• Progress in Medical Physics
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• v.15 no.3
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• pp.156-160
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• 2004

An essential quality assurance (QA) procedure in high dose rate (HDR) remote after-loading brachytherapy is that of the verification of the Ir-192 HDR source positioning accuracy. A number of methods using mechanical rulers or autoradiograph and video cameras have been reported to check the positional error of the Ir-192 source. In this study, the feasibility of a CMOS (Complementary Metal Oxide Semiconductor) PC camera, with a fluorescent screen, was investigated. The agreement between the planned and measured dwell position was better than 1 mm and dwell times better than 0.4 sec. Our results indicate that the CMOS PC camera system could be used as a QA tool for the on-line determination of the source position and dwell time.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.118-118
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• 2006

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.813-818
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• 2014

Aims: To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer. Materials and Methods: Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour. The patients treated with IBT alone (n=42) received 39-42 Gy/10-14 fractions (median=40 Gy/10 fractions). With respect to the combination therapy group (n=42), prescription dose comprised of 12-18 Gy/3-6 fractions (median=15 Gy/5 fractions) for IBT and 40-50 Gy/20-25 fractions (median=50 Gy/25 fractions) for external radiotherapy. Brachytherapy was given as 2 fractions per day 6 hours apart with 4 Gy per fraction for monotherapy and 3 Gy per fraction for combination therapy. Results: Four patients were not evaluable in the analysis of outcome. The primary site relapse rates were 23.8% (10/42) and 68.4% (26/38) in patients treated with IBT alone and combination therapy, respectively (p<0.001). Salvage surgery was performed in 19 patients. The 5-year local control rate was estimated at 62% and the disease-free survival (DFS) rate at 52% for all patients. Local control with respect to T1 and T2 tumours was 84% and 42%, respectively. Conclusions: Our present series on HDR-IBT and the previous report on LDR-IBT for head and neck cancer demonstrated similar DFS rates at 5 years (52%). The rate of regional failure in node-negative patients was <20% in both of our series. HDR-IBT offers similar results to LDR-IBT for head and neck cancer.

• Progress in Medical Physics
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• v.27 no.4
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• pp.213-219
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• 2016

The position verification of the radiation source utilized in brachytherapy forms a critical factor in determining the therapeutic efficiency. Currently, films are used to verify the source position; however, this method is encumbered by the lengthy time interval required from film scanning to analysis, which makes real-time position verification difficult. In general, the source position accuracy is usually tested in a monthly quality assurance check. In this context, this study investigates the feasibility of the real-time position verification of the radiation source in high dose rate (HDR) brachytherapy with the use of scintillating fibers. To this end, we construct a system consisting of scintillating fibers and a silicon photomultiplier (SiPM), optimize the dosimetric software setup and radiation system characteristics to obtain maximum measurement accuracy, and determine the relative ratio of the measured signals dependent upon the position of the scintillating fiber. According to the dosimetric results based on a treatment plan, in which the dwell time is set at 30 and 60 s at two dwell positions, the number of signals is 31.5 and 83, respectively. In other words, the signal rate roughly doubles in proportion to the dwell time. The source position can also be confirmed at the same time. With further improvements in the spatial resolution and scintillating fiber array, the source position can be verified in real-time in clinical settings with the use of a scintillating fiber-based system.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.167-172
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• 2018

This study evaluated absorbed dose of brachytherapy according to the nanoparticle in prostate cancer which many occurred in Korean man and provided basic data. Absorbed dose evaluation was using MCNPX program which was applied Monte Carlo simulation. Source was applied $^{192}Ir$ which was many using in Korean HDR machine and gold, ferric oxide, gadolinium and iodine nanoparticle were applied. Prostate absorbed dose result was increased when using nanoparticle, in particular gold nanoparticle was the highest result as $3.13E-03J/kg{\cdot}e$. Absorbed dose of surrounding organs and distance was similar between using nanoparticle and non-using nanoparticle. Therefore, brachytherapy was used nanoparticle was increased therapeutic ratio and efficiency of radiation therapy.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.227-232
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• 1991

