• Progress in Medical Physics
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• v.3 no.1
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• pp.45-52
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• 1992

Authors started IORT for stomach cancer patient on 1988 and rectal cancer on 1991. We devloped various sized. shaped IORT cones for better clinical application and homogeneous surface and depth dose distribution. Authors obtained results as following. 1. The acryl cover fixed on the end for rectal IORT cone not only improvement of surface dose but also flattness of dose distribution. 2. Dose distribution of elliptical cone were shown almost 100% at inner field. 3. The output with acryl cone size were similar output of made electron cone.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.455-461
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• 1993

Experimental measurements of dose characteristics with pentagonal applicator at nominal energy of 4, 6, 9, 12 and 15 MeV electron beam were performed for intraoperative radiotherapy (IORT) in ML-15MDX linear accelerator. This paper presents the percent depth dose, surface dose, beam flatness and output factors of using the IORT applicator in different electron beam energy. The output factor showed as a 24 percent higher in IORT applicator than that of reference $10{\times}10cm^2$ applicator. The surface dose of using the IORT applicator showed 7.7 and 2.7 percent higher than that of reference field in 4 and 15 MeV electron beam, respectively. In our experiments, the variation of percent depth dose was very small but the output factor and flatnees at 0.5 cm depth have showed a large value in IORT applicator.

• Radiation Oncology Journal
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• v.12 no.1
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• pp.117-121
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• 1994

In spite of remarkable improvement of surgical skills and anesthesia, local failure still occurred in 36-45$ \% $ of locally advanced colorectal cancer after curative resection with or without pre-or post-operative irradiation. Intraoperative radiation therapy(IORT) is the ideal modality which resectable lesions are removed surgically 3nd the remaining cancer nests are sterilized by irradiation during a surgical procedure. Therefore, the excellent local control without the damage of the adjacent normal tissues can be achieved. In IORT, judicious set up of the treatment cone on the treatment surface of the patient is required for accurate and homogenous dose distribution within treatment field, especially on the slopping surface of sacrum and pelvic sidewall which are the common sites of the local recurrence in rectal cancer. For this purpose, adequate co-ordination of gantry rotation and table tilting are essential. Adjusting gantry rotation is not difficult but tilting of the table is impossible inconventional treatment couch. Department of Therapeutic Radiology in Yeungnam University Medical Center developed the IORT table for colorectal cancer which is easy to set up and detach on the Linac treatment couch within 5 minutes. The range of tilting with head-up and head-down is about 30 degree which is efficient and easy-to-use, not only for IORT but also for colorectal surgery. So far, authors performed IORT with newly developed treatment table in 2 patients with rectal cancer and we found that this newly developed table could contribute in improving the dose distribution of IORT and surgical procedure for colorectal cancer.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.187-192
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• 1992

Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and inclose distant metastasis free suwival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT En patients with gastric cancer. No local failure has been reported by regular follow up so far. Nine cases ($17\%$) of treatment related complicaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's $25.2\%$ (chemotherapy + operation), Kim's $18\%$ (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation (--4500 cGy) and extensive chemotherapy(FAM, 5FU + MMC, BACOP).

• Progress in Medical Physics
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• v.2 no.2
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• pp.141-148
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• 1991

A since authors started IORT for stomach cancer patient on 198, we developed various sized, shaped IORT cones for better clinical application and homogeneous surface and depth dose distribution. Authors concluded as following. 1. The shaping block should be fixed on the tray, not under the tray for homogeneous dose distribution. 2. The straight cone was showed better dose distribution than divergence cone. 3. The acryl cone was superior than the stainless-steel cone. 4. The acryl cover fixed on the end for IORT cone not only improvement of surface dose, but also homogenity of depth dose.

• The Journal of Korean Society for Radiation Therapy
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• v.2 no.1
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• pp.75-80
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• 1987

Intraoperative Radiation therapy (IORT) is a cancer treatment modality in which resectable masses or organs are removed surgically and residual cancer calls are sterilized by irradiation with a single massive dose during while patient is still anesthetized. Because it is possible that the turner mass can be visualized directly at the time of surgical exploration, tumor volume can be determined more precisely and at the same tin e sensitive adjacent structures can be pulled aside from the irradiation. With these theoretical advantages as compare to conventional external irradiation, IORT can improve the therapeutic ratio of tumor control to normal tissue injury. Yonsei cancer center initiated a pilot study of multidisciplinary IORT program in february of 1986 for the fist attempt in Korea. IORT Was performed in 7 patients with stomach cancer by using existing NELAC-1018 Linear Accelerator treatment room as a surgical suite. IOTR team included department of surgery, Department of Anethesiology, Department of Clinical pathology, operating room nursing personal and Department of radiation oncology.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.121-128
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• 2017

Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusions: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.265-270
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• 1991

Colorectal cancer is the second most frequent malignant tumor in the United States and fourth most frequent tumor in Korea. Surgery has been used as a primary treatment modality but reported overall survivals after curative resection were from $20\%\;to\;50\%$. Local recurrence is the most common failure in the treatment of locally advanced colorectal cancer. Once recurrence has developed, surgery has rarely the role and the five year survival of locally advanced rectal cancer is less than $5\%$, in spite of massive combination therapy. Intraoperative radiotherapy (IORT) with or without external beam irradiation has been advocated for reducing local recurrence and improving survival. The recent report of local failure by this modality was only $5\%$, this indicated that significant improvement of local control could be achieved. We performed 6 cases of IORT for locally advanced colorectal cancer which is the first experience in Korea. Patient's eligibility, treatment applicator, electron energy, dose distribution on the surface and depth within the treatment field and detailed skills are discussed. We hope that our IORT protocol can reduce local failure and increase the long term survival significantly.

• The Journal of Korean Society for Radiation Therapy
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• v.5 no.1
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• pp.106-109
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• 1992

• 대한두경부종양학회:학술대회논문집
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• 1998.05a
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• pp.118-120
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• 1998