331 patients of stage IIb uterine cervix cancer trated by radiation alone at Kosin Medical Center between June 1980 and Dec. 1985 were analysed to determine parameters of radiotherapy associated to disease states. Survival rate was highest among the reported ($82.8{\%}$ for crude and $82.4{\%}$ for disease free survival). Pelvic control rate in 6 weeks after the end of radiotherapy was $93.6{\%}$ in the patients treated with ICR following total pelvic radiation and $71.6{\%}$ with small field additional external irradiation. 5 year survival rate in those who achieved pelvic control was $98.9{\%}$ and $12.9{\%}$ in those who had pelvic failure and/or metastasis after radiation. The survival rate figured maximal $88.5{\%}$ with dosage of $7500{\~}8500$ cGy to point A with acceptable incidence of complications ($4.9{\%}$) but without increasing survival above it and minimal $74.1{\%}$ with dosage of less than 6500 cGy. The treatment failure was counted $18.7{\%}$ (62 of 331 patients): Local failure $72.6{\%}$ (45 of 62 patients), locoregional failure $3.2{\%}$ (2 of 62 patients) and distant failure $24{\%}$ (15 of 62 patients). Late complications were found in 50 patients ($15.1{\%}$) and $42{\%}$ of them was rectal bleeding and stenosis. The dose of 8500 cGy to point A was found to be critical for complication and $70{\%}$ of complications occurred above it and was more serious one such as fistula. Rectal complications were developed above rectal dose 6500 cGy and bladder complication above bladder dose 7500 cGy. Major cause of death was cachexia due to locoregional failure ($73.7{\%}$ of death), next was due to metastasis to lung, liver and bone, and only 3 patients died of complication of intestinal perforations and obstruction. In conclusion higher external radiation dose for a bulky uterine cervix and barrel shaped uterus was essential for local control.
The Journal of Korean Society for Radiation Therapy
/
v.19
no.2
/
pp.107-112
/
2007
Purpose: The pelvic phantom was fabricated in the following purposes: (1) Dose verification of IMRT plan using Eclipse planning computer, (2) to study the interface effect at the interface between rectal wall and air. The TLD can be inserted in the pelvic phantom to confirm the dose distribution as well as uncertainty at the interface. Materials and Methods: A pelvic phantom with the dimension of 30 cm diameter, 20 cm height and 20 cm thickness was fabricated to investigate the dose at the rectal wall. The phantom was filled with water and has many features like bladder, rectum, and prostate and seminal vesicle (SV). The rectum is made of 3 cm-dimater plastic pipe, and it cab be blocked by using a plug, and film can be inserted around the rectal wall. The phantom was scanned with Philips Brillance scanner and various organs such as prostate, SV, and rectal wall, and bladder wall were delineated. The treatment parameters used in this study are the same as those used in the protocols in the SNUH. TLD chips are inserted to the phantom to evaluate the dose distribution to the rectal wall (to simulate high dose gradient region), bladder wall and SV (to simulate the high dose region) and 2 spots in anterior surface (to simulate the low dose region). The TLD readings are compared with those of the planning computer (ECLIPSE, Varian, USA). Results: The target TLD doses represented as the prostate and SV show excellent agreements with the doses from the RTP within +/-3%. The rectal wall doses measured at the rectal wall are different from the those of the RTP by -11%. This is in literatures called as an interface effect. The underdosages at the rectal wall is independent of 3 heterogeneity correction algorithm in the Eclipse RTP. Also the low dose regions s represented as surface in this study were within +/-1%. Conclusion: The RTP estimate the dosage very accurately withihn +/-3% in the high dose (SV, or prostate) and low dose region (surface). However, the dosage at the rectal wall differed by as much as 11% (In literatures, the underdosage of 9$\sim$15% were reported). This range of errors occurs at the interface, for example, at the interface between lung and chest wall, or vocal cord. This interface effect is very important in clinical situations, for example, to estimate the NTCP (normal tissue complication probability) and to estimate the limitations of the current RTP system. Monte-carlo-based RTP will handle this issue correctly.
