• Radiation Oncology Journal
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• 제15권2호
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• pp.121-128
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• 1997

Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

• Radiation Oncology Journal
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• 제22권3호
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• pp.165-176
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• 2004

Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

• Journal of the Korean Society of Food Science and Nutrition
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• 제46권7호
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• pp.876-885
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• 2017

This study aimed to identify the characteristics of Home Meal Replacement (HMR) product purchases and the need for HMR product development for Hong Kong consumers in order to suggest market segmentation strategies according to consumers' dietary lifestyle. For this, an online survey was conducted on a panel of 521 Hong Kong consumers with HMR purchase experience registered at a specialized organization. Data analysis was performed using SPSS (ver. 23.0). HMR purchase characteristics of Hong Kong consumers according to dietary lifestyle showed significant differences in all items, including 'number of purchases', 'purchase location', 'cost of single purchase', and 'reason for purchase'. According to dietary lifestyle, participants were divided into three clusters: 'High interest', 'normal interest', and 'low interest'. In the case of 'high interest in dietary life group', 'low-sodium food' was the most common, followed by 'heating food', 'low sugar food', and 'low calorie food'. In the case of 'moderate interest in dietary life group', 'low-sodium food' was the most common, followed by 'low sugar food', 'low calorie food', and 'nutritious meal'. In the case of 'low interest in dietary life group', 'low sugar food' was the most common, followed by 'low-sodium food', 'various new menu', and 'easy-to-carry dehydrated food'. For the 'high interest' group, the highest proportion of consumers were male in between the ages of 20 to 29, married, and worked in an office job. The 'high interest' consumers also showed a tendency to pay '15,000 to 20,000 KRW' per single purchase. The 'normal interest' group consisted of an even proportion of male and female consumers, with the most common age range being from 30 to 39 years, and most were married. These consumers preferred to spend 'less than 10,000 KRW' or '10,000 KRW to 15,000 KRW' per single purchase, which is in the lower price range for HMR purchases. The 'low interest in dietary life group' had more females gender-wise, were unmarried, and worked in an office job, For a single purchase, the 'low interest' group chose to pay less than 10,000 KRW, which is relatively lower than the other two clusters. The results of this study can be used as baseline data for building marketing strategies for HMR product development. It can also provide basic data and directions for new HMR export products that reflect consumer needs in order to create a market segmentation strategy for industrial applications.

• Tuberculosis and Respiratory Diseases
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• 제48권4호
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• pp.448-463
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• 2000

Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

• Journal of Global Scholars of Marketing Science
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• 제20권3호
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• pp.239-248
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• 2010

This paper describes a collaborative project between academia and industry which focused on improving the marketing and product development strategies for two private label apparel brands of a large regional department store chain in the southeastern United States. The goal of the project was to revitalize product lines of the two brands by incorporating student ideas for new solutions, thereby giving the students practical experience with a real-life industry situation. There were a number of key players involved in the project. A privately-owned department store chain based in the southeastern United States which was seeking an academic partner had recognized a need to update two existing private label brands. They targeted middle-aged consumers looking for casual, moderately priced merchandise. The company was seeking to change direction with both packaging and presentation, and possibly product design. The branding and product development divisions of the company contacted professors in an academic department of a large southeastern state university. Two of the professors agreed that the task would be a good fit for their classes - one was a junior-level Intermediate Brand Management class; the other was a senior-level Fashion Product Development class. The professors felt that by working collaboratively on the project, students would be exposed to a real world scenario, within the security of an academic learning environment. Collaboration within an interdisciplinary team has the advantage of providing experiences and resources beyond the capabilities of a single student and adds "brainpower" to problem-solving processes (Lowman 2000). This goal of improving the capabilities of students directed the instructors in each class to form interdisciplinary teams between the Branding and Product Development classes. In addition, many universities are employing industry partnerships in research and teaching, where collaboration within temporal (semester) and physical (classroom/lab) constraints help to increase students' knowledge and experience of a real-world situation. At the University of Tennessee, the Center of Industrial Services and UT-Knoxville's College of Engineering worked with a company to develop design improvements in its U.S. operations. In this study, Because should be lower case b with a private label retail brand, Wickett, Gaskill and Damhorst's (1999) revised Retail Apparel Product Development Model was used by the product development and brand management teams. This framework was chosen because it addresses apparel product development from the concept to the retail stage. Two classes were involved in this project: a junior level Brand Management class and a senior level Fashion Product Development class. Seven teams were formed which included four students from Brand Management and two students from Product Development. The classes were taught the same semester, but not at the same time. At the beginning of the semester, each class was introduced to the industry partner and given the problem. Half the teams were assigned to the men's brand and half to the women's brand. The teams were responsible for devising approaches to the problem, formulating a timeline for their work, staying in touch with industry representatives and making sure that each member of the team contributed in a positive way. The objective for the teams was to plan, develop, and present a product line using merchandising processes (following the Wickett, Gaskill and Damhorst model) and develop new branding strategies for the proposed lines. The teams performed trend, color, fabrication and target market research; developed sketches for a line; edited the sketches and presented their line plans; wrote specifications; fitted prototypes on fit models, and developed final production samples for presentation to industry. The branding students developed a SWOT analysis, a Brand Measurement report, a mind-map for the brands and a fully integrated Marketing Report which was presented alongside the ideas for the new lines. In future if the opportunity arises to work in this collaborative way with an existing company who wishes to look both at branding and product development strategies, classes will be scheduled at the same time so that students have more time to meet and discuss timelines and assigned tasks. As it was, student groups had to meet outside of each class time and this proved to be a challenging though not uncommon part of teamwork (Pfaff and Huddleston, 2003). Although the logistics of this exercise were time-consuming to set up and administer, professors felt that the benefits to students were multiple. The most important benefit, according to student feedback from both classes, was the opportunity to work with industry professionals, follow their process, and see the results of their work evaluated by the people who made the decisions at the company level. Faculty members were grateful to have a "real-world" case to work with in the classroom to provide focus. Creative ideas and strategies were traded as plans were made, extending and strengthening the departmental links be tween the branding and product development areas. By working not only with students coming from a different knowledge base, but also having to keep in contact with the industry partner and follow the framework and timeline of industry practice, student teams were challenged to produce excellent and innovative work under new circumstances. Working on the product development and branding for "real-life" brands that are struggling gave students an opportunity to see how closely their coursework ties in with the real-world and how creativity, collaboration and flexibility are necessary components of both the design and business aspects of company operations. Industry personnel were impressed by (a) the level and depth of knowledge and execution in the student projects, and (b) the creativity of new ideas for the brands.

