• Radiation Oncology Journal
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• v.24 no.2
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• pp.81-87
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• 2006

Purose: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS). Materials and Methods: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on 'serial shrinking field' concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed. Results: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 ($1{\sim}58$) months and the mean XQS of all 51 patients was $8.4{\pm}1.9\;(6{\sim}14)$. XQS continuously and significantly decreased over time after 3D CRT ($X^2$=-0.484, p<0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (P=0.001). XQS of patients receiving total mean parotid dose ${\ge}35 Gy$ was significantly higher than <35 Gy (p=0.05). Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose ${\ge}35 Gy$ were suggested to adversely affect radiation-induced xerostomia.

• Progress in Medical Physics
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• v.15 no.4
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• pp.247-254
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• 2004

According to developing high energy linear accelerators and treatment methods, like (3 dimensional conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT), many radiotherapy centers are replacing older linear accelerators with new higher technical machines. This often presents a shielding problem as the designed shield for the existing rooms is not adequate for the higher technical machines. Additional shielding in limited existing space becomes necessary. We are replacing older brachytherapy room with new higher technical linear accelerator for IMRT. This room is not adequate for the IMRT machine without additional shielding design. The logical development of optimum structural shielding designs with concrete and high density shielding blocks are presented. We obtained following results by comparison between the pre-calculating values and actual survey of completed LINAC installation. High density shielding blocks have more powerful radiation protection about 2 times.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.399-408
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• 1998

Purpose : This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. Materials and Methods : The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. Results : The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2$\%$ over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6$\%$ with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. Conclusion : This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning. but prospective studies are required to define the true clinical benefit.

• 대한두경부종양학회:학술대회논문집
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• 1999.12a
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• pp.259.1-259.1
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• 1999

• Journal of radiological science and technology
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• v.36 no.4
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• pp.327-335
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• 2013

This study investigates the case of clinical application for TomoDirect 3D-CRT(TD-3D) and TomoHelical 3D-CRT(TH-3D) with evaluating dose distribution for clinical application in each case. Treatment plans were created for 8 patients who had 3 dimensional conformal radiation therapy using TD-3D and TH-3D mode. Each patients were treated for sarcoma, CSI(craniospinal irradiaion), breast, brain, pancreas, spine metastasis, SVC syndrome and esophagus. DVH(dose volume histogram) and isodose curve were used for comparison of each treatment modality. TD-3D shows better dose distribution over the irradiation field without junction effect because TD-3D was not influenced by target length for sarcoma and CSI case. In breast case, dosimetric results of CTV, the average value of D 99%, D 95% were $49.2{\pm}0.4$ Gy, $49.9{\pm}0.4$ Gy and V 105%, V 110% were 0%, respectively. TH-3D with the dosimetric block decreased dose of normal organ in brain, pancreas, spine metastasis case. SCV syndrome also effectively decreased dose of normal organ by using dose block to the critical organs(spinal cord <38 Gy). TH-3D combined with other treatment modalities was possible to boost irradiation and was total dose was reduced to spinal cord in esophagus case(spinal cord <45 Gy, lung V 20 <20%). 3D-CRT using Tomotherapy could overcomes some dosimetric limitations, when we faced Conventional Linac based CRT and shows clinically proper dose distribution. In conclusion, 3D-CRT using Tomotherapy will be one of the effective 3D-CRT techniques.

• The Journal of Korean Society for Radiation Therapy
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• v.12 no.1
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• pp.144-146
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• 2000

삼차원 입체조형치료는 정상조직의 장해를 최소화하고 종양부위에 집중적으로 조사할 수 있는 장점을 가지고 있어 임상 적용범위가 넓어지고 있다. 일반적으로 정상조직의 장해를 줄이기 위해 다양한 방사선 조사방향이 사용되며 특히 비 동일면상에서의 조사가 많이 이루어진다. 따라서 couch 회전이 동반되며 couch는 선형가속기의 다른 기계적 오차보다 많은 오차를 유발할 수 있는 잠재적인 위험을 안고 있다. 저자는 이러한 오차의 정도를 파악하고 이를 개선할 수 있는 방법에 대해 알아보고자 했다. couch 회전에 따른 Isocenter의 변화를 평가하기 위해 3대(Primus, Simens, USA/CL600c & 2100c, Varian, USA)의 선형가속기를 이용하였으며 이중 1대의 장비에는 couch 회전시 오차를 줄이기 위해 고안된 couch 고정장치를 장착하였다. 환자가 테이블에 부하를 주지 않은 상태에서 회전을 실시하여 Isocenter의 변화를 측정하고 환자가 테이블에 누워있는 상황을 재현하기 위해 human phantom을 위치시킨 후 동일한 회전검사를 실시하여 각각의 오차를 비교 분석하였다. 각 실험은 10회씩 반복 측정하여 평균치를 얻었으며 오차의 분석은 AAPM 권고안인 오차중심의 반경으로 표현했다. 3대의 선형가속기를 이용하여 얻은 결과 테이블에 부하를 주지 않은 상태의 회전오차는 평균 2mm, 3.2mm, 2mm로 측정되었으며 휴먼 phantom을 올려놓고 부하를 준 상태에서의 오차는 평균 2.1mm, 4mm, 2.1 mm이였다. 또한 고정장치를 이용한 상태에서의 평균오차는 1.9mm로 나타났다. 삼차원 입체조형치료 시 couch 회전에 따른 Isocenter 오차는 장비의 종류 및 작업자의 사용방법에 따라 다르게 나타났으며 테이블의 부하가 클수록 많은 오차를 보였다. 또한 couch 고정장치를 부착한 장비에서의 결과치 만이 AAPM에서 권고하는 오차의 한계에(${\le}2mm$) 들어감을 알 수 있었다. 따라서 정기적인 QA가 필수적이며 Couch Locking System과 같이 오차를 줄일 수 있는 보조장치의 부착이 많은 도움을 줄 것으로 생각된다. 아울러 이러한 오차를 보정할 수 있는 방법이 강구되어야 할 것으로 사료된다.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.335-343
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• 2012

