• Title/Summary/Keyword: Dose Distribution

Search Result 1,176, Processing Time 0.029 seconds

Development of $^{166}Ho$-Stent for the Treatment of Esophageal Cancer (식도암 치료용 $^{166}Ho$-Stent 개발)

  • Park, Kyung-Bae;Kim, Young-Mi;Kim, Kyung-Hwa;Shin, Byung-Chul;Park, Woong-Woo;Han, Kwang-Hee;Chung, Young-Ju;Choi, Sang-Mu;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
    • /
    • v.34 no.1
    • /
    • pp.62-73
    • /
    • 2000
  • Purpose: Esophageal cancer patients have a difficulty in the intake of meals through the blocked esophageal lumen, which is caused by an ingrowth of cancer cells and largely influences on the prognosis. It is reported that esophageal cancer has a very low survival rate due to the lack of nourishment and immunity as the result of this. In this study a new radioactive stent, which prevents tumor ingrowth and restenosis by additional radiation treatment, has been developed. Materials and Methods: Using ${\ulcorner}HANARO{\lrcorner}$ research reactor, the radioactive stent assembly ($^{166}Ho$-SA) was prepared by covering the metallic stent with a radioactive sleeve by means of a post-irradiation and pre-irradiation methods. Results: Scanning electron microscopy and autoradiography exhibited that the distribution of $^{165/166}Ho\;(NO_3)$ compounds in polyurethane matrix was homogeneous. A geometrical model of the esophagus considering its structural properties, was developed for the computer simulation of energy deposition to the esophageal wall. The dose distributions of $^{166}Ho$-stent were calculated by means of the EGS4 code system. The sources are considered to be distributed uniformly on the surface in the form of a cylinder with a diameter of 20 mm and length of 40 mm. As an animal experiment, when radioactive stent developed in this study was inserted into the esophagus of a Mongrel dog, tissue destruction and widening of the esophageal lumen were observed. Conclusion: We have developed a new radioactive stent comprising of a radioactive tubular sleeve covering the metallic stent, which emits homogeneous radiation. If it is inserted into the blocked or narrowed lumen, it can lead to local destruction of the tumor due to irradiation effect with dilatation resulting from self-expansion of the metallic property. Accordingly, it is expected that restenosis esophageal lumen by the continuous ingrowth and infiltration of cancer after insertion of our radioactive stent will be decreased remarkably.

  • PDF

Characteristics of Fertility on Strawberry Cultivated Soil of Plastic Film House in Chungnam Province in Korea (충남지역 시설 딸기재배 토양 비옥도 특성)

  • Choi, Moon-Tae;Lee, Jin-Il;Yun, Yeo-Uk;Lee, Jong-Eun;Lee, Bong-Chun;Yang, Euy-Seog;Lee, Young-Han
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.43 no.2
    • /
    • pp.160-165
    • /
    • 2010
  • To reduce the dose of fertilizers is very important to sustainable production of many horticultural crops, including strawberry. In order to practice the environment friendly agriculture of strawberry cultivation in plastic film house, soil chemical properties of 435 soil samples (232 for loam, 83 for sandy loam, and 120 for silt loam) in Chungnam Province from2008 to 2009 were determined. The average of pH, EC, OM, Av. $P_2O_5$, Ex. $K^+$, Ex. $Ca^{2+}$, Ex. $Mg^{2+}$, and Ex. $Na^+$ was 6.5, 2.28 dS $m^{-1}$, 26 g $kg^{-1}$, 910 mg $kg^{-1}$, 1.09 $cmol_c\;kg^{-1}$, 8.3 $cmol_c\;kg^{-1}$, 2.5 $cmol_c\;kg^{-1}$, and 0.58 $cmol_c\;kg^{-1}$, respectively. The content of Av. $P_2O_5$ in sandy loam soil was significantly higher than silt loam soil, whereas other properties showed no difference between soil texture. The kinds of strawberry cultivars showed no difference in soil chemical properties. The frequency distribution within optimum range of soil chemical properties was 30.6%, 35.4%, 37.0%, 5.3%, 8.5%, 8.5%, and 17.9% for pH, EC, OM, Av. $P_2O_5$, Ex. $K^+$, Ex. $Ca^{2+}$, and Ex. $Mg^{2+}$, respectively. Especially, excessive portion of Av. $P_2O_5$, and Ex. $Ca^{2+}$ were high 86.9%, and 86.0%, respectively. EC values of soil samples were significantly positive correlatoin with all chemical properties except soil pH. In principle component analysis of chemical properties in soil samples, the percentage of variance explained by PC 1 was 38.8%, while PC 2 explained 17.8%of the variance, for a cumulative total of 56.6%. These results were able to distinguish between soil textures and strawberry cultivars. Also, these results considered that understanding of soil chemical properties under using principal component analysis be able to improve amounts of fertilizers for sustainable agriculture in plastic film house.

