• Korean Journal of Clinical Pharmacy
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• v.14 no.1
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• pp.1-10
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• 2004

Studies of oxaliplatin, 5-fluorouracil and leucovorin in pretreated metastatic colorectal cancer showed that oxaliplatin dose intensity is important prognostic factor for objective response rates and progression-free-survival (PFS). To evaluate response rates, PFS and toxicity according to oxaliplatin dose intensity, we retrospectively analyzed data from patients with metastatic colorectal cancer received oxaliplatin,5-fluorouracil, leucovorin regimens. Sixty-three patients were reviewed in this study, 42 patients received low dose intensity oxaliplatin (LDI: $\leq85\;mg/m^2/2wks$) and 21 patients high dose intensity oxaliplatin (HDI: $>85\;mg/m^2/2wks$). Objective responses occurred in 10 $(47.7\%)$ HDI patients and 9 $(21.4\%)$ LDI patients (p = 0.014). Median PFS was 24.7 weeks in HDI group, with $45.1\%$ of HDI patients progression free at 6 months, and 20.5 weeks in LDI group, with $33.5\%$ of LDI patients progression free at 6 months (p = 0.344). Increased oxaliplatin dose intensity was not associated with neutropenia, thrombocytopenia, neuropathy, nausea and vomiting. This study showed that oxaliplatin dose intensification significantly improves objective response rate in pretreated metastatic colorectal cancer without increasing severe toxicity.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.61-64
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• 2002

As intensity modulated radiation therapy compared with conventional radiation therapy, tumor target dose increased and normal tissues and critical organs dose reduced. In brain tumor, treatment planning of intensity modulated radiation therapy was practiced in 4MV, 6MV, 15MV X-ray energy. In these X-ray energy, was considered the dose distribution and dose volume histogram. As 4MV X-ray compared with 6MV and 15MV, maximum dose of right optic-nerve increased 10.1 %, 8.4%. Right eye increased 5.2%, 2.7%. And left optic-nerve, left eye, optic chiasm and brainstem incrased 1.7% - 5.2%. Even though maximum dose of PTV and these critical organs show different from 1.7% - 10.1% according to X-ray energies, these are a piont dose. Therefore in brain tumor, treatment planning of intensity modulated radiation therapy in 9 treatment field showed no relation with energy dependency.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.64-64
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• 2003

Objectives: Patient dose verification is clinically the most important parts in the treatment delivery of radiation therapy. The three dimensional(3D) reconstruction of dose distribution delivered to target volume helps to verify patient dose and determine the physical characteristics of beams used in intensity modulated radiation therapy(IMRT). We present Beam Intensity Scanner(BInS) system for the pre treatment dosimetric verification of two dimensional photon intensity. The BInS is a radiation detector with a custom made software for relative dose conversion of fluorescence signals from scintillator. Methods: This scintillator is fabricated by phosphor Gadolinium Oxysulphide and is used to produce fluorescence from the irradiation of 6MV photons on a Varian Clinac 21EX. The digitized fluoroscopic signals obtained by digital video camera will be processed by our custom made software to reproduce 3D relative dose distribution. For the intensity modulated beam(IMB), the BInS calculates absorbed dose in absolute beam fluence, which are used for the patient dose distribution. Results: Using BInS, we performed various measurements related to IMRT and found the followings: (1) The 3D dose profiles of the IMBs measured by the BInS demonstrate good agreement with radiographic film, pin type ionization chamber and Monte Carlo simulation. (2) The delivered beam intensity is altered by the mechanical and dosimetric properties of the collimating of dynamic and/or static MLC system. This is mostly due to leaf transmission, leaf penumbra, scattered photons from the round edges of leaves, and geometry of leaf. (3) The delivered dose depends on the operational detail of how to make multileaf opening. Conclusions: These phenomena result in a fluence distribution that can be substantially different from the initial and calculative intensity modulation and therefore, should be taken into account by the treatment planing for accurate dose calculations delivered to the target volume in IMRT.

