• Radiation Oncology Journal
• /
• v.4 no.2
• /
• pp.115-128
• /
• 1986

Hyperthermia can enhance the radiation effect as a synergistic reaction in combined X-ray irradiation and hyperthermia; hyperthermia sensitize radioresistant S-phase cells and inhibit cellular recovery from sublethal damage. We fabricated 100 watts, 2450 MHz microwave applicator for hyperthermia and planned the method and condition of heating and measured the temperature by using Agar phantom as a preliminary test. For biological examination, 102 rats were divided into 4 groups as hyperthermia, X-ray irradiation (6Gy-15Gy), combined X-ray and hyperthermia, and normal control groups. Microscopic examination of the rectum and bladder was done and the results were as followings: 1. The microwave generator with 100 watts, 2450MHz magnetron could be heating up to $40^{\circ}{\sim}50^{\circ}C$ for one hour in living tissue. 2. The thermal distribution in tissue equivalent phantom with microwave can be maintained at $40^{\circ}{\sim}44^{\circ}C$ in area of 3cm in depth and 2-10cm in diameter. 3. In Hyperthermia alone group, there was submucosal edema of the rectum but no histologic change in the urinary bladder was seen. 4. The minimal necrosis of the mucosa was appeared in the rectum and bladder after 15 days of 6 Gy and 8 Gy irradiation respectively. The minimal necrosis of the muscle layer of rectum and bladder was appeared after 15 days of 8Gy and 60days of 10Gy irradiation respectively. 5. In combined group of radiation and hyperthermia, thermal enhancement ratio (calculated at necrosis of mucosa and muscle layer) of rectum and bladder was 1.0, and it suggest that there is no change of tolerance dose of normal rectum and bladder.

• Journal of the Korean Society of Radiology
• /
• v.4 no.2
• /
• pp.21-25
• /
• 2010

Recently, various semiconductor compounds as radiation detection material have been researched for a diagnostic x-ray detector application. In this paper, we have fabricated the CdS detecton sensor that has good photosensitivity and high x-ray absorption efficiency among other semiconductor compounds, and evaluated the application feasibility by investigating the detection properties about energy range of diagnostic x-ray generator. We have fabricated the line voltage selector(LCV) for a signal acquisition and quantities of CdS sensor, and designed the voltage detection circuit and rectifying circuit. Also, we have used a relative relation algorithm according to x-ray exposure condition, and fabricated the interface board with DAC controller. Performance evaluation was investigated by data processing using ANOVA program from voltage profile characteristics according to resistive change obtained by a tube voltage, tube current, and exposure time that is a exposure condition of x-ray generator. From experimental results, an error rates were reduced according to increasing of a tube voltage and tube current, and a good properties of 6%(at 90 kVp) and 0.4%(at 320 mA) ere showed. and coefficient of determination was 0.98 with relative relation of 1:1. The error rate according to x-ray exposure time showed exponential reduction because of delayed response velocity of CdS material, and the error rate has 2.3% at 320 msec. Finally, the error rate according to x-ray dose is below 10%, and a high relative relation was showed with coefficient of determination of 0.9898.

• Journal of the Korean Society of Radiology
• /
• v.13 no.1
• /
• pp.125-132
• /
• 2019

Potassium cyanate (KCN) is an inorganic reagent and can induce the post-translation carbamylation of proteins. The carbamylated reaction in the body is involved in cell death in various diseases. According the results in our previous study, KCN enhances the radiosensitivity of human colorectal cancer cell line, HCT 116 cells. However, it was not enough to confirm the mechanism that KCN works in these cells. To determinated the mechanisms of KCN in the cells with increased radiosensitivity, HCT 116 cells were treated KCN with low-dose gamma-radiation. And then, we examined alteration of the cell cycle, cell proliferation, cytokine level and the activation of cell signaling protein. As a result, cell cycle arrest and cell death were induced by the activation of caspase-3 and PARP in the irradiated cells with KCN treatment. These changes of the irradiated cell with KCN treatment were induced by the release of $TNF-{\alpha}$ via $NF-{\kappa}B$ activation. In conclusions, enhanced radio-sensitivity mediated by KCN induced cell death and it occurs by $NF-{\kappa}B$-dependent $TNF-{\alpha}$ production.

• Journal of the Korean GEO-environmental Society
• /
• v.12 no.4
• /
• pp.25-31
• /
• 2011

In this study, the experimental design methodology was applied to optimize 1,4-dioxane treatment in E-beam process. Main factor was mathematically described as a function of parameters 1,4-dioxane removal efficiencies(%), TOC removal efficiencies(%) modeled by the use of the central composite design(CCD) method among the response surface methodology(RSM). Concentration of 1,4-dioxane is designated as "$x_1$" and Irradiation intensity is designated as "$x_2$". The regression equation in coded unit between the 1,4-dioxane concentration and removal efficiencies(%) was $y=71.00-10.85x_1+20.67x_2+{1.53x_1}^2-{7.92x_2}^2-1.23x_1x_2$. The regression equation in coded unit between the 1,4-dioxane concentration and TOC removal efficiencies(%) was $y=44.48-13.25x_1+9.54x_2+{5.43x_1}^2-{1.35x_2}^2+4.45x_1x_2$. The model predictions agreed well with the experimentally observed results $R^2$(Adj) over 90%. Toxicity test using algae Pseudokirchneriella Subcapitata showed that the inhibition was reduced according to increasing an E-beam irradiation.

