• 제목/요약/키워드: Pelvic irradiation

검색결과 69건 처리시간 0.02초

앉은 자세에서 탄력밴드를 이용한 PNF 팔 패턴의 방산효과가 골반의 압력에 미치는 영향 (The Relationship of Pelvic Pressure and Irradiation of the PNF Upper Arm Pattern in the Sitting Position with an Elastic Band -A Randomized Control Trial-)

  • 양재만;여고은;김동욱;이정훈
    • PNF and Movement
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    • 제17권3호
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    • pp.421-429
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    • 2019
  • Purpose: This study evaluated the relationship between pelvic pressure and irradiation of the proprioceptive neuromuscular facilitation (PNF) upper arm pattern exercises with an elastic band while in a sitting position. Methods: Fourteen subjects with asymptomatic pelvic pressure participated in this study. Pelvic pressure was measured using a Gaitview® system while sitting and performing PNF bilateral upper arm patterns. Resistance strength was provided by the blue elastic band. The statistical significance of the results was evaluated using a repeated one-way ANOVA and the independent t-test. The Bonferroni method was used for the post-hoc test. Results: The results revealed a significant change in the pelvic pressure when performing the PNF arm pattern. The average resistance pressure on the pelvis, with the elastic band, significantly increased after the initial sitting position (F=3.91, 3.92; p<0.05). No significant pelvic pressure changes were noted for each PNF upper arm pattern (p>0.05). Conclusion: The results of this study showed a positive relationship between pelvic pressure and the irradiation of PNF upper arm pattern exercises with resistance in the sitting position.

Assessment of inter- and intra-fractional volume of bladder and body contour by mega-voltage computed tomography in helical tomotherapy for pelvic malignancy

  • Kim, Sunghyun;You, Sei Hwan;Eum, Young Ju
    • Radiation Oncology Journal
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    • 제36권3호
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    • pp.235-240
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    • 2018
  • Purpose: We describe the daily bladder volume change observed by mega-voltage computed tomography (MVCT) during pelvic radiotherapy with potential predictors of increased bladder volume variations. Materials and Methods: For 41 patients who received pelvic area irradiation, the volumes of bladder and pelvic body contour were measured twice a day with pre- and post-irradiation MVCT from the 1st to the 10th fraction. The median prescription dose was 20 Gy (range, 18 to 30 Gy) up to a 10th fraction. The upper and lower margin of MVCT scanning was consistent during the daily treatments. The median age was 69 years (range, 33 to 86 years) and 10 patients (24.4%) were treated postoperatively. Results: Overall bladder volume on planning computed tomography was 139.7 ± 92.8 mL. Generally, post-irradiation bladder volume (POSTBV) was larger than pre-irradiation bladder volume (PREBV) (p < 0.001). The mean PREBV and POSTBV was reduced after 10 fraction treatments by 21.3% (p = 0.028) and 25.4% (p = 0.007), respectively. The MVCT-scanned body contour volumes had a tendency to decrease as the treatment sessions progressed (p = 0.043 at the 8th fraction and p = 0.044 at the 10th fraction). There was a statistically significant correlation between bladder filling time and PREBV (p = 0.001). Conclusion: Daily MVCT-based bladder volume assessment was feasible both intra- and inter-fractionally.

림프절 전이를 동반한 초기 자궁경부암에서 수술 후 방사선치료의 역할 (The Role of Pelvic Irradiation after Hysterectomy in Early Stage Cervical Carcinoma with Pelvic Nodal Metastasis)

