Increasing frequency of skin cancer, mycosis fungoides, Kaposi's sarcoma etc, it need to treatment dose planning for total skin electron beam (TSEB) therapy. Appropriate treatment planning for TSEB therapy is needed to give homogeneous dose distribution throughout the entire skin surface. The energy of 6 MeV electron from the 18 MeV medical linear accelerator was adapted for superficial total skin electron beam therapy. The energy of the electron beam was reduced to 4.2 MeV by a $0.5\;cm\times90\;cm{\times}180\;cm$ acryl screen placed in a feet front of the patient. Six dual field beam was adapted for total skin irradiation to encompass the entire body surface from head to toe simultaneously. The patients were treated behind the acryl screen plate acted as a beam scatterer and contained a parallel-plate shallow ion chamber for dosimetry and beam monitoring. During treatment, the patient was placed in six different positions due to be homogeneous dose distribution for whole skin around the body. One treatment session delivered 400 cGy to the entire skin surface and patients were treated twice a week for eight consecutive weeks, which is equivalent to TDF value 57. instrumentation and techniques developed in determining the depth dose, dose distribution and bremsstrahlung dose are discussed.
Purpose : To obtain the uniform dose at limited depth to entire surface of the body, the dose characteristics of degraded electron beam of the large target-skin distance and the dose distribution of the six-dual electron fields were investigated Materials and Method : The experimental dose distributions included the depth dose curve, spatial dose and attenuated electron beam were determined with 300 cm of target-skin distance (TSD) and full collimator size (35*35 $cm^2$ on TSD 100 cm) in 4 MeV electron beam energy. Actual collimated field size of 105 cm * 105 cm at the distance of 300 cm could include entire hemibody. A patient was standing on step board with hands up and holding the pole to stabilize his/her positions for the six-dual fields technique. As a scatter-degrader, 0.5 cm of acrylic plate was inserted at 20 cm from the body surface on the electron beam path to induce ray scattering and to increase the skin dose. Results : The full width at half maximum(FWHM) of dose profile was 130 cm in large field of 105*105 $cm^2$ The width of $100\pm10\%$ of the resultant dose from two adjacent fields which were separated at 25 cm from field edge for obtaining the dose unifomity was extended to 186 cm. The depth of maximum dose lies at 5 mm and the 80$\%$ depth dose lies between 7 and 8 mm for the degraded electron beam by using the 0.5 cm thickness of acrylic absorber. Total skin electron beam irradiation (TSEBI) was carried out using the six dual fields has been developed at Stanford University. The dose distribution in TSEBI showed relatively uniform around the flat region of skin except the protruding and deeply curvatured portion of the body, which showed excess of dose at the former and less dose at the latter. Conclusion : The percent depth dose, profile curves and superimposed dose distribution were investigated using the degraded electron beam through the beam absorber. The dose distribution obtained by experiments of TSEBI showed within$\pm10\%$ difference except the protruding area of skin which needs a shield and deeply curvatured region of skin which needs boosting dose.
Jang, Bum-Sup;Kim, Eunji;Kim, Il Han;Kang, Hyun-Cheol;Ye, Sung-Joon
Radiation Oncology Journal
/
v.36
no.2
/
pp.153-162
/
2018
Purpose: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. Materials and Methods: Total 19 patients confirmed with MF between 1999-2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. Results: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. Conclusion: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.
Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is $60^{\circ}$ around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.
The Journal of Korean Society for Radiation Therapy
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v.12
no.1
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pp.112-116
/
2000
Purpose : The vertex scalp is always tangentially irradiated during total skin electron beam(TSEB) This study was discuss to the dose distribution at the vertex scalp and to evaluate the use of an electron reflector. positioned above the head as a means of improving the dose uniformity. Methods and Materials Vetex dosimetry was performed using ion-chamber and TLD. Measurements were 6 MeV electron beam obtained by placing an acrylic beam speller in the beam line. Studies were performed to investigate the effect of electron scattering on vertex dose when a lead reflector $40{\times}40cm$ in area, was positioned above the phantom. Results : The surface dose at the vertex, in the without of the reflector was found to be less than $37.8\%$ of the skin dose. Use of the lead reflector increased this value to $62.2\%$ for the 6 MeV beam. Conclusion : The vertex may be significantly under-dosed using standard techniques for total skin electron beam. Use of an electron reflector improves the dose uniformity at the vertex and may reduce or eliminate the need for supplemental irradiation.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.15
no.1
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pp.27-40
/
1985
This study was undertaken to observe the histopathologic changes in salivary gland of the white rats when exposed to megavoltage fractionated dose of cobalt-60 irradiation and 78 female white rats, weighing approximately 180gm, were divided into control and 3 experimental groups. Irradiation on experimental groups was delivered by using 6000 curies MeV ALCYON cobalt-60 teletherapy unit with exposure rate 183 rads per minute, in source skin distance 80cm, 600 rads every 3 days. In experimental groups, Group Ⅰwas irradiated of total dose 1200 rads for a period of 6 days, Group Ⅱ was irradiated of total dose 2400 rads for a period of 12 days and Group Ⅲ was irradiated of total dose of 4800 rads for a period of 24 days. The animals were sacrificed serially at 3 hours, 6 hours, 10 hours, 1st day, 4th day, 7th day after each completion of irradiation exposure. At sacrifice, salivary glands were excised and examined microscopically and electromicroscopically. The results were as follows: 1. The acinar cells of parotid and submaxillary gland showed damage varied with dose, 1200 rads resulted in very mild injury while 4800 rads caused most extensive injury. 2. The acinar cells of parotid and submandibular gland showed similar ultrastructural alterations, appeared as pleomorphic nucleus, decreased numbers and pleomorphism of secretory granules, distention of rough endplasmic reticulum, expansion and pallor appearance of mitochondria, and hypertrophy of Golgi complex. 3. Parotid serous cells were the most sensitive components, displaying morphological alterations of radiation damage as early as 3 hours, followed by submandibular seromucinous cells and secretory tubular cells. 4. The mucous cells of sublingual gland, as well as the whole ductal lining cells of each salivary gland, displayed no significant alterations. No evidence of microvascular injury through whole experimental groups indicated that microvascular impairment does not contribute to early salivary gland injury.
