• 대한방사선치료학회지
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• 제29권2호
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• pp.19-26
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• 2017

목 적: 폐에서 VMAT치료는 연속적으로 회전을 하면서 방사선을 조사하므로 정상적인 폐에 저 선량을 증가시킨다. 이로 인해 방사선 부작용 중 방사선 폐렴의 발생률이 증가 할 수 있다. 본 연구에서는 방사선 폐렴의 발생 확률 증가 원인이 되는 폐의 저 선량 영역의 방사선을 줄일 수 있는 H-VMAT 방법을 적용하여 치료를 받은 환자를 대상으로 치료계획별 폐의 저 선량 영역과 주변 정상장기들에 전달되는 방사선량을 비교 분석하여 H-VMAT의 유용성을 평가하고자 하였다. 대상 및 방법: 폐암방사선 치료 환자 중 H-VMAT 방법을 적용한 환자 25명을 대상으로 하였으며, 치료 계획용 용적의 처방선량은 총 선량 44 Gy를 22회 분할 조사로 적용하였다. 각 환자마다 Conventional RT, VMAT, H-VMAT 방법으로 계획을 진행하였다. Conventional RT는 치료계획용적의 크기, 위치, 모양 및 주변장기들의 위치를 고려하여 4~5개 조사야로 치료계획을 진행하였고, VMAT 치료계획의 경우는 $360^{\circ}$를 2번 회전하는 방법과 $180^{\circ}$를 2~3회 회전하는 방법으로 계획하였다. H-VMAT은 폐의 선량 및 주변 장기의 허용선량을 고려하여 VMAT 치료계획에서 2개의 고정조사야를 추가 하여 계획하였다. 결 과: 폐선량은 비소세포성폐암에서 치료계획용적을 제외한 폐의 $V_5$, $V_{10}$은 H-VMAT이 $55.40{\pm}13.39%$, $32.05{\pm}11.37%$로 가장 낮았고, 소세포성폐암에서도 $V_5$, $V_{10}$의 값은 $64.32{\pm}16.15%$, $35.50{\pm}9.91%$로 가장 낮았다. 비소세포성폐암에서 VMAT의 척수 선량은 $21.15{\pm}4.02Gy$로 다른 치료방법과 비교하여 최대 7.94 Gy 차이만큼 낮은 선량이 전달되었고, 소세포성폐암에서는 $19.72{\pm}1.82Gy$로 가장 낮은 선량을 보였다. 심장의 $V_{20}$은 H-VMAT와 VMAT의 비교 결과 VMAT이 최대 16.2 % 더 낮은 값을 보이기도 하였다. 식도에 전달되는 평균선량 역시 소세포성폐암과 비소세포성폐암에서 $17.44{\pm}2.04Gy$, $17.84{\pm}9.20Gy$로 VMAT이 가장 낮았다. 결 론: 주변 정상 장기 선량의 값을 비교해 보았을 때, VMAT에서는 심장, 식도, 척수 등에서 나머지 치료계획보다 더 적은 선량이 전달되는 것을 알 수 있었다. 하지만 척수를 제외한 나머지 장기에서는 H-VMAT과 큰 차이를 보이지 않았다. H-VMAT은 일부 정상 장기의 선량이 증가하였지만 허용선량을 초과하지 않았다. 그리고 폐의 $V_5$, $V_{10}$에서 낮은 값을 보였다. Conventional RT, VMAT, H-VMAT을 비교하였을 때 심장, 식도, 척수 등에 전달되는 선량이 부작용을 발생시킬 수 있는 선량보다 적다면 폐의 저 선량 영역의 장점을 보이는 H-VMAT 방법을 적용함으로써 방사선폐렴의 발생률을 낮출 수 있을 것이라고 사료된다.

