• Radiation Oncology Journal
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• v.26 no.2
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• pp.96-103
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• 2008

Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.45-52
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• 2015

Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.125-131
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• 2005

Purpose : For stereotactic radiosurgery (SRS) of a tumor in the region whose movement due to respiration is significant, like Lung lower lobe, the gated therapy, which delivers radiation dose to the selected respiratory phases when tumor motion is small, was performed using the Respiratory gating system and its clinical effectiveness was evaluated. Materials and Methods : For two SRS patients with a tumor in Lung lower lobe, a marker block (infrared reflector) was attached on the abdomen. While patient' respiratory cycle was monitored with Real-time Position Management (RPM, Varian, USA), 4D CT was performed (10 phases per a cycle). Phases in which tumor motion did not change rapidly were decided as treatment phases. The treatment volume was contoured on the CT images for selected treatment phases using maximum intensity projection (MIP) method. In order to verify setup reproducibility and positional variation, 4D CT was repeated. Results : Gross tumor volume (GTV) showed maximum movement in superior-inferior direction. For patient #1, motion of GTV was reduced to 2.6 mm in treatment phases ($30{\sim}60%$), while that was 9.4 mm in full phases ($0{\sim}90%$) and for patient #2, it was reduced to 2.3 mm in treatment phases ($30{\sim}70%$), while it was 11.7 mm in full phases ($0{\sim}90%$). When comparing two sets of CT images, setup errors in all the directions were within 3 mm. Conclusion : Since tumor motion was reduced less than 5 mm, the Respiratory gating system for SRS of Lung lower lobe is useful.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.133-140
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• 2010

Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.167-171
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• 2000

Objectives: To compare the outcomes of treatment with a focus on the effectiveness of the two primary techniques of radiation used for treating parotid gland malignancies. Materials and Methods: A retrospective analysis of 70 patients with parotid gland cancer treated between 1981-1997. Radiation was delivered through an ipsilateral field of high energy electron and photon in 37 patients(52.9%). Two wedge paired photon was used to treat in 33 patients(47.1%). The median dose was 60 Gy, typically delivered at 1.8-2.0Gy per fraction. The median follow-up times for surviving patients was 60 months. Results: The overall and disease free 5 year survival rates were 71.6% and 69.5%, respectively. Wedge paired photon and photon-electron treatment disease tree 5 year survival rates were 61.1% and 80.5%, respectively. Overall local failure rate was 18.6%. Local failure rate of wedge paired photon technique was higher than that of mixed beam technique. Late complication rate was 37.1%, but most of them were mild grade. Conclusion: Techniques of radiation were associated with local control. The technique of using an ipsilateral field encompassing the parotid bed and treated with high energy electrons often mixed photons was effective with minimal severe late toxicity. To irradiate deep sited tumors, we consider 3-D conformal treatment plan for well encompassing the target volume.

• Korean Journal of Animal Reproduction
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• v.17 no.2
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• pp.165-171
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• 1993

While ornithine decarboxylase (ODC) is considered a key enzyme in the biosynthesis of polyamines, difluoromethylornithine(DFMO) acts as an inhibitor of polyamine synthesis. Cycling crossbred gilts were randomly assigned to one of two (treatment and control) groups (6/group). An indwelling silicone catheter was surgically implanted in the jugular vein of each animal. DFMO was dissolved in saline(200 mg/ml) and adminstered by i. m. injection at a dose of 80 mg/kg/day. The control group received an equivalent volume saline injection. DFMO was injected 3 times daily(08:00. 16:00. 24:00h) from day 16 of estrous cycle to 21 or until estrus. Once daily blood samples (10ml) were taken from day 14 until two days after the last DFMO treatment. Window blood samples were collected every 15 min for 8 h (from 08:00 to 16:00h) starting on day 16 and continuing until day 21 from one gilt per day. Serum progesterone (P$_4$), estradiol (E$_2$), LH and FSH were measured. Typical concentration profiles for P$_4$ and E$_2$ were seen during the follicular phase regardless of DFMO treatment. Injection of DFMO suppressed the preovulatory LH concentration in the serum(p<0.01) while having no effect on FSH profile. The present results indicate that DFMO had an inhibitory effect on LH secretion in the pig, but did not affect PI, E2 or FSH release.

