• Title/Summary/Keyword: Radiation delivery

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Mechanisms of radiation-induced normal tissue toxicity and implications for future clinical trials

  • Kim, Jae Ho;Jenrow, Kenneth A.;Brown, Stephen L.
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.103-115
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    • 2014
  • To summarize current knowledge regarding mechanisms of radiation-induced normal tissue injury and medical countermeasures available to reduce its severity. Advances in radiation delivery using megavoltage and intensity-modulated radiation therapy have permitted delivery of higher doses of radiation to well-defined tumor target tissues. Injury to critical normal tissues and organs, however, poses substantial risks in the curative treatment of cancers, especially when radiation is administered in combination with chemotherapy. The principal pathogenesis is initiated by depletion of tissue stem cells and progenitor cells and damage to vascular endothelial microvessels. Emerging concepts of radiation-induced normal tissue toxicity suggest that the recovery and repopulation of stromal stem cells remain chronically impaired by long-lived free radicals, reactive oxygen species, and pro-inflammatory cytokines/chemokines resulting in progressive damage after radiation exposure. Better understanding the mechanisms mediating interactions among excessive generation of reactive oxygen species, production of pro-inflammatory cytokines and activated macrophages, and role of bone marrow-derived progenitor and stem cells may provide novel insight on the pathogenesis of radiation-induced injury of tissues. Further understanding the molecular signaling pathways of cytokines and chemokines would reveal novel targets for protecting or mitigating radiation injury of tissues and organs.

Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015

  • Ryu, Samuel;Yoon, Hannah;Stessin, Alexander;Gutman, Fred;Rosiello, Arthur;Davis, Raphael
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.1-11
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    • 2015
  • With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in selected group of patients. The experience indicates that spine radiosurgery has a potential to change the clinical practice in the management of spine metastasis and spinal cord compression.

Quality Assurance for High Dose Rate Brachytherapy (고선량율 근접치료의 정도관리)

  • Bang, Dong-Wan;Cho, Chung-Hee;Park, Jae-Il
    • The Journal of Korean Society for Radiation Therapy
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    • v.10 no.1
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    • pp.30-44
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    • 1998
  • Accurate delivery of doses using a high dose rate(HDR) brachytherapy, remote afterloading system(RALS) depends on knowing the strength of the radioactive source at the time of treatment, the precision and consistency of the timer, and the ability of the unit to position the source at the proper dwell location along the applicator. Periodic Quality Assurance(QA) on HDR machines is a part of the standard protocol of any user. The safety of the patient & staff, positional accuracy, temporal accuracy, and dose delivery accuracy are periodically(weekly, quarterly, monthly) estimated using HDR source(Ir-192), treatment planning devices, measurement devices, and overall treatment devices with regard to treatment delivery. The overall measurement results are estimated successfully and assessed its clinical significance. As a result, our HDR brachytherapy units has been very accurate until now. The QA program protocol permits routine clinical use and provides a high confidence level in the accurate operation of HDR units. Therefore, regular QA of HDR brachytherapy is essential for successful treatment.

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Freeze-dried bovine amniotic membrane as a cell delivery scaffold in a porcine model of radiation-induced chronic wounds

  • Oh, Daemyung;Son, Daegu;Kim, Jinhee;Kwon, Sun-Young
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.448-456
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    • 2021
  • Background Locoregional stem cell delivery is very important for increasing the efficiency of cell therapy. Amnisite BA (Amnisite) is a freeze-dried amniotic membrane harvested from bovine placenta. The objective of this study was to investigate the retention of cells of the stromal vascular fraction (SVF) on Amnisite and to determine the effects of cell-loaded Amnisite in a porcine radiation-induced chronic wound model. Methods Initially, experiments were conducted to find the most suitable hydration and incubation conditions for the attachment of SVF cells extracted from pig fat to Amnisite. Before seeding, SVFs were labeled with PKH67. The SVF cell-loaded Amnisite (group S), Amnisite only (group A), and polyurethane foam (group C) were applied to treat radiation-induced chronic wounds in a porcine model. Biopsy was performed at 10, 14, and 21 days post-operation for histological analysis. Results Retaining the SVF on Amnisite required 30 minutes for hydration and 1 hour for incubation. A PKH67 fluorescence study showed that Amnisite successfully delivered the SVF to the wounds. In histological analysis, group S showed increased re-epithelialization and revascularization with decreased inflammation at 10 days post-operation. Conclusions SVFs had acceptable adherence on hydrated Amnisite, with successful cell delivery to a radiation-induced chronic wound model.

