• Journal of Pharmacopuncture
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• v.19 no.2
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• pp.114-121
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• 2016

Objectives: Lung cancer remains a deadly disease with unsatisfactory overall survival. Cisplatin, a standard platinum (Pt)-based chemotherapeutic agent, has the potential to inhibit the growth of lung cancer. Its use, however, is occasionally limited by severe organ toxicity. However, until now, no systematic study has been conducted to verify its efficacy with proper experimental support in vivo. Therefore, we examined whether biosynthesized Pt nanoparticles (NPs) inhibited human lung cancer in vitro and in vivo to validate their use in alternative and complementary medicine. Methods: We evaluated the in vitro and the in vivo anticancer efficiencies of biosynthesized Pt NPs in a subcutaneous xenograft model with A549 cells. Severe combined immune deficient mice (SCID) were divided into four groups: group 1 being the vehicle control group and groups 2, 3 and 4 being the experimental groups. Once the tumor volume had reached $70-75mm^3$, the progression profile of the tumor growth kinetics and the body weights of the mice were measured every week for 6 weeks after oral administration of Pt NPs. Doses of Pt NPs of 500, 1,000 and 2,000 mg/kg of body weight were administered to the experimental groups and a dose of honey was administered to the vehicle control group. The efficacy was quantified by using the delay in tumor growth following the administration of Pt NPs of A549 human-lung-cancer xenografts growing in SCID mice. Results: The in vitro cytotoxicity evaluation indicated that Pt NPs, in a dose-dependent manner, inhibited the growth of A549 cells, and the in vivo evaluation showed that Pt NPs at the mid and high doses effectively inhibited and delayed the growth of lung cancer in SCID mice. Conclusion: These findings confirm the antitumor properties of biosynthesized Pt NPs and suggest that they may be a cost-effective alternative for the treatment of patients with lung cancer.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.113-119
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• 1989

In recent years there has been a growing interest in total body, hemibody, total lymphoid irradiation. For refractory leukemia or lymphoma patients, various techniques and dose regimens were introduced, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosuppression prior to bone marrow transplantation, and low dose total body irradiation for treatment of lymphocytic leukemia or lymphomas. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. Purposes of this paper are to discuss calibrating Cobalt Unit in 3m distance using Rando Phantom, to compare calculated dose, calibrated dose, and compensating filters for homogeneous dose distribution in the head and neck, the lung, and the pelvis. Results were following. 1. Measured dose on the lung was 6% higher than on the abdomen. Measured dose on the head (10%) and neck (18%) were higher than the abdomen because of thinness. Pelvic dose was measured 12% less than the abdomen. Those data suggest that compensating filter was essential. 2. Measured dose according to distance was 3% less than calculated dose which suggest that all doses in clinical use should be compared with calculated dose for minimizing error.

• Tuberculosis and Respiratory Diseases
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• v.77 no.2
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• pp.60-64
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• 2014

MicroRNAs (miRNAs) are a class of small noncoding RNAs that modulate target gene activity, and are aberrantly expressed in most types of cancer as well in lung cancer. A miRNA can potentially target a diverse set of mRNAs; further, it plays a critical role in lung tumorigenesis as well as affects patient outcome. Previous studies focused mainly on abnormal miRNAs expressions in lung cancer tissues. Interestingly, circulating miRNAs were identified in human plasma and serum in 2008. Since then, considerable effort has been directed to the study of circulating miRNAs as one of the biomarkers of lung cancer. miRNAs expression of tissues and blood in lung cancer patients is being analyzed by more researchers. Recently, to overcome the high false-positivity of low-dose chest computed tomography scan, miRNAs in lung cancer screening are being investigated. This article summarizes the recent researches regarding clinical applications of miRNAs in the diagnosis and management of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.319-323
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• 2012

Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.239-245
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• 2015

