• Title/Summary/Keyword: set prescription

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Review of Recent Clinical Trials for Depression in Traditional Chinese Medicine-Based on Randomized Controlled Trials and Systematic Reviews- (우울증 치료의 중의학 최신 임상연구 동향-무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로-)

  • Woo, Jeong A;Nam, Yu Jin;Park, Yoon Jin;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.6
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    • pp.458-466
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    • 2015
  • The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.

Development of Instruction Consulting Strategy for Improving Science Teacher's Gaze Empathy Using Eye-tracking (과학교사의 시선 공감 향상을 위한 시선 추적 기반 수업 컨설팅 전략 개발)

  • Kwon, Seung-Hyuk;Kwon, Yong-Ju
    • Journal of Science Education
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    • v.42 no.3
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    • pp.334-351
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    • 2018
  • Teacher's gaze empathy for students in science class is considered to be effective in enhancing the learning effect. Thus, studies on gaze empathy have been conducted, but most of the studies are just to reveal the characteristics of gaze. Therefore, it is necessary to deal with a research to raise the level of science teacher's gaze empathy. The purpose of this study is to develop an instruction consulting strategy based on eye tracking for improving science teachers' gaze empathy. In this study, we selected and analyzed relevant literature on teacher's gaze empathy. We also designed a consulting strategy and then revised the design through expert reviews on validity and reliability. The developed consulting strategy was aimed to improve science teacher's gaze empathy and set quantitative goal based on eye tracking. The consulting strategy consisted of six steps: preparation for consulting, measurement and analysis of teacher's gaze empathy, instruction and feedback of gaze empathy, training for improving gaze empathy, evaluation of consulting result, and completion of the consulting. In addition, the consultation was completed or repeated again through the measurement and evaluation of gaze empathy using eye tracking. The developed consulting strategy has a value in that it provides an alternative with quantitative diagnosis and prescription for improving gaze empathy. The strategy can contribute to enhance teacher professional competency through the analysis of teaching behavior.

Effects of Whole Body Electric Muscle Stimulation Training on Body Composition and Heart Rate Variability based on Obesity Level in Women

  • Seung-Hyeon Lim;Jin-Wook Lee;Yong-Hyun Byun
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.3
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    • pp.137-146
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    • 2024
  • The purpose of this study was to determine the effects of 12 weeks of WB-EMS training on body composition and heart rate variability based on BMI Level in Women. The subjects of the study were premenopausal women, and they were classified into the BMI-N(n=15) group for BMI<25, the BMI-1(n=16) group for BMI=25~29.9, and the BMI-2(n=9) group for BMI>30. And then, WB-EMS training was performed of 3 times a week for 12 weeks. Body composition and HRV were measured before and after the participation in exercise, which were subjected to a repeated-measures two-way ANOVA. In the case of a significant interaction between time and group, paired sample t-tests were conducted for a post-hoc analysis within each subject group. Tukey's method was used for post-hoc testing of differences between groups, and the significance level was set at 0.5. The results were as follows; First, The effect of WB-EMS training was found in all variables of body composition. In particular, Weight, BMI, FFM, and FM decreased the most in the BMI-2 group, followed by the BMI-1 and BMI-N groups. %BF and VF decreased the most in the BMI-2 group. Second, There was a difference in BPM in all groups, and the BMI-2 group showed the greatest decrease. There were differences in SDNN and RMSSD for each group, and there was no difference according to obesity level. There was no difference in LF, HF, and LF/HF ratio. In conclusion, it was confirmed that WB-EMS training can be an exercise therapy that has a positive effect on the body composition change and cardiac circulatory system in women with a high level of obesity.

The Causes Analysis for the Number of Patients Waiting in General X-ray Room (Focus on Utilization of Quality Improvement (QI)) (일반촬영실의 환자대기건수에 대한 원인별 분석 - QI 활용을 중심으로 -)

