양성자 치료에서 Moving Phantom을 이용한 Single Scan PBS와 Layered Rescanning PBS의 선량비교

김경태,김선영,김대웅,김재원,박지연,전상민,Kim, Kyeong Tae,Kim, Seon Yeong,Kim, Dae Woong,Kim, Jae Won,Park, Ji Yeon,Jeon, Sang Min 대한방사선치료학회 2019 대한방사선치료학회지 Vol.31 No.1

목 적: 움직이는 장기에 취약한 Pencil Beam Scanning(PBS)을 보완하기 위해 고안된 Layered Rescanning PBS 기법을 Moving Phantom에 적용하여 Single Scan PBS와 선량비교를 통해 Homogeneity를 비교해 본다. 대상 및 방법: Matrix X(IBA, Belgium)와 Moving Phantom(standard imaging, USA)을 이용하였다. 가상의 tumor $10{\times}10{\times}5cm$에 AP 방향에서 200 cGy의 선량을 조사하였다. 치료계획은 single scan PBS, rescan 4, 8, 12회 총 4가지로 하였고 각 치료계획별로 3번씩 반복 측정하였다. 측정 시 Moving Phantom의 호흡주기는 한 cycle당 4초로 설정 후 S-I 방향 움직임 2 cm으로 설정하였다. 추가로 beam on time을 측정하였다. 결 과: PTV 내에서 $D_{max}$의 평균값은 single scan, 4, 8, 12회 rescan 순서로 각각 $246.47{\pm}18.8cGy$, $223.43{\pm}8.92cGy$, $222.47{\pm}7.7cGy$, $213.9{\pm}6.11cGy$ $D_{min}$의 평균값은 각각 $165.53{\pm}4.32cGy$, $173.13{\pm}11.94cGy$, $184.13{\pm}8.04cGy$, $182.67{\pm}4.38cGy$으로 $D_{mean}$ $192.77{\pm}6.98cGy$, $196.7{\pm}4.01cGy$, $198.17{\pm}4.96cGy$, $195.77{\pm}3.15cGy$으로 측정되었다. 그리고 rescan 횟수가 늘어날수록 Homogeneity Index가 1에 가까워졌으며, beam on time은 평균 2분 15초, 3분 15초, 4분 30초, 5분 37초로 rescan 횟수가 증가할수록 치료시간이 증가되었다. 측정하는 과정에서 MU가 낮은 선량 layer에서는 설정한 rescan 횟수만큼 실제로 rescan하지 못하는 문제점이 발견되었다. 결 론: 장기 움직임이 있는 종양 치료 시 Layered Rescanning PBS을 적용했을 때 single scan PBS보다 균일한 선량분포를 확인할 수 있었다. 그리고 rescan 횟수가 증가할수록 균일한 선량분포를 보였다. single scan PBS와 12회 Layered rescanning 비교 시 HI 수치가 0.32 향상되었다. 추후 연구를 통하여 호흡동조 방사선치료가 불가능환자에게 적용이 가능할 것으로 사료된다. Purpose : We apply the Layered Rescanning PBS designed to complement the Pencil Beam Scanning(PBS), which is vulnerable to moving organs with the Moving Phantom, and compare the homogeneity with the single scan PBS. Methods and materials: Matrix X (IBA, Belgium) and Moving Phantom (standard imaging, USA) were used. A dose of 200 cGy was measured in the AP direction on a hypothetical tumor $10{\times}10{\times}5cm$. The plan type was planned as 4 kinds of sinlge scan PBS, rescan number 4, 8, 12 times. Were measured three times for each types. During the measurement, the respiratory cycle of the Moving Phantom was generally set to 4 seconds per cycle, and the movement radius in the S-I direction was set to 2 cm. In addition, beam on time was measured. Results : The mean values of $D_{max}$ in the PTV were $246.47{\pm}18.8cGy$, $223.43{\pm}8.92cGy$, and $222.47{\pm}7.7cGy$, $213.9{\pm}6.11cGy$ and the mean values of $D_{min}$ were $165.53{\pm}4.32cGy$, $173.13{\pm}11.94cGy$, $184.13{\pm}8.04cGy$, $182.67{\pm}4.38cGy$ and the mean values of $D_{mean}$ $192.77{\pm}6.98cGy$, $196.7{\pm}4.01cGy$, $198.17{\pm}4.96cGy$, $195.77{\pm}3.15cGy$ respectively. As the number of rescanning increased, the Homogeneity Index converged to 1. The beam on time was measured as 2:15, 3:15, 4:30, 5:37 on average. In the measurement process, in the low dose layer of the MU, the problem was found that it was not rescanned as many times as the set number of rescan. Conclusions : In the treatment of tumors with long-term movements, the application of layered rescanning PBS showed a more uniform dose distribution than single scan PBS. And as the number of rescan increase, the distribution of homogeneity is uniform. Compared with single scan plan and 12 rescan plan, HI value was improved by 0.32. Further studies are expected to be applicable to patients who can not be treated with respiratory synchronous radiation therapy.

