• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2813-2818
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• 2015

Objective: To investigate the regulatory effect of curcumin on expression of signal transducer and activator of transcription 3 (STAT3) in skin squamous cell carcinoma tissues as well as possible mechanisms of curcumin in prevention and treatment of skin squamous cell carcinoma. Materials and Methods: Highly invasive A431 cells were treated with curcumin at various doses .The cytotoxic effects of treatment with 5, 10, 15, 20, 25, 30, 35, 40 and 50 umol/L curcumin for 24, 48 and 72 hours on A431 cells were measured by MTT assay. The invasion capacity of cells treated with 5, 10 and 15 umol/L curcumin was measured by Transwell test, while adhesive ability was assessed by cell adhesion assay. The effects of 5,10 and 15 umol/L curcumin on expression levels of STAT3 were determined by Western blotting and on transcription levels of STAT3 mRNA by RT-PCR. Results: Treatment with curcumin at a doses of more than 15 umol/L for more than 24 hour inhibited the growth of A431 cells in a time-and dose-dependent fashion (p<0.001). The doses of 15 umol/L and less for 24 hours showed no significant cytotoxic effects on the cells, survival rates being more than 85%.The invasion and adhesive abilities decreased gradually with the increasing curcumin concentration, 15 umol/L exerting the strongest inhibitory effects (p<0.05). Curcumin showed significant dose-dependent inhibitory effects on the transcription level of STAT3 mRNA (p<0.05). Conclusions: Curcumin may reduce the invasive ability of A431 cells by inhibiting the activation of STAT3 signal pathway and expression of STAT3 as a target gene in the pathway.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3365-3370
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• 2015

Radiotherapy has an important role in the treatment of prostate cancer. Three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques are all applied for this purpose. However, the risk of secondary radiation-induced bladder cancer is significantly elevated in irradiated patients compared surgery-only or watchful waiting groups. There are also reports of risk of secondary cancer with low doses to normal tissues. This study was designed to compare received volumes of low doses among 3D-CRT, IMRT and VMAT techniques for prostate patients. Ten prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated using 3D-CRT, IMRT and VMAT techniques. Conformity index (CI), homogenity index (HI), receiving 5 Gy of the volume (V5%), receiving 2 Gy of the volume (V2%), receiving 1 Gy of the volume (V1%) and monitor units (MUs) were compared. This study confirms that VMAT has slightly better CI while thev olume of low doses was higher. VMAT had lower MUs than IMRT. 3D-CRT had the lowest MU, CI and HI. If target coverage and normal tissue sparing are comparable between different treatment techniques, the risk of second malignancy should be a important factor in the selection of treatment.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.25-31
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• 2017

Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

• Biomolecules & Therapeutics
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• v.21 no.1
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• pp.84-88
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• 2013

High risk of cardiovascular diseases caused by existing PPAR-${\gamma}$ agonists such as rosiglitazone and pioglitazone has been recently reported. CKD-501 is a novel selective PPAR-${\gamma}$ agonist as a potential target to reduce cardiovascular risk in non-insulin dependent diabetes mellitus (NIDDM). In this study, We investigated potential cardiotoxicity of CKD-501 and compared its toxicity with that of rosiglitazone or pioglitazone using db/db mice. After 12-week repeated administration of CKD-501 at doses of 3, 10 and 30 mg/kg/day or rosiglitazone at doses of 10 and 30 mg/kg/day or pioglitazone at doses of 200 and 540 mg/kg/day, animals were sacrificed for investigation of potential toxicities. Diameters of left ventricles and areas of cardiomyocytes were measured. And lipid accumulation and apoptosis in heart muscle were examined by oil red O staining and TUNEL staining, respectively. Diameters of left ventricles were significantly increased in high dose treatment group of pioglitazone compared to control (p<0.05), while other groups showed a tendency for an increase. All test articles induced significantly the increase of area of cardiomyocytes in heart compared to control (p<0.01), in regular order as pioglitazone > CKD-501 ${\geq}$ rosiglitazone. However, lipid accumulation and apoptotic changes in heart were not observed in all dosing groups. Taken together, the myocardial cell hypertrophy of CKD-501 are relatively lower than that of pioglitazone and similar to rosiglitazone. And it is suggested that the myocardial cell hypertrophy of CKD-501 are less adverse in clinical use for the management of the NIDDM.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.227-234
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• 2018

