• Radiation Oncology Journal
• /
• 제35권3호
• /
• pp.249-256
• /
• 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
• /
• 제17권4호
• /
• pp.1349-1364
• /
• 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.

• 대한방사선치료학회지
• /
• 제9권1호
• /
• pp.40-45
• /
• 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.

• 한국콘텐츠학회논문지
• /
• 제7권12호
• /
• pp.139-144
• /
• 2007

안와 림프종의 치료에 가장 효과적인 치료법인 방사선 치료는 안구 질환의 증가로 인해 계속 늘어나는 추세이다. 항암화학요법과 치료 기술의 비약적인 발전으로 치료 및 예후가 좋아지고는 있지만 백내장, 안구건조, 망막병증 등의 부작용이 발생되고 있다. 이에 본 연구에서는 안와 림프종의 방사선치료 시 백내장 발생의 방어수단으로써 Lens Shielding Device(이하 LSD)를 고안 제작하였고 이의 제작방법과 방사선 차폐 정도에 대해 알아보았다. 안구 표면에 해당하는 깊이에서 TLD의 측정결과는 3개의 평균값이 5.7%로 나타났고 관심부위인 수정체의 위치에서는 TLD 4.2%, markus chamber 5.1%의 선량값을 나타내었다. 본 연구에서 안와에 발생한 림프종의 방사선 치료로 인한 부작용을 예방하기 위해 제작한 LSD는 치료 중 조사받게 되는 총 30Gy의 선량 중에서 5%에 해당하는 약 1.5Gy의 방사선량만이 수정체와 각막에 영향을 미치는 것으로 확인되어 백내장의 역치선량인 2Gy와 임상적으로 백내장이 발생된다고 보고된 5Gy보다 적은 선량이 조사됨을 알 수 있었다. 방사선 치료 시 발생할 수 있는 여러 부작용의 예방에 유용한 기구임을 확인하였고 환자의 안구와 일치되도록 개인별로 제작하여 착용 시 이물감에 의한 불편을 줄일 수 있을 뿐만 아니라 치료 시 고정 또한 매우 용이함을 검증하였다.

• Journal of the Korean Data and Information Science Society
• /
• 제17권3호
• /
• pp.889-904
• /
• 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.

• 한국안광학회지
• /
• 제1권2호
• /
• pp.1-6
• /
• 1996

실명의 제일 흔한 원인은 백내장이다. 백내장의 원인은 아직 확실하게 규명되지는 않았으나, 유발 원인으로 방사선, 당의 대사장애, 약물, 외상, 영양물질의 불균형, 선천성, 눈의 질환으로 인해 2차적으로 발생하는 백내장 등등이 있다. 일반적으로, 수정체 섬유의 산화가 수정체의 혼탁을 유발 시키는 주원인으로 알려져 있다. 수정체가 투명도를 유지하기 위해서는 수정체 섬유의 구조가 완전 하여야 한다. 수정체 섬유에 고분자 단백질의 양이 증가하면 수정체 섬유는 혼탁해 진다. 수정체 섬유내 단백질의 변화는 칼슘 이온과 관계가 깊다. 만약 칼슘 이온이 수정체 섬유내 알파-크리스탈린 단백질에 결합되면 수정체 섬유에는 고분자 단백질들이 많이 형성되어 수정체 섬유는 혼탁해 진다. 만약 칼슘 이온이 알파-크리스탈린 단백질에서 떨어져 나가면 수정체 섬유에는 저분자 단백질로 이루어지게 되므로 수정체 섬유는 다시 투명해 진다. 이 논문에서는 노인성 백내장의 발병이 연령의 증가와 복합하여 백내장을 유발시키는 여러 발병인자를 찾는데 앞으로도 더 많은 노력이 필요하다는 것을 알 수 있으며, 당뇨병 환자에서 혈당과 삼투압이 백내장의 발생에 어떠한 영향을 미치는지와 백내장의 발생기전을 알아 보고자 하였다.

• Journal of Yeungnam Medical Science
• /
• 제7권2호
• /
• pp.115-120
• /
• 1990

18MeV 선형가속기와 코발트 원격치료기를 사용하여 방사선 조사면적 내에 차폐물이 있는 경우, 차폐물에 의한 산란선이 선량분포에 미치는 영향에 관하여 고찰하여 다음과 같은 결과를 얻었다. 1. 차폐물이 이루는 각이 예각일수록 산란선의 효과는 더 크게 나타났다. 2. 차폐물의 넓이가 좁을수록 산란선의 효과는 더 크게 나타났다. 3. 조사면적에 따른 출력특성은 선형적이지만, 차폐물에 의한 출력특성은 조사면적에 대하여 선형가속기는 거의 무관하게 나타났으며, 코발트 원격치료기는 기울기가 적은 선형성을 나타내었다.

• 대한방사선치료학회지
• /
• 제14권1호
• /
• pp.89-94
• /
• 2002

I. 목적 : Sebaceous gland carcinoma, Squamouse cell ca., basal cell ca., low grade MALToma 등에서 전자선을 이용하여 eyelid 치료시 안구의 선량은 될 수 있는 한 최소선량으로 관리되어야 한다. 그러나 upper나 lower eyelid 전부를 포함하는 조사면은 치료후 백내장등의 심각한 부작용을 만들어 낼 수 있다. 본원에서는 상용되는 Tungsten eyeball shielding block과 기존의 lead block에 의한 차폐시 안구의 선량을 비교하여 Tungsten eyeball shielding block의 유용성에 대해 평가해 보고자한다. 2. 재료 및 방법: 시판되고 있는 BOLX-I 물질을 이용하여 모형안구를 제작하고 안구의 6곳 주요지점을 선정한 후 TLD chip을 이용하여 주로 사용되는 6MeV와 9MeV electron beam의 선량을 측정, Tungsten eyeball shielding block과 lead block의 선량을 비교하였다. 3. 결과 : Tungsten eyeball shielding block의 사용이 안구의 주요 지점인 각막, 망막, 시신경부위의 선량을 lead block사용 때보다 $90\%$에서 $50\%$의 감소효과가 있었다. 4. 결론 : Tungsten eyeball shielding block은 6MeV 전자선 치료시 보다 뛰어난 차폐효과를 보여 임상에서의 유용성이 인정되었다. 그러나 안구에 삽입시 환자의 고통과 불쾌감을 줄일 수 있는 방안이 모색되어야 하는 숙제를 남겼다.

• Radiation Oncology Journal
• /
• 제34권2호
• /
• pp.121-127
• /
• 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
• /
• 제17권7호
• /
• pp.3643-3646
• /
• 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.