• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.1-5
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• 2006

Purpose: IMRT quality assurance(Q.A) is consist of the absolute dosimetry using ionization chamber and relative dosimetry using the film. We have in general used 0.015 cc ionization chamber, because small size and measure the point dose. But this ionization chamber is too small to give an accurate measurement value. In this study, we have examined the degree of calculated to measured dose difference in intensity modulated radiotherapy(IMRT) based on the observed/expected ratio using various kinds of ion chambers, which were used for absolute dosimetry. Materials and Methods: we peformed the 6 cases of IMRT sliding-window method for head and neck cases. Radiation was delivered by using a Clinac 21EX unit(Varian, USA) generating a 6 MV x-ray beam, which is equipped with an integrated multileaf collimator. The dose rate for IMRT treatment is set to 300 MU/min. The ion chamber was located 5cm below the surface of phantom giving 100cm as a source-axis distance(SAD). The various types of ion chambers were used including 0.015cc(pin point type 31014, PTW. Germany), 0.125 cc(micro type 31002, PTW, Germany) and 0.6 cc(famer type 30002, PTW, Germany). The measurement point was carefully chosen to be located at low-gradient area. Results: The experimental results show that the average differences between plan value and measured value are ${\pm}0.91%$ for 0.015 cc pin point chamber, ${\pm}0.52%$ for 0.125 cc micro type chamber and ${\pm}0.76%$ for farmer type 0.6cc chamber. The 0.125 cc micro type chamber is appropriate size for dose measure in IMRT. Conclusion: IMRT Q.A is the important procedure. Based on the various types of ion chamber measurements, we have demonstrated that the dose discrepancy between calculated dose distribution and measured dose distribution for IMRT plans is dependent on the size of ion chambers. The reason is small size ionization chamber have the high signal-to-noise ratio and big size ionization chamber is not located accurate measurement point. Therefore our results suggest the 0.125 cc farmer type chamber is appropriate size for dose measure in IMRT.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.91-99
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• 1999

Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.