• Radiation Oncology Journal
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• v.35 no.3
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• pp.249-256
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• 2017

Purpose: We retrospectively reviewed the results of radiotherapy for localized ocular adnexal MALT lymphoma (OAML) to investigate the risk factors of cataract. Methods: Sixty-seven patients with stage IE OAML treated with radiotherapy at Seoul St. Mary's Hospital from 2001 to 2016 were included. Median treatment dose was 30 Gy. Lens protection was done in 52 (76%) patients. Radiation therapy (RT) extent was as follows: superficial (82.1%), tumor mass (4.5%), and entire orbital socket (13.4%). The risk factors for symptomatic cataract were analyzed using the Cox proportional hazard model. Results: Median follow-up time was 50.9 months (range, 1.9 to 149.4 months). All patients were alive at the time of analysis. There were 7 recurrences and there was no local recurrence. Median time to recurrence was 40.4 months. There were 14 cases of symptomatic cataract. Dose >30 Gy had hazard ratio of 3.47 for cataract (p = 0.026). Omitting lens protection showed hazard ratio of 4.10 (p = 0.008). Conclusions: RT achieves excellent local control of ocular MALT lymphoma. Consideration of RT-related factors such as lens protection and radiation dose at the stage of RT planning may reduce the risk of RT-induced cataract after radiotherapy.

• Journal of the Korean Data and Information Science Society
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• v.17 no.4
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• pp.1349-1364
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• 2006

An analytic approach that provides explicit estimates of risk on cataract and epilation data is evaluated by reasonableness of conceivable relative risk models regarding a simple, odds, logistic or Gompertz regression method, assuming a binomial distribution. In these analyses, we apply relative risk models with two thresholds between epilators and nonepilators from a highly characteristic lesion of which radiation cataract does not occur around 2 gray for a single acute exposure. The risk models are fitted to the data assuming 10 as a constant relative biological effectiveness of neutron. The likelihood of observing the entire data set in these models fitted is evaluated by an individual binary-response array. Estimation of a threshold with or without severe epilation and the 100 ($1-\alpha$)% confidence limits are derived from the maximum likelihood approach. The relative risk model with two thresholds can be expressed as a formula with structure of Background $\times$ RR, where RR includes threshold models with or without epilation. The radiosensitivity of ionizing radiation to cataracts has been examined for the relationship between epilators and nonepilators.

• The Journal of Korean Society for Radiation Therapy
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• v.9 no.1
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• pp.40-45
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• 1997

When therapeutic irradiation is indicated for the orbital tumors, the greatest concern is the risk of radiation-induced cataract. Conjunctival lymphoma is one of the good examples. We would like to report the procedure of the lens shielding device(L.S.D) and the result of irradiated dose to the lens. L.S.D. consistes of two parts : load alloy to attenuate electron beam, and dental acryl which completely covers the lead alloy to avoid discomfort of cornea from contacting directly with cerrobend and side scattering by cerrobend. And for easy location and removal, side bars were made on each side. Radiation doses were meaured with TLD(TLD 3500 Hawshaw). Markus chamber in a polystyrene phantom. The phantom was irradiated with 9MeV electron beams from Clinac 2100C with $6{\times}6cm$ electron cone. The relative dose at 6mm depth where the lens is located was $4.2\%$ with TLD and $5.1\%$ with Markus chamber clinically when 2600 cGy are irradiated to the eyeball, the mapinary dose to the lens will be 109 cGy or 132 cGy, which will significently reduce the cataract.

