• Radiation Oncology Journal
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• 제31권4호
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• pp.177-184
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• 2013

Purpose: The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Materials and Methods: Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. Results: The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Conclusion: Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

• Journal of Radiation Protection and Research
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• 제42권3호
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• pp.146-153
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• 2017

Background: Acute radiation syndrome (ARS) primarily refers to damage to the hematopoietic system, myeloid system, and gastrointestinal (GI) system caused by radiation exposure. Such damage progresses to become life-threatening. In particular, as the syndrome develops very rapidly-within several hours from radiation exposure-prompt and accurate diagnosis and treatment are needed, as is further research into appropriate diagnostic and treatment modalities. Materials and Methods: Minipigs, which display human-like properties, underwent whole-body irradiation at 2 or 4 Gy (doses causing hematopoietic ARS) or at higher doses of 7 or 12 Gy. Changes in the blood cells and clinical symptoms were analyzed and we performed a necropsy when the animals succumbed to ARS. Results and Discussion: The minipig irradiated with 2 Gy showed a decrease in white blood cells, including neutrophils, lymphocytes, and platelets in the early stages. However, the blood cell counts gradually increased and returned to normal values. The minipig irradiated with 4 Gy succumbed due to hematopoietic ARS. In contrast, the minipigs irradiated with 7 or 12 Gy exhibited clinical symptoms of combined GI damage and hematopoietic syndrome. Moreover, a characteristic pattern of platelet changes was observed in the 7 and 12 Gy irradiated minipigs. Conclusion: The changes in the platelet count caused by radiation exposure observed in minipigs, which are hematologically and pathohistologically similar to humans, suggest that they can be used as a novel diagnostic criterion.

• 방사선산업학회지
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• 제17권3호
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• pp.265-273
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• 2023

To effectively and safely manage the radiation exposure to nuclear power plant (NPP) workers in accidents, major overseas NPP operators such as the United States, Germany, and France have developed and applied realistic 3D model radiation dose assessment software for workers. Continuous research and development have recently been conducted, such as performing NPP accident management using 3D-VR based on As Low As Reasonably Achievable (ALARA) planning tool. In line with this global trend, it is also required to secure technology to manage radiation exposure of workers in Korea efficiently. Therefore, in this paper, it is described the application method and assessment results of radiation exposure scenarios for workers in response to accidents assessment technology, which is one of the fundamental technologies for constructing a realistic platform to be utilized for radiation exposure prediction, diagnosis, management, and training simulations following accidents. First, the post-accident sampling after the Loss of Coolant Accident(LOCA) was selected as the accident and response scenario, and the assessment area related to this work was established. Subsequently, the structures within the assessment area were modeled using MCNP, and the radiation source of the equipment was inputted. Based on this, the radiation dose distribution in the assessment area was assessed. Afterward, considering the three principles of external radiation protection (time, distance, and shielding) detailed work scenarios were developed by varying the number of workers, the presence or absence of a shield, and the location of the shield. The radiation exposure doses received by workers were compared and analyzed for each scenario, and based on the results, the optimal accident response scenario was derived. The results of this study plan to be utilized as a fundamental technology to ensure the safety of workers through simulations targeting various reactor types and accident response scenarios in the future. Furthermore, it is expected to secure the possibility of developing a data-based ALARA decision support system for predicting radiation exposure dose at NPP sites.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.223-235
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• 2021

Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to "radiotherapy" and synonyms combined with keywords related to "panoramic radiography" and "oral diagnosis" and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion: The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

• Radiation Oncology Journal
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• 제34권4호
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• pp.290-296
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• 2016

Purpose: Radiotherapy (RT) is considered a mainstay of treatment in parameningeal rhabdomyosarcoma (PM-RMS). We aim to determine the treatment outcomes and prognostic factors for PM-RMS patients who treated with RT. In addition, we tried to evaluate the adequate dose and timing of RT. Materials and Methods: Twenty-two patients with PM-RMS from 1995 to 2013 were evaluated. Seven patients had intracranial extension (ICE) and 17 patients had skull base bony erosion (SBBE). Five patients showed distant metastases at the time of diagnosis. All patients underwent chemotherapy and RT. The median radiation dose was 50.4 Gy (range, 40.0 to 56.0 Gy). Results: The median follow-up was 28.7 months. Twelve patients (54.5%) experienced failure after treatment; 4 local, 2 regional, and 6 distant failures. The 5-year local control (LC) and overall survival (OS) were 77.7% and 38.5%, respectively. The 5-year OS rate was 50.8% for patients without distant metastases and 0% for patients with metastases (p < 0.001). Radiation dose (<50 Gy vs. ${\geq}50Gy$) did not compromise the LC (p = 0.645). However, LC was affected by ICE (p = 0.031). Delayed administration (>22 weeks) of RT was related to a higher rate of local failure (40.0%). Conclusion: RT resulted in a higher rate of local control in PM-RMS. However, it was not extended to survival outcome. A more effective treatment for PM-RMS is warranted.

