• Radiation Oncology Journal
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• v.14 no.3
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• pp.201-209
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• 1996

Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.237-244
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• 1996

Purpose : The accurate dosimetry of independent collimator equipped for 6MV and 15MV X-ray beam was investigated to search for the optimal correction factor. Materials and Methods : The field size factors, beam quality and dose distribution were measured by using 6MV, 15MV X-ray Field size factors were measured from $3{\times}3cm^2$ to $35{\times}35cm^2$ by using 0.6cc ion chamber (NE 2571) at Dmax. Beam qualities were measured at different field sizes, off-axis distances and depths. Isodose distributions at different off-axis distance using $10\times10cm^2$ field were also investigated and compared with symmetric field. Result: 1) Relative field size factors was different along lateral distance with maximum changes in $3.1\%$ for 6MV and $5\%$ for 15MV. But the field size factors of asymmetric fields were identical to the modified central-axis values in symmetric field, which corrected by off-axis ratio at Dmax. 2) The HVL and PDD was decreased by increasing off-axis distance. PDD was also decreased by increasing depth For field size more than $5{\times}cm^2$ and depth less than 15cm, PDD of asymmetric field differs from that of symmetric one ($0.5\~2\%$ for 6MV and $0.4\~1.4\%$ for 15MV). 3) The measured isodose curves demonstrate divergence effects and reduced doses adjacent to the edge close to the flattening filter center was also observed. Conclusion . When asymmetric collimator is used, calculation of MU must be corrected with off-axis and PDD with a caution of underdose in central axis.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.1-9
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• 2004

Purpose : The aim of this study is to investigate the properties of small field size and to measure the penumbra and central axis depth dose varying to the jaw setting and off axis distance for indicate this data to small field sizes radiation therapy. Material and methods : The percentage depth dose, beam profile and central axis output dose was measured by farmer type ion chamber and pinpoint chamber using Primart linac with 6MV energy. Beam quality and penumbra variations according to the central axis shift, from center to every 2cm outside increment, and field size, from $1{\times}1cm$ to $10{\times}10cm$ was investigated and compared with that of the standard geometrical condition's results Results : The differences of measured values between two ion chamber was about $37\%$ at 10cm depth with $1{\times}1cm$ field sizes but as field size increased this differences was diminished gradually. Measured data from various off axis distance with the different asymmetric collimations are not changed significantly but as size decreased the dose variation was increased and at $1{\times}1cm$ field size dose difference among off axis distance was as much as $13\%$, and as shallower the measured depth the central axis dose variations among the OAD was increased, penumbra was not changed noticeably depending on off axis distance but the percentage of penumbra from its initial field sizes was strongly dependant on field sizes and penumbra occupation rates of its own field sizes ranging from $6\%$ at $10{\times}10cm$ to $50\%$ at $1{\times}1cm$ field size. Conclusion : For imrt treatment, there are several numbers of different gentry angles with beams of nonuniform fluences are required and several complex factors involved. Among them the characteristics of beam output varying to the geometrical setting and design of collimators are of important to attaining a good treatment results. As mentioned in results the differences of measured values are changed significantly depends on ion chamber volume, depths and field size. For providing quality radiation treatment, especially at small field size, those factor's should have considering deliberately.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.2
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• pp.69-79
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• 2004

In the process of photon treatments, linear accelerators with energies higher than 10 MV produce neutrons through the (${\gamma}$, n) interactions with the composite materials of the linac head md these materials further produce the induced radiations. We investigate the possible risks from these induced radiations especially in the wedge filters to the radiation workers. Wedge filters are used to modify the isodose profiles in the radiation treatment using the linear accelerator and always be handled by the radiation workers. For the background radiation, we measured the radiation in both the waiting room and the outside of the building for two hospitals, S and H. The results of S hospital were $0.11\;{\mu}Sv/hr$ and $0.10\;{\mu}Sv/hr$ for waiting room and outside respectively, and in the case of H hospital, they were $0.12\;{\mu}Sv/hr$ and $0.11\;{\mu}Sv/hr$. Using a survey meter, we measured the radiation from wedge filters inserted in 10 MV and 15 MV Siemens linear accelerators. The time series measurements were done in ${\sim}1$ minutes after exposure of 5 Gy of monitor units for the field size of $25{\times}25cm^2$. The starting value of 10 MV machine was about $3.26\;{\mu}Sv/hr$, which was three times higher than that of 10 MV. The measured radiation was from $^{28}Al$ and $^{53}Fe$ with a half life of 3.5 min. If the treatment patients are $20{\sim}50$ per day and the number of process of wedge filter change per patient is one or two, the annual dose equivalent is $0.08{\sim}0.4\;mSv$ for 10 MV, and $0.27{\sim}1.36\;mSv$ for 15 MV, which are in the range of dose equivalent limits of radiation workers.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.2
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• pp.63-67
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• 2004

Purpose : New therapy technique appeared in 3D-CRT or IMRT according to a radiation treatment developing and worked. Such treatment technique requires the radiation irradiation of many direction. It has many restriction at radiation irradiation of many direction to the linear acceleration deception of now actually. Consequently We make new fix device and measure consequently the improvement of the activate range. Method and Material : We upload the fix device on a linear accelerator Couch. We fixed Gantry at 45, 90, 135 and Couch is spin and measure the clearance of the equipment. Couch is fixed at 0 45 90 and measures the clearance of Gantry. We upload the Extended head holder(EHH) on a linear accelerator Couch. and We measure with the experiment of the front. Result : The action range did not have big difference to increase Gantry45. but The activate range of Couch increases the angle in Gantry 90 and Gantry 135 when it uses EHH. The activate range of Gantry increases the angle in Couch 45 when it uses EHH. We showed good activate situation all in Couch 0 and Couch 90. The utility of EHH could keep a behind radiation diminution. Conclusion : The radiation irradiation of many direction comes to be possible the utility of the fix instrument(EHH). The safety space between the patient and equipment or between equipment and equipment increased the utility of the fix device. Also, The manufacture is possible imports to rather cheap price. and We could bring the frugality of the treatment expendable supplies.

