• Title/Summary/Keyword: ICR Fractionation

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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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Treatment of Carcinoma of the Uterine Cervix with High-Dose-Rate Intracavitary Irradiation using Ralstron (고선량률 강내조사를 사용한 자궁경부암의 치료)

  • Suh Chang Ok;Kim Gwi Eon;Loh John J.K.
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.231-239
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    • 1990
  • From May 1979 through December 1981 a total of 524 patients with carcinoma of the uterine cervix were treated by radiation therapy with curative intent. Among the 524 patients, 350 were treated with a high-dose-rate (HDR), remote-controlled, afterloading intracavitary irradiation (ICR) system using a cobalt source (Ralstron), and 168 patients received a low-dose-rate (LDR) ICR using a radium source. External beam irradiation with a total dose of 40-50 Gy to the whole pelvis followed by intracavitary irradiation with a total dose of 30-39 Gy in 10-13 fractions to point A was the treatment protocol. ICR was given three times a week with a dose of 3 Gy per fraction. Five-year actuarial survival rates in the HDR-ICR group were $77.6{\%}$ in stage IB (N=20), $68.2{\%}$ in stage II (N=182), and $50.9{\%}$ in stage III (N=148). In LDR-ICR group, 5-year survival rates were $87.5{\%}$ in stage IB (N=22), $66.3{\%}$ in stage II (N=91), and $55.4{\%}$ in stage III (N=52). Survival rates showed a statistically significant difference by stage, but there was no significant difference between the two ICR groups. Late bowel complications after radiotherapy were noted in $3.7{\%}$ of the HDR-ICR group and $8.4{\%}$ of the LDR-ICR group. There was no severe complication requiring surgical management. The incidence of bladder complications was $1.4{\%}$ in the HDR-ICR group and $2.4{\%}$ in the LDR-ICR group. The application of HDR-ICR was technically simple and easily performed on an outpatient basis without anesthesia, and the patients tolerated it very well. Radiation exposure to personnel was virtually nil in contrast to that of LDR-ICR. Within a given period of time, more patients can be treated with HDR-ICR because of the short treatment time. Therefore, the HDR-ICR system is highly recommended for a cancer center, particularly one with a large number of patients to be treated. In order to achieve an improved outcome, however, the optimum dose-fractionation schedule of HDR-ICR and optimum combination of intracavitary irradiation with external beam irradiation should be determined through an extensive protocol.

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Radiotherapy Results of Early Uterine Cervix Cancer (초기 자궁경부암의 방사선치료 성적)

  • Choi, Doo-Ho;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.33-39
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    • 1996
  • Purpose : This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. Materials and Methods : Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy, Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. Results : Overall 5 year survival rate and relapse free survival rate were $72.3\%$, and $72.8\%$ respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months Late complication rate of bladder and rectum were $8.8\%,\;15\%$ respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. Conclusion : These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients. To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed.

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Studies on Constituents of the Higher Fungi of Korea(XLI) -An Antitumor Fraction from the Culture Filtrate of Lentinus edodes DMC7- (한국산(韓國産) 고등(高等) 균류(菌類)의 성분(成分) 연구(硏究)(제41보)(第41報) -Lentinus edodes DMC7 균주(菌株)의 배양(培養) 여액(濾液)의 항암(抗癌) 성분(成分)-)

  • Chung, Kyeong-Soo;Choi, Eung-Chil;Kim, Byong-Kak
    • The Korean Journal of Mycology
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    • v.12 no.4
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    • pp.129-132
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    • 1984
  • To find antitumor constituents in Korean basidiomycetes, the mycelia of Lentinus edodes DMC7, which had shown a good mycelial growth in shakeflasks, were cultured at $27^{\circ}C$ on an orbital shaking incubator at 180 rev/min for 12 days. The medium was composed of glucose (50g/l), yeast extract (9g/l), peptone (9g/l), and seven inorganic salts. A water soluble macromolecular fraction, LF-3, was obtained from the culure filtrate by fractionation with ethanol and dialysis using a Visking tube. When LF-3 was administered i.p. at 50mg/kg/day once daily for 10 consecutive days to female ICR mice which were implanted s.c. with sarcoma 180 $(10^6\;cells/mouse)$, it exerted a highly significant antitumor activity, with the tumor inhibition ratio of 53. 1%.

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Antithrombin and Thrombosis Prevention Activity of Buckwheat Seed, Fagopyrum esculentum Moench (메밀 종자의 항트롬빈 활성과 혈전증 예방효과)

  • Sohn, Ho-Yong;Kwon, Chong-Suk;Son, Kun-Ho;Kwon, Gi-Seok;Ryu, Hee-Young;Kum, Eun-Joo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.2
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    • pp.132-138
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    • 2006
  • Direct thrombin inhibitor, which is effective to prevent or cure the thrombosis, has been investigated in worldwide. In this study, we tried to screen antithrombosis agent from edible or medicinal plant. A strong antithrombin activity was identified from methanol or $95\%$ ethanol extract of buckwheat seeds. The solvent fractionation of buckwheat extracts using hexane, ethylacetate, butanol revealed that the butanol fraction has a prominent antithrombin activity. Thrombin time (blood-clot formation time) exceeded to over $2,000\%$ by addition of the butanol fraction at concentration of $312.5{\mu}g/mL$, whereas thrombin time extended to $336\%$ by addition of aspirin at concentration of $1,500{\mu}g/mL$. The butanol fraction showed anthrone-positive and ninhydrine-negative reaction. The active components were heat-liable, acid-unstable non-proteinous macromolecules (>30 KD). In vivo analysis using ICR male mouse showed that the buckwheat extract was superior than the aspirin in pulmonary thrombosis, KCN-induced coma and death. Our results suggest that the buckwheat is a potential as an antithrombosis agent and medicinal food.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

