• Title/Summary/Keyword: 부작용확률

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Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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The Effect of Photoneutron Dose in High Energy Radiotherapy (10 MV 이상 고에너지 치료 시 발생되는 광중성자의 영향)

  • Park, Byoung Suk;Ahn, Jong Ho;Kwon, Dong Yeol;Seo, Jeong Min;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.9-14
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    • 2013
  • Purpose: High-energy radiotherapy with 10 MV or higher develops photoneutron through photonuclear reaction. Photoneutron has higher radiation weighting factor than X-ray, thus low dose can greatly affect the human body. An accurate dosimetric calculation and consultation are needed. This study compared and analyzed the dose change of photoneutron in terms of space according to the size of photon beam energy and treatment methods. Materials and Methods: To measure the dose change of photoneutron by the size of photon beam energy, patients with the same therapy area were recruited and conventional plans with 10 MV and 15 MV were each made. To measure the difference between the two treatment methods, 10 MV conventional plan and 10 MV IMRT plan was made. A detector was placed at the point which was 100 cm away from the photon beam isocenter, which was placed in the center of $^3He$ proportional counter, and the photoneutron dose was measured. $^3He$ proportional counter was placed 50 cm longitudinally superior to and inferior to the couch with the central point as the standard to measure the dose change by position changes. A commercial program was used for dose change analysis. Results: The average integral dose by energy size was $220.27{\mu}Sv$ and $526.61{\mu}Sv$ in 10 MV and 15 MV conventional RT, respectively. The average dose increased 2.39 times in 15 MV conventional RT. The average photoneutron integral dose in conventional RT and IMRT with the same energy was $220.27{\mu}Sv$ and $308.27{\mu}Sv$ each; the dose in IMRT increased 1.40 times. The average photoneutron integral dose by measurement location resulted significantly higher in point 2 than 3 in conventional RT, 7.1% higher in 10 MV, and 3.0% higher in 15 MV. Conclusion: When high energy radiotherapy, it should consider energy selection, treatment method and patient position to reduce unnecessary dose by photoneutron. Also, the dose data of photoneutron needs to be systematized to find methods to apply computerization programs. This is considered to decrease secondary cancer probabilities and side effects due to radiation therapy and to minimize unnecessary dose for the patients.

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Clinical Experience of LINAC-based Stereotactic Radiosurgery for Angiographically Occult Vascular Malformations (혈관조영상 잠재혈관기형에 대한 선형가속기형 정위방사선수술의 임상경험)

  • Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Lee Jeong Eun;Yeo Inhwan;Huh Seung Jae;Noh Young Joo;Shin Seong Soo;Hong Seung-Chyul;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.1-9
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    • 2001
  • Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

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Potential Role of Hedgehog Signaling in Radiation-induced Liver Fibrosis (방사선에 의한 간섬유증에서 헤지호그의 잠재적 역할)

  • Wang, Sihyung;Jung, Youngmi
    • Journal of Life Science
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    • v.23 no.5
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    • pp.710-720
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    • 2013
  • Radiotherapy is commonly used in treating many kinds of cancers which cannot be cured by other therapeutic strategies. However, radiotherapy also induces the damages on the normal tissues. Radiation-induced fibrosis is frequently observed in the patients undergoing radiotherapy, and becomes a major obstacle in the treatment of intrahepatic cancer. Hedgehog (Hh) that is an essential in the liver formation during embryogenesis is not detected in the healthy liver, but activated and modulates the repair process in damaged livers in adult. The expression of Hh increases with the degree of liver damage, regulating the proliferation of hepatic progenitors and hepatic stellate cells (HSC). In addition, Hh induces epithelial-to-mesencymal transition (EMT) and activation of myofibroblasts. In the irradiated livers, up-regulated expression of Hh signaling was associated with proliferation of progenitors, EMT induction, and increased fibrosis. Female-specific expression of Hh leaded to the expansion of progenitors and the accumulation of collagen in the irradiated livers of female mice, indicating that gender disparity in Hh expression may be related with radiation-susceptibility in female. Hence, Hh signaling becomes a novel object of studies for fibrogenesis induced by radiation. However, the absence of the established experimental animal models showing the similar physiopathology with human liver diseases and fibrosis-favorable microenvironment hamper the studies for the radiation-induced fibrosis, providing a few descriptive results. Therefore, further research on the association of Hh with radiation-induced fibrosis can identify the cell and tissue-specific effects of Hh and provides the basic knowledge for underlying mechanisms, contributing to developing therapies for preventing the radiation-induced fibrosis.