• 한국방사선학회논문지
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• 제15권5호
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• pp.723-730
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• 2021

방사선 치료 시 주로 쓰이는 Arc 치료기법과 Tomotherapy 치료법의 선량적인 측면에서 상호 비교하고자 한다. 대상자는 폐암의 환자를 대상으로 하여 치료계획용적에 60.0 Gy를 처방선량을 기준으로 설정하였다. PTVmean는 Arc의 경우 61.04 Gy, Tomotherapy가 58.50 Gy, 이었다. 전체 폐용적(total lung)은 각각 3.0 Gy, 4.24 Gy, 심장(heart)은 0.13, 0.34, 기도(trachea)는 1.35, 2.58, 식도(Esophagus)는 0.41, 0.86, 척수는 3.65, 4.68의 평균선량을 보였다. DHV 곡선상 치료효과의 적합성은 모두 적합해 보였으며 둘 중에는 Tomotherpy의 치료법이 정상조직 방호적인 측면에서 우세한 것으로 나타났다. 제한적인 공간에서 오랜시간 치료를 받아야 하는 점을 극복한다면 tomotherapy치료가 우세하지만 그렇지 않은 경우 Arc 치료로 진행해도 무방할 것으로 사료된다. 본 연구는 치료계획 영상으로 분석한 것으로 실제 치료의 결과와 다르다는 제한점이 있다. 이러한 제한점을 극복하고자 더 많은 연구를 진행한다면 방사선 치료의 효과는 더욱 상승할 것으로 사료된다.

• Korean Journal of Acupuncture
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• 제27권4호
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• pp.15-23
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• 2010

Objectives : In order to confirm the anti-cancer effect of Trichosanthes kirilowii pharmacopuncture fluid, this study was proceeded. Methods : A549 lung cancer cells were cultured to be treated by Trichosanthes kirilowii pharmacopuncture fluid as dose dependent manner for 72 hours. And then the cell viability, nucleus fragmentaion, p21 and p53 protein expression, Bcl-2 and Bax protein expression, procaspase-3 PARP protein expression. Results : 1. Trichosanthes kirilowii pharmacopuncture fluid decrease A549 cell viability as dose dependent manner. 2. Trichosanthes kirilowii pharmacopuncture fluid induced the nucleus fragmentation in A549 lung cancer cells as dose dependent manner. 3. Trichosanthes kirilowii pharmacopuncture fluid increase the p21 and p53 protein expression. 4. Trichosanthes kirilowii pharmacopuncture fluid decrease the Bcl-2 protein expression but cannot affect the Bax protein expression. 5. Trichosanthes kirilowii pharmacopuncture fluid increase the activation of caspase-3 and PARP protein. Conclusions : As the above results, it was conclused the Trichosanthes kirilowii pharmacopuncture fluid had the anti-cancer effects to induce apoptosis.

• 동의생리병리학회지
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• 제16권4호
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• pp.745-755
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• 2002

To examine the effects of Yunpyesan on the cell proliferation of A549 human lung carcinoma cell line, we performed various experiments such as dose-dependent effect of Yunpyesan on cell proliferation and viability, morphological changes, quantification of apoptotic cell death and alterations of apoptosis/cell cycle-regulatory gene products. Yunpyesan declined cell viability and proliferation in both a dose- and a time-dependent manner. The anti-proliferative effect by Yunpyesan treatment in A459 cells was associated with morphological changes such as membrane shrinking and cell rounding up. Yunpyesan Induced apoptotic cell death in a time-dependent manner, which was associated with degradation of poly-(ADP-ribose) polymerase (PARP), an apoptotic target protein, without alterations of the balance between Bcl-2 and Bax expressions. DNA flow cytometric histograms showed that population of G1 phase of the cell cycle was increased by Yunpyesan treatment in a dose-dependent manner. Western blot analysis revealed that cyclin D1 and A were reduced by Yunpyesan treatment, whereas cyclin dependent kinase (Cdk) inhibitor p27 was markedly increased in a time-dependent fashion. The level of tumor suppressor p53 proteins was also increased by Yunpyesan treatment and its increase might be linked to increase of Cdk inhibitor p27. In addition, Mdm2, negative regulator of p53, was down-regulated by Yunpyesan treatment. Since the expression of retinoblastome protein (pRB), a key regulator of G1/S progression, was reduced by Yunpyesan treatment, we supposed that phosphorylation of pRB might be also blocked. The present results indicated that Yunpyesan-induced inhibition of lung cancer cell proliferation is associated with the induction of apoptosis and the blockage of G1/S progression.

