• 한국의학물리학회지:의학물리
• /
• 제31권3호
• /
• pp.99-110
• /
• 2020

With hope and concern, the first Korean proton therapy facility was introduced to the National Cancer Center (NCC) in 2007. It added a new chapter to the history of Korean radiation therapy. There have been challenging clinical trials using proton beam therapy, which has seen many impressive results in cancer treatment. Compared to the rapidly increasing number of proton therapy facilities in the world, only one more proton therapy center has been added since 2007 in Korea. The Samsung Medical Center installed a proton therapy facility in 2015. Most radiation oncology practitioners would agree that the physical properties of the proton beam provide a clear advantage in radiation treatment. But the expensive cost of proton therapy facilities is still one of the main reasons that hospitals are reluctant to introduce them in Korea. I herein introduce the history of proton therapy and the cutting edge technology used in proton therapy. In addition, I will cover the role of a medical physicist in proton therapy and the future prospects of proton therapy, based on personal experience in participating in proton therapy programs from the beginning at the NCC.

• 대한방사선방어학회:학술대회논문집
• /
• 대한방사선방어학회 2011년도 추계 학술발표회 및 심포지엄
• /
• pp.204-205
• /
• 2011

• Journal of Korean Neurosurgical Society
• /
• 제61권3호
• /
• pp.386-392
• /
• 2018

Radiation therapy is highly effective for the management of pediatric malignant central nervous system (CNS) tumors including embryonal tumors. With the increment of long-term survivors from malignant CNS tumors, the radiation-related toxicities have become a major concern and we need to improve the treatment strategies to reduce the late complications without compromising the treatment outcomes. One of such strategies is to reduce the radiation dose to craniospinal axis or radiation volume and to avoid or defer radiation therapy until after the age of three. Another strategy is using particle beam therapy such as proton beams instead of photon beams. Proton beams have distinct physiologic advantages over photon beams and greater precision in radiation delivery to the tumor while preserving the surrounding healthy tissues. In this review, I provide the treatment principles of pediatric CNS embryonal tumors and the strategic improvements of radiation therapy to reduce treatment-related late toxicities, and finally introduce the increasing availability of proton beam therapy for pediatric CNS embryonal tumors compared with photon beam therapy.

• Radiation Oncology Journal
• /
• 제37권4호
• /
• pp.232-248
• /
• 2019

Proton beams have been used for cancer treatment for more than 28 years, and several technological advancements have been made to achieve improved clinical outcomes by delivering more accurate and conformal doses to the target cancer cells while minimizing the dose to normal tissues. The state-of-the-art intensity modulated proton therapy is now prevailing as a major treatment technique in proton facilities worldwide, but still faces many challenges in being applied to the lung. Thus, in this article, the current status of proton therapy technique is reviewed and issues regarding the relevant uncertainty in proton therapy in the lung are summarized.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.154-156
• /
• 2002

Brachytherapy has a long history in the treatment of cancer. However, the treatment planning technique for brachytherapy has lagged somewhat behind the corresponding developments for external beam therapy as far as the imaging technique is concerned. Currently, the orthogonal-film-based treatment planning is performed at most institutions even though the CT-based planning is available. The aim of this study is to evaluate the CT-based vs. the orthogonal-film-based treatment planning in cervix cancer. The doses to point A, point B, rectum and bladder points according to ICRU 38 were calculated for the two methods above. In addition, the volumetric studies such as 3D dose computation and DVH were obtained for the CT-based planning. For the bulky tumor, the isodose lines of point A prescription were not fairly covered for the CTV. The CT -based dose planning can overestimate the maximum dose delivered to bladder and rectum by 30%. The CT-based planning has several advantages over the orthogonal-film-based such as 3D dose display, DVH, and more accurate target delineation. It is suggested that the prescription point in cervix cancer be revised especially for the bulky tumor.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
• /
• pp.69-71
• /
• 2004

양성자 치료는 양성자 빔의 선량분포 특성인 브래그 피크를 이용한 방사선 치료방법으로 기존의 전자 및 광자빔을 이용하는 방사선 치료와 비교하여 정상세포에는 현저히 적은 선량을 주고, 암세포에는 대부분의 선량을 줄 수 있어 최근에 각광받고 있다. 양성자 치료 빔은 치료 부위에서 완전히 멈추고 인체 내 각기 다른 밀도를 가진 장기들에 의해 양성자 빔의 비정이 불확실하기 때문에 체내 양성자 빔의 분포를 확인하고 빔을 조정하면서 치료할 수 있는 적절한 방법이 없다. 양성자 빔의 물질에 대한 흡수선량 분포와 물질과 양성자의 핵반응으로 방출되는 즉발 감마선의 상관관계를 이용한 측정시스템을 몬테칼로 전산코드로 전산모사하고 계산한 결과 체내 양성자 빔의 위치를 실시간으로 측정할 수 있음을 확인하였다.

