• Radiation Oncology Journal
• /
• v.27 no.4
• /
• pp.240-248
• /
• 2009

Purpose: To provide a simple research tool that may be used to analyze a dose volume histogram from different radiation therapy planning systems for NTCP (Normal Tissue Complication Probability), OED (Organ Equivalent Dose) and so on. Materials and Metohds: A high-level computing language was chosen to implement Niemierko's EUD, Lyman-Kutcher-Burman model's NTCP, and OED. The requirements for treatment planning analysis were defined and the procedure, using a developed GUI based program, was described with figures. The calculated data, including volume at a dose, dose at a volume, EUD, and NTCP were evaluated by a commercial radiation therapy planning system, Pinnacle (Philips, Madison, WI, USA) for comparison. Results: The volume at a special dose and a dose absorbed in a volume on a dose volume histogram were successfully extracted using DVH data of several radiation planning systems. EUD, NTCP and OED were successfully calculated using DVH data and some required parameters in the literature. Conclusion: A simple DVH analyzer program was developed and has proven to be a useful research tool for radiation therapy.

• Journal of radiological science and technology
• /
• v.36 no.3
• /
• pp.237-244
• /
• 2013

The purpose of this study is to compare method in the treatment of breast cancer using dose index. And, it is to find the optimized treatment technique to the patient. The phantom filled with tissue-equivalent material were used simulation and treatment as techniques of 3D-CRT, IMRT, VMAT was planned using Eclipse v10. By using HI(homogeneity index), CI(Conformity index), OED(Organ equivalent dose), EAR(Excess Absolute Risk), were assessed for each treatment plans. HI and CI of 3D-CRT, IMRT, VMAT were calculated 16.89, 11.21, 9.55 and 0.59, 0.61, 0.83. The organ average doses of Lt lung, Rt lung, liver, heart, esophagus, cord, Lt breast, trachea and stomach were 0.01 ~ 2.02 Gy, 0.36 ~ 5.01 Gy, 0.25 ~ 2.49 Gy, 0.14 ~ 6.92 Gy, 0.03 ~ 2.02 Gy, 0.01 ~ 1.06 Gy, 0.25 ~ 6.08 Gy, 0.08 ~ 0.59 Gy, 0.01 ~ 1.34 Gy, respectively. The OED, EAR of the IMRT and VMAT show higher than 3D-CRT. As the result of this study, we could confirm being higher dose index(HI, CI) in IMRT and VMAT than 3D-CRT, but doses of around normal organs was higher IMRT, VMAT than 3D-CRT.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.12
• /
• pp.5107-5111
• /
• 2016

Background: Epidemiological studies have indicated an increasing incidence of radiation induced secondary cancer (SC) in breast cancer patients after radiotherapy (RT), most commonly in the contra-lateral breast (CLB). The present study was conducted to estimate the SC risk in the CLB following 3D conformal radiotherapy techniques (3DCRT) including wedge field and forward intensity modulated radiotherapy (fIMRT) based on the organ equivalent dose (OED). Material and Methods: RT plans treating the chest wall with conformal wedge field and fIMRT plans were created for 30 breast cancer patients. The risks of radiation induced cancer were estimated for the CLB using dose-response models: a linear model, a linear-plateau model and a bell-shaped model with full dose response accounting for fractionated RT on the basis of OED. Results: The plans were found to be ranked quite differently according to the choice of model; calculations based on a linear dose response model fIMRT predict statistically significant lower risk compared to the enhanced dynamic wedge (EDW) technique (p-0.0089) and a non-significant difference between fIMRT and physical wedge (PW) techniques (p-0.054). The widely used plateau dose response model based estimation showed significantly lower SC risk associated with fIMRT technique compared to both wedge field techniques (fIMRT vs EDW p-0.013, fIMRT vs PW p-0.04). The full dose response model showed a non-significant difference between all three techniques in the view of second CLB cancer. Finally the bell shaped model predicted interestingly that PW is associated with significantly higher risk compared to both fIMRT and EDW techniques (fIMRT vs PW p-0.0003, EDW vs PW p-0.0032). Conclusion: In conclusion, the SC risk estimations of the CLB revealed that there is a clear relation between risk associated with wedge field and fIMRT technique depending on the choice of model selected for risk comparison.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.337-343
• /
• 2014

Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.

