Soyoung Lee;Young-Hwa Kim;In Ho Song;Ji Young Choi;Hyewon Youn;Byung Chul Lee;Sang Eun Kim
Journal of Radiopharmaceuticals and Molecular Probes
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v.6
no.2
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pp.92-101
/
2020
The cyclic Arg-Gly-Asp (cRGD) peptide is well-known as a binding molecule to the integrin αvβ3 receptor which is highly expressed on activated endothelial cells and new blood vessels in tumors. Although numerous results have been reported by the usage of cRGD peptide-based ligands for cancer diagnosis and therapy, the distinct mechanisms, and functions of cRGD-integrin binding to cancer cells are still being investigated. In this study, we evaluated the internalization efficacy of different types of cRGD peptides (monomer, dimer and tetramer form) in integrin αvβ3 overexpressing cancer cells. Western blot and flow cytometric analysis showed U87MG expresses highly integrin αvβ3, whereas CT-26 does not show integrin αvβ3 expression. Cytotoxicity assay indicated that all cRGD peptides (0-200 µM) had at least 70-80% of viability in U87MG cells. Fluorescence images showed cRGD dimer peptides have the highest cellular internalization compare to cRGD monomer and cRGD tetramer peptides. Additionally, transmission electron microscope results clearly visualized the endocytic internalization of integrin αvβ3 receptors and correlated with confocal microscopic results. These results support the rationale for the use of cRGD dimer peptides for imaging, diagnosis, or therapy of integrin αvβ3-rich glioblastoma.
A docking intraoperative electron beam applicator system, which is easily docking in the collimator for a linear accelerator after setting a sterilized transparent cone on the tumor bearing area in the operation room, has been designed to optimize dose distribution and to improve the efficiency of radiation treatment method with linear accelerator. This applicator system consisted of collimator holder with shielded metals and docking cone with transparent acrylic cylinder, A number of technical innovations have been used in the design of this system, this dooking cone gives a improving latral dose coverage at therapeutic volume. The position of $90\%$ isodose curve under suface of 8 cm diameter cone was extended $4\sim7$ mm at 12 MeV electron and the isodose measurements beneath the cone wall showed hot spots as great as $106\%$ for acrylic cone. The leakage radiation dose to tissues outside the cone wall was reduced as $3\sim5\%$ of output dose. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented.
Lee Sung Ah;Lee Jeong Ok;Moon Sun Rock;Won Jong Jin;Kang Jeong Ku;Kim Seung Kon
Radiation Oncology Journal
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v.13
no.3
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pp.285-289
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1995
Purpose : We compared the calcualted percent depth dose curves of 6 MeV electron beam to that of measured to evaluate the usefulness of Monte-carlo simulation method in radiation physics. Materials and Methods : The radiation dose values of 6 MeV electron beam using EGS4 code with one million histories in water were compared values that were measured from the depth dose curve of electron beam irradiated by medical accelerator ML6M. The central axis dose values were calculated according to the changing field size. such as $5{\times}5,\;10{\times}10,\;15{\times}15,\;20{\times}20cm^2$. Results : The value calculated showed a very similar shape to depth dose curve. The calculated and measured value of $D_max$ at $10{\times}10cm^2$ cone is 15mm and 14mm respectively. The calculated value of the surface radiation dose rate is $65.52\%$ and measured one is $76.94\%$. The surface radiation dose rate has varied from $64.43\%$ to $66.99\%$. The calculated values of $D_max$ are in the range between 15mm and 18mm. The calculated value was fitted well with measured value around the $D_max$ area, excluding build up range and below the $90\%$ depth dose area. Conclusion : This result suggested that the calculation of dose value can be replace the direct measurement of the dose for radiation therapy. Also, EGS4 may be a very convenient program to assess the effect of radiation dose using by personal computers.
Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.
