• Radiation Oncology Journal
• /
• v.11 no.2
• /
• pp.241-247
• /
• 1993

Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

• The Journal of Korean Society for Radiation Therapy
• /
• v.22 no.1
• /
• pp.11-18
• /
• 2010

Purpose: In every time radiation therapy set up errors occur because internal anatomical organs move due to breathing and change of patient's position. These errors may affect the change of dose distribution between target area and normal structure. This study investigates the usefulness of body-fix in clinical treatment. Materials and Methods: Among 55~60 aged male patients who has hepatocellular carcinoma in area of liver's couinaud classification, we chose 10 patients and divided two groups by using body-fix or not. When applying body-fix, we maintained a vacuum of 80 mbar pressure by using vacuum pump (Medical intelligence, Germany). Patients had free breathing with supine position. After working to fuse and consist MV-CT (megavoltage computed tomography) with KV-CT (kilovoltage computed tomography) obtained by 5 times treatments, we compared and analyzed set up errors occurred to (Right to Left, RL) of X axis, (Anterioposterio, AP) of Z axis, (Cranicoudal, CC) of Y axis. Results: Average Set up errors through image fusion showed that group A moved $0.3{\pm}1.1\;mm$ (Cranicoudal, CC), $-1.1{\pm}0.7\;mm$ (Right to Left, RL), $-0.2{\pm}0.7\;mm$ (Anterioposterio, AP) and group B moved $0.62{\pm}1.94\;mm$ (Cranicoudal, CC), $-3.62{\pm}1.5\;mm$ (Right to Left, RL), $-0.22{\pm}1.2\;mm$ (Anterioposterio, AP). Deviations of X, Y and Z axis directions by applying body-fix indicated that maximum X axis was 5.5 mm, Y axis was 19.8 mm and Z axis was 3.2 mm. In relation to analysis of error directions, consistency doesn't exist for every patient but by using body-fix showed that the result of stable aspect in spite of changes of everyday's patient position and breathing. Conclusion: Using body-fix for liver cancer patient is considered effectively for tomotherapy. Because deviations between group A and B exist but they were stable and regular.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.311-323
• /
• 1998

Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

• Journal of Radiation Protection and Research
• /
• v.40 no.3
• /
• pp.124-131
• /
• 2015

Radiation exposure to humans can be caused by the gamma rays emitted from natural radioactive elements(such as uranium, thorium and potassium and any of their decay products) of Naturally Occurring Radioactive Materials(NORM) or Technologically Enhanced Naturally Occurring Radioactive Materials(TENORM) added consumer products. In this study, assume that activity of radioactive elements is $^{238}U$, $^{235}U$, $^{232}Th$ $1Bq{\cdot}g^{-1}$, $^{40}K$ $10Bq{\cdot}g^{-1}$ and the gamma rays emitted from these natural radioactive elements radioactive equilibrium state. In this study, reflected End-User circumstances and evaluated annual exposure dose for products based on ICRP reference voxel phantoms and ICRP Recommendation 103 using the Monte Carlo Method. The consumer products classified according to the adhere to the skin(bracelet, necklace, belt-wrist, belt-ankle, belt-knee, moxa stone) or not(gypsum board, anion wallpaper, anion paint), and Geometric Modeling was reflected in Republic of Korea "Residential Living Trend-distributions and Design Guidelines For Common Types of Household.", was designed the Room model($3m{\times}4m{\times}2.8m$, a closed room, conservatively) and the ICRP reference phantom's 3D segmentation and modeling. The end-user's usage time assume that "Development and Application of Korean Exposure Factors." or conservatively 24 hours; in case of unknown. In this study, the results of the effective dose were 0.00003 ~ 0.47636 mSv per year and were confirmed the meaning of necessary for geometric modeling to ICRP reference phantoms through the equivalent dose rate of belt products.