• 한국산업보건학회지
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• 제29권4호
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• pp.508-516
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• 2019

Objectives: The present study was performed to obtain acute toxicity information on glyoxal in male rats after intratracheal instillation. Methods: In order to calculate the LD₅₀ of glyoxal using Probit analysis with SAS, the test article was one intratracheal instillation to male Sprague-Dawley rats at dose levels of 0, 225, 451 or 902 mg/kg. During the test period, mortality, clinical signs, and body and organ weights were examined. At the end of the 14-day observation period, all animals were sacrificed and complete gross postmortem and histopathological examinations were performed. Results: Four animals of the 902 mg/kg group died within one week after the administration of glyoxal. All treatment group in a dose dependent manner, decreased body weight was found during the study period. The absolute and relative lung weight, and histopathological changes (bronchiolar-alveolar hyperplasia, chronic inflammation) of lung exhibited an increased in glyoxal treated groups in a dose dependent manner. However, there were no changes on the organ weights and histopathological changes of any other organ except lung. Conclusions: The results obtained in the present study suggest that the LD₅₀ in male Sprague-Dawley rats after a single intratracheal instillation of glyoxal was considered to be 866.9 mg/kg and the lung was found to be the target organ for glyoxal.

• Radiation Oncology Journal
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• 제7권2호
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• pp.227-233
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• 1989

From April 1986 to Dec 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospital Of the 51 patients, $31(61\%)$ were squamous cell ca, $8(15.7\%)$ were small cell ca, and remained $4(7.9\%)$ were other cell types. Total radiation dose was average $64Gy (60\~75 Gy)$ for group A and 45Gy $(40\~59Gy)$ for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above $50\%$ of total volume was noted in 23 patients $(74.2\%)$ among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate (above $50\%$ of total volume) was $83.3\%$ (10/12) in group A compared to $50\%$ (3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR $42.9\%$, PR $35.7\%$, no response $21.4\%$ and in group B, CR $55.6\%,\;PR\;33.3\%$, no response $11.1\%$. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment planning and multimodality combination therapy without increasing si.do elect or complication is recommended in management of inoperable bronchogenic carcinoma.

• 한국산업보건학회지
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• 제31권4호
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• pp.473-483
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• 2021

Objectives: The present study aimed to evaluate the potential toxicity of 2-butoxyethanol after intratracheal instillation in male rats. Methods: In order to calculate median lethal dose (LD₅₀) of 2-butoxyethanol using Probit analysis with SAS program, the 2-butoxyethanol was administered with dose levels of 0, 101.64, 203.28 and 406.56 mg/kg by once intratracheal instillation to male rats. During the test period, clinical signs, mortality, body weights, organ weights, hematology, and serum biochemistry were examined. At the end of 14 days observation period, all animals were sacrificed and gross finding and histopathological examination were performed. Results: All animals of 406.56 mg/kg group died within 2 weeks after the administration of 2-butoxyethanol. Treatment-related clinical signs, gross observation and histopathological changes (mucous cell hyperplasia, alveolar macrophage aggregation, and hemorrhage) of lung exhibited an increased in 2-butoxyethanol treated groups in a dose dependent manner. However, there were no changes in the organ weights, hematology and serum biochemistry, and histopathology of any other organ except lung. Conclusions: On the basis of the results, it was concluded that a single intratracheal instillation of 2-butoxyethanol in male Sprague-Dawley rats resulted in some adverse effects on mortality, clinical sign, and histopathology in the lung. In the experimental conditions, the LD₅₀ of 2-butoxyethanol was considered to be 287.2 mg/kg and lung was founded to be the target organ of 2-butoxyethanol.

• Radiation Oncology Journal
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• 제2권1호
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• pp.149-153
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• 1984