Less execution of the electron arc treatment could in large part be attributed to the lack of an adequate planning system. Unlike most linear accelerators providing the electron arc mode, no commercial planning systems for the electron arc plan are available at this time. In this work, with the expectation that an easily accessible planning system could promote electron arc therapy, a commercial planning system was commissioned and evaluated for the electron arc plan. For the electron arc plan with use of a Varian 21-EX, Pinnacle3 (ver. 7.4f), with an electron pencil beam algorithm, was commissioned in which the arc consisted of multiple static fields with a fixed beam opening. Film dosimetry and point measurements were executed for the evaluation of the computation. Beam modeling was not satisfactory with the calculation of lateral profiles. Contrary to good agreement within 1% of the calculated and measured depth profiles, the calculated lateral profiles showed underestimation compared with measurements, such that the distance-to-agreement (DTA) was 5.1 mm at a 50% dose level for 6 MeV and 6.7 mm for 12 MeV with similar results for the measured depths. Point and film measurements for the humanoid phantom revealed that the delivered dose was more than the calculation by approximately 10%. The electron arc plan, based on the pencil beam algorithm, provides qualitative information for the dose distribution. Dose verification before the treatment should be mandatory.
The aims are to evaluate the effects of an 1.0 cm acrylic plate and SSD on the dose profile and depth dose distribution of 9 MeV electron beam and to analyse adequacy for using an acrylic plate to reduce energy of electron beams. An acrylic plate of 1.0 cm thickness was used to reduce energy of 9 MeV electron beam to 7 MeV. The plate was put on an electron applicator at 65.4 cm distance from x-ray target. The size of the applicator was 10${\times}$l0cm at 100 cm SSD. For 100cm, l05cm and 110cm SSD, depth dose on beam axis and dose profiles at d$\_$max/ on two principal axes were measured using a 3D water phantom. From depth dose distributions, d$\_$max/, d$\_$85/, d$\_$50/ and R$\_$p/, surface dose, and mean energy and peak energy at surface were compared. From dose profiles flatness, penumbra width and actual field size were compared. For comparison, 9 MeV electron beams were measured. Surface dose of 7 MeV electron beams was changed from 85.5% to 82.2% increasing SSD from 100 cm to 110 cm, and except for dose buildup region, depth dose distributions were independent of SSD. Flatness of 7 MeV ranged from 4.7% to 10.4% increasing SSD, comparing 1.4% to 3.5% for 9 MeV. Penumbra width of 7 MeV ranged from 1.52 cm to 3.03 cm, comparing 1.14 cm to 1.63 cm for 9 MeV. Actual field size increased from 10.75 cm to 12.85 cm with SSD, comparing 10.32 cm to 11.46 cm for 9 MeV. Virtual SSD's of 7 and 9 MeV were respectively 49.8 cm and 88.5cm. In using energy reducer in electron therapy, depth dose distribution were independent of SSD except for buildup region as well as open field. In case of using energy reducer, increasing SSD made flatness to deteriorate more severely, penumbra width more wide, field size to increase more rapidly and virtual SSD more short comparing with original electron beam. In conclusion, it is desirable to use no energy reducer for electron beam, especially for long SSD.
Purpose : To evaluate the effects of surgical excision followed by radiation therapy for Prevention of keloids and hypertrophic scars. Materials and Methods : From October 1987 to April 1995, radiation therapy was applied to 167 sites in 106 patients with surgical excision in an attempt to prevention of recurrence against keloids and hypertrophic scars. The main etiology of the keloids and hypertrophic scars were surgery in $49.2\%,\;trauma\;in\;25.0\%,\;ear-piercing\;in\;5.4\%,\;and\;burn\;in\;5.4\%$, The Patients' ages ranged from 3 to 70 years with a median of 32 years. Radiation therapy used ranged from 6 to 8MeV electron beam. Radiation therapy was delivered within 24 hours of surgical excision. Several dose schedules were used, varing from 400cGy in 1 daily fraction to 1900cGy in 4 daily fractions. The average total dose was 1059cGy, and the average dose per fraction was 433cGy. All patients were followed up from 24 to 114 months with a median follow up of 49 months. Results : The overall recurrence rate was $12.6\%$ (21/167) The overall 1-year and 2-year recurrence rates were $10.2\%\;and\;11.4\%$, respectively Among 21 recurrent sites, seventeen sites $(81\%)$ were confirmed within 12 months after surgical excision. Period to recurrence ranged from 1 month to 47 months with a median recurrence time of 9.6 months, The history of previous therapy was only a significant factor in recurrence. Twenty-four patients had history of previous therapy recurrence rates was significantly higher in this group than those without history of Previous therapy $(22.6\%\;vs.\;11.0\%,\;p=0.04)$. There was no serious complication related to radiation therapy. Conclusion : This study suggests that surgical excision followed by radiation therapy is an effective method of preventing keloids and hypertrophic scars.
