• Title/Summary/Keyword: 2차 방사선

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Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.327-334
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    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

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Reading and Influence of Personal Dose Meter in University Hospital C (C 대학병원의 개인선량계 판독과 영향)

  • Lee, Joo-Ah
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.357-363
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    • 2022
  • This study aims to improve the safety inspection awareness of occupational exposure and help radiation safety management by analyzing radiation exposure doses by occupational type of radiation related-workers and radiation workers. Radiation-related workers and radiation workers were classified into three occupations (radiological technologist, doctors, and nurses). A nominal risk coefficient based on ICRP 103 was used to calculate the probability of causing side effects of the lungs due to exposure doses. As a result of analyzing the exposure dose of all workers for one year, the exposure dose of radiological technologist among radiation-related workers was 1.63 ± 2.84 mSv, doctors 0.12 ± 0.22 mSv, and nurses 0.59 ± 1.08 mSv. The one-year deep dose for radiation workers was 2.44 ± 3.30 mSv for radiological technologists, 0.19 ± 0.26 mSv for doctors, and 0.12 ± 0.00 mSv for nurses. Due to this dose, the probability of causing side effects in the lungs was 1.2 per 100,000 radiological technologist, 0.096 doctors, and 0.06 nurses. In this study, it is believed that the probability of side effects on lungs by occupation of radiation exposure dose will be studied and used as useful data for radiation safety management in relation to probabilistic effects in the future.

The Physical Penumbra of the 6MV X-ray (6MV 방사선의 물리학적 Penumbra)

  • Cho Moon-June;Kang Wee-Saing
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.333-336
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    • 1991
  • High energy Photon beam has a sharp beam margin due to a less side scatter and the other things. But there still remains a penumbra where the dose changes rapidly in the region near the edge of a radiation beam, although it is short in width. It is suggested that the width of the penumbra depends on the source size, distance from source to diaphragm, source to skin distance, and depth in tissue. However, it is also supposed that the other factors influence the penumbra width. In this paper, we investigate changes of the physical penumbra widths according to various field sizes and depths, by using the three dimensional dosimetry system. As a result, we found that as field size and depth increase, the physical penumbra width also increases.

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Phase II Study of Induction Irinotecan + Cisplatin Chemotherapy Followed by Concurrent Irinotecan + Cisplatin Plus Twice-Daily Thoracic Radiotherapy (유제한성 병기의 소세포 폐암에서 3주 간격으로 시행된 irinotecan과 cisplatin을 이용한 과다분할 방사선 동시 요법)

  • Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Cho, Moon June;Kim, Jin Hwan;Lee, Choong Sik;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.154-164
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    • 2007
  • Background: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. Irinotecan also can act as a potential radiation sensitizer along with cisplatin. To evaluate efficacy and toxicity of irinotecan plus cisplatin (IP) with concurrent thoracic radiotherapy, we conducted a phase II study of IP followed by concurrent IP plus hyperfractionated thoracic radiotherapy in patients with previously untreated limited-stage small-cell lung cancer. Methods: Twenty-four patients with previously untreated small-cell lung cancer were enrolled onto the study since November 2004. Irinotecan $60mg/m^2$ was administered intravenously on days 1 and 8 in combination with cisplatin $60mg/m^2$ on day1 every 21 days. From the first day of third cycle, twice-daily thoracic irradiation (total 45 Gy) was given. Prophylactic cranial irradiation was given to the patients who showed complete remission after concurrent chemoradiotherapy. Restaging was done after second and sixth cycle with chest CT and/or bronchosocpy. Results: Up to November 2004, 19 patients were assessable. The median follow-up time was 12.5 months. A total of 99 cycles (median 5.2 cycles per patient) were administered. The actual dose intensity values were cisplatin $19.6mg/m^2$/week and irinotecan $38.2mg/m^2$/week. Among the 19 patients, the objective response rate was 95% (19 patients), with 9 patients (47%) having a complete response (CR). The major grade 3/4 hematological toxicities were neutropenia (35% of cycles), anemia (7% of cycles), thrombocytopenia (7% of cycles). Febrile neutropenia was 4% of cycles. The predominant grade 3/4 non-hematological toxicities was diarrhea (5% of cycles). Toxicities was not significantly different with concurrent administration of irinotecan and cisplatin with radiotherapy, except grade 3/4 radiation esophagitis (10% of patients). No treatment-related deaths were observed. The 1-year and 2-year survival rate of eligible patients was 89% (16/18) and 47% (9/18), respectively. Conclusion: Three-week schedule of irinotecan plus cisplatin followed by concurrent IP plus hyperfractionated thoracic radiotherapy is an effective treatment for limited disease small-cell lung cancer, with acceptable toxicity.

