• Title/Summary/Keyword: 치료 부위

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Analysis of Dose Distribution of Rectal IORT Cone (Rectal IORT cone의 선량분포에 관한 연구)

  • 김성규;신세원;김명세
    • Progress in Medical Physics
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    • v.3 no.1
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    • pp.45-52
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    • 1992
  • Authors started IORT for stomach cancer patient on 1988 and rectal cancer on 1991. We devloped various sized. shaped IORT cones for better clinical application and homogeneous surface and depth dose distribution. Authors obtained results as following. 1. The acryl cover fixed on the end for rectal IORT cone not only improvement of surface dose but also flattness of dose distribution. 2. Dose distribution of elliptical cone were shown almost 100% at inner field. 3. The output with acryl cone size were similar output of made electron cone.

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Feasibility study of the usefulness of SRS thermoplastic mask for head & neck cancer in tomotherapy (두경부 종양의 토모치료 시 정위적방사선수술 마스크의 유용성 평가에 대한 연구)

  • Jeon, Seong Jin;Kim, Chul Jong;Kwon, Dong Yeol;Kim, Jong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.355-362
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    • 2014
  • Purpose : When head&neck cancer radiation therapy, thermoplastic mask is applied for patients with fixed. The purpose of this study is to evaluate usefulness of thermoplastic mask for SRS in tomotherapy by conparison with the conventional mask. Materials and Methods : Typical mask(conventional mask, C-mask) and mask for SRS are used to fix body phantom(rando phantom) on the same iso centerline, then simulation is performed. Tomotherapy plan for orbit and salivary glands is made by treatment planning system(TPS). A thick portion and a thin portion located near the treatment target relative to the mask S-mask are defined as region of interest for surface dose dosimetry. Surface dose variation depending on the type of mask was analyzed by measuring the TPS and EBT film. Results : Surface dose variation due to the type of mask from the TPS is showed in orbit and salivary glands 0.65~2.53 Gy, 0.85~1.84 Gy, respectively. In case of EBT film, -0.2~3.46 Gy, 1.04~3.02 Gy. When applied to the S-mask, in TPS and Gafchromic EBT3 film, substrantially 4.26%, 5.82% showed maximum changing trend, respectively. Conclusion : To apply S-mask for tomotherapy, surface dose is changed, but the amount is insignificant and be useful when treatment target is close critical organs because decrease inter and intra fractional variation.

A Study on Prospective Plan Comparison using DVH-index in Tomotherapy Planning (토모 테라피 치료 시 선량 체적 히스토그램 표지자를 이용한 치료계획 비교에 관한 연구)

  • Kim, Joo-Ho;Cho, Jeong-Hee;Lee, Sang-Kyoo;Jeon, Byeong-Chul;Yoon, Jong-Won;Kim, Dong-Wook
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.113-122
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    • 2007
  • Purpose: We proposed the method using dose-volume Histogram index to compare prospective plan trials in tomotherapy planning optimization. Materials and Methods: For 3 patients in cranial region, thorax and abdominal region, we acquired computed tomography images with PQ 5000 in each case. Then we delineated target structure and normal organ contour with pinnacle Ver 7.6c, after transferred each data to tomotherapy planning system (hi-art system Ver 2.0), we optimized 3 plan trials in each case that used differ from beam width, pitch, importance. We analyzed 3 plan trials in each region with isodose distribution, dose-volume histogram and dose statistics. Also we verified 3 plan trials with specialized DVH-indexes that is dose homogeneity index in target organ, conformity index around target structure and dose gradient index in non-target structures. Results: We compared with the similarity of results that the one is decide the best plan trial using isodose distribution, dose volume histogram and dose statistics, and the another is using DVH-indexes. They all decided the same plan trial to better result in each case. Conclusion: In some of case, it was appeared a little difference of results that used to DVH-index for comparison of plan trial in tomotherapy by special goal in it. But because DVH-index represented both dose distribution in target structure and high dose risk about normal tissue, it will be reasonable method for comparison of many plan trials before the tomotherapy treatments.

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Evaluation of Skin Dose of Intensity Modulated Radiation Therapy in Breast Cancer Patients (유방암환자의 세기조절방사선치료에서 피부선량 평가)

  • Kim, Sung-Kyu;Kim, Myung-Se;Yun, Sang-Mo
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.167-171
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    • 2007
  • In the case of radiotherapy following breast conservation therapy for breast cancer patients, the characteristic of skin dose was investigated in the treatment of intensity modulated radiation therapy (IMRT) for breast cancer patients by comparing and analysing entrance skin dose irradiated during radiotherapy using tangential technique radiotherpy, and IMRT. The calculation dose irradiated to breast skin was compared with TLD measurement dose in treatment planning by performing the two methods of radiotherapy using tangential technique, and IMRT in treatment planning equipment. The skin absorbed dose was measured to pass a nipple by spacing of 1 cm distance from center to edge of body. In the radiotherapy of tangential technique, for the irradiation of 180 cGy to PTV, the calculation dose was ranged from 103.5 cGy to 155.2 cGy, measurement dose was ranged from 107.5 cGy to 156.2 cGy, and skin dose in the center was maximum 1.45 times more irradiated than that in the edge. In the IMRT, for the irradiation of 180 cGy to PTV, the calculation dose was ranged 9.8 cGy at 80.2 cGy, measurement dose was ranged 8.9 cGy at 77.2 cGy, and skin dose in the center was maximum 0.23 times less irradiated than that in the edge. IMRT was more effective for skin radiation risks because radiation dose irradiated to skin in IMRT was much less than that in radiotherapy of tangential field technique.

