• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.54-54
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• 2003

목적 : 방사선치료는 복잡하고 다양한 장비를 이용하여 고에너지 고선량의 방사선을 다루기 때문에 세심한 정도관리를 바탕으로 기술적 관점에서의 적절한 방사선치료장비 사용과 실제 환자치료시의 절차들에 대한 완벽한 지침서가 마련되어야 할 필요가 있다. 본 연구의 목적은 의료용 선형가속기에 연관된 방사선사고와 잠재적 사고유형들을 분석하여 환자와 종사자의 안전을 보장하고 사고를 예방키 위한 안전관리 기준을 개발하고자 하였다. 대상 및 방법 : 본 연구에서는 국내 13 개 방사선치료기관에 대한 안전관리 실태를 자체 개발한 100 여 문항의 설문으로 조사, 분석하였다. 또한, 국제적으로 사용하고 있는 안전관리기준들과 보고된 방사선 사고사례 들을 조사하였고, 방사선치료 전 과정을 통해 잠재적 사고유형을 추정함으로서 방사선치료의 안전관리를 위 해 필요한 요구사항들을 도출하고 이를 바탕으로 의료용 선형가속기에 관련된 안전관리 기준을 마련하였다. 결과 : 본 연구에서는 방사선치료 시 환자와 종사자의 안전을 보장하고 사고방지를 위하여 단계별 안전관리 기준을 개발하였으며, 방사선 치료과정에서 일어날 수 있는 다양한 실수나 사고들을 일목요연하게 관리 할 수 있는 흐름도를 구축하였다. 결론 : 본 연구 결과는 방사선치료에 사용되는 선형가속기에 대한 방사선의 안전과 품질보증을 개선하게 될 것으로 생각된다. 또한, 잠재적 방사선 사고의 예방뿐 아니라 국내의 방사선치료 안전관리 기준 마련에 기초자료로 활용될 수 있을 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.458-463
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• 2006

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

• 대한방사선치료학회:학술대회논문집
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• 2002.05a
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• pp.8-10
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• 2002

• Radiation Oncology Journal
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• v.9 no.2
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• pp.177-184
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• 1991

From December 1984 to February 1990, 16 patients with tumors of pineal and suprasellar location were treated with radiation therapy. Tissue diagnoses were obtained before radiation therapy in 5 patients and 11 were irradiated without histologic confirmation. Initial treatments for these patients were craniospinal plus boost primary irradiation(six), whole brain plus boost primary irradiation(nine), primary tumor site irradiation(one). The 5 year actuarial survival rate is $71\%$. Three cases with elevated beta-human chorionic gonadotropin(HCG) responded favorably to radiation, but pineal tumors with elevated alpha-fetoprotein(AFP) did not respond well. Spinal metastasis developed in 2 cases(2/15) with elevated AFP : one received prophylactic spinal irradiation, another did not. Our studies suggest that more aggressive treatment would be necessary in patient with elevated AFP and in this patient, radiation therapy may be initiated without pathologic confirmation. From the result of our study, routine use of prophylactic spinal irrdiation for all patients with pineal region tumor is not indicated and use of prophylactic spinal irradiation is considered for the patients with positive craniospinal fluid cytology, meningeal seeding, disease extension along the ventricular wall and biopsy proven germinoma.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.16-22
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• 1999