• Radiation Oncology Journal
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• v.34 no.1
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• pp.64-75
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• 2016

Purpose: In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. Materials and Methods: In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. Results: The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median $R^2$ of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Conclusion: Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.248-251
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• 2002

The intensity modulated radiation therapy (IMRT) with a multileaf collimator (MLC) requires the conversion of a radiation fluence map into a leaf sequence file that controls the movement of the MLC during radiation treatment of patients. Patient dose verification is clinically one of the most important parts in the treatment delivery of the radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to the target helps to verify patient dose and to determine the physical characteristics of beams used in IMRT. A new method is presented for the pretreatment dosimetric verification of two dimensional distributions of photon intensity by means of Beam Intensity Scanner System (BISS) as a radiation detector with a custom-made software for dose calculation of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6MV photons on a Varian Clinac 21EX. The BISS reproduces 3D- relative dose distribution from the digitized fluoroscopic signals obtained by digital video camera-based scintillator(DVCS) device in the IMRT. For the intensity modulated beams (IMBs), the calculations of absorbed dose are performed in absolute beam fluence profiles which are used for calculation of the patient dose distribution. The 3D-dose profiles of the IMBs with the BISS were demonstrated by relative measurements of photon beams and shown good agreement with radiographic film. The mechanical and dosimetric properties of the collimating of dynamic and/or step MLC system alter the generated intensity. This is mostly due to leaf transmission, leaf penumbra and geometry of leaves. The variations of output according to the multileaf opening during the irradiation need to be accounted for as well. These phenomena result in a fluence distribution that can be substantially different from the initial and calculative intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT.

• Progress in Medical Physics
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• v.23 no.1
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• pp.62-69
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• 2012

The dose re-calculation process using Megavoltage cone-beam CT images is inevitable process to perform the Adaptive Radiation Therapy (ART). The purpose of this study is to improve dose re-calculation accuracy using MVCBCT images by applying intensity calibration method and three dimensional rigid body transform and filtering process. The three dimensional rigid body transform and Gaussian smoothing filtering process to MVCBCT Rando phantom images was applied to reduce image orientation error and the noise of the MVCBCT images. Then, to obtain the predefined modification level for intensity calibration, the cheese phantom images from kilo-voltage CT (kV CT), MVCBCT was acquired. From these cheese phantom images, the calibration table for MVCBCT images was defined from the relationship between Hounsfield Units (HUs) of kV CT and MVCBCT images at the same electron density plugs. The intensity of MVCBCT images from Rando phantom was calibrated using the predefined modification level as discussed above to have the intensity of the kV CT images to make the two images have the same intensity range as if they were obtained from the same modality. Finally, the dose calculation using kV CT, MVCBCT with/without intensity calibration was applied using radiation treatment planning system. As a result, the percentage difference of dose distributions between dose calculation based on kVCT and MVCBCT with intensity calibration was reduced comparing to the percentage difference of dose distribution between dose calculation based on kVCT and MVCBCT without intensity calibration. For head and neck, lung images, the percentage difference between kV CT and non-calibrated MVCBCT images was 1.08%, 2.44%, respectively. In summary, our method has quantitatively improved the accuracy of dose calculation and could be a useful solution to enhance the dose calculation accuracy using MVCBCT images.

• Progress in Medical Physics
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• v.13 no.2
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• pp.104-108
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• 2002

As intensity modulated radiation therapy compared with conventional radiation therapy, tumor target dose increased and normal tissues and critical organs dose reduced. In brain tumor, treatment planning of intensity modulated radiation therapy was practiced in 4MV, 6MV, 15MV X-ray energy. In these X-ray energy, was considered the dose distribution and dose volume histogram. As 4MV X-ray compared with 6MV and 15MV, maximum dose of right optic-nerve increased 10.1％, 8.4％. Right eye increased 5.2％, 2.7％. And left optic-nerve, left eye, optic chiasm and brainstem increased 1.7％ - 5.2％. Even though maximum dose of PTV and these critical organs show different from 1.7％ - 10.1％ according to X-ray energies, these are a piont dose. Therefore in brain tumor, treatment planning of intensity modulated radiation therapy in 9 treatment field showed no relation with energy dependency.