• Radiation Oncology Journal
• /
• v.28 no.3
• /
• pp.133-140
• /
• 2010

Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

• Radiation Oncology Journal
• /
• v.28 no.4
• /
• pp.205-210
• /
• 2010

Purpose: To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Materials and Methods: Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39~89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0~64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. Results: The median follow-up time was 62 months (2~202 months). The 5-year overall survival, loco regional relapse-free survival, disease-free survival, and colostomy-free survival rates were 86.0%, 71.7%, 71.7%, 78.2%, respectively. Regarding overall survival, the Eastern Cooperative Oncology Group (ECOG) performance status and complete response were found to be significant prognostic factors on univariate analysis. For multivariate analysis, only the ECOG performance status was significant. No significant factor was found for locoregional relapse-free survival or disease-free survival and similarly for treatment response, no significant factor was determined on logistic regression analysis. There were 7 patients who had local or regional recurrences and one patient with distant metastasis. The only evaluable toxicity in all patients was radiation dermatitis of perianal skin (grade 3), which developed in 4 patients (9.5%) and grade 2 in 22 patients (52.4%). Conclusion: This study revealed that patients with a performance score of ECOG 0-1 survived significantly longer than those with a poorer score. Finally, there was no significant predicting factors tested for treatment response.

• Radiation Oncology Journal
• /
• v.15 no.1
• /
• pp.1-10
• /
• 1997

Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.

• Radiation Oncology Journal
• /
• v.28 no.2
• /
• pp.85-90
• /
• 2010

Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.311-323
• /
• 1998

Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.291-301
• /
• 1998

Purpose : A retrospective study was conducted comparing single daily fraction (SDF) thoracic radiotherapy (TRT) with twice daily (BID) TRT to determine the potential benefit of BID TRT in limited-stage small cell lung cancer (SCLC). Endpoints of the study were response. survival, pattern of failure, and acute toxicity. Materials and Methods : Between November 1989 to December 1996, 78 patients with histologically proven limited-stage SCLC were treated at the Department of Therapeutic Radiology, Chungnam National University Hospital. Of these, 9 were irradiated for palliative intent, and 1 had recurrent disease. Remaining 68 patients were enrolled in this study. There were 26 patients with a median age of 58 years, and 22 (85$\%$) ECOG performance score of less than 1 in SDF TRT. There were 42 patients with a median age of 57 years, and 36 (86$\%$) ECOG performance score of less than 1 in BID TRT By radiation fractionation regimen, there were 26 in SDF TRT and 42 in BID TRT. SDF TRT consisted of 180 cGy, 5 days a week. BID TRT consisted of 150 cGy BID, 5 days a week in 13 of 42 and 120 cGy BID, in 29 of 42. And the twice daily fractions were separated by at least 4 hours. Total radiotherapy doses were between 5040 and 6940 cGy (median, 5040 cGy) in SDF TRT and was between 4320 and 5100 cGy (median, 4560 cGy) in BID TRT. Prophylactic cranial irradiation (PCI) was recommended for patients who achieved a CR. The recommended PCI dose was 2500 cGy/10 fractions. Chemotherapy consisted of CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) alternating with VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) every 3 weeks in 25 (96$\%$) of SDF TRT and in 40 (95$\%$) of BID TRT. Median cycle of chemotherapy was six in both group. Timing for chemotherapy was sequential in 23 of SDF TRT and in 3 BID TRT, and concurrent in 3 of SDF TRT and in 39 of BID TRT Follow-up ranged from 2 to 99 months (median, 14 months) in both groups. Results : Of the 26 SDF TRT, 9 (35$\%$) achieved a complete response (CR) and 14 (54$\%$) experienced a partial response (PR). Of the 42 BID TRT, 18 (43$\%$) achieved a CR and 23 (55$\%$) experienced a PR. There was no significant response difference between the two arms (p=0.119). Overall median and 2-year survival were 15 months and 26.8$\%$, respectively. The 2-year survivals were 26.9$\%$ and 28$\%$ in both arm, respectively (p=0.51). The 2-rear survivals were 35$\%$ in CR and 24.2$\%$ in PR, respectively. The grade 2 to 3 esophageal toxicities and grade 2 to 4 neutropenias were more common in BID TRT (p=0.028 0.003). There was no difference in locoregional and distant metastasis between the two arms (p=0 125 and 0.335, respectively). The most common site of distant metastasis was the brain. Conclusion : The median survival and 2-year survival were 17 months and 20.9$\%$ in SDF TRT with sequential chemotherapy, and 15 months and 28$\%$ in BID TRT with concurrent chemotherapy, respectively. We did not observe a substantial improvement of long-term survival in the BID TRT with concurrent chemotherapy compared with standard schedules of SDF TRT with sequential chemotherapy. The grade 2 to 3 esophageal toxicities and glade 2 to 4 neutropenias were more common in BID TRT with concurrent chemotherapy. Although the acute toxicities were more common in BID TRT with concurrent chemotherapy than SDF TRT with sequential chemotherapy, a concurrent chemotherapy and twice daily TRT was feasible. However further patient accrual and long-term follow up are needed to determine the potential benefits of BID TRT in limited-stage SCLC.