  • Dong, Kyung-Rae;Chung, Woon-Kwan;Kim, Chang-Bok;Park, Yong-Soon;Kim, Ho-Sung;Im, In-Chul;Lee, Chang-Lae;Shin, Gyoo-Seul
    • Journal of radiological science and technology
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    • v.31 no.4
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    • pp.337-346
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    • 2008
  • A questionaire survey was conducted for patients who had been examined at the Department of Radiology to investigate the items that need to be improved. Brainstorming was also conducted by team members to suggest the tactics that can efficiently perform the QI activity by selecting the most frequently answered topics for the reduction of waiting time of x-ray examination. From September 2006 to November 2007, number of patients before and after conducting QI was compared for 3 months by each category differentiated by types of detailed causes. A patient case was set as one shooting for one patient. After conducting QI, the waiting cases before conducting QI were evaluated for the method of improvement for 3 month through the QI team discussion and conducted by following the improvement method for the next 1 month and the waiting cases were measured and the difference before and after the QI activity was compared in percentage. 1. When patient waiting cases were compared before and after conducting QI activity against the causes of repetition, it resulted in 3.9% of reduction effect. 2. When patient waiting cases were compared before and after conducting QI activity against the causes for the lack of guiding, it resulted in 1.1% of reduction effect. 3. When patient waiting cases were compared before and after conducting QI activity against the causes of miss-inputting prescription, it resulted in 1.1% of reduction effect. 4. When patient waiting cases were compared before and after conducting QI activity against the causes for emergency patients, patients with acute pain and discomfort patients, it resulted in 12.0% of reduction effect. 5. When patient waiting cases were compared before and after conducting QI activity against the causes for shooting overlapping of outpatients and hospitalized patients, it resulted in 4.7% of reduction effect. There are many factors to reduce the patient waiting cases in radiography. The first step is for radiology department to find these factors through QI, to improve them, which is the reason why the QI team is organized to perform the QI activities.

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The Usability Analysis of 3D-CRT, IMRT, Tomotherpy Radiation Therapy on Nasopharyngeal Cancer (NPC의 방사선치료시 3D-CRT, IMRT, Tomotherapy의 유용성 분석)

  • Song, Jong-Nam;Kim, Young-Jae;Hong, Seung-Il
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.365-371
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    • 2012
  • The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.

A research on Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) (Restoration and Medico-Historic Investigation) (향약구급방(鄕藥救急方)에 대(對)한 고증(考證))

  • Sheen, Yeong-Il
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.71-83
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    • 1996
  • Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) is our own, medical work written about the middle of the time of Korea Dynasty. I restored and researched this book because it needed to be illuminated about its medico-historic value and then I came to some conclusions as follows. 1. Hyang-Yack-Ku-Keup-Bang was published in Dae-jang-do-kam(大藏都監) of Kanghaw island(江華島) about the middle of Korea Dynasty. Choi Ja-ha(崔自河) republished it on original publication ground in Euiheung(義興) of Kyungsang-Province(慶尙道) in July, Taejong's(太宗) 17th year of Chosen Dynasty (A.D.1417) and this book was published again in Chungcheng Province(忠淸道) in Sejong's(世宗) 9th year(A.D.1427). The book published in Taejong's days was in the possession of books department of Kung-nae-cheng(宮內廳) in Japan and was the oldest medical book of existing ones. 2. Bang-Jung-Hyang-Yack-Mock-Cho-Bu(方中鄕藥目草部) of this book was originally intended to be adjusted in each division with the title of Bang-Jung-Hyang-Yack-Mock(方中鄕藥目). But Herb part(草部) only followed editing progress of Jeung-Lew-Bon-Cho(證類本草), the rest is not divided into each part and is together arranged at the below of Herb part with the title of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. The Korean inscriptions on some drugstuffs in this book are different between Native Name(鄕名) of three volumes of provisions and general-spoken(俗云) of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. In this, it is estimated that the publishing time and editor of tile volume of provisions and Bang-Jung-Hyang-Yack-Mock-Cho-Bu are different. I think Choi Ja-ha compiled this behind three volumes of provisions when he published. 3. This book picked some prescriptions which consisted of obtainable drugs with ease in Korea in the books of Chell-Keum-Yo-Bang(千金要方), Oi-Dae-Bi-Yo(外臺秘要), Tae-Peong-Sung-Hye-Bang(太平聖惠方), Ju-Hu-Bang(?後方), Kyung-Hum-Yang- Bang(經驗良方) Bo-Je-Bon-Sa-Bang(普濟本事方) Bi-Ye-Baik-Yo-Bang(備預百要方) and so on and got together our own prescriptions. On the whole Bi-Ye-Baik-Yo-Bang was a chief referrence book, On this, other books referred to and corrected. 4. In provisions quoted from Hyang-Yack-Jip-Sung-Bang(鄕藥集成方), there are seven provisions; leg-paralysis part, coughing part, headache part, obstetrics part, etc. don't show in this book. This is why Choi Ja-ha published only certain texts on Dae-jang-do-kam edition his own posession. So we can think the existing edition has a little misses compared with original edition. 5. This book recorded only names of drugstuffs in animal drug department like fowls, crab, goldbug, earthworm, etc. and didn't tell us ways of taking those. This is effect of Buddhist culture on medicine. This is efforts to practice 'Don't murder';one of Five Prohibition of Buddhism. 6. Beacause this book was published at the time, when our originative medicine would be set forth. This followed the Chinese ways in Theory, Treatment, Prescription and used 'Hyang Yack' in Medication out of theory of Korean medicine, which was a transitional form. So this is all important material which tell us aspects of development of 'Hyang Yack' the middle of Korea Dynasty.and this is also the beginning of originative, medical works like Dong-Eui-Bo-Kam(東醫寶鑑), Dong-Eui-Su-Bo-Won(東醫壽世保元). 7. There are few contents based on 'Byen-Jeung-Lon-Chi(辨證論治)'in this book. So we can see this book is not for doctors who study medical thoughts but for general public who suffer from diseases resulted from war. Because this book was written for a first-aid treatmeant, this is an index of medical service for the people those days. And this is also an useful datum for first-aid medicine or military medicine in these modern days. 8. Nowadays, parts of learned world of Korean medicine disregard essential theories and want to explain Korean medicine only by the theories or the methods of Western medicine. Moreover they don't adopt Chinese and Japanese theorys & thoughts about Oriental medicine in our own style and just view in there level. What was worse, there is a growing tendency for them to indulge in a trimming policy of scholarship and to take others' ideas. I think these trends to ignore our own medical thoughts involving growth of 'Hyang Yack' in the middle of Korea Dynasty, Dong-Eui-Bo-Kam and Dong-Eui-Su-Se-Bo-Won. So we, as researchers of Korean medicine, must get out of this tendency, and take over brilliant tradition and try to develop originative Korean medicine.

