• Radiation Oncology Journal
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• v.31 no.4
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• pp.247-251
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• 2013

Purpose: This study aimed to investigate efficient approaches for determining internal target volume (ITV) from four-dimensional computed tomography (4D CT) images used in stereotactic body radiotherapy (SBRT) for patients with early-stage non-small cell lung cancer (NSCLC). Materials and Methods: 4D CT images were analyzed for 15 patients who received SBRT for stage I NSCLC. Three different ITVs were determined as follows: combining clinical target volume (CTV) from all 10 respiratory phases ($ITV_{10Phases}$); combining CTV from four respiratory phases, including two extreme phases (0% and 50%) plus two intermediate phases (20% and 70%) ($ITV_{4Phases}$); and combining CTV from two extreme phases ($ITV_{2Phases}$). The matching index (MI) of $ITV_{4Phases}$ and $ITV_{2Phases}$ was defined as the ratio of $ITV_{4Phases}$ and $ITV_{2Phases}$, respectively, to the $ITV_{10Phases}$. The tumor motion index (TMI) was defined as the ratio of $ITV_{10Phases}$ to $CTV_{mean}$, which was the mean of 10 CTVs delineated on 10 respiratory phases. Results: The ITVs were significantly different in the order of $ITV_{10Phases}$, $ITV_{4Phases}$, and $ITV_{2Phases}$ (all p < 0.05). The MI of $ITV_{4Phases}$ was significantly higher than that of $ITV_{2Phases}$ (p < 0.001). The MI of $ITV_{4Phases}$ was inversely related to TMI (r = -0.569, p = 0.034). In a subgroup with low TMI (n = 7), $ITV_{4Phases}$ was not statistically different from $ITV_{10Phases}$ (p = 0.192) and its MI was significantly higher than that of $ITV_{2Phases}$ (p = 0.016). Conclusion: The $ITV_{4Phases}$ may be an efficient approach alternative to optimal $ITV_{10Phases}$ in SBRT for early-stage NSCLC with less tumor motion.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.91-98
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• 2014

Purpose : To compare the dosimetry for the left breast cancer treatment between three dimensional conformal radiation radiotherapy (3D-CRT) and Hybrid planning and to estimate usefulness of Hybrid planning Materials and Methods : Five patients with left breast cancer were included in the study. They were planned using several different radiotherapy techniques including: 1)open rectangular field, 2)tangential wedge-based field 3)field in field, 4)hybrid planning(energy, wedge combine). For each patient planning was using Light Speed RT-16 CT and PINNACLE planning system-ver.9.2. Hybrid plan was made using same system and using the same targets and optimization goals. We comparing the Homogeneity Index(HI), normal organs at the does-volume histogram(DVH) Results : In all plans, the Homogeneity Index(HI) of Hybrid planning was significantly better than other. Dose comparison of HI= 2D-RT:38.32, TW:38.32, FIF:29.22, HYBRID:30.57. 2D-RT, TW, FIF Hybrid$V_{75_-lung}$=112.33, 125.14, 121.3, 123.78. $V_{50_-lung}$=155.43, 159.62, 157.96, 159.06. $V_{25_-lung}$=199.86, 200.22, 198.65, 200.31. $V_{50_-heart}$=26.07, 27.1, 26.85, 27.17 $V_{30_-heart}$=33.71, 34.37, 34.15, 34.65 Conclusion : In summary, 3D-CRT, Hybrid planning techniques were found to have acceptableCTV coverage in our study. However the Hybrid planning increased radiation dose exposure to normal tissue. If you apply for treatment of inhomogeneity areas like lung, For best results will be achieved.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.37-43
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• 2008

Purpose: To evaluate dosimetry results of three different techniques for whole breast irradiation after conservative surgery of large pendulous breast patient. Materials and Methods: Planning computed tomography (CT) scans for three techniques were performed on a GE Hi-speed advantage CT scanner in the supine (SP), supine with breast supporting Device (SD) and prone position on a custom prone mattress (PP). Computed tomography images were acquired at 5 mm thickness. The clinical target volumes (CTV), ipsilateral lung and heart were delineated to evaluate the dose statistic, and all techniques were planned with the tangential photon beams (Pinnacle$^3$, Philips Medical System, USA). The prescribed dose was 50 Gy delivered in 25 fractions. To evaluate the dose coverage for CTV, we analysed percent volume of CTV receiving minimum of 95%, 100%, 105%, and 110% of prescription dose ($V_{95}$, $V_{100}$, $V_{105}$, and $V_{110}$) and minimal dose covering 95% ($D_{95}$) of CTV. The dosimetric comparison for heart and ipsilateral lung was analysed using the minimal dose covering 5% of each organs ($D_5$) and the volume that received >18 Gy for the heart and >20 Gy for the ipsilateral lung. Results: Target volume coverage ($V_{95}$ and $V_{100}$) was not significantly different for all technique. The V105 was lower for PP (1.2% vs. 4.4% for SP, 11.1% for SD). Minimal dose covering 95% ($D_{95}$) of target was 47.5 Gy, 47.7 Gy and 48 Gy for SP, SD and PP. The volume of ipsilateral lung received >20 Gy was 21.7%, 11.6% and 4.9% for SP, SD and PP. The volume of heart received >18 Gy was 17.0%, 16.1% and 9.8% for SP, SD and PP. Conclusion: Prone positioning of patient for large pendulous breast irradiation enables improving dose uniformity with minimal heart and lung doses.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.740-747
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• 2000

