• 제목/요약/키워드: high-dose therapy

검색결과 640건 처리시간 0.027초

비인강암 환자의 고선량 강내 방사선 치료의 효과 (The Role of High Dose Rate (HDR) Intracavitary Radiation Therapy for the Management of Nasopharyngeal Carcinoma)

  • 조정길;장혜숙;최은경
    • Radiation Oncology Journal
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    • 제11권1호
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    • pp.91-96
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    • 1993
  • From September 1989 to June 1992,22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stge II (T2NO), 4 with stage III (T3NO, T1-3N1), and 16 with stage IV (T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 months). Twenty one patients showed a complete response ore month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was $100{\%}$ in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were $94{\%}$ and $67{\%}$, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap. given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.

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Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation

  • Yoo, Taeyeon;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권4호
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    • pp.244-251
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    • 2017
  • Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed $2.1{\pm}0.3$ times and $2.9{\pm}0.4$ times, respectively. After disimpaction, the frequency of defecation increased from $2.2{\pm}0.3$ per week to once a day ($1.1{\pm}0.1$ per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

방사성 요오드 치료 후, 퇴원 선량 측정에 있어 각국의 기준 및 권고 비교 (The Study on the Dilution Time of Radioactive Tracer in Estradiol Measurement)

  • 이승재;서수현;이성하;박용성;오기백;김재삼
    • 핵의학기술
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    • 제21권2호
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    • pp.49-54
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    • 2017
  • Purpose The high-dose administration of I-131 has been standing for the basic therapy method of thyroid cancer. In korea, it is not necessary for patients to be hospitalized if the administration dose are under 1.2 GBq. However, if the dose are over 1.2 GBq, the patients should be stay in special ward with radiation shield. In such cases, the radioactivity level upon release should be under a dose of $70{\mu}Sv/hr$ at a distance of approx. 1m. This regulation bring the patients to stay for about 2 to 3 days in ward before the release. Materials and Methods Using the inpatients' release data of severance hospital, an inpatient-days were retrospectively calculated and compared with practical data and estimate the inpatient-days with the conditions of korea ($70{\mu}Sv/hr$), Japan ($30{\mu}Sv/hr$), germany ($3.5{\mu}Sv/hr$ at a distance of approx. 2 m), and other european countries. Results When a effective half-life of 15.4 was used, the expected inpatient-days were calculated as 2.15 days in the condition of Japanese regulation and 1.37 days in the condition of korean regulation. The practical inpatient-days of patients in Severance hospital were 1.32 days. Conclusion As ICRP 94 has been mentioned that the release of patients administrated with I-131 for the therapy should be carefully considered because each patients has different thyroid uptake rate and their conditions with family members after the release from the ward. Nonetheless, efforts to bring more aquate data which is for getting closer to the practical data should be continuously studied.

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EPID와 FSRT를 이용한 치료표적위치 검증에 관한 연구 (A Study on Treatment Target Position Verification by using Electronic Portal Imaging Device & Fractionated Stereotatic Radiotherapy)

  • 이동훈;권장우;박승우;김윤종;이동한;지영훈
    • 전자공학회논문지SC
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    • 제46권3호
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    • pp.44-51
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    • 2009
  • 고 에너지 방사선을 이용하여 종양을 치료하는 과정 중 발생하는 오차를 확인하여 보다 정교한 치료를 시행하는 것은 매우 중요하다. 특히, 두경부 종양을 치료하기 위해 작은 조사면에 방사선을 집중 조사하는 정위 방사선 분할치료와 같은 특수 치료에서는 치료위치의 확인을 더욱 요구하고 있다. 작은 조사면에 고선량의 방사선을 표적체적에 집중 조사하는 정위 방사선 분할 치료법에서 치료 중심점의 정확도 검증은 매우 중요하므로 표적에 3mm 납 볼을 놓고 정위 방사선 분할 치료용 25mm 콘을 장착한 후 얻은 전자 포탈 영상으로부터 콘 원의 중심점과 볼 원의 중심점을 영상처리를 통해 서로 비교해 본 결과 1픽셀(0.76mm)의 정확도까지 얻을 수 있었다. 정위 방사선 분할 치료에 전자 포탈 영상 장치를 적용하여 치료위치오차 여부를 검증하였다. 이를 위해 첫 번째 정위 방사선 분할 치료 영상과 임의로 2mm 이동시킨 후 얻은 영상의 두개골 외곽선을 검출한 후 서로 비교해 본 결과 발생된 2mm 오차를 검증할 수 있었다. 본 논문에서는 개발된 비디오 기반 전자포탈영상장치와 정위 방사선 분할치료장치를 이용하여 실시간적으로 포탈영상을 획득할 수 있었으며 치료위치 검증을 통해 보다 정교한 방사선 치료를 할 수 있으리라 본다.