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The Study of Dose Distribution according to the Using Linac and Tomotherapy on Total Lymphnode Irradiation (선형가속기와 토모치료기를 이용한 전림프계의 방사선 치료시 선량분포에 관한 연구)

  • Kim, Youngjae;Seol, Gwanguk
    • Journal of the Korean Society of Radiology
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    • v.7 no.4
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    • pp.285-291
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    • 2013
  • In this study, compare and analyze the dose distribution and availability of radiation therapy when using a different devices to TNI(Total Lymphnodal Irradiation). Test subjects(patients) are 15 people(Male 7, Female 8). Acquire CT Simulation images of the 15 people using Somatom Sansation Open 16 channel and then acquired images was transferred to each treatment planning system Pinnacle Ver 8.0 and Tomotherapy Planning System and separate the tumor tissue and normal tissues(whole lung, spinal cord, Rt kidney, Lt kidney). Tumor prescription dose was set to 750 cGy. and then Compare the Dose Compatibility, Normal Tissue's Absorbed Dose, Dose Distribution and DVH. Statistical analysis was performed SPSS Ver. 18.0 by paired sample Assay. The absorbed dose in the tumor tissue was $751.0{\pm}4.7cGy$ in tomotherapy planning, $746.9{\pm}14.1cGy$ in linac. Tomotherapy's absorbed dose in the tumor was more appropriate than linac. and These values are not statistically significant(p>0.05). Tomotherapy plan's absorbed dose in the normal tissues were less than linac's plan. This value was statistically significant(p<0.05) excepted of whole lung. In DVH, appropriated on tumor and normal tissues in tomotherapy and linac but tomotherapy's TER was better than linac. Namely, a result of Absorbed dose in tumor and normal tissue, Dose distribution pattern, DVH, Both radiation therapy devices were appropriated in radiation therapy on TER. The Linac has a short treatment time(about 15-20 min) and open space on treatment time. It cause infant and pediatric patients to receiving uncomfortable treatment. So, In this case, it will be fine that Linac based therapy was restricted use. and if the patient was cooperative, it will be show a better prognosis that Tomotherapy using Radiation Therapy.