Intensity-modulated radiotherapy(IMRT) have the ability to provide better dose conformity and sparing of critical normal tissues than three-dimensional radiotherapy(3DCRT). Especially, with the benefit of health insurance in 2011, its use now increasingly in many modern radiotherapy departments. Also the use of linear accelerator with high-energy photon beams over 10 MV is increasing. As is well known, these linacs have the capacity to produce photonueutrons due to photonuclear reactions in materials with a large atomic number such as the target, flattening filters, collimators, and multi-leaf collimators(MLC). MLC-based IMRT treatments increase the monitor units and the probability of production of photoneutrons from photon-induced nuclear reactions. The purpose of this study is to quantitatively evaluate the dose of photoneutrons produced from 3DCRT and IMRT technique for Rando phantom in cervical cancer. We performed the treatment plans with 3DCRT and IMRT technique using Rando phantom for treatment of cervical cancer. An Rando phantom placed on the couch in the supine position was irradiated using 15 MV photon beams. Optically stimulated luminescence dosimeters(OSLD) were attached to 4 different locations (abdomen, chest, head and neck, eyes) and from center of field size and measured 5 times each of locations. Measured neutron dose from IMRT technique increased by 9.0, 8.6, 8.8, and 14 times than 3DCRT technique for abdomen, chest, head and neck, and eyes, respectively. When using IMRT with 15 MV photonbeams, the photoneutrons contributed a significant portion on out-of-field. It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, it is need to provide the additional safe shielding on a linear accelerator and should therefore reduce the out-of-field dose.

• Journal of the Korean Magnetics Society
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• v.25 no.6
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• pp.208-218
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• 2015

Recently, radiation therapy is used in the CT existing conventional two-dimensional radiation image, and set the size and location of the tumor in a manner that the image is going to change the treatment plan. After using the simulation using CT, radiation therapy it is four-dimensional or three-dimensional treatment made possible. and radiation therapy became the more effective ever before. High technology radiation therapy such as the treatment of SRS,IMRT, IGRT, SBRT, is a need to try contemplating the possibility to apply appropriate analysis and situation, so it has its own characteristics. and then it is believed that it is necessary to analyze and try it worries the proper applicability of the situation. The configuration of the various treatment that is applicable in many hospitals is necessary to try to determine how to practically apply the patients. Critical organs surrounding tumor give a small dose to avoid side effects and then the tumor has the therapeutic effect by providing a larger dose than before the radiation treatment.

• Progress in Medical Physics
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• v.9 no.2
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• pp.77-88
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• 1998

Wedge shaped isodoses are desired in a number of clinical situations. Hard wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths along with the practical consequendes of filter handling and placement problems. Dynamic wedging uses a combination of a moving collimator and changing monitor dose to achieve angled isodoses. The segmented treatment tables(STT) that monitor unit setting by every distance of moving collimator, was induced by numerical formular. The characteristics of dynamic wedge by STT compared with real dosimetry. Methods and Materials : The accelerator CLINAC 2100C/D at Yonsei Cancer Center has two photon energies (6MV and 10MV), currently with dynamic wedge angles of 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$. The segmented treatment tables(STT) that drive the collimator in concert with a changing monitor unit are unique for field sizes ranging from 4.0cm to 20.0cm in 0.5cm steps. Transmission wedge factors were measured for each STT with an standard ion chamber. Isodose profiles, isodose curves, percentage depth dose for dynamic wedge filters were measured with film dosimetry. Dynamic wedge angle by STT was well coincident with film dosimetry. Percent depth doses were found to be closer to open field but more shallow than hard wedge filter. The wedge transmission factor were decreased by increased the wedge angle and more higher than hard wedge filters. Dynamic wedging probided more consistent gradients across the field compared with hard wedge filters. Dynamic wedging has practical and dosimetric advantages over hard filters for rapid setup and keeping from table collisions. Dynamic wedge filters are positive replacement for hard filters and introduction of dynamic conformal radiotherapy and intensity modulation radiotherapy in a future.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.115-122
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• 2008

Purpose: The cancer treatment which uses radiation from next year when the X-ray is discovered with the fact that it is started. The radiation treatment technique for a cancer treatment is developed ceaselessly without and it is come and, with advancement of the computer and electromagnetic engineering it joins in and quickly, it was made to do a many development from radiation treatment field. Accordingly, this study is examine in the radiotherapy technique which is developed that importance to therapeutic principles and methods. Materials and Methods: We had investigated record for radiotherapy technique which is developed and we had acquired information widely at clinical experience data. Results: The cancer treatment which uses the radiation of today is repeating a dazzling development. Past the treatment which is two-dimensional it does not correspond in therapeutic objective but currently 3 dimension three-dimensional moulding treatment or centurial control radiation treatment this the fourth dimension therapeutic technique which is in parallel to be introduced the complication solution in compliance with a normal organization protection and the radiation which are a difficult problem of during that time radiation treatment possibly did. Conclusion: 3-dimensional and 4-dimensional modern radiation treatment which is developen is that corresponding in objective of radiation treatment and the evaluation that again it does thick, judges in about the cancer treatment which uses radiation with the fact that the protection of normal organization is almost become accomplished.