New Fiduciary Plate and Orientation Marker forHigh Energy Radiation Therapy

우홍균,허순녕,김학재 대한방사선종양학회 2004 대한방사선종양학회지 Vol.22 No.1

Purpose: A new fiduciary plate and orientation marker have been devised to assist the quality assurance (QA) procedures for port films in radiation therapy department. The plate is used in conjunction with the film/cassette combination during weekly QA procedures, at Seoul National University Hospital (SNUH), in order to verify treatment fields in high energy radiation therapy. Materials and Methods: A new fiduciary plate was fabricated using an acrylic plate, cerrobend, standard blocking tray and mercury. The acrylic plate had the dimension of 1×25×25 cm, with two fiduciary markers. The plate was rigidly attached onto the standard blocking tray, thus making it easier to set the fiduciary plate to the center of the radiation field of the linear accelerator. The plate had two 2-mm vertical and horizontal lines, with the minor scales in 2-cm steps. The orientation marker was a small mercury filled disk, which was inserted into the plate. Results: The geometrical structure of the lines in the plate makes it easier to correlate two different images between the simulation and port films. The marker clearly indicated the orientation of the film, for example, the anterior, posterior, left, right and various oblique orientations, without the placement of a conventional orientation marker. Also, the new orientation marker could easily be applied to the simulator by placing the small orientation marker onto the image intensifier or in front of the film/cassette holder. Conclusions: The new fiduciary plate appears to be useful in verifying the treatment fields, and the new orientation marker makes the film orientation simple, which is expected to lower the block fabrication errors. 목 적: 선형가속기를 이용한 방사선 치료시 치료부위의 확인을 위한 하나의 방법으로 port film이 사용되고 있다. 서울대학병원에서는 port film 촬영 시 기계적 변수를 port film상에 나타내기 위하여 방향성 표시기(orientation marker)를 갖는 fiduciary plate를 개발하였다. 대상 및 방법: Fiduciary plate의 제작에는 아크릴 plate와 cerrobend, 수은이 사용되었다. 아크릴 plate의 크기는 1 cm×25 cm×25 cm로 그 내부에 두 개의 방향성 표시기가 내재되었고, 선형가속기의 blocking tray slot에 삽입이 가능하도록 제작되었다. Plate 내부에는 2 cm 간격으로 2 mm 두께의 수평과 수직으로 만들어진 cerrobend line이 위치해 있고, 방향성 표시기 내부에는 수은으로 채워져 있다. 결 과: 아크릴 plate의 cerrobend line은 simulation films과 port films간의 치료 영역의 비교를 용이하게 한다. 수은을 이용하여 만들어진 방향성 표시기는 납으로 만들어진 일반적인 표시기가 없이도 전후좌우와 다양한 각도로 경사진 방향을 구분할 수 있게 한다. 또한 방향성 표시기는 film/cassette holder에 부착함으로써 simulation 시에도 이용될 수 있다. 결 론: Fiduciary plate는 치료 영역 확인에 유용하고, 수은을 이용한 방향성 표시기내의 혼합액의 기하학적인 모양에 따라 port film의 촬영 parameter를 용이하게 파악할 수 있어 치료과정에서 촬영한 port film 간의 임상정도관리에 유용한 방법이 될 수 있다.

식도암의 방사선치료 성적 - 장기 추적관찰의 결과

우홍균,박석원,박찬일,Wu Hong-Gyun,Park Suk-Won,Park Charn-Il 대한방사선종양학회 1998 대한방사선종양학회지 Vol.16 No.4

Purpose : 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. Methods and Materials : From June of 1979 through December 1992, 289 patients with esophageal carcinoma were treated 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 s1aging system, there were 2 patients with stage 1, 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. Results : The Median survival period of all the patients was II 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. Conclusion : We could get 10.2$\%$ of 5 year survival rate and 5.3$\%$ of 10 year survival rate with radiation therapy alone. The size of tumor and N-stage were statistically significant prognostic factors for survival on multivariate analyses.

