• 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.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.200-207
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• 2004

Purpose: An analysis was to compare the results of radiation alone with those of radiation with dally low dose cisplatin as a radiation sensitizer in locally advanced cervical cancer. Materials and Methods: A retrospective analysis of 59 patients diagnosed with locally advanced uterine cervix cancer between December 1996 and March 2001 was peformed. Thirty one patients received radiation alone and 28 patients received dally low dose cisplatin, as a radiation sensitizer, and radiation therapy. The median follow-up period was 34 months, ranging from 2.5 to 73 months. The radiation therapy consisted of 4500 cGy external beam irradiation to the whole pelvis (midline block after 3060 cGy), a 900$\~$l,000 cGy boost to the involved parametrium and high dose-rate intracavitary brachytherapy (a total dose of 3,000$\~$3,500 cGy/500 cGy per fraction to point A, twice per week). In the chemoradiation group, 10 mg of daily intravenous cisplatin was given daily from the 1st day of radiation therapy to the 20th day of radiation therapy. According to the FIGO classification, the patients were subdivided into 51 (86.4$\%$) and 8 (13.6$\%$) stages IIB and stage IIIB, respectively. Results: The overall 5 year survival rate was 65.65$\%$ and according to treatment modality were 56.75$\%$ and 73.42$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.180). The 5 year disease-free survival rates were 49.39$\%$ and 63.34$\%$ in the radiation alone and chemoradiatoin groups, respectively (p=0.053), The 5 year locoregional control rates were 52.34$\%$ and 73.58$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.013). The 5 year distant disease-free survival rates were 59.29$\%$ and 81.46$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.477), Treatment related hematologic toxicity were prominent in the chemoradiation group. Leukopenia $\geq$grade) occurred in 3.2$\%$and 28.5$\%$ of the radiation alone and chemoradiation groups, respectively (p=0.02). There were no statistical differences in the incidences of vesical, rectal and small bowel complications between two groups. Conclusion: Radiation therapy with low dose cisplatin did not improve the rates of survival and response rates, but did improve the rate of disease free survival and locoregional control rates In locally advanced cervical cancer. The incidence of bone marrow suppression was higher in the chemoradiation group.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.62-73
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• 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.

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.325-331
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• 1996

Purpose : To assess the functional change of salivary gland, recovery of salivary destruction, difference of susceptibility to irradiation between the parotid and sub-mandibular gland, correlation between the xerostomia and excretory rate by irradiation in salivary scan using $^{99m}Tc$-pertechnetate in patients with head and neck cancer. Materials and Methods : We evaluated 19 patients with head and neck cancer who had taken $^{99m}Tc$-pertechnetate salivary gland scan before, during and after radiotherapy. We measured the uptake of radioactivity every 5 minutes for 60 minutes after injection of $^{99m}Tc$-pertechnetate(370MBq). We also evaluated the first excretory function stimulated by 5% citric acid at 30 minutes after injection of $^{99m}Tc$-pertechnetate and then the second excretory function stimulated by 10% citric acid at 45 minutes. Results : The mean uptake curves showed a sharp increase at the 1st week of radiotherapy and then showed a gradual decrease afterwards during radiotherapy. And the mean uptake curves after radiotherapy Persistently decreased on follow up scans without being recovered. The excretory rates decreased gradually as radiation dose increased and were not recovered after radiotherapy. Our study was not satisfactory enough to show the difference of susceptibility to irradiation between the parotid and salivary gland and the correlation between the symptom of xerostomia and the change of the excretory rates. Conclusion : The parotid and submandibular gland scans using $^{99m}Tc$-pertechnetate are useful in the assessment of the functional change of the salivary gland by radiotherapy and predicted the functional change of the salivary gland until 1 year-follow up scan.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.147-153
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• 2005

Purpose : We should use a computed tomography-simulator for the body measure and compensator manufacture process was practiced with TBI's positioning in process and to estimate the availability.,Materials and Methods : Patient took position that lied down. and got picture through computed tomography-simulator. This picture transmitted to Somavision and measured about body measure point on the picture. Measurement was done with skin, and used the image to use measure the image about lungs. We decided thickness of compensator through value that was measured by the image. Also, We decided and confirmed position of compensator through image. Finally, We measured dosage with TLD in the treatment department.,Results : About thickness at body measure point. we could find difference of $1{\sim}2$ cm relationship general measure and image measure. General measure and image measure of body length was seen difference of $3{\sim}4$ cm. Also, we could paint first drawing of compensator through the image. The value of dose measurement used TLD on head, neck, axilla, chest(lungs inclusion), knee region were measured by $92{\sim}98%$ and abdomen, pelvis, inquinal region, feet region were measured by $102{\sim}109%$.,Conclusion : It was useful for TBI's positioning to use an image of computed tomography-simulator in the process. There was not that is difference of body thickness measure point, but measure about length was achieved definitely. Like this, manufacture of various compensator that consider body density if use image is available. Positioning of compensator could be done exactly. and produce easily without shape of compensator is courted Positioning in the treatment department could shortened overall $15\{sim}20$ minute time. and reduce compensator manufacture time about 15 minutes.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.137-147
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• 1996

