• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.191-197
• /
• 2014

Purpose : This study presents the usefulness assessment of metal artifact reduction for orthopedic implants(O-MAR) to decrease metal artifacts from materials with high density when acquired CT images. Materials and Methods : By CT simulator, original CT images were acquired from Gammex and Rando phantom and those phantoms inserted with high density materials were scanned for other CT images with metal artifacts and then O-MAR was applied to those images, respectively. To evaluate CT images using Gammex phantom, 5 regions of interest(ROIs) were placed at 5 organs and 3 ROIs were set up at points affected by artifacts. The averages of standard deviation(SD) and CT numbers were compared with a plan using original image. For assessment of variations in dose of tissue around materials with high density, the volume of a cylindrical shape was designed at 3 places in images acquired from Rando phantom by Eclipse. With 6 MV, 7-fields, $15{\time}15cm2$ and 100 cGy per fraction, treatment planning was created and the mean dose were compared with a plan using original image. Results : In the test with the Gammex phantom, CT numbers had a few difference at established points and especially 3 points affected by artifacts had most of the same figures. In the case of O-MAR image, the more reduction in SD appeared at all of 8 points than non O-MAR image. In the test using the Rando Phantom, the variations in dose of tissue around high density materials had a few difference between original CT image and CT image with O-MAR. Conclusion : The CT images using O-MAR were acquired clearly at the boundary of tissue around high density materials and applying O-MAR was useful for correcting CT numbers.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.40 no.6
• /
• pp.173-179
• /
• 2012

The experiments, which analyze the injury symptoms and diagnose growth conditions utilizing IRVT and analyzing each parts of H. helix L., had been held under a low temperature. Greenhouse and outdoor growing Genus hedera had been prepared and compared with each Genus hedera's peak and bottom leaves' surface temperature under the experimental categories $-6^{\circ}C$ and $-12^{\circ}C$. As results, analyzing the surface thermal property of peak part leaves' of outdoor growing Genus hedera, at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged from $-2^{\circ}C{\sim}-7^{\circ}C$ and $-2^{\circ}C{\sim}-15^{\circ}C$. On the other hand, the surface thermal property of bottom part leaves at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged $-2^{\circ}C{\sim}-11^{\circ}C$ and $-1^{\circ}C{\sim}-12^{\circ}C$. It appears that the thermal properties of leaves' surface on $-6^{\circ}C$ peaks and $-12^{\circ}C$ bottoms were more broadband than bottoms and peaks. It means that the peaks were more sensitive than bottoms, as like $-2^{\circ}C{\sim}-15^{\circ}C$, $-1{\sim}-12^{\circ}C$. Moreover, as similar results had seen to leaves surface temperature added to cold wind conditions. How the cold wind damaged the outdoor growing Genus hedera, analyzed the surface thermal property by IRVT data under $0^{\circ}C$, $-2^{\circ}C$, $-4^{\circ}C$ condition, it resulted to $-6.2^{\circ}C$, $-6.8^{\circ}C$, $-7.5^{\circ}C$. It appeared more $3.5{\sim}6.2^{\circ}C$ low temperature than experimental setting point. In addition, each parts thurmal property of peaks and bottoms was not similar, it referred to each parts' sensitivities of low temperature were different on the peak and bottom leaves surface temperature.

• The Journal of Korean Society for Radiation Therapy
• /
• v.29 no.1
• /
• pp.27-35
• /
• 2017

Purpose: On the left side, breast cancer patients have more side effects than those on the right side because of unnecessary doses in normal organs such as heart and lung. DIBH is performed to reduce this. To evaluate the dose of peripheral organs in the left breast cancer including supraclavicular lymph nodes and internal mammary lymph nodes according to the treatment planning method of Conventional Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy. Materials and Methods: We performed CT-simulation using free breathing and deep inspiration breath-hold technique for 8 patients including left supraclavicular lymph nodes and internal mammary lymph nodes. Based on the acquired CT images, the contour of the body is drawn and the convention is performed so that $95%{\leftarrow}PTV$, $Dmax{\leftarrow}110%$. Conventional Radiation Therapy used a one portal technique on the supraclavicular lymph node and used a field in field technique tangential beam on the breast. Intensity Modulated Radiation Therapy was composed of 7 static fields. Volumetric Modulated Arc Therapy was planned using 2 ARC with a turning radius of $290^{\circ}$ to $179^{\circ}$. The peripheral normal organs dose was analyzed by referring to the dose volume of Eclipse. Results: By applying the deep inspiration breath-hold technique, the mean interval between the heart and chest wall increased $1.6{\pm}0.6cm$. The mean dose of lung was $19.2{\pm}1.0Gy$, which was the smallest value in Intensity Modulated Radiation Therapy. The V30 (%) of the heart was $2.0{\pm}1.9$, which was the smallest value in Intensity Modulated Radiation Therapy. In the left anterior descending coronary artery, the dose was $25.4{\pm}5.4Gy$, which was the smallest in Intensity Modulated Radiation Therapy. The maximum dose value of the Right breast was $29.7{\pm}4.3Gy$ at Intensity Modulated Radiation Therapy. Conclusion: When comparing the values of surrounding normal organs, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy were applicable values for treatment. Among them, Intensity Modulated Radiation Therapy is considered to be a suitable treatment planning method.

• Journal of Digestive Cancer Research
• /
• v.1 no.1
• /
• pp.36-42
• /
• 2013

Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

• The Journal of Korean Society for Radiation Therapy
• /
• v.28 no.2
• /
• pp.171-178
• /
• 2016

Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

• Radiation Oncology Journal
• /
• v.18 no.1
• /
• pp.27-31
• /
• 2000

Purpose : The aim of this study was to investigate treatment results, toxicity and efficacy of hypefractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. Materials and Methods: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hypefractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 51 years. Initial FIGO stage was 1 stage IBI, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recurrent disease with superior margin at T12, and inferior margin was between L5 and S1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m$^{3}$ to 30 mg/m$^{3}$ (median, 25 mg/m$^{3}$), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. Results : Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75$\%$ and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30$\%$ and 7 months, respectively. At 1 month after treatment, 4 (40$\%$) achieved a complete response and 6 (60$\%$) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence In 2 patients after paraaortic node irradiation. There was 2 patients with grade 3 to 4 leukopenla and 8 patients with grade 1 to 2 nausea/ vomiting which was usually tolerable with antlemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. Conclusion : hypefractionated radiation therapy combined with paclitaxel chemotherapy diosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer Therefore, present results suggest that hypefractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.