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Development and Thermal Distribution of An RF Capacitive Heating Device.

Sung Sil CHU ; Chang Ok SUH ; Gwi Eon KIM ; John Kyu LOH ; Byung Soo KIM

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):49-58.

Hypertermia for the treatment of cancer has been introduced for a long time and the biological effect for the use of hyperthermia to treat malignant tumors has been well established and encouraging clinical results have been obserbed. Unfortunately, however, the engineering or technical aspects of hyperthermia for the deep seated tumors has not been satisfactory. We developed the radiofrequency capactive hyperthermia device (Greenytherm-GY8) in cooperation with Yonsei Cancer Center and Green Cross Medical Corporation. It was composed with 8~10 MHz RF generator, capacitive electrode, matching system, cooling system, temperature measuring system and control PC computer. The thermal profile was investigated in agar phantom, animals and in human tumors, heated with capactivie RF device. Deep and homogeneous heating could be achieved in a large phantom of 25 cm diameter and 19 cm thick when heated with a pair of 23 cm diameter electrodes, coupled to both bases of the phantom, when the size of the two electrodes was not the same, the region near the smaller electrode was preferentially heated. It was, therefore, possible to control the depth of heating by choosing proper size of electrodes. Therapeutic temperature (42degree C~43degree C) could be obtained in the living animal experiments. Indications are that deep heating of human tumors might be achieved with the capacitive method, provided that subcutaneous fat layer is cooled by temperature controlled bolus and large size of electrodes.
Agar ; Animal Experimentation ; Animals ; Electrodes ; Fever ; Heating* ; Hot Temperature* ; Humans ; Subcutaneous Fat

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Primary Malignant Melanoma of the Cervical Spinal Cord: Case Report.

Chyl Yong KIM ; Myung Sun CHOI

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):43-48.

Primary malignant melanom of the spinal cord is extremely rare. The best treatment appears to be total surgical excision, when possible and postoperative irradiation, but the value of radiotherapy is unknown because the number of cases that have been irradiated postoperatively is small. The 2-year survival rate for primary malignant melanoma of the spinal cord is usually less than 16% and most patients died within 1 year. The prognosis of this tumor is poor.
Humans ; Melanoma* ; Prognosis ; Radiotherapy ; Spinal Cord* ; Survival Rate

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Angiofollicular Lymph Node Hyperplasia(=Castleman's Disease): Report of A Case.

Hak Jun GIL ; Yoon Kyung OH ; Sei Chul YOON ; Kyung Sub SHINN ; Yong Whee BAHK

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):37-42.

Angiofollicular lymph node hyperplasia (AFLNH) with well marginated lymphoid masses, is a rare benign disease of unknown etiology. The majority of the disease develop intrathoracically. Histologically this disease can be divided into the hyaline-vascular and the plasma cell types with the hyaline-vascular type prevailing. The plasma cell variant has been associated with nephritic syndrome, anemia, growth failure, fever, hyperglobulinemia, peripheral neuropathy, and hypoalbuminemia. Surgical resection is known to be treatment of choice in most cases, and radiotherapy is reserved for advanced, unresectable lesions. We report a complete remission of AFLNH in a case treated by surgical excision followed by irradiation.
Anemia ; Fever ; Giant Lymph Node Hyperplasia ; Hypoalbuminemia ; Lymph Nodes* ; Peripheral Nervous System Diseases ; Plasma Cells ; Radiotherapy

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Effect of Microwave Hyperthermia on Radiotherapy of Human Mailignant Tumors: An Analysis of Clinicl Response of 42 Patients.

Sei Chul YOON ; Yoon Kyung OHO ; Hak Jun GIL ; Su Mi CHUNG ; Kyung Sub SHINN ; Yong Whee BAHK

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):31-36.

Radiobiological and clinical evidences indicate that hyperthermia combined with ionizing radiation produces a significant improvement in therapeutic effect of cancer. In general, malignant cells are more sensitive to heat than normal cells in the heat range of 41~45degree C. We report the experiences obtained from 42 patients with advanced malignant neoplasms managed with 2,450 MHz microwave-induced local hyperthermia and ionizing radiation at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A clinical analysis of 42 thermoirradiated patients showed result of 11(26%), 15(36%), 11(26%) and 5(12%) patients with complete response (CR), partial response (PR), minor response (MR) and no response (NR), respectively. Histologically, there were 17 (40.2%) squamous cell carcinomas, 12(28.6%) adenocarcinomas and 6 (14.3%) miscellaneous cancers. Eleven patients with CR consisted of five squamous cell carcinomas, five adenocarcinomas, and one chloroma. Among 15 patients with PR were five squamous cell carcinomas, five adenocarcinomas, three unknown primary tumors, and one poorly differentiated, and miscellaneous tumor each.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Fever* ; Hot Temperature ; Humans* ; Hyperthermia, Induced ; Microwaves* ; Neoplasms, Unknown Primary ; Radiation, Ionizing ; Radiotherapy* ; Sarcoma, Myeloid

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Combined Surgery and Radiotherapy in the Stage I and II Primary Gastrointestinal Non-Hodgkin's Lymphomas.

Kyoo Yung CHAI ; Il Han KIM ; Sung Whan HA ; Charn Il PARK ; Kuk Jin CHOE ; Jin Pok KIM

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):23-30.