• Journal of Intelligence and Information Systems
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• 제18권3호
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• pp.153-169
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• 2012

Exhibitions have played a key role of effective marketing activity which directly informs services and products to current and potential customers. Through participating in exhibitions, exhibitors have got the opportunity to make face-to-face contact so that they can secure the market share and improve their corporate images. According to this economic importance of exhibitions, show organizers try to adopt a new IT technology for improving their performance, and researchers have also studied services which can improve the satisfaction of visitors through analyzing visit patterns of visitors. Especially, as smart technologies make them monitor activities of visitors in real-time, they have considered booth recommender systems which infer preference of visitors and recommender proper service to them like on-line environment. However, while there are many studies which can improve their performance in the side of new technological development, they have not considered the choice factor of visitors for booth recommender systems. That is, studies for factors which can influence the development direction and effective diffusion of these systems are insufficient. Most of prior studies for the acceptance of new technologies and the continuous intention of use have adopted Technology Acceptance Model (TAM) and Extended Technology Acceptance Model (ETAM). Booth recommender systems may not be new technology because they are similar with commercial recommender systems such as book recommender systems, in the smart exhibition environment, they can be considered new technology. However, for considering the smart exhibition environment beyond TAM, measurements for the intention of reuse should focus on how booth recommender systems can provide correct information to visitors. In this study, through literature reviews, we draw factors which can influence the satisfaction and reuse intention of visitors for booth recommender systems, and design a model to forecast adaptation of visitors for booth recommendation in the exhibition environment. For these purposes, we conduct a survey for visitors who attended DMC Culture Open in November 2011 and experienced booth recommender systems using own smart phone, and examine hypothesis by regression analysis. As a result, factors which can influence the satisfaction of visitors for booth recommender systems are the effectiveness, perceived ease of use, argument quality, serendipity, and so on. Moreover, the satisfaction for booth recommender systems has a positive relationship with the development of reuse intention. For these results, we have some insights for booth recommender systems in the smart exhibition environment. First, this study gives shape to important factors which are considered when they establish strategies which induce visitors to consistently use booth recommender systems. Recently, although show organizers try to improve their performances using new IT technologies, their visitors have not felt the satisfaction from these efforts. At this point, this study can help them to provide services which can improve the satisfaction of visitors and make them last relationship with visitors. On the other hands, this study suggests that they managers along the using time of booth recommender systems. For example, in the early stage of the adoption, they should focus on the argument quality, perceived ease of use, and serendipity, so that improve the acceptance of booth recommender systems. After these stages, they should bridge the differences between expectation and perception for booth recommender systems, and lead continuous uses of visitors. However, this study has some limitations. We only use four factors which can influence the satisfaction of visitors. Therefore, we should development our model to consider important additional factors. And the exhibition in our experiments has small number of booths so that visitors may not need to booth recommender systems. In the future study, we will conduct experiments in the exhibition environment which has a larger scale.