타의 종류에 따른 컨테이너선의 조종성능 특성 연구

김연규(Yeon-Gyu Kim),김선영(Sun-Young Kim),김성표(Sung-Pyo Kim),이석원(Suk-Won Lee) 대한조선학회 2004 大韓造船學會 論文集 Vol.41 No.5

대학신입생들의 구강상태 인식도와 상대구강진료필요도에 관한 상관관계 조사연구

원상연,신승철,김선영 ( Sang Yeon Won,Seung Chul Shin,Sun Young Kim ) 대한예방치과·구강보건학회 1997 大韓口腔保健學會誌 Vol.21 No.3

2기 직장암의 예후인자

황보현 ( Bo Hyun Hwang ),박지원 ( Ji Won Park ),박성찬 ( Sung Chan Park ),김선영 ( Sun Young Kim ),백지연 ( Ji Yeon Baek ),김대용 ( Dae Yong Kim ),장희진 ( Hee Jin Chang ),최효성 ( Hyo Sung Choi ),오재환 ( Jae Hwan Oh ) 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2

목적: 2기 직장암에 있어서 근치적 수술 후 보조 치료의 유용성에 대해서는 의견이 분분하다. 본 연구에서는 2기 직장암의 예후인자를 분석해보고자 하였다. 방법: 2000년 10월부터 2008년 12월까지 국립암센터에서 수술을 받은 총 200명의 2기 직장암 환자를 대상으로 하였다. 단변량 및 다변량 분석을 이용하여 생존율 분석을 하였으며 이를 근거로 2기 직장암 환자의 예후인자를 예측해보고자 하였다. 결과: 2기 직장암에서 5년 생존율과 5년 무병 생존율은 각각 89.2%, 89.0% 였다. 다변량 분석을 하였을 때 5년 생존율에 영향을 주는 예후 인자는 측방절제연의 침범이었고 5년 무병 생존율의 경우 나쁜 분화도와 측방절제연의 침범이 통계적으로 유의하였다. 결론: 측방절제연의 침범 여부가 5년 생존율의 독립적인 예후인자였고 암종의 분화도와 측방절제연의 침범 여부가 2기 직장암의 5년 무병 생존율에 있어서 독립적인 예후인자였다. Background: In stage II rectal cancer, it has remained controversial whether patients get the benefit from adjuvant treatment after curative resection. The aim of this study is to evaluate the prognostic factors of stage II rectal cancer. Methods: From October 2000 to December 2008, 200 patients with stage II rectal cancer underwent surgery at National Cancer Center. Univariate and multivariate survival analyses were performed to determine the prognostic factors in stage II rectal cancer. Results: In stage II rectal cancer, 5-year overall survival and disease free survival were 89.2% and 89.0%, respectively. For overall survival, there was no significant prognostic factor in multivariable analysis. For disease-free survival, tumor differentiation and circumferential resection margin were significant prognostic factors in multivariable analysis. Conclusion: Tumor differentiation and circumference resection margin are independent prognostic factors in disease free survival of stage II rectal cancer. Adjuvant treatment may be considered in patients with these factors.

대학 신입생들의 구강상태 인식도와 상대구강진료필요도에 관한 상관관계 조사연구

원상연,신승철,김선영 단국대학교 치과대학 예방치과 1997 예방치과 세미나집 Vol.- No.11

The purpose of this study was to determine the correlation between the awareness and the status of their won oral diseases. A questionnaire survey form was designed to determine the awareness of their won oral diseases and asked aoo of the university freshmen students to fill out the all of questionaries. They were then immediately examined for을 새 determine their status of dental hard tissures by using the WHO criteria. Also determined were the CPITN and the needs for orthodontic as well as prosthodontic treatments. The results were then statistically analyzed to determine the correlation coefficiencies between the awareness and the status of oral diseases by using SPSS statistical package. The results suggested the followings; 1. The correlation coefficiencies between the awareness and the status for number of teeth decayed, missed, and indicated for extractions were 0.18, 0.06 and 0.09 respectively. 2. The correlation coefficiency between the awareness and the status in treated teeth(F component) and CPITN were 0.622 and 0.10 respectively. 3. the agreement between examiners and examinees on the needs for prosthodontic treatments was 87.31% and their sensitivity and specificity were 47.54% and 88.55% respectively. 4. the agreement between examiners and examinees on the needs for orthodontic treatment was 70.40% and their sensitivity and specificity were 77.27% and 60.71% respectively. Data indicate that a majority of respondents are lacking in the awareness of their own oral disease status. Therefore, it is concluded that a regular oral examination, a regular counselling on oral health status as well as specific oral health education for each individual warranted.

대학신입생들의 구강상태 인식도와 상대구강진료필요도에 관한 상관관계 조사연구

원상연,신승철,김선영 단국대학교 치과대학 예방치과 1998 예방치과 세미나집 Vol.- No.12

The purpose of this study was to detemine toe correlation between the awareness and the status of their won oral diseases. A questionnaire survey form was desinged to determine the awareness of their won oral diseases and asked aoo of the university freshmen students to fill out the al of questionaries. They were then immediately examined for을 새 determine their status of dental hard tissures by using the WHO criteria. Also determined were the CPITN and the needs for orthodontic as well as prosthodontic treatments. The results were then statistically analyzed to determine the correlation coefficiencies between the awareness and the status of oral diseases by using SPSS statistical package. The results suggested the followings; 1. The correlation coefficiencies between the awareness and the status for number of teeth decayed, missed, and indicated for extractions were 0.18, 0.06 and 0.09 respectively. 2. The correlationg coefficiency between the awareness and the status in treated teeth(F component) and CPITN were 0.622 and 0.10 respectively. 3. The agreement between examiners and examiners on the needs for prosthodontic treatments was 87.31% and their sensitivity and specificity were 47.54% and 88.55% respectively. 4. The agreement between examiners and examinees on the needs for orthodontic treatment was 70.40% and their sensitivity and specificity were 77.27% and 69.71% respectively. Data indicate that a majority of respondents are lacking in the awareness of their own oral disease status. Therefore, it is concluded that a regular oral examination, a regular counselling on oral health status as well as specific oral health education for each individual warranted.