The ultimate goal of radiation treatment is to use enough radiation dosage in order to examine a tumor while protecting normal tissue. Respiratory guided radiotherapy is being clinically implemented to examine a given stabilized area in order to compensate for the problems of patient breathing. This study investigates the effects of breathing movements on 40 patients with liver cancer through the actual radiation therapy plan using 4D-CT and respiratory guided radiotherapy using RPM. Using a commercial RPM respiratory gating system 4D-CT, we acquired 4D CT on multislice helical CT scanners that use different approaches to 4D CT image reconstruction. The results from analyzing forty patients according to age and direction showed no relationship between gender and transition change. The mean left-right, anteroposterior, and craniocaudal total movements were $3.19{\pm}1.29$, $5.44{\pm}2.07$, and $12.54{\pm}4.70$ mm, respectively. Changes were the largest with CC directions and as patients advanced in age, movements were larger. Therefore, as changes occur in treatment areas because of movements caused from breathing, respiratory gating system is put into operation to revise movement and can increase the radiotherapeutics effects in treating liver cancer.
Lee Sam-Sun;Kang Beom-Hyun;Choi Hang-Moon;Jeon In-Seong;Heo Min-Suk;Choi Soon-Chul
Imaging Science in Dentistry
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v.30
no.4
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pp.275-279
/
2000
Purpose: Radiation damage is produced and viable cell number is reduced. We need to know the type of cell death by the ionizing radiation and the amount and duration of cell cycle arrest. In this study, we want to identified the main cause of the cellular damage in the oral cancer cells and normal keratinocytes with clinically useful radiation dosage. Materials and Methods: Human gingival tissue specimens obtained from healthy volunteers were used for primary culture of the normal human oral keratinocytes (NHOK). Primary NHOK were prepared from separated epithelial tissue and maintained in keratinocyte growth medium containing 0.15 mM calcium and a supplementary growth factor bullet kit. Fadu and Hep-2 cell lines were obtained from KCLB. Cells were irradiated in a /sup 137/Cs γ-irradiator at the dose of 10 Gy. The dose rate was 5.38 Gy/min. The necrotic cell death was examined with Lactate Dehydrogenase (LDH) activity in the culture medium. Every 4 day after irradiation, LDH activities were read and compared control group. Cell cycle phase distribution and preG1-incidence after radiation were analyzed by flow cytometry using Propidium Iodine staining. Cell cycle analysis were carried out with a FAC Star plus flowcytometry (FACS, Becton Dickinson, USA) and DNA histograms were processed with CELLFIT software (Becton Dickinson, USA). Results: LDH activity increased in all of the experimental cells by the times. This pattern could be seen in the non-irradiated cells, and there was no difference between the non-irradiated cells and irradiated cells. We detected an induction of apoptosis after irradiation with a single dose of 10 Gy. The maximal rate of apoptosis ranged from 4.0% to 8.0% 4 days after irradiation. In all experimental cells, we detected G2/M arrest after irradiation with a single dose of 10 Gy. Yet there were differences in the number of G2/M arrested cells. The maximal rate of the G2/M ranges from 60.0% to 80.0% 24h after irradiation. There is no significant changes on the rate of the G0/G1 phase. Conclusion: Radiation sensitivity was not related with necrosis but cell cycle arrest and apoptosis. These data suggested that more arrested cell is correlated with more apoptosis.
Background: Although many clinicians know about the reducing effects of the pulsed and low-dose modes for fluoroscopic radiation when performing interventional procedures, few studies have quantified the reduction of radiation-absorbed doses (RADs). The aim of this study is to compare how much the RADs from a fluoroscopy are reduced according to the C-arm fluoroscopic modes used. Methods: We measured the RADs in the C-arm fluoroscopic modes including 'conventional mode', 'pulsed mode', 'low-dose mode', and 'pulsed + low-dose mode'. Clinical imaging conditions were simulated using a lead apron instead of a patient. According to each mode, one experimenter radiographed the lead apron, which was on the table, consecutively 5 times on the AP views. We regarded this as one set and a total of 10 sets were done according to each mode. Cumulative exposure time, RADs, peak X-ray energy, and current, which were viewed on the monitor, were recorded. Results: Pulsed, low-dose, and pulsed + low-dose modes showed significantly decreased RADs by 32%, 57%, and 83% compared to the conventional mode. The mean cumulative exposure time was significantly lower in the pulsed and pulsed + low-dose modes than in the conventional mode. All modes had pretty much the same peak X-ray energy. The mean current was significantly lower in the low-dose and pulsed + low-dose modes than in the conventional mode. Conclusions: The use of the pulsed and low-dose modes together significantly reduced the RADs compared to the conventional mode. Therefore, the proper use of the fluoroscopy and its C-arm modes will reduce the radiation exposure of patients and clinicians.
