• Title/Summary/Keyword: Contralateral dose

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Adjuvant Radiotherapy after Breast Conserving Treatment for Breast Cancer:A Dosimetric Comparison between Volumetric Modulated Arc Therapy and Intensity Modulated Radiotherapy

  • Liu, Zhe-Ming;Ge, Xiao-Lin;Chen, Jia-Yan;Wang, Pei-Pei;Zhang, Chi;Yang, Xi;Zhu, Hong-Cheng;Liu, Jia;Qin, Qin;Xu, Li-Ping;Lu, Jing;Zhan, Liang-Liang;Cheng, Hong-Yan;Sun, Xin-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3257-3265
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    • 2015
  • Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.

The Patient Care During Before Radiotherapy in Oral Cavity Cancer (구강내 종양환자의 방사선 치료시의 Patient Care)

  • Jeon Byeong-chul;Park Jae-il
    • The Journal of Korean Society for Radiation Therapy
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    • v.7 no.1
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    • pp.92-96
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    • 1995
  • All patients who will Undergo irraidiation of the oral cavity cancer will need dental before and during Radiotherapy. The extent of the region and the presence of numerous critical normal tissues(mucosa, gingiva, teeth and the alveolar ridge, alveolar bony structure, etc) in the oral cavity area, injury to which could result in serious functional impairment. Therefore I evaluate the Usefulness of custom-made intraoral shielding device before and during Radiotherapy in oral cavity cancer. Materials and Methods(1) : Manufacture process of Custom-made intraoral shielding device Containing Cerroband. A. Acquisition of impression B. Matrix Constitution C. Separation by Separator D. Sprincle on method E. Trimming F. Spacing G. Fill with Cerroband Materials and Methods (2) A. Preannealing B. TLD Set up C. Annealing D. TLD Reading = Results = Therefore dosimetric characteristics in oral cavity by TLD Compared to isodose curve dose distribution Ipsilateral oral mucosa, Contralateral oral mucosa, alveolar ridge, tongue, dose was reduced by intraoral shielding device containning Cerroband technique Compard to isodose plan = Conclusions = The custom-made intra-oral shielding device containing Cerroband was useful in reducing the Contralateral oral mucosa dose and Volume irradiated.

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The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy (인공 유방 확대술을 받은 환자의 유방암 치료 시 크기에 따른 반대 측 유방의 피폭 선량 및 차폐 효율 평가)

  • Kim, Jong Wook;Woo, Heon;Jeong, Hyeon Hak;Kim, Kyeong Ah;Kim, Chan Yong;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.329-336
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    • 2014
  • Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.

Dosimetric Characteristics of Dynamic Wedge Technique (Dynamic Wedge의 조직내 방사선량 분포의 특성)

  • Oh Young Taek;Keum Ki Chang;Chu Seong Sil;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.323-332
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    • 1996
  • Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.

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Diuretic action of hoelen in the dog (복령의 이뇨작용)

  • ;;Lee, Dohn Ill;Moon, Yung Hee
    • YAKHAK HOEJI
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    • v.18 no.1
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    • pp.39-48
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    • 1974
  • Intravenously administered total water extract of Hoelen, (Pachymae fungus) in a dose of 10mg/kg and its methanol lextract, in a smaller dose than total water extract, produced significantly increase on urinary volume, sodium nad potassium excretion, and osmolar nad free water clearances. Increasing the doses produced more pronounced renal responses. Glomerular filtration rate and renal plasma flow changed littl with both extract. On the contrary, water extract from residue obtained on extraction with organic solvents exhibited no significant changes on the parameters of the renal function. In experiments, in which the total water extract was infused directly into a renal artery and urines from both ureters were collected separetely, a small dose of 0.3mg/kg/min showed no diuresis, but a large dose of 1.0mg/kg/min elicited diuretic action even on the contralateral kindneys. It is, therfore, concluded that Hoelen induces diuresis, mainly by inhibiting reabsorption of electrolytes in the renal tubules, and that the renotropic action may be mediated by some endogenous humoral substances.