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
    • /
    • v.22 no.1
    • /
    • pp.11-18
    • /
    • 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.

  • PDF

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity.modulated Radiation Therapy (세기조절방사선치료 시 콘빔CT (CBCT)를 이용한 환자자세 검증 및 보정평가)

  • Do, Gyeong-Min;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.21 no.2
    • /
    • pp.83-88
    • /
    • 2009
  • Purpose: Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. Materials and Methods: The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. Results: When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07o in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. Conclusion: By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and correct the change of position and target volume and treat more accurately, and could calculate and compare the errors. The results of this study show that CBCT was useful to deliver accurate treatment according to the treatment plan and to increase the reproducibility of repeated treatment, and satisfactory results were obtained. Accuracy enhanced through CBCT is highly required in IMRT, in which the shape of the target volume is complex and the change of dose distribution is radical. In addition, further research is required on the criteria for match focus by treatment site and treatment purpose.

  • PDF

Experiences of the First 130 Patients in Gangnam Severance Hospital (강남세브란스병원 토모테라피를 이용한 치료환자의 130예 통계분석 및 경험)

  • Ha, Jin-Sook;Jeon, Mi-Jin;Kim, Sei-Joon;Kim, Jong-Dae;Shin, Dong-Bong
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.20 no.1
    • /
    • pp.45-53
    • /
    • 2008
  • Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

  • PDF

Studies on the Epidemiological Change of Clonorchiasis After Mass Chemotherapy in Highly endemic Areas (집단치료사업에 따른 간흡충증의 역학적 변동에 관한 조사)

  • Joo, Kyoung-Hwan;Chu, Paul B.;Rim, Han-Jong;Lee, Joon-Sang
    • Journal of agricultural medicine and community health
    • /
    • v.12 no.1
    • /
    • pp.80-93
    • /
    • 1987
  • Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

  • PDF

Effect of Trichostatin A on Anti HepG2 Liver Carcinoma Cells: Inhibition of HDAC Activity and Activation of Wnt/β-Catenin Signaling

  • Shi, Qing-Qiang;Zuo, Guo-Wei;Feng, Zi-Qiang;Zhao, Lv-Cui;Luo, Lian;You, Zhi-Mei;Li, Dang-Yang;Xia, Jing;Li, Jing;Chen, Di-Long
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.18
    • /
    • pp.7849-7855
    • /
    • 2014
  • Purpose: To investigate the effect of deacetylase inhibitory trichostatin A (TSA) on anti HepG2 liver carcinoma cells and explore the underlying mechanisms. Materials and Methods: HepG2 cells exposed to different concentrations of TSA for 24, 48, or 72h were examined for cell growth inhibition using CCK8, changes in cell cycle distribution with flow cytometry, cell apoptosis with annexin V-FTIC/PI double staining, and cell morphology changes under an inverted microscope. Expression of ${\beta}$-catenin, HDAC1, HDAC3, H3K9, CyclinD1 and Bax proteins was tested by Western blotting. Gene expression for ${\beta}$-catenin, HDAC1and HDAC3 was tested by q-PCR. ${\beta}$-catenin and H3K9 proteins were also tested by immunofluorescence. Activity of Renilla luciferase (pTCF/LEF-luc) was assessed using the Luciferase Reporter Assay system reagent. The activity of total HDACs was detected with a HDACs colorimetric kit. Results: Exposure to TSA caused significant dose-and time-dependent inhibition of HepG2 cell proliferation (p<0.05) and resulted in increased cell percentages in G0/G1 and G2/M phases and decrease in the S phase. The apoptotic index in the control group was $6.22{\pm}0.25%$, which increased to $7.17{\pm}0.20%$ and $18.1{\pm}0.42%$ in the treatment group. Exposure to 250 and 500nmol/L TSA also caused cell morphology changes with numerous floating cells. Expression of ${\beta}$-catenin, H3K9and Bax proteins was significantly increased, expression levels of CyclinD1, HDAC1, HDAC3 were decreased. Expression of ${\beta}$-catenin at the genetic level was significantly increased, with no significant difference in HDAC1and HDAC3 genes. In the cytoplasm, expression of ${\beta}$-catenin fluorescence protein was not obvious changed and in the nucleus, small amounts of green fluorescence were observed. H3K9 fluorescence protein were increased. Expression levels of the transcription factor TCF werealso increased in HepG2 cells following induction by TSA, whikle the activity of total HDACs was decreased. Conclusions: TSA inhibits HDAC activity, promotes histone acetylation, and activates Wnt/${\beta}$-catenin signaling to inhibit proliferation of HepG2 cell, arrest cell cycling and induce apoptosis.