Fetal dose from Head and Neck Tomotherapy Versus 3D Conformal Radiotherapy

  • Park, So Hyun;Choi, Won Hoon;Choi, Jinhyun
    • Journal of Radiation Protection and Research
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    • 제44권4호
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    • pp.156-160
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    • 2019
  • Background: To compare the dose of radiation received by the fetus in a pregnant patient irradiated for head and neck cancer using helical tomotherapy and three-dimensional conformal radiation therapy (3DCRT). Materials and Methods: The patient was modeled with a humanoid phantom to mimic a gestation of 26 weeks. Radiotherapy with a total dose of 2 Gy was delivered with both tomotherapy (2.5 and 5.0 cm jaw size) and 3DCRT. The position of the fetus was predicted to be 45 cm from the field edge at the time of treatment. The delivered dose was measured according to the distance from the field edge and the fetus. Results and Discussion: The accumulated dose to the fetus was 1.6 cGy by 3DCRT and 2 and 2.3 cGy by the 2.5 and 5 cm jaw tomotherapy plans. For tomotherapy, the fetal dose with the 2.5 cm jaw was lower than that with the 5 cm jaw, although the radiation leakage was greater for 2.5 cm jaw plan due to the 1.5 fold longer beam-on time. At the uterine fundus, tomotherapy with a 5 cm jaw delivered the highest dose of 2.4 cGy. When the fetus moves up to 35 cm at the 29th week of gestation, the resultant fetal doses for 3DCRT and tomotherapy with 2.5 and 5 cm jaws were estimated as 2.1, 2.7, and 3.9 cGy, respectively. Conclusion: For tomotherapy, scattering radiation was more important due to the high monitor unit values. Therefore, selecting a smaller jaw size for tomotherapy may reduce the fetal dose. however, evaluation of risk should be individually performed for each patient.

고 에너지 전자선 치료를 위한 3D 프린터 물질의 차폐 성능평가 (Evaluation of Shielding Performance of 3D Printer Materials for High-energy Electron Radiation Therapy)

  • 오창우;배상일;문영민;양현경
    • 한국방사선학회논문지
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    • 제16권6호
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    • pp.687-695
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    • 2022
  • 고 에너지 전자선 치료 시 차폐체로 사용되는 납을 대체할 수 있는 3D 프린터 소재를 찾기 위해 MCNP6 프로그램을 사용하였다. 고 에너지 전자선을 방출하는 선형가속기의 PDD(Percent Depth Dose), Flatness, Symmetry를 측정하고, MCNP6로 선형가속기를 모의 모사 후 비교하여 실측과 모의 모사와의 선원항이 일치함을 확인하였다. 납 차폐체를 모의 모사하여, 흡수선량의 95 % 이상을 차폐할 수 있는 납 차폐체의 적정 두께를 선정하였다. 3 mm 두께의 납 차폐체에 대한 흡수선량 데이터를 기준으로 하여 ABS + W(10%), ABS + Bi(10%), PLA + Fe(10%) 소재들의 1, 5, 10, 15 mm 두께 별로 모의 모사로 분석하여 차폐성능을 분석하였다. 3D 프린터로 각각의 시제품을 제작하여 모의 실험과 같은 조건으로 측정하여 분석한 결과 ABS+W(10%) 소재가 최소 10 mm 이상의 두께로 형성되었을 때, 3 mm 두께의 납을 대체할 수 있는 차폐성능을 가지는 것을 확인하였다. 주사전자현미경(SEM)과 EDS 스펙트럼을 이용하여 ABS + W(10%) 소재의 원소조성 및 표면형상을 분석하였다. 이러한 결과를 통해, 상용화 된 납 차폐체를 ABS + W(10%) 소재로 대체하면 납과 같은 차폐효과를 낼 뿐만 아니라 3D 프린터를 이용하여 환자 맞춤형으로 제작할 수 있어 고 에너지 전자선 치료에 매우 유용할 수 있음을 확인하였다.

