• 제목/요약/키워드: Bladder dose

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The Prognostic Factors Affecting Survival in Muscle Invasive Bladder Cancer Treated with Radiotherapy (방사선치료를 받은 근 침윤성 방광암의 예후 인자)

  • Chung Woong-Ki;Oh Bong-Ryoul;Ahn Sung Ja;Nah Byung Sik;Kwon Dong-Deuk;Park Kwangsung;Ryu Soo-Bang;Park Yang-IL
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.130-138
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    • 2002
  • Purpose : This study analyzed the prognostic factors affecting the survival rate and evaluated the role of radiation therapy in muscle-invading bladder cancer. Materials and Methods : Twenty eight patients with bladder cancer who completed planned definitive radiotherapy in the Departments of Therapeutic Radiology and Urology, Chonnam National University Hospital between Jan. 1986 to Dec. 1998 were retrospectively analyzed. The reviews were peformed based on the patients' medical records. There were 21 males and 7 females in this study. The median of age was 72 years old ranging from 49 to 84 years. All patients were confirmed as having transitional cell carcinoma with histological grade 1 in one patient, grade 2 in 15, grade 3 in 9, and uninformed in 3. Radiation therapy was peformed using a linear accelerator with 6 or 10 MV X-rays. Radiation was delivered daily with a 1.8 or 2.0 Gy fraction size by 4 ports (anterior-posterior, both lateral, alternatively) or 3 ports (Anterior and both lateral). The median radiation dose delivered to the isocenter of the target volume was 61.24 Gy ranging from 59 to 66.6 Gy. The survival rate was calculated by the Kaplan-Meier method. Multivariate analysis was peformed on the prognostic factors affecting the survival rate. Results : The survival rate was $76\%,\;46\%,\;33\%,\;33\%$ at 1, 2, 3, 5 years, respectively, with 19 months of median survival. The potential factors of age (less than 70 years vs above 70), sex, diabetes mellitus, hypertension, hydronephrosis, 1-stage (T3a vs T3b), TUR, chemotherapy, total duration of radiotherapy, radiation dose (less than 60 Gy vs above 60 Gy), and the treatment response were investigated with uniand multivariate analysis. Un univariate analysis, the T-stage (p=0.078) and radiation dose (p=0.051) were marginally significant, and the treatment response (p=0.011) was a statistically significant factor on the survival rate. Multivariate analysis showed there were no significant prognostic factors affecting the survival rate. Conclusion : The treatment response and radiation dose are suggested as th은 statistically significant factors affecting the survival rate of muscle invasive bladder cancer. A Further prospective randomized study is needed to confirm these prognostic factors.

Growth Inhibition and Induction of Apoptosis in Human Bladder Cancer Cells Induced by Fermented Citrus Kombucha (감귤 콤부차 발효액의 인체 방광암세포에 대한 성장억제와 Apoptosis에 미치는 영향)

  • Kim, Chung-I;Shin, Seung-Shick;Park, Sung-Soo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.10
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    • pp.1422-1429
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    • 2016
  • Kombucha is a slightly sour beverage fermented by symbiotic micro-organisms, including bacteria and yeasts. In this study, we examined the biological activities of citrus Kombucha (CK) produced by addition of citrus extract to original Kombucha (K). After fermentation for 10 days, radical scavenging activity examined by ABTS and DPPH assays increased by approximately 20% compared to that of K. Moreover, content of total phenolic compounds significantly increased by 60% compared to that of K. Cell proliferation assays utilizing MTT showed that CK treatment significantly inhibited growth of bladder cancer cells, T-24 and 5637, in a dose-dependent manner with $IC_{50}$ values of 4 and 7 mg/mL, respectively. Annexin V staining showed that CK treatment led to apoptosis of cells in a dose-dependent manner. T-24 cells were more sensitive to CK treatment than 5637 cells, as 8 mg/mL of CK resulted in 97% apoptosis of T-24 cells. Western blotting showed that CK treatment led to up-regulation of apoptotic proteins, including caspases-3, -8, -9, and PARP, in bladder cells not in K-treated cells. Taken together, these results demonstrate that CK may be developed as a functional beverage.

