• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.225-232
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• 2014

Purpose : The purpose of this study was to evaluate the surface and superficial dose for patients requiring postmastectomy radiation therapy(PMRT) with different treatment techniques. Materials and Methods : Computed tomography images were acquired for the phantom(I'mRT, IBA) consisting of tissue equivalent material. Hypothetical chestwall and lung were outlined and modified. Five treatment techniques(Wedged Tangential; WT, 4-field IMRT, 7-field IMRT, TOMO DIRECT, TOMO HELICAL) were evaluated using only 6MV photon beam. GafChromic EBT3 film was used for dose measurements at the surface and superficial dose. Surface dose profiles around the phantom were obtained for each treatment technique. For superficial dose measurements, film were used inside the phantom and analyzed superficial region for depth from 1-6mm. Results : TOMO DIRECT showed the highest surface dose by 47~70% of prescribed dose, while 7-field IMRT showed the lowest by 35~46% of prescribed dose. For the WT, 4-field IMRT and 7-field IMRT, superficial dose were measured over 60%, 70%, and 80% for 1mm, 2mm, and 5mm depth, respectively. In case of TOMO DIRECT and TOMO HELICAL, over 75%, 80%, and 90% of prescribed dose was measured, respectively. Surface and superficial dose range were uniform in overall chestwall for the 7-field IMRT and TOMO HELICAL. In contrast, Because of the dose enhancement effect with oblique incidence, The dose was gradually increased toward the obliquely tangential angle for the WT and TOMO DIRECT. Conclusion : For PMRT, TOMO DIRECT and TOMO HELICAL deliver the higher surface and superficial doses than treatment techniques based linear accelerator. It showed adequate dose(over 75% of prescribed dose) at 1mm depth in skin region.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.225-232
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• 1994

Purpose : This study was to obtain the basic dosimetric data using the 10 MV X-ray for the total body irradiation. Materials and Methods : A linear accelerator photon beam is planned to be used as a radiation source for total body irradiation (TBI) in Chonnam University Hospital. The planned distance from the target to the midplane of a patient is 360cm and the maximum geometric field size is 144cm x 144cm. Polystyrene phantom sized $30{\times}30{\times}30.2cm^3$ and consisted of several sheets with various thickness, and a parallel plate ionization chamber were used to measure surface dose and percent depth dose (PDD) at 345cm SSD, and dose profiles. To evaluate whether a beam modifier is necessary for TBI, dosimetry in build up region was made first with no modifier and next with an 1cm thick acryl plate 20cm far from the polystyrene phantom surface. For a fixed sourec-chamber distance, output factors were measured for various depth. Results : As any beam modifier was not on the way of radiation of 10MV X-ray, the $d_{max}$ and surface dose was 1.8cm and $61\%$, respectively, for 345cm SSD. When an 1cm thick acryl plate was put 20cm far from polystyrene phantom for the SSD, the $d_{max}$ and surface dose were 0.8cm and $94\%$, respectively. With acryl as a beam spoiler, the PDD at 10cm depth was $78.4\%$ and exit dose was a little higher than expected dose at interface of exit surface. For two-opposing fields for a 30cm phantom thick phantom, the surface dose and maximum dose relative to mid-depth dose in our experiments were $102.5\%$ and $106.3\%$, respectively. The off-axis distance of that point of $95\%$ of beam axis dose were 70cm on principal axis and 80cm on diagonal axis. Conclusion: 1. To increase surface dose for TBI by 10MV X-ray at 360cm SAD, 1cm thick acrylic spoiler was sufficient when distance from phantom surface to spoiler was 20cm. 2. At 345cm SSD, 10MV X-ray beam of full field produced a satisfiable dose uniformity for TBI within $7\%$ in the phantom of 30cm thickness by two-opposing irradiation technique. 3. The uniform dose distribution region was 67cm on principal axis of the beam and 80cm on diagonal axis from beam axis. 4. The output factors at mid-point of various thickness revealed linear relation with depth, and it could be applicable to practical TBI.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.67-77
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• 2003