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Sphenoid Sinus Carcinoma with Intramedullary Spinal Cord Metastasis and Syringomyelia -Report of A Case- (접형동암 환자에서 척수공동증을 동반한 척수내 전이 -증례 보고-)

  • Oh, Yoon-Kyeong;Kim, Young-Sook
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.61-67
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    • 1996
  • Purpose : Primary sphenoid carcinoma is rare. It accounts for $0.3\%$ of all primary paranasal sinus malignancies. Because of the rarity of sphenoid carcinoma, large series of patients with outcome and survival statistics are currently unavailable. So we followed up the 1 case of sphenoid sinus carcinoma treated in our hospital and reported the course of the disease. Case report : In a review of case reports and small series of patients, 2-rear survival was $7\%$. Our case is alive at 29 months after diagnosis of sphenoid sinus carcinoma. Intramedullary spinal cord metastasis (ISCM) is an unusual complication of cancer. In our case rapidly progressive paraparesis and urinary retention developed at 25 months after diagnosis of sphenoid sinus carcinoma. MRI of the thoracic spines showed the intramedullary spinal cord tumor mass at T3 and 74 level with accompanying syringomyelia. Here we report a case of ISCM associated with syringomyelia which has developed after primary sphenoid sinus carcinoma with a review of literature about the clinical behavior and treatment of this lesion.

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Design and Implementation of A Medical Image Guided System for Vertebroplasty (척추성형술을 위한 의료 영상 시스템의 설계 및 개발)

  • Tack, Gye-Rae;Lee, Sang-Bum;Lee, Sung-Jae
    • The KIPS Transactions:PartB
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    • v.10B no.5
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    • pp.503-508
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    • 2003
  • Since surgical treatment of the spine should overcome neurological compromises, the operative procedures need to be carefully planned and carried out with high degree of precision. Percutaneous vertebroplasty is a surgical procedure that was introduced for the treatment of compression fracture of the vertebrae. This procedure includes puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate relief of pain. However, failures of treatment due to excessive PMMA volume injection have been reported as one of complications in vertebroplasty. It is believed that the control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Therefore, clinical success of vertebroplasty can be dependent on the volume of PMMA injection for a given patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient.

The evaluation for usefulness of the custom made immobilization device for the anteroperitoneal resection patients with rectal cancer (복 회음부 절제술 환자를 위한 고정용구 제작 및 유용성 평가)

  • Yang Oh Nam;Lee Woo Seok;Hong Tack Kyun;Jo Young Pil;Yun Hwa Ryong;Kim Jung Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.61-65
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    • 2003
  • I. Purpose Patient immobilization is essential factor for successful radiation therapy and major problem is reproducibility to maintain patient position during total radiation therapy period. Purpose of this study is evaluation for usefulness of the custom made immobilization device for the anteroperitoneal resection patients with rectal cancer II. Materials and Methods The object of this study were patients who underwent anteroperitoneal resection and undergo radiation therapy at present with rectal cancer. We made immobilization device for patient individually and analyzed its set up reproducibility, patient position deviation and errors. III. Results There was $5mm{\sim}10mm$ deviation in patient position without individual immobilization device, but we improved the deviation within few mm limitation with individual immobilization device. IV. Conclusion Custom made immobilization device was very helpful for anteroperitoneal resection patient with rectal cancer. We improved the patient position deviation within few mm limitation, shorten the set up time and we could give the comfort to patients.

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Evaluation on Usefulness of Applying Body-fix to Liver Cancer Patient in Tomotherapy (간암환자의 토모치료시 Body-fix 사용유무에 따른 유용성 평가)