A Novel Pathway Underlying the Inhibitory Effects of Melatonin on Isolated Rat Urinary Bladder Contraction

  • Han, June-Hyun;Chang, In-Ho;Myung, Soon-Chul;Lee, Moo-Yeol;Kim, Won-Yong;Lee, Seo-Yeon;Lee, Shin-Young;Lee, Seung-Wook;Kim, Kyung-Do
    • The Korean Journal of Physiology and Pharmacology
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    • v.16 no.1
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    • pp.37-42
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    • 2012
  • The aim of the present study was to elucidate the direct effects of melatonin on bladder activity and to determine the mechanisms responsible for the detrusor activity of melatonin in the isolated rat bladder. We evaluated the effects of melatonin on the contractions induced by phenylephrine (PE), acetylcholine (ACh), bethanechol (BCh), KCl, and electrical field stimulation (EFS) in 20 detrusor smooth muscle samples from Sprague-Dawley rats. To determine the mechanisms underlying the inhibitory responses to melatonin, melatonin-pretreated muscle strips were exposed to a calcium channel antagonist (verapamil), three potassium channel blockers [tetraethyl ammonium (TEA), 4-aminopyridine (4-AP), and glibenclamide], a direct voltage-dependent calcium channel opener (Bay K 8644), and a specific calcium/calmodulin-dependent kinase II (CaMKII) inhibitor (KN-93). Melatonin pretreatment ($10^{-8}{\sim}10^{-6}M$) decreased the contractile responses induced by PE ($10^{-9}{\sim}10^{-4}M$) and Ach ($10^{-9}{\sim}10^{-4}M$) in a dose-dependent manner. Melatonin ($10^{-7}M$) also blocked contraction induced by high KCl ($[KCl]_{ECF}$; 35 mM, 70 mM, 105 mM, and 140 mM) and EFS. Melatonin ($10^{-7}M$) potentiated the relaxation response of the strips by verapamil, but other potassium channel blockers did not change melatonin activity. Melatonin pretreatment significantly decreased contractile responses induced by Bay K 8644 ($10^{-11}{\sim}10^{-7}M$). KN-93 enhanced melatonin-induced relaxation. The present results suggest that melatonin can inhibit bladder smooth muscle contraction through a voltage-dependent, calcium-antagonistic mechanism and through the inhibition of the calmodulin/CaMKII system.

The Study of Shielding Effect on Ovoids of Three Different Gynecological Applicator Sets in microSelectron-HDR System (microSelectron-HDR System에서 부인암 강내조사에 쓰이는 세 가지 Applicator Set들의 Ovoids에 대한 차폐효과 연구)

  • Cho, Young-K.;Park, Sung-Y.;Choi, Jin-H.;Kim, Hung-J.;Kim, Woo-C.;Loh, John-J.K.;Kim, Joo-Y.
    • Journal of Radiation Protection and Research
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    • v.23 no.4
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    • pp.259-266
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    • 1998
  • There are three different types of gynecological applicator sets available in microSelectron-high dose-rate(HDR) System by Nucletron; standard applicator set(SAS), standard shielded applicator set(SSAS), and Fletcher-Williamson applicator set(FWAS). Shielding effect of a SAS without shielding material was compared with that of a SSAS with shielding material made of stainless steel(density ${\varrho}=8,000kg/m^3$) at the top and bottom of each ovoid, and of a FWAS with shielding material made of tungsten alloy(density ${\varrho}=14,000kg/m^3$ at the top and bottom of each ovoid. The shielding effects to the rectum and bladder of these two shielded applicator sets were to be measured at reference points with an ion chamber and specially designed supporting system for applicator ovoids inside of the computerized 3-dimensional water phantom. To determine the middle point of two ovoids the measurement was performed with the reference tip of ion chamber placed at the same level and at the middle point from the two ovoids, while scanning the dose with the ion chamber on each side of ovoids. The doses to the reference points of rectum were measured at 20(Rl), 25(R2), 30(R3), 40(R4), 50(R5), and 60(R6) mm located posteriorly on the vertical line drawn from M5(the middle dwell position of ovoid), and the doses to the bladder were measured at 20(Bl), 30(B2), 40(B3), 50(B4), and 60(B5) mm located anteriorly on the vertical line drawn from M5. The same technique was employed to measure the doses on each reference point of both SSAS and FWAS. The differences of measured rectal doses at 25 mm(R2) and 30 mm(R3) between SAS and SSAS were 8.0 % and 6.0 %: 25.0% and 23.0 % between SAS and FWAS. The differences of measured bladder doses at 20 mm(Bl) and 30 mm(B2) between SAS and SSAS were 8.0 % and 3.0 %: 23.0 % and 17.0 % between SAS and FWAS. The maximum shielding effects to the rectum and bladder of SSAS were 8.0 % and 8.0 %, whereas those of FWAS were 26.0 % and 23.0 %, respectively. These results led to the conclusion that FWAS has much better shielding effect than SSAS does, and when SSAS and FWAS were used for gynecological intracavitary brachytherapy in microSelectron-HDR system, the dose to the rectum and bladder was significantly reduced to optimize the treatment outcome and to lower the complication rates in the rectum and bladder.

