• Progress in Medical Physics
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• v.19 no.4
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• pp.305-312
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• 2008

The aim of this study is to introduce the accuracy of Ir-192 source's apparent activity using the well-type chamber and the Farmer-type ionization chamber in the high dose rate brachytherapy. We measured the apparent activity of Ir-192 that each medical center in the country has and the apparent activity of calibration certificate provided by manufacturer is compared with that by our experimental measurement. The number of sources used for the activity comparison was 5. The accuracy of the measured activity was in the range of -2.8% to -1.0% and -2.1% to 0.2% for the Farmer-type chamber system (Jig) and for the well-type, respectively. The maximum difference was within 1.0% for comparison with two calibration's tool. Our results demonstrate that well-type chamber as wall as Farmer-type chamber is a appropriate system as the routine source calibration procedures in HDR brachytherapy. Whenever a new source is installed to use in clinics, by periods, a source calibration should be carried out.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.167-175
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• 1998

Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

• Progress in Medical Physics
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• v.15 no.3
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• pp.134-139
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• 2004

This study was aimed to develop a new ovoid applicator for vaginal high-dose rate intracavitary radiation therapy, evaluate uniformity of dose distribution, and assess clinical applicability. The authors evaluated dose uniformity of vaginal mucosa according to 5-different ovoid-separation using 2-channel and modified 3-channel ovoid applicator. There were no significant differences in the dose distribution along the vaginal mucosa with 2 and 2.5 cm separations, but there were between the 2-channel and 3-channel ovoid applicator with a separation of 3 cm or more. Although a low dose area was shown between two ovoid applicators with the 2-channel ovoid applicator, the dose distribution along the vaginal mucosa with the 3-channel ovoid applicator was very uniform.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.243-252
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• 1994

The use of high dose rate remote afterloading system for the treatment of intraluminal lesions necessitates the need for a more accurate of dose distributions around the high intensity brachytherapy sources, doses are often prescribed to a distance of few centimeters from the linear source, and in this range the dose distribution is very difficult to assess. Accurated and optimized dose calculation with stable numerical algorithms by PC level computer was required to treatment intraluminal lesions by high dose rate brachytherapy system. The exposure rate from sources was calculated with Sievert integral and dose rate in tissue was calculated with Meisberger equation, An algorithm for generating a treatment plan with optimized dose distribution was developed for high dose rate intraluminal radiotherapy. The treatment volume becomes the locus of the constrained target surface points that is the specified radial distance from the source dwelling positions. The treatment target volume may be alternately outlined on an x-ray film of the implant dummy sources. The routine used a linear programming formulism to compute which dwell time at each position to irradiate the constrained dose rate at the target surface points while minimizing the total volume integrated dose to the patient. The exposure rate and the dose distribution to be confirmed the result of calculation with algorithm were measured with film dosimetry, TLD and small size ion chambers.

• Progress in Medical Physics
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• v.6 no.1
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• pp.13-18
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• 1995

Dose distribution of HDR-RALS source represents an inverse square law as the distance. Difference of measurement value and calculation value according of brachytherapy. Therefore, in HDR-RALS dose calibration and calculation have an important effect in treatment of uterine cervical cancer and absorbed dose of interesting points. In intracavitary therapy, particula attention is paid for precise determination of the doses to be applied. In this report, we have discussed that the calibration of a HDR-RALS, differences between calculation dose use of isodose chart and measurement in rectum. Dose rate calibration of radiation sources are obtained from air kerma and Г factor with calibraed ion chamber for cobalt source. and used semiconductor detector for compared with measurement in phantom. Eighteen patients were treated with a HDR-RALS for intrcavitarty irradiation (ICR) using a cobalt-cesium source. Repoductivity of dose measurements were 0.3 -1.1％ in phantom. The means of dose distribution was -6- ＋21％ between calculation of isodose chart and measurement of recyum, and was same mean value upper 6.3％ in measurement value than calculation does.

• Progress in Medical Physics
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• v.8 no.1
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• pp.25-29
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• 1997

Ir-192 source activity for high dose rate brachytherapy is measured using Farmertype ionization chamber. The source-to-chamber distance is 10 cm and the measured charge unit is converted to activity unit. The measured values are compared to the values provided from vendor. Because of time dependency of Ir-192 source activity, the activities are regularly checked and compared to calculated values. As the accuracy of Ir-192 source activity is depend on the mechanical measurement setup, we estimated the precision of remote controlled source dwell position using home-made device and film scanner. The difference between measured and predicted dwell position is within 1 mm. As a result, the errors of source activity are 0.7${\pm}$1.5 ％ for measured and vendor-provided values and 0.l${\pm}$1.2％ for measured and time-dependent calculated vlaues. In conclusion, our measured activity has been comparable to the values provided from vendor and our brachytherapy unit has been very accurate until now. Regular quality control of brachytherapy is essential for successful treatment which depends on the accuracy of source position and activity.