Purpose: We compared how doses delivered via two-dimensional (2D) intracavitary brachytherapy (ICBT) and three-dimensional (3D) ICBT varied anatomically. Materials and Methods: A total of 50 patients who received 30 Gy of 3D ICBT after external radiotherapy (RT) were enrolled. We compared the doses of the actual 3D and 2D ICBT plans among patients grouped according to six anatomical variations: differences in a small-bowel V_2Gy, small bowel circumference, the direction of bladder distension, bladder volume, sigmoid V_3.5Gy, and sigmoid circumference. Seven dose parameters were measured in line with the EMBRACE recommendations. Results: In terms of bladder volume, the bladder and small-bowel D_2cc values were lower in the 150-250 mL bladder volume subgroup; and the rectum, sigmoid, and bladder D_2mL values were all lower in the >250 mL subgroup, for 3D vs. 2D ICBT. In the sigmoid V_3.5Gy >2 _mL subgroup, the sigmoid and bladder D_2mL values were significantly lower for 3D than 2D ICBT. The bladder D_2mL value was also significantly lower for 3D ICBT, as reflected by the sigmoid circumference. In patients with a small bowel V_2.0Gy >10 mL or small bowel circumference >15%, most dose parameters were significantly lower for 3D than 2D ICBT. The bladder distension direction did not significantly affect the doses. Conclusion: Compared to 2D ICBT, a greater bladder volume can reduce the internal 3D ICBT organ dose without affecting the target dose.

• Progress in Medical Physics
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• v.32 no.1
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• pp.18-24
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• 2021

Purpose: Kilovoltage computed tomography (kV-CT) is essential for radiation treatment planning. However, kV-CT images are significantly distorted by artifacts when a metallic prosthesis is present in the patient's body. Thus, the accuracies of target delineation and treatment dose calculation are inevitably lowered. We evaluated the accuracy of the calculated doses using an image restoration method with hybrid CT, which was introduced in our previous study. Methods: A cylindrical phantom containing four metals, namely, silver, copper, tin, and tungsten, was scanned using kV-CT and megavoltage CT to produce hybrid CT images. We created six verification plans for three head and neck patients on kV-CT and hybrid CT images of the phantom and calculated their doses. The actual doses were measured with film patches during beam delivery using tomotherapy. We used the gamma evaluation method to compare dose distribution between kV-CT and hybrid CT with three gamma criteria, namely, 3%/3 mm, 2%/2 mm, and 1%/1 mm. Results: The gamma pass rates decreased as the gamma criteria were strengthened, and the pass rate of hybrid CT was higher than that of kV-CT in all cases. When the 1%/1 mm criterion was used, the difference in gamma pass rates between them was up to 13%p. Conclusions: According to our findings, we expect that the use of hybrid CT can be a suitable approach to avoid the effect of severe metal artifacts on the accuracy of dose calculation and contouring.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3945-3949
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• 2015