I. Purpose Uniform dose distribution of the whole body is essential factor for the total body irradiation(TBI). In order to achieved this goal, we used to compensation filter to compensate body contour irregularity and thickness differences. But we can not compensate components of body, namely lung or bone. The purpose of this study is evaluation of dose attenuation in bone tissue when TBI using diode detectors and TLD system. II. Materials and Methods The object of this study were 5 patients who undergo TBI at our hospital. Dosimetry system were diode detectors and TLD system. Treatment method was bilateral and delivered 10MV X-ray from linear accelerator. Measurement points were head, neck, pelvis, knees and ankles. TLD used two patients and diode detectors used three patients. III. Results Results are as followed. All measured dose value were normalized skin dose. TLD dosimetry : Measured skin dose of head, neck, pelvis, knees and ankles were $92.78{\pm}3.3,\;104.34{\pm}2.3,\;98.03{\pm}1.4,\;99.9{\pm}2.53,\;98.17{\pm}0.56$ respectably. Measured mid-depth dose of pelvis, knees and ankles were $86{\pm}1.82,\;93.24{\pm}2.53,\;91.50{\pm}2.84$ respectably. There were $6.67\%{\sim}11.65\%$ dose attenuation at mid-depth in pelvis, knees and ankles. Diode detector : Measured skin dose of head, neck, pelvis, knees and ankles were $95.23{\pm}1.18,\;98.33{\pm}0.6,\;93.5{\pm}1.5,\;87.3{\pm}1.5,\;86.90{\pm}1.16$ respectably. There were $4.53\%{\sim}12.6\%$ dose attenuation at mid-depth in pelvis, knees and ankles. IV. Conclusion We concluded that dose measurement with TLD or diode detector was inevitable when TBI treatment. Considered dose attenuation in bone tissue, We must have adequately deduction of compensator thickness that body portion involved bone tissue.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.813-818
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• 2014

Aims: To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer. Materials and Methods: Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour. The patients treated with IBT alone (n=42) received 39-42 Gy/10-14 fractions (median=40 Gy/10 fractions). With respect to the combination therapy group (n=42), prescription dose comprised of 12-18 Gy/3-6 fractions (median=15 Gy/5 fractions) for IBT and 40-50 Gy/20-25 fractions (median=50 Gy/25 fractions) for external radiotherapy. Brachytherapy was given as 2 fractions per day 6 hours apart with 4 Gy per fraction for monotherapy and 3 Gy per fraction for combination therapy. Results: Four patients were not evaluable in the analysis of outcome. The primary site relapse rates were 23.8% (10/42) and 68.4% (26/38) in patients treated with IBT alone and combination therapy, respectively (p<0.001). Salvage surgery was performed in 19 patients. The 5-year local control rate was estimated at 62% and the disease-free survival (DFS) rate at 52% for all patients. Local control with respect to T1 and T2 tumours was 84% and 42%, respectively. Conclusions: Our present series on HDR-IBT and the previous report on LDR-IBT for head and neck cancer demonstrated similar DFS rates at 5 years (52%). The rate of regional failure in node-negative patients was <20% in both of our series. HDR-IBT offers similar results to LDR-IBT for head and neck cancer.

• Progress in Medical Physics
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• v.23 no.4
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• pp.269-278
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• 2012

Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.351-355
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• 1998

Cutaneous angiosarcomas are uncommon malignancies which account about 1$\%$ of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed Photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed to the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7$\%$ of the prescribed dose by TLD readings.

• Proceedings of the Korean Vacuum Society Conference
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• 2016.02a
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• pp.312.1-312.1
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• 2016

We have deposited ZnO thin films by ultraviolet (UV) enhanced atomic layer deposition using diethylznic (DEZ) and water (H2O) as precursors with UV light. The atomic layer deposition relies on alternating dose of the precursor on the surface and subsequent chemisorption of the precursors with self-limiting growth mechanism. Though ALD is useful to deposition conformal and precise thin film, the surface reactions of the atomic layer deposition are not completed at low temperature in many cases. In this experiment, we focused on the effects of UV radiation during the ALD process on the properties of the inorganic thin films. The surface reactions were found to be complementary enough to yield uniform inorganic thin films and fully react between DEZ and H2O at the low temperature by using UV irradiation. The UV light was effective to obtain conductive ZnO film. And the stability of TFT with UV-enhanced ZnO was improved than ZnO by thermal ALD method. High conductive UV-enhanced ZnO film have the potential to applicability of the transparent electrode.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.2
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• pp.81-87
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• 2006

Purpose: Few researches have been peformed on the dose distribution of the moving organ for radiotherapy so far. In order to simulate the organ motion caused by respiratory function, multipurpose phantom and moving device was used and dosimetric measurements for dose distribution of the moving organs were conducted in this study. The purpose of our study was to evaluate how dose distributions are changed due to respiratory motion. Materials and Methods: A multipurpose phantom and a moving device were developed for the measurement of the dose distribution of the moving organ due to respiratory function. Acryl chosen design of the phantom was considered the most obvious choice for phantom material. For construction of the phantom, we used acryl and cork with density of $1.14g/cm^3,\;0.32g/cm^3$ respectively. Acryl and cork slab in the phantom were used to simulate the normal organ and lung respectively. The moving phantom system was composed of moving device, moving control system, and acryl and cork phantom. Gafchromic film and EDR2 film were used to measure dose ditrbutions. The moving device system may be driven by two directional step motors and able to perform 2 dimensional movements (x, z axis), but only 1 dimensional movement(z axis) was used for this study. Results: Larger penumbra was shown in the cork phantom than in the acryl phantom. The dose profile and isodose curve of Gafchromic EBT film were not uniform since the film has small optical density responding to the dose. As the organ motion was increased, the blurrings in penumbra, flatness, and symmetry were increased. Most of measurements of dose distrbutions, Gafchromic EBT film has poor flatness and symmetry than EDR2 film, but both penumbra distributions were more or less comparable. Conclusion: The Gafchromic EBT film is more useful as it does not need development and more radiation dose could be exposed than EDR2 film without losing film characteristics. But as response of the optical density of Gafchromic EBT film to dose is low, beam profiles have more fluctuation at Gafchromic EBT. If the multipurpose phantom and moving device are used for treatment Q.A, and its corrections are made, treatment quality should be improved for the moving organs.