In the field of radiation therapy using photon beams and electron beams, since each patient has a different sensitivity to radiation, skin side effects may occur even at the same dose. Therefore, if there is a risk of excessive dose to the skin, a dosimeter is attached to verify whether the correct dose is being investigated. However, since the skin dosimeter checks the attachment site visually by measuring a point dose, it is difficult to confirm an accurate dose distribution. As a result, the measurement and simulation errors of the material HgI2 in the 6 MV photon beam were 3.73% and 5.24%, respectively, at the minimum thickness of 25 ㎛, and the material PbI2 was 4.73% and 5.65%, respectively. On the other hand, as a result of the 6 MeV electron beam, the measurement and simulation errors of the material HgI2 were 1.35% and 1.12%, respectively, at a minimum thickness of 25 ㎛, and the material PbI2 showed relatively low attenuation error, 1.67% and 1.20%, respectively. Therefore, it was evaluated that the thickness of the photon beam within 25 ㎛ and the electron beam within 100 ㎛ is suitable to have a reduction rate error within 5%. This study presents a new research direction for a flexible dosimeter attached to the human body that is required in clinical practice and the construction conditions of a future skin dosimeter.
For intraoperative radiation therapy using electron beams, a cone system to deliver a large dose to the tumor during surgical operation and to save the surrounding normal tissue should be developed and dosimetry for the cone system is necessary to find proper X-ray collimator setting as well as to get useful data for clinical use. We developed a docking type of a cone system consisting of two parts made of aluminum: holder and cone. The cones which range from 4cm to 9cm with 1cm step at 100cm SSD of photon beam are 28cm long circular tubular cylinders. The system has two 26cm long holders: one for the cones larger than or equal to 7cm diamter and another for the smaller ones than 7cm. On the side of the holder is an aperture for insertion of a lamp and mirror to observe treatment field. Depth dose curve. dose profile and output factor at dept of dose maximum. and dose distribution in water for each cone size were measured with a p-type silicone detector controlled by a linear scanner for several extra opening of X-ray collimators. For a combination of electron energy and cone size, the opening of the X-ray collimator was caused to the surface dose, depths of dose maximum and 80%, dose profile and output factor. The variation of the output factor was the most remarkable. The output factors of 9MeV electron, as an example, range from 0.637 to 1.549. The opening of X-ray collimators would cause the quantity of scattered electrons coming to the IORT cone system. which in turn would change the dose distribution as well as the output factor. Dosimetry for an IORT cone system is inevitable to minimize uncertainty in the clinical use.
This study peformed to confirm the corrected dose In different electron density materials using the superposition/FFT convolution method in radiotherapy Planning system. The experiments of the $K_2HPO_4$ diluted solution for bone substitute, Cork for lung and n-Glucose for soft tissue are very close to effective atomic number of tissue materials. The image data acquisited from the 110 KVp and 130 KVp CT scanner (Siemes, Singo emotions). The electron density was derived from the CT number (H) and adapted to planning system (Xio, CMS) for heterogeneity correction. The heterogeneity tissue phantom used for measurement dose comparison to that of delivered computer planning system. In the results, this investigations showed the CT number is highly affected in photoelectric effect in high Z materials. The electron density in a given energy spectrum showed the relation of first order as a function of H in soft tissue and bone materials, respectively. In our experiments, the ratio of electron density as a function of H was obtained the 0.001026H+1.00 in soft tissue and 0.000304H+1.07 for bone at 130 KVp spectrum and showed 0.000274H+1.10 for bone tissue in low 110 KVp. This experiments of electron density calibrations from CT number used to decide depth and length of photon transportation. The Computed superposition and FFT convolution dose showed very close to measurements within 1.0% discrepancy in homogeneous phantom for 6 and 15 MV X rays, but it showed -5.0% large discrepancy in FFT convolution for bone tissue correction of 6 MV X rays. In this experiments, the evaluated doses showed acceptable discrepancy within -1.2% of average for lung and -2.9% for bone equivalent materials with superposition method in 6 MV X rays. However the FFT convolution method showed more a large discrepancy than superposition in the low electron density medium in 6 and 15 MV X rays. As the CT number depends on energy spectrum of X rays, it should be confirm gradient of function of CT number-electron density regularly.
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