• 제목/요약/키워드: Intracavitary irradiation

검색결과 54건 처리시간 0.017초

누도를 따라 재발한 직장암의 강내조사 (Intracavitary Irradiation of Locally Advanced Recurrent Adenocarcinoma of Rectum Along the Fistula Tract)

  • 김경애;김성규;신세원;김명세;송선교;심민철;권굉보
    • Radiation Oncology Journal
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    • 제6권2호
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    • pp.289-293
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    • 1988
  • 방사선 치료는 악성 종양의 치료에서 국소 치료의 효과를 높이기 위한 수술 전후의 보조치료로서, 혹은 수술 불가능한 암, 잔여암, 또는 재발암의 치료로서 널리 사용되어 왔으며 외부 방사선 치료, 동위원소를 사용한 자입치료 등에 의한 장기간의 국소 치료효과 및 증상의 호전에 대한보고는 많다. 그러나 수술전후의 방사선 요법과 수술을 병행한 직장암 환자에서의 치료후의 재발은 외과적 치료가 대부분에서 불가능하여 외부 방사선 요법, 화학요법 등이 증상판화의 목적으로 사용되어 왔으나 강내 조사의 보고는 거의 없다. 영남대학교 치료방사선과에서는 수술전 경사에서 수술 불가능으로 판명되어 수술전 방사선 치료를 받은 후 개복 하였으나 절제가 불가능하였던 환자에서 발생한 누도(fistula tract)를 따라 재발된 직장암 환자에서 강내 치료를 실시하여 매우 빠른 증세의 호전을 경험하였기에 문헌 고찰과 함께 보고하는 바이다

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강내 조사를 이용한 비인강압 치험2예 (Two Cases of Nasopharyngeal Carcinoma Treated with Co-60 HDR ICR)

  • 신세원;강철훈;김성규;김명세
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.197-201
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    • 1990
  • 저자들은 비인강암의 포괄적인 방사선 치료의 일부로서 외부 방사선 치료에 뒤이은 고선량율 강내조사를 시행하여 부작용이나 합병증 없이 종양의 완전관해를 얻었기에 문헌고찰과 함께 보고하는 바이다.

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비인강암의 강내조사법 (Intracavitary Irradiation of Carcinoma of the Nasopharynx)

  • 허승재;박찬일
    • Radiation Oncology Journal
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    • 제3권2호
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    • pp.159-161
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    • 1985
  • 비인강암의 강내조사법은 외부조사후 추가조사법으로서, 또한 재발병소에 비교적 용이하게 재조사할 수 있는 장점이 있으며 비인강암의 국소치유율을 상승시킬 수 있다. 저자는 비인강암 환자에게 추가조사법으로서 또한 재발된 예에서 비인강암의 강내조사를 시행하여 보고하는 바이다.

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자궁경부암 고선량율 강내조사치료시 A, B점 선량과 Curie-minutes 단위의 비교 (Intracavitary Dosimetry: A Comparison of Doses at Point A and B to Curie-minutes in Cervical Cancer)

  • 허승재
    • Radiation Oncology Journal
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    • 제7권1호
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    • pp.81-83
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    • 1989
  • This study, involving thirty-two patients with carcinoma of uterine cervix treated by high dose rate intracavitary irradiation using a remotely controlled afterloading system, compares the doss at point A and 8 with the Curie-minutes prescription. A linear least-square regression analysis was used to compare the two sets of date. Correlation coefficients between doses at points A and B and the Ci-min prescription are 0.92 (p<0.001) and 0.90 (p<0.001), respectively, and linear relationship is observed between these two system. The limitation and significance of the comparison of the two approaches to intracavitary dosimetry is discussed.

