[en] The incidence of esophageal carcinoma is increasing. Radical surgery is the treatment of choice, but large proportion of the esophageal cancer patients are with unresectable disease at the time of initial diagnosis, so radiation therapy has been the major treatment modality. We carried out retrospective analysis to see the outcome and prognostic factors of radiation therapy alone for esophageal carcinoma. From June of 1979 through December 1992, 289 patients with esophageal carcinoma were threated with radiation therapy alone at Department of Therapeutic Radiology, Seoul National University Hospital. Of these patients, 84 patients were excluded as they were ineligible for the current analyses. Twenty-two patients had distant metastasis other than supraclavicular lymph node metastasis, 52 patients received less than 45 Gy, and 10 patient were lost from follow-up. Therefore 205 patients constituted the base population of this study. According to AJCC staging system, there were 2 patients with stage I, 104 with stage IIA, 26 with stage IIB, 48 with stage III, and 25 with stage IV. Radiation dose ranged from 4500 cGy to 6980 cGy with median dose of 5940 cGy. Follow-up period of the alive patients ranged from 77 to 180 months. The median survival period of all the patients was 11 months and the 2-, 5-, and 10-year overall survival rates were 22.4%, 10.2% and 5.3%, respectively. Most of the failures were local recurrences. Of 169 failures, 134 had local failure as a component and 111 had local recurrence only. The Lymph node was most common distant metastatic site and the next was the lung. The stage, T-stage, N-stage, functional status, tumor size, and aim of treatment were statistically significant prognostic factors for survival by univariate analyses. But only tumor size and N-stage were significant by multivariate analyses. We could get 10.2% of 5 year survival rate and 5.3% of 10 year survival rate with radiation theraph alone. The size of tumor and N-stage were statistically significant prognostic factors for survival on multivariate analyses

[en] Prostate specific antigen (PSA) is a useful tumor marker, which is widely used as a diagnostic index and predictor of both treatment and follow-up result in prostate cancer. A prospective analysis was carried out to obtain the period of PSA normalization and the half life of PSA and to analyze the factors influencing the period of PSA normalization. The PSA level was checked before and serially after radical radiotherapy. Twenty patients with clinically localized prostate cancer who underwent radical external beam radiotherapy were enrolled in this study. Accrual period was from April 1993 to May 1998. Median follow-up period was 26 months. Radiotherapy was given to whole pelvis followed by a boost to prostate. Dose range for the whole pelvis was from 45 Gy to 50 Gy and boost dose to prostate, from 14 Gy to 20 Gy. The post-irradiation PSA normal value was under 3.0 ng/ml. The physical examination and serum PSA level evaluation were performed at 3 month interval in the first on year, and then at every 4 to 6 months. PSA value was normalized in nineteen patients (95%) within 12 months. The mean period of PSA normalization was 5.3 (±2.7) months. The half life of PSA ofd the nonfailing patients was 2.1 (±0.9) month. The nadir PSA level of the nonfailing patients was 0.8 (±0.5) ng/ml. The period of PSA normalization had the positive correlation with pretreatment PSA level (R²=0.468). The nadir PSA level had no definite positive correlation with the pretreatment PSA level (R²=0.175). The half life of serum PSA level also had no definite correlation with pretreatment PSA level (R²=0.029). The PSA level was mostly normalized within 8 months (85%). If it has not normalized within 12 months, we should consider the residual disease in prostate or distant metastasis. In 2 patients, the PSA level increased 6 months or 20 months before clinical disease was detected. So the serum PSA level can be used as early diagnostic indicator of treatment failure

[en] This study was done to implement intensity-modulated radiation therapy (IMRT) for the treatment of primary prostate cancer and to compare this technique with conventional treatment methods. A 72-year-old male patient with prostate cancer stage T2a was treated with IMRT delivered with dynamic multi-leaf collimation. Treatment was designed using an inverse planning algorithm, which accepts dose and dose-volume constraints for targets and normal structures. The IMRT plan was compared with a three-dimensional (3D) plan using the same 6 fields technique. Lower normal tissue doses and improved target coverage were achieved using IMRT at current dose levels, and facilitate dose escalation to further enhance locoregional control and organ movement during radiotherapy is an important issue of IMRT in prostate cancer