  • Oh, Byeong-Cheon;Choi, Tae-Gu;Kim, Gi-Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.11-18
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    • 2010
  • Purpose: In every time radiation therapy set up errors occur because internal anatomical organs move due to breathing and change of patient's position. These errors may affect the change of dose distribution between target area and normal structure. This study investigates the usefulness of body-fix in clinical treatment. Materials and Methods: Among 55~60 aged male patients who has hepatocellular carcinoma in area of liver's couinaud classification, we chose 10 patients and divided two groups by using body-fix or not. When applying body-fix, we maintained a vacuum of 80 mbar pressure by using vacuum pump (Medical intelligence, Germany). Patients had free breathing with supine position. After working to fuse and consist MV-CT (megavoltage computed tomography) with KV-CT (kilovoltage computed tomography) obtained by 5 times treatments, we compared and analyzed set up errors occurred to (Right to Left, RL) of X axis, (Anterioposterio, AP) of Z axis, (Cranicoudal, CC) of Y axis. Results: Average Set up errors through image fusion showed that group A moved $0.3{\pm}1.1\;mm$ (Cranicoudal, CC), $-1.1{\pm}0.7\;mm$ (Right to Left, RL), $-0.2{\pm}0.7\;mm$ (Anterioposterio, AP) and group B moved $0.62{\pm}1.94\;mm$ (Cranicoudal, CC), $-3.62{\pm}1.5\;mm$ (Right to Left, RL), $-0.22{\pm}1.2\;mm$ (Anterioposterio, AP). Deviations of X, Y and Z axis directions by applying body-fix indicated that maximum X axis was 5.5 mm, Y axis was 19.8 mm and Z axis was 3.2 mm. In relation to analysis of error directions, consistency doesn't exist for every patient but by using body-fix showed that the result of stable aspect in spite of changes of everyday's patient position and breathing. Conclusion: Using body-fix for liver cancer patient is considered effectively for tomotherapy. Because deviations between group A and B exist but they were stable and regular.

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Improvement of patient's quality of life by improving patient's set-up line in radiotherapy (방사선 치료 시 환자 Set-up Line 개선을 통한 암환자 삶의 질 만족도 향상)

  • Choi, Jin Hyuk;Ahn, Woo Sang;Lee, Woo Seok;Kim, Dae Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.185-189
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    • 2018
  • Purpose : We evaluated the quality of life satisfaction of patients with radiation therapy while maintaining the set-up line. Materials and Methods : We retrospectively reviewed 60 patients who visited our clinic in January, 2018. The most common complaint was the inconvenience of not being able to wash during treatment (64 %), and a surgical tape was placed on the Set-up Line to help patients wash during the treatment period. A total of 50 patients who underwent surgical tape were evaluated on a 5-point scale (1 point was very unsatisfactory, 2 points were unsatisfactory, 3 points were average, 4 points were satisfied, 5 points were very satisfied). Forty patients out of 50 responded to the first treatment, and 10 patients underwent treatment. Results : In the first survey, 68 % of the patients and 32 % of the males were aged 34 %, 50~60 % and 38 %, respectively. Treatment areas were breast (57 %), chest (13 %), pelvis (10 %). The results of the second questionnaire after applying the surgical tape showed that 25 of the 40 patients and 15 of the male patients were treated. The treatment area was 22 breast and 18 pelvic areas. In the satisfaction of the 5-point scale, 5 to 15 points were satisfied with 1-3 points, and 4-5 points with 35 points (1 point 2 points, 2 points 2 points, 3 point 1 points, 4 point points 17 point points, % And 43 %, respectively. The results of the questionnaire survey of patients who were applied during the treatment showed that 9 out of 10 women and 1 male were treated. The treatment area was 8 breast and 2 pelvic areas. One point was satisfied with one point, and five points with nine points were satisfied with 90 %. Conclusions : The importance of improving the quality of life of patients with cancer is also important. After applying the surgical tape, 88 % of the patients who started the treatment and 90 % of the patients who applied during the treatment were satisfied. Particularly, patients who applied during treatment showed higher satisfaction. If this is not possible for all patients, selective application to patients with discomfort will be helpful in improving the quality of life of cancer patients.

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Arthroscopic Treatment of Osteochondritis Dissecans of the Talus (거골 박리성 골 연골염의 관절경적 치료)

  • Choi, Chong-Hyuk;Cheon, Yong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.161-170
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    • 2002
  • Purpose : To investigate arthroscopic simple excision for the treatment of osteochondritis dissecans of the talus and to examine gross change and histological evaluation of the defect through second look arthroscopy. Materials and Methods : This study included twenty-two patients who had osteochondritis dissecans of the talus that was treated with excision of arthroscopic loose body and necrotic bone tissue, leaving bleeding bed. In 7 cases, we performed second look arthroscopic examination for the evaluation of gross change of defects and histologic findings. Final results were evaluated with two clinical and functional protocols. Average follow up period was 42 months from 14 months to 8 years. Results : Ankle-hindfoot score (100 point) was improved significantly (p<0.003). Subjective and functional scores (100 points) averaged 82 points. The defect of lesion had a tendency of filling with fibrous tissue and fibrocartilage. Although the defect was filled with fibrocartilage, specific secondary lesion was not detected through second look arthroscopic examination. Conclusion : Arthroscopic debridement was an effective method for the treatment of osteochondritis dissecans of the talus without progression of secondary lesion even though the defect was filled with fibrocartilage.

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