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방사선 치료용 고에너지 전자선의 조직 내 선량분포 특성에 관한 연구 (Study on Characteristics of Dose Distribution in Tissue of High Energy Electron Beam for Radiation Therapy)

  • 나수경
    • 대한방사선치료학회지
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    • 제14권1호
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    • pp.175-186
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    • 2002
  • The purpose of this study is directly measure and evaluate about absorbed dose change according to nominal energy and electron cone or medical accelerator on isodose curve, percentage depth dose, contaminated X-ray, inhomogeneous tissue, oblique surface and irradiation on intracavitary that electron beam with high energy distributed in tissue, and it settled standard data of hish energy electron beam treatment, and offer to exactly data for new dote distribution modeling study based on experimental resuls and theory. Electron beam with hish energy of $6{\sim}20$ MeV is used that generated from medical linear accelerator (Clinac 2100C/D, Varian) for the experiment, andwater phantom and Farmer chamber md Markus chamber und for absorbe d dose measurement of electron beam, and standard absorbed dose is calculated by standard measurements of International Atomic Energy Agency(IAEA) TRS 277. Dose analyzer (700i dose distribution analyzer, Wellhofer), film (X-OmatV, Kodak), external cone, intracavitary cone, cork, animal compact bone and air were used for don distribution measurement. As the results of absorbed dose ratio increased while irradiation field was increased, it appeared maximum at some irradiation field size and decreased though irradiation field size was more increased, and it decreased greatly while energy of electron beam was increased, and scattered dose on wall of electron cone was the cause. In percentage depth dose curve of electron beam, Effective depth dose(R80) for nominal energy of 6, 9, 12, 16 and 20 MeV are 1.85, 2.93, 4.07, 5.37 and 6.53 cm respectively, which seems to be one third of electron beam energy (MeV). Contaminated X-ray was generated from interaction between electron beam with high energy and material, and it was about $0.3{\sim}2.3\%$ of maximum dose and increased with increasing energy. Change of depth dose ratio of electron beam was compared with theory by Monte Carlo simulation, and calculation and measured value by Pencil beam model reciprocally, and percentage depth dose and measured value by Pencil beam were agreed almost, however, there were a little lack on build up area and error increased in pendulum and multi treatment since there was no contaminated X-ray part. Percentage depth dose calculated by Monte Carlo simulation appeared to be less from all part except maximum dose area from the curve. The change of percentage depth dose by inhomogeneous tissue, maximum range after penetration the 1 cm bone was moved 1 cm toward to surface then polystyrene phantom. In case of 1 cm and 2 cm cork, it was moved 0.5 cm and 1 cm toward to depth, respectively. In case of air, practical range was extended toward depth without energy loss. Irradiation on intracavitary is using straight and beveled type cones of 2.5, 3.0, 3.5 $cm{\phi}$, and maximum and effective $80\%$ dose depth increases while electron beam energy and size of electron cone increase. In case of contaminated X-ray, as the energy increase, straight type cones were more highly appeared then beveled type. The output factor of intracavitary small field electron cone was $15{\sim}86\%$ of standard external electron cone($15{\times}15cm^2$) and straight type was slightly higher then beveled type.

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자궁경암(子宮頸癌) 방사선치료(放射線治療)에 의한 직장손상(直腸損傷) (Rectal Injuries after Radiotherapy for Carcinoma of the Uterine Cervix)

  • 김정진
    • Radiation Oncology Journal
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    • 제1권1호
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    • pp.103-109
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    • 1983
  • 47 out of 56 cases of intact uterine cervix cancer treated by radiation at the Hanyang University Hospital were followed 18 months or more after treatment. (7 patients died before 18 months, 2 cases lost to follow-up). Age distribution reveal 5 cases in 30's, 18 cases in 40's, 17 cases in 50's, 7 cases in 60's. Histologically, all cases were squamous cell type except one case of adenocarcinoma. 1. 45 cases were treated by combined external Co-60 irradiation and intracavitary irradiation by Cs-137 small sources. 1 case was treated by external irradiation only, and 1 case by intracavitary only. 2. Rectal injuries were observed in 13 cased (27.6%), 4 cases in Grade 1, 8 cased in Grade 2 and 1 cases in Grade 3 which needed surgical management. 3. Average intervals of rectal injury following treatment was 9.2 months varying from 5 to 15 months. 4. Relation between rectal injury and point A dose reveal 6 cases between 7000-7999 rad and 6 cases between 8000-8999 rad and 1 case above 9000 rad. Even though there is no direct relation between point A dose and rectal injury, it is expected that rectal injury increases as point A dose increase. 5. In the normal condition, rectal injury can't be attributed to one major cause. Radiation dose, small source distribution, general condition of patients, local anatomy of the individual patient, history of PID and previous surgery, all play complex roles.