Authors described the remote afterloading endobronchial brachytherapy (EBBT technique using the microSelectron HDR Ir-192 and the Asan Medical Center experience. Total 28 EBBT in 9 patients were performed since November 1989 and 24 EBBT in 8 patients were emploiyed for palliation and 3 EBBT in 1 patient was treated curatively. Authors observed a significant relief of obstructive symptom with tumor regression in 7 patients out of 8 who were treated palliatively but one of them died of pulmonary congestion in 3 weeks after EBBT One patient with prior therapy of extensive electrocautery expired within 1 day after 2nd EBBT procedure with massive hemorrhage from the lesion. EBBT procedure has been tolerable and can be performed as an outpatient.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5075-5079
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• 2015

Background: Adverse effects of treatment prolongation beyond 8 weeks with radiotherapy for cervical cancer have been established. Clinical data also show that cisplatin increases the biologically effective dose of radiotherapy. However, there are no data on the effect of overall treatment time in patients with locally advanced cervical cancer treated with concomitant chemo-radiotherapy (CCRT) in an Indian population. The present study concerned the feasibility of concurrent chemotherapy and interspacing brachytherapy during the course of external radiotherapy to reduce the overall treatment time and compare the normal tissue toxicity and loco-regional control with a conventional schedule. Materials and Methods: Between January 2009 and March 2012 fifty patients registered in the Gynaecologic Oncology Clinic of Institute Rotary Cancer Hospital with locally advanced cervical cancer (FIGO stage IIB-IIIB) were enrolled. The patients were randomly allocated to treatment arms based on a computer generated random number. Arm I (n=25) treatment consisted of irradiation of the whole pelvis to a dose of 50 Gy in 27 fractions, and weekly cisplatin $40mg/m^2$. High dose rate intra-cavitary brachytherapy (HDR-ICBT) was performed after one week of completion of external beam radiotherapy (EBRT). The prescribed dose for each session was 7Gy to point A for three insertions at one week intervals. Arm II (n=25) treatment consisted of irradiation of the whole pelvis to a dose of 50 Gy in 27 fractions. Mention HDR-ICBT ICRT was performed after 40Gy and 7Gy was delivered to point A for three insertions (days 23, 30, 37) at one week intervals. Cisplatin $20mg/m^2/day$ was administered from D1-5 and D24-28. Overall treatment time was taken from first day of EBRT to last day of HDR brachytherapy. The overall loco-regional response rate (ORR) was determined at 3 and 6 months. Results: A total of 46 patients completed the planned treatment. The overall treatment times in arm I and arm II were $65{\pm}12$ and $48{\pm}4$ days, respectively (p=0.001). At three and six months of follow-up the ORR for arm I was 96% while that for arm II was 88%. No statistically significant difference was apparent between the two arms. The overall rate of grade ${\geq}3$ toxicity was numerically higher in arm I (n=7) than in arm II (n=4) though statistical significance was not reached. None of the predefined prognostic factors like age, performance status, baseline haemoglobin level, tumour size, lymph node involvement, stage or histopathological subtype showed any impact on outcome. Conclusions: In the setting of concurrent chemoradiotherapy a shorter treatment schedule of 48 days may be feasible by interspacing brachytherapy during external irradiation. The response rates and toxicities were comparable.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.35-43
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• 2003

Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

• 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.

• Progress in Medical Physics
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• v.6 no.1
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• pp.13-18
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• 1995

Dose distribution of HDR-RALS source represents an inverse square law as the distance. Difference of measurement value and calculation value according of brachytherapy. Therefore, in HDR-RALS dose calibration and calculation have an important effect in treatment of uterine cervical cancer and absorbed dose of interesting points. In intracavitary therapy, particula attention is paid for precise determination of the doses to be applied. In this report, we have discussed that the calibration of a HDR-RALS, differences between calculation dose use of isodose chart and measurement in rectum. Dose rate calibration of radiation sources are obtained from air kerma and Г factor with calibraed ion chamber for cobalt source. and used semiconductor detector for compared with measurement in phantom. Eighteen patients were treated with a HDR-RALS for intrcavitarty irradiation (ICR) using a cobalt-cesium source. Repoductivity of dose measurements were 0.3 -1.1％ in phantom. The means of dose distribution was -6- ＋21％ between calculation of isodose chart and measurement of recyum, and was same mean value upper 6.3％ in measurement value than calculation does.