• Title/Summary/Keyword: 이차방사선

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Curative Radiotherapy of Supralottic Cancer (성문상부암의 근치적 방사선치료)

  • Kim, Yong-Ho;Chai, Gyu-Young
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.139-145
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    • 1998
  • Purpose : The purpose of this study was to evaluate the efficacy of curative radiotherapy in the management of supralottic cancer. Materials and Methods : Twenty-one Patients with squamous cell carcinoma of the supralottis were treated with radiotherapy at Gyeongsang National University Hospital between 1590 and 1994. Median follow-up period was 36 months and 95% were observed for at least 2 years. Results : Actuarial survival rate at 5 years was 39.3% for 21 patients. The 5-rear actuarial survival rate was 75.0% in Stage I, 42.9% in Stage II, 33.3% in Stage III and 28.6% in Stage IV(p=0.54), The 5-year local control rate was 52.0% for 21 patients. The 5-rear local control rate was 75.0% in Stage I, 57.1% in Stage II, 66.7% in Stage III, and 28.6% in Stage IV(p=0.33). Double primary cancer was developed in 3 patients and those were all esophageal cancers. Conclusion : In early stage(Stage I and II) supralottic cancer, curative radiotherapy would be a treatment of choice and surgery would be better to be reserved for salvage of radiotherapy failure. In advanced stage(Stage III and IV), radiotherapy alone is inadequate for curative therapy and combination with surgery should be done in operable patients. This report emphasizes the importance of esophagoscopy and esophagogram at the follow-up of patients with supralottic cancer.

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BUGLE93 라이브러리를 이용한 원자로 일차차폐에 대한 차폐해석

  • 박재원;강상호
    • Proceedings of the Korean Nuclear Society Conference
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    • 1996.05a
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    • pp.275-281
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    • 1996
  • ENDF/B-VI 핵단면적자료를 기초로 생성된 BUGLE93$^{[1]}$ 라이브러리를 이용하여 울진 3.4호기 원자로 주변의 콘크리트 일차차폐벽에 대한 방사선차폐해석을 수행하였다. 중성자 및 감마선 수송계산은 일차원 각분할 해석코드인 ANISN-ORNL$^{[2]}$ 을 이용하였다. 또한, 기존의 영광 3.4호기 설계에 이용하였던 CASK$^{[3]}$ 라이브러리를 대체할 경우 예상되는 차폐효과의 변화를 평가하기 위하여 노심으로부터 일차차폐벽 사이의 모든 매질에 대한 중성자 및 감마선속을 계산하고. 계산결과를 비교.분석하여 제시하였다. 중성자선속에 대한 분석결과, BUGLE93을 이용한 계산결과는 원자로용기 내부에서는 CASK를 이용한 결과보다 적은, 보다 현실적인 결과를 제공하지만 일차차폐벽내에서는 CASK를 이용한 결과보다 오히려 큰 선속을 보였다. 그러나 이차감마선에 의한 분석결과는 원자로용기 내부에서의 큰 차이에도 불구하고 일차차폐벽을 통과하면서 두결과가 거의 일치하였다. 이것은 BUGLE93 라이브러리가 노심 및 철성분에 대해서는 증가된 핵단면적을 제공하지만 콘크리트 성분에 대한 핵단면적은 오히려 감소하였기 때문이다. 결론적으로. 최소 7피트 두께의 일차차폐벽 외부에서 중성자선속은 감마선속에 비하여 무시할 수 있을 정도이므로. 원자로 내부영역에서 CASK 라이브러리와는 다른 결과를 보이는 BUGLE93 라이브러리를 원자로 일차차폐벽의 방사선차폐해석에 사용할 경우 기존의 CASK 라이브러리를 이용한 해석결과와 동일한 결과를 보이는 것으로 평가되었다.

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The Accuracy Evaluation according to Dose Delivery Interruption and Restart for Volumetric Modulated Arc Therapy (용적변조회전 방사선치료에서 선량전달의 중단 및 재시작에 따른 정확성 평가)