심박조율기를 장착한 환자에서의 방사선치료 -증례 보고 -

우홍균,김보경,강위생,박진흥,Wu Hong-Gyun,Kim Bo-Kyoung,Kang Wee-Saeng,Park Jin Hong 대한방사선종양학회 2000 대한방사선종양학회지 Vol.18 No.1

A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.

후각신경아세포종의 치료 및 결과

우홍균,김일한,Wu Hong-Gyun,Kim Il Han 대한방사선종양학회 2000 대한방사선종양학회지 Vol.18 No.3

Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.

Salivary Gland Cancer - Advances in the Radiation Therapy

우홍균 대한두경부종양학회 2004 대한두경부종양학회 학술대회 논문집 Vol.2004 No.1

Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma

우홍균,박찬일,하성환,김일한,Wu Hong-Gyun,Park Chan Il,Ha Sung Whan,Kim Il Han The Korean Society for Radiation Oncology 1999 대한방사선종양학회지 Vol.17 No.2

Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

Evaluating Ice Nucleation Ability (INA) of Cellulose for Cloud Seeding Using Droplet Freezing Method

우홍균,이혜미,김정규,박성민,엄준식,이재준 한국고분자학회 2025 한국고분자학회 학술대회 연구논문 초록집 Vol.50 No.1

설암의 방사선치료

우홍균 대한두경부종양학회 2007 대한두경부종양학회 학술대회 논문집 Vol.2007 No.1

Signifcance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Eso phageal Carcinoma

우홍균(Hong-Gyun Wu),박찬일(Charn Il Park),하성환(Sung Whan Ha),김일한(Il Han Kim) 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.2

목 적 : 1997년에 개정된 AJCC 병기분류법에 의하면 흉부식도암의 쇄골상림프절전이는 원격전이로 분류된다. 연구자들은 다른 국소림프절전이와 쇄골상림프절전이의 임상적 양상의 차이에 대하여 연구하였다. 대상 및 방법 : 1979년 6월부터 1992년 12월 사이에 임상적으로 절제가 불가능한 식도암 환자 289명이 방사선치료를 받았다. 이 중 25명의 환자에서 쇄골상림프절전이가 관찰되었다. 쇄골상림프절의 임상적 중요성을 평가하기 위하여, 국소림프절전이 환자와 생존율 및 재발양상에 대한 결과를 비교 분석하였다. 결 과 : 쇄골상림프절전이 환자의 생존중앙치는 7개월이었으며 2년 및 5년 생존율은 각각 12.0% 및 4.0% 였다. 국소림프절전이 환자에서는 9개월, 17.0% 및 3.8% 였다. 두 군 사이에 통계적 유의성은 관찰할 수 없었다. 또한 재발양상에 있어서도 두 군 사이에 차이가 없었다. 결 론 : 본 연구의 결과 흉부식도에서 발생한 식도암에서 쇄골상림프절로의 전이는 현재의 분류인 원격전이이기 보다는 국소림프절전이로 분류되어야 할 것이며, 향후 이에 대한 다기관공동연구가 필요할 것이다. Background and Purpose : Involvement of supraclavicular lymph nodes (SCL) is considered distant metastas is for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional lymph node involvement. Materials and Methods :Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients , 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric lymph node pos itive patients to evaluate prognostic s ignificance of SCL involvement. Res ults :Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0% and 4.0% respectably. Corresponding features for regional node positive patients were 9 month, 17.0% and 3.8%. There was no s ignificant difference between two groups. There was also no difference in patterns of recurrence . Conclusion : Results of this analys is showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