• Progress in Medical Physics
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• v.15 no.4
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• pp.192-196
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• 2004

The activity of Ir-192 sources for high dose rate (HDR) Brachytherapy in Korea were measured by using the well-type chamber and using the calibration Jig with the Farmer-type ionization chamber to compare the manufacturer certificated source strength which is supplied with each new Ir-192 source. The activity of two different source models used in six hospitals were measured. The range of measured activities to the manufacturer's suggested ones was -2.40% to +3.31% for the calibration Jig and -3.12% to 0.00% for the well-type chamber system. The source strength values given by the manufacturer for the 6 sources were within ${\pm}5%$ for the two different measuring equipment. Our results demonstrate that well-type chamber as wall as Farmer-type chamber system are appropriate system for the routine source calibration procedures in HDR brachytherapy. Whenever a new source is installed to use in clinics, a source calibration should be carried out.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.331-338
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• 1995

Purpose : To evaluate our clinical experience with the combination of teletherapy and intraluminal brachytherapy in patients with unresectable or inoperable esophageal cancers. Materials and Methods : From Nov 1989 to Mar 1993, twenty patients with esophageal cancer were treated with radical radiotherapy and intraluminal brachytherapy at Yonsei Cancer Center. All patients had squamous histolgy and stage distribution was as follows: stage II, 4($20{\%}$)patients; III, 15 ($75{\%}$)patients; IV, 1($5{\%}$)patients. A dose of S-12Gy/1-3weeks with intraluminal brachytherapy (3-5Gy/fraction) to 5mm from the outside of the esophageal tube using high dose rate Iridium-192 remotely afterloading brachytherapy machine was given 2 weeks after a total dose of 59-64Gy with external radiotherapy. Induction chemotherapy using cisplatin and 5-FU was performed in 13 patients with median 3 cycles(1-6 cycles), Response rate, local control rate, survival and complications were analysed retrospectively. Results : Two-year overall survival rate and median survival were $15.8{\%}$ and 13.5 months. Response rates were as follows complete remission(CR) 5($25{\%}$): partial remission a(PRa) 7($35{\%}$): partial remission b(PRb) 7($35{\%}$), no response(NR) 1($5{\%}$). Patterns of failure were as follows; local failure 13($65{\%}$), local and distant failure 3($15{\%}$), distant failure 0($0{\%}$). Ultimate local control rate was $20{\%}$. Treatment related complications included esophageal ulcer in two patients and esophageal stricture in one. Conclusion : Though poor local conrol rate, median survival was improved as compared with previous results of radiation therapy alone(8months) and chemoradiation combined treatment(11 months) in Yonsei Cancer Center High-dose-rate intraluminal brachytherapy following external irradiation is an effective treatment modality with acceptable toxicity in esophageal cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.29-37
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• 2004

Purpose : A rectum and a bladder should be carefully considered in order to decrease side effects when HDR patient of uterine cervix cancer. Generally speaking, the value of dosimeter at a rectum and a bladder only depends on the value of a planning equipment, while some analyses of the value of dosimetry at rectum with TLD has been reported Or the contrary, it is hardly to find a report with in vivo dosimetry(diode detector). On this thesis, we would like to suggest the following. When a patient of uterine cervix cancer is in therapy, it is helpful to put a diode detector inside of a rectum in order to measure the rectal dose Based upon the result of the dosimetry, the result can be used as basic data at decreasing side effects. Materials and Methods : Six patients of uterine cervix cancer(four with tandem and ovoid, one with cylinder, and the other one with tandem and cylinder) who had been irradiated with HDR. Ir-192 totally 28 times from February 2003 to June 2003. We irradiated twice in the same distant spots with anterior film and lateral film whenever we measured with a diode detector. Then we did planning and compared each film. Results : The result of the measurement 4 patients with a diode detector is the following. The average and deviation from 3 patients with tandem and ovoid were $274.1{\pm}13.4cGy$, from 1 patient with tandem and ovoid were $126.1{\pm}7.2cGy$, from 1 patient with cylinder were $99.7{\pm}7.1cGy$, and from 1 patient with tandem and cylinder were $77.7{\pm}11.5cGy$. Conclusion : It is difficult to predict how the side effect of a rectum since the result of measurement with a diode detector depends on the state of a rectum. According to the result of the study, it is effective to use a TLD or an in vivo dosimetry and measure a rectum in order to consider the side effect. It is very necessary to decrease the amount of irradiation by controlling properly the duration of the irradiation and gauze packing, and by using shield equipments especially when side effects can be expected.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.407-413
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• 2008

Measurements of the peripheral dose were performed using a 2D array ion chamber and solid water phantom for a $10{\times}10cm$, source-surface distance (SSD) 90cm, 6 and 15MV photon beam at depths of 0.5cm, 5cm through $d_{max}$. Measurements of peripheral dose at 0.5cm and 5cm depths were performed from 1cm to 5cm outside of fields for the dynamic wedge and physical wedge $15^{\circ}$, $45^{\circ}$. For 6MV photon beam, the average peripheral dose of dynamic wedge were lower by 1.4% and 0.1% than that of physical wedge For 15MV photon beam, the peripheral dose of dynamic wedge were lower by maximum 1.6% that of physical wedge. The results showed that dynamic wedge can reduce scattered dose of clinical organ close to the field edge. The wedge systems produce different peripheral dose that should be considered in properly choosing a wedge system for clinical use.