Background: For brachytherapy of cervical cancer, applicator shifts can not be avoided. The present investigation concerned Utrecht interstitial applicator shifts and their effects on organ movement and DVH parameters during 3D CT-based HDR brachytherapy of cervical cancer. Materials and Methods: After the applicator being implanted, CT imaging was achieved for oncologist contouring CTVhr, CTVir, and OAR, including bladder, rectum, sigmoid colon and small intestines. After the treatment, CT imaging was repeated to determine applicator shifts and OARs movements. Two CT images were matched by pelvic structures. In both imaging results, we defined the tandem by the tip and the base as the marker point, and evaluated applicator shift, including X, Y and Z. Based on the repeated CT imaging, oncologist contoured the target volume and OARs again. We combined the treatment plan with the repeated CT imaging and evaluated the change range for the doses of CTVhr D90, D2cc of OARs. Results: The average applicator shift was -0.16 mm to 0.10 mm for X, 1.49 mm to 2.14 mm for Y, and 1.9 mm to 2.3 mm for Z. The change of average physical doses and EQD2 values in Gy${\alpha}/{\beta}$ range for CTVhr D90 decreased by 2.55 % and 3.5 %, bladder D2cc decreased by 5.94 % and 8.77 %, rectum D2cc decreased by 2.94 % and 4 %, sigmoid colon D2cc decreased by 3.38 % and 3.72 %, and small intestines D2cc increased by 3.72 % and 10.94 %. Conclusions: Applicator shifts and DVH parameter changes induced the total dose inaccurately and could not be ignored. The doses of target volume and OARs varied inevitably.

• Progress in Medical Physics
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• v.27 no.4
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• pp.203-212
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• 2016

Dose differences between three-dimensional (3D) and four-dimensional (4D) doses could be varied according to the geometrical relationship between a planning target volume (PTV) and an organ at risk (OAR). The purpose of this study is to evaluate the correlation between the overlap volume histogram (OVH), which quantitatively shows the geometrical relationship between the PTV and OAR, and the dose differences. 4D computed tomography (4DCT) images were acquired for 10 liver cancer patients. Internal target volume-based treatment planning was performed. A 3D dose was calculated on a reference phase (end-exhalation). A 4D dose was accumulated using deformation vector fields between the reference and other phase images of 4DCT from deformable image registration, and dose differences between the 3D and 4D doses were calculated. An OVH between the PTV and selected OAR (duodenum) was calculated and quantified on the basis of specific overlap volumes that corresponded to 10%, 20%, 30%, 40%, and 50% of the OAR volume overlapped with the expanded PTV. Statistical analysis was performed to verify the correlation with the OVH and dose difference for the OAR. The minimum mean dose difference was 0.50 Gy from case 3, and the maximum mean dose difference was 4.96 Gy from case 2. The calculated range of the correlation coefficients between the OVH and dose difference was from -0.720 to -0.712, and the R-square range for regression analysis was from 0.506 to 0.518 (p-value <0.05). However, when the 10% overlap volume was applied in the six cases that had OVH value ${\leq}2$, the average percent mean dose differences were $34.80{\pm}12.42%$. Cases with quantified OVH values of 2 or more had mean dose differences of $29.16{\pm}11.36%$. In conclusion, no significant statistical correlation was found between the OVH and dose differences. However, it was confirmed that a higher difference between the 3D and 4D doses could occur in cases that have smaller OVH value.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.249-260
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• 2007

Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.

• Nuclear Engineering and Technology
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• v.54 no.12
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• pp.4698-4707
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• 2022

As part of the ICRP Task Group 103 project, we developed ten thyroid models for the pediatric mesh-type reference computational phantoms (MRCPs). The thyroid is not only a radiosensitive target organ needed for effective dose calculation but an important source region particularly for radioactive iodines. The thyroid models for the pediatric MRCPs were constructed by converting those of the pediatric voxel-type reference computational phantoms (VRCPs) in ICRP Publication 143 to a high-quality mesh format, faithfully maintaining their original topology. At the same time, we improved several anatomical parameters of the thyroid models for the pediatric MRCPs, including the mass, overlying tissue thickness, location, and isthmus dimensions. Absorbed doses to the thyroid for the pediatric MRCPs for photon external exposures were calculated and compared with those of the pediatric VRCPs, finding that the differences between the MRCPs and VRCPs were not significant except for very low energies (<0.03 MeV). Specific absorbed fractions (target ⟵ thyroid) for photon internal exposures were also compared, where significant differences were frequently observed especially for the target organs/tissues close to the thyroid (e.g., a factor of ~1.2-~327 for the thymus as a target) due mainly to anatomical improvement of the MRCP thyroid models.