Purpose: The current study investigates the feasibility of a platform for a nationwide dose monitoring system for dental radiography. The essential elements for an unerring system are also assessed. Materials and Methods: An intraoral radiographic machine with 14 X-ray generators and five sensors, 45 panoramic radiographic machines, and 23 cone-beam computed tomography (CBCT) models used in Korean dental clinics were surveyed to investigate the type of dose report. A main server for storing the dose data from each radiographic machine was prepared. The dose report transfer pathways from the radiographic machine to the main sever were constructed. An effective dose calculation method was created based on the machine specifications and the exposure parameters of three intraoral radiographic machines, five panoramic radiographic machines, and four CBCTs. A viewing system was developed for both dentists and patients to view the calculated effective dose. Each procedure and the main server were integrated into one system. Results: The dose data from each type of radiographic machine was successfully transferred to the main server and converted into an effective dose. The effective dose stored in the main server is automatically connected to a viewing program for dentist and patient access. Conclusion: A patient radiation dose monitoring system is feasible for dental clinics. Future research in cooperation with clinicians, industry, and radiologists is needed to ensure format convertibility for an efficient dose monitoring system to monitor unexpected radiation dose.
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.7
/
pp.3117-3122
/
2011
Skull A-P projections are the bi-product where the ESD (Entrance Surface Dose) for digital radiography is much higher than that conventional screen-film radiography. Therefore, the aim of this study was to reduce radiation doses to patients by using an added filter. This research focuses on the identification of the reduction of exposure to radiation based on the thickness of an added filter when applying the 'Skull A-P Projection' by using the 'Skull Phantom'. Also, an experiment was conducted to evaluate the qualitative decline of images through filtration. The measurement of one's exposed dose to radiation was executed by locating the 'Skull Phantom' on the position of the 'Skull AP,' while changing 16 kinds of added filters from 0.1 mmAl to 0.5 mmCu + 2.0 mmAl in terms of incident and penetrating doses. For the qualitative evaluation of images, a total number of 17 images have been acquired in the 'Skull Phantom' under the same conditions as those for the measurement of one's exposed dose. The acquired images have been evaluated by a radiological specialist. As a result, the images with a diagnostic value have been obtained by using such added filters as the compound filter of 0.2 mmCu +1.0 mmAl. The exposed dose absorbed on the 'Skull Phantom' is about 0.6 mGy. The value is only 12% of 5 mGy, the ESD value acquired on the 'Skull P-A Projection', which is recommended by the International Atomic Energy Agency (IAEA). As a result, depending on the parts of inspection, it is possible to reduce the patient's exposed dosage of radiation considerably by using an appropriate added filter.
This study examined the properties of photons and the dose distribution in a human body via a simulation where the total body irradiation(TBI) is performed on a pediatric anthropomorphic phantom and a child size water phantom. Based on this, we tried to find the optimal photon beam energy and material for beam spoiler. In this study, MCNPX (Ver. 2.5.0), a simulation program based on the Monte Carlo method, was used for the photon beam analysis and TBI simulation. Several different beam spoiler materials (plexiglass, copper, lead, aluminium) were used, and three different electron beam energies were used in the simulated accelerator to produce photon beams (6, 10, and 15 MeV). Moreover, both a water phantom for calculating the depth-dependent dosage and a pediatric anthropomorphic phantom for calculating the organ dosage were used. The homogeneity of photon beam was examined in different depths for the water phantom, which shows the 20%-40% difference for each material. Next, the org an doses on pediatric anthropomorphic phantom were examined, and the results showed that the average dose for each part of the body was skin 17.7 Gy, sexual gland 15.2 Gy, digestion 13.8 Gy, liver 11.8 Gy, kidney 9.2 Gy, lungs 6.2 Gy, and brain 4.6 Gy. Moreover, as for the organ doses according to materials, the highest dose was observed in lead while the lowest was observed in plexiglass. Plexiglass in current use is considered the most suitable material, and a 6 or 10 MV photon energy plan tailored to the patient condition is considered more suitable than a higher energy plan.