Background: Chronic obstructive pulmonary disease is characterized by emphysema, chronic bronchitis, and small airway remodeling. The alveolar destruction associated with emphysema cannot be repaired by current clinical practices. Stem cell therapy has been successfully used in animal models of cigarette smoke- and elastase-induced emphysema. However, the optimal dose of mesenchymal stem cells (MSCs) for the most effective therapy has not yet been determined. It is vital to determine the optimal dose of MSCs for clinical application in emphysema cases. Methods: In the present study, we evaluated the therapeutic effects of various doses of MSCs on elastase-induced emphysema in mice. When 3 different doses of MSCs were intravenously injected into mice treated with elastase, only $5{\times}10^4$ MSCs showed a significant effect on the emphysematous mouse lung. We also identified action mechanisms of MSCs based on apoptosis, lung regeneration, and protease/antiprotease imbalance. Results: The MSCs were not related with caspase-3/7 dependent apoptosis. But activity of matrix metalloproteinase 9 increased by emphysematous lung was decreased by intravenously injected MSCs. Vascular endothelial growth factor were also increased in lung from MSC injected mice, as compared to un-injected mice. Conclusion: This is the first study on the optimal dose of MSCs as a therapeutic candidate. This data may provide important basic data for determining dosage in clinical application of MSCs in emphysema patients.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.384-389
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• 2018

Background: Airway anastomotic complications are a leading cause of mortality after lung transplantation. Among the factors that cause airway complications, preoperative steroid use has been considered to be related with postoperative airway healing. We analyzed the influence of preoperative steroid use on postoperative airway complications. Methods: The medical records of 66 double-lung transplant recipients from January 2014 to December 2015 were reviewed. Forty patients were prescribed steroids preoperatively. The daily steroid dose was standardized using the patient's body mass index (BMI). Patients who received preoperative steroids were sub-divided into high-dose (HD) and low-dose (LD) groups (cut-off value, 1.6 mg/BMI/day). Results: Thirteen patients suffered from airway complications postoperatively (bronchopulmonary fistula, 9; bronchial stenosis, 4). There was a tendency for early development of airway complications in the steroid use group compared to the non-steroid use group, but it was not significant (percentage free from airway complications in year 1: non-steroid group, 90.9% vs. steroid group, 79.2%; p=0.43). The percentage of patients in the LD and HD groups who were free from airway complications in year 1 was not significantly different (84.0% vs. 77.8%, p=0.39). Conclusion: The airway complication rate did not vary significantly according to steroid use. Additionally, in patients who received preoperative steroids, the dose did not affect the rate of development of airway complications.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9033-9038
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• 2014

Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). Materials and Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock. Two thermoplastic masks were prepared for each patient, one for normal free breathing and a second made with breath-hold to maintain reproducibility. DIBH CT scans were performed in the prospective mode of the Varian real time position management (RPM) system. The planning target volume (PTV) included the left chest wall and supraclavicular nodes and PTV prescription dose was 5000cGy in 25 fractions. DIBH-3DCRT planning was performed with the single iso-centre technique using a 6MV photon beam and the field-in-field technique. VMAT plans for FB and DIBH contained two partial arcs ($179^{\circ}-300^{\circ}CCW/CW$). Dose volume histograms of PTV and OAR's were analyzed for DIBH-VMAT, FB-VMAT and DIBH-3DCRT. In DIBH mode daily orthogonal ($0^{\circ}$ and $90^{\circ}$) KV images were taken to determine the setup variability and weekly twice CBCT to verify gating threshold level reproducibility. Results: DIBH-VMAT reduced the lung and heart dose compared to FB-VMAT, while maintaining similar PTV coverage. The mean heart $V_{30Gy}$ was $2.3%{\pm}2.7$, $5.1%{\pm}3.2$ and $3.3%{\pm}7.2$ and for left lung $V_{20Gy}$ was $18.57%{\pm}2.9$, $21.7%{\pm}3.9$ and $23.5%{\pm}5.1$ for DIBH-VMAT, FB-VMAT and DIBH-3DCRT respectively. Conclusions: DIBH-VMAT significantly reduced the heart and lung dose for left side chest wall patients compared to FB-VMAT. PTV conformity index, homogeneity index, ipsilateral lung dose and heart dose were better for DIBH-VMAT compared to DIBH-3DCRT. However, contralateral lung and breast volumes exposed to low doses were increased with DIBH-VMAT.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.53-60
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• 2002

