• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.315-320
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• 2021

Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.

• Journal of Radiation Protection and Research
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• 제46권2호
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• pp.39-47
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• 2021

Background: The National Institutes for Quantum and Radiological Science and Technology-National Institute of Radiological Sciences (QST-NIRS) has continuously investigated the undesired radiation exposure in ion beam radiotherapy mainly in carbon-ion radiotherapy (CIRT). This review introduces our investigations on the secondary neutron dose in CIRT with the broad and scanning beam methods. Materials and Methods: The neutron ambient dose equivalents in CIRT are evaluated based on rem meter (WENDI-II) measurements. The out-of-field organ doses assuming prostate cancer and pediatric brain tumor treatments are also evaluated through the Monte Carlo simulation. This evaluation of the out-of-field dose includes contributions from secondary neutrons and secondary charged particles. Results and Discussion: The measurements of the neutron ambient dose equivalents at a 90#x00B0; angle to the beam axis in CIRT with the broad beam method show that the neutron dose per treatment dose in CIRT is lower than that in proton radiotherapy (PRT). For the scanning beam with the energy scanning technique, the neutron dose per treatment dose in CIRT is lower than that in PRT. Moreover, the out-of-field organ doses in CIRT decreased with distance to the target and are less than the lower bound in intensity-modulated radiotherapy (IMRT) shown in AAPM TG-158 (American Association of Physicists in Medicine Task Group). Conclusion: The evaluation of the out-of-field doses is important from the viewpoint of secondary cancer risk after radiotherapy. Secondary neutrons are the major source in CIRT, especially in the distant area from the target volume. However, the dose level in CIRT is similar or lower than that in PRT and IMRT, even if the contributions from all radiation species are included in the evaluation.

• 한국의학물리학회지:의학물리
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• 제31권1호
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• pp.1-7
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• 2020

Hadron therapy, such as carbon and helium ions, is increasingly coming to the fore for the treatment of cancers. Such hadron therapy has several advantages over conventional radiotherapy using photons and electrons physically and clinically. These advantages are due to the different physical and biological characteristics of heavy ions including high linear energy transfer and Bragg peak, which lead to the reduced exit dose, lower normal tissue complication probability and the increased relative biological effectiveness (RBE). Despite the promising prospects on the carbon ion radiation therapy, it is in dispute with which bio-mathematical models to calculate the carbon ion RBE. The two most widely used models are local effect model and microdosimetric kinetic model, which are actively utilized in Europe and Japan respectively. Such selection on the RBE model is a crucial issue in that the dose prescription for planning differs according to the models. In this study, we aim to (i) introduce the concept of RBE, (ii) clarify the determinants of RBE, and (iii) compare the existing RBE models for carbon ion therapy.

• 대한방사선기술학회지:방사선기술과학
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• 제42권6호
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• pp.413-422
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• 2019

Heavy ion particle, represented carbon ion, radiotherapy is currently most advanced radiation therapy technique. Conventional radiation therapy has made remarkable changes over a relatively short period of time and leading various developments such as intensity modulated radiation therapy, 4D radiation therapy, image guided radiation therapy, and high precisional therapy. However, the biological and physical superiority of particle radiation, represented by Bragg peak, can give the maximum dose to tumor and minimal dose to surrounding normal tissues in the treatment of cancers in various areas surrounded by radiation-sensitive normal tissues. However, despite these advantages, there are some limitations and factors to consider. First, there is not enough evidence, such as large-scale randomized, prospective phase III trials, for the clinical application. Secondly, additional studies are needed to establish a very limited number of treatment facilities, uncertainty about the demand for heavy particle treatment, parallel with convetional radiotherapy or indications. In addition, Bragg peak of the heavy particles can greatly reduce the dose to the normal tissues front and behind the tumor compared to the photon or protons. High precision and accuracy are needed for treatment planning and treatment, especially for lungs or livers with large respiratory movements. Currently, the introduction of the heavy particle therapy device is in progress, and therefore, it is expected that more research will be active.

