• Title/Summary/Keyword: dose intensity

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Determining the Optimal Dose Prescription for the Planning Target Volume with Stereotactic Body Radiotherapy for Non-Small Cell Lung Cancer Patients

  • Liu, Xi-Jun;Lin, Xiu-Tong;Yin, Yong;Chen, Jin-Hu;Xing, Li-Gang;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2573-2577
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    • 2016
  • Objective: The aim of this study was to determine a method of dose prescription that minimizes normal tissue irradiation outside the planning target volume (PTV) during stereotactic body radiotherapy (SBRT) for patients with non-small cell lung cancer. Methods: Previous research and patients with typical T1 lung tumors with peripheral lesions in the lung were selected for analysis. A PTV and several organs at risk (OARs) were constructed for the dose calculated; six treatment plans employing intensity modulated radiotherapy (IMRT) were produced, in which the dose was prescribed to encompass the PTV, with the prescription isodose level (PIL) set at 50, 60, 70, 80, 90 or 95% of the isocenter dose. Additionally, four OARs around the PTV were constructed to evaluate the dose received in adjacent tissues. Results: The use of higher PILs for SBRT resulted in improved sparing of OARs, with the exception of the volume of lung treated with a lower dose. Conclusions: The use of lower PILs is likely to create significant inhomogeneity of the dose delivered to the target, which may be beneficial for the control of tumors with poor conformity indices.

The Study on the Head and Neck Phantom for Quality Assurance of Intensity Modulated Radiotherapy (세기변조방사선치료의 정도관리를 위한 두경부 팬톰 제작에 관한 연구)

  • Shin Dongho;Park Sung-Yong;Kim Joo Young;Lee Se Byeong;Cho Jung Keun;Kim Dae Yong;Cho Kwan Ho
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.39-46
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    • 2005
  • For the QA of IMRT treatment of head and neck cancer by using M3 (BrainLAB Inc. Germany), it is not easy to measure delivery dose exactly because the dose attenuation appears by the couch according to the position of table and gantry. In order to solve this problem, we fabricated head and neck phantom which would be implemented on the couch mount of Brain Lab Inc. We investigated dose attenuation by the couch and found the difference of dose distribution by the couch, in the applying this phantom to the clinic. After measurement, we found that point dose attenuation was 35% at maximum and dose difference was 5.4% for a point dose measurement of actual patient quality assurance plan.

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Feasibility Study of UV-Disinfection for Water Reuse of Effluent from Wastewater Treatment Plant (용수재이용을 위한 하수처리 유출수의 UV 소독 효율 연구)

  • 윤춘경;정광욱;함종화;전지홍
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.45 no.2
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    • pp.126-137
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    • 2003
  • The feasibility study of UV-disinfection system was performed for disinfection of effluent from wastewater treatment plant. Three low-pressure UV lamps of 17, 25, and 41 W were examined with various flow rates. Low-pressure UV lamps of 17W were examined with various turbidity, DOM (dissolved organic matter), and SS (suspended solid). The pilot plant was a flow-through type UV-disinfection system, and the range of exposure time varied from 5 to 40 seconds, turbidity from 0 to 40 NTU, DOM from 0 to 30 mg/L, and SS from 10 to 40 mg/L. The 41W lamp demonstrated complete disinfection showing no survival ratio in all the experimental conditions, and generally 17W and 25W lamps also showed high removal ratio over 97%. For the same UV dose (UV intensity times exposure time), high intensity-short exposure conditions showed better disinfection efficiency than low intensity-long exposure conditions. While the effects of turbidity and DOM were not apparent, the effects of SS was significant on the disinfection efficiency which indicates that SS control before UV-disinfection appears to be necessary to increase removal efficiency. Considering characteristics of effluent from existing wastewater treatment plants, cost-effectiveness, stable performance, and minimum maintenance, the flow-through type UV-disinfection system with high intensity and low-pressure lamps was thought to be a competitive disinfection system for wastewater reclamation.