• The Journal of the Korea Contents Association
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• v.7 no.12
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• pp.139-144
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• 2007

Radiotherapy which is the most effective for orbit lymphoma has been used increasingly due to the increase of orbit or ocular adnexal tumor patients. Curative effects and convalescence have been being more satisfied thanks to remarkable development of cancer chemotherapy and medical treatments, but side effects such as cataract, dry eye and retinopathy still break out. Thus, in this study, a Lens Shielding Device (LSD hereafter) was designed to prevent occurring of cataract due to radiation therapy for orbit lymphoma and its efficacy through dosimetry were evaluated. And in this paper, its manufacturing process was also explained. LSD is composed of a cover body covering the lens and a side fixing part supporting the cover body. To measure radiation, the patient therapy conditions were simulated and the measurement of the radiation was conducted with Thermo Luminescence Detector (TLD) and Markus chamber. The average TLD value was 5.7% and the TLD value and Markus chamber value were acquired as 4.2% and 5.1% respectively at 6 mm depth where zero lens center was located. Only 1.5Gy ($300Gy{\times}\;5%$) or 5% of total 30Gy with 9 MeV electron beam is estimated to affect on patient's lens. That is smaller dose than the threshold value of cataract (2GY) or the value (5Gy) that was reported to cause cataract in clinical conditions. Thus, these findings suggest that LSD be very useful for prevention of cataract during radiotherapy for malignant lymphoma of orbit and ocular adnexa. Furthermore, it might be possible to reduce patient's discomfort caused by alien substances and to make it easier to fix the device with customized manufacturing manners.

• Journal of the Korean Data and Information Science Society
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• v.17 no.3
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• pp.889-904
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• 2006

Our purpose is to ascertain, if possible, whether atomic bomb survivors with cataracts and epilation were more radiosensitive than those survivors with cataracts but without epilation. A major ophthalmologic survey was conducted in Hiroshima and Nagasaki in 1963-64. At that time, 2125 individuals were examined. Among these individuals, estimated eye organ doses, based on the DS86 dosimetry system, and information on the occurrence of epilation within the first 60 days following the bombings are available on 1742. In the analysis of these data we have assumed that each individual represents a sample of one from a binomial distribution, and that the occurrence of cataracts and epilation are independent biological phenomena. We got following results. The threshold for cataract induction and its 95% confidence limits have been estimated from data on the occurrence of cataract and epilation. Among the 1742 study subjects, 40 had both cataracts and severe epilation. The estimated threshold based on these cases is 0.98 sievert(Sv), with 95% lower and upper confidence bounds of 0.72, and 1.32 Sv, respectively, and is highly statistically significant. Among the 27 cases of cataracts where severe epilation was not reported, the estimated threshold is 1.74 Sv with 95% lower and upper confidence bounds of 1.21 Sv, and "not estimable". The difference between these two estimates is not statistically significant although the effect of dose is highly significant in both instances. The potential importance of biases in the DS86 dose estimates is discussed. The difference between the threshold estimated from cataract cases with epilation and that from cases without epilation is not statistically significant at the 5% or 10% level, and thus affords no support for the notion of increased radiosensitivity.

• Journal of Korean Ophthalmic Optics Society
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• v.1 no.2
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• pp.1-6
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• 1996

The most common cause of blindness is cataract. The possible causes, radiation, sugar, drugs, trauma, nutrition, congenital, secondary to eye disease etc. Generally, the opacification of the lens are the result fa oxidation of the lens fibers. The basis for lens transparency is the structural integrity of lens fibers. Opacities were occur if there is a significant amount of high molecular weight protein aggregates. If Ca ions combined with lens ${\alpha}$-crystallin proteins, the lens fibers were aggregated by high molecular weight proteins and the lens were opacified. If Ca ions detached from lens ${\alpha}$-crystallin proteins, the lens fibers were aggregated by low molecular weight proteins and the lens were re-cleared. We need to find out the variety of factors can initiated the process of age-related cataract. And to understanding the mechanism how the various kind, of diabetic cataracts occur.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.115-120
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• 1990