Radiation Shielding to Minimize Image Information Loss (영상 정보 손실을 최소화하는 방사선 차폐체 연구)

  • Su-han Jang;Sang-Hyeun Park;Myeong-Sik Ju
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.449-457
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    • 2023
  • Shielding for reducing exposure dose can make the diagnosis limited. The purpose of this study is to increase the efficiency of radiation protection and minimize the loss of image information by producing the shielding made of the water and the contrast medium which has different proportion and finding out the ideal proportion of them. Each shielding materials were made of water and water-soluble iodine contrast medium with the different proportion. The attenuation rate of absorbed dose was evaluated by the shielding materials in the plastic contents for measuring the efficiency of the radiation protection. As a result, the higher ratio of the contrast medium, the more efficient it is for radiation attenuation. The anatomical structure was observed most properly in case of the solution with 20 ml of the contrast medium and most difficultly in case of more than 60 ml of the contrast medium. In case of the signal intensity between skeleton and gas, the difference of average value had a significant as p < 0.001. Shielding with contrast medium attenuates less than the conventional shielding but in the examination for the sensitive part to radiation, it can be used to minimize the loss of the image information and reduce the exposure dose.

The Efficacy of Induction Chemotherapy in Stage III Non-Small Cell Lung Cancer (제 3기 비소세포 폐암에서 유도 화학 요법의 효과)

  • Cho Heung Lae;Joo Young Don;Sohn Seung Chang;Sohn Chang Hak
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.283-289
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    • 1998
  • Purpose : This study was performed to analyze the efficacy of induction chemotherapy fellowed by radiation therapy in locally advanced non-small cell lung cancer Materials and Methods : Eighty patients with locally advanced non-small cell lung cancer treated from 1989 to 1995 at Pusan Paik hospital were analyzed retrospectively. Twenty-one patients were treated with induction chemotherapy followed by radiation therapy and Fifty-nine Patients were treated with radiation therapy alone. Chemotherapy regimen consisted of cisplatin-based combination (2 or 3 drugs). All patients were treated by Co-60 or 6 MV linear accelerators. Radiation dose ranged from 50 Gy to 80 Gy (median 64.8 Gy). We evaluated response rate, survival rate, and pattern of failure in both treatment groups. Results : Overall response rate in induction chemotherapy group and radiotherapy alone group were 48% and 45%, respectively. Of the 80 patients, 46 patients were evaluable for pattern of failure. Initial failure pattern in induction chemotherapy group was as follows: 8 (67%) at locoregional, 4 (33) in distant metastasis. Radiation alone group was 21 (71%) and 5 (29%), respectively. Results showed no difference of distant failure between induction chemotherapy group and radiation alone group. The 1 and 2 year survival rate in induction chemotherapy group were 43% and 14%, respectively and in radiotherapy alone group, 31% and 7%, respectively (p=0.135). Conclusion : In stage III non-small cell lung cancer, induction chemotherapy and radiation therapy showed increased tendency in survival with no statistical significance Induction chemotherapy seems to have no effect of decreasing distant failure and no survival advantage compared with radiotherapy alone.

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Gynecologic Patients' Recognition of Radiation Exposure in Gyeongbuk Area (경북 지역 산부인과 환자의 방사선피폭 인식)

  • Park, Jeong-Kyu
    • The Journal of the Korea Contents Association
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    • v.8 no.8
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    • pp.176-187
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    • 2008
  • As the radiological medical instruments have been competitively developed in recent years, its utilization for the patient treatment has been expanded. The medical examination using the radiation has been gradually increased, so that it is recognized as a significant factor of increasing the radiation exposure. In this study, the recognition about the radiation exposure was analyzed for 555 gynecologic patients in 8 secondary and tertiary medical centers in Gyeongbuk from November 17 to April 19, 2007. The results are followed. There was a significant difference on the recognition for the radiation by age and education (p<0.05), There was the significant difference in the recognition about the radiological instruments by age and occupation (p<0.05), and there was the significant difference in the information identification & analysis by age and occupation (p<0.05). As the result of analyzing a correlation of the radiation's harmfulness, recognition, psychological state and exposure prevention, there was the correlation of 0.572 between the harmfulness and recognition, the correlation of 0.740 between the harmfulness and the psychological state, and the correlation of 0.477 between the harmfulness and the exposure prevention. It was statistically very significant (p<0.01). But, there was no significance with the radiological instrument and information identification (p>0.05). As the result of the study, it could be known that the mental threat factor was more included than the physical threat from the position of gynecologic patients who were sensitive to the radiation. Accordingly, radiological technologist who manages the radiation needs to let the patient or its guardians recognize the degree of physical harmfulness exactly.

