• Title/Summary/Keyword: Breast Radiation Therapy

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The Palliative Radiotherapy in Bone Metastases (전이성 골종양의 고식적 방사선 치료)

  • Choi, Young-Min;Lee, Hyung-Sik;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.201-207
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    • 1994
  • To objectively compare the response of the palliative radiotherapy in bone metastatic patients which decreases pain and prevents pathologic fractures, we introduced and applied the RTOG pain and narcotic measure system. From Oct in 1991 to July in 1993, thirty-two patients with painful bone metastases, 17 of them were solitary lesions and others were multiple lesions, were treated with mainly 6 MV photon otherwise 15 MV photon. Radiation doses to bone metastatic sites ranged about from 2000 to 4600cGy. Responses of radiation therapy were compared with days of pre-RT, RT finish, 3, 6, 9 months after the start of RT and solitary versus multiple lesions and follow up scores according to the RTOG measure system. Survival analysis was done. Pain and narcotic score of the entire patients were 7.3, 7.8 at the pre-RT period and 2.6, 3.9 at the immediate or 2 weeks after RT, which was $64{\%},\;50{\%}$ decrement compared with the pre-RT score, Pain scores of 3, 6 and 9 months after the beginning of irradiation were 3.6, 3.7 and 3.3. The best response found in the breast and prostate primaries was $84\%,\;78\%$ decrement of pain score as compared with pre-RT score(statistically insignificant). Median survival was 5.5 months and mean survival was 5 months. We conclude that the RTOG pain and narcotic measure system is relatively effective scale in the comparison of before and after palliative irradiation to the painful bone metastatic sites but more detailed parameters will be required in the narcotic scoring system. More aggressive but less or similiar toxic radiotherapy is needed in the patients having relatively long life expected time.

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The Evaluation of Usefulness of the Manufactured DTAB (Double Tilt Angle Board) System (Double Tilt Angle Board (DTAB)의 자체 제작에 관한 유용성 평가)

  • Lee, Joung-Jin;Jang, In-Gi;Kim, Wan-Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.43-51
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    • 2006
  • Purpose: To resolution of A hospital-handmade modification double tilt angle immobilization system (DTAB immobilization system) and to report the clinical results of it. Material and Methods: It was developed in conjunction with the breast board for patients unable to achieve and maintain the desired uncomfortable respiration and position of set-up needed in the treatment of RT (This custom design provides an alternative to accomplishing this desired head angle needed to relax position treatment area, realizing that the lenses totally protected eye-ball out) By using the angled breast board and SBDD(small bowel device), reproducibility of set-up and patient comfort were addressed throughout the simulation, computed tomography planning and treatment process. Results: Usually patients the error range-within 5 mm. When use of Aqua patients error range-within 3 mm. Conclusion: It was constructed in tandem with a unique custom-built double tilt angle board (DTAB). It was designed to eliminate clinical set-up problems with head immobilization and instability during treatment, thus providing for a more comfortable head rest for the patient.

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Survival Rates of Breast Cancer Patients Aged 40 to 49 Years according to Detection Modality in Korea: Screening Ultrasound versus Mammography

  • So Yeon Won;Hyung Seok Park;Eun-Kyung Kim;Seung Il Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Youngjean Park;Seho Park;Min Jung Kim;Young Up Cho;Byeong-Woo Park
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.159-167
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    • 2021
  • Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

Radiation Therapy for Patients with Early-Stage Breast Carcinoma Treated with Breast-Conserving Surgery (조기 유방암에서 유방 보존술후 방사선 치료)

  • Shin, S.O.
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.274-284
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    • 1997
  • 조기 유방암에 대한 바람직한 치료는 유방의 형태를 최대한 보존하면서 악성 종양을 치료하는 것이다. 이러한 목적을 충분히 달성하기 위하여 최대한 조기에 유방암을 진단하고 미용상 종양 절제술에 적합한 환자를 선택하여 절제 범위를 최소화한 유방 보존술을 시행하며 수술 후 유방 전체에 대한 근치적인 방사선 치료를 적절히 시행하면 된다. 여러 연구에서 전통적인 치료법인 근치적 또는 변형 근치적 유방 절제술의 성적과 비교하여 차이가 없으므로 조기 유방암의 치료에는 이상적인 치료법으로 인정된다. 이와 병행하여 액와부 림프절 및 전신적인 재발에 대한 진단 및 예방을 위하여 액와 림프절에 대한 충분한 외과적인 처치와 병리학적인 검사를 시행하여 불필요한 방사선 치료로 인한 부작용을 최소화하여야 한다. 만약 전신적인 치료가 요구되는 경우에는 항암제 및 내분비 요법을 병행하여 재발을 억제해야 유방 보존술의 장점을 살릴 수 있다. 결론적으로 이 치료법이 조기 유방암 환자의 삶의 질을 개선시키면서 최상의 치료 효과를 얻기 위해서는 유관 진료 각과의 의료진이 유기적으로 협조하여 조기 진단률을 높히고, 유방 보존술 및 방사선 치료 과정에서 환자들에게 치료 결과에 대한 확신을 심어주도록 열심히 노력해야 된다. 또한 치료와 연관된 부작용이나 합병증을 최대한 줄여나가는 방향으로 치료 방법을 계속 보완 발전시키는 것이 매우 중요하며 아직도 발전의 여지가 많은 이 치료법이 조기 유방암의 이상적인 치료법으로 정착하기 위해서는 향후 다양한 임상적인 경험을 통한 더 많은 연구가 필요하리라 생각한다.