A Randomised, Placebo-controlled Trial of the Effects of Preoperative Pregabalin on Pain Intensity and Opioid Consumption following Lumbar Discectomy

  • Hegarty, Dominic A.;Shorten, George D.
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.22-30
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    • 2011
  • Background: Pregabalin has been shown to have analgesic effect in acute pain models. The primary objective was to examine the efficacy a single dose of pregabalin, would have on morphine consumption following lumbar discectomy. Methods: With ethical approval a randomized, placebo-controlled prospective trial was undertaken in 32 patients (ASA I-II, 18-65 years) with radicular low back pain for > 3 months undergoing elective lumbar discectomy. Patients received either oral pregabalin 300 mg (PG Group) or placebo (C Group) one hour before surgery. Pain intensity, the accumulative morphine consumption and adverse effects were recorded for 24 hours following surgery. Functional, psychological and quantitative sensory testing were also assessed. Results: Fourteen patients out of the 32 recruited were randomized to receive pregabalin. Morphine consumption was reduced (absolute difference of 42.3%) between groups with medium effect size. (Mann-Whitney; U =52.5, z-score= 2.84, P = 0.004, r = 0.14). This was not associated with a significant difference in the incidence of adverse effects between the two groups. The median pain intensity (VAS) on movement was not significantly different between groups. Conclusions: A single pre-operative dose of pregabalin (300 mg) did not result in a reduction in pain intensity compared to placebo in this patient cohort but the significant reduction in morphine consumption suggests that a fixed peri-operative dosing regime warrants investigation.

The Characteristics of Thermoluminescence from $^{137}$ Cs Irradiated Beta-Eucryptite ($^{137}$ Cs으로 조사된 베타-유크립타이트의 열자극발광 특성)

  • 김태규;이병용;박영우;추성실;황정남
    • Progress in Medical Physics
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    • v.3 no.2
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    • pp.23-31
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    • 1992
  • The thermally stimulated luminecence (Thermoluminescence:TL) of manufactured beta-eucryptite was studied for dose range of 200cGy-20000Gy. The TL spectrum from cesium irradiated beta-eucryptite was measured over the temperature range of 300K to 600K. The linearity of TL intensity vs irradiation dose is valid up to 50Gy and beyond higher dose supralinearity and saturation come out. At the dose of 2000Gy, the net number of supralinearity is maximum. The net amount of supralinearity form newly formed trapping center by photon irradiation and totally calculated TL intensity are accord with the experimental results except for the 50Gy range that supralinearity appears.

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The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer

  • Moon, Sung Ho;Suh, Yang-Gun
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.184-190
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    • 2020
  • Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC.

Analysis of the major factors of influence on the conditions of the Intensity Modulated Radiation Therapy planning optimization in Head and Neck (두경부 세기견조방사선치료계획 최적화 조건에서 주요 인자들의 영향 분석)

  • Kim, Dae Sup;Lee, Woo Seok;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.11-19
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    • 2014
  • Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

Estimated Risk of Radiation Induced Contra Lateral Breast Cancer Following Chest Wall Irradiation by Conformal Wedge Field and Forward Intensity Modulated Radiotherapy Technique for Post-Mastectomy Breast Cancer Patients