Purpose : This study was done to analyze prognostic factors and patterns of failure of patients with histologically confirmed adenocarcinoma of the uterine cervix. Materials and Methods : From June 1988 to December 1990, a retrospective analysis was undertaken for 45 patients who were treated with curative radiation therapy for adenocarcinoma of the uterine cervix at the department of Therapeutic Radiology of Keimyung University Hospital. According to FIGO staging classification, f2 patients were stage Ib, 9 patients were lla, 19 patients were IIB, and 5 patients were lIIb. Median age of the patients was 54 years. The radiation therapy consisted of a combination of external and intracavitary irradiation. Only the pelvis was treated for external irradiation, but 6 patients were treated with extended field irradiation including paraaortic nodes. Intracavitary irradiation was performed with high dose rate sources (Co-60). Neoadiuvant chemotherapy was undertaken for 10 patients. Median and maximum follow-up duration was 64 and 116 months, respectively. Results : The overall 5-year survival rate was 55.2$\%$, and the 5-year survival rates for stage Ib, IIa, IIb, and IIIb were 100$\%$, 50.8$\%$, 46.8$\%$, and 40$\%$ (3-year survival rate), respectively. Of the many clinicopathologic variables evaluated for prognosis, only the stage and the tumor size were significant prognostic factors. Statistically, pelvic failure rates for stage Ib, IIa, IIb, and IIIb were 0$\%$, 33.3$\%$, 57.9$\%$, and 60$\%$, respectively. Distant metastasis rates were 0$\%$, 33.3$\%$, 21.1$\%$, and 40$\%$ for stage Ib, IIa, IIb, and IIIb, respectively. Especially the 6 patients who were irradiated with extended field to treat the paraaortic nodes were free of distant metastasis all. But, 9 patients (23.1$\%$) of the 39 patients who were not irradiated the paraaortic nodes were suffered and expired from uncontrolled distant metastasis. Conclusions : As compared with other studies, the survival rates were similar, but distant metastasis rates including paraaortic nodes metastasis were likely somewhat higher than expected, especially for patients with stage II. So, we think that the effect of prophylactic paraaortic nodes irradiation should be studied prospectively, especially for patients with pelvic nodes involvement or advanced stage of disease.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.274-284
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• 1997

조기 유방암에 대한 바람직한 치료는 유방의 형태를 최대한 보존하면서 악성 종양을 치료하는 것이다. 이러한 목적을 충분히 달성하기 위하여 최대한 조기에 유방암을 진단하고 미용상 종양 절제술에 적합한 환자를 선택하여 절제 범위를 최소화한 유방 보존술을 시행하며 수술 후 유방 전체에 대한 근치적인 방사선 치료를 적절히 시행하면 된다. 여러 연구에서 전통적인 치료법인 근치적 또는 변형 근치적 유방 절제술의 성적과 비교하여 차이가 없으므로 조기 유방암의 치료에는 이상적인 치료법으로 인정된다. 이와 병행하여 액와부 림프절 및 전신적인 재발에 대한 진단 및 예방을 위하여 액와 림프절에 대한 충분한 외과적인 처치와 병리학적인 검사를 시행하여 불필요한 방사선 치료로 인한 부작용을 최소화하여야 한다. 만약 전신적인 치료가 요구되는 경우에는 항암제 및 내분비 요법을 병행하여 재발을 억제해야 유방 보존술의 장점을 살릴 수 있다. 결론적으로 이 치료법이 조기 유방암 환자의 삶의 질을 개선시키면서 최상의 치료 효과를 얻기 위해서는 유관 진료 각과의 의료진이 유기적으로 협조하여 조기 진단률을 높히고, 유방 보존술 및 방사선 치료 과정에서 환자들에게 치료 결과에 대한 확신을 심어주도록 열심히 노력해야 된다. 또한 치료와 연관된 부작용이나 합병증을 최대한 줄여나가는 방향으로 치료 방법을 계속 보완 발전시키는 것이 매우 중요하며 아직도 발전의 여지가 많은 이 치료법이 조기 유방암의 이상적인 치료법으로 정착하기 위해서는 향후 다양한 임상적인 경험을 통한 더 많은 연구가 필요하리라 생각한다.