• Herbal Formula Science
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• v.21 no.1
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• pp.51-70
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• 2013

Objectives : The object of this study was to observe anticancer and related immunomodulatory effects of Insamyangyoung-tang extracts (ISYYTe) on non-small cell lung carcinoma (squamous epithelial carcinoma), NCI-H520, xenograft Balb/c nu-nu nude mice. Methods : Three different dosages of ISYYTe, 50, 100 and 200 mg/kg were orally administered once a day for 42 days from 11 days after tumor cell inoculation. Six groups, which are intact control, tumor bearing control, 5-fluorouracil (FU) 30 mg/kg, ISYYTe 50 mg/kg, ISYYTe 100 mg/kg, ISYYTe 200 mg/kg, each of 8 mice per group were used in the present study. Changes on the body weight, tumor volume and weight, lymphatic organ (spleen and popliteal lymph node), serum interferon (IFN)-${\gamma}$ levels, splenocytes NK cell activity and peritoneal macrophage activities, splenic tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-$1{\beta}$ and IL-10 contents were observed with tumor mass and lymphatic organ histopathology to detect anticancer and immunomodulatory effects. Results : As results of ISYYTe 50, 100 and 200 mg/kg treatment, decreases in the tumor volumes and weights were detected. At histopathological observations, decreases of tumor cell volumes in tumor masses were dose-dependently decreased mediated by increases of apoptosis among tumor cells by treatment of all three different dosages of ISYYTe. As results of tumor cell inoculation, marked decreases of spleen and popliteal lymph node weights, serum IFN-${\gamma}$, splenic TNF-${\alpha}$, IL-$1{\beta}$ and IL-10 contents and splenocytes were observed with histopathological atrophic changes of spleen and popliteal lymph nodes. Conclusions : Over 50 mg/kg of ISYYTe showed favorable anticancer effects on the NCI-H520 cell xenograft with immunomodulatory effects. Although relatively lower anticancer effects were observed in ISYYTe 200 mg/kg treated mice as compared with 5-FU 30 mg/kg treated mice, there are no meaningful favorable immunomodulatory effects were observed after 5-FU treatment in the present study.

• Asian-Australasian Journal of Animal Sciences
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• v.15 no.7
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• pp.1066-1070
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• 2002

10 male piglets at 5-6 weeks old with similar body weight (BW) were randomly assigned into the experimental (EXP) and control (CON) groups. The animals in EXP received intro-muscular injection with daidzein (DA) at the dose of 0.5 mg DA per kg start BW on day 1. The same procedures were repeated once every 3 days for eight times. The animals in CON received the injection only with same volume of control peanut oil. The animals were weighted on day 14 and 28 and the blood samples were obtained at different stages of the treatment for determining IGF-I levels and blood parameters. At the end of the experiment, the thymus and spleen from all the animals were surgically taken out and weighted. The results showed that BW and average daily gain (ADG) were not significantly different between the groups in term of the whole period, but ADG between days 14-28 was higher in EXP than in CON (p<0.05). On days 18, 21 and 25, IGF-I levels in EXP group were 20.53% (p<0.05), 15.92% (p>0.05) and 23.46% (p<0.05), respectively, higher than those in CON. The weights of thymus and spleen, the ratios of their weights to BW and red blood count (RBC) did not significantly differ between the groups at all stages. White blood count (WBC) in EXP steadily increased from day 22, reached its apex on day 24, which was higher than in CON (p<0.05) and its own levels on day 20 and 22 (p<0.01 or p<0.05), and remained higher on the later time (p=0.058). The results of percentage of T-Lymphocytes also demonstrated similar trend to WBC, but TLymphocyte transformation rate (%) appeared no significant change between the groups. In conclusion, Daidzein could stimulate male piglet growth and elevate serum IGF-I levels at certain stages of the treatment. It could also increase WBC and T-Lymphocyte rates, but had no significant impacts on RBC and T-Lymphocyte transformation rate.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.534-540
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• 2012