Objective: The low level lasers currently in the market vary in wavelength, dosage, and frequency. These devices are used with much different clinical pathology. Most notably, some studies claim that wounds heal faster with low level laser therapy due to the fact that bacteria commonly found in wounds are killed by laser light. Systemic and meta-analysis studies found the difficulty of comparison of numerous research studies because of differences in the intensities and frequencies of low level laser treatment (LLLT). The purpose of this study was to determine the effectiveness of LLLT on controlling bacterial growth. Design: Cross-sectional study. Methods: Variables included LLLT dosage and wavelength on 3 bacteria commonly seen in wounds, strains of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were used on commercially available 5.0-cm agar plates. Blue, green, and red, ultraviolet (UV) and infrared laser light sources were adjusted to either low or high intensity settings. Five Petri dishes at a time were placed directly beneath laser light sources with the exception of UV which was placed six inches below the suspended light and infrared which was placed directly on top of the Petri dish lid. Each group of five Petri dishes was irradiated for 15 minutes. Results: The results showed no effect of any of 9 different LLLT intensities or colors on bacteria growth compared to sham light. Conclusions: At least for claims of bacterial growth inhibition with LLLT, no support for this claim can be found here.
In an effort to improve the major tree species in Korea, the seed of Robinia pseudoacacia, Pinus rigida, Pinus densiflora, Pinus thunbergii and Larix leptolepis were treated with X-ray and thermal neutron at the Brookhaven National Laboratory, and germination rate of the seed and some characteristics of the seedlings from irradiated seed were investigated and the results were summarized as follows. 1. The germination rate of the irradiated seed of Robinia pseudoacacia, Pinus densiflora, Pinus thunbergii and Pinus rigida was decreased, when the irradiation time of thermal neutron increased from 3 hours to 9 hours. The seed of Larix leptolepis was completely died out in all range of irradiation time. 2. The seed of Pinus densiflora, Robinia pseudoacacia and Pinus rigida showed low germination rate, when the dosage of radiation increased in the range of 10,000r-30,000r X-ray. This dosage of radiation was almost lethal to the seed of Pinus thunbergii and Larix leptolepis. 3. The growth rate of radiated Robinia pseudoacacia has been decreased when the dosage of X-ray and thermal neutron increased. However, the trees treated with thermal neutron for 3 hours showed 14.9 percent-increase in seedling height and some thornless individuals appeared in this treatment. 4. Individuals with variegated leaf, rugose leaf and albino were appeared in X-ray and thermal neutron treatment. 5. Abnormal mitosis of somatic cell, cell with two nucleoli, cell with two nuclei and chromosome clump in mitosis of somatic cell were observed in Robinia pseudoacacia irradiated with thermal neutron. 6. Resistanty against pawdery mildew was decreased in Robinia pseudoacacia radiated with X-ray and thermal neutron. 7. Length of stomata did not show any difference however number of stomata per unit area decreased in Robinia pseudoacacia radiated with thermal neutron. The leaves of Robinia pseudoacacia radiated with thermal neutron were thicker than those of non-treated one, but width of palisade tissue was decreased. The most sensitive one among those species to the thermal neutron treatment was Larix leptolepis, followed by Pinus densiflora, Robinia pseudoacacia, Pinus thunbergii and Pinus rigida in the order. In X-ray treatment, the most sensitive one was Larix leptolepis, followed by Pinus densiflora, Pinus thunbergii, Pinus rigida and Robinia pseudoacacia in the order. Morphological, cytological variation of the radiated Robinia pseudoacacia seemed to indicate some possibility to be used for tree improvement.
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