• 대한방사선치료학회지
• /
• 제26권2호
• /
• pp.183-189
• /
• 2014

목 적 : 조영제는 CT모의치료시 정상조직과 악성종양을 구분하는데 뛰어난 대조도를 제공하기 때문에 CT모의치료에 널리 사용하고 있다. 하지만 조영제는 치료계획 CT에서 일시적으로 존재하기 때문에, 치료계획과 실제 치료 사이에는 Hounsfield Unit(HU)의 차이가 발생하게 된다. 이에 본 연구에서는 조영제 사용으로 인한 HU의 변화가 양성자 치료계획에 미치는 영향을 확인 하고자한다. 대상 및 방법 : 20명의 간암 환자에게서 Phase에 따른 HU값의 변화를 측정하였다, 그리고 5명의 양성자치료계획에서 HU변화에 따른 Range와 Spread-Out Bragg peak(SOBP)의 변화를 살펴보았다. Hand made water phantom을 이용하여 깊이와 HU의 변화에 따른 Range와 SOBP의 변화를 확인하였다. 결 과 : 20명 간암 환자의 HU 변화(Pre contrast, Arterial phase, Porta phase)는 간 조직에서 ($58{\pm}5.7$, $75{\pm}9.5$, $117{\pm}14.6$)이었으며 대동맥에서($40{\pm}6.1$, $279{\pm}49.0$, $154{\pm}22.8$)이었다. 5명의 간암 양성자치료계획에서 HU 변화에 따른 Range 변화는 평균 2.5 mm, SOBP 변화는 평균 1.4 mm 이었다. Hand made water phantom study에서는 HU가 증가함에 따라 Range는 감소되었고 SOBP는 줄어들었다. 결 론 : 양성자 치료계획에서 HU값의 변화는 양성자 Range와 SOBP를 변화시켰다. 실제 양성자 빔에서 HU 변화에 따른 Range와 SOBP의 변화에 대한 추가적인 연구가 필요할 것으로 사료 된다.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.298-299
• /
• 2002

WERC (Wakasa Wan Energy Research Center) has started the proton cancer therapy since June 2002. We use Hitachi 3D treatment planning (version 1.6) that can calculate the proton dose distribution by use of the pencil beam algorithm as well as the broad beam algorithm practically fast. This treatment planning software satisfies almost functions required in the proton therapy and includes some advanced techniques such as the 3D region glowing function that can search the target region three-dimensionally based on the CT-values. In this paper, we will introduce this planning system and present our evaluation from point of view of both clinical usage and QA.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 1999년도 Japanese Journal of Medical Physics
• /
• pp.69-72
• /
• 1999

We present a method of quality assurance (QA) for dose and dose distribution anticipated in treatment planning at proton therapy using a particle-based simulation method.

• 대한후두음성언어의학회지
• /
• 제28권2호
• /
• pp.123-127
• /
• 2017

Background and Objectives : Contact granuloma is granulation tissue that occurs mainly in the vocal process of arytenoid cartilage. Among several etiological factors, gastric acid reflux is known to be an important cause. The aim of this study was to evaluate clinical characteristics of contact granuloma and analyze the effectiveness of proton pump inhibitor in the treatment of contact granuloma. Materials and Methods : We retrospectively reviewed the medical records of 40 patients who were treated with proton pump inhibitor (PPI) for contact granuloma from January 2011 to December 2015. Reflux finding score (RFS), reflux symptom index (RSI) and size of granuloma were evaluated before and after treatment serially to assess the effectiveness of proton pump inhibitor. Results : Of 40 patients, 25 patients (62.5%) and 10 patients (25%) showed improvement and partial improvement of granuloma, respectively. Five patients showed no response. The mean times of partial improvement and improvement were $2.08{\pm}2.23$ months and $4.60{\pm}2.77$ months, respectively and mean duration of PPI treatment was $6.8{\pm}5.2$ months. Conclusion : Proton pump inhibitors is effective in the treatment of contact granuloma.