Usefulness assessment of the Volumetric Modulated Arc Therapy technique for reducing low-dose areas during radiotherapy for patients with multiple metastatic cancers (다발성 전이암 환자의 방사선치료 시 저선량 영역 감소를 위한 용적조절 회전 방사선치료(Volumetric Modulated Arc Therapy) 기법의 유용성 평가)

  • Yun-won Choi;Dong-min Jeong;Se-young Kim;Ryeong-hwang Park;I-ji Kim;Yong-wan Cho;Yongjae Kwon;Byeol-nim Park;Gyeong-min Yoo;Ho-kyung Moon;Dong-jae Jang;Jae-young Lee;Dayoung Lim;Sang-gyu Lee;Jong-geol Baek
    • The Journal of Korean Society for Radiation Therapy
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    • v.35
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    • pp.23-31
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    • 2023
  • Purpose: The purpose of this study is to evaluate the usefulness of Non-Treat Functionality Volumetric Modulated Arc Therapy(NTF-VMAT) and Treat Functionality VMAT(TF-VMAT) treatment plans in reducing the low-dose area during radiation therapy for patients with multiple metastatic cancers. Materials and Methods: The study was conducted on an Arccheck phantom, treatment planning target locations were set in pairs at intervals of 2 cm, 4 cm, and 6 cm on the X, Y, and Z axes. Based on these location settings, the volume of the low-dose area in NTF-VMAT and TF-VMAT was measured and compared. Results: The results of the study showed that, within a prescription dose range of 10% ~ 70%, the difference in low-dose area volumes across each axis was as follows: On the X-axis, there was a maximum difference of -47.6% and a minimum difference of -2.2%. On the Y-axis, there was a maximum difference of -17.5% and a minimum difference of -7.3%. The Z-axis showed a maximum difference of -39.7%, with the smallest difference being -6.8%. Conclusion: In radiation therapy for patients with multiple metastatic cancers, the TF-VMAT treatment plan was able to reduce the low-dose area by 10-40% compared to NTF-VMAT. This suggests that utilizing Treat Functionality, which includes the Island block technique, improves dose distribution and minimizes side effects, making it beneficial for the treatment of patients with multiple metastatic cancers.

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Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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Evaluation of the Modified Hybrid-VMAT for multiple bone metastatic cancer (다중표적 뼈 전이암의 하이브리드 세기변조(modified hybrid-VMAT) 방사선치료계획 유용성 평가)

  • Jung, Il Hun;Cho, Yoon Jin;Chang, Won Suk;Kim, Sei Joon;Ha, Jin Sook;Jeon, Mi Jin;Jung, In Ho;Kim, Jong Dea;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.161-167
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    • 2018
  • Purpose : This study evaluates the usefulness of the Modified Hybrid-VMAT scheme with consideration of background radiation when establishing a treatment plan for multiple bone metastatic cancer including multiple tumors on the same axis. Materials and Methods : The subjects of this study consisted of five patients with multiple bone metastatic cancer on the same axis. The planning target volume(PTV) prescription dose was 30 Gy, and the treatment plan was established using Ray Station(Ray station, 5.0.2.35, Sweden). In the treatment plan for each patient, two or more tumors were set as one isocenter. A volumetric modulated arc therapy(VMAT) plan, a hybrid VMAT(h) plan with no consideration of background radiation, and a modified hybrid VMAT(mh) with consideration of background radiation were established. Then, using each dose volume histogram(DVH), the PTV maximum dose($D_{max}$), mean dose($D_{mean}$), conformity index(CI), and homogeneity index(HI) were compared among the plans. In addition, the organ at risk(OAR) of each treatment site was evaluated, and the total MU(Monitor Unit) and treatment time were also analyzed. Results : The PTV $D_{max}$ values of VMAT, VMAT(h) and VMAT(mh) were 3188.33 cGy, 3526 cGy, and 3285.67 cGy, the $D_{mean}$ values were 3081 cGy, 3252 cGy, and 3094 cGy; the CI values were $1.35{\pm}0.19$, $1.43{\pm}0.12$, and $1.30{\pm}0.06$; the HI values were $1.06{\pm}0.01$, $1.14{\pm}0.06$, and $1.09{\pm}0.02$; and the VMAT(h) OAR value was increased 3 %, and VMAT(mh) OAR value was decreased 18 %, respectively. Furthermore, the mean MU values were 904.90, 911.73, and 1202.13, and the mean beam on times were $128.67{\pm}10.97$, $167.33{\pm}7.57$, and $190.33{\pm}4.51$ respectively. Conclusions : Applying Modified Hybrid-VMAT when treating multiple targets can prevent overdose by correcting the overlapping of doses. Furthermore, it is possible to establish a treatment plan that can protect surrounding normal organs more effectively while satisfying the inclusion of PTV dose. Long-term follow-up of many patients is necessary to confirm the clinical efficacy of Modified Hybrid-VMAT.

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