Evaluation after Applicated a Mold to a Paraneoplastic Autoimmune Multiorgan Syndrome Patient with Hypervascular Ulcer in the Oral Cavity during Treatment with Mold Brachytherapy (Paraneoplastic Autoimmune Multiorgan Syndrome으로 인하여 구강 내 국소적으로 발생한 과다혈관성 궤양의 방사선 근접치료 시 자체 제작한 Mold의 유용성 평가)

  • Park, Ju-Kyeong;Lee, Sun-Young;Lim, Seok-Geon;Kwak, Geun-Tak;Lee, Seung-Hun;Kim, Yang-Su;Hwang, Ho-In;Cha, Seok-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.25-31
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    • 2009
  • Purpose: Evaluate the mold we have made to improve the reproducibility of the patient position and make homogeneous dose distribution to the treatment volume effectively when treating the patient who has hypervascular ulcer on her tongue caused by paraneoplastic autoimmune multiorgan syndrome by mold brachytherapy. Materials and Methods: The mold is consisted of upper and lower parts. We inserted 2 mm of lead sheet on the gums toward the oral cavity to protect them from unnecessary irradiation during the treatment. We had planned on orthogonal images obtained the patient. 200 cGy was delivered in every fraction with a total dose of 3000 cGy. To evaluate the effect of the lead sheet, we made a measurement with a phantom that has gums and tongue made of tissue with an equivalent material (bolus). Five of TLDs were placed on the interesting points of gums to measure the dose during irradiation with lead sheet and without lead sheet for three times respectively. Results: The result of the measurement without lead sheet are A: 33.9 cGy, B: 30.1 cGy, C: 31.8 cGy, D: 23.3 cGy, E: 24.1 cGy. The results of measurement with lead sheet are A: 20.6 cGy, B: 18.8 cGy, C: 19.6 cGy, D: 14.7 cGy, E: 15.1 cGy. Conclusion: Since we are using the mold made in our department during the treatment of the patient with hypervascular ulcer on tongue, we could deliver a proper dose to the treatment volume. In addition, the mold provided highly accurate and reproducible treatment and reduced the dose to the gums and teeth. Therefore, the possibility of side effects could be decreased significantly.

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The evaluation of lens absorbed dose according to the Optimold for whole brain radiation therapy (전뇌 방사선치료 시 Optimold에 따른 수정체의 흡수선량 평가)

  • Yang, Yong Mo;Park, Byoung Suk;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.77-81
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    • 2014
  • Purpose : In the current whole brain Radiation Therapy, Optimold was used to immobilize the head. However, skin dose was increased about 22% due to the scattering radiation by the Optimold. Since the minimum dose causing cataracts was 2 Gy, it could be seen that the effects were large especially on the lens. Therefore, in the whole brain Radiation Therapy, it was to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part. Materials and Methods : In order to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part, the Optimold mask was made ??up to 5mm bolus on the part of the eye lens in the human model phantom (Anderson Rando Phantom, USA). In the practice treatment, to measure the lens dose, the simulation therapy was processed by placing the GafChromic EBT3 film under bolus, and after the treatment plan was set up through the treatment planning system (Pinnacle, PHILIPS, USA), the treatments were measured repeatedly three times in the same way. After removing the Optimold mask in the eyeball part, it was measured in the same way as above. After scanning the film and measuring the dose by using the Digital Flatbed Scanner (Expression 10000XL, EPSON, USA), the doses were compared and evaluated according to the presence of Optimold mask in the eyeball part. Results : When there was the Optimold mask in the eyeball part, it was measured at $10.2cGy{\pm}1.5$ in the simulation therapy, and at $24.8cGy{\pm}2.7$ in the treatment, and when the Optimold mask was removed in the eye part, it was measured at $12.9cGy{\pm}2.2$ in the simulation therapy, and at $17.6cGy{\pm}1.5$ in the treatment. Conclusion : In case of removing the Optimold mask in the eyeball part, the dose was increased approximately 3 cGy in the simulation therapy and was reduced approximately 7 cGy in the treatment in comparison to the case that the Optimold mask was not removed. During the whole treatment, since the lens absorbed dose was reduced about 27%, the chance to cause cataracts and side effects was considered to be reduced due to decrease of the absorbed dose to the eye lens which had the high sensitivity on the radiation.

A Comparative Evaluation of Dosal Usefulness in Total Scalp Irradiation according to Treatment Plans and Methods (총 두피 방사선치료 시 치료계획 방법에 따른 선량적 유용성 비교 평가)

