• Title/Summary/Keyword: Volume per Dose

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Novel biological strategies to enhance the radiation therapeutic ratio

  • Kim, Jae Ho;Jenrow, Kenneth A.;Brown, Stephen L.
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.172-181
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    • 2018
  • Successful anticancer strategies require a differential response between tumor and normal tissue (i.e., a therapeutic ratio). In fact, improving the effectiveness of a cancer therapeutic is of no clinical value in the absence of a significant increase in the differential response between tumor and normal tissue. Although radiation dose escalation with the use of intensity modulated radiation therapy has permitted the maximum tolerable dose for most locally advanced cancers, improvements in tumor control without damaging normal adjacent tissues are needed. As a means of increasing the therapeutic ratio, several new approaches are under development. Drugs targeting signal transduction pathways in cancer progression and more recently, immunotherapeutics targeting specific immune cell subsets have entered the clinic with promising early results. Radiobiological research is underway to address pressing questions as to the dose per fraction, irradiated tumor volume and time sequence of the drug administration. To exploit these exciting novel strategies, a better understanding is needed of the cellular and molecular pathways responsible for both cancer and normal tissue and organ response, including the role of radiation-induced accelerated senescence. This review will highlight the current understanding of promising biologically targeted therapies to enhance the radiation therapeutic ratio.

Comparison of the Dose Distributions with Beam Arrangements in the Stereotactic Body Radiotherapy (SBRT) for Primary Lung Cancer (원발성 폐암에서 정위적 체부 방사선치료의 빔 배열에 따른 선량분포의 비교)

  • Yea, Ji Woon
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.110-115
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    • 2014
  • To compare 2 beam arrangements, circumferential equally angles (EA) beams or partially angles (PA) beams for stereotactic body radiation therapy (SBRT) of primary lung cancer for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) delivery techniques with respect to target, ipsilateral lung, contralateral lung, and organs-at-risk (OAR) dose-volume metrics, as well as treatment delivery efficiency. Data from 12 patients, four treatment plans were generated per data sets ($IMRT_{EA}$, $IMRT_{PA}$, $VMAT_{EA}$, $VMAT_{PA}$). The prescribed dose (PD) was 60 Gy in 4 fractions to 95% of the planning target volume (PTV) for a 6-MV photon beam. When compared with the IMRT and VMAT treatment plan for 2 beams, conformity index, homogeneity index, high dose spillage, D2 cm (Dmax at a distance ${\geq}2cm$ beyond the PTV), R50 (ratio of volume circumscribed by the 50% isodose line and the PTV), resulted in similar. But Dmax of the Organ at risk (OAR), spinal cord, trachea, resulted in differ between four treatment plans. Especially $HDS_{location}$ showed big difference in 21.63% vs. 26.46%.

Dosimetric and Radiobiological Evaluation of Dose Volume Optimizer (DVO) and Progressive Resolution Optimizer (PRO) Algorithm against Photon Optimizer on IMRT and VMAT Plan for Prostate Cancer

  • Kim, Yon-Lae;Chung, Jin-Beom;Kang, Seong-Hee;Eom, Keun-Yong;Song, Changhoon;Kim, In-Ah;Kim, Jae-Sung;Lee, Jeong-Woo
    • Progress in Medical Physics
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    • v.29 no.4
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    • pp.106-114
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    • 2018
  • This study aimed to compare the performance of previous optimization algorithms against new a photon optimizer (PO) algorithm for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans for prostate cancer. Eighteen patients with prostate cancer were retrospectively selected and planned to receive 78 Gy in 39 fractions of the planning target volume (PTV). All plans for each patient optimized with the dose volume optimizer (DVO) and progressive resolution optimizer (PRO) algorithms for IMRT and VMAT were compared against plans optimized with the PO within Eclipse version 13.7. No interactive action was performed during optimization. Dosimetric and radiobiological indices for the PTV and organs at risk were analyzed. The monitor units (MU) per plan were recorded. Based on the plan quality for the target coverage, prostate IMRT and VMAT plans using the PO showed an improvement over DVO and PRO. In addition, the PO generally showed improvement in the tumor control probability for the PTV and normal tissue control probability for the rectum. From a technical perspective, the PO generated IMRT treatment plans with fewer MUs than DVO, whereas it produced slightly more MUs in the VMAT plan, compared with PRO. The PO showed over potentiality of DVO and PRO whenever available, although it led to more MUs in VMAT than PRO. Therefore, the PO has become the preferred choice for planning prostate IMRT and VMAT at our institution.