[en] A vibration atomic layer deposition reactor was developed for fabricating a conformal thin-film coating on nanosize particles. In this study, atomic layer deposition of 10–15-nm-thick Al₂O₃ films was conducted on a high-surface-area acetylene black powder with particle diameters of 200–250 nm. Intense vibration during the deposition resulted in the effective separation of particles, overcoming the interparticle agglomeration force and enabling effective diffusion of the precursor into the powder chunk; this phenomenon led to the formation of a conformal film coating on the nanopowder particles. It was also confirmed that the atomic layer deposition Al₂O₃ films initially grew on the high-surface-area acetylene black powder particles as discrete islands, presumably because chemisorption of the precursor and water occurred only on a few sites on the high-surface-area acetylene black powder surface. Relatively sluggish growth of the films during the initial atomic layer deposition cycles was identified from composition analysis

[en] On-line image guided radiation therapy (on-line IGRT) and (kV X-ray images or cone beam CT images) were obtained by an on-board imager (OBI) and cone beam CT (CBCT), respectively. The images were then compared with simulated images to evaluate the patient's setup and correct for deviations. The setup deviations between the simulated images (kV or CBCT images), were computed from 2D/2D match or 3D/3D match programs, respectively. We then investigated the correctness of the calculated deviations. After the simulation and treatment planning for the RANDO phantom, the phantom was positioned on the treatment table. The phantom setup process was performed with side wall lasers which standardized treatment setup of the phantom with the simulated images, after the establishment of tolerance limits for laser line thickness. After a known translation or rotation angle was applied to the phantom, the kV X-ray images and CBCT images were obtained. Next, 2D/2D match and 3D/3D match with simulation CT images were taken. Lastly, the results were analyzed for accuracy of positional correction. In the case of the 2D/2D match using kV X-ray and simulation images, a setup correction within 0.06 .deg. for rotation only, 1.8 mm for translation only, and 2.1 mm and 0.3 .deg. for both rotation and translation, respectively, was possible. As for the 3D/3D match using CBCT images, a correction within 0.03 .deg. for rotation only, 0.16 mm for translation only, and 1.5 mm for translation and 0.0 .deg. for rotation, respectively, was possible. The use of OBI or CBCT for the on-line IGRT provides the ability to exactly reproduce the simulated images in the setup of a patient in the treatment room. The fast detection and correction of a patient's positional error is possible in two dimensions via kV X-ray images from OBI and in three dimensions via CBCT with a higher accuracy. Consequently, the on-line IGRT represents a promising and reliable treatment procedure

[en] Total body irradiation (TBO or whole body irradiation is used to acquire immune suppression, to treat malignant lymphoma and leukemia, and as an conditioning regimen for bone marrow transplantation. For these purposes, many methods were developed to obtain homogenous dose distribution. The objective of this study was to analyze and confirm the accuracy and the homogeneity of the treatment setup, the parallel opposed lateral technique, currently used in Seoul National University Hospital. Surface dose data, measured with a thermoluminescent dosimeter, of 8 patients among 10 patients, who were given total body irradiation with the parallel opposed lateral technique between September 1996 to August 1998, at Seoul National University Hospital were analyzed. Surface doses were measured at the head, neck, axilla, thigh, and ankle level. Surface and midline doses were measured with similar set-up and technique in the Humanoid phantom. Measured surface doses relative to prescribed dose for the head, neck, axilla, thigh, and ankle level were 91.3±7.8, 98.3±7.5, 95.1±6.3, 98.3±5.5, and 95.3±6.3%, respectively. The midline doses of the head, neck, axilla, thigh, and ankle level estimated from the surface-to-midline ratios in the Humanoid phantom were 1 03.4±9.0, 107.8±10.5, 91.1±6.1, 93.8±4.5, and 104.5±9.3%, respectively. Measured Surface doses and estimated midline doses ranged from -8.9% to +7.8%. Midline doses at the neck and the axilla level deviated more than 5% from the prescribed doses. The difference of the estimated midline doses at the neck and the axilla level and the actual doses were attributed to the thickness differences between the Humanoid phantom and the patients. Distribution of the midline doses as well as the surface doses were measured to be within -8.7 - + 7.8% range. Actual dose distribution in the patient is expected to be better than the measured dose range mainly attributed to thickness difference between the patient and the Humanoid phantom

