• Title/Summary/Keyword: External treatment

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Effect of Pelvic Irradiation on the Bone Mineral Content of Lumbar Spine in Cervical Cancer (자궁경부암 환자에서 방사선 치료가 골무기물 함량에 미치는 영향)

  • Youn Seon Min;Choi Tae Jin;Koo Eun Sil;Kim Ok Bae;Lee Seung Moon;Suh Soo Jhi
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.145-151
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    • 1997
  • Purpose : To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. Method and materials : Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using Photon energy of 120 and 80kVp, The numbers of Patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth and 11 in seventh decade, those of patient group were 14 in filth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for Pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer, Results : The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about $13\%\;to\;40\%$ maximally. The BMC of L3 and L4 a region that is out of a radiation field for the Patient group demonstrated $119.5\pm30.6,\;117.0\pm31.7\;for\;fifth,\;83.3\pm37.8,\;88.3\pm46.8\;for\;sixth\;and\;61.5\pm18.3,\;56.2\pm26.6mg/cc$ for seventh, Contrasted by the normal control group has shown $148.0\pm19.9,\;153.2\pm23.2\;for\;fifth,\;96.1\pm30.2,\;105.6\pm26.5\;for\;sixth\;and\;73.9\pm27.9,\;77.2\pm27.2mg/cc$ for seventh decade, respectively The BMG of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In Particular, the BMC of L5 within the radiation field was significantly decresed to $33\%,\;31\%,\;40\%$ compared with the control group of the fifth, sixth and seventh decades, respectively. Conclusion : The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in Patient group with Pelvic irradiation in contrast to that of the normal control groups.

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Results of Hyperfractionated Radiation Therapy in Bulky Stage Ib, IIa, and IIb Uterine Cervical Cancer (종괴가 큰 병기 Ib, IIa, IIb 자궁경부암에서 다분할 방사선치료의 결과)

  • Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.349-356
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    • 1997
  • Purpose : To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb Materials and Materials : Fourty one patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University. School of Medicine from Jul, 1991 to Apr, 1994. According to FIGO s1aging system, therewere stage Ib (3 patients) IIa (6 patients) with exophytic ($\geq$5cm in dinmeter) and huge endophytic mass. and IIb (32 patients) with median age of 55 yeavs old. Radiation therapy consisted of hyperfractionated external irradition to the whole pelvis (120cGy/fraction, 2 fraction/day (minimum interval of 6 hours), 3600-5520cGy) and boost parametrial doses (for a total of 4480-6480cGy) with midline shield $(4\times10cm)$, and combined with intracavitary irradiation (up to 7480-8520cGy in Ib, IIa and 8480-9980cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively . Results : Five year local control rate was $78\%$ and the actuarial overall five year survival rate was $66.1\%$ for all patients, $44.4\%$ for stage Ib, IIa and $71.4\%$ for stage IIb. In bulky IIb (above 5cm in tumor size, 11 patients) five year local control rate and five rear survival rate was $88.9\%,\;73\%$ respectively Pelvic lymph node status (negative : $74\%,\;positive:25\%$, p=0.0015) was significant Prognostic factor affecting to five rear survival rate. There was marginally significant survival difference by total dose to A point ($>84Gy\;:\;70\%,\;>84Gy\;:\;42.8\%$, p=0.1). We consider that the difference of total dose to A point by stage (mean Ib,IIa : 79Gy. IIb 89Gy P=0.001) is one of the causes in worse local control and survival of Ib,IIa than IIb The overall recurrence rate was $39\%$ (16/41). The rates of local failure alone. distant failure alone. and combined local and distant failure were $9.7\%,\;19.5\%,\;and\;9.7\%$, respectively. Two Patients developed leukopenia ($\geq$ grade 3) and Three patients develoued grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. Conclusion : We thought that it may be necessary to increase A point dose to more than 85Gy in hyperfractionated radiotherapy of huge exophytic and endophvtic stage Ib,IIa. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients.

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Location and Construction Characteristics of Imdaejeong Wonlim based on Documentation (기문(記文)을 중심으로 고찰한 임대정원림(臨對亭園林)의 입지 및 조영 특성)

  • Rho, Jae-Hyun;Park, Tae-Hee;Shin, Sang-Sup;Kim, Hyoun-Wuk
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.4
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    • pp.14-26
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    • 2011
  • Imdaejeong Wonlim is located on the verge of Sangsa Village in Sapyeong-ri, Daepyeong-myeon, Hwasun-gun Gyeongsangnam-do toward Northwest. It was planned by Sa-ae, Minjuhyeon in 1862 on the basis of Gobanwon built by Nam Eongi in 16th century against the backdrop of Mt. Bongjeong and facing Sapyeong Stream. As water flows from west to east in the shape of crane, this area is a propitious site standing for prosperity and happiness. This area shows a distinct feature of Wonlim surrounding the Imdaejeong with multi layers as consisting of 5 districts - front yard where landmark stone with engraved letters of 'Janggujiso of Master Sa-ea' and junipers are harmoniously arranged, internal garden of upper pavilion ranging from a pavilion to square pond with a little island in the middle, Sugyeongwon of under pavilionu consisting of 2 ponds with a painting of three taoist hermits, forest of Mt. Bonggeong and external garden including Sapyeong Stream and farmland. According to documentation and the results of on-site investigation, it is certainly proved that Imdaejeong Wonlim was motivated by Byeoseo Wonlim which realized the idea of 'going back to hometown after resignation' following the motives of Janggujiso, a hideout aimed to accomplish the ideology, 'training mind and fostering innate nature,' on the peaceful site surrounded by water and mountain, as well as motives of Sesimcheo(洗心處) to be unified with morality of Mother Nature, etc. In addition, it implies various imaginary landscapes such as Pihangji, Eupcheongdang, square pond with an island and painting of three Taoist hermits based on a notion that 'the further scent flies away, the fresher it becomes,' which is originated from Aelyeonseol(愛蓮說). In terms of technique of natural landscape treatment, divers techniques are found in Imdaejeong Wonlim such as distant view of Mt. Bongjeong, pulling view with an intention of transparent beauty of moonlight, circle view of natural and cultural sceneries on every side, borrowed scenary of pastoral rural life adopted as an opposite view, looked view of Sulyundaero, over looked view of pond, static view in pavilion and paths, close view of water space such as stream and pond, mushroom-and-umbrella like view of Imdaejeong, vista of pond surrounded by willows, imaginary view of engraved letters meaning 'widen knowledge by studying objectives' and selected view to comprise sunrise and sunset at the same time. In the beginning of construction, various plants seemed to be planted, albeit different from now, such as Ginkgo biloba, Phyllostachys spp., Salix spp., Pinus densiflora, Abies holophylla, Morus bombycis, Juglans mandschurica, Paulownia coreana, Prunus mume, Nelumbo nucifera, etc. Generally, it reflected dignity of Confucianism or beared aspect of semantic landscape implying Taoist taste and idea of Phoenix wishing a prosperity in the future. Furthermore, a diversity of planting methods were pursued for such as liner planting for the periphery of pond, bosquet planting and circle planting adopted around the pavilion, spot planting using green trees, solitary planting of monumentally planted Paulownia coreana and opposite planting presenting the Abies holophylla into yin and yang.