Urosodeoxycholic Acid Therapy in a Child with Trimethoprim- Sulfamethoxazole-induced Vanishing Bile Duct Syndrome

  • Cho, Hyun Jeong;Jwa, Hye Jeong;Kim, Kyu Seon;Gang, Dae Yong;Kim, Jae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권4호
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    • pp.273-278
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    • 2013
  • We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.

In Vitro and in Vivo Antitumor Evaluation of Berbamine for Lung Cancer Treatment

  • Hou, Zhi-Bo;Lu, Kai-Jin;Wu, Xiao-Li;Chen, Cong;Huang, Xin-En;Yin, Hai-Tao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권4호
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    • pp.1767-1769
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    • 2014
  • Purpose: Lung cancer, one of the most frequently diagnosed cancers in the world, is characterized by relatively high morbidity and mortality. Berbamine (BER) has been initially reported to exert anti-proliferative effects against a series of cancers. Methods: In this study the in vitro cytotoxicity of BER was measured by MTT assay. In vivo anti-cancer efficacy of BER was assessed in A549 xenografts. Results: Cytotoxicity tests showed dose-dependent cell growth inhibition effects of BER against A549 cells. Moreover, BER significantly reduced the growth of lung cancer in a dose-dependent manner in nude mice with prolonged survival time. Conclusion: Therefore, BER might be in herbal medicine for cancer therapy and further efforts are needed to explore therapeutic strategies.

방사선 조사 마우스에서 오가피의 면역활성 효과 (Immunostimulating Effects of Acanthopanax in mice following Gamma-ray irradiation)

  • 김계엽;정현우;김경윤
    • 동의생리병리학회지
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    • 제20권3호
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    • pp.670-674
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    • 2006
  • This experimental study was carried out to investigate the immunostimulating effect of Acanthopanax, as Oriental rhizomata herbs, on jejunal survival, endogenous spleen colony formation, apoptosis in jejunal crypt cells and lipid peroxidation in the liver of mice following Gamma-ray irradiation. The subject of this study includes 72 mice which were divided into each 7 groups. Acanthopanax experiment groups were Acanthopanax. Gamma-ray(lOGy), Acanthopanax. Gamma-ray(3Gy), Acanthopnax. Gamma-ray(1Gy), Gamma-ray control(1OGy), Gamma-ray control(3Gy), Gamma-ray control(1Gy), Normal groups. The results of this study were as follows : Treatment with Acanthopanax showed significantly increased(p<0.05) on the cell death apoptosis in crypt, intestine crypts survival of intestine in mice following low-dose(1Gy) Gamma-ray radiation. And that significantly increased(p<0.05) on jejunal crypt survival and reduced(p<0.05) on lipid peroxidation in mice following high-dose(1OGy) Gamma-ray radiation. The above results suggest that Acathopanax were immunostimulating effectively reduced Gamma-ray irradiation.

Long-term management of Graves disease: a narrative review

  • Hyo-Jeong Kim
    • Journal of Yeungnam Medical Science
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    • 제40권1호
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    • pp.12-22
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    • 2023
  • Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.