The Radiobiological Evaluation on Abnormal Delivery of Cattle around Nuclear Power Plant using Micronucleus Assay in Lymphocyte (림프구 미소핵 측정법을 이용한 원자력발전소 주변 소의 이상산에 대한 방사선 생물학적 평가)

  • 김세라;김성호
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.364-368
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    • 2003
  • Cytogenetic and hematological analysis was performed in peripheral blood from the cattle associated with abnormal delivery around nuclear power plant area. The frequency of micronuclei (MN) in peripheral blood lymphocytes from cattle was used as a biomarker of radiobiological effects resulting from exposure to environmental radiation. An estimated dose of radiation was calculated by best fitting linear-quadratic model based on the radiation-induced MN data over the range from 0 Gy to 4 Gy from the bovine lymphocytes with in vitro irradiation. MN rates in live malformed calf, dams of malformed calves and other cattle living in the same barn from the regions around nuclear power plant, and cattle in control area were 9/1000, 10.8/1000, 13.3/1000 and 10.0/1000, respectively. There were no significant differences in MN frequencies and hematological values between the cattle associated with abnormal delivery around nuclear power plant area and those of control area. This study indicates that the congenital abnormalities near nuclear power plant seemed to be caused by other aetiology.

Evaluating the Effects of Dose Rate on Dynamic Intensity-Modulated Radiation Therapy Quality Assurance

  • Kim, Kwon Hee;Back, Tae Seong;Chung, Eun Ji;Suh, Tae Suk;Sung, Wonmo
    • Progress in Medical Physics
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    • v.32 no.4
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    • pp.116-121
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    • 2021
  • Purpose: To investigate the effects of dose rate on intensity-modulated radiation therapy (IMRT) quality assurance (QA). Methods: We performed gamma tests using portal dose image prediction and log files of a multileaf collimator. Thirty treatment plans were randomly selected for the IMRT QA plan, and three verification plans for each treatment plan were generated with different dose rates (200, 400, and 600 monitor units [MU]/min). These verification plans were delivered to an electronic portal imager attached to a Varian medical linear accelerator, which recorded and compared with the planned dose. Root-mean-square (RMS) error values of the log files were also compared. Results: With an increase in dose rate, the 2%/2-mm gamma passing rate decreased from 90.9% to 85.5%, indicating that a higher dose rate was associated with lower radiation delivery accuracy. Accordingly, the average RMS error value increased from 0.0170 to 0.0381 cm as dose rate increased. In contrast, the radiation delivery time reduced from 3.83 to 1.49 minutes as the dose rate increased from 200 to 600 MU/min. Conclusions: Our results indicated that radiation delivery accuracy was lower at higher dose rates; however, the accuracy was still clinically acceptable at dose rates of up to 600 MU/min.

A Comparison of Patient-specific Delivery Quality Assurance (DQA) Devices in Radiation Therapy (방사선치료에서 환자맞춤형 선량품질보증 장치의 비교)

  • Kyung Hwan Chang
    • Journal of radiological science and technology
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    • v.46 no.3
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    • pp.231-238
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    • 2023
  • This study aimed to compare the results of delivery quality assurance (DQA) using MapCHECK and OCTAVIUS for radiation therapy. Thirty patients who passed the DQA results were retrospectively included in this study. The point dose difference (DD) and gamma passing rate (GPR) were analyzed to evaluate the agreement between the measured and planned data for all cases, Plan complexity was evaluated to analyze dosimetric accuracy by quantifying the degree of modulation according to each plan. We analyzed the monitor units (MUs) and total MUs for each plan to evaluate the correlation between the MUs and plan complexity. We used a paired t-test to compare the DD and GPRs that were obtained using the two devices. The DDs and GPRs were within the tolerance range for all cases. The average GPRs difference between the two devices was statistically significant for the brain, and head and neck for gamma criteria of 3%/3 mm and 2%/2 mm. There was no significant correlation between the modulation index and total MUs for any of the cases. These DQA devices can be used interchangeably for routine patient-specific QA in radiation therapy.

Optimization of CORVUS Planning System with PRIMART Linac for Intensity Modulated Radiation Therapy

  • Lee, Se-Byeong;Jino Bak;Cho, Kwang-Hwan;Chu, Sung-sil;Lee, Suk;Suh, Chang-ok
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.83-85
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    • 2002
  • Yonsei Cancer Center introduced an IMRT System at the beginning of February, 2002. The system consists of CORVUS(NOMOS) inverse planning machine, LANTIS(SIEMENS), PRIMEVIEW and PRIMART Linac(SIEMENS). The optimization of CORVUS planning system with PRIMART is an important work to get an efficient treatment plan. So, we studied two Finite Size Pencil Beams, 1.0 x 1.0 cm$^2$ and 0.5 x 1.0 cm$^2$, and four leaf transmission sets, 5%, 10%, 20%, 33%. We compared the dose distribution of target volume and delivery efficiency of the plan results.

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Intensity-modulated radiation therapy: a review with a physics perspective

  • Cho, Byungchul
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.1-10
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    • 2018
  • Intensity-modulated radiation therapy (IMRT) has been considered the most successful development in radiation oncology since the introduction of computed tomography into treatment planning that enabled three-dimensional conformal radiotherapy in 1980s. More than three decades have passed since the concept of inverse planning was first introduced in 1982, and IMRT has become the most important and common modality in radiation therapy. This review will present developments in inverse IMRT treatment planning and IMRT delivery using multileaf collimators, along with the associated key concepts. Other relevant issues and future perspectives are also presented.