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Predictors of Mammography Performance in Job Women (직장여성의 유방촬영술이행 예측요인)

  • Kim, Young Im;Lee, Chang Hyun
    • Korean Journal of Occupational Health Nursing
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    • v.22 no.4
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    • pp.343-351
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    • 2013
  • Purpose: This study was to identify factors affecting mammography screening behavior in job women by attitude, social influence and self-efficacy model. Methods: The data were obtained from 171 job women in one residency area by structural questionnaire from March to June 2013 and analysed by using $x^2$-test, ANOVA, Spearman's correlation and logistic regression analysis. Results: The each performance rate was 45.1% in mammography, 44.9% in breast self examination and 48.5% in physical examination. The mammography performance rate in job women showed higher significance in the groups of 1) older age, urban residency, marital status or high economic state, 2) shorter office hours or higher job position, 3) childbirth experience or menopause and 4) preferring soy bean food, practicing regular exercise, suffering chronic disease or receiving radiation therapy. Attitude, social influences and self-efficacy made significant differences in mammography performance. Logistic regression analysis showed that 50 years or older, urban residency, social influences towards mammography and high self-efficacy were significant relationship. Conclusion: In order to increase the mammography performance rate, the intervention strategies are needed to increase positive social influences or self-efficacy and to offer public information to younger age.

The Effect of Therapy Oriented CT in Radiation Therapy Planning (치료 계획용 전산화 단층촬영이 방사선 치료계획에 미치는 효과)

  • Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.149-155
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    • 1987
  • The success of radioation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (plannng CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients $(28\%)$. Treatment planning was changed in $47\%$ of head and neck tumor, $79\%$ of intrathoracic tumor and $63\%$ of abdmonial tumor. in breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was $10\%$ in intrathoracic and intra-abdominal tumors but $20\%$ in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT Planning is very helpful in radiotherapy Planning.

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Effect of Low Magnetic Field on Dose Distribution in the Partial-Breast Irradiation (부분유방 방사선조사 시 저자기장이 선량분포에 미치는 영향)

  • Kim, Jung-in;Park, So-Yeon;Lee, Yang Hoon;Shin, Kyung Hwan;Wu, Hong-Gyun;Park, Jong Min
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.208-214
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    • 2015
  • The aim of this study is to investigate the effect of low magnetic field on dose distribution in the partial-breast irradiation (PBI). Eleven patients with an invasive early-stage breast carcinoma were treated prospectively with PBI using 38.5 Gy delivered in 10 fractions using the $ViewRay^{(R)}$ system. For each of the treatment plans, dose distribution was calculated with magnetic field and without magnetic field, and the difference between dose and volume for each organ were evaluated. For planning target volume (PTV), the analysis included the point minimum ($D_{min}$), maximum, mean dose ($D_{mean}$) and volume receiving at least 90% ($V_{90%}$), 95% ($V_{95%}$) and 107% ($V_{107%}$) of the prescribed dose, respectively. For organs at risk (OARs), the ipsilateral lung was analyzed with $D_{mean}$ and the volume receiving 20 Gy ($V_{20\;Gy}$), and the contralateral lung was analyzed with only $D_{mean}$. The heart was analyzed with $D_{mean}$, $D_{max}$, and $V_{20\;Gy}$, and both inner and outer shells were analyzed with the point $D_{min}$, $D_{max}$ and $D_{mean}$, respectively. For PTV, the effect of low magnetic field on dose distribution showed a difference of up to 2% for volume change and 4 Gy for dose. In OARs analysis, the significant effect of the magnetic field was not observed. Despite small deviation values, the average difference of mean dose values showed significant difference (p<0.001), but there was no difference of point minimum dose values in both sehll structures. The largest deviation for the average difference of $D_{max}$ in the outer shell structure was $5.0{\pm}10.5Gy$ (p=0.148). The effect of low magnetic field of 0.35 T on dose deposition by a Co-60 beam was not significantly observed within the body for PBI IMRT plans. The dose deposition was only appreciable outside the body, where a dose build-up due to contaminated electrons generated in the treatment head and scattered electrons formed near the body surface.