• Progress in Medical Physics
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• v.2 no.2
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• pp.109-120
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• 1991

Total body irradiation is operated to irradicate malignant cells of bone marrow of patients to be treated with bone marrow transplantation. Field size of a linear accelerator or cobalt teletherapy unit with normal geometry for routine technique is too small to cover whole body of a patient. So, any special method to cover patient whole body must be developed. Because such environments as room conditions and machine design are not universal, some characteristic method of TBI for each hospital could be developed. At Seoul National University Hospital, at present, only a cobalt unit is available for TBI because source head of the unit could be tilted. When the head is tilted outward by 90$^{\circ}$, beam direction is horizontal and perpendicular to opposite wall. Then, the distance from cobalt source to the wall was 319 cm. Provided that the distance from the wall to midsagittal plane of a patient is 40cm, nominal field size at the plane(SCD 279cm) is 122cm$\times$122cm but field size by measurement of exposure profile was 130cm$\times$129cm and vertical profile was not symmetric. That field size is large enough to cover total body of a patient when he rests on a couch in a squatting posture. Assuming that average lateral width of patients is 30cm, percent depth dose for SSD 264cm and nominal field size 115.5cm$\times$115.5cm was measured with a plane-parallel chamber in a polystyrene phantom and was linear over depth range 10～20cm. An anthropomorphic phantom of size 25cm wide and 30cm deep. Depth of dose maximum, surface dose and depth of 50% dose were 0.3cm, 82% and 16.9cm, respectively. A dose profile on beam axis for two opposing beams was uniform within 10% for mid-depth dose. Tissue phantom ratio with reference depth 15cm for maximum field size at SCD 279cm was measured in a small polystyrene phantom and was linear over depth range 10～20cm. An anthropomorphic phantom with TLD chips inserted in holes on the largest coronal plane was bilaterally irradiated by 15 minute in each direction by cobalt beam aixs in line with the cross line of the coronal plane and contact surface of sections No. 27 and 28. When doses were normalized with dose at mid-depth on beam axis, doses in head/neck, abdomen and lower lung region were close to reference dose within $\pm$ 10% but doses in upper lung, shoulder and pelvis region were lower than 10% from reference dose. Particulaly, doses in shoulder region were lower than 30%. On this result, the conclusion such that under a geometric condition for TBI with cobalt beam as SNUH radiotherapy departement, compensators for head/neck and lung shielding are not required but boost irradiation to shoulder is required could be induced.

• Journal of radiological science and technology
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• v.33 no.3
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• pp.277-282
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• 2010

The study is to verify non-uniform dose distribution in Field-In-Field (FIF) technique using two-dimensional ionization chamber (MatriXX, Wellhofer Dosimetrie, Germany) for breast tangential irradiation. The MatriXX and an inverse planning system (Eclipse, ver 6.5, Varian, Palo Alto, USA) were used. Hybrid plans were made from the original twenty patients plans. To verify the non-uniform dose distribution in FIF technique, each portal prescribed doses (90 cGy) was delivered to the MatriXX. The measured doses on the MatriXX were compared to the planned doses. The quantitative analyses were done with a commercial analyzing tool (OmniPro IMRT, ver. 1.4, Wellhofer Dosimetrie, Germany). The delivered doses at the normalization points were different to average 1.6% between the calculated and the measured. In analysis of line profiles, there were some differences of 1.3-5.5% (Avg: 2.4%), 0.9-3.9% (Avg: 2.5%) in longitudinal and transverse planes respectively. For the gamma index (criteria: 3 mm, 3%) analyses, there were shown that 90.23-99.69% (avg: 95.11%, std: 2.81) for acceptable range ($\gamma$-index $\geq$ 1) through the twenty patients cases. In conclusion, through our study, we have confirmed the availability of the FIF technique by comparing the calculated with the measured using MatriXX. In the future, various clinical applications of the FIF techniques would be good trials for better treatment results.