  • 서현숙
    • Radiation Oncology Journal
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    • 제16권4호
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    • pp.469-475
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    • 1998
  • 목적 : 병기 I, IIA 자궁경부암환자중 자궁절제술후 골반 림프절 전이가 발견되어 방사선치료를 받은 환자를 대상으로 생존율과 재발양상 및 이들에 영향을 미치는 인자들을 후향적으로 분석함으로써 방사선치료의 역할을 규명하고저 한다. 대상 및 방법 : 1983년 10월에서 1996년 6월까지 초기 자궁경부암으로 진단받고 수술후 골반림프절 전이가 확인되어 방사선치료를 받았던 68명을 대상으로 하였다. 방사선치료는 외부방사선 및 강내 방사선치료가 시행되었으며 외부방사선치료는 4 MV의 선형가속기를 이용하여 골반조사야로 주어졌다. 54례는 질ovids 또는 질실린더를 사용하여 강내 방사선조사를 추가 시행받았다. 5년 생존율 및 5년 무병생존율, 재발양상과 이들에 관련되는 다양한 예후인자들을 분석하였다. 결과 : 평균 추적기간은 52개월이었다. 전체 환자의 5년생존율 및 무병생존율은 각각 81.8$\%$, 81.7$\%$이었다. 자궁내막의 침윤이 없었던 경우와 있었던 경우 5년 무병생존율이 각각 87.5$\%$와 57.1$\%$를 보였으며 통계적으로 유의한 차이를 보여 주었다(p=0.0074). 림프혈관계의 침윤이 있었던 경우와 없었던 경우 5년 무병생존율이 각각 91.3$\%$, 65.0$\%$(p>0.05)이었고 자궁옆조직 침윤이 없었던 경우와 있었던 경우 각각 85.6$\%$, 65.3$\%$(p>0.05)이었다. 다변량분석시 5년 무병생존율에 유의한 영향을 미치는 인자는 자궁내막(endometrial) 침윤으로 확인되었다. 총 15례 (22$\%$)의 재발중 국소재발은 2례(3$\%$), 원격전이는 11례(16$\%$), 국소와 원격전이 동시재발은 2례에서 발생하였다. 결론 : 골반 림프절 전이가 동반된 초기 자궁경부암 환자에서의 수술후 방사선치료는 국소관해율의 향상에 큰 역할을 하고 있으나 원격전이 재발율이 여전히 높아 주요 사망 원인이 되고 있다. 따라서 고위험군 즉 자궁내막 침윤과 같은 불량한 예후를 지닌 환자에서는 방사선치료와 더불어 원격전이를 효과적으로 예방할 수 있는 치료방법이 적극적으로 고려되어야 할 것이다.

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골반 방사선 치료후의 골 변화와 손상 (Post Pelvic Radiotherapy Bony Changes)

  • 허승재
    • Radiation Oncology Journal
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    • 제27권1호
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    • pp.1-9
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    • 2009
  • 방사선치료후 발생할 수 있는 골 손상은 골반 부전골절, 방사선 골 괴사, 무혈성 괴사, 골 육종 등이다, 특히 최근 방사선치료후의 골탄성도의 변화로 발생하는 골반 부전골절에 관하여 많은 보고가 있었다. 과거 방사선치료 후의 골 손상 특히 골절의 빈도는 선형가속기를 이용한 메가볼트 방사선치료 바뀌면서 현저히 줄어 들어서 매우 낮은 것으로 보고 되었으나 최근에는 $8{\sim}20%$로 보고가 되고 있다. 따라서 골반 부전골절의 임상적 의미와 중요성과 예방 및 치료에 대하여 관심이 증가되고 있다. 저자는 자궁경부암 치료 후 관찰한 골반 부전골절, 골 괴사, 무혈성 괴사, 및 2차성 골육종등 골반골 변화와 손상에 관하여 저자의 경험과 문헌고찰을 통하여 보고 하고자 한다.

자궁 경부암의 방사선 치료계획에서 자기공명 영상을 이용한 조사야 교정 (Treatment Planning Correction Using MRI in the Radiotherapy of Cervical Cancer)