  • Park byeal nim;Jung dong min;Kwon yong jae;Cho yong wan;Kim se young;Park kwang soon;Park ryeong hwang;Baek jong geol
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.43-50
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    • 2022
  • Objective: The purpose of this study is to choose a treatment plan and equipment to maximize tangential irradiation to protect the normal brain tissues as much as possible during total scalp irradiation. Subjects and Methods: After zoning the total scalp of a phantom and selecting a target area for treatment, the study made a Helical TomoTherapy(HT) plan, a Helical TomoTherapy with a Complete Block(HTCB) plan, and a Volumetric Modulated Arc Therapy(VMAT) plan. All of these plans made sure that the volume of a treatment plan with 95% of a prescription dose(40 Gy) would not exceed 95% of the entire volume and that Dmax would not be more than 110% of the prescription dose. The therapy plans compared doses among organs at risk of damage including the brain. Doses in the brain tissues were assessed based on the volumetric criteria for normal tissues in Emami et al. Results: HT, HTCB, and VMAT had a dose of 21.68 Gy, 13.75 Gy, and 20.89 Gy, respectively, in brain tissues at D33%, a dose of 7.06 Gy, 3.21 Gy, and 7.84 Gy, respectively, at D67%, and a dose of 3.14 Gy, 1.75 Gy, and 3.84 Gy, respectively, at D100%. They recorded a Dmean of 16.64 Gy, 11.78 Gy, and 16.64 Gy, respectively. These results show that the overall dose was low in the HTCB plan. When the volume of a low dose was calculated based on 5 Gy, they recorded 87%, 49%, and 96%, respectively, in V5Gy. In addition, the maximum dose in the remaining organ(brain stem, hippocampus, and both lenses) except for the optic pathway was the lowest in HTCB Conclusion: The findings demonstrate that TomoTherapy with a complete block minimized a dose in organs at risk of damage including the brain and hippocampus on both sides and accordingly reduced the probability of side effects such as radiation-induced brain injuries and a resulting decrease in neurocognitive functions. In addition to total scalp irradiation, if additional studies on ring targets treated in various areas are conducted to establish the benefits of tangential irradiation, it is believed that TomoTherapy using Complete Block can be used to maximize tangential irradiation in treatment planning.

A Study on the Improvement of Recommendation Accuracy by Using Category Association Rule Mining (카테고리 연관 규칙 마이닝을 활용한 추천 정확도 향상 기법)

  • Lee, Dongwon
    • Journal of Intelligence and Information Systems
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    • v.26 no.2
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    • pp.27-42
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    • 2020
  • Traditional companies with offline stores were unable to secure large display space due to the problems of cost. This limitation inevitably allowed limited kinds of products to be displayed on the shelves, which resulted in consumers being deprived of the opportunity to experience various items. Taking advantage of the virtual space called the Internet, online shopping goes beyond the limits of limitations in physical space of offline shopping and is now able to display numerous products on web pages that can satisfy consumers with a variety of needs. Paradoxically, however, this can also cause consumers to experience the difficulty of comparing and evaluating too many alternatives in their purchase decision-making process. As an effort to address this side effect, various kinds of consumer's purchase decision support systems have been studied, such as keyword-based item search service and recommender systems. These systems can reduce search time for items, prevent consumer from leaving while browsing, and contribute to the seller's increased sales. Among those systems, recommender systems based on association rule mining techniques can effectively detect interrelated products from transaction data such as orders. The association between products obtained by statistical analysis provides clues to predicting how interested consumers will be in another product. However, since its algorithm is based on the number of transactions, products not sold enough so far in the early days of launch may not be included in the list of recommendations even though they are highly likely to be sold. Such missing items may not have sufficient opportunities to be exposed to consumers to record sufficient sales, and then fall into a vicious cycle of a vicious cycle of declining sales and omission in the recommendation list. This situation is an inevitable outcome in situations in which recommendations are made based on past transaction histories, rather than on determining potential future sales possibilities. This study started with the idea that reflecting the means by which this potential possibility can be identified indirectly would help to select highly recommended products. In the light of the fact that the attributes of a product affect the consumer's purchasing decisions, this study was conducted to reflect them in the recommender systems. In other words, consumers who visit a product page have shown interest in the attributes of the product and would be also interested in other products with the same attributes. On such assumption, based on these attributes, the recommender system can select recommended products that can show a higher acceptance rate. Given that a category is one of the main attributes of a product, it can be a good indicator of not only direct associations between two items but also potential associations that have yet to be revealed. Based on this idea, the study devised a recommender system that reflects not only associations between products but also categories. Through regression analysis, two kinds of associations were combined to form a model that could predict the hit rate of recommendation. To evaluate the performance of the proposed model, another regression model was also developed based only on associations between products. Comparative experiments were designed to be similar to the environment in which products are actually recommended in online shopping malls. First, the association rules for all possible combinations of antecedent and consequent items were generated from the order data. Then, hit rates for each of the associated rules were predicted from the support and confidence that are calculated by each of the models. The comparative experiments using order data collected from an online shopping mall show that the recommendation accuracy can be improved by further reflecting not only the association between products but also categories in the recommendation of related products. The proposed model showed a 2 to 3 percent improvement in hit rates compared to the existing model. From a practical point of view, it is expected to have a positive effect on improving consumers' purchasing satisfaction and increasing sellers' sales.