Objective : Brainstem arteriovenous malformation (AVM) is rare and radiosurgical management is complicated by the sensitivity of the adjacent neurological structures. Complete obliteration of the nidus is not always possible. We describe over 20 years of radiosurgical procedures for brainstem AVMs, focusing on clinical outcomes and radiosurgical techniques. Methods : Between 1992 and 2011, the authors performed gamma knife radiosurgery (GKRS) in 464 cerebral AVMs. Twenty-nine of the 464 patients (6.3%) reviewed had brainstem AVMs. This series included sixteen males and thirteen females with a mean age of 30.7 years (range : 5-71 years). The symptoms that led to diagnoses were as follows : an altered mentality (5 patients, 17.3%), motor weakness (10 patients, 34.5%), cranial nerve symptoms (3 patients, 10.3%), headache (6 patients, 20.7%), dizziness (3 patients, 10.3%), and seizures (2 patients, 6.9%). Two patients had undergone a previous nidus resection, and three patients had undergone a previous embolization. Twenty-four patients underwent only GKRS. With respect to the nidus type and blood flow, the ratio of compact type to diffuse type and high flow to low flow were 17 : 12 and 16 : 13, respectively. In this series, 24 patients (82.8%) had a prior hemorrhage. The mean target volume was 1.7 $cm^3$ (range 0.1-11.3 $cm^3$). The mean maximal and marginal radiation doses were 38.5 Gy (range 28.6-43.6 Gy) and 23.4 Gy (range 18-27 Gy), and the mean isodose profile was 61.3% (range 50-70%). Results : Twenty-four patients had brainstem AVMs and were followed for more than 3 years. Obliteration of the AVMs was eventually documented in 17 patients (70.8%) over a mean follow-up period of 77.5 months (range 36-216 months). With respect to nidus type and blood flow, the obliteration rate of compact types (75%) was higher than that of diffuse types (66.7%), and the obliteration rate of low flow AVMs (76.9%) was higher than that of high flow AVMs (63.6%) (p<0.05). Two patients (6.9%) with three hemorrhagic events suffered a hemorrhage during the follow-up period. The annual bleeding rate of AVM after GKRS was 1.95% per year. No adverse radiation effects or delayed cystic formations were found. Conclusion : GKRS has an important clinical role in treatment of brainstem AVMs, which carry excessive surgical risks. Angiographic features and radiosurgical techniques using a lower maximal dose with higher isodose profiles are important for lesion obliteration and the avoidance of complications.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.10
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• pp.1446-1458
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• 2013

The study assessed the effect of dietary supplementation of leaf meal mixture (LMM) containing condensed tannins (CT) on feed intake, nutrient utilization and performance of sheep infected with Haemonchus contortus. Eighteen adult sheep of similar age and body weight ($25.03{\pm}1.52$) were included in this study and out of these, 12 sheep were infected with single dose of infective third stage larvae of H. contortus at 2,000 larvae per sheep. The experimental sheep were allocated in three different groups' i.e. negative control (NC; no infection), control (C; H. contortus infected) and treatment (T; H. contortus infected+CT at 1.5% of the DM through LMM) and the experiment was conducted for a period of 90 d. The intake of dry matter (DM), organic matter (OM) and digestibility of DM, OM, neutral detergent fibre (NDF) and acid detergent fibre (ADF) were comparable among three animal groups. However, digestibility of crude protein (CP) and ether extract (EE) were significantly (p<0.05) higher in NC group as compared to both C and T groups. Nitrogen (N) retention (g/d or % of N intake) was significantly (p = 0.038) lower in C group as compared to T and NC groups. Daily intake (g/kg $W^{0.75}$) of digestible crude protein (DCP), digestible organic matter (DOM) and total digestible nutrient (TDN) did not differ significantly (p<0.05) in the three groups. Haemoglobin (Hb) and packed cell volume (PCV) were significantly (p<0.001) higher in treatment group as compared to control. The level of Hb and PCV reduced (p<0.001) after 30 days of experimental feeding. CT significantly (p<0.001) reduced serum urea in T group as compared to NC and C groups. Serum proteins differed significantly (p<0.01) among the three groups. The activity of serum enzymes AST, ALT, ALP and LDH were also statistically non significant (p<0.05) among treatments. The weight of abomasal lymph nodes (ALN) in T group was higher (p<0.05) than in C group. Treatment group had lower (p<0.05) total worms and fecal egg count compared to control group. It may be concluded that dietary supplementation of CT through LMM significantly improved the N retention, and inhibited the different developmental stages of Haemonchus contortus in experimental sheep.