• The Journal of the Korea Contents Association
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• v.7 no.12
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• pp.139-144
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• 2007

Radiotherapy which is the most effective for orbit lymphoma has been used increasingly due to the increase of orbit or ocular adnexal tumor patients. Curative effects and convalescence have been being more satisfied thanks to remarkable development of cancer chemotherapy and medical treatments, but side effects such as cataract, dry eye and retinopathy still break out. Thus, in this study, a Lens Shielding Device (LSD hereafter) was designed to prevent occurring of cataract due to radiation therapy for orbit lymphoma and its efficacy through dosimetry were evaluated. And in this paper, its manufacturing process was also explained. LSD is composed of a cover body covering the lens and a side fixing part supporting the cover body. To measure radiation, the patient therapy conditions were simulated and the measurement of the radiation was conducted with Thermo Luminescence Detector (TLD) and Markus chamber. The average TLD value was 5.7% and the TLD value and Markus chamber value were acquired as 4.2% and 5.1% respectively at 6 mm depth where zero lens center was located. Only 1.5Gy ($300Gy{\times}\;5%$) or 5% of total 30Gy with 9 MeV electron beam is estimated to affect on patient's lens. That is smaller dose than the threshold value of cataract (2GY) or the value (5Gy) that was reported to cause cataract in clinical conditions. Thus, these findings suggest that LSD be very useful for prevention of cataract during radiotherapy for malignant lymphoma of orbit and ocular adnexa. Furthermore, it might be possible to reduce patient's discomfort caused by alien substances and to make it easier to fix the device with customized manufacturing manners.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.321-330
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• 1995

Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients were managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A : minimal 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using Co-60 teletherapy machine. A total of 10Gy(2Gy/fr. x 5days) was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due to multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients($86{\%}$) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who were received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary change. One patient who refused RT after 2Gy died due to pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggresive supportive treatment appears to decrease Pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.

• Journal of the Korean Society of Radiology
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• v.7 no.2
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• pp.151-156
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• 2013

As the number of cancer patients and its death rate increases, this study is to understand the occurrences in cancer patients in Busan area and to provide active help for treatment, prevention and management of cancer patients. It was investigated and analyzed based on 4462 patients who were diagnosed with cancer and received radiation therapy from Jan. 2011 to Dec. 2012 at tertiary medical institution in Busan area. The seven main cancer types were breast cancer, cervical cancer, lung cancer, colon rectal cancer, brain tumor, laryngopharyngeal cancer and liver cancer. The most common type of cancer was breast cancer which takes up 38.1% of cancer patients stood out from other cancer types. Breast cancer is that shows increasing trend and in need of appropriate countermeasures and managements for decreasing cancer risk. Therefore the causes and prevention of breast cancer analysis, an appropriate management program is required.

• Radiation Oncology Journal
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• v.4 no.1
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• pp.15-20
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• 1986

From 1979 to 1984, 39 local allograft irradiations were given to 29 patients: 10 irradiations were administered for prevention and 29 for reversal of acute rejection of transplanted kidney. Three doses of 150 cGy every other day were combined with high-dose of methylprednisolone pulse (1 gm/day) for 3 days. For prevention of acute rejection, local irradiation was delivered on the days 1, 3, and 5 after the transplantation, and for reversal, irradiation started after the diagnosis of acute rejection. Eight out of 10 patients irradiated for prevention had acute allograft rejection, and, what is more, there was no surviving graft at 15 months after transplantation. Reversal of acute rejection was achieved in $71\%$. When the pre-irradiation level of serum creatinine was below $5.5mg\%$, the reversal rate was $93\%$, but above $5.5mg\%$ the reversal rate was only $17\%$ (p<0.01). Reirradiation after failure was not successful. Among 15 reversed patients, $7(47\%)$ had subsequent rejection (s). The functional graft survivals at 6 month, 1, 2, and 3 year were $70\%,\;65\%,\; 54\%,\;and\;54\%$, respectively. Therapeutic irradiation resulted in better graft survival when serum creatinine was below $5.5mg\%$ (p<0.001) or when irradiation started within 15 days after the diagnosis of acute rejection (p<0.001).