A study on the Hematologic Effects of Radioactive Iodine($^{131}I$) Therapy on Various Thyroid Diseases (방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)의 치료량(治療量)이 갑상선종환자(甲狀腺腫患者)의 혈액상(血液像)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Myung-Jae;Kim, Noe-Kyeong;Lee, Jung-Sang;Choi, Keun-Chul;Lee, Ryong-Woo;Kim, Kee-Won;Kang, Shin-Il
    • The Korean Journal of Nuclear Medicine
    • /
    • v.3 no.1
    • /
    • pp.51-58
    • /
    • 1969
  • To clarify the hematologic effects of the radioiodine ($^{131}I$) in therapeutic doses ($5{\sim}10$ mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ($^{131}I$) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10 mCi of radioiodine ($^{131}I$) with single or fractionated administrations. The blood pictures of peripheral blood were repeated after 3 months in 40 cases of 65 cases who had been treated with $^{131}I$. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with $^{131}I$ therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter: 35.4% Nontoxic nodular goiter: 29.7% Euthyroid: 13.8% Nontoxic diffuse goiter: 12.6% Hypothyroidism: 4.3% Thyroiditis($\bar{s}$ subacute form): 1.8% Toxic nodular goiter: 1.4% Malignancy: 1.0% 2) Age incidence: The range of distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. $80.6{\sim}82.6%$ of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence: Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in. the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with $^{131}I$ toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter. One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ($^{131}I$) does not result any residual effect on the hematopoietic function. Radioiodine ($^{131}I$) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study.

  • PDF

Breast Conserving Operation and Radiation Therapy in Early Breast Cancer : Interim Analysis (초기유방암에서 유방보존수술 후 방사선치료 : 중간분석)

  • Kim, Jin-Hee;Kim, Ok-Bae;Kim, You-Sah
    • Radiation Oncology Journal
    • /
    • v.19 no.1
    • /
    • pp.27-33
    • /
    • 2001
  • Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.

  • PDF

Postoperative Radiotherapy for Low Grade Glioma of the Brain (뇌 신경교종의 수술 후 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
    • /
    • v.18 no.2
    • /
    • pp.79-84
    • /
    • 2000
  • Purpose : To evaluate the effectiveness and tolerance of postoperative e지ernai beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Materials and Methods : Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58$\%$), mixed oligodendrogliomas-19 patients (27$\%$), oiigodendrogliomas-11 patients (15$\%$). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. Ail of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000 $\~$ 5500 cGy. Results : The overall 5 and 7 year survival rates for entire group of 72 patients were 61$\~$ and 50$\~$. Corresponding disease free survival rates for entire patients were 53$\~$ and 45$\~$, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogiiomas, and oligodendrogiiorras were 48$\%$ and 45$\%$, 76$\%$ and 56$\%$, and 80$\%$ and 52$\%$, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for sub total resection patients and biopsy alone patients were 57$\%$ and 43$\%$, respectively. Forty six patients who were 40 years or younger survived batter than 26 patients who were 41 years or older (overall survival rate at 5 years, 69$\%$ vs 45$\%$). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Conclusion : Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.

  • PDF