Scatter-air ratios are used for the purpose of calculating scattered dose in the medium. The computation of the primary and the scattered dose separately is particularly useful in the dosimetry of irregular fields with shielding block in radiation field, dose distribution of scattered radiation using 18MeV Linear accelerator and Co-50 teletherapy measured. The effect of scattered radiation dose by protecting block was been ignored in radiation therapy, 2-3% of scattered radiation may be 90-200 cGy which could be influence vitial complications such as cataract, oligospermia or sterility. So that exect calculation of such scattered radiation especially for large field $\bar{c}$ small protection of vitial organ is very important. The purpose of this article is to calculate scattered radiation by protecting block exactly for irregular field $\bar{c}$ Linac or Co-60 irradiation and to applicate these data in clinical radiation field. Authors could obtain following results. 1. The lesser angle between shielding block showed more scattered radiation. 2. With decreasing distance between shielding blocks, the dependent of scattered radiation were increased. 3. Output of 18MeV Linear accelerator and Co-60 was related linear proportion on field size, but independent according to the size of shielding block in 18MeV Linear accelerator.

• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.89-94
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• 2002

During radiation therapy with electron beam to eyelid, we must keep the minimal dose on eyeball as possible. especially in the treatment of Sebaceous gland carcinoma, Squamouse cell ca., and basal cell ca. of eyelid and low grade MALToma etc. But if radiation field covered the upper & lower eyelid, it makes a cataract on lens of treated eye, in late complications. Now we reports the advantages of Tungsten eyeball shielding block compare to previously used lead block. with BOLX-I material, we made a eyeball model and measured the absorbed dose of 6MeV & 9MeV electron hem at 6 point of eyeball model with TLD chip. And compare the absorbed dose to previously lead block and other types of Tungsten eyeball shielding block.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.121-127
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• 2016

Purpose: To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. Materials and Methods: From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Results: Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Conclusion: Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3643-3646
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• 2016

Management of eyelid cancers is based on surgery and/or radiotherapy (RT). The treatment objective is to control tumors with acceptable functional and esthetic outcomes. The aim of this study was to evaluate the results of radiation therapy in management of epithelial eyelid cancers, reviewing retrospectively the clinical records of patients treated in our institution from January 1989 to December 2013. We focused on clinical and histological features, treatment characteristics, tolerance and disease control. One hundred and eight patients (62 men and 46 women) were enrolled, with a mean age of 61 years [ranges 15-87]. The most frequent tumor location was the inner canthus (42.6%). Median tumor size was 21 mm [ranges 4-70]. Histological type was basal cell carcinoma in 88 cases (81.5%), squamous cell carcinoma in 16 (14.8%) and sebaceous carcinoma in 4 (3.7%). Radiation therapy was exclusive in 67 cases (62%) and post-operative for positive or close margins in the remaining cases. Kilovoltage external beam radiotherapy (KVRT) was used in 63 patients (58.3%) and low-dose-rate interstitial brachytherapy in 37 (34.3%). Eight (7.4%) were treated with cobalt or with a combination of KVRT-cobalt, KVRT-electron beams, KVRT-brachytherapy or cobalt-electron beams. The total delivered radiation doses were 70 Gy (2 Gy/fraction) in 62 patients (57.4%), 66 Gy (2 Gy/fraction) in 37 (34.3%) and 61.2 Gy (3.4Gy/fraction) in 9 (8.3%). After a median follow-up of 64 months, we noted 10 cases of local recurrences(9.2%): 7 after exclusive and 3 after post-operative RT. No local recurrence occurred in patients treated with brachytherapy. Actuarial 5-year local recurrence-free rate, disease-free survival and overall survival were respectively 90%, 90% and 97%. T-stage was found to be a significant factor for recurrence (p=0.047). All acute radiation-related reactions were scored grade I or II. Delayed effects were eye watering in 24 cases (22.2%), eye dryness in 19 (17.6%), unilateral cataract in 7 (6.4%) and ectropion in 4 (3.7%). Radiation therapy and especially brachytherapy is an efficient treatment of eyelid cancers, allowing eye conservation and functional preservation with good local control rates and acceptable toxicity.