• Imaging Science in Dentistry
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• 제45권4호
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• pp.263-265
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• 2015

Cone-beam computed tomography (CBCT) is routinely recommended for dental diagnosis and treatment planning. CBCT exposes patients to less radiation than does conventional CT. Still, lack of proper education among dentists and specialists is resulting in improper referral for CBCT. In addition, aiming to generate high-quality images, operators may increase the radiation dose, which can expose the patient to unnecessary risk. This letter advocates appropriate radiation dosing during CBCT to the benefit of both patients and dentists, and supports moving from the concept of "as low as reasonably achievable" (ALARA) to "as low as diagnostically acceptable" (ALADA).

• Journal of Radiation Protection and Research
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• 제12권2호
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• pp.37-50
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• 1987

The exposure of the population in the United States to ionizing radiation has recently been evaluated by the National Council on Radiation Protection and Measurements (NCRP). This was done by constituting six organizational groups to address various phases of the work and the results of this work are summarized in this article. The article is based on the report, by the same title, which is scheduled for publication by the NCRP in September, 1987. The six organizational groups are titled Radiation Exposure from Consumer Products, Natural Background Radiation, Radiation Associated with Medical Examinations, Radiation Received by Radiation Employees, Public Exposure from Nuclear Power, and Exposure from Miscellaneous Environmental Sources. These titles are descriptive of the subject areas covered by each of these separate groups. The data evaluated are for the years 1977-1984 with the majority of the data being for the period 1980-1982. Summary information is presented and discussed for the number of people exposed to given sources, the effective dose equivalent, the average effective dose equivalent to the U.S. population, and the genetically significant dose equivalent. The average annual effective dose equivalent from all sources to the U.S. population is approximately 3.6 mSv (360 mrem). Exposures to natural sources make the largest contribution to this total. Radon and radon decay products contribute 2.0 mSv (200 mrem) whereas the other naturally occurring radionuclides contribute 1.0 mSv (100 mrem). Among man-made or enhanced sources, medical exposures make the largest additional contributions, namely 0.39 mSv (39 mrem) for diagnosis and 0.14 mSv (14 mrem) for nuclear medicine. It was not possible to evaluate exposures for therapy. Most of the other sources of population exposure, including nuclear power and consumer products, are minor. A possible exception would be the use of tobacco products. These exposures are discussed in relation to a negligible individual risk level of $10{\mu}Sv/y$ (1 mrem/y). The NCRP considers exposures below the negligible individual risk level as trivial and as such should be dismissed.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3873-3877
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• 2014

Melanoma of the skin is a malignant tumor, which incidence is still increasing. It was estimated that in the United States one person died from this cause every hour. The major risk factor of this disease is exposure to ultraviolet radiation, especially associated with the occurrence of sunburns. Patients diagnosed with distant metastases have median survival of 6-9 months. The aim of this paper was to identify the causes of delayed diagnosis of melanoma as diagnosis at an early stage seems to be the key to improve the survival rates. For this purpose, a search of medical databases such as PubMed, Google Scholar and Cancer Registers was conducted and an analysis of the literature from the years 1979-2013 was conducted.

• 한국임상보건과학회지
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• 제2권2호
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• pp.133-147
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• 2014

Purpose. Radiation therapy for oncologic emergencies is an important modality in the management of cancer patients. The aim of the present study was to review the roles of RT in oncologic emergencies based on literature review. Methods. The oncologic emergencies requiring rapid treatment include superior vena cava syndrome, spinal cord compression, brain metastasis, and bone metastasis. We reviewed the literatures on the pathophysiology, diagnosis, and treatment of oncologic emergencies. Results. In this literature review, radiation therapy among treatment modalities for oncologic emergencies has been shown to be fast and very effective treatment modality for oncologic emergencies. Conclusions. Based on this review, we conclude that the literature provides support for the role of radiation therapy in the situation of oncologic emergencies. As the number of cancer patients increase, the prevalence of oncologic emergencies will increase. In the future, the development of RT techniques will provide the improvement of not only patient's quality of life but also the survival.

• Journal of Radiation Protection and Research
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• 제40권1호
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• pp.36-45
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• 2015

by providing objective information regarding medical radiation for elementary, middle, and high school students in Korea, who are expected to have a high ripple effect in education, and by analyzing behavioral changes in the selection of medical radiation, this study aimed to deduce the basis for educational intervention. The tools used in the study were a questionnaire, including questions about perception, knowledge, attitude, and behavior toward medical radiation; video and Power-point materials for the lesson; simulated radiation diagnosis selection form; and radiation treatment selection form to find out about behavior. A post-test demonstrated that the objective knowledge about medical radiation of all the students turned out to be significantly higher (p<0.000) after the lesson compared to before the lesson. However, there were no statistically significant behavioral changes. Rather, for high school students, the behavior of selecting medical radiography and treatment was significantly lower (p<0.000) after the lesson. For the more impressionable children in the lower grades, the lesson must not only provide an opportunity to understand and pay attention to diverse viewpoints, but also encourage them to make ethical decisions based on value. Since it can be predicted that attitude or behavioral changes through education or publicity can be expected from adults older than high school students, issues regarding dangers like radiation exposure must be treated as an issue of value judgment predicated on multifaceted considerations.