• Title/Summary/Keyword: Brachytherapy

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High-Dose-Rate Brachytherapy for Uterine Cervical Cancer : The Results of Different Fractionation Regimen (자궁경부암의 고선량률 근접치료 : 분할선량에 따른 결과 비교)

  • Yoon, Won-Sup;Kim, Tae-Hyun;Yang, Dae-Sik;Choi, Myung-Sun;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.228-236
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    • 2002
  • Purpose : Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. Methods and Materials : From November 1992 to March 1998, 224 patients with uterine conical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was $45\~54\;Gy$ (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. Results : The local control rate (LCR) at 5 years was $80\%$ in group A and $84\%$ in group B (p=0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was $60.9\%$ in group A and $76.9\%$ in group B (p=0.2557). In post-operative radiation therapy patients, LCR at 5 years was $92.6\%$ In group A and $91.6\%$ in group B (p=0.8867). The incidence of late complication was $18\%$ (22 patients) and $29.4\%$ (30 patients), of bladder complication was $9.8\%$ (12 patients) and $14.7\%$ (15 patients), and of rectal complication was $9.8\%$ (12 patients) and $21.6\%$ (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication (p=0.0405) (rectal complication, p=0.0147; bladder complication, p=0.115). The same result was observed in postoperative radiation therapy patients (p=0.0860) and radiation only treated patients (0=0.0370). Conclusion : For radiation only treated patients, a greater number of itemized studies on the proper fraction size of HDR brachytherapy, with consideration for stages and prognostic factors, are required. In postoperative radiation therapy, the fraction size of HDR brachytherapy did not have much effect on local control, yet the incidence of late complication increased with the elevation in fraction size. We suggest that HDR brachytherapy three times weekly with 3 Gy could be an alternative method of therapy.

Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES (원격조정 고선량 근접 치료)

  • Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.267-275
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    • 1992
  • Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

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Development of Phantom for Evaluate the Suitability of Ir-192 HDR Source with Brachytherapy Tools (근접치료용 하나로 생산 Ir-192 선원의 임상기기 적합성평가용 팬톰개발)

  • Shin, Kyo Chul;Choi, Sang Gyu;Kim, Ki Hwan;Son, Kwang Jae;Jeong, Dong Hyeok;Kim, Jeung Kee
    • Progress in Medical Physics
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    • v.24 no.3
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    • pp.171-175
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    • 2013
  • Applicator of various kind of number ten kinds is used to raise from efficiency of brachytherapy to maximum. The compatibility of radiation source and applicator is very important subject for safety brachytherapy. Developed high dose rate brachytherapy source through Hanaro nuclear reactor in Korea Atomic Energy Research Institute and improve compatibility with using equipment in present. In this research, we wished to evaluate stability mechanical safety of radiation source and we developed phantom for evaluate several quality about Ir-192 sealed source that improve newly in Korea Atomic Energy Research Institute and is improved. The result for suitability of Ir-192 HDR source with brachytherapy tools that did normal operation in 2.2~2.7 cm extent about change of equal curvature and consider change of sudden curvature that did normal operation in radius 1.5~1.8 cm extent.

High Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual Disease

  • Pesee, Montien;Krusun, Srichai;Padoongcharoen, Prawat
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4835-4837
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    • 2012
  • Objectives: To evaluate residual disease in uterine cervical cancer patients treated with teletherapy using combined high dose rate Cobalt-60 brachytherapy. Materials and Methods: A retrospective study of uterine cervical cancer patients, FIGO stages IB-IVB (International Federation of Gynecologists and Obstetricians recommendations), treated by radiotherapy alone between April 1986 and December 1988 was conducted and the outcomes analysed. The patients were treated using teletherapy 50 Gy/25 fractions, five fractions per week to the whole pelvis together with HDR Cobalt -60 afterloading brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions. Results: The study covered 141 patients with uterine cervical cancer. The mean age was 50.0 years with a range of 30-78 years. The mean tumor size was 4.1 cm in diameter (range 1-8 cm). Mean follow - up time was 2.94 years (range 1 month-6.92 years). The overall incidence of residual locoregional disease was 3.5%. Residual disease, according to stage IIB, IIIB and IVA was present in 2.78%, 3.37% and 50.0%. It was noted that there was no evidence of residual disease in stage IB and IIA cases. Conclusion: Combined teletherapy along with high dose rate Cobalt -60 brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions resulted in overall 3.5% residual disease and a 96.5% complete response. The proposed recommendation for improving outcome is initiation of measurements for early detection of disease.

Measurements of relative depth dose rates for a brachytherapy Ir-192 sourceusing an organic scintillator fiber-optic radiation sensor (유기 섬광체-광섬유 방사선 센서를 이용한 근접 방사선원 Ir-192의 상대 깊이 선량율 측정)

  • Shin, Sang-Hun;Jang, Kyoung-Won;Cho, Dong-Hyun;Yoo, Wook-Jae;Seo, Jeong-Ki;Lee, Bong-Soo;Moon, Joo-Hyun;Kim, Sin;Park, Byung-Gi
    • Journal of Sensor Science and Technology
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    • v.17 no.6
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    • pp.462-469
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    • 2008
  • In this study, we have fabricated a fiber-optic radiation sensor using an organic scintillator and plastic optical fiber for brachytherapy dosimetry. Also, we have measured relative depth dose rates of Ir-192 source using a fiber-optic sensor and compared them with the results obtained using a conventional EBT film. Cerenkov lights which can be a noise in measuring scintillating light with a fiber-optic sensor are measured and eliminated by using of a background optical fiber. It is expected that a fiber-optic radiation sensor can be used in brachytherapy dosimetry due to its advantages such as a low cost, simple usage and a small volume.