  • 신세원;조길호;박찬원
    • Journal of Yeungnam Medical Science
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    • 제12권2호
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    • pp.203-209
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    • 1995
  • 본 연구는 최근에 개발되어 임상적으로 널리 이용되는 자기공명 영상상을 20명의 자궁 경부암 환자의 치료계획에 적용하여 전통적인 치료계획과 비교하여 아래의 결과를 얻었다. 1. 측방 조사야의 가로길이는 11 cm가 7명(35%)으로 가장 많았으며, 10 cm가 6명(30%), 9 cm와 12 cm가 각각 3명(15%)이었으며 13 cm는 1명(5%)이었다. 2. 측방 조사야의 중심 이동은 자궁의 크기나 골반의 횡경과는 무관하였다. 3. 자기공명 영상을 이용한 방사선치료계획을 한 결과 전통적인 방법으로 결정된 전골반 측방 조사야의 변경이 20명 중 5명(25%)에서 있었으므로 향후 자궁 경부암이나 자궁 체부암의 정확한 치료를 위해서는 자기공명 영상이 매우 중요함을 시사하였으며 향후 더 많은 환자를 대상으로 자기공명 영상을 이용한 방사선치료 성적을 전통적인 방법에 의한 성적과 비교하는 연구가 요구된다.

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자궁경부암의 방사선치료성적 (Results of Radiotherapy for the Uterine Cervical Cancer)

  • 김철용;최명선;서원혁
    • Radiation Oncology Journal
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    • 제6권1호
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    • pp.63-73
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    • 1988
  • One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.

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방사선치료를 받은 암환자의 식욕상태 및 영양상태 변화양상 평가 (Assessment of Appetite and Nutritional Status in Cancer Patients Undergoing Radiation Therapy : A Prospective Study)

  • 소향숙
    • 대한간호학회지
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    • 제29권6호
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    • pp.1179-1191
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    • 1999
  • This study was conducted to identify appetite and nutritional status of 48 cancer patients who have been irradiated over 150$\textrm{cm}^2$ on chest or pelvic area over the three-month period. The data were gathered 3 phases, Each from initiation to completion of radiotherapy through the questionnaires of anorexia, the anthropometric and biochemical measures were used such as weight, TSF, MAC, MAMC, serum albumin and hemoglobin, TLC. Using SAS program, data were analyzed by percentage, Mean$\pm$SD, and two-way repeated measures ANOVA. The results were summarized as follows : 1. Eighty five percent(85%) of the subjects were aged from fifties to sixties. Cancers in the chest area occurred in 100% of men, 56% of the all subjects. The other 44% were pelvic cancer and 71% of the pelvic cancer occurred in women. 2. There were no significant differences in the appetite scores by all groups(characteristics). Changes of the appetite score over time were statistically significant by age, sex, cancer areas staging, treatment modality, and radiation dosage (F=4.0, p=.022; t=6.09, p=.003; t=4.90, p=.009; F=3.28, p=.042; t=5.04, p=.0084; t=4.76, p=.011). The appetite score on the 2nd phase (4 weeks after initiating radiotherapy) decreased from the 1st phase (initiating irradiation), and then increased on the 3rd phase (completing irradiation). 3. There were no significant differences in the body weight and MAMC by all characteristics, and no changes in the body weight and MAMC over time. However there were significant differences of TSF, MAC, level of hemoglobin, level of albumin, and TLC by all characteristics during the three phases. TSF of the men and the chest cancer were lower than those of the women and the pelvic cancer (t=73.20, p=.0001; t=22.91, p=.0001). And there was significant difference by cancer staging(F=3.19, p=.050). But there was no change in TSF over time. MAC of the men and the chest cancer were lower than those of the women and the pelvic cancer each(t=9.23, p=.004; t=17.85, p=.0001). But no change in MAC over time. Levels of hemoglobin had significant differences by age, sex and cancer areas; levels of hemoglobin of older than the fifties, men, and chest area were higher than those on the others(F=3.82, p=.029; t=21.75, p=.0001; t=8.71, p=.005). Levels of albumin were significant differences by sex and cancer areas; levels of albumin on women, and pelvic area were higher than those on the others(t=6.34, p=.015; t=15.23, p=.0003). While the levels of hemoglobin were changed over time, levels of albumin were not changed and within normal limit. TLC of the men was higher than women(t=5.05, p=.029). Changes in the level of hemoglobin over time were statistically significant according to sex, cancer areas, and radiation dosage(t=3.49, p=.035; t=3.36, p=.039; t=4.04, p=.021).