  • Lee, Dong Hyung;Bae, Sun Myung;Kwak, Jung Won;Kang, Tae Young;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.77-85
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    • 2013
  • Purpose: The accurate movement of gantry rotation, collimator and correct application of dose rate are very important to approach the successful performance of Volumetric Modulated Arc Therapy (VMAT), because it is tightly interlocked with a complex treatment plan. The interruption and restart of dose delivery, however, are able to occur on treatment by various factors of a treatment machine and treatment plan. If unexpected problems of a treat machine or a patient interrupt the VMAT, the movement of treatment machine for delivering the remaining dose will be restarted at the start point. In this investigation, We would like to know the effect of interruptions and restart regarding dose delivery at VMAT. Materials and Methods: Treatment plans of 10 patients who had been treated at our center were used to measure and compare the dose distribution of each VMAT after converting to a form of digital image and communications in Medicine (DICOM) with treatment planning system (Eclipse V 10.0, Varian, USA). We selected the 6 MV photon energy of Trilogy (Varian, USA) and used OmniPro I'mRT system (V 1.7b, IBA dosimetry, Germany) to analyze the data that were acquired through this measurement with two types of interruptions four times for each case. The door interlock and the beam-off were used to stop and then to restart the dose delivery of VMAT. The gamma index in OmniPro I'mRT system and T-test in Microsoft Excel 2007 were used to evaluate the result of this investigation. Results: The deviations of average gamma index in cases with door interlock, beam-off and without interruption on VMAT are 0.141, 0.128 and 0.1. The standard deviations of acquired gamma values are 0.099, 0.091, 0.071 and The maximum gamma value in each case is 0.413, 0.379, 0.286, respectively. This analysis has a 95-percent confidence level and the P-value of T-test is under 0.05. Gamma pass rate (3%, 3 mm) is acceptable in all of measurements. Conclusion: As a result, We could make sure that the interruption of this investgation are not enough to seriously affect dose delivery of VMAT by analyzing the measured data. But this investigation did not reflect all cases about interruptions and errors regarding the movement of a gantry rotation, collimator and patient So, We should continuously maintain a treatment machine and program to deliver the accurate dose when we perform the VMAT for the many kinds of cancer patients.

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Clinical and Histopathological Study in Repaired Cartilage after Microfracture Surgery in Degenerative Arthritis of the Knee (퇴행성 슬관절염에서 미세 천공술후 재생된 연골의 임상 및 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;So, Jae-Keun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.18-28
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

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최적화알고리듬을 이용한 세기변조방사선치료의 정량적인 정도관리

  • Park, Dong-Hyun;Park, Dal;Park, Sung-Yong;Kim, Tae-Hyun;Shin, Kyung-Hwan;Kim, Dae-Yong;Cho, Kwan-Ho
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.35-35
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    • 2003
  • 목적 : 세기변조방사선치료의 정도관리 중 선량 분포의 비교에 관한 새로운 정량적인 방법을 제시하였다. 이 과정 중에서 선량의 기울기가 큰 영역에서의 문제점을 해결하기 위하여 최적화 알고리듬을 사용하였다. 대상 및 방법 : 필름을 통해 측정된 선량분포와 컴퓨터를 통해 구해진 선량분포를 각각 5mm 간격과 lmm 간격의 해상도로 컴퓨터를 이용해 2 차원 선량분포로 구현한다. 그 후 두 선량분포사이의 차이를 각 선량분 포의 원점을 일치시킨 후 구해낸다. 이때 일반적으로 두 선량분포 사이의 차이는 선량의 기울기가 큰 영역에서 상당히 크게 나타나게 되는데 이것은 측정 장비의 원점을 구하는 과정에서 발생되는 이차원 상의 미세한 원점의 불일치 효과로 선량의 차이가 선량의 기울기가 큰 영역에서 더욱 커지기 때문이다. 이 불일치를 보정하기 위해서, 측정된 선량분포를 계산된 선량분포 위에서 lmm 간격으로 이동시켜가면서 선량의 차이를 계산하여 이 값이 최소가 되는 위치를 확인한다. 이때의 이동치는 가속기가 갖는 허용오차 이내에 있어야 하며 이 값은 2mm로 알려져 있다. 이 과정과는 독립적으로 이온 챔버를 통해 측정된 절대선량 값을 이용하여 두 선량분포 사이를 재 규격화한 뒤 차이를 구하게 되면 우리는 5mm 간격의 2 차원 절대선량 분포 비교를 실험상의 오차들 중 가장 크게 작용하는 원점 오차로 인한 오차를 제거한 뒤 수행한 것과 같은 결과를 얻게 된다. 여기서 계산된 선량분포의 해상도는 장비의 허용오차 보다 항상 작아야 한다. 결과 : 머리와 목에 환부를 갖는 여러 환자들에 대한 선량분포 비교 결과를 통해서, 측정된 선량분포와 계산된 선량분포사이의 허용오차 범위에 대한 일시적 기준을 마련하였다. 이 기준은 물론 더 많은 환자들에 대한 선량분포 비교를 통해 개선되어질 수 있다. 결론 : 측정 장비의 원점 불일치의 보정뿐만 아니라 측정 장비의 회전에 의한 오차 보정, 필름의 광학적 밀도에 관한 보정 등 여러 가지 계통적 오차들에 대한 보정들이 선량분포 확인과정의 이해와 그 기준마련에 도움이 되겠지만 우리가 다룬 원점 불일치에 비해서 상대적으로 무시할 수 있었다. 마지막으로 선량분포 확인의 최종목표인 3 차원 선량분포 확인의 실제 적용을 위한 연구가 최적화 알고리듬을 이용하여 실험 중에 있다.