• Radiation Oncology Journal
• /
• v.1 no.1
• /
• pp.29-36
• /
• 1983

The treatment of tumors along curved surfaces with stationary electron beams using cone collimation may lead to non-uniform dose distributions due to a varying air gap between the cone surface and patient. For large tumors, more than one port may have to be used in irradiation of the chest wall, often leading to regions of high or low dose at the junction of the adjacent ports. Electron-beam arc therapy may elimination many of these fixed port problems. When treating breast tumors with electrons, the energy of the internal mammary port is usually higher than that of the chest wall port. Bolus is used to increase the skin dose or limit the range of the electrons. We invertiaged the effect of various arc beam parameters in the isodose distributions, and combined into a single arc port for adjacent fixed ports of different electron beam eneries. The higher fixed port energy would be used as the arc beam energy while the beam penetration in the lower energy region would be controlled by a proper thickness of bolus. We obtained the results of following: 1. It is more uniform dose distribution of electron to use rotation than stationary irradiation. 2. Increasing isocenter depth on arc irradiation, increased depth of maximum dose, reduction in surface dose and an increasing penetration of the linear portion of the curve. 3. The deeper penetration of the depth dose curve and higher X-ray background for the smaller field sized. 4. If the isocenter depth increase, the field effect is small. 5. The decreasing arc beam penetration with decreasing isocenter depth and the isocenter depth effect appears at a greater depth as the energy increases. 6. The addition of bolus produces a shift in the penetration that is the same for all depths leaving the shape of the curves unchanged. 7. Lead strips 5 mm thick were placed at both ends of the arc to produce a rapid dose drop-off.

• Radiation Oncology Journal
• /
• v.1 no.1
• /
• pp.41-45
• /
• 1983

To obtain 7 MeV electron beam which is suitable for treatment of the chest wall after radical of modified radical mastectomy, the authors reduced the energy of electron beam by means by Lucite plate inserted in the beam. To determine the proper thickness of the Lucite plate necessary to reduce the energy of 9 MeV electron beam to 6 MeV, dosimetry was made by using a parallel plate ionization chamber in polystyrene phantom. Separation between two adjacent fields, 7 MeV for chest wall and 12 MeV for internal mammary region, was studied by means of film dosimetry in both polytyrene phantom and Humanoid phantom. The results were as follows. 1. The average energy of 9 MeV electron beam transmitted through the Lucite plate was reduced. Reduction was proportional to the thickness of the Lucite plate in the rate of 1.7 MeV/cm. 2. The proper thickness of the Lucite plate necessary to obtain 6 MeV electron beam from 9 MeV was 1.2 cm. 3. 7 MeV electron beam, 80% dose at 2cm depth, is adequate for treatment of the chest wall. 4. Proper separation between two adjacent electron fields, 7 MeV and 12 MeV, was 5mm on both flat surface and sloping surface to produce uniform dose distribution.

• Journal of Radiation Protection and Research
• /
• v.1 no.1
• /
• pp.22-30
• /
• 1976

The perturbation of dose distribution adjacent to cavities in high energy electron has shown that the percentage of dose increase varies markedly as a function of the build-up layer, the length and thickness of the cavities, and the electron energy. The dose distribution showed that cavities similar in size to those encountered in the head and neck measured by industrial film dosimetry and corrected by ionization chambers. The most increased doses by measuring are resulted in a localized dose of up to 130% of that measured at the depth of maximum dose within a homogeneous tissue equivalent phantom. The measured values and correction factors of dose perturbation due to air cavities showed in diagrams and would be summarized as follows. 1. In $8{\sim}12MeV$ electron beams, the most marked dose is observed when the build-up layer thickness is 0.5cm and cavity volume is $2{\times}2{\times}2cm^3$. 2. The highest dose point is located under cavity when the energy is increased and cavity length is longer. 3. The cavity length at which the maximum percentage dose occurs decreases with increasing energy. 4. The highest percentage cavity doses are obtained when the energy is high, the build-up layer is thin, the thickness of the cavity is large, and the length of the cavity is approximately 1 to 3cm. 5. The doses of upper portion of cavity are less than the standard dose distribution as 5 to 10%. 6. The maximum range of electron beam are extended as much as thickness of cavity. 7. A cavity having a length of 5cm closely approximates a cavity of infinite length.