1-Benzyl indazole derivative-based 18F-labeled PET radiotracer: Radiosynthesis and cell uptake study in cancer cells

  • More, Kunal N.;Lee, Jun Young;Park, Jeong-Hoon;Chang, Dong-Jo
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.5 no.1
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    • pp.36-47
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    • 2019
  • Hypoxia-inducible factor-1 ($HIF-1{\alpha}$) is a transcription factor activated in response to low oxygen level, and is highly expressed in many solid tumors. Moreover, $HIF-1{\alpha}$ is a representative biomarker of hypoxia and also helps to maintain cell homeostasis under hypoxic condition. Most solid tumors show hypoxia, which induces poor prognosis and resistance to conventional cancer therapies. Thus, early diagnosis of hypoxia with positron emission tomography (PET) radiotracer would be highly beneficial for management of malignant solid tumors with effective cancer therapy. YC-1 is a most promising candidate among several $HIF-1{\alpha}$ inhibitors. As an effort to develop a hypoxia imaging tool as a PET radiotracer, we designed and synthesized [$^{18}F$]DFYC based on potent derivative of YC-1 and performed preliminary in vitro cell uptake study. [$^{18}F$]DFYC showed a significant accumulation in SKBR-3 cells among other cancer cells, proving as a good lead to develop a hypoxic solid tumor such as breast cancer.

Inhibition of DNA-dependent Protein Kinase by Blocking Interaction between Ku Complex and Catalytic Subunit of DNA-dependent Protein Kinase

  • Kim, Chung-Hui;Cuong, Dang-Van;Kim, Jong-Su;Kim, Na-Ri;Kim, Eui-Yong;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.1
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    • pp.9-14
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    • 2003
  • Recent studies indicated that cancer cells become resistant to ionizing radiation (IR) and chemotherapy drugs by enhanced DNA repair of the lesions. Therefore, it is expected to increase the killing of cancer cells and reduce drug resistance by inhibiting DNA repair pathways that tumor cells rely on to escape chemotherapy. There are a number of key human DNA repair pathways which depend on multimeric polypeptide activities. For example, Ku heterodimer regulatory DNA binding subunits (Ku70/Ku80) on binding to double strand DNA breaks (DSBs) are able to interact with 470-kDa DNA-dependent protein kinase catalytic subunit (DNA-PKcs), and are essential for DNA-dependent protein kinase (DNA-PK) activity. It has been known that DNA-PK is an important factor for DNA repair and also is a sensor-transmitting damage signal to downstream targets, leading to cell cycles arrest. Our ultimate goal is to develop a treatment of breast tumors by targeting proteins involved in damage-signaling pathway and/or DNA repair. This would greatly facilitate tumor cell cytotoxic activity and programmed cell death through DNA damaging drug treatment. Therefore, we designed a domain of Ku80 mutants that binds to Ku70 but not DNA end binding activity and used the peptide in co-therapy strategy to see whether the targeted inhibition of DNA-PK activity sensitized breast cancer cells to irradiation or chemotherapy drug. We observed that the synthesized peptide (HNI-38) prevented DNA-PKcs from binding to Ku70/Ku80, thus resulting in inactivation of DNA-PK activity. Consequently, the peptide treated cells exhibited poor to no DNA repair, and became highly sensitive to IR or chemotherapy drugs, and the growth of breast cancer cells was inhibited. Additionally, the results obtained in the present study also support the physiological role of resistance of cancer cells to IR or chemotherapy.

The establishment of Digital Image Capture System(DICS) using conventional simulator (Conventional simulator를 이용한 Digital image capture system(DICS)의 구축)

  • Oh Taesung;Park Jongil;Byun Youngsik;Shin HyunKyoh
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.25-32
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    • 2004
  • Purpose : The simulator is used to determine patient field and ensure the treatment field, which encompasses the required anatomy during patient normal movement such as during breathing. The latest simulator provide real time display of still, flouroscopic and digitalized image, but conventional simulator is not yet. The purpose of this study is to introduce digital image capture system(DICS) using conventional simulator and clinical case using digital captured still and flouroscopic image. Methods and materials : We connect the video signal cable to the video terminal in the back up of simulator monitor, and connect the video jack to the A/D converter. After connection between the converter jack and computer, We can acquire still image and record flouroscopic image with operating image capture program. The data created with this system can be used in patient treatment, and modified for verification by using image processing software. (j.e. photoshop, paintshop) Result : DICS was able to establish easy and economical procedure. DCIS image was helpful for simulation. DICS imaging was powerful tool in the evaluation of the department specific patient positioning. Conclusion : Because the commercialized simulator based of digital capture is very expensive, it is not easily to establish DICS simulator in the most hospital. DICS using conventional simulator enable to utilize the practical use of image equal to high cost digitalized simulator and to research many clinical cases in case of using other software program.

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