This study examined the properties of photons and the dose distribution in a human body via a simulation where the total body irradiation(TBI) is performed on a pediatric anthropomorphic phantom and a child size water phantom. Based on this, we tried to find the optimal photon beam energy and material for beam spoiler. In this study, MCNPX (Ver. 2.5.0), a simulation program based on the Monte Carlo method, was used for the photon beam analysis and TBI simulation. Several different beam spoiler materials (plexiglass, copper, lead, aluminium) were used, and three different electron beam energies were used in the simulated accelerator to produce photon beams (6, 10, and 15 MeV). Moreover, both a water phantom for calculating the depth-dependent dosage and a pediatric anthropomorphic phantom for calculating the organ dosage were used. The homogeneity of photon beam was examined in different depths for the water phantom, which shows the 20%-40% difference for each material. Next, the org an doses on pediatric anthropomorphic phantom were examined, and the results showed that the average dose for each part of the body was skin 17.7 Gy, sexual gland 15.2 Gy, digestion 13.8 Gy, liver 11.8 Gy, kidney 9.2 Gy, lungs 6.2 Gy, and brain 4.6 Gy. Moreover, as for the organ doses according to materials, the highest dose was observed in lead while the lowest was observed in plexiglass. Plexiglass in current use is considered the most suitable material, and a 6 or 10 MV photon energy plan tailored to the patient condition is considered more suitable than a higher energy plan.
This study was performed to investigate the cytoprotective effects of Stachys riederi var. japonica ethanol extract (SREE) to control oxidative stress induced by UVA-irradiation by examining antioxidant capacity and gene expression of cytochrome c using human dermal fibroblasts. The total polyphenolics and flavonoids in the SREE were 41.2 and 25.4 mg/g, respectively. At concentrations of 500 and $1000{\mu}g/mL$, the electron-donating ability of SREE was 48.6% and 82.0%, respectively, and the 2,2'-azino-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activity was 62.3% and 78.8%, respectively. These findings showed that SREE has a fairly good antioxidant capacity. As determined by an MTT assay, the maximum permissible level for treating SREE to human dermal fibroblasts was shown to be over $200{\mu}g/mL$. SREE ($200{\mu}g/mL$) significantly decreased cytochrome c mRNA and protein expression by 31.1% (p<0.001) and 38.8% (p<0.01), respectively. These findings suggest that SREE may protect human skin cells against mitochondrial-dependent apoptosis. Therefore, SREE seems to be a natural antioxidant to protect cells against oxidative stress induced by UVA-irradiation.
This study evaluated the improving efficacy of Lespedeza cuneata ethanol extract on skin photoaging induced by ultraviolet (UV) irradiation. The total polyphenol and flavonoid contents of the extract were respectively $134.98{\pm}1.70$ and $16.20{\pm}0.05$ mg/g, respectively. The superoxide anion radical scavenging activity and electron-donating ability of the extract were shown to be dependent on concentration, and the antioxidant ability was shown to be more effective in superoxide anion radical scavenging activity than in electron-donating ability under the same concentration conditions. In the in vivo test conducted using hairless mouse with skin photoaging induced by UVB irradiation, the skin erythema of the groups treated with the extract (AS) reduced to 28% of the control, and the skin moisture content increased to 131%.. The extract treatment of the UV-damaged skin improved the morphological and histopathological state of the skin. Furthermore, the SOD, GST and CAT activities in the skin tissue of the AS group increased, and the XO activity and TBARS generation decreased. With regard to the genes related to the photoaging skin, the expression of PAK, p38, c-Fos, c-Jun, TNF-${\alpha}$ and MMP-3 in the skin of the AS group were found to have decreased. It was therefore concluded that Lespedeza cuneata ethanol extract can reduce wrinkle formation in the skin due to the regulation of the gene expression caused by the exposure to UVB light.
Journal of the Korean Society of Food Science and Nutrition
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v.42
no.11
/
pp.1744-1752
/
2013
We investigated the protective effect of UVB inducing photodamage from mulberry extract (ME) and Lithospermum erythrorhizon extract (LE). The contents of total anthocyanin and shikonin as a color compound of ME and LE were 4.92 mg/g and 9.58 mg/g, respectively. The electron donating ability and superoxide radical scavenging activity of ME were 84.32% and 76.34%, respectively. The oxygen radical absorbance capacity of the ME ($545.37{\mu}moles$ TE/g) was higher than LE ($427.18{\mu}moles$ TE/g). MMP-1 production in the HS68 cells were exposed to UVB suppressed by treatment with $200{\mu}g/mL$ of ME (68.6%) and LE (32.7%). ME and LE were applied to a skin aging mouse model, which was induced by the irradiation of UVB to the backs of hairless mice. The value of skin erythema index, wrinkle depth and thickness, epidermis thickness, and collagenous fiber damage in the experiment groups (MEL: ME 3%, MEM: ME 5%, MEH: ME 7%, LEL: LE 3%, LEM: LE 5%, LEH: LE 7%) were remarkably reduced than in the control group (only UVB exposure group), while water capacity increased. The level of total wrinkles depth in the skin was decreased to be 30% of the control group by MEH and LEM. These results suggest that ME and LE are useful cosmetic materials for skin protection against UVB-inducing.
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