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골반 방사선치료 시 소장의 위치변화를 위한 벨리보드의 유용성 (Effectiveness of Bellyboard Device for Displacement of Small Bowel in Pelvic Irradiation)

  • 이레나;이경자;서현숙
    • 한국의학물리학회지:의학물리
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    • 제18권4호
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    • pp.202-208
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    • 2007
  • 골반 방사선치료 시 방사선조사부위에서 소장을 제외하여 방사선에 의한 소장의 독성 감소에 가장 효율적인 방법을 알아보기 위하여 본 연구가 시행되었다. 연구대상은 자궁경부암, 자궁내막암, 직장암, S-결장암과 난소암으로 수술 후 골반에 방사선치료를 받은 환자 14명이다. 환자는 모의치료를 시행하기 1시간 30분 전에 150 ml의 바륨과 방광을 채우기 위해 물 500 ml를 마시고 환자의 자세변화와 벨리보드 사용 유무에 따라 5종류의 조영촬영을 하였다. 첫 번째는 방광을 채운 후 누운 자세로 전 후면과 측면을 촬영한다. 두 번째는 방광을 채운 상태에서 엎드린 자세로, 세 번째는 방광을 비운 후 누운 자세로, 네 번째는 방광을 비운 후 엎드린 자세로, 다섯 번째는 방광을 비운 후 벨리보드를 사용하여 엎드린 자세로 각각의 전 후면과 측면을 촬영한다. 모든 조영촬영 사진에서 방사선조사부위에 포함되는 소장의 용적을 측정하였다. 결과는 방광을 채우거나 비운상태 모두 엎드린 자세가 누운 자세보다 소장의 용적이 감소되었으며 특히 측면사진에서 더욱 감소되었다. 엎드린 자세에서는 방광을 채운 상태의 소장 용적이 방광을 비운상태에 비해 전후면 사진에서 13%, 측면 사진에서 26%가 감소되었다. 방광을 비운 후 벨리보드를 사용한 상태의 소장 용적이 벨리보드를 사용하지 않고 엎드린 자세에 비해 전 후면에서 $62.8{\pm}27.1%$, 측면에서 $63{\pm}32.9%$가 감소되었다. 결론적으로 골반에 방사선치료를 시행할 경우 방광을 비운 후 벨리보드를 사용함으로써 소장의 용적을 최소화시킬 수 있었다.

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PNF 어깨뼈-골반 패턴이 편마비 환자의 보행에 미치는 영향 -증례보고- (The Influence of Scapular-Pelvic Patterns of Proprioceptive Neuromuscular Facilitation on Hemiplegic Gait -A Case Report-)

  • 최재원;황신필
    • PNF and Movement
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    • 제16권1호
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    • pp.27-32
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    • 2018
  • Purpose: This study examined changes in gait speed and stride length after an intervention involving simultaneous scapular and pelvic patterns of proprioceptive neuromuscular facilitation in a hemiplegic patient. Methods: A 58-year-old woman with left hemiplegia who had complained of slowness of gait speed and weakness of leg strength took part in an intervention involving scapular postdepression patterns on the affected side and pelvic postdepression patterns on the nonaffected side. The intervention was performed with the patient lying on her left side, in a half kneeling position, and in a standing posture. Rhythmic initiation was used for teaching the movements to the patient and improvement of kinesthesia, and a combination of isotonic was employed for increasing strength and irradiation of the scapula and pelvic movement. The intervention took place for 30 min. It was implemented twice a day, 5 days a week, for 3 weeks. After three repetitions, the average time taken to complete the 10-m walk test (10 MWT), in addition to stride length, was measured to determine gait speed. Results: After the 3-week program, the patient's performance in the 10 MWT improved from 21.7sec to 17.1sec, and her stride length improved from 31.4cm to 38.7cm. Conclusion: The results showed that trunk movement exercise, especially coordinative movements of the scapula and pelvis can improve gait speed and stride length by increasing trunk stability and mobility. A combination of pelvic and scapular patterns can facilitate trunk rotation, thereby improving gait speed and stride length.