• Radiation Oncology Journal
• /
• v.13 no.2
• /
• pp.199-203
• /
• 1995

Purpose: To evaluate the dose under lung block as a function of depth and the effectiveness of a block as a function of block width. Materials and Methods : Field size of mantle field was $22.8{\times}32.4cm^2.$ Dose distribution of the mantle field was measured with two dimensional water phantom system. To analyze the effectiveness of the lung block. central axis plane, 5cm off-axis plane, and 10cm off-axis plane were studied. Results: The dose under the lung block was recorded with maximum at the depth between 5cm and 10cm. In the central axis plane, dosimetric block width was $10-15\%$ less than physical block width. In the 5cm off-axis plane, dosimetric block width was $4-9\%$ less than physical block width. In the 10cm off-axis plane, dosimetric block width was $2\%$ less than physical block width. Conclusion: Depth dependence of the dose under the lung block was founded. Also, block width dependence of the lung block was founded. To induce the accurate relation between the physical block width and the 'effective' block width, it needs more detailed understanding of the variables involved.

• Journal of Radiation Protection and Research
• /
• v.3 no.1
• /
• pp.6-22
• /
• 1978

High energy electron beams took effect for tumor radio-therapy, however, had a lot of problems in clinical application because of various conversion factors and complication of physical reactions. Therefor, we had experimentally studied the important properties of high energy electron beams from the linear accelerator, LMR-13, installed in Yonsei Cancer Center. The results of experimental studies on the problems in the 8, 10, 12 Mev electron beam therapy were reported as following. 1. On the measurements of the outputs and absorbed doses, the ionization type dosimeters that had calibrated by $^{90}Sr$ standard source were suitable as under 3% errors for high energy electrons to measure, but measuring doses in small field sizes and the regions of rapid fall off dose with ionization chambers were difficult. 2. The electron energy were measured precisely with energy spectrometer consisted of magnet analyzer and tele-control detector and the practical electron energy was calculated under 5% errors by maximum range of high energy electron beam in the water. 3. The correcting factors of perturbated dose distributions owing to radiation field, energy and material of the treatment cone were checked and described systematically and variation of dose distributions due to inhomogeneous tissues and sloping skin surfaces were completely compensated. 4. The electron beams, using the scatterers; ie., gold, tin, copper, lead, aluminium foils, were adequately diffused and minimizing the bremsstrahlung X-ray induced by the electron energy, irradiation field size and material of scatterers, respectively. 5. Inproving of the dose distribution from the methods of pendulum, slit, grid and focusing irradiations, the therapeutic capacity with limited electron energy could be extended.

• Radiation Oncology Journal
• /
• v.2 no.2
• /
• pp.271-280
• /
• 1984

The peripheral dose, defined as the dose outside therapeutic photon fields, which is responsible for the functional damage of the critical organs, fetus, and radiation. induced carcinogenesis, has been investigated for $^{60}Co\;\gamma$ ray and 10 MV Xray. It was measured by silicon diode controlled by semiautomated water phantom without any shielding or with lead plate of HVL thickness put horizontally or vertically to shield stray radiations. Authors could obtain following results. 1. The peripheral dose was larger than $0.7\%$ of central axis maximum dose even at 20cm distance from field margin. That is clinically significant, so it should be reduced. 2. Even for square fields of 10 MV Xray, radial peripheral dose distribution did not coincide with transverse distribution, because of the position of collimator jaws. 3. Between surface and $d_m$, the peripheral dose distributions show a pattern of the dose distribution of electron beams and the maximum doss was approximately proportional to the length of a side of square field. 4. The peripheral doses depended on radiation quality, field size, distance from field margin and depth in water. Distance from field margin was the most important factor. 5. Except for near surface, the peripheral dose from phantom was approximately equal to that from therapy unit. 6. To reduce the surface dose outside fields, therapist should shield stray radiations from therapy unit by lead plate of at least one HVL for 10 MV X-ray and by bolus equivalent to tissue of 0.5cm thickness for $^{60}Co$. 7. To reduce the dose at depth deeper than $d_m$, it is desirable to shield stray radiations from therapy unit by lead.