Background : To compare the efficacies and side effects of etoposide, cisplatin/cyclophosphamide, adriamycin, vincristine(VPP/CAV) with those of carboplatin etoposide(CE) in extensive stage small cell lung cancer patients. Method : Patients with extensive stage small lung cancer who has measurable disease were eligible. VPP/CAV group(n=22) was treated with cisplatin(60mg/$m^2$ iv. D1) etoposide(100mg/$m^2$ iv. D1-3), and 3 weeks later cyclophosphamide(1000mg/$m^2$ iv. D1), adriamycin( 40mg/$m^2$ iv. D1), and vincristine(1.4mg/$m^2$ iv. D1), were administered alternatively. CE group(n=22) was treated with carboplatin(325mg/$m^2$ iv. D1) and etoposide (100mg/$m^2$ iv. D1-3) ; repeated treatment was performed every 3 weeks. Result : Forty four patients were eligible for the study. The overall response rate was 61.4% (complete remission rate 0%, partial response rate 61.4%, stable disease rate 25%, progressive disease rate 13.6%), and median survival was 10.8 months. In VPP/CAV group, response rate was 54.5% (complete remission rate 0%, partial response rate 54.4%, stable disease rate 27.3%, progressive disease rate 18.2%), and, in carboplatin/etoposide group, the response rate was 68.2%(complete remission rate 0%, partial response rate 68.2%, stable disease rate 22.7%, progressive disease rate 9.1%). The median survival time was 9.5 months in the VPP/CAV group and 11 months in CE group. The toxicity of both group was moderate, and anemia was more frequent in the CE group. Conclusion : VPP/CAV regimen and CE regimen produced similar response rates and survival times in extensive stage small cell lung cancer patients. CE regimen may be effective as part of the initial therapy for extensive stage small cell lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.835-838
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• 2016

Background: Lung cancer remains one of the most common cancers in the world, both in terms of new cases (about 13% of total per year) and deaths (nearly one cancer death in five), because of the high case fatality. Errors in lung cancer type or malignant growth determination lead to degraded treatment efficacy, because anticancer strategy depends on tumor morphology. Materials and Methods: We have made an attempt to evaluate effectiveness of machine learning algorithms in the task of lung cancer classification based on gene expression levels. We processed four publicly available data sets. The Dana-Farber Cancer Institute data set contains 203 samples and the task was to classify four cancer types and sound tissue samples. With the University of Michigan data set of 96 samples, the task was to execute a binary classification of adenocarcinoma and non-neoplastic tissues. The University of Toronto data set contains 39 samples and the task was to detect recurrence, while with the Brigham and Women's Hospital data set of 181 samples it was to make a binary classification of malignant pleural mesothelioma and adenocarcinoma. We used the k-nearest neighbor algorithm (k=1, k=5, k=10), naive Bayes classifier with assumption of both a normal distribution of attributes and a distribution through histograms, support vector machine and C4.5 decision tree. Effectiveness of machine learning algorithms was evaluated with the Matthews correlation coefficient. Results: The support vector machine method showed best results among data sets from the Dana-Farber Cancer Institute and Brigham and Women's Hospital. All algorithms with the exception of the C4.5 decision tree showed maximum potential effectiveness in the University of Michigan data set. However, the C4.5 decision tree showed best results for the University of Toronto data set. Conclusions: Machine learning algorithms can be used for lung cancer morphology classification and similar tasks based on gene expression level evaluation.