Effects of vertical head rotation on the posteroanterior cephalometric measurements (정모두부방사선사진 촬영시 두부의 수직회전에 따른 투사오차)

  • Koh, Eun-Hee;Lee, Ki-Heon;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.33 no.2 s.97
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    • pp.73-84
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    • 2003
  • This study was performed to find out how much projection errors in the cephalometric measurements were made by vertical head rotation in taking posteroanterior cephalograms. 25 adults without any apparent facial asymmetry or severe sagittal skeletal discrepancy were selected and the posteroanterior cephalograms were taken with the head rotated $5^{\circ},\;10^{\circ}$ superior and inferior each to the reference $position(0^{\circ})$. The 7 height, 5 width and 6 angular measurements were taken at each 5 positions. Through the statistical analysis of all measurements taken at each rotated position, folowing results were obtained.1. The projection errors of height measurements were remarkably target than those of width or angular measure nents. f. Among the height measurements, the farther to the rotation axis the measurements were, the larger the projection errors were. 3. Among the width measurements, mandibular width and mandibular width of mandibular first molars showed significant differences between the values taken at each rotated position, while nasal width, maxillary width and intermolar width of maxillary first molars did not. 4. Among the angular measurements, the angle between horizontal reference line and the line that is connected to crista galli and antegonion or maxillare showed significant differences between the values taken at each rotated Position. The above results suggest that it is needed to the effort to keep constant head position for taking the useful posteroanterior cephalogra, because projection errors are caused by vertical head rotation.

Application of the ExacTrac System in Respiratory Gated Radiotherapy for Lung Cancer Patients (폐암 환자의 호흡연동방사선치료를 위한 ExacTrac 시스템 적용)

  • Ko, Seung Young;Lee, Jung Il
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.325-332
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    • 2019
  • This study analyzed the movement of tumors using 4DCT. Appropriate uniform IM were identified using TC, II and CI depending on ITV margins. DVH and NTCP were also compared in each case. Dose analysis on tumors with uniform IM showed that the optimal treatment plan for satisfying all TC, CI, II was evaluated as 2 mm in phase 20 and 3 mm in 40%. That was compared to the dose from the normal tissues of $PTV_{20}$, $PTV_{40}$. In the 20% radiation field, V5, V10, and V20 for the lungs increased 1.49, 1.26, and 0.65%, while 40% increased by 1.9, 2.41 and 1.23%. NTCP had a dose increase of 0.57 to 0.029% from 20% and 40%. There was a dose increase in the spinal cord and heart at uniform IM, but there was no significant difference. These data suggest that the ITV setting of 20%, phase for Respiratory Gated Radiotherapy using Novalis ExacTrac system can be applied with a uniform IM 2 mm and 40% with 3 mm for optimal treatment plan.

A Study on the Fabrication and Physical Properties of $Ca_2SiO_4$:La Thermoluminescent Phosphors ($Ca_2SiO_4$: La 열형광체 제작과 물리적 특성에 관한 연구)

  • Kim, Choung-Mi;Seo, Mi-Kyong
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.5-10
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    • 2010
  • The $Ca_2SiO_4$ phosphors doped by La with 0.1 wt%, 0.3 wt%, 0.5 wt%, and 1.0 wt% concentration were prepared by sintering at $1000^{\circ}C$ for 90 minutes in N2 atmosphere. The phosphors were ground in powdered form and were grouped in $100{\mu}m$ size, then the samples had been exposed to low energy X-ray and UV light. The TL glow curves were measured by heating the phosphors at $10^{\circ}C/s$ rate. There was no significantly meaningful correlation between the TL intensity and the doping level. The intensities of the TL peak measured from X-ray irradiated samples doped with 0.1 wt% were relatively strong. The activation energy and the frequency factor were 0.434 ~ 0.516 eV and 0.5 ~ 0.56, respectively. The intensities of the TL peak measured from UV irradiated samples doped with 0.3 wt% were relatively strong. The activation energy and frequency factor were 0.415 ~ 0.477 eV and 0.5 ~ 0.53, respectively. The TL process were found to be the 2nd order for both X-ray and UV irradiation. The TL intensity was increased linearly with the increase of the radiation dose. In summary, the $Ca_2SiO_4 phosphors developed in this study showed good TL characteristics at low energy X-ray and UV light. We believe they will be used as TLDs in near future for personal and environmental radiation detection dosimetry.