• Progress in Medical Physics
• /
• v.29 no.4
• /
• pp.143-149
• /
• 2018

To verify the correlations between the clinical outcomes and physical factors of short-course chemoradiotherapy (SCRT) and long-course chemoradiotherapy (LCRT) with delayed surgery in patients with rectal cancer. Seventy-two patients with rectal cancer were enrolled in this study. Nineteen patients were treated with SCRT (25 Gy, 5 fractions) by intensity-modulated radiation therapy (IMRT), and 53 patients were treated with LCRT (50.4 Gy, 28 fractions) by three-dimensional conformal radiation therapy (3DCRT). Various physical factors for the target and organs at risk (OARs) were calculated to compare the clinical outcomes. The organ equivalent dose (OED) and lifetime attributable risk (LAR) of bowels and bladders were similar between the SCRT and LCRT groups, whereas the values of femurs were higher in the LCRT group. The equivalent uniform dose and normal tissue complication probability were higher in the LCRT than the SCRT group for most organs. Treatment complications, including anastomotic leakage, bowel adhesion, and hematologic toxicity, were not significantly different between SCRT and LCRT groups. CIs were $0.84{\pm}0.2$ and $0.61{\pm}0.1$ for SCRT and LCRT, respectively. The CVIs were $1.07{\pm}0.0$ and $1.10{\pm}0.1$, and the HIs were $0.09{\pm}0.0$ and $0.11{\pm}0.1$ for SCRT and LCRT, respectively. The sphincter-saving rates were 89.5% and 94.3% for SCRT and LCRT, respectively. The complete pathologic remission rates were 21.1% and 13.2%, and the down-staging rates were 47.4% and 26.4% for SCRT and LCRT, respectively. SCRT with IMRT is comparable to conventional LCRT in both physical indexes and clinical outcome. The preoperative SCRT, compensated by IMRT, is an effective and safe modality.

• Journal of radiological science and technology
• /
• v.37 no.4
• /
• pp.331-339
• /
• 2014

To test feasibility of proton arc therapy (PAT) in the treatment of para-aortic lymph node tumor and compare its dosimetric properties with advanced radiotherapy techniques such as intensity modulated radiation therapy (IMRT) and conventional 3D conformal proton beam therapy (PBT). The treatment plans for para-aortic lymph node tumor were planned for 9 patients treated at our institution using IMRT, PBT, and PAT. Feasibility test and dosimetric evaluation were based on comparisons of dose volume histograms (DVHs) which reveal mean dose, $D_{30%}$, $D_{60%}$, $D_{90%}$, $V_{30%}$, $V_{60%}$, $V_{90%}$, organ equivalent doses (OEDs), normal tissue complication probability (NTCP), homogeneity index (HI) and conformity index (CI). The average doses delivered by PAT to the liver, kidney, small bowel, duodenum, stomach were 7.6%, 3%, 17.3%, 26.7%, and 14.4%, of the prescription dose (PD), respectively, which is higher than the doses delivered by IMRT (0.4%, 7.2%, 14.2%, 15.9%, and 12.8%, respectively) and PBT (4.9%, 0.5%, 14.12%, 16.1% 9.9%, respectively). The average homogeneity index and conformity index of tumor using PAT were 12.1 and 1.21, respectively which were much better than IMRT (21.5 and 1.47, respectively) and comparable to PBT (13.1 and 1.23, respectively). The result shows that both NTCP and OED of PAT are generally lower than IMRT and PBT. This study demonstrates that PAT is better in target conformity and homogeneity than IMRT and PBT but worse than IMRT and PBT for most of dosimetric factor which indicate that PAT is not recommended for the treatment of para-aortic lymph node tumor.

• Progress in Medical Physics
• /
• v.24 no.4
• /
• pp.295-302
• /
• 2013

We estimated secondary scattered and leakage doses for intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT) and tomotherapy (TOMO) in patients with liver cancer. Five liver patients were planned by IMRT, VMAT and TOMO. Secondary scatter (and leakage) dose and organ equivalent doses (OEDs) are measured and estimated at various points 20 to 80 cm from the iso-center by using radiophotoluminescence glass dosimeter (RPLGD). The secondary dose per Gy from IMRT, VMAT and TOMO for liver cancer, measured 20 to 80 cm from the iso-center, are 0.01~3.13, 0.03~2.34 and 0.04~1.29 cGy, respectively. The mean values of relative OED of secondary dose of VMAT and TOMO for five patients, which is normalized by IMRT, measured as 75.24% and 50.92% for thyroid, 75.14% and 40.61% for bowel, 72.30% and 47.77% for rectum, 76.21% and 49.93% for prostate. The secondary dose and OED from TOMO is relatively low to those from IMRT and VMAT. OED based estimation suggests that the secondary cancer risk from TOMO is less than or comparable to the risks from conventional IMRT and VMAT.