  • Athiyaman, Hemalatha;M, Athiyaman;Chougule, Arun;Kumar, HS
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5107-5111
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    • 2016
  • Background: Epidemiological studies have indicated an increasing incidence of radiation induced secondary cancer (SC) in breast cancer patients after radiotherapy (RT), most commonly in the contra-lateral breast (CLB). The present study was conducted to estimate the SC risk in the CLB following 3D conformal radiotherapy techniques (3DCRT) including wedge field and forward intensity modulated radiotherapy (fIMRT) based on the organ equivalent dose (OED). Material and Methods: RT plans treating the chest wall with conformal wedge field and fIMRT plans were created for 30 breast cancer patients. The risks of radiation induced cancer were estimated for the CLB using dose-response models: a linear model, a linear-plateau model and a bell-shaped model with full dose response accounting for fractionated RT on the basis of OED. Results: The plans were found to be ranked quite differently according to the choice of model; calculations based on a linear dose response model fIMRT predict statistically significant lower risk compared to the enhanced dynamic wedge (EDW) technique (p-0.0089) and a non-significant difference between fIMRT and physical wedge (PW) techniques (p-0.054). The widely used plateau dose response model based estimation showed significantly lower SC risk associated with fIMRT technique compared to both wedge field techniques (fIMRT vs EDW p-0.013, fIMRT vs PW p-0.04). The full dose response model showed a non-significant difference between all three techniques in the view of second CLB cancer. Finally the bell shaped model predicted interestingly that PW is associated with significantly higher risk compared to both fIMRT and EDW techniques (fIMRT vs PW p-0.0003, EDW vs PW p-0.0032). Conclusion: In conclusion, the SC risk estimations of the CLB revealed that there is a clear relation between risk associated with wedge field and fIMRT technique depending on the choice of model selected for risk comparison.

Dosimetric comparison of coplanar and non-coplanar volumetric-modulated arc therapy in head and neck cancer treated with radiotherapy

  • Gayen, Sanjib;Kombathula, Sri Harsha;Manna, Sumanta;Varshney, Sonal;Pareek, Puneet
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.138-147
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    • 2020
  • Purpose: To evaluate the dosimetric variations in patients of head and neck cancer treated with definitive or adjuvant radiotherapy using optimized non-coplanar (ncVMAT) beams with coplanar (cVMAT) beams using volumetric arc therapy. Materials and Methods: Twenty-two patients of head and neck cancer that had received radiotherapy using VMAT in our department were retrospectively analyzed. Each of the patients was planned using coplanar and non-coplanar orientations using an optimized couch angle and fluences. We analyzed the Conformity Index (CIRTOG), Dose Homogeneity Index (DHI), Heterogeneity Index (HIRTOG), low dose volume, target and organs-at-risk coverage in both the plans without changing planning optimization parameters. Results: The prescription dose ranged from 60 Gy to 70 Gy. Using ncVMAT, CIRTOG, DHI and HIRTOG, and tumor coverage (ID95%) had improved, low dose spillage volume in the body V5Gy was increased and V10Gy was reduced. Integral dose and intensity-modulated radiation therapy factor had increased in ncVMAT. In the case of non-coplanar beam arrangements, maximum dose (Dmax) of right and left humeral head were reduced significantly whereas apex of the right and left lung mean dose were increased. Conclusion: The use of ncVMAT produced better target coverage and sparing of the shoulder and soft tissue of the neck as well as the critical organ compared with the cVMAT in patients of head and neck malignancy.

A Comparison between Three Dimensional Radiation Therapy and Intensity Modulated Radiation Therapy on Prostate Cancer (전립샘암의 방사선 치료 시 입체조형치료법와 세기조절방사선 치료법의 비교)

  • Kim, YoungJae;Lee, JaeSub;Hong, Seongill;Ko, HyeJin
    • Journal of the Korean Society of Radiology
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    • v.7 no.6
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    • pp.409-414
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    • 2013
  • In this study, we evaluated to the superiority of treatment techniques on prostate cancer, apply to each other treatment techniques-3D conformal therapy versus IMRT-using dose distribution and dose coverages. Obtained 10 patients CT simulation, divided tumor volume and critical organs. Prescription dose was 80 Gy on tumor volume and Each of plans was set by two different plans. As a result, Dose coverage was superior to IMRT. The IMRT's tumor absorbed dose(100.2%) was close to prescription doses. Normal tissue(bladder, rectal, bowel Lt Rt fumoral head) absorbed dose rate was superior. In other words, the radiation therapy of prostate cancer with intensity modulated radiation therapy was better than conformal radiation therapy on dose.