Purpose : This report is the result f retrospective analysis for children who received prophylactic cranial irradiation combined with intrathecal chemotherapy. Materials and Methods : Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. Results : Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was $6.7\%$. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse were associated with hematologic relapse. and $78\%$ of CNS relpase occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are $68\%$ and $42\%$, respectively with median of 43 months. The Prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype and CALGB risk criteria. The DFS at 2 and 5 years are 61 and $39\%$, respectively with median of 34 months. The prognostic factors affecting DFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype, POG and CALGB risk criteria. Conclusions : In our study, $6.7\%$ of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.

• Progress in Medical Physics
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• v.15 no.3
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• pp.161-166
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• 2004

A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

• Korean Journal of Food Science and Technology
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• v.30 no.6
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• pp.1312-1320
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• 1998

Some commercial beef loins in raw state were packaged with PVDC as aerobic and vacuum condition. The other beef samples were cooked until core temperature arrived at $70^{\circ}C$ and then packaged immediately in the same way as the raw state. These samples were irradiated by electron beam (0, 1, 2 kGy), and then stored in refrigerator $(2{\sim}4^{\circ}C)$. Identity and quantity of cholesterol oxides were analysed at the 0, 7th, 14th day of storage. In the samples that were raw and packaged aerobically, $7{\alpha}-hydroxycholesterol,\;{\beta}-epoxide,\;7{\beta}-hydroxycholesterol$ and 7-ketocholesterol were detected over $0.5\;{\mu}g/g$. Cholestanetriol and${\alpha}-epoxide$ were detected at levels below $0.5\;{\mu}g/g$ during storage. In the samples that were raw and vacuum-packaged, $7{\alpha}-hydroxycholesterol$, 7-ketocholesterol and cholestanetriol were detected. In the samples that were cooked and packaged aerobically, cholestanetriol and ${\alpha}-epoxide$ were detected below $0.5\;{\mu}g/g$ during storage. $7{\alpha}-hydroxycholesterol,\;{\beta}-epoxide,\;7{\beta}-hydroxycholesterol$and 7-ketocholesterol were detected as $1.53{\sim}26.81,\;1.07{\sim}5.23,\;40.64{\sim}101.30\;and\;7.16{\sim}33.91\;{\mu}g/g$, respectively. In all results, total amounts of cholesterol oxide increased significantly as irradiation dose and storage time increased (P<0.05).

• Radiation Oncology Journal
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• v.11 no.1
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• pp.79-82
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• 1993

From October 1989 to March 1992, ten patients diagnosed as primary central nervous system (CNS) lymphoma were treated with radiation therapy at Asan Medical Center. To obtain pathologic diagnosis, five patients had stereotactic biopsy and the others underwent craniotomy & tumor removal. According to the classification by International Working Formulation, seven of 10 patients showed diffuse large cell types and the remaining 3 had diffuse mixed cell types. Computed tomographic scans of the brain disclosed solitary (6 cases) or multiple (4 cases) intracranial lesions. All patients received 4000 cGy/20 fx to the whole brain followed by an additional 2000 cGy/10 fx boost to the primary lesion. Six patients with initial cerebrospinal fluid (CSF involvement were treated with whole brain irradiation and intrathecal Methotrexate (IT-MTX) chemotherapy. One of them received an additional spinal irradiation after 3 cycles of IT-MTX chemotherapy because of MTX induced arachnoiditis. One patient received 3 cycles of systemic chemotherapy prior to rodiation therapy and one received 5 cycles of salvage chemotherapy for recurrence. With a median follow up time of 8 months, all patients were followed from 7 to 26 months. Radiologically seven patients showed complete remission and the remaining three showed partial remission at one month after radiotherapy. The 1 and 2 year survival rate was $86{\%}\;and\;69{\%}$ respectively. Until now, two patients expired at 7 and 14 months. These patients developed extensive CSF seeding followed by local failure. Considering initial good response to radiation therapy and low incidence of extraneural dissemination in primary CNS lymphoma, we propose to increase total tumor dose to the primary lesion by hyperfractionated radiotherapy or stereotactic radiosurgery. For the patients with CSF involvement at diagnosis, we propose craniospinal irradiation with IT MTX chemotherapy.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.267-275
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• 1993

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery. And 70 patients received external irradiation only by $^{60}Co$ with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was $43.9\%,$ 3 year survival rates were $60.9\%$ for stage I + II, and $23.1\%$ for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient (p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially In the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.