• 한국의학물리학회지:의학물리
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• 제31권3호
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• pp.71-80
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• 2020

This paper provides a brief review of the advanced technologies for carbon ion radiotherapy (CIRT), with a focus on current developments. Compared to photon beam therapy, treatment using heavy ions, especially a carbon beam, has potential advantages due to its physical and biological properties. Carbon ion beams with high linear energy transfer demonstrate high relative biological effectiveness in cell killing, particularly at the Bragg peak. With these unique properties, CIRT allows for accurate targeting and dose escalation for tumors with better sparing of adjacent normal tissues. Recently, the available CIRT technologies included fast pencil beam scanning, superconducting rotating gantry, respiratory motion management, and accurate beam modeling for the treatment planning system. These techniques provide precise treatment, operational efficiency, and patient comfort. Currently, there are 12 CIRT facilities worldwide; with technological improvements, they continue to grow in number. Ongoing technological developments include the use of multiple ion beams, effective beam delivery, accurate biological modeling, and downsizing the facility.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.219-221
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• 2002

In this work, single event spectra were measured in order to gain the microdosimetric parameters of some heavy ion radiotherapy fields at HIMAC. Microdosimetry is now a well-established technique for the investigation of complex mixed radiation field. Changes in frequency mean lineal energy y$\_$F/ as a function of thickness of A150 phantom were obtained. The absorbed dose was obtained by using y$\_$F/. A direct relation between this single event probability distribution and relative biological effectiveness (RBE) was assumed in order to estimate RBE using the response function.

• Journal of Radiation Protection and Research
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• 제41권3호
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• pp.222-228
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• 2016

Background: We are developing a small size dosimeter for dose estimation in particle therapies. The developed dosimeter is an optical fiber based dosimeter mounting an radiation induced luminescence material, such as an OSL or a scintillator, at a tip. These materials generally suffer from the quenching effect under high LET particle irradiation. Materials and Methods: We fabricated two types of the small size dosimeters. They used an OSL material Eu:BaFBr and a BGO scintillator. Carbon ions were irradiated into the fabricated dosimeters at Heavy Ion Medical Accelerator in Chiba (HIMAC). The small size dosimeters were set behind the water equivalent acrylic phantom. Bragg peak was observed by changing the phantom thickness. An ion chamber was also placed near the small size dosimeters as a reference. Results and Discussion: Eu:BaFBr and BGO dosimeters showed a Bragg peak at the same thickness as the ion chamber. Under high LET particle irradiation, the response of the luminescence-based small size dosimeters deteriorated compared with that of the ion chamber due to the quenching effect. We confirmed the luminescence efficiency of Eu:BaFBr and BGO decrease with the LET. The reduction coefficient of luminescence efficiency was different between the BGO and the Eu:BaFBr. The LET can be determined from the luminescence ratio between Eu:BaFBr and BGO, and the dosimeter response can be corrected. Conclusion: We evaluated the LET dependence of the luminescence efficiency of the BGO and Eu:BaFBr as the quenching effect. We propose and discuss the correction of the quenching effect using the signal intensity ratio of the both materials. Although the correction precision is not sufficient, feasibility of the proposed correction method is proved through basic experiments.

• 대한방사선기술학회지:방사선기술과학
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• 제39권1호
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• pp.43-49
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• 2016

본 연구에서는 탄소이온을 이용한 고LET 방사선 치료시 CR-39 고체비적검출기(SSNTD)를 선량계로 사용하기 위하여 일본 중입자가속기연구소(HIMAC)의 400 MeV/u 탄소 이온을 이용한 교정실험을 수행하였다. 탄소 이온을 조사한 CR-39 검출기는 일본 우주항공연구개발기구(JAXA)의 고체비적검출기 전처리 프로토콜에 따라 화학적 에칭을 하였고, 에칭된 CR-39 검출기의 표면에 형성된 트랙은 디지털 카메라로 촬영한 후 Image J를 이용하여 분석하였다. 분석결과 400 MeV/u 탄소 이온의 ${\bar{y_F}}$와 ${\bar{y_D}}$는 각각 $8.5keV/{\mu}m$ 및 $10.1keV/{\mu}m$이었으며, 이 결과는 한국천문연구원의 조직등가비례계수기(TEPC)로 측정한 값 및 GEANT4 몬테칼로 시뮬레이션으로 계산한 값과 잘 일치하였다. 본 연구를 통하여 CR-39의 선량 및 LET 교정인자를 결정할 수 있었으며, 고LET 방사선 치료시 CR-39를 이용한 선량평가의 가능성을 확인하였다.