• Journal of Radiation Protection and Research
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• v.40 no.1
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• pp.17-24
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• 2015

To improve accuracy of dose calculation on kilovoltage cone beam computed tomography (kV CBCT) images, a custom-made phantom was fabricated to acquire an accurate CT number to electron density curve by full scatter of cone beam x-ray. To evaluate the dosimetric accuracy, 9 volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and 9 VMAT plans for lung cancer were generated with an anthropomorphic phantom. Both CT and CBCT images of the anthropomorphic phantom were acquired and dose-volumetric parameters on the CT images with CT density curve (CTCT), CBCT images with CT density curve ($CBCT_{CT}$) and CBCT images with CBCT density curve ($CBCT_{CBCT}$) were calculated for each VMAT plan. The differences between $CT_{CT}$ vs. $CBCT_{CT}$ were similar to those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for HN VMAT plans. However, the differences between $CT_{CT}$ vs. $CBCT_{CT}$ were larger than those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for lung VMAT plans. Especially, the differences in $D_{98%}$ and $D_{95%}$ of lung target volume were statistically significant (4.7% vs. 0.8% with p = 0.033 for $D_{98%}$ and 4.8% vs. 0.5% with p = 0.030 for $D_{95%}$). In order to calculate dose distributions accurately on the CBCT images, CBCT density curve generated with full scatter condition should be used especially for dose calculations in the region of large inhomogeneity.

• Journal of Ginseng Research
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• v.42 no.4
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• pp.562-570
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• 2018

Background: Lung cancer is the leading cause of cancer-related death worldwide. In this study, we used a bioactivity-guided isolation technique to identify constituents of Korean Red Ginseng (KRG) with antiproliferative activity against human lung adenocarcinoma cells. Methods: Bioactivity-guided fractionation and preparative/semipreparative HPLC purification were used with LC/MS analysis to separate the bioactive constituents. Cell viability and apoptosis in human lung cancer cell lines (A549, H1264, H1299, and Calu-6) after treatment with KRG extract fractions and constituents thereof were assessed using the water-soluble tetrazolium salt (WST-1) assay and terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, respectively. Caspase activation was assessed by detecting its surrogate marker, cleaved poly adenosine diphosphate (ADP-ribose) polymerase, using an immunoblot assay. The expression and subcellular localization of apoptosis-inducing factor were assessed using immunoblotting and immunofluorescence, respectively. Results and conclusion: Bioactivity-guided fractionation of the KRG extract revealed that its ethyl acetate-soluble fraction exerts significant cytotoxic activity against all human lung cancer cell lines tested by inducing apoptosis. Chemical investigation of the ethyl acetatesoluble fraction led to the isolation of six ginsenosides, including ginsenoside Rb1 (1), ginsenoside Rb2 (2), ginsenoside Rc (3), ginsenoside Rd (4), ginsenoside Rg1 (5), and ginsenoside Rg3 (6). Among the isolated ginsenosides, ginsenoside Rg3 exhibited the most cytotoxic activity against all human lung cancer cell lines examined, with $IC_{50}$ values ranging from $161.1{\mu}M$ to $264.6{\mu}M$. The cytotoxicity of ginsenoside Rg3 was found to be mediated by induction of apoptosis in a caspase-independent manner. These findings provide experimental evidence for a novel biological activity of ginsenoside Rg3 against human lung cancer cells.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.84-106
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• 1994

Hyperbaric oxygen (HBO) therapy for carbon monoxide (CO) poisoning eventually inducing the hypoxia-reoxygenation condition, may produce oxygen free radicals, which forms 8-hydroxydeoxyguanosine (8-OH-dG) by attacking C-8 position of deoxyguanosine (dG) in DNA. Effects of oxygen partial pressure or duration of HBO therapy with or without CO poisoning on the tissue 8-OH-dG formation were investigated. Male Sprague-Dawley rats were grouped and exposed to air (control group), 4000 ppm of CO for 10 to 30 minutes (CO only group), air for 30 minutes after 30 minute exposure to 4000 ppm of CO(CO-air exposure group), HBO after 30 minute exposure to 4000 ppm of CO(CO-HBO group), or HBO therapy fo. $10{\sim}120$ minutes(HBO only group). The 8-OH-4G concentrations in the brain and the lung tissues were measured with high performance liquid chromatography and electrochemical detector (ECD). Average concentrations of the 8-OH-dG of each group were statistically compared. In the brain tissues, 8-OH-dG concentrations of the CO only group, the CO-air exposure group, and the CO-HBO group did not significantly differ from those of the control group. Similar insignificance was also found between the CO-HBO group and the HBO only groups. No appreciable dose-response relationship was observed between the 8-OH-dG concentration and the oxygen partial pressure or the duration of HBO. However, the 8-OH-dG concentrations of the 30 minute CO only group were higher than those of the CO-air exposure group (p-value<0.05). In the lung tissues, there were no significant differences between the 8-OH-dG concentrations of the control group and those of the CO only group, the CO-air exposure group, and the CO-HBO group. However, mean 8-OH-dG concentration of the CO-air exposure group was significantly higher than that of the CO only group under the same CO exposure condition(p-value<0.05). With the duration of CO exposure, the 8-OH-dG concentrations of the lung tissues decreased significantly (p-value<0.05). The concentrations of 8-OH-dG in the lung tissues proportionally increased with the duration of HBO, but no such relation was observed with the oxygen partial pressure. These results suggest that the brain may be more resistant to oxygen free radicals as compared with the lungs, and that oxygen toxicity following HBO may be affected by factors other than oxygen free radicals.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.35-46
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• 2021