[en] Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 01 cm. Through the on-line IGRT using cone beam CT, were could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients

[en] Two-dimensional (2D) dose comparisons are widely performed by using a gamma evaluation with patient-specific intensity modulated radiation therapy quality assurance (IMRT QA) or dose delivery quality assurance (DQA). In this way, a pass/fail determination is made for a particular treatment plan. When gamma evaluation results are close to the failure criterion, the pass/fail decision may change applying a small shift to the center of the 2D dose distribution. In this study, we quantitatively evaluated the meaning of such a small relative shift in a 2D dose distribution comparison. In addition, we propose the use of a small shift for a pass/fail criterion in gamma analysis, where the concept of isocenter optimal matching (IOM) is applied to IMRT QA of 20 patients. Gamma evaluations were performed to compare two dose distributions, one with and the other without IOM. In-house software was developed in C++ in order to find IOM values including both translational and rotational shifts. Upon gamma evaluation failure, further investigation was initiated using IOM. In this way, three groups were categorized: group 1 for ‘pass’ on gamma evaluation, group 21 for ‘fail’ on the gamma evaluation and ‘pass’ on the gamma the evaluation with IOM, and group 22 for ‘fail’ on the both gamma evaluations and the IOM calculation. IOM results revealed that some failures could be considered as a ‘pass’. In group 21, 88.98% (fail) of the averaged gamma pass rate changed to 90.45% (pass) when IOM was applied. On average, a ratio of γ ≥ 1 was reduced by 11.06% in 20 patients. We propose that gamma evaluations that do not pass with a rate of 85% to 90% may be augmented with IOM to reveal a potential pass result.

[en] This work reports the atomic layer deposition (ALD) of tin oxide-phosphate films using tetrakis(dimethylamino)tin and trimethyl phosphate as precursors. The growth rates were 1.23–1.84 Å/cycle depending upon the deposition temperature and precursor combination. The ionic conductivity of the ALD tin oxide-phosphate films was evaluated by cross-plane impedance measurements in the temperature range of 50–300 °C under atmospheric air, with the highest conductivity measured as 1.92 × 10"−"5 S cm"−"1 at 300 °C. Furthermore, high-resolution x-ray photoelectron spectroscopy exhibited two O1s peaks that were classified as two subpeaks of hydroxyl ions and oxygen ions, revealing that the quantity of hydroxyl ions in the ALD tin oxide-phosphate films influences their ionic conductivity

[en] Purpose : To estimate the dose to the embryo/fetus of a pregnant patient with brain tumors, and to design an shielding device to keep the embryo/fetus dose under acceptable levels. Materials and Methods : A shielding wall with the dimension of 1.55 m height, 0.9 m width, and 30 mm thickness is fabricated with 4 trolleys under the wall. It is placed between a patient and the treatment head of a linear accelerator to attenuate the leakage radiation effectively from the treatment head, and is placed 1 cm below the lower margin of the treatment field in order to minimize the dose to a patient from the treatment head. An anti-patient scattering neck supporters with 2 cm thick Cerrobend metal is designed to minimize the scattered radiation from the treatment fields and it is divided into 2 section. They are installed around the patient neck by attach from right and left sides. A shielding bridge for anti-room scattered radiation is utilized to place 2 sheets of 3 mm lead plates above the abdomen to setup three detectors under the lead sheets. Humanoid phantom is irradiated with the same treatment parameters, and with and without shielding devices using TLD, and ionization chambers with and without a build-up cap. Results : The dose to the embryo/fetus without shielding was 3.20, 3.21, 1.44, 0.90 cGy at off-field distances of 30, 40, 50, and 60 cm. With shielding, the dose to embryo/fetus was reduced to 0.88, 0.60, 0.35, 0.25, cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy. The dose measured by the survey meter was 10.9 mR/h at the patient's surface of abdomen. The dose to the embryo/fetus was estimated to be about 1 cGy during the entire treatment