방사선 조사에 의한 세포사에 있어서 세포고사의 의미

우홍균(HG Wu),김일한(IH Kim) 대한방사선종양학회 2001 대한방사선종양학회지 Vol.19 No.3

목 적 :사람의 두경부종양 세포주를 대상으로 방사선 조사 후에 일어나는 아포토시스를 측정하여 전체 세포사에서의 중요성 및 방사선감수성과의 관련성을 알아보고자 하였다. 대상 및 방법 :방사선치료가 주 치료방법인 두경부종양 세포주(PCI- 1, PCI- 13, SNU- 1066)와 정상세포 중 섬유모세포 세포주(LM217), 혈액종양 세포주 중 백혈병 세포주(CCRF-CEM)를 대상으로 하였다. 방사선 조사는 동물실험용 Cs- 137 방사선조사기를 사용하였다. 전체 세포사는 집락형성능측정을 이용하였고, 아포토시스의 측정은 annexin-V와 propidium iodide를 이용하는 염색법을 사용하였다. 결 과 :2 Gy 방사선 조사 시의 생존분획인 SF2는 PCI- 1, PCI- 13, SNU- 1066, CCRF-CEM, LM217 세포주에서 각각 0.741, 0.544, 0.313, 0.302, 0.100으로, LM217 세포주가 방사선감수성이 가장 높았고 PCI- 1 세포주의 방사선감수성이 가장 낮았다. 두경부암 세포주인 PCI- 1, PCI- 13, SNU- 1066에서는 모두 72시간이 경과한 후 아포토시스지수가 최대치 에 도달하였으며, LM217과 CCRF-CEM에서는 24시간 후에 최대치에 도달하였다. 방사선량의 증가에 따라서 전체세포사는 현저하게 증가하였으나 아포토시스지수의 변화는 매우 작았다. 전체 세포사에 대한 아포토시스의 분획(아포토시스분획)은 2 Gy 조사 시 PCI- 1, PCI- 13, SNU- 1066, CCRF-CEM, LM217에서 각각 46%, 48%, 46%, 24%, 19%이었고, 6 Gy 조사 시 각각 20%, 33%, 35%, 17%, 20%이었다. 아포토시스의 정도와 6 Gy 조사 시의 방사선 감수성과는 일정한 관계를 보이지 않았으나, 2 Gy 조사 시 방사선에 감수성이 비교적 높은 세포주가 아포토시스분획이 작았다. 결 론 :본 연구에서 사용한 두경부암세포주에서 방사선 조사 후 아포토시스가 관찰되었으며, 발생 양상이 시간적으로 정상 섬유모세포 및 백혈병세포주와 다른 것을 확인하였다. 또한 아포토시스보다는 다른 종류의 세포사인 증식사가 더 중요하게 작용하고 있음을 알 수 있었다. 아포토시스분획과 2 Gy 조사 시 방사선감수성 사이에 관련 가능성이 제시되었다. Purpose : The objectives of this study are to investigate the significance of apoptotic death compared to total cell death after γ- ray irradiation in human H&N cancer cell lines and to find out correlation between apoptos is and radiation sensitivity. Materials and method : Head and neck cancer cell lines (PCI- 1, PCI- 13, and SNU- 1066), leukemia cell line (CCRF- CEM), and fibroblast cell line (LM217) as a normal control were used for this study. Cells were irradiated us ing Cs- 137 animal experiment irradiator. Total cell death was measured by clonogenic assay. Annexin-V staining was used to detect the fraction of apoptotic death. Results : Surviving fraction at 2 Gy (SF2) were 0.741, 0.544, 0.313, 0.302, and 0.100 for PCI- 1, PCI- 13, SNU- 1066, CCRF- CEM, and LM217 cell lines , respectively. Apoptos is was detected in all cell lines. Apoptotic index reached peak value at 72 hours after irradiation in head and neck cancer cell lines , and that was at 24 hours in CCRF-CEM and LM217. Total cell death increased exponentially with increasing radiation dose from 0 Gy to 8 Gy, but the change was minimal in apoptotic index. Apoptotic fractions at 2 Gy were 46%, 48%, 46%, 24%, and 19% and at 6 Gy were 20%, 33%, 35%, 17%, and 20% for PCI-1, PCI- 13, SNU- 1066, CCRF- CEM, and LM217, respectively. The radiores istant cell lines showed more higher apoptotic fraction at 2 Gy, but there was not such correlation at 6 Gy. Conclusion :All cell lines used in this study showed a poptos is after irradiation, but time course of apoptos is was different from that of leukemia cell line and normal fibroblast cell line. Reproductive cell death was more importa nt mode of cell death than apoptotic death in all cell lines used in this study. But there was correlation between apoptotic fraction and radiation sens itivity at 2 Gy.