• The Journal of Korean Society for Radiation Therapy
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• v.5 no.1
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• pp.88-91
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• 1992

• Korean Journal of Head & Neck Oncology
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• v.23 no.2
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• pp.181-184
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• 2007

Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.85-93
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• 1992

We have studied the dosimetric properties of electron beam using Lyon intraoperative device for intraoperative radiation therapy. The dosimetry data had compiled in such a way that a quick and correct decision regarding the cone shape, energy, and accurate calculations could be made. Using 3 dimensional water phantom, we have got the following data: cone output ratios, surface dose, $d_{max}$, $d_{90}$, flatness, symmetry, beam profiles, isodose curve, and SSD correction factors. The cone output ratios were measured with straight and bevelled cone, respectively. As the cone size and the energy were reduced, the cone output ratios decreased rapidly. With the flattening filter, the surface dose increased by electron beam to $85.3\%$, $89.2\%$, and $93.4\%$, for 6 MeV, 9 MeV, and 12 MeV, respectively. It is important to increase the surface dose to $90\%$ or more. Inspite of diminishing dose rate and beam penetration, this flattening filter increases the treatment volume significantly. With the combination of the three levels collimation and the flattening filter, we achieved good homogeneity of the beam and better flatness and the diameter of the 90$\%$ isodose curve was increased. It is important to increase the area that is included in the $90\%$ isodose level. The value of measured and calculated SSD correction factors did not agree over the clinically important range from 100 cm to 110 cm.

• 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.9 no.1
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• pp.123-130
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• 1991

A docking intraoperative electron beam applicator system, which is easily docking in the collimator for a linear accelerator after setting a sterilized transparent cone on the tumor bearing area in the operation room, has been designed to optimize dose distribution and to improve the efficiency of radiation treatment method with linear accelerator. This applicator system consisted of collimator holder with shielded metals and docking cone with transparent acrylic cylinder, A number of technical innovations have been used in the design of this system, this dooking cone gives a improving latral dose coverage at therapeutic volume. The position of $90\%$ isodose curve under suface of 8 cm diameter cone was extended $4\sim7$ mm at 12 MeV electron and the isodose measurements beneath the cone wall showed hot spots as great as $106\%$ for acrylic cone. The leakage radiation dose to tissues outside the cone wall was reduced as $3\sim5\%$ of output dose. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.11-20
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• 2006

Puroose: In order to find out whether stereotactic radiation therapy (RT) using CyberKnife (CK) could improve survival rate and lower acute toxicity compared to conventional RT. Materials and Methods: From April 2003 through April 2004, 19 patients with Eastern Cooperative Oncology Group (ECOG) performance status ${\leq}3$ and locally advanced pancreas cancer without distant metastasis, evaluated by CT or PET/CT, were included. We administered stereotactic RT consisting of either 33 Gy, 36 Gy or 39 Gy in 3 fractions to 6, 4 and 9 patients, respectively, in an effort to increase the radiation dose step by step, and analyzed the survival rate and gastrointestinal toxicities by the acute radiation morbidity criteria of Radiation Therapeutic Oncology Group (RTOG). Prognostic factors of age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9, planning target volume (PTV), and adjacent organ and vessel invasion on CT scan were evaluated by Log Rank test. Results: The median survival time was 11 months with 1-year survival rate of 36.8%. During follow-up period (range $3{\sim}20$ months, median 10 months), no significant gastrointestinal acute toxicity (RTOG grade 3) was observed. In univariate analysis, age, sex, ECOG performance score, chemotherapy, bypass surgery, radiation dose, CA 19-9 level, and adjacent organ and vessel invasion did not show any significant changes of survival rate, however, patients with PTV (80 cc showed more favorable survival rate than those with PTV>80 cc (p-value<0.05). In multivariate analysis, age younger than 65 years and PTV>80 cc showed better survival rate. Conclusion: In terms of survival, the efficacy of stereotactic radiation therapy using CK was found to be superior or similar to other recent studies achieved with conventional RT with intensive chemotherapy, high dose conformal RT, intraoperative RT (IORT), or intensity modulated RT (IMRT). Furthermore, severe toxicity was not observed. Short treatment time in relation to the short life expectancy gave patients more convenience and, finally, quality of life would be increased. Consequently, this could be regarded as an effective novel treatment modality for locally advanced, unresectable pancreas cancer. PTV would be a helpful prognostic factor for CK.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.13-22
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• 2015