Studies on the Hemolytic Activities of Korean Wild Mushrooms (III) - Hemolytic Characteristics and in vivo Toxicity of Hemolysin of Hebelma crustuliniforme - (한국산 야생버섯의 용혈작용에 대한 연구 - 제 3보 : 무우자갈버섯(Hebeloma crustuliniforme) 용혈독소의 용혈특성 및 in vivo 독성 -)

  • Yang, Hee-Jung;Lee, Ji-Seon;Chung, Kyeong-Soo
    • The Korean Journal of Mycology
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    • v.30 no.2
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    • pp.119-123
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    • 2002
  • In the previous studies, we surveyed 68 Korean wild mushrooms for their hemolytic activity and found that cold-water extract of Hebeloma crustuliniforme contained heat-resistant hemolysin. In this study, partially purified hemolysin of the mushroom was obtained by cold-water extraction followed by precipitation with ammonium sulfate, solubility fractionation and then dialysis. The hemolysin was found to be > 12,000 in molecular weight and its optimal hemolytic temperature was $37^{\circ}C$ and it's hemolytic activity, on washed erythrocytes and unwashed erythrocytes, respectively, was in the order of sheep > rat > human ${\geq}$ mouse > chicken and sheep > mouse > human ${\geq}$ rat > chicken. When ip injected into ICR mice at 1.38 mg/kg, it incurred prompt hemolysis as well as severe renal toxicity and hepatotoxicity. These results strongly suggest that the toxicity of Hebeloma crustuliniforme, which had been well-known as a toxic wild mushroom, may be at least partly due to its hemolysin.

Potent Anticarcinogenic Action of Moutan radix for Mouse Ascites Cancer Induced by Mouse Sarcoma 180 Cells (Moutan radix의 mouse sarcoma 180 cell로 유발한 mouse ascites cancer에 대한 항암효과)

  • Bahn, Kyeong-N.;Lee, Eun-J.;Yang, Min-S.;Kim, Jeong-O.;Ha, Yeong-L.
    • Applied Biological Chemistry
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    • v.38 no.4
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    • pp.364-369
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    • 1995
  • Anticarcinogenic activity of Moutan radix for mouse ascites cancer induced by mouse Sarcoma 180 (S-180) cells was investigated. Methanol extract of Moutan radix including other folk medicinal plants (Taxus cuspidata, Curcuma longa, Artemisia capillaris, Ligrstri fructus, and Liriope platyphylla) used to remedy or cure many chronic human diseases like cancer was fractionated into hexane, chloroform ($CHCl_3$), ethylacetate (EtOAc), and butanol (BuOH) fractions. Anticarcinogenic activity of the fractions, exhibited a strong cytotoxicity for L1210 and S-180 cells, was examined for mouse ascites cancer induced by S-180 cells. Male ICR mice (7 mice/treatment, $5{\sim}6$ weeks of age, $23{\pm}1\;g$ were injected i.p. with S-180 cells ($1{\times}10^{7}\;cell/1\;ml$ PBS). One day later, each mouse was given 0.1 ml of 10% DMSO containing sample ($30\;{\mu}g/g$ body weight) every day for 10 consecutive days. Control mice were only given 0.1ml S-180 cells and 0.1 ml 10% DMSO. Mice treated with EtOAc fraction of Moutan radix showed 28.7 days of life, which is 167% of control mice's life. Based on the dose-dependant experiment mice treated with $30\;{\mu}g$ showed longer life relative to mice treated with ootherr doses (5, 15, $60\;{\mu}g$), and mice treated with $60\;{\mu}g$ exhibited toxic symptoms. Body weight of mice treated with Moutan radix was significantly reduced relative to that of control mice (p<0.05). GC-MS analysis in conjunction with silica-gel column chromatography revealed that the EtOAc fraction contained 2-methoxylphenol, benzoic acid, 1-(4-hydroxy-3-methoxyphenyl)ethanone, 8-methyl-2,4(1H,3H)pteridinedione and 2,5-furan-dicarboxylic dimethyl ester as regards to the anticarcinogenic property of the EtOAc fraction. These results suggest that Moutan radix might be included as an anticarcinogenic medicinal plant for treatment of ascites cancer.

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Development of Source Template ICRT Dose Planning Software for Uterine Cervix Using the HDR: $^{192}Ir$ (강내조사를 위한 고선량률 근접조사 선원맞춤형 선량계획)

  • Choi, Tae-Jin;Oh, Young-Kee;Kim, Jin-Hee;Kim, Ok-Bae
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.112-118
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    • 2009
  • The source position and source dwelling time in a given source arrangement in the applicators is very high effect to determine the expose time which in general is derived from the brachytherapy planning system. In high dose rate (HDR) intracavitary radiation therapy (ICRT), the treatment is often performed in based out-patient during the whole fractionation irradiations. However, the patient should be waited on coutch for ICR treatment in first start fraction as unconvinent and immobilized state until perform the dose plannings. In our experiments, the HDR source contributed dose for$55.89{\pm}4.20%$ for straight tandem source, $38.14{\pm}4.46%$ for the right ovoid soucre on the fornix and$5.97{\pm}0.50%$ for left ovoid source. It also showed the $60.33{\pm}6.53%$ for the tandem, $33.10{\pm}6.74%$ for right ovoid and $6.58{\pm}0.30%$ for the left ovoid source in 10 degrees of applicator. The authors designed the source template dose planning software for ICRT of uterine cervix results average $-0.55{\pm}2.15%$ discrepancy of the full charged brachytherapy dose planning. Developed Source temperate ICRT plaanning software guide a minimized the complains and operating times within a ${\pm}3%$ of dose discrepancies.

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