• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4935-4937
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• 2016

Objective: To compare dosimetric parameters of 3 dimensional conformal radiotherapy (3 DCRT) and intensity modulated radiotherapy (IMRT) in terms of target coverage and doses to organs at risk (OAR) in the management of rectal carcinoma. Methods: In this prospective study, conducted between August 2014 and March 2016, all patients underwent CT simulation along with a bladder protocol and target contouring according to the Radiation Therapy Oncology Group (RTOG) guidelines. Two plans were made for each patient (3 DCRT and IMRT) for comparison of target coverage and OAR. Result: A total of 43 patients were recruited into this study. While there were no significant differences in mean Planning Target Volume (PTV) D95% and mean PTV D98% between 3 DCRT and IMRT, mean PTV D2% and mean PTV D50% were significantly higher in 3 DCRT plans. Compared to IMRT, 3 DCRT resulted in significantly higher volumes of hot spots, lower volumes of cold spots, and higher doses to the entire OAR. Conclusion: This study demonstrated that IMRT achieves superior normal tissue avoidance (bladder and bowel) compared to 3 DCRT, with comparable target dose coverage.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.67-72
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• 2004

Purpose : Patient immobilization is crucial factor for radiation therapy. Generally, we have been used vacuum bag immobilization device(Vac-Lock) for whole body immobilization. In order to easily set up of vacuum bag(Vac-Lock), we made a 3DCA(3-Dimensional Conformal Accessary). The purpose of this study is evaluation of effectiveness of 3DCA using Vack-Lock for patient immobilization. Materials and Methods : We made 3DCA(3-Dimensional Conformal Accessary) tool of wooden boards. The reasons to choice of wooden boards are its easily handling nature and cheap expenses. Results : (1) We reduced man power from $5{\sim}6$persons to 1person to make immobilizations, (2) Shortened work time from 1hour to within 10minutes. (3) Avoid a collision to treatment gantry head. (4) Its shapes are smart and clean. Conclusion : We have made and used 3DCA(3-Dimensional Conformal Accessary) tool was very effective and convenience for the patients and users.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.95-100
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• 1992

Since LINAC-based stereotactic radiosurgery uses multiple noncoplanar arcs, three-dimensional dose evaluation and many beam parameters, a lengthy computation time is required to optimize even the simplest case by a trial and error. The basic approach presented in this paper is to show promising methods using an experimental optimization and an analytic optimization The purpose of this paper is not to describe the detailed methods, but introduce briefly, proceeding research done currently or in near future. A more detailed description will be shown in ongoing published papers. Experimental optimization is based on two approaches. One is shaping the target volumes through the use of multiple isocenters determined from dose experience and testing. The other method is conformal therapy using a beam's eye view technique and field shaping. The analytic approach is to adapt computer-aided design optimization in finding optimum irradiation parameters automatically.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.431-437
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• 1993

An important problem in radiosurgery is the utilization of the proper beam parameters, to which dose shape is sensitive. Streotactic radiosurgery techniques for a linear accelerator typically, use circular radiation fields with multiple arcs to produce an spherical radiation distribution. Target volumes are irregular in shape for a certain case, and spherical distributions can irradiate normal tissues to high dose as well as the target region. The current improvement to dose distribution utilizes treating multiple isocenters or weighting various arcs to change treatment volume shape. in this paper another promising study relies upon dynamically shaping the treatment beam to fit the beam's eye view of the target. This conformal irradiation technique was evaluated by means of visual three dimensional dose distribution, dose volume histograms to the target volume and surrounding normal brain. It is shown that using even less arcs than multiple isocenter irradiation technique, the conformal therapy yields comparable dose gradients and superior homogeneity of dose within the target volume.

• Radiation Oncology Journal
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• v.36 no.4
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• pp.276-284
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• 2018

Purpose: Traditionally, three-dimensional conformal radiation therapy (3D-CRT) is used for neoadjuvant chemoradiation in locally advanced rectal cancer. Intensity-modulated radiation therapy (IMRT) was later developed for more conformal dose distribution, with the potential for reduced toxicity across many disease sites. We sought to use the National Cancer Database (NCDB) to examine trends and predictors for IMRT use in rectal cancer. Materials and Methods: We queried the NCDB from 2004 to 2015 for patients with rectal adenocarcinoma treated with neoadjuvant concurrent chemoradiation to standard doses followed by surgical resection. Odds ratios were used to determine predictors of IMRT use. Univariable and multivariable Cox regressions were used to determine potential predictors of overall survival (OS). Propensity matching was used to account for any indication bias. Results: Among 21,490 eligible patients, 3,131 were treated with IMRT. IMRT use increased from 1% in 2004 to 22% in 2014. Predictors for IMRT use included increased N stage, higher comorbidity score, more recent year, treatment at an academic facility, increased income, and higher educational level. On propensity-adjusted, multivariable analysis, male gender, increased distance to facility, higher comorbidity score, IMRT technique, government insurance, African-American race, and non-metro location were predictive of worse OS. Of note, the complete response rate at time of surgery was 28% with non-IMRT and 21% with IMRT. Conclusion: IMRT use has steadily increased in the treatment of rectal cancer, but still remains only a fraction of overall treatment technique, more often reserved for higher disease burden.