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Planning Aspects of Volumetric Modulated Arc Therapy and Intensity Modulated Radio therapy in Carcinoma Left Breast - A Comparative Study

  • Ekambaram, Varadharajan;Velayudham, Ramasubramanian;Swaminathan, Shiyama;Loganathan, Padmanabhan;Swaminathan, Vijaya
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1633-1636
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    • 2015
  • Background: The advantages of Rapid Arc plans versus Intensity modulated radiotherapy plans for Carcinoma left breast were analyzed. Materials and Methods: In this study 20 Post mastectomy carcinoma left breast patients were analyzed. Both Intensity modulated Radiotherapy and Rapid Arc plans were generated for these patients. IMRT plans with 7 beams in an arc fashion and VMAT plans with two semi arcs were made to achieve 95% dose coverage to 100% volume. The plans were evaluated using Dose volume Histograms. Results: The mean Conformity and Homogeneity index in VMAT is found to be 1.05 and 0.065 respectively whereas in IMRT it was 1.07 and 0.069. The 20% volume of Heart received a mean dose of 960cGy in VMAT and 1300cGy in IMRT. The mean dose was 1236cGy in VMAT and 1870cGy in IMRT. The ipsilateral Lung received 3395cGy to 5% volume and 1840cGy to 20% volume on an average and the mean dose was 1205cGy in VMAT, while the same were found to be 3525cGy, 2012cGy and 1435cGy respectively in IMRT. The Contralateral Lung received a mean dose of 505cGy in VMAT and 553cGy in IMRT. The mean Monitor units in VMAT were 512MU and 1170MU in IMRT. The NTID in VMAT is $108.8{\times}10^5Gycm^3$ and $110.1{\times}10^5Gycm^3$ in IMRT. Conclusions: The target coverage, homogeneity and Conformity index were better in VMAT plans. The Ipsilateral Lung and heart dose were very less in VMAT plans. The Contralateral Lung dose and the Normal Tissue Integral Dose were also lesser in VMAT plans however the difference is not very appreciable. The MU in VMAT plans is almost 50% that of the IMRT plans which results in the reduction of treatment time. On the whole VMAT proves to be a better modality for treating Ca. Left Breast Patients.

Pharmacological Studies on Ether Fraction of Corni Fructus (산수유 에텔분획물의 약리작용에 관한 연구)

  • 이은방;최병천;조태순
    • YAKHAK HOEJI
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    • v.29 no.1
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    • pp.1-10
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    • 1985
  • The ether fraction obtained from dry fruit of Cornus officinalis was investigated for the anti-inflammatory action, acute toxicity and central nervous system activities. From several pharmacological examinations, it was found that the ether fraction suppressed considerably carrageenin edema at the dose of 600mg/kg p.o. in rats, inhibited the granuloma formation in rats as given 100mg/kg p.o. for 7 days and decreased the swelling of both of complete adjuvant injected and noninjected (contralateral) paws of the rats at the dose of 100mg/kg p.o. given for 14 days. The $LD_{50}$ of the fraction are estimated to be more than 2,000mg/kg p. o. and 642mg/kg i. p. in mice. And the fraction did not show any sedative, stimulative, analgesic and anticonvulsant action but exhibited hypothermic action. These results might be concluded that the ether fraction of Corni fructus showed anti-inflammatory action in both of acute and chronic type models without any considerable central nervous depressant activity and exhibited very weak acute toxicity in mice.

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Effect of DHEA on Recovery of Muscle Atrophy Induced by Parkinson' s Disease

