on internal mammary region and 7MeV electron on chest wall. Exposure time of $^{60}Co\;\gamma$ and monitor unit of 9MeV were selected so that dose of $^{60}Co$ at 4cm depth was the same as that of 7Mev electron at $80\%$ dose depth. The position and direction of electron beam were changed for $^{60}Co$ beam: $0^{\circ},\;5^{\circ}$ for 0cm seperation; $0^{\circ},\;5^{\circ},\;10^{\circ}$ for 0.5cm seperation; $5^{\circ},\;10^{\circ},\;15^{\circ}$ for 1cm seperation. The results are as followings. 1. When the seperation of two fields was increased, dose on the axis of $^{60}Co$ beam was increased and dose at the junction region decreased while the volume of lung to be exposed to high dose and hot spot size were irregularly changed. 2. The dose distribution in the target volume of internal mammary and chest wall was most ideal when the seperation of two fields was $0\~0.5cm$ and the direction of electron beam was parallel to $^{60}Co$ beam.

• Journal of Digital Convergence
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• v.13 no.1
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• pp.331-339
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• 2015

The purpose of this study is to evaluate utility of rotating adjustment using Xsight spine tracking system in 3D DOF location adjusting method, to minimize error between 6D DOF and 3D DOF in fiducial tracking system. In this study, the result of 6D DOF target location error is $0.124{\pm}0.058mm$, using fiducial inside tumor 3D DOF $0.673{\pm}0.142mm$, outside tumor $1.126{\pm}0.253mm$, apply with Xsight spine tracking system 3D DOF $0.542{\pm}0.103mm$. As the experiment shows, it was demonstrated that rotating adjustment through Xsight spine tracking system is valuable in case of treatment in 3D DOF location error that makes increasing accuracy and dose distribution each approximately 48% and 3%. In accordance with result of this study is useful rotation.

• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.69-77
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• 1998

When a high energy photon beam is used to treat lesions located in the upper respiratory air passages or in maxillary sinus, the beams often must traverse an air cavity before it reaches the lesion. Because of this traversal of air, it is not clear that the surface layers of the lesion forming the air-tumor tissue interface will be in a state of near electronic equilibrium; if they are not, underdosing of these layers could result. Although dose corrections at large distances beyond an air cavity are accountable by attenuation differences, perturbations at air-tissue interfaces are complex to measure or calculate. This problem has been investigated for 4MV and 10MV X-ray beams which are becoming widely available for radiotherapy with linear accelerator. Markus chamber was used for measurement with variouse air cavity geometries in X-ray beams. Underdosing effects occur at both the distal and proximal air cavity interface. The magnitude depended on geometry, energy, field sizes and distance from the air-tissue interfaces. As the cavity thickness increased, the central axis dose at the distal interface decreased. Increasing field size remedied the underdosing, as did the introduction of lateral walls. Fellowing a $20{\times}2{\times}2\;cm^3$\;air\;cavity,\;4{\times}4\;cm\;field\;there\;was\;an\;11.5\%\;and\;13\%\;underdose\;at\;the\;distal\;interface,\;while\;a\;20{\times}20{\times}2\;cm^3\;air\;cavity\;yielded\;a\;24\%\;and\;29\%$ loss for the 4MV and 10MV beams, respectively. The losses were slightly larger for the 10MV beams. The measurements reported here can be used to guide the development of new calculation models under non-equilibrium conditions. This situation is of clinical concern when lesions such as larynx and maxillary carcinoma beyond air cavities are irradiated.

• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.88-93
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• 1998

Multileaf collimator is essential equipment in conformal radiation therapy, however the use is limitted by increase of penumbra width and undulating dose distribution at the field edge. The purpose of this study is to improve the penumbra and dose distribution in the multileaf collimator field edge. Measurement were performed with X-omat V film in solid water phantom using 6MV photon beam from Siemens linear accelerator. All the measurement were made along the central axis of $5{\times}5cm,\;10{\times}10cm$ circular field for constant SSD of 100 cm. To improve the penumbra and dose distribution collimator was rotated by 15 degrees from 0 to 90 degrees (collimator rotation method) and center was shifted to the longitudinal direction by fourth of lead width (center shift method). We compare the penumbra and dose distribution at the field edge to alloy block. Dose distribution and penumbra width at the feild edge of MLC showed undulated dose pattern and increased penumbra compared with alloy block. However, in the collimator rotation method and center shift method we abtained simular results with alloy block. Through the study we expected that clinical use of MLC will be increase.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.299-305
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• 2003

Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.186-193
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• 2005

Purpose: To improve the management of a medical linear accelerator, the records of operational failures of a Varian CL2l00C over a ten year period were retrospectively analyzed. Materials and Methods: The failures were classified according to the involved functional subunits, with each class rated Into one of three levels depending on the operational conditions. The relationships between the failure rate and working ratio and between the failure rate and outside temperature were investigated. In addition, the average life time of the main part and the operating efficiency over the last 4 years were analyzed. Results: Among the recorded failures (total 587 failures), the most frequent failure was observed in the parts related with the collimation system, including the monitor chamber, which accounted for $20\%$ of all failures. With regard to the operational conditions, 2nd level of failures, which temporally interrupted treatments, were the most frequent. Third level of failures, which interrupted treatment for more than several hours, were mostly caused by the accelerating subunit. The number of failures was increased with number of treatments and operating time. The average life-times of the Klystron and Thyratron became shorter as the working ratio increased, and were 42 and $83\%$ of the expected values, respectively. The operating efficiency was maintained at $95\%$ or higher, but this value slightly decreased. There was no significant correlation between the number of failures and the outside temperature. Conclusion: The maintenance of detailed equipment problems and failures records over a long period of time can provide good knowledge of equipment function as well as the capability of predicting future failure. Wore rigorous equipment maintenance Is required for old medical linear accelerators for the advanced avoidance of serious failure and to improve the qualify of patient treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.1
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• pp.41-46
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• 2010

Purpose: To analyze differences in the dose uniformity for the computed breast radiation therapy planning with tangential beam between conventional RT using wedge filter and FiF-IMRT using multileaf collimator based onsizes and volumes of breasts. Materials and Methods: Thirty breast cancer patients were classified according to the sizes and volumes of the breasts using Eclipse treatment planning system ($Varian^{TM}$, USA, V8.0). Conformity Index and Homogeneity Index were computed along with Dose Volume Histogram. Results: No differencein CI (${\pm}1.2%$) was observed. However, lower mean HI (1.67%) in FiF-IMRT was observed compared to that of the conventional RT. Statically significant (P<0.01) correlation was identified between the values of ${\Delta}HI$ (%) and physical parameters such as breast volumes and separations. Conclusion: Increase in breast volume and separation improves the dose uniformities in computed radiation therapy planning for FiF-IMRT. Physical dimension of the breast should be considered to optimize the compured radiation therapy planning.