• Journal of radiological science and technology
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• v.36 no.1
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• pp.31-38
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• 2013

The prostate cancer is the most common malignant tumor in males. Prostate cancer is the most common malignant tumor that occurs in the male in Korea in 2007 to an annual average of 5,292 cases and 3.3% of the total cancer incidence seventh occurred. Our study compared property for tomotherapy and proton therapy in radiotherapy of prostate cancer patients. We analyzed DVH(Dose Volume Histogram) and dose distribution for prostate, bladder and rectum for radiation treatment planning of prostate cancer with 11 patients in Ilsan K cancer hospital from June to November 2011. There was no differences between tomotherapy and proton therapy in the purpose of prostate cancer therapy for PTV. The adjacent organs of bladder and rectum of average dose-volume were 2port proton therapy that it was low dose treatment comparing with tomotherapy and 5port proton therapy. $H{\cdot}I$ of proton therapy was less than $H{\cdot}I$ of tomotherapy. Also, 5port was less than 2port in $H{\cdot}I$ of proton therapy. However, 2port proton therapy has more advantage over 5port proton therapy that the bladder and rectum of average dose-volume and control time of equipment in radiotherapy of prostate cancer.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.200-209
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• 2018

Purpose: To evaluate the effectiveness and feasibility of chemoradiotherapy (CRT) using simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in locally advanced pancreatic cancer (LAPC) patients. Materials and Methods: Between January 2011 and May 2015, 47 LAPC patients received CRT using SIB-IMRT. Prior to SIB-IMRT, 37 patients (78.7%) received induction chemotherapy (IC-CRT group) and remaining 10 patients (21.3%) did not received induction chemotherapy (CRT group). During SIB-IMRT, all patients received concomitant chemotherapy, with gemcitabine (n = 37) and capecitabine (n = 10). Results: At the time of analysis, 45 patients had died and 2 patients remained alive and the median follow-up time was 14.2 months (range, 3.3 to 51.4 months). For all patients, the median times of local progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were 18.1, 10.3, and 14.2 months, respectively. The median time of LPFS between IC-CRT and CRT groups was similar (18.1 months vs. 18.3 months, p = 0.711). IC-CRT group had a higher trend in PFS (10.9 months vs. 4.1 months, p = 0.054) and had significantly higher OS (15.4 months vs. 9.5 months, p = 0.007) than CRT group. In multivariate analysis, the use of induction chemotherapy and tumor response were significant factors associated with OS (p < 0.05, each). During SIB-IMRT, toxicity of grade ≥3 was observed in 7 patients (14.9%) in all patients. Conclusions: CRT using SIB-IMRT is feasible and promising in LAPC patients.

• Journal of the Korea Convergence Society
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• v.9 no.10
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• pp.191-198
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• 2018

This study was conducted to evaluate the clinical effectiveness of proton therapy as an advanced convergent cancer therapy. Clinical data of proton therapy were analyzed. As proton enters patient's body, it releases low dose of energy and shows an increasing energy deposition as it reaches certain point unlike x-ray. It may therefore reduce the radiation dose to the normal tissues in front and beyond the lesion and minimize the radiation damage. Proton therapy is expected to improve clinical outcomes and reduce treatment related toxicities. It is used in various cancers. Further studies are necessary.

• Progress in Medical Physics
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• v.19 no.1
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• pp.35-41
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• 2008

The main benefit of proton therapy over photon beam radiotherapy is the absence of exit dose, which offers the opportunity for highly conformal dose distributions to target volume while simultaneously irradiating less normal tissue. For proton beam therapy two patient specific beam modifying devices are used. The aperture is used to shape the transverse extension of the proton beam to the shape of the tumor target and a patient-specific compensator attached to the block aperture when required and used to modify the beam range as required by the treatment plan for the patient. A block of range shifting material, shaped on one face in such a way that the distal end of the proton field in the patient takes the shape of the distal end of the target volume. The mechanical quality assurance of range compensator is an essential procedure to confirm the 3 dimensional patient-specific dose distributions. We proposed a new quality assurance method for range compensator based on image processing using X-ray tube of proton therapy treatment room. The depth information, boundaries of each depth of plan compensatorfile and x-ray image of compensator were analyzed and presented over 80% matching results with proposed QA program.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.252-254
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• 2002

A new protocol for dosimetry in external beam radiotherapy is published by the Japan Society of Medical Physics (JSMP) in 2002. The protocol deals with proton and heavy ion beams as well as photon and electron beams, in accordance with IAEA Technical Report Series No. 398. To establish inter-institutional uniformity in proton beam dosimetry, an intercomparison program was carried out with the new protocol. The absorbed doses are measured with different cylindrical ionization chambers in a water phantom at a position of 30-mm residual range for a proton beam, that had range of 155 mm and a spread out Bragg peak (SOBP) of 60-mm width. As a result, the intercomparison showed that the use of the new protocol would improve the +/- 1.0 % (one standard deviation) and 2.7 % (maximum discrepancy) differences in absorbed doses stated by the participating institutions to +/- 0.3% and 0.9 %, respectively. The new protocol will be adopted by all of the participants.

