• Radiation Oncology Journal
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• v.26 no.2
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• pp.96-103
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• 2008

Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

• 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.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.14 no.4
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• pp.343-356
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• 2016

The Korea Radioactive Waste Agency (KORAD) has developed a dual-purpose metal cask for the dry storage of spent nuclear fuel that has been generated by domestic light-water reactors. The metal cask was designed in compliance with international and domestic technology standards, and safety was the most important consideration in developing the design. It was designed to maintain its integrity for 50 years in terms of major safety factors. The metal cask ensures the minimization of waste generated by maintenance activities during the storage period as well as the safe management of the waste. An activation evaluation of the main body, which includes internal and external components of metal casks whose design lifetime has expired, provides quantitative data on their radioactive inventory. The radioactive inventory of the main body and the components of the metal cask were calculated by applying the MCNP5 ORIGEN-2 evaluation system and by considering each component's chemical composition, neutron flux distribution, and reaction rate, as well as the duration of neutron irradiation during the storage period. The evaluation results revealed that 10 years after the end of the cask's design life, $^{60}Co$ had greater radioactivity than other nuclides among the metal materials. In the case of the neutron shield, nuclides that emit high-energy gamma rays such as $^{28}Al$ and $^{24}Na$ had greater radioactivity immediately after the design lifetime. However, their radioactivity level became negligible after six months due to their short half-life. The surface exposure dose rates of the canister and the main body of the metal cask from which the spent nuclear fuel had been removed with expiration of the design lifetime were determined to be at very low levels, and the radiation exposure doses to which radiation workers were subjected during the decommissioning process appeared to be at insignificant levels. The evaluations of this study strongly suggest that the nuclide inventory of a spent nuclear fuel metal cask can be utilized as basic data when decommissioning of a metal cask is planned, for example, for the development of a decommissioning plan, the determination of a decommissioning method, the estimation of radiation exposure to workers engaged in decommissioning operations, the management/reuse of radioactive wastes, etc.

• Proceedings of the Korean Radioactive Waste Society Conference
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• 2005.11a
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• pp.339-347
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• 2005

A type IP-2 transport package should prevent a loss or dispersal of the radioactive contents and a more than $20\%$ increase in the maximum radiation level at any external surface of the package when it were subjected to the drop test under the normal conditions of transport. If a shielding thickness of IP-2 transport package is thick, a bolted lid type may prevent a loss or dispersal of the radioactive contents than the door type of ISO containers which are generally used as a type IP-2 transport package. In this paper, to evaluate the effect of drop directions on the bolt tension and the coherence of a bolt, the drop tests of preliminary small model are tested and evaluated for seven directions before the drop test of a type IP-2 transport package with a bolted lid type under the normal conditions of transport. Seven drop directions which are a bottom-vertical drop, a lid-vortical drop. a horizontal drop and four corner drops have been carried out. Using a force sensor, the bolt tension during the drop impact is measured. The coherence of bolt is evaluated by the difference between the fastening torque of bolt before a drop test and the unfastening torque of bolt after a drop impact.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.230-236
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• 2001

Purpose : To evaluate treatment results in terms of local control, complications and survival after reirraidiation in recurrent cervical cancer following definite radiation therapy. Material and methods : From November 1987 through March 1998, eighteen patients with recurrent cervical cancer following definite radiation therapy were subsequently treated with reirradiation at Keimyung University Dongsan Medical Center. In regard to the initial FIGO stage, one patient was stage la, five were stage IIa, three were IIb, two were IIb and two were IVa. The age range was 37 to 79 years old with median age of 57. The time interval from initial definite radiation therapy to recurrence ranged from 6 to 122 months with a median of 58 months. The recurrent sites were the uterine cervix in seven patients, vagina in ten and pelvic lymph node in one. Reirradiation was peformed with external radiation and intracavitary radiation in twelve patients, external radiation and implantation in four and external radiation alone in two. The range of external radiation dose was $2,100\~5,400\;cGy$ and the range of the total radiation dose was $3,780\~8,550\;cGy$. The follow-up periods ranged from 8 to 20 months with median of 25 following reirradiation. Results : Fourteen of eighteen patients $(78\%)$ had local control just after reirradiation. The two year disease free survival (2YDFS) rate was $53.6\%$. There were statistically significant differences in the 2YDFS according to both recurrent site (2YDFS $28.5\%$ in uterine cervix, $71.4\%$ in vagina, (p=0.03)) and the total dose (2YDFS $71.8\%$ in >6,000 cGy , $25\%$ in $\leq6,000$ cGy, p=0.007). Seven of ten patients who were followed for more than 20 months remain alive and disease free (7/18, $39\%$). Patients treated with external radiation and intracavitary radiation had a higher rate of 2YDFS. Seven patients including 4 patients with no local control experienced local failure in the uterus or vagina and two patients died with distant metastasis. Complications included rectal bleeding in 3 patients, bowel obstruction treated with surgery in two, hematuria in one, radiation cystitis in two, soft tissue swelling in two and vaginal necrosis spontaneously healed in one. There was no statistical difference in complications according to the total dose or the time to recurrence from initial radiation. Conclusion : In patients with recurrence following definite radiation therapy in the uterine cervical cancer, reirradiation may be effective but requires an effort to reduce radiation induced severe complications.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.43-51
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• 1999

Purpose : To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy Materials and Methods : Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1 ~l.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery, Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. Results : All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOGIEORTC grade 3 or 4). Conclusion : The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.349-356
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• 1997