• The Journal of Korean Society for Radiation Therapy
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• 제16권2호
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• pp.9-17
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• 2004

Purpose : Although Improve of CT, MRI Radio-diagnosis and Radiation Therapy Planing, but we still use ICRU38 Planning system(2D film-based) broadly. 3-Dimensional ICR plan(CT image based) is not only offer tumor and normal tissue dose but also support DVH information. On this study, we plan irradiation-goal dose on CTV(CTV plan) and irradiation-goal dose on ICRU 38 point(ICRU38 plan) by use CT image. And compare with tumor-dose, rectal-dose, bladder-dose on both planning, and analysis DVH Method and Material : Sample 11 patients who treated by Ir-192 HDR. After 40Gy external radiation therapy, ICR plan established. All the patients carry out CT-image scanned by CT-simulator. And we use PLATO(Nucletron) v.14.2 planing system. We draw CTV, rectum, bladder on the CT image. And establish plan irradiation-$100\%$ dose on CTV(CTV plan) and irradiation-$100\%$ dose on A-point(ICRU38 plan) Result : CTV volume($average{\pm}SD$) is $21.8{\pm}26.6cm^3$, rectum volume($average{\pm}SD$) is $60.9{\pm}25.0cm^3$, bladder volume($average{\pm}SD$) is $116.1{\pm}40.1cm^3$ sampled 11 patients. The volume including $100\%$ dose is $126.7{\pm}18.9cm^3$ on ICRU plan and $98.2{\pm}74.5cm^3$ on CTV plan. On ICRU planning, the other one's $22.0cm^3$ CTV volume who residual tumor size excess 4cm is not including $100\%$ isodose. 8 patient's $12.9{\pm}5.9cm^3$ tumor volume who residual tumor size belows 4cm irradiated $100\%$ dose. Bladder dose(recommended by ICRU 38) is $90.1{\pm}21.3\%$ on ICRU plan, $68.7{\pm}26.6\%$ on CTV plan, and rectal dose is $86.4{\pm}18.3\%,\;76.9{\pm}15.6\%$. Bladder and Rectum maximum dose is $137.2{\pm}50.1\%,\;101.1{\pm}41.8\%$ on ICRU plan, $107.6{\pm}47.9\%,\;86.9{\pm}30.8\%$ on CTV plan. Therefore CTV plan more less normal issue-irradiated dose than ICRU plan. But one patient case who residual tumor size excess 4cm, Normal tissue dose more higher than critical dose remarkably on CTV plan. $80\%$over-Irradiated rectal dose(V80rec) is $1.8{\pm}2.4cm^3$ on ICRU plan, $0.7{\pm}1.0cm^3$ on CTV plan. $80\%$over-Irradiated bladder dose(V80bla) is $12.2{\pm}8.9cm^3$ on ICRU plan, $3.5{\pm}4.1cm^3$ on CTV plan. Likewise, CTV plan more less irradiated normal tissue than ICRU38 plan. Conclusion : Although, prove effect and stability about previous ICRU plan, if we use CTV plan by CT image, we will reduce normal tissue dose and irradiated goal-dose at residual tumor on small residual tumor case. But bigger residual tumor case, we need more research about effective 3D-planning.

• Journal of Intelligence and Information Systems
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• 제19권2호
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• pp.177-189
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• 2013