Motion of lung tumors from respiration has been reported in the literature to be as large as of 1-2 cm. This motion requires an additional margin between the Clinical Target Volume (CTV) and the Planning Target Volume (PTV). While such a margin is necessary, it may not be sufficient to ensure proper delivery of Intensity Modulated Radiotherapy (IMRT) to the CTV during the simultaneous movement of the DMLC. Gated treatment has been proposed to improve normal tissues sparing as well as to ensure accurate dose coverage of the tumor volume. The following questions have not been addressed in the literature: a) what is the dose error to a target volume without gated IMRT treatment\ulcorner b) what is an acceptable gating window for such treatment. In this study, we address these questions by proposing a novel technique for calculating the 3D dose error that would result if a lung IMRT plan were delivered without gating. The method is also generalized for gated treatment with an arbitrary triggering window. IMRT plans for three patients with lung tumor were studied. The treatment plans were generated with HELIOS for delivery with 6 MV on a CL2100 Varian linear accelerator with a 26 pair MLC. A CTV to PTV margin of 1 cm was used. An IMRT planning system searches for an optimized fluence map ${\Phi}$ (x,y) for each port, which is then converted into a dynamic MLC file (DMLC). The DMLC file contains information about MLC subfield shapes and the fractional Monitor Units (MUs) to be delivered for each subfield. With a lung tumor, a CTV that executes a quasi periodic motion z(t) does not receive ${\Phi}$ (x,y), but rather an Effective Incident Fluence EIF(x,y). We numerically evaluate the EIF(x,y) from a given DMLC file by a coordinate transformation to the Target's Eye View (TEV). In the TEV coordinate system, the CTV itself is stationary, and the MLC is seen to execute a motion -z(t) that is superimposed on the DMLC motion. The resulting EIF(x,y)is inputted back into the dose calculation engine to estimate the 3D dose to a moving CTV. In this study, we model respiratory motion as a sinusoidal function with an amplitude of 10 mm in the superior-inferior direction, a period of 5 seconds, and an initial phase of zero.

• Journal of Radiation Protection and Research
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• v.46 no.3
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• pp.98-105
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• 2021

Background: In recent events of the coronavirus disease 2019 (COVID-19) pandemic, computed tomography (CT) scans are being globally used as a complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. It will be important to be aware of major organ dose levels, which are more relevant quantity to derive potential long-term adverse effect, for Korean pediatric and adult patients undergoing CT for COVID-19. Materials and Methods: We calculated organ dose conversion coefficients for Korean pediatric and adult CT patients directly from Korean pediatric and adult computational phantoms combined with Monte Carlo radiation transport techniques. We then estimated major organ doses delivered to the Korean child and adult patients undergoing CT for COVID-19 combining the dose conversion coefficients and the international survey data. We also compared our Korean dose conversion coefficients with those from Caucasian reference pediatric and adult phantoms. Results and Discussion: Based on the dose conversion coefficients we established in this study and the international survey data of COVID-19-related CT scans, we found that Korean 7-year-old child and adult males may receive about 4-32 mGy and 3-21 mGy of lung dose, respectively. We learned that the lung dose conversion coefficient for the Korean child phantom was up to 1.5-fold greater than that for the Korean adult phantom. We also found no substantial difference in dose conversion coefficients between Korean and Caucasian phantoms. Conclusion: We estimated radiation dose delivered to the Korean child and adult phantoms undergoing COVID-19-related CT examinations. The dose conversion coefficients derived for different CT scan types can be also used universally for other dosimetry studies concerning Korean CT scans. We also confirmed that the Caucasian-based CT organ dose calculation tools may be used for the Korean population with reasonable accuracy.

• Progress in Medical Physics
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• v.4 no.2
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• pp.19-25
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• 1993

Treatment planning of lung cancer with density corrected Computed tomography. Eighty-seven patients with lung cnacer who had radiation therapy in Yeungnam University Medical Center between, April 1 1990 and Aug. 30 1993 were retrospectively evaluated total tumor dose, dose distribution, field correction, and loading change, compared with contour or CT image planning and density corrected CT planning. In dose distribution, higher dose was calculated in compare with density corrected CT planning less than 5% difference were found in 45 patient(52%), 5-10% in 25 patients (29%), 10-15% in 15 patients (17%) and over 15% in 2 patients (2%). Correction of treatment field was performed in 18 patients (21%) and changing of dose loading was given in 15 patients (17%). In conclusion, we emphasize that density corrected CT planning is the very important factor which contribute to increase therapeutic gain by exact selection of target volume, target dose, normal tissue dose and dose of critical organ.