• Title/Summary/Keyword: Dose fractionations

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Analysis of High Dose Rate Intracavitary Radiotherapy(HDR-ICR) Treatment Planning for Uterine Cervical Cancer (자궁경부암의 고선량율 강내치료 선량계획 분석)

  • Chai, Gyu-Young
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.387-392
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    • 1994
  • Purpose : This study was done to confirm the reference point variation according to variation in applicator configuration in each fractioation of HDR ICR. Materials and Methods : We analyzed the treatment planning of HDRICR for 33 uterine cervical cancer patients treated in department of therapeutic radiology from January 1992 to February 1992. Analysis was done with respect to three view points-Interfractionation A point variation, interfractionation bladder and rectum dose ratio variation, interfractionation treatment volume variation. Interfractionation A point variation was defined as difference between maximum and minimum distance from fixed rectal point to A point in each patient. Interfractionation bladder and rectum dose ratio variation was defined as difference between maximum and minimum dose ratio of bladder or rectum to A point dose in each patient, Interfractionation treatment volume variation was defined as difference between miximum and minimum treatment volume which absorbed over the described dose-that is, 350 cGy or 400 cGy-in each patient. Results The mean of distance from rectum to A point was 4.44cm, and the mean of interfractionation distance variation was 1.14 cm in right side,1.09 cm in left side. The mean of bladder and rectum dose ratio was $63.8\%$ and $63.1\%$ and the mean of interfractionation variation was $14.9\%$ and $15.8\%$ respectively. With fixed planning administration of same planning to all fractionations as in first fractionation planning-mean of bladder and rectum dose ratio was $64.9\%$ and $72.3\%$.and the mean of interfraction variation was $28.1\%$ and $48.1\%$ reapectively. The mean of treatment volume was $84.15cm^3$ and the interfractionation variation was $21.47cm^2$. Conclusion : From these data, it was confirmed that there should be adapted planning for every fractionation ,and that confirmation device installed in ICR room would reduce the interfractionation variation due to more stable applicator configuration.

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Is higher dose always the right answer in stereotactic body radiation therapy for small hepatocellular carcinoma?

  • Lee, Kyung Hwa;Yu, Jeong Il;Park, Hee Chul;Park, Su Yeon;Shin, Jung Suk;Shin, Eun Hyuk;Cho, Sungkoo;Jung, Sang Hoon;Han, Young Yih;Lim, Do Hoon
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.129-138
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    • 2018
  • Purpose: This study was conducted to compare clinical outcomes and treatment-related toxicities after stereotactic body radiation therapy (SBRT) with two different dose regimens for small hepatocellular carcinomas (HCC) ${\leq}3cm$ in size. Materials and Methods: We retrospectively reviewed 44 patients with liver-confined HCC treated between 2009 and 2014 with SBRT. Total doses of 45 Gy (n = 10) or 60 Gy (n = 34) in 3 fractions were prescribed to the 95% isodose line covering 95% of the planning target volume. Rates of local control (LC), intrahepatic failure-free survival (IHFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Results: Median follow-up was 29 months (range, 8 to 64 months). Rates at 1 and 3 years were 97.7% and 95.0% for LC, 97.7% and 80.7% for OS, 76% and 40.5% for IHFFS, and 87.3% and 79.5% for DMFS. Five patients (11.4%) experienced degradation of albumin-bilirubin grade, 2 (4.5%) degradation of Child-Pugh score, and 4 (9.1%) grade 3 or greater laboratory abnormalities within 3 months after SBRT. No significant difference was seen in any oncological outcomes or treatment-related toxicities between the two dose regimens. Conclusions: SBRT was highly effective for local control without severe toxicities in patients with HCC smaller than 3 cm. The regimen of a total dose of 45 Gy in 3 fractions was comparable to 60 Gy in efficacy and safety of SBRT for small HCC.

Pharmacological Action of Machilus Thunbergii Siebold Zuccarini (한국산 생약제들의 혈압강하작용에 대한 연구 II. 한국산 후박수피의 혈압강하 작용)