Postoperative radiotherapy of breast cancer makes it possible to reduce loco-regional recurrence of breast cancer. The treatment technique, which can reduce the low-dose region at the junction and lung, is required. To produce proper dose distribution of internal mammary chain and chest wall, authors tried to find the method to expose $^{60}Co\;\gamma-ray$ on internal mammary region and 7MeV electron on chest wall. Exposure time of $^{60}Co\;\gamma$ and monitor unit of 9MeV were selected so that dose of $^{60}Co$ at 4cm depth was the same as that of 7Mev electron at $80\%$ dose depth. The position and direction of electron beam were changed for $^{60}Co$ beam: $0^{\circ},\;5^{\circ}$ for 0cm seperation; $0^{\circ},\;5^{\circ},\;10^{\circ}$ for 0.5cm seperation; $5^{\circ},\;10^{\circ},\;15^{\circ}$ for 1cm seperation. The results are as followings. 1. When the seperation of two fields was increased, dose on the axis of $^{60}Co$ beam was increased and dose at the junction region decreased while the volume of lung to be exposed to high dose and hot spot size were irregularly changed. 2. The dose distribution in the target volume of internal mammary and chest wall was most ideal when the seperation of two fields was $0\~0.5cm$ and the direction of electron beam was parallel to $^{60}Co$ beam.

• 한국방사선학회논문지
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• 제10권4호
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• pp.233-239
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• 2016

방사선 치료시 최근 많이 쓰이고 있는 IMRT, Tomotherapy, mArc(modulation arc therapy)의 치료법을 선량적인 측면에서 상호 비교하고자 한다. 비소세포성 폐암의 환자를 대상으로 하여 치료계획용적에 58.0 Gy를 처방선량을 기준으로 설정하였으며 주변 정상장기는 척수, 식도, 간을 설정 하였다. PTVmean는 mArc의 경우 57.60 Gy, Tomotherapy가 61.04 Gy, IMRT는 58.95 Gy이었다. 식도(Esophagus)의 평균선량은 mArc가 2.84 Gy였고, Tomotherapy가 5.14 Gy, IMRT가 1.84 Gy로 나타났다. 간(Liver)은 mArc는 19.44 Gy, Tomotherpy가 12.22 Gy, IMRT는 21.97 Gy이었고 척수(Spinal Cord)은 mArc 5.72 Gy, Tomotherapy가 7.08 Gy, IMRT는 6.15 Gy로 측정되었다. 또한, 선량포함도와 선량체적곡선 등의 자료를 관찰해 본 결과 mArc와 Tomotherapy 그리고 IMRT의 결과와 현저한 차이를 보이지는 않았다. 하지만, 본 연구는 폐암이라는 질환으로 한정하였었고 실험군의 수가 적은 단점을 가지고 있으므로 좀 더 많은 질환과 환자를 대상으로 연구를 폭넓게 진행 한다면 환자 맞춤형 치료기법을 개발하여 적용될 것으로 사료된다.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1179-1186
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• 2018

Objective: The purposes of this study were to evaluate size-specific dose estimate (SSDE) of low-dose CT (LDCT) in the Korean Lung Cancer Screening (K-LUCAS) project and to determine whether CT protocols from Western countries are appropriate for lung cancer screening in Korea. Materials and Methods: For participants (n = 256, four institutions) of K-LUCAS pilot study, volume CT dose index ($CTDI_{vol}$) using a 32-cm diameter reference phantom was compared with SSDE, which was recalculated from $CTDI_{vol}$ using size-dependent conversion factor (f-size) based on the body size, as described in the American Association of Physicists in Medicine Report 204. This comparison was subsequently assessed by body mass index (BMI) levels (underweight/normal vs. overweight/obese), and automatic exposure control (AEC) adaptation (yes/no). Results: Size-specific dose estimate was higher than $CTDI_{vol}$ ($2.22{\pm}0.75mGy$ vs. $1.67{\pm}0.60mGy$, p < 0.001), since the f-size was larger than 1.0 for all participants. The ratio of SSDE to $CTDI_{vol}$ was higher in lower BMI groups; 1.26, 1.37, 1.43, and 1.53 in the obese (n = 103), overweight (n = 70), normal (n = 75), and underweight (n = 4), respectively. The ratio of SSDE to $CTDI_{vol}$ was greater in standard-sized participants than in large-sized participants independent of AEC adaptation; with AEC, SSDE/$CTDI_{vol}$ in large- vs. standard-sized participants: $1.30{\pm}0.08$ vs. $1.44{\pm}0.08$ (p < 0.001) and without AEC, $1.32{\pm}0.08$ vs. $1.42{\pm}0.06$ (p < 0.001). Conclusion: Volume CT dose index based on a reference phantom underestimates radiation exposure of LDCT in standard-sized Korean participants. The optimal radiation dose limit needs to be verified for standard-sized Korean participants.