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

  • 서창옥;김귀언;노준규
    • Radiation Oncology Journal
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    • 제8권2호
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    • pp.231-239
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    • 1990
  • 1979년 5월부터 1981년 12월까지 총 524명의 자궁경부암 환자가 근치적 목적하에 방사선 치료를 받았다. 524명의 환자중, 356명이 코발트 선원을 사용한 원격 조정 아프터로딩 고선량률 강내조사 시스템 (Ralstron)으로써 치료받았으며 168명의 환자는 라듐 선원을 사용한 저선량률 강내 조사를 받았다. 외부조사는 골반부 전체에 총 40-50 Gy가 주어졌으며, 이어서 A지점에 10-13번에 걸쳐 30-39 Gy의 강내 조사를 시행하는 치료지침이 사용되었다. 강내조사는 3 Gy씩, 일주일에 세번 주어졌다. 고선량률 강내조사를 받은 군에서의 5년 실제생존률은 IB기 (N=20)가 $77.6{\%}$, II기 (N=182)가 $68.2{\%}$ 그리고 III기 (N=148)가 $50.9{\%}$였다. 저산량률 강내조사군에서의 5년 생존률은 IB기 (N=22)가 $87.5{\%}$, II기 (N=91)가 $66.3{\%}$, 그리고 III기 (N=52)가 $55.4{\%}$였다. 생존률은 병기에 따라서는 통계학적으로 유의한 차이를 보였지만, 두 강내조사군 간에는 유의한 차이가 없었다. 방사선치료후 내장의 후기 합병증은 고선량률 강내조사 군에서 $3.7{\%}$, 저산량률 강내조사군은 $8.4{\%}$에서 관찰되었다. 그러나 외과적 치료가 필요할 만큼 심한 합병증은 없었다. 방광에서 발생한 합병증의 빈도는 고선량률 강내조사군이 $1.4{\%}$, 저선량률 강내조사군은 $2.4{\%}$였다. 고선량률 강내조사의 시술은 외래 환자에 시행하기에 기술적으로 간단하고 쉬우며 마취가 필요없고, 환자가 매우 잘 견딘다. 담당자에 대한 방사선 피폭도 저선량률 강내조사에 비해 사실상 거의 없다. 고선량률 강내조사의 경우 치료시간이 짧기 때문에 주어진 시간내에 더 많은 환자를 치료할 수 있다. 따라서 많은 환자를 치료해야 되는 암센터의 경우, 고선량률 강내조사 시스템이 훨씬 더 권장되어 진다. 그러나 더욱 향상된 결과를 얻기 위하여, 다른 치료 방식으로 광범위한 연구를 통해, 고선량률 강내조사의 적절한 선량-분할조사 계획과 외부조사와 강내조사의 적절한 배합이 이루어져야 할 것이다.