In Smart Education, the roles of digital textbook is very important as face-to-face media to learners. The standardization of digital textbook will promote the industrialization of digital textbook for contents providers and distributers as well as learner and instructors. In this study, the following three objectives-oriented digital textbooks are looking for ways to standardize. (1) digital textbooks should undertake the role of the media for blended learning which supports on-off classes, should be operating on common EPUB viewer without special dedicated viewer, should utilize the existing framework of the e-learning learning contents and learning management. The reason to consider the EPUB as the standard for digital textbooks is that digital textbooks don't need to specify antoher standard for the form of books, and can take advantage od industrial base with EPUB standards-rich content and distribution structure (2) digital textbooks should provide a low-cost open market service that are currently available as the standard open software (3) To provide appropriate learning feedback information to students, digital textbooks should provide a foundation which accumulates and manages all the learning activity information according to standard infrastructure for educational Big Data processing. In this study, the digital textbook in a smart education environment was referred to open digital textbook. The components of open digital textbooks service framework are (1) digital textbook terminals such as smart pad, smart TVs, smart phones, PC, etc., (2) digital textbooks platform to show and perform digital contents on digital textbook terminals, (3) learning contents repository, which exist on the cloud, maintains accredited learning, (4) App Store providing and distributing secondary learning contents and learning tools by learning contents developing companies, and (5) LMS as a learning support/management tool which on-site class teacher use for creating classroom instruction materials. In addition, locating all of the hardware and software implement a smart education service within the cloud must have take advantage of the cloud computing for efficient management and reducing expense. The open digital textbooks of smart education is consdered as providing e-book style interface of LMS to learners. In open digital textbooks, the representation of text, image, audio, video, equations, etc. is basic function. But painting, writing, problem solving, etc are beyond the capabilities of a simple e-book. The Communication of teacher-to-student, learner-to-learnert, tems-to-team is required by using the open digital textbook. To represent student demographics, portfolio information, and class information, the standard used in e-learning is desirable. To process learner tracking information about the activities of the learner for LMS(Learning Management System), open digital textbook must have the recording function and the commnincating function with LMS. DRM is a function for protecting various copyright. Currently DRMs of e-boook are controlled by the corresponding book viewer. If open digital textbook admitt DRM that is used in a variety of different DRM standards of various e-book viewer, the implementation of redundant features can be avoided. Security/privacy functions are required to protect information about the study or instruction from a third party UDL (Universal Design for Learning) is learning support function for those with disabilities have difficulty in learning courses. The open digital textbook, which is based on E-book standard EPUB 3.0, must (1) record the learning activity log information, and (2) communicate with the server to support the learning activity. While the recording function and the communication function, which is not determined on current standards, is implemented as a JavaScript and is utilized in the current EPUB 3.0 viewer, ths strategy of proposing such recording and communication functions as the next generation of e-book standard, or special standard (EPUB 3.0 for education) is needed. Future research in this study will implement open source program with the proposed open digital textbook standard and present a new educational services including Big Data analysis.

• Journal of Genetic Medicine
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• 제7권2호
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• pp.125-132
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• 2010

Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

• The Journal of Korean Society for Radiation Therapy
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• 제30권1_2호
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• pp.83-95
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• 2018

Purpose : After planning the Respiratory Gated Radiotherapy for Lung cancer, the movement and volume change of sparing normal structures nearby target are not often considered during dose evaluation. This study carried out 4-D dose evaluation which reflects the movement of normal structures at certain phase of Respiratory Gated Radiotherapy, by using Deformable Image Registration that is well used for Adaptive Radiotherapy. Moreover, the study discussed the need of analysis and established some recommendations, regarding the normal structures's movement and volume change due to Patient's breathing pattern during evaluation of treatment plans. Materials and methods : The subjects were taken from 10 lung cancer patients who received Respiratory Gated Radiotherapy. Using Eclipse(Ver 13.6 Varian, USA), the structures seen in the top phase of CT image was equally set via Propagation or Segmentation Wizard menu, and the structure's movement and volume were analyzed by Center-to Center method. Also, image from each phase and the dose distribution were deformed into top phase CT image, for 4-dimensional dose evaluation, via VELOCITY Program. Also, Using $QUASAR^{TM}$ Phantom(Modus Medical Devices) and $GAFCHROMIC^{TM}$ EBT3 Film(Ashland, USA), verification carried out 4-D dose distribution for 4-D gamma pass rate. Result : The movement of the Inspiration and expiration phase was the most significant in axial direction of right lung, as $0.989{\pm}0.34cm$, and was the least significant in lateral direction of spinal cord, as -0.001 cm. The volume of right lung showed the greatest rate of change as 33.5 %. The maximal and minimal difference in PTV Conformity Index and Homogeneity Index between 3-dimensional dose evaluation and 4-dimensional dose evaluation, was 0.076, 0.021 and 0.011, 0.0 respectfully. The difference of 0.0045~2.76 % was determined in normal structures, using 4-D dose evaluation. 4-D gamma pass rate of every patients passed reference of 95 % gamma pass rate. Conclusion : PTV Conformity Index was more significant in all patients using 4-D dose evaluation, but no significant difference was observed between two dose evaluations for Homogeneity Index. 4-D dose distribution was shown more homogeneous dose compared to 3D dose distribution, by considering the movement from breathing which helps to fill out the PTV margin area. There was difference of 0.004~2.76 % in 4D evaluation of normal structure, and there was significant difference between two evaluation methods in all normal structures, except spinal cord. This study shows that normal structures could be underestimated by 3-D dose evaluation. Therefore, 4-D dose evaluation with Deformable Image Registration will be considered when the dose change is expected in normal structures due to patient's breathing pattern. 4-D dose evaluation with Deformable Image Registration is considered to be a more realistic dose evaluation method by reflecting the movement of normal structures from patient's breathing pattern.