Purpose : To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb Materials and Materials : Fourty one patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University. School of Medicine from Jul, 1991 to Apr, 1994. According to FIGO s1aging system, therewere stage Ib (3 patients) IIa (6 patients) with exophytic ($\geq$5cm in dinmeter) and huge endophytic mass. and IIb (32 patients) with median age of 55 yeavs old. Radiation therapy consisted of hyperfractionated external irradition to the whole pelvis (120cGy/fraction, 2 fraction/day (minimum interval of 6 hours), 3600-5520cGy) and boost parametrial doses (for a total of 4480-6480cGy) with midline shield $(4\times10cm)$, and combined with intracavitary irradiation (up to 7480-8520cGy in Ib, IIa and 8480-9980cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively . Results : Five year local control rate was $78\%$ and the actuarial overall five year survival rate was $66.1\%$ for all patients, $44.4\%$ for stage Ib, IIa and $71.4\%$ for stage IIb. In bulky IIb (above 5cm in tumor size, 11 patients) five year local control rate and five rear survival rate was $88.9\%,\;73\%$ respectively Pelvic lymph node status (negative : $74\%,\;positive:25\%$, p=0.0015) was significant Prognostic factor affecting to five rear survival rate. There was marginally significant survival difference by total dose to A point ($>84Gy\;:\;70\%,\;>84Gy\;:\;42.8\%$, p=0.1). We consider that the difference of total dose to A point by stage (mean Ib,IIa : 79Gy. IIb 89Gy P=0.001) is one of the causes in worse local control and survival of Ib,IIa than IIb The overall recurrence rate was $39\%$ (16/41). The rates of local failure alone. distant failure alone. and combined local and distant failure were $9.7\%,\;19.5\%,\;and\;9.7\%$, respectively. Two Patients developed leukopenia ($\geq$ grade 3) and Three patients develoued grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. Conclusion : We thought that it may be necessary to increase A point dose to more than 85Gy in hyperfractionated radiotherapy of huge exophytic and endophvtic stage Ib,IIa. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.5 no.3
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• pp.199-212
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• 2007

If a type IP-2 transport package were to be subjected to a free drop test and a penetration test under the normal conditions of transport, it should prevent a loss or dispersal of the radioactive contents and a more than 20% increase in the maximum radiation level at any external surface of the package. In this paper, we suggested the analytic method to evaluate the structural safety of a type IP-2 transport package using a thick steel plate for a structure part and a bolt for tying a bolt. Using an analysis a loss or dispersal of the radioactive contents and a loss of shielding integrity were confirmed for two kinds of type IP-2 transport packages to transport radioactive waste drums from a waste facility to a temporary storage site in a nuclear power plant. Under the free drop condition the maximum average stress at the bolts and the maximum opening displacement of a lid were compared with the tensile stress of a bolt and the steps in a lid, which were made to avoid a streaming radiation in the shielding path, to evaluate a loss or dispersal of radioactive waste contents. Also a loss of shielding integrity was evaluated using the maximum decrease in a shielding thickness. To verify the impact dynamic analysis for free drop test condition and evaluate experimentally the safety of two kinds of type IP-2 transport packages, free drop tests were conducted with various drop directions. For the tests we examined the failure of bolts and the deformation of flange to evaluate a loss or dispersal of radioactive material and measured the shielding thickness using a ultrasonic thickness gauge to assess a loss of shielding integrity. The strains and accelerations acquired from tests were compared with those by analyses to verify the impact dynamic analysis. The analytic results were larger than the those of test so that the analysis showed the conservative results. Finally, we evaluated the safety of the type IP-2 transport package under the stacking test condition using a finite element analysis. Under the stacking test condition, the maximum Tresca stress of the shielding material was 1/3 of the yielding stress. Two kinds of a type IP-2 transport package were safe for the free drop test condition and the stacking test condition.

• Journal of Radiation Protection and Research
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• v.40 no.3
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• pp.124-131
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• 2015

Radiation exposure to humans can be caused by the gamma rays emitted from natural radioactive elements(such as uranium, thorium and potassium and any of their decay products) of Naturally Occurring Radioactive Materials(NORM) or Technologically Enhanced Naturally Occurring Radioactive Materials(TENORM) added consumer products. In this study, assume that activity of radioactive elements is $^{238}U$, $^{235}U$, $^{232}Th$ $1Bq{\cdot}g^{-1}$, $^{40}K$ $10Bq{\cdot}g^{-1}$ and the gamma rays emitted from these natural radioactive elements radioactive equilibrium state. In this study, reflected End-User circumstances and evaluated annual exposure dose for products based on ICRP reference voxel phantoms and ICRP Recommendation 103 using the Monte Carlo Method. The consumer products classified according to the adhere to the skin(bracelet, necklace, belt-wrist, belt-ankle, belt-knee, moxa stone) or not(gypsum board, anion wallpaper, anion paint), and Geometric Modeling was reflected in Republic of Korea "Residential Living Trend-distributions and Design Guidelines For Common Types of Household.", was designed the Room model($3m{\times}4m{\times}2.8m$, a closed room, conservatively) and the ICRP reference phantom's 3D segmentation and modeling. The end-user's usage time assume that "Development and Application of Korean Exposure Factors." or conservatively 24 hours; in case of unknown. In this study, the results of the effective dose were 0.00003 ~ 0.47636 mSv per year and were confirmed the meaning of necessary for geometric modeling to ICRP reference phantoms through the equivalent dose rate of belt products.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.199-206
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• 2003

Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.