• Journal of radiological science and technology
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• v.4 no.1
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• pp.63-71
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• 1981

The metal-plates(Aluminium. Copper, Lead) of change the variation thickness have been penetrated by the collimated beam($450mm{\times}4mm{\phi}$) of Gamma-ray from $^{192}Ir$. Then, the scattered $\gamma$-ray dose in variable angle and the directly transmitted $\gamma$-ray dose were measured using the electrometer of ionization chamber. The results were summarized as follows: 1. Obtained the mass attenuation coefficients of $Al;0.0937cm^2g^{-1},\;Cu;0.0937cm^2g^{-1},\;pb;0.244cm^2g^{-1}$. 2. Total intensity of front scattered $\gamma$-ray follow the order of Al>Cu>pb. 3. The scattered $\gamma$-ray intensity with the lager angle of scattering was saturated after increase rapidly, and the scattering angle of the more larger was decreased. 4. The scattered $\gamma$-ray intensity through plates of aluminium or copper was saturated after increase with thicker scatterer, and the intensity was decreased at the more thicker. But the variation of scattered $\gamma$-ray dose in the lead plate made the fewest than Al and Cu. 5. The ratio of the scattered $\gamma$-ray dose and the directly transmitted $\gamma$-ray dose was saturated after increase with the thicker scatterer, and the scatterer of the more thicker was decreased. Degree of total intensity in these ratios was followed the order of Cu>Al>Pb.

• Progress in Medical Physics
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• v.32 no.4
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• pp.116-121
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• 2021

Purpose: To investigate the effects of dose rate on intensity-modulated radiation therapy (IMRT) quality assurance (QA). Methods: We performed gamma tests using portal dose image prediction and log files of a multileaf collimator. Thirty treatment plans were randomly selected for the IMRT QA plan, and three verification plans for each treatment plan were generated with different dose rates (200, 400, and 600 monitor units [MU]/min). These verification plans were delivered to an electronic portal imager attached to a Varian medical linear accelerator, which recorded and compared with the planned dose. Root-mean-square (RMS) error values of the log files were also compared. Results: With an increase in dose rate, the 2%/2-mm gamma passing rate decreased from 90.9% to 85.5%, indicating that a higher dose rate was associated with lower radiation delivery accuracy. Accordingly, the average RMS error value increased from 0.0170 to 0.0381 cm as dose rate increased. In contrast, the radiation delivery time reduced from 3.83 to 1.49 minutes as the dose rate increased from 200 to 600 MU/min. Conclusions: Our results indicated that radiation delivery accuracy was lower at higher dose rates; however, the accuracy was still clinically acceptable at dose rates of up to 600 MU/min.

• Progress in Medical Physics
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• v.33 no.3
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• pp.25-35
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• 2022

Purpose: Planning for radiotherapy relies on implicit estimation of the probability of tumor control and the probability of complications in adjacent normal tissues for a given dose distribution. Methods: The aim of this pilot study was to reconstruct dose-volume histograms (DVHs) from text files generated by the Eclipse treatment planning system developed by Varian Medical Systems and to verify the integrity and accuracy of the dose statistics. Results: We further compared dose statistics for intensity-modulated radiotherapy of the head and neck between the Eclipse software and software developed in-house. The dose statistics data obtained from the Python software were consistent, with deviations from the Eclipse treatment planning system found to be within acceptable limits. Conclusions: The in-house software was able to provide indices of hotness and coldness for treatment planning and store statistical data generated by the software in Oracle databases. We believe the findings of this pilot study may lead to more accurate evaluations in planning for radiotherapy.