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The Radiopharmaceutical Therapy for Multiple Bone Metastases of Cancer (암의 다발성 뼈 전이의 방사성동위원소 치료)

  • Choi, Sang Gyu
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.207-215
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    • 2014
  • Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.

Intramedullary Spinal Cord Metastasis : A Report of Two Cases and a Review of the Literature (척수내 전이암 - 2례 보고 및 문헌고찰 -)

  • Oh, Yoon-Kyeong;Park, Hee-Chul
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.353-358
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    • 2001
  • Intramedullary spinal cord metastases (ISCM) account for only $3.4\%$ of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, Including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM In the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.

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Monte Carlo Simulation of a Varian 21EX Clinac 6 MV Photon Beam Characteristics Using GATE6 (GATE6를 이용한 Varian 21EX Clinac 선형가속기의 6 MV X-선 특성모사)

  • An, Jung-Su;Lee, Chang-Lae;Baek, Cheol-Ha
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.571-575
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    • 2016
  • Monte Carlo simulations are widely used as the most accurate technique for dose calculation in radiation therapy. In this paper, the GATE6(Geant4 Application for Tomographic Emission ver.6) code was employed to calculate the dosimetric performance of the photon beams from a linear accelerator(LINAC). The treatment head of a Varian 21EX Clinac was modeled including the major geometric structures within the beam path such as a target, a primary collimator, a flattening filter, a ion chamber, and jaws. The 6 MV photon spectra were characterized in a standard $10{\times}10cm^2$ field at 100 cm source-to-surface distance(SSD) and subsequent dose estimations were made in a water phantom. The measurements of percentage depth dose and dose profiles were performed with 3D water phantom and the simulated data was compared to measured reference data. The simulated results agreed very well with the measured data. It has been found that the GATE6 code is an effective tool for dose optimization in radiotherapy applications.

Chromosomal Aberrations Induced by in Vitro Irradiation of $^{131}I$ ($^{131}I$의 체외 방사선조사에 의한 염색체이상)

  • Kim, Eun-Sil;Kim, Myung-Seon;Seo, Doo-Seon;Jeong, Nae-In;Rho, Seung-Ik;Lee, Jae-Yong;Kim, Chong-Soon;Han, Seung-Soo;Kim, Hee-Geun;Kang, Duck-Won;Song, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.133-140
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    • 1994
  • Recently, there are many considerations and studies on biological effects of radiations in radiation workers, as well as in accidentally or therapeutically irradiated persons. The most practical and reliable method of dosimetry for radiation accidents is the scoring of gross chromosomal aberrations in human lymphocytes (Ydr) as a biological dosimetry. By the way, although usual doses of $^{131}I$ administered therapeutically for thyroid cancer are ranging from 100 mCi to 200 mCi, there are differences of absorbed doses and Ydr, ranging from 0.004 to 0.04, on equally administered $^{131}I$ due to variations in metabolic characteristics, stage of tumors and physical status of subjects. In this study, We exert to obtain the dose-response relationships of $^{131}I$, as a good guide to evaluating acute effects of accidental irradiations and radiation induced leukemia or solid tumor, by in vitro induction of chromosomal aberrations. we studied the relationship between radiation dose (D) and the frequency of chromosomal aberrations (Ydr) obserbed in peripheral lymphocytes that were irradiated in vitro with $^{131}I$ at doses ranging from 0.05 to 6.00 Gy. By scoring cells with unstable chromosomal aberrations (dicentric chromosomes and ring chromosomes) we obtained this linear-quadratic dose response equation Ydr=0.064351 $D^2$-0.13143 D+0.045684 This dose-response relationship may be useful for evaluating acute and chronic $^{131}I$ induced biological effects.

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Results of Coventional Radiotherapy for Carcinomas of the Tonsillar Region (편도암의 방사선 치료 성적)

  • Nah Byung Sik;Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.97-104
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    • 1997
  • of $PLC-\gamma$ 1 activity. Results : In the immunohistochemistry, the expression of $PLC-\beta$ was negative for all grnups. The expression of $PLC-\gamma$ 1 was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of PKC-01 was strong1y positive in group I followed by group II in the damaged surface epithelium. The above findings were also confirmed in the immunoblotting study. In the irnrnunoblotting study, the expressions of $PLC-\beta,\;PLC-\gamma\;1,\;and\;PLC-\delta$ were the same as the results of immunohistochemistry The expression of ras oncoprotein was weakly Positive in groups II, III and IV. The of EGFR was the highest in the group II, III, followed by group W and the expression of PKC was weakly positive in the group II and III. Conclusion : $PLC-\gamma$ 1 mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role irL mucosal regeneration after irradiation. $PLC-\delta$ 1 mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PLC-\delta$ 1.

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