Purpose : By comparing and analyzing treatment plans using abdominal compression and The Continuous Positive Air Pressure(CPAP) during SABR of lung cancer, we try to contribute to the improvement of radiotherapy effect. Materials & Methods : In two of the lung SABR patients(A, B patient), we developed a SABR plan using abdominal compression device(the Body Pro-Lok, BPL) and CPAP and analyze the treatment plan through homogeneity, conformity and the parameters proposed in RTOG 0813. Furthermore, for each phase, the X, Y, and Z axis movements centered on PTV are analyzed in all 4D CTs and compared by obtaining the volume and average dose of PTV and OAR. Four cone beam computed tomography(CBCT) were used to measure the directions from the center of the PTV to the intrathoracic contacts in three directions out of 0°, 90°, 180° and 270°, and compare the differences from the average distance values in each direction. Result : Both treatment plans obtained using BPL and CPAP followed recommendations from RTOG, and there was no significant difference in homogeneity and conformity. The X-axis, Y-axis, and Z-axis movements centered on PTV in patient A were 0.49 cm, 0.37 cm, 1.66 cm with BPL and 0.16 cm, 0.12 cm, and 0.19 cm with CPAP, in patient B were 0.22 cm, 0.18 cm, 1.03 cm with BPL and 0.14 cm, 0.11 cm, and 0.4 cm with CPAP. In A patient, when using CPAP compared to BPL, ITV decreased by 46.27% and left lung volume increased by 41.94%, and average dose decreased by 52.81% in the heart. In B patient, volume increased by 106.89% in the left lung and 87.32% in the right lung, with an average dose decreased by 44.30% in the stomach. The maximum difference of A patient between the straight distance value and the mean distance value in each direction was 0.05 cm in the a-direction, 0.05 cm in the b-direction, and 0.41 cm in the c-direction. In B patient, there was a difference of 0.19 cm in the d-direction, 0.49 cm in the e-direction, and 0.06 cm in the f-direction. Conclusion : We confirm that increased lung volume with CPAP can reduce doses of OAR near the target more effectively than with BPL, and also contribute more effectively to restriction of tumor movement with respiration. It is considered that radiation therapy effects can be improved through the application of various sites of CPAP and the combination with CPAP and other treatment machines.

• Journal of Ginseng Research
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• v.47 no.1
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• pp.81-88
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• 2023

Background: Air pollution has led to an increased exposure of all living organisms to fine dust. Therefore, research efforts are being made to devise preventive and therapeutic remedies against fine dust-induced chronic diseases. Methods: Research of the respiratory protective effects of KRG extract in a particulate matter (PM; aerodynamic diameter of <4 ㎛) plus diesel exhaust particle (DEP) (PM4+D)-induced airway inflammation model. Nitric oxide production, expression of pro-inflammatory mediators and cytokines, and IRAK-1, TAK-1, and MAPK pathways were examined in PM4-stimulated MH-S cells. BALB/c mice exposed to PM4+D mixture by intranasal tracheal injection three times a day for 12 days at 3 day intervals and KRGE were administered orally for 12 days. Histological of lung and trachea, and immune cell subtype analyses were performed. Expression of pro-inflammatory mediators and cytokines in bronchoalveolar lavage fluid (BALF) and lung were measured. Immunohistofluorescence staining for IRAK-1 localization in lung were also evaluated. Results: KRGE inhibited the production of nitric oxide, the expression of pro-inflammatory mediators and cytokines, and expression and phosphorylation of all downstream factors of NF-κB, including IRAK-1 and MAPK/AP1 pathway in PM4-stimulated MH-S cells. KRGE suppressed inflammatory cell infiltration and number of immune cells, histopathologic damage, and inflammatory symptoms in the BALF and lungs induced by PM4+D; these included increased alveolar wall thickness, accumulation of collagen fibers, and TNF-α, MIP2, CXCL-1, IL-1α, and IL-17 cytokine release. Moreover, PM4 participates induce alveolar macrophage death and interleukin-1α release by associating with IRAK-1 localization was also potently inhibited by KRGE in the lungs of PM4+D-induced airway inflammation model. KRGE suppresses airway inflammatory responses, including granulocyte infiltration into the airway, by regulating the expression of chemokines and inflammatory cytokines via inhibition of IRAK-1 and MAPK pathway. Conclusion: Our results indicate the potential of KRGE to serve as an effective therapeutic agent against airway inflammation and respiratory diseases.