• Title/Summary/Keyword: 조직내 방사선치료

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High Dose Rate Interstitial Brachytherapy in Soft Tissue Sarcomas : Technical Aspect (연부조직종양에서 고선량율 조직내 방사선치료: 기술적 측면에서의 고찰)

  • Chun Mison;Kang Seunghee;Kim Byoung-Suck;Oh Young-Taek
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.43-51
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    • 1999
  • Purpose : To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy Materials and Methods : Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1 ~l.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery, Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. Results : All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOGIEORTC grade 3 or 4). Conclusion : The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.

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Dose Calculation of Heterogeneous Lung Tissue on 6MV X-ray Therapy (6MV X-선에 의한 폐조직의 심부선량변화와 임상응용)

  • 이경자;장승희;추성실
    • Progress in Medical Physics
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    • v.9 no.4
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    • pp.247-257
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    • 1998
  • For effective radiotherapy, it should always be considered that calculation of different dose distribution in heterogenous tissue is important particularly on lung which has low density and large volume. To take precise dose distribution of 6MV X-ray in the thoracic cage, the authors had made a tissue equivalent phantom for thorax, measured dose distribution by thermoluminescent dosimeter and mm dosimeter, and derived methmetical equation coincided with provided theoretical formula. In comparision with isodose curve on case of homogeneous soft tissue, dose of heterogeneous lung tissue had been shown increase about 4% per cm depth on one and multiportal field, less than 15% difference on rotation field for esophagus, and around 20% difference on rotation field for lung according to the degree of rotation angle that must be corrected by dose compensation.

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High Energy Photon Dosimetry by ESR Spectroscopy in Radiotherapy (ESR Spectroscopy에 의한 치료용 고에너지 광자선의 선량측정)

  • Chu, Sung-Sil
    • Progress in Medical Physics
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    • v.1 no.1
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    • pp.31-42
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    • 1990
  • The finding of long lived free radicals produced by ionizing radiation in organic crystals and the quantification of this effect by electron spin resonance(ESR) spactroscopy has proven excellent dosimetric applicability. The tissue equivalent alanine dosimeter also appear appropriate for radiation therapy level dosimetry. The dose measurement was performed in a Rando phantom using high energy photons as produced by high energy medical linear accelerator and cobalt-60 teletherapy unit. The absorbed dose range of the ESR/alanine dosimetry system could be extended down to 0.1 Gy. The response of the alanine dosimeters was determined for photons at different therapeutic dose levels from less than 0.1 Gy to 100 Gy and the depth dose measurements were carried out for photon energies of 1.25MeV, 6 and 10 MV with alanine dosimeters in Rando phantom. Comparisons between ESR/alanine in a Rando phantom and ion chamber in a water phantom were made performing depth dose measurements to examine the agreement of both methods under field conditions.

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4-Dimensional Imaging and Planning (4차원 영상 및 치료계획)

  • Jo, Byeong-Cheol;Park, Hui-Cheol;Kim, Su-San;O, Do-Hun;Bae, Hun-Sik
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2005.04a
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    • pp.11-15
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    • 2005
  • 입체조형 및 세기조절 방사선치료가 보편화되어 가고 있는 현 시점에서, 치료율을 높이기 위해 종양처방선량은 증가시키는 반면 부작용은 최소화하고자 하는 요구가 증가하고 있다. 셋업오차 및 체내운동(internal motion)은 이러한 요구를 충족시키는데 대한 한계로 작용하고 있다. 4차원방사선치료(4-dimensional radiation therapy)는 체내운동을 최소화시키거나 또는 움직임을 추적하여 방사선치료를 시행함으로써 “종양선량최대화/정상조직선량최소화”라는 고정밀방사선치료의 요구에 부응할 수 있는 치료기술로 기대를 모으고 있다. 체내운동은 호흡에 의한 움직임과 같이 단기적으로 발생되는 조사분할내(intra-fraction)와 종양의 수축, 체중 변화 등과 같이 장기적으로 발생하는 조사분할간(inter-fraction)움직임으로 구분되는데, 본 연제에서는 주로 조사분할내 움직임, 즉 호흡에 의한 움직임에 대처하는 4차원방사선치료를 위한 동적영상 획득 및 방사선치료계획과정에 초점을 맞추어 소개하고자 한다.

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Quality Assurance of Brachytherapy System(Physical Aspects) (근접방사선치료 시스템의 QA(물리적 측면))

  • Ji, Young-Hoon
    • Progress in Medical Physics
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    • v.4 no.1
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    • pp.17-21
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    • 1993
  • 근접방사선치료는 방사성동위원소를 종양에 밀착시키거나 또는 종양내에 직접 삽입하여 치료하는 방법으로서 종양에는 일시에 많은 선량을 주는 반면 주위 정상조직에는 선량을 최소화시킬 수 있는 장점이 있다. 따라서 근래에 들어 종양치료에 있어서 외부방사선치료와 병행하여 근접방사선치료를 시행하는 병원이 증가하고 있다. 그러나 근접방사선치료는 방출 방사선의 에너지가 낮고, 대부분 짧은 반감기를 가지며, 소형의, 수 mCi에서 수Ci 정도의 방사능을 가진 방사성동위원소들을 인체에 직접 삽입하는 것으로 정확한 선량 분포를 위해서는 방사성동위원소의 방사능량, 위치, 분포 등의 정확성 확보가 절실히 요구된다. 따라서 이 논문은 근접방사선치료시스템의 QA프로그램 개발을 위하여 작성하였다.

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Dosimetric Characteristics of Dynamic Wedge Technique (Dynamic Wedge의 조직내 방사선량 분포의 특성)

  • Oh Young Taek;Keum Ki Chang;Chu Seong Sil;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.323-332
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    • 1996
  • Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.

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Interstitial Radium Implantation and Cobalt-60 Irradiation of the Tongue Cancer (IbidI) (설암의 조직간내 라디움치료에 관하여)

  • 안경성;박주방;윤용규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.16.1-16
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    • 1972
  • In 1971 there were 5 cases of the tongue cancer in stage I & II treated concomitantly with interstitial radium implantation and Cobalt-60 irradiation at the Yonsei University Hospital Cancer Center. This is the interim report of the course of the primary site of those treated cases.

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Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES (원격조정 고선량 근접 치료)

  • Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.267-275
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    • 1992
  • Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

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