OBJECTIVE: It is to find the optimum beam angle by comparing the proper directional beam angle with various methods at time of treatment plan of stereotactic spinal radiation therapy. Also, it is to increase the therapy efficiency of spinal stereotactic body radiation therapy (SBRT) by providing the optimal target coverage through the therapy plan establishing various kinds of direction of beams and by decreasing the integral dose. METHODS: The object patients of treatment plan in this study have targeted 10 persons of thoracic spine bone metastasis patients. The treatment plan of prescription dose with 3 fraction of each 8 Gy has been established, it has been normalized so that it may be D95=2,400 cGy. Total 4 groups of treatment plan: the physical factor has been compared for the part for the target and the critical organ by establishing the treatment plan respectively in intensity-modulated radiation therapy (IMRT) and RapidArc therapy in (1) 1 group of IMRT (9 pieces of beam at 40 degrees equispaced angle intervals), (2) 2 groups of IMRT (9 pieces of half beam of non-equispaced angle), (3) arc 1 group (full arc), (4) arc 2 groups (half 2 arc) and eclipse planning (ver. 8.9). The physical factor for the target has been analyzed for the target coverage, maximum dose, minimum dose, maximum dose/prescribed dose (MD/PD). The maximum dose, mean dose, dose by each volume, and therapy time have been compared and analyzed for the spinal cord and esophagus adjacent to the target. RESULTS: The maximum dose of patients group of IMRT 1 group has appeared lower by 15% compared with the full arc and half arc plan as the analysis result of therapy plan for the object patients of thoracic spine. There has been no big difference in maximum dose of IMRT 1 group and 2 group. The full arc plan of conformity index showed the best result with the average 1.06, half arc plan of conformity index showed the highest result value with the average 1.15. Half arc plan of MD/PD showed the best value with the average 1.12. The half IMRT in D1 of planning target volumes showed the lowest value with the average 2,605 cGy; it showed the difference from the average from as small as 1% to as big as 11% as the comparison result with other groups. The plan of IMRT group of non-equispaced angle in D99 (cGy) showed the best value with the average 2,287.56 cGy. The IMRT of non-equispaced angle in Dmax of spinal cord showed the lowest with the average 1,779.9 cGy, D0.1cc and D1cc as well showed the lowest value with the average 1,605.19 cGy and 1,272.63 cGy. The IMRT plan of non-equispaced angle in throat showed the lowest value. The full arc (2 arc) of equispaced angle in therapy time was the shortest with 3.54 minutes, full IMRT of equispaced angle showed the longest time with the average 8.08 minutes. CONCLUSION: The treatment plan for IMRT of non-equispaced angle showed all good value in the target and critical organ as the analysis result of proper beam angle according to the respective therapy technique at time of treatment plan of spinal SBRT. It could find that the good therapy plan satisfactory to all target and critical organ at time of using the beam between 80 degrees and 280 degrees.
Esophagus ; Humans ; Neoplasm Metastasis ; Pharynx ; Planning Techniques* ; Prescriptions ; Spinal Cord ; Spine

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.
Disaster Medicine ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medicine ; Humans ; Military Medicine ; Mortality ; Triage