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Comparison of Clinical Efficacy of Three Different Neoadjuvant Approaches (Chemotherapy Combined Vaginal Intracavitary Irradiation, Neoadjuvant Chemotherapy Alone or Radiotherapy) Combined with Surgery for Patients with Stage Ib2 and IIa2 Cervical Cancer

  • Fu, Jian-Hong;Gao, Zhan;Ren, Chen-Chen;Shi, Yong-Gang
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2377-2381
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    • 2013
  • A total of 285 patients with stage Ib2 and IIa2 cervical cancer were categorized into three groups, and received preoperative neoadjuvant chemotherapy combined with vaginal intracavitary irradiation, neoadjuvant chemotherapy alone or radiotherapy, respectively. The effective rate of 70.6 % in group 1 was much higher than 41.4% in group 2 (P=0.000) and 46.9 % in group 3 (P=0.000); The percentage of patients receiving postoperative adjuvant therapy was 44.1% in group 1, much lower than 67.8% in group 2 (P=0.001) and 64.6% in group 3 (P=0.004); The percentage of patients with no postoperative risk factor in group 1 was 52.0%, much higher than 32.2% in group 2 (P=0.006) and 35.4% in group 3 (P=0.019); The occurrence rate of surgery-related complications in groups 1, 2 and 3 were 29.4%, 28.7%, and 33.3%, respectively, with no statistical differences among the groups (P=0.981). Regarding preoperative neoadjuvant complications, none were obvious in group 3, while occurrence rates of myelosuppression in groups 1 and 2 were 89.1% and 86.6%, of nausea and vomitting were 78.4% and 78.2%, but without significant differences (all P>0.05). Among 166 patients who received postoperative adjuvant therapy in the three groups, the occurrence rates were: 65.4%, 64.3% and 61.1% respectively for myelosuppression; 42.3%, 38.1%, and 38.9% for nausea and vomiting; 9.6%, 9.5% and 9.7% for urocystitis; and 63.5%, 69.0% and 65.3% enteritis and rectitis. There were no statistically significant differences among them (all P>0.05). The five-year disease-free survival rates (DFS) in groups 1, 2, 3 were 78.3%, 75.1%, 80.9%, respectively; the five-year overall survival rates (OS) were 81.4%, 78.2%, and 81.1%, respectively. The five-year OS of 166 patients receiving postoperative in the three groups were 72.4%, 69.5%, and 71.8%, respectively, with no significant variation (all P>0.05). Although there were no differences among three groups in DFS and OS, preoperative neoadjuvant chemotherapy combined with intracavitary radiotherapy may increase the effective rate and the percentage of patients with no postoperative risk factors and decrease the percentage of patients receiving postoperative adjuvant therapy, thereby decreasing complications indirectly and increasing quality of life.

고 선량률 강내 치료기를 이용한 식도암 치험 1례 (One Case of Esophageal Cancer Treated with High Dose Rate ICR)

  • 김경애;김성규;신세원;김명세
    • Journal of Yeungnam Medical Science
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    • 제5권1호
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    • pp.147-151
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    • 1988
  • 식도암 환자에서 외부 방사선 치료와 고 선량률 강내 치료를 병용하여 자각 증상의 호전은 물론 식도 촬영상에서도 좋은 반응을 보인 환자에서 장기간이 경과후에 발생한 식도 출혈과 식도 기관루를 경험하였기에 문헌 고찰도 함께 하였다

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Personal computer를 이용한 자궁경부암의 고선량을 강내치료 계획 (Treatment Planning Software for High Dose Rate Remote Afterloading Brachytherapy of Uterine Cervical Cancer)

  • 허승재;강위생
    • Radiation Oncology Journal
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    • 제4권2호
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    • pp.183-186
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    • 1986
  • 고선량율을 이용한 자궁강내 치료시 정확하고 신속한 계산을 위하여 저자들은 개인용 컴퓨터를 이용하여 기준점의 선량분포 및 방사선조사 시간을 간편하게 계산할 수 있는 software를 개발하였다. 치료 계획용 software를 이용하여 짧은 시간내에 선량 분포 및 조사시간을 용이하고 정확하게 계산할 수 있으며, 고선량을 자궁경부암 임상적응에 효과적으로 이용할 수 있어서 보고한다.

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