• Radiation Oncology Journal
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• v.18 no.3
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• pp.167-176
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• 2000

The objective of recent radiation therapy is to improve the quality of treatment and the after treatment quality of life. In Korea, sharing the same objective, significant advancement was made due to the gradual increase of patient number and rapid increase of treatment facilities. The advancement includes generalization of three-dimensional conformal radiotherapy (3D-CRT), application of linac-based stereotactic radiosurgery (SRS), and furthermore, the introduction of intensity modulated radiation therapy (IMRT). Authors in this paper prospectively review the followings: the advancement of radiation oncology in Korea, the recent status of four-dimensional radiation therapy, IMRT, the concept of the treatment with biological conformity, the trend of combined chemoradiotherapy, the importance of internet and radiation oncology information management system as influenced by the revolution of information technology, and finally the global trend of telemedicine in radiation oncology. Additionally, we suggest the methods to improve radiotherapy treatment, which include improvement of quality assurance (QA) measures by developing Koreanized QA protocol and system, regional study about clinical protocol development for phase three clinical trial, suggestion of unified treatment protocol and guideline by academic or research societies, domestic generation of treatment equipment's or system, establishment of nationwide data base of radiation-oncology-related information, and finally patterns-of-care study about major cancers.

• 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.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.11-15
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• 2008

Purpose: The goal of radiation treatment is to deliver a prescribed radiation dose to the target volume accurately while minimizing dose to normal tissues. In this paper, we comparing the dose distribution between three dimensional conformal radiation radiotherapy (3D-CRT) and helical tomotherapy (TOMO) plan for partial breast cancer. Materials and Methods: Twenty patients were included in the study, and plans for two techniques were developed for each patient (left breast:10 patients, right breast:10 patients). For each patient 3D-CRT planning was using pinnacle planning system, inverse plan was made using Tomotherapy Hi-Art system and using the same targets and optimization goals. We comparing the Homogeneity index (HI), Conformity index (CI) and sparing of the organs at risk for dose-volume histogram. Results: Whereas the HI, CI of TOMO was significantly better than the other, 3D-CRT was observed to have significantly poorer HI, CI. The percentage ipsilateral non-PTV breast volume that was delivered 50% of the prescribed dose was 3D-CRT (mean: 40.4%), TOMO (mean: 18.3%). The average ipsilateral lung volume percentage receiving 20% of the PD was 3D-CRT (mean: 4.8%), TOMO (mean: 14.2), concerning the average heart volume receiving 20% and 10% of the PD during treatment of left breast cancer 3D-CRT (mean: 1.6%, 3.0%), TOMO (mean: 9.7%, 26.3%) Conclusion: In summary, 3D-CRT and TOMO techniques were found to have acceptable PTV coverage in our study. However, in TOMO, high conformity to the PTV and effective breast tissue sparing was achieved at the expense of considerable dose exposure to the lung and heart.

• Journal of radiological science and technology
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• v.20 no.2
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• pp.79-82
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• 1997

Image-based three dimensional radiation treatment planning(3D RTP) has a potential of generating superior treatment plans. Advances in computer technology and software developments quickly make 3D RTP a feasible choice for routine clinical use. However, it has become clear that an evaluation of a 3D plan is more difficult than a 2D plan. A number of tools have been developed to facilitate the evaluation of 3D RTP both qualitatively and quantitatively. For example, beam's eye view(BEV) is one of the most powerful and time-saving method as a qualitative tools. Dose-volume histogram(DVH) has been proven to be one of the most valuable methods for a quantitative tools. But it has a limitation to evaluate several different plans for biological effects of the tissue and critical organ. Therefore, there is a strong interest in developing quantitative models which would predict the likely biological response of irradiated organs and tissues, such as tumor control probability(TCP) and normal tissue complication probability(NTCP). DVH and NTCP of hepatoma were evaluated for three dimensional conformal radiotherapy(3D CRT). Also, 3D RTP was analysed as a dose optimization based on beam arrangement and beam modulation.

• Progress in Medical Physics
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• v.33 no.3
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• pp.25-35
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• 2022

Purpose: Planning for radiotherapy relies on implicit estimation of the probability of tumor control and the probability of complications in adjacent normal tissues for a given dose distribution. Methods: The aim of this pilot study was to reconstruct dose-volume histograms (DVHs) from text files generated by the Eclipse treatment planning system developed by Varian Medical Systems and to verify the integrity and accuracy of the dose statistics. Results: We further compared dose statistics for intensity-modulated radiotherapy of the head and neck between the Eclipse software and software developed in-house. The dose statistics data obtained from the Python software were consistent, with deviations from the Eclipse treatment planning system found to be within acceptable limits. Conclusions: The in-house software was able to provide indices of hotness and coldness for treatment planning and store statistical data generated by the software in Oracle databases. We believe the findings of this pilot study may lead to more accurate evaluations in planning for radiotherapy.