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Usability Assessment of Plan Transfer between TOMO HAD and Radixact : Planning Study (TOMO HDA와 Radixact 치료 계획 간 Transfer에 대한 유용성 평가 : Planning Study)

  • An, Ye Chan;Kim, Jong Sik;Kwon, Dong Yeol;Kim, Jin Man;Choi, Byeong Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.117-128
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    • 2018
  • Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

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Dosimetry and Medical Internal Radiation Dose of Re-188-DTPA for Endovascular Balloon Brachytherapy Against Restenosis after Coronary Angioplasty (혈관성형술 후 재협착 방지 치료에 사용하기 위한 원통형 풍선 Re-188-DTPA의 선량 분포와 내부피폭 선량)

  • Lee, Jin;Lee, Dong-Soo;Shin, Seung-Ae;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.2
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    • pp.163-171
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    • 1999
  • Purpose: Liquid beta emitter filled in angioplasty balloon could be used to perform endovascular balloon brachytherapy to prevent coronary artery restenosis. We investigated the dosimetry for Re-188-DTPA liquid-filled balloon and medical internal radiation dosimetry in case of balloon leakage. Materials and Methods: We estimated radiation dose from an angioplasty balloon (20 mm length, 3 mm diameter cylinder) to the adjacent vessel wall using Monte Carlo EGS4 code. We obtained time-activity curves of kidneys in normal dog and calculated $T_{max},\;T_{1/2}$. Using MIRDOSE3 program, we estimated absorbed doses to the major organs (kidneys, bladder) and the whole body when we assumed that balloon leaked all the isotope contained. Results: The radiation dose was 17.5 Gy at the balloon surface when we applied 3,700 MBq/ml of Re-188 for 100 seconds, Fifty percent of the energy deposited within 1 mm from the balloon surface. The estimated internal dose to the whole body was 0.005 mGy/MBq and 18.5 mGy for the spillage of 3,700 MBq of Re-188. Conclusion: We suggest that Re-188-DTPA can be used for endovascular balloon brachytherapy to inhibit coronary artery restenosis after angioplasty with tolerable whole body radiation dose in case of balloon rupture.

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Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy (고선량율 질강 근접조사를 위한 새로운 적용구의 제작)

  • Shin, Sei One
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.123-128
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    • 2000
  • Purpose: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. Methods: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). Results: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. Conclusions: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

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Clinical Risk Evaluation Using Dose Verification Program of Brachytherapy for Cervical Cancer (자궁경부암 근접치료 시 선량 검증 프로그램을 통한 임상적 위험성 평가)

  • Dong‑Jin, Kang;Young‑Joo, Shin;Jin-Kyu, Kang;Jae‑Yong, Jung;Woo-jin, Lee;Tae-Seong, Baek;Boram, Lee
    • Journal of radiological science and technology
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    • v.45 no.6
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    • pp.553-560
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    • 2022
  • The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.

Ameliorating Activity of Aspalactone on Cisplatin Induced Nephrotoxicity (백금항암제 Cisplatin의 신장독성에 대한 Aspalactone의 경감작용)

  • 정세영
    • Environmental Analysis Health and Toxicology
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    • v.14 no.1_2
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    • pp.13-19
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    • 1999
  • Cisplatin is an inorganic complex formed by a central atom of platinum surrounded by chlorine and ammonia atoms in the cis position in the horizontal plane, Cisplatin is one of the most effective anticancer drug, widely used against various tumor such as testicular tumor, brain tumor, ovary tumor, bladder carcinoma, colon cancer etc. However its clinical use has been limited by nephrotoxicity, ototoxicity , gastrointestinal disturbances, myeloscrppression and allergic reactions. In these toxicities, dose related and cumulative nephrotoxicity is the major dose limit factor. So, to evaluate the protective effect of aspalactone on cisplatin nephrotoxicity in rats, both compounds were given intraperitoneally, Protective effects of aspalactone against nephrotoxicity of cisplatin were observed when aspalactone was administered to rats 1hr beforecisplatin injection. Hepatotoxicity induced by combination treatment of cisplatin and aspalactone was not observed. The present results indicate that aspalactone may provide protection against cisplatin nephrotoxicity, when it is given 1hr before cisplatin injection.

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