  • Choe, Myoung-Ae;An, Gyeong-Ju;Koo, Byung-Soo;Jeon, Song-Hee
    • Journal of Korean Academy of Nursing
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    • v.41 no.6
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    • pp.834-842
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    • 2011
  • Purpose: The purpose of this study was to determine the effect of dehydroepiandrosterone (DHEA) on recovery of muscle atrophy induced by Parkinson's disease. Methods: The rat model was established by direct injection of 6-hydroxydopamine (6-OHDA, 20 ${\mu}g$) into the left striatum using stereotaxic surgery. Rats were divided into two groups; the Parkinson's disease group with vehicle treatment (Vehicle; n=12) or DHEA treatment group (DHEA; n=22). DHEA or vehicle was administrated intraperitoneally daily at a dose of 0.34 mmol/kg for 21 days. At 22-days after DHEA treatment, soleus, plantaris, and striatum were dissected. Results: The DHEA group showed significant increase (p<.01) in the number of tyrosine hydroxylase (TH) positive neurons in the lesioned side substantia nigra compared to the vehicle group. Weights and Type I fiber cross-sectional areas of the contralateral soleus of the DHEA group were significantly greater than those of the vehicle group (p=.02, p=.00). Moreover, extracellular signal-regulated kinase (ERK) phosphorylation significantly decreased in the lesioned striatum, but was recovered with DHEA and also in the contralateral soleus muscle, Akt and ERK phosphorylation recovered significantly and the expression level of myosin heavy chain also recovered by DHEA treatment. Conclusion: Our results suggest that DHEA treatment recovers Parkinson's disease induced contralateral soleus muscle atrophy through Akt and ERK phosphorylation.

Influence of Isoproterenol on Intra-renal Blood Flow in the Dog (개의 신내혈류(腎內血流)에 미치는 Isoproterenol의 영향(影響))

  • Park, Ki-Dong
    • The Korean Journal of Pharmacology
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    • v.5 no.2
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    • pp.141-148
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    • 1969
  • The direct effect of isoproterenol on renal function, when given intravenously, is usually obscured by its potent hypotensive action. To obviate the latter action, isoproterenol was infused directly into one renal artery of the dog, the other kidney serving as a control for the general action. And following results were obtained. In the first series of experiments, the directic action of isoproterenol was ascertained. $1.0\;{\mu}g/kg/min$. reduced on both kidneys the urine flow, clearances of PAH and creatinine, as well as the amount of sodium excreted, but the effect was weaker on the experimental side than on contralateral side. With $0.1\;{\mu}g/kg/min$., two cases among 6 experiments showed marked diuresis, two cases no apparent effect, and another two marked antidiuresis on the experimental kidney, whereas the contralateral kidney exhibited antidiuresis in all cases. Further reducing the dose unmasked the diuretic action on the ,experimental kidney. In another series, the effects of isoproterenol on the blood flow distribution within the kidney and on sodium concentration gradient within the kidney tissue were observed. $0.05\;{\mu}g/kg/min$ isoproterenol markedly increased the medullary plasma flow and slightly increased total renal plasma flow and glomerular filtration rate, along with concomitant increase in the amount of sodium excreted and osmolar clearance, and decrease in reabsorption of free water. Sodium concentration gradient markedly decreased in the experimental kidney, reaching 2/3 of the value observed in the contralateral kidney at the papilla. It is thus concluded that isoproterenol exerts a diuretic action, when infused directly into a renal artery, and the mechanism of the action rests on its hemodynamic action, substantiated as the increase in glomerular filtration and in the medullary blood flow, resulting in washout of hyperosmolality produced by the coutercurrent multiplier system.

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The Pattern of Failure after Definitive Radiotherapy for Squamous Cell Carcinoma of the Lung (편평상피 세포성 폐암의 방사선치료 실패 양상)

  • Jang Yang Suk;Kim Jae Cheol;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.45-50
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    • 1989
  • From Feb.1985 to Feb.1988,76 patients with squamous cell carcinoma of the lung treated at the Department of Therapeutic Radiology in Kyungpook National University Hospital were available for the analysis of this study. All patients received radiation of 4000cGy-6600cGy with curative aim. The overall rate of complete response was 25.0% and partial response was 452.6% The complete and partial regression of tumor was 14.3% in patients treated with dose below 5000cGy and 84.1% in the group treated with dose above 5000cGy (p<0.01). The complete response was seen only in the group of patients received radiation at least 6000cGy. The patterns of failure were as follows. The rate of initial intrathoracic recurrence was 52.6% in patients with complete response. The overall rate of failure was 68.8%. Distant metastasis was found in 47.4% of patients. Bone, contralateral lung, and brain were common metastatic sites in decreasing order All of the distant metastases and 80% of local recurrences were found within the first year after treatment.

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