  • Cho B.H.;Kim I.H.;Lee S.B.;Cho K.C.;Lee J.H.
    • The Korean Journal of Pharmacology
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    • v.15 no.1_2 s.25
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    • pp.45-56
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    • 1979
  • With a view to searching after a new antihypertensive or hypotensive agents in the botanical crude plants, authors intended to reevaluate several natural products caltivated in Korea. This experiment was undertaken to compare pharmacogical actions of Machilus thunbergii Siebold et Zuccarini with those of Magnolia obovata Thunberg in anesthetized rats and in normal mice. Machilus thunbergii Sieb. et Zucc., a tree belonging to the Lauraceae family, is caltivated at Ull-ung Do, and their cortecies have been used as folk medicine mingled with those of Magnolia obovata Thunberg. These two cortecies have teen also applied in chinese medicine, it was advocated that these cortecies exerted good therapeutic effects on gastritis, convulsive abdominal pain, nausea, vomiting and urinary tract disorders. Therefore, we intended to determine the pharmacological action of two palnt of different family each other, especially their effects on blood pressure and heart rate, and also their mechanism of action were observed. We studied their action with extracts of hexane(MTHE), ether(MTEE), methanol(MTME) and water(MTWE) from Machilus thunhergii Sieb. et Zucc., and also fractionations of methanol(MOME), chloroform(MOCE) and water(MOWE) from Mapolia obovata Thunberg. The results of this experiment were as follows; 1) MTME, when intravenously administered to rats, elicited the significant hypotensive responses dependent on the administered dosage. 2) MOWE was also exhibited the hypotensive effect dependent on the treated dose. 3) Depressor effect of MTME was blocked by pretreatment with hexamethonium. 4) The hypotensive response of MOWE was blocked by pretreatment with hexamethonium or hrdralazine. 5) HTME and MOWE were also observed the anticonvulsive effect and sedative effect. These results suggested that MTME may induce the hypotensive response via central sympathetic effect, but the site of action in brain are not clarified, and the hypotensive effect of MOWE may be due to dual mechanism of central sympathetic action and direct vasodilation of blood vessel.

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Clinical Usefulness of Implanted Fiducial Markers for Hypofractionated Radiotherapy of Prostate Cancer (전립선암의 소분할 방사선치료 시에 위치표지자 삽입의 유용성)

  • Choi, Young-Min;Ahn, Sung-Hwan;Lee, Hyung-Sik;Hur, Won-Joo;Yoon, Jin-Han;Kim, Tae-Hyo;Kim, Soo-Dong;Yun, Seong-Guk
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.91-98
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    • 2011
  • Purpose: To assess the usefulness of implanted fiducial markers in the setup of hypofractionated radiotherapy for prostate cancer patients by comparing a fiducial marker matched setup with a pelvic bone match. Materials and Methods: Four prostate cancer patients treated with definitive hypofractionated radiotherapy between September 2009 and August 2010 were enrolled in this study. Three gold fiducial markers were implanted into the prostate and through the rectum under ultrasound guidance around a week before radiotherapy. Glycerin enemas were given prior to each radiotherapy planning CT and every radiotherapy session. Hypofractionated radiotherapy was planned for a total dose of 59.5 Gy in daily 3.5 Gy with using the Novalis system. Orthogonal kV X-rays were taken before radiotherapy. Treatment positions were adjusted according to the results from the fusion of the fiducial markers on digitally reconstructed radiographs of a radiotherapy plan with those on orthogonal kV X-rays. When the difference in the coordinates from the fiducial marker fusion was less than 1 mm, the patient position was approved for radiotherapy. A virtual bone matching was carried out at the fiducial marker matched position, and then a setup difference between the fiducial marker matching and bone matching was evaluated. Results: Three patients received a planned 17-fractionated radiotherapy and the rest underwent 16 fractionations. The setup error of the fiducial marker matching was $0.94{\pm}0.62$ mm (range, 0.09 to 3.01 mm; median, 0.81 mm), and the means of the lateral, craniocaudal, and anteroposterior errors were $0.39{\pm}0.34$ mm, $0.46{\pm}0.34$ mm, and $0.57{\pm}0.59$ mm, respectively. The setup error of the pelvic bony matching was $3.15{\pm}2.03$ mm (range, 0.25 to 8.23 mm; median, 2.95 mm), and the error of craniocaudal direction ($2.29{\pm}1.95$ mm) was significantly larger than those of anteroposterior ($1.73{\pm}1.31$ mm) and lateral directions ($0.45{\pm}0.37$ mm), respectively (p<0.05). Incidences of over 3 mm and 5 mm in setup difference among the fractionations were 1.5% and 0% in the fiducial marker matching, respectively, and 49.3% and 17.9% in the pelvic bone matching, respectively. Conclusion: The more precise setup of hypofractionated radiotherapy for prostate cancer patients is feasible with the implanted fiducial marker matching compared with the pelvic bony matching. Therefore, a less marginal expansion of planning target volume produces less radiation exposure to adjacent normal tissues, which could ultimately make hypofractionated radiotherapy safer.