• Journal of Radiation Protection and Research
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• v.46 no.2
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• pp.39-47
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• 2021

Background: The National Institutes for Quantum and Radiological Science and Technology-National Institute of Radiological Sciences (QST-NIRS) has continuously investigated the undesired radiation exposure in ion beam radiotherapy mainly in carbon-ion radiotherapy (CIRT). This review introduces our investigations on the secondary neutron dose in CIRT with the broad and scanning beam methods. Materials and Methods: The neutron ambient dose equivalents in CIRT are evaluated based on rem meter (WENDI-II) measurements. The out-of-field organ doses assuming prostate cancer and pediatric brain tumor treatments are also evaluated through the Monte Carlo simulation. This evaluation of the out-of-field dose includes contributions from secondary neutrons and secondary charged particles. Results and Discussion: The measurements of the neutron ambient dose equivalents at a 90#x00B0; angle to the beam axis in CIRT with the broad beam method show that the neutron dose per treatment dose in CIRT is lower than that in proton radiotherapy (PRT). For the scanning beam with the energy scanning technique, the neutron dose per treatment dose in CIRT is lower than that in PRT. Moreover, the out-of-field organ doses in CIRT decreased with distance to the target and are less than the lower bound in intensity-modulated radiotherapy (IMRT) shown in AAPM TG-158 (American Association of Physicists in Medicine Task Group). Conclusion: The evaluation of the out-of-field doses is important from the viewpoint of secondary cancer risk after radiotherapy. Secondary neutrons are the major source in CIRT, especially in the distant area from the target volume. However, the dose level in CIRT is similar or lower than that in PRT and IMRT, even if the contributions from all radiation species are included in the evaluation.

• Progress in Medical Physics
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• v.19 no.2
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• pp.89-94
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• 2008

TomoTherapy has a merit to treat cancer with Intensity modulated radiation and combines precise 3-D imaging from computerized tomography (CT scanning) with highly targeted radiation beams and rotating beamlets. In this paper, we comparing the dose distribution between TomoTherapy and linear accelerator based intensity modulated radiotherapy (IMRT) for 10 Head & Neck patients using TomoTherapy which is newly installed and operated at National Cancer Center since Sept. 2006. Furthermore, we estimate how the homogeneity and Normal Tissue Complication Probability (NTCP) are changed by motion of target. Inverse planning was carried out using CadPlan planning system (CadPlan R.6.4.7, Varian Medical System Inc. 3100 Hansen Way, Palo Alto, CA 94304-1129, USA). For each patient, an inverse IMRT plan was also made using TomoTherapy Hi-Art System (Hi-Art2_2_4 2.2.4.15, TomoTherapy Incorporated, 1240 Deming Way, Madson, WI 53717-1954, USA) and using the same targets and optimization goals. All TomoTherapy plans compared favorably with the IMRT plans regarding sparing of the organs at risk and keeping an equivalent target dose homogeneity. Our results suggest that TomoTherapy is able to reduce the normal tissue complication probability (NTCP) further, keeping a similar target dose homogeneity.

• Progress in Medical Physics
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• v.18 no.4
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• pp.226-232
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• 2007

We studied a Monte Carlo simulation of the proton beam delivery system at the National Cancer Center (NCC) using the Geant4 Monte Carlo toolkit and tested its feasibility as a dose verification framework. The Monte Carlo technique for dose calculation methodology has been recognized as the most accurate way for understanding the dose distribution in given materials. In order to take advantage of this methodology for application to external-beam radiotherapy, a precise modeling of the nozzle elements along with the beam delivery path and correct initial beam characteristics are mandatory. Among three different treatment modes, double/single-scattering, uniform scanning and pencil beam scanning, we have modeled and simulated the double-scattering mode for the nozzle elements, including all components and varying the time and space with the Geant4.8.2 Monte Carlo code. We have obtained simulation data that showed an excellent correlation to the measured dose distributions at a specific treatment depth. We successfully set up the Monte Carlo simulation platform for the NCC proton therapy facility. It can be adapted to the precise dosimetry for therapeutic proton beam use at the NCC. Additional Monte Carlo work for the full proton beam energy range can be performed.

• Progress in Medical Physics
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• v.20 no.3
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• pp.180-190
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• 2009

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.

• 대한두경부종양학회:학술대회논문집
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• 2009.05a
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• pp.70-70
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• 2009