Dose Calculation of Heterogeneous Lung Tissue on 6MV X-ray Therapy (6MV X-선에 의한 폐조직의 심부선량변화와 임상응용)

  • 이경자;장승희;추성실
    • Progress in Medical Physics
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    • v.9 no.4
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    • pp.247-257
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    • 1998
  • For effective radiotherapy, it should always be considered that calculation of different dose distribution in heterogenous tissue is important particularly on lung which has low density and large volume. To take precise dose distribution of 6MV X-ray in the thoracic cage, the authors had made a tissue equivalent phantom for thorax, measured dose distribution by thermoluminescent dosimeter and mm dosimeter, and derived methmetical equation coincided with provided theoretical formula. In comparision with isodose curve on case of homogeneous soft tissue, dose of heterogeneous lung tissue had been shown increase about 4% per cm depth on one and multiportal field, less than 15% difference on rotation field for esophagus, and around 20% difference on rotation field for lung according to the degree of rotation angle that must be corrected by dose compensation.

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Finger Doses Received during $^{99m}Tc$ Injections Calculated with GEANT4 (GEANT4를 이용한 $^{99m}Tc$ 주입시 손가락 선량계산)

  • Han, Dong-Hyun;Kang, Sang-Koo;Kim, Chong-Yeal
    • Journal of Radiation Protection and Research
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    • v.33 no.1
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    • pp.41-46
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    • 2008
  • To estimate the finger dose absorbed by $^{99m}Tc$ injection, simulations are carried out to calculate the dose equivalent of each finger per second with radioactivity of 370 MBq, based on the GEANT4 simulator. For the $^{99m}Tc$ source of the volume of 0.4mL and the radioactivity of 370 MBq, we obtained the dose equivalent of the right thumb ($0.29\;{\mu}Sv{\cdot}sec^{-1}$), the right index finger ($1.19\;{\mu}Sv{\cdot}sec^{-1}$), the right middle finger ($1.07\;{\mu}Sv{\cdot}sec^{-1}$), the left thumb ($4.36\;{\mu}Sv{\cdot}sec^{-1}$), and the left index finger ($3.37\;{\mu}Sv{\cdot}sec^{-1}$), respectively. This simulation results may serve as a useful data in the prediction of finger dose absorbed by $^{99m}Tc$ injection.

Testicular Toxicity of 2-Bromopropane in Male Sprague-Dawley Rats (2-Bromopropane의 수컷 랫트를 이용한 고환 독성시험)

  • Cha, Sang-Eun;Park, Sang-Rae;Kim, Kgu-Hwan;Choi, Jeung-Suk;Kim, Sung-Kuk;Jeon, Tae-Won
    • Environmental Analysis Health and Toxicology
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    • v.15 no.4
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    • pp.123-130
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    • 2000
  • 2-Bromopropane, important industrial chemical, specially in electronic industry at Yangsan in Korea has been reported to cause amenorrhea for female and azoospermia, oligozoospermia or reduced sperm motility for male. 2-BP was investigated through 21 days of repeated dose in male Sprague-Dawley rats. The dose levels per body weight were 0 (control), 250,500 and 1,000 mg/kg. 2-BP dissolved in vehicle olive oil was injected into the intraperitoneum 6 times per week for 3 weeks, but 1,000 mg/kg dose group was 2 weeks because of serious illness. Male rats showed significant decreases in body weight and right and left testis showed typical weight losses depending on the 2-BP. The number of white blood cell and red blood cell , percentage of monocytes, and hemoglobin decreased significantly in high dose (P< 0.05). Red cell volume distribution width increased significantly in the high dose (P< 0.05). Histopathological findings of testes showed a decrease of spermatogenic cells, exfoliation of spermatid and spermatocyte, vacuolization of Sertoli cells and hyperplasia of Leydig cells. Protein band density between 113,000 dalton ($\beta$-galactosidase) and 53,900 dalton (ovalbumin) has decreased in 250 mg/kg dose group, but it has gradually increased to the higher density in 1,000 mg/kg dose group than in control group.

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Evaluation of Dose Distributions Recalculated with Per-field Measurement Data under the Condition of Respiratory Motion during IMRT for Liver Cancer (간암 환자의 세기조절방사선치료 시 호흡에 의한 움직임 조건에서 측정된 조사면 별 선량결과를 기반으로 재계산한 체내 선량분포 평가)

  • Song, Ju-Young;Kim, Yong-Hyeob;Jeong, Jae-Uk;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.79-88
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    • 2014
  • The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array. Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Because the Gate-IMRT method also has disadvantages such as unsuspected dosimetric variations when applying the gating system and an increased treatment time, it is better to perform a prior analysis of the patient's respiratory condition and the importance and fulfillment of the IMRT plan dose constraints in order to select an optimal IMRT method with which to correct the respiratory organ motional effect.