• Journal of radiological science and technology
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• v.27 no.2
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• pp.35-43
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• 2004

Radioprotective effects of ginseng extracts on liver damage induced by high energy x-ray were studied. To one group of ICR male mice were given white(50 mg/kg/day for 7days, orally) and fermenta ginseng extracts(500 mg/kg/day for 7days, orally) before irrdiation. To another group were irradiated by 5 Gy dose of high energy x-ray. Contrast group were given with saline(0.1 ml). This study also investigated the radioprotective effect between SOD, CAT, hydrogen peroxide and ginseng extracts on hepatic damage. This study measured the level of superoxide dismutase(SOD), catalase(CAT), hydrogen peroxide($H_2O_2$) in liver tissue. Administrating orally white (50 mg/kg/day for 7days, orally) and fermenta ginseng extracts(500 mg/kg/day), the activity of SOD, CAT were generally increased and the hydrogen peroxide($H_2O_2$) was decreased. After irradiation, the activity of SOD, CAT were generally decreased and the hydrogen peroxide($H_2O_2$) was increased. Therefore, ginseng extracts increased antioxidative enzyme activity. And We know that the antioxidatant effect of extracts from white and fermenta ginseng protect radiation damage by direct antioxidant effect involving SOD, CAT. It was included that ginseng can protect against radiation damage through its antioxidatant properties.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.58-66
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• 2006

Purpose: Renal irradiation can lead to the development of radiation nephropathy, and this is characterized by the accumulation of extracellular matrix and final fibrosis. To determine the possible role of the glomerular epithelial cell, the radiation-induced changes in the expression of its genes associated with the extracellular matrix were analyzed. Materials and Methods: Rat glomerular epithelial cells (GEpC) were irradiated with a single dose of 0, 2, 5, 10 and 20 Gy with using 6 MV LINAC (Siemens, USA), and the samples were collected 6, 24, 48 and 72 hours post-irradiation, respectively. Northern blotting, western blotting and zymography were used to measure the expression level of fibronectin (Fn), plasminogen activator inhibitor-1 (Pai-1), matrix metalloproteinases-2, 9 (MMP-2, 9), tissue inhibitor of metalloproteinase-2 (TIMP-2), tissue-type plasminogen activator (t-PA) and urokinase-type plasminogen activator (u-PA). Results: Irradiation with a single dose of 10 Gy resulted in a significant increase in Fn mRNA since 24 hours post-irradiation, and a single dose of 5 and 10 Gy significantly increased the Fn immunoreactive protein measured 48 hours post-irradiation. An increase in Pai-1 mRNA and protein was also observed and especially, a single dose of 10 Gy significantly increased the mRNA measured 24 and 48 hours post-irradiation. The active MMP-2 measured 24 hours post-irradiation slightly increased in a dose dependent manner, but this increase did not reach statistical significance. The levels of MMP-9, TIMP-2, t-PA and u-PA appeared unaltered after irradiation. Conclusion: Irradiation of the glomerular epithelial cells altered the expression of genes associated with the extracellular matrix, implying that the glomerular epithelial cell may be involved in the development of radiation nephropathy.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.517-529
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• 1998

Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.469-475
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• 1998

Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.31-39
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• 2020

Purpose: The aims of this study were to compare the superficial dose with Optically Stimulated Luminescence Dosimeter(OSLD) measurement and Treatment Planning System(TPS) calculation for 6MV-Flattening Filter Free(FFF) energy using HalcyonTM and TrueBeamTM. Materials and methods: Phantom study was performed using the CT images of human phantom. In the treatment planning system, the Planning Target Volume(PTV) was contoured which is similar to Glottic cancer. Furthermore, Point(M), Point(R), and Point(L) were contoured at the iso-center of head and neck region and 5mm bolus was applied to the body contour. Each treatment plans using 6MV-FFF energy from HalcyonTM and TrueBeamTM with static Intensity Modulated Radiation Therapy(IMRT) and Volumetric Modulated Arc Therapy(VMAT) were established with eclipse. To reproduce the same position as the TPS, OSLDs were placed at the iso-center point and 5mm bolus was applied to compare the error rate after the dose delivery. Result: The results of the study using human phantom are as follows. In case of HalcyonTM, the mean absolute error rates of the point dose using the treatment planning system and the dose measured by OSLD were 1.7%±1.2% for VMAT and 4.0±2.8% for IMRT. Also TrueBeamTM was identified as 2.4±0.4% and 8.6±1.8% respectively for VMAT and IMRT. Conclusion: Through the results of this study, TrueBeamTM confirmed that the average error rate was 2.4 times higher for VMAT and 3.6 times higher for IMRT than HalcyonTM. Therefore, based on the results of this study, If we need a more accurate dose assessment for the superficial dose, It is expected that using HalcyonTM would be better than TrueBeamTM.