Purpose : We investigated the safety of Intrabeam$^{TM}$ system, X-ray unit for Intraoperative Radiotheray (IORT) by measuring surface dose using Optically Stimulated Luminescent Dosimeter(OSLD). Materials and Methods : 30 patients were selected, who were in breast cancer patients and had an operation of breast conserving surgery (BCS). At the inner surface of tumor bed, 20 Gy were described, and 5 Gy at 1cm depth from the inner surface. Along the size of tumor bed which could be decided after resection of tumor, the size of applicator were determined. Usual treatment time were from 18 to 40 minutes. For the measurement of surface doses, OSLD were placed at superior(U1,2), inferior(D1,2), lateral(L1,2) and medial(M1,2) directions from the center of applicator. Each direction, two OSLD were placed at 0.5 cm and 1.5 cm from the center. Mean, maximum, and minimum doses were analyzed to be compared. Results : Mean values were U1 $2.23{\pm}0.80Gy$, U2 $1.54{\pm}0.53Gy$, D1 $1.73{\pm}0.63Gy$, D2 $1.25{\pm}0.45Gy$, L1 $1.95{\pm}0.82Gy$, L2 $1.38{\pm}0.42Gy$, M1 $2.03{\pm}0.70Gy$, and M2 $1.51{\pm}0.58Gy$. Maximum values were 4.34 Gy at U1, and Minimum values were 0.45 Gy at M2. 13.3 % of patient (4pts out of 30) were reported that surface dose were over 4 Gy. Conclusion : The fact that skin dose of all patients were less than 5 Gy based on OSLD measurement showed the safety of Intrabeam$^{TM}$ system. In the relatively small breast volume, the tendency that surface dose was increased had been shown, which was analyzed by the data of patients who irradiated over 4Gy at skin surface. Therefore, for appropriate indication for IORT, it is suggested that breast volume as well as the size and position of tumor should be carfully considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.422-426
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• 2000

We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.199-205
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• 2011

Purpose: The present study compared the difference between intraoperative transrectal ultrasound (iTRUS)-based prostate volume and preplan computed tomography (CT), preplan magnetic resonance imaging (MRI)-based prostate volume to estimate the number of seeds needed for appropriate dose coverage in permanent brachytherapy for prostate cancer. Materials and Methods: Between March 2007 and March 2011, among 112 patients who underwent permanent brachytherapy with $^{125}I$, 60 image scans of 56 patients who underwent preplan CT (pCT) or preplan MRI (pMRI) within 2 months before brachytherapy were retrospectively reviewed. Twenty-four cases among 30 cases with pCT and 26 cases among 30 cases with pMRI received neoadjuvant hormone therapy (NHT). In 34 cases, NHT started after acquisition of preplan image. The median duration of NHT after preplan image acquisition was 17 and 21 days for cases with pCT and pMRI, respectively. The prostate volume calculated by different modalities was compared. And retrospective planning with iTRUS image was performed to estimate the number of $^{125}I$ seed required to obtain recommended dose distribution according to prostate volume. Results: The mean difference in prostate volume was 9.05 mL between the pCT and iTRUS and 6.84 mL between the pMRI and iTRUS. The prostate volume was roughly overestimated by 1.36 times with pCT and by 1.33 times with pMRI. For 34 cases which received NHT after image acquisition, the prostate volume was roughly overestimated by 1.45 times with pCT and by 1.37 times with pMRI. A statistically significant difference was found between preplan image-based volume and iTRUS-based volume (p<0.001). The median number of wasted seeds is approximately 13, when the pCT or pMRI volume was accepted without modification to assess the required number of seeds for brachytherapy. Conclusion: pCT-based volume and pMRI-based volume tended to overestimate prostate volume in comparison to iTRUS-based volume. To reduce wasted seeds and cost of the brachytherapy, we should take the volume discrepancy into account when we estimate the number of $^{125}I$ seeds for permanent brachytherapy.

• Nuclear Engineering and Technology
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• v.55 no.10
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• pp.3844-3853
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• 2023

Although radiation and chemotherapy methods for cancer therapy have advanced significantly, surgical resection is still recommended for most cancers. Therefore, intraoperative imaging studies have emerged as a surgical tool for identifying tumor margins. Intraoperative imaging has been examined using conventional imaging devices, such as optical near-infrared probes, gamma probes, and ultrasound devices. However, each modality has its limitations, such as depth penetration and spatial resolution. To overcome these limitations, hybrid imaging modalities and tracer studies are being developed. In a previous study, a multi-modal laparoscope with silicon photo-multiplier (SiPM)-based gamma detection acquired a 1 s interval gamma image. However, improvements in the near-infrared fluorophore (NIRF) signal intensity and gamma image central defects are needed to further evaluate the usefulness of multi-modal systems. In this study, an attempt was made to change the NIRF image acquisition method and the SiPM-based gamma detector to improve the source detection ability and reduce the image acquisition time. The performance of the multi-modal system using a complementary metal oxide semiconductor and modified SiPM gamma detector was evaluated in a phantom test. In future studies, a multi-modal system will be further optimized for pilot preclinical studies.