Dose Distribution of Intensity Modulated Radiation Therapy in Prostate Cancer (전립선암에서 세기조절방사선치료의 선량분포 특성)

  • Kim, Sung-Kyu;Choi, Ji-Hoon;Yun, Sang-Mo
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.298-303
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    • 2010
  • The aim of this study was to compare the dose distribution of intensity modulated radiation therapy (IMRT) with 3 dimensional conformal radiation therapy (3DCRT) in prostate cancer. The IMRT plan and the 3DCRT plan used the 9 fields technique, respectively. In IMRT, tumor dose was a total dose of 66 Gy at 2.0 Gy per day, 5 days a week for 5 weeks. All cases were following the dose volume histogram (DVH) constraints. The maximum and minimum tumor dose constraints were 6,700 cGy and 6,500 cGy, respectively. The rectum dose constraints were <35% over 50 Gy. The bladder dose constraints were <35% over 40 Gy. The femur head dose constraints were <15% over 20 Gy. Tumor dose in the 3DCRT were 66 Gy. In IMRT, the maximum dose of PTV was 104.4% and minimum dose was 89.5% for given dose. In 3DCRT, the maximum dose of PTV was 105.3% and minimum dose was 85.5% for given dose. The rectum dose was 34.0% over 50 Gy in IMRT compared with 63.3% in 3DCRT. The bladder dose was 30.1% over 40 Gy in IMRT compared with 30.6% in 3DCRT. The right femur head dose was 9.5% over 20 Gy in IMRT compared with 17.5% in 3DCRT. The left femur head dose was 10.6% over 20 Gy in IMRT compared with 18.3% in 3 DCRT. The dose of critical organs (rectum, bladder, and femur head) in IMRT showed to reduce than dose of 3DCRT. The rectum dose over 50 Gy in IMRT was reduced 29.3% than 3DCRT. The bladder dose over 40 Gy in IMRT was similar to 3DCRT. The femur head dose over 20 Gy in IMRT was reduced about 7~8% than 3DCRT.

Non-coplanar whole brain radiotherapy is an effective modality for parotid sparing

  • Park, Jaehyeon;Park, Jae Won;Yea, Ji Woon
    • Journal of Yeungnam Medical Science
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    • v.36 no.1
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    • pp.36-42
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    • 2019
  • Background: The purpose of this study was to evaluate the efficacy and feasibility of non- coplanar whole brain radiotherapy (NC-WBRT) for parotid sparing. Methods: Fifteen cases, previously treated with WBRT were selected. NC-WBRT plans were generated. The beam arrangement for the non-coplanar plans consisted of superior anterior, right, and left beams. After generation of the non-coplanar plans a field-in-field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC-WBRT plans were subsequently compared with the previously generated bilateral WBRT (B-WBRT) plans. A field-in-field technique was also used with the B-WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week. Results: The mean dose to the parotid gland for the two different plans were 16.2 Gy with B-WBRT and 13.7 Gy with NC-WBRT (p<0.05). In the NC-WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B-WBRT plan. The $D_{max}$ of the lens was also lower by 10% with NC-WBRT. Conclusion: The use of NC-WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose-volume parameters of the parotid gland.

28-Day Oral Toxicity of Cadmium Selenide in Sprague-Dawley Rats

  • Kim, Yong-Soon;Song, Moon-Yong;Kim, Jin-Sik;Rha, Dae-Sik;Jeon, Yong-Joon;Kim, Ji-Eun;Ryu, Hyeon-Yeol;Yu, Il-Je;Song, Kyung-Seuk
    • Toxicological Research
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    • v.25 no.3
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    • pp.140-146
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    • 2009
  • This study was performed to evaluate the toxicity of cadmium selenide for a period of 28 days in Sprague-Dawley rats. Each of 10 healthy male and females rats per group received daily oral administration for 28-day period at dosage levels 30, 300 and 1,000 mg/kg of body weight. Mortality and clinical signs were checked, and body weight, water intake and food consumption were also recorded weekly. There were no dose-related changes in food consumption or urine volume. All animals survived to the end of study with no clinical signs or differences in body weight gain observed when compared with the control group. At the end of study, all animals including control group, were subjected to necropsy. Blood samples were collected for hematology tests including coagulation time and biochemistry analysis. Blood coagulation time and relative organ weight were unaffected by all received doses. White Blood Cell (WBC) counts significantly increased in the 300 mg/kg administered male animal group when compared to the control. Monocyte (MO) value were also increased significantly in both 300 and 1,000 mg/kg male animal group. However, Mean Corpuscular Volume (MCV) were significantly decreased compared with the control in the 1,000 mg/kg dose groups for male and female animals. Mean Corpuscular Hemoglobin (MCH) decreased significantly for female in the 300 and 1,000 mg/kg group compared to the control. Blood biochemical values of Inorganic phosphorus (IP) were significantly increased in both the 300 and 1,000 mg/kg dose groups in male animals when compared to the control. Creatinine (CRE) levels indicated significant increase in kidney function for the female, 30 mg/kg dose group when compared with control. There was a significant decrease in thymus absolute organ weight in the female, 1,000 mg/kg dose group when compared with control. Histopathological findings revealed no evidence of injury related to cadmium selenide except for one case of focal hepatic inflammation in the high dose (1,000 mg/kg) group. One case of lung inflammation was also seen in the control group. Basis on these result, the No Observable Adverse Effect Level (NOAEL) of cadmium selenide was determined to be more than 1,000 mg/kg/day for male and female rats under conditions in this study.