Thirty eight patients with stage Iand II primary gastrointestinal non-Hodgkin's lymphoma were treated in the Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1984. There were 6 systemic disseminations during radiotherapy, and the overall failure rate were 31% in the cases with tumor bulk less than 5 cm in diameter before radiotherapy and 75% in the cases with tumor bulk greater than 5 cm in diameter (p<0.05). The overall 5 year survival rate were 69.2% in 28 patients who completed radiotherapay and 72% in 24 patients with tumor bulk less than 5 cm in diameter (small or no tumor bulk). The 5 year disease free survival rate were 71% in cases with tumor bulk less than 5 cm in diameter and 25% in cases with tumor bulk greater than 5 cm in diameter (p<0.01). But the initial stage was not related with treatment result in all cases or subgroups of cases. Thus the cases with small or no tumor bulk were shown to be curable with combined surgery and postoperative radiotherapy, but for the control of the cases with large tumor bulk that had a guarded prognosis combined radiotherapy and chemotherapy should be tried.
Disease-Free Survival ; Drug Therapy ; Humans ; Lymphoma, Non-Hodgkin* ; Prognosis ; Radiation Oncology ; Radiotherapy* ; Seoul ; Survival Rate

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The Effect of Hyperthermia Combined with Radiation on Crypts of the Mouse Jejunum.

Hoon Sik BAE ; Charn Il PARK ; Jung Jin KIM

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):13-22.

The effect of local hyperthermia of 41 to 43degree C for 30 minutes on radiosensitivity of normal tissue was studied utilizing jejunal crypt microcolony assay. Hyperthermia of this range enhanced the radiation effect and the effect was mainly additive without significant effect on the slopes of cell survival curves. At the isoeffect level of 20 microcolony formation, the thermal enhancement ratio was 1.02, 1.10 and 1.39 for 41degree 42degreeand 43degree C, respectively. The distribution of microcolony formation along the circumference of jejunum was not uniform, having more colonies around the mesenteric border, and this suggests the effect of uneven cooling by blood circulation.
Animals ; Blood Circulation ; Cell Survival ; Fever* ; Hyperthermia, Induced ; Jejunum* ; Mice* ; Radiation Effects ; Radiation Tolerance

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Early and Late Effect of External Abdominal Irradiation on Small Intestine of Mice at various Total Dose and Intervals: Histopathologic Aspects of Damage and Recovery.

Myung Se KIM ; Won Hee CHOI

Journal of the Korean Society for Therapeutic Radiology.1987;5(1):1-12.

Total 396 mice were irradiated with 2' cm abdominal field and 200'/wk regimen with orthovoltage x-ray machine. All animals were divided into 2 large groups, damage and recovery, and histopathologic changes were analyzed at various total dose level (1,000 cCy-5,000 cCy) and intervals (1 week-15 weeks). Almost acute changes such as decreased mitotic activity, villi shortening and focal erosion of mucosa recovered within 1-2 weeks in 1,000-3,000 cGy irradiated group but mild changes persisted in 4,000 and 5,000 cCy irradiated groups. Chronic delayed changes such as thickening of vessel wall with focal thrombosis, submucosal fibrosis, mucosal atrophy and chronic ulcer were observed from 2-3 week specimens in 4,000 and 5,000 cGy groups. These late changes recovered slightly, as increasing time intervals after irradiation but mild, persistant changes were observed throught all follow up period. These data suggest hat even 4,000 cCy is not completely safe for possible permanent damage and judicious modificiation of total dose, dose rate, fraction size, and field size should be considered for better results.
Animals ; Atrophy ; Fibrosis ; Follow-Up Studies ; Intestine, Small* ; Mice* ; Mucous Membrane ; Thrombosis ; Ulcer

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Hypothyroidism Following Surgery and Radiation Therapy for Head and Neck Cancer.

In Kyu PARK ; Jae Cheol KIM

Journal of the Korean Society for Therapeutic Radiology.1997;15(3):225-232.

PURPOSE: Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer. We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. MATERIALS AND METHODS: From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy. The follow-up duration was 3 to 80 months. RESULTS: The overall incidence of hypothyroidism was 56.3% (40/71); 7 out of 71 patients (9.9%) developed clinical hypothyroidism and 33 patients (46.4%) developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P= 0.0000). Four of 26 patients (15.4%) with neck dissection alone developed hypothyroidism while 36 of 45 patients (80%) with laryngectomy and neck dissection developed hypothyroidism. CONCLUSION: The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced the incidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.
Female ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Hormone Replacement Therapy ; Humans ; Hyperthyroidism ; Hypopharynx ; Hypothyroidism* ; Incidence ; Laryngectomy ; Larynx ; Male ; Maxillary Sinus ; Mouth ; Neck ; Neck Dissection ; Oropharynx ; Prospective Studies ; Risk Factors ; Salivary Glands ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Nodule

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Results of Stereotactic Radiosurgery with Linear Accelerator for Intracranial Arteriovenous Malformation.

Kang Kyoo LEE ; Kyung Ran PARK ; Jong Young LEE ; Yong Ha LEE

Journal of the Korean Society for Therapeutic Radiology.1997;15(3):215-224.

PURPOSE: Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM). We present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. MATERIALS AND METHODS: From January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a single fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. RESULTS: Angiography was available in 13 patients with a follow-up period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. CONCLUSION: We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.
Angiography ; Arteriovenous Malformations ; Brain Edema ; Edema ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Incidence ; Intracranial Arteriovenous Malformations* ; Neurologic Manifestations ; Particle Accelerators* ; Radiosurgery* ; Seizures

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Radiation Therapy of Intracranial Germinoma.

Young Ju NHO ; Hyesook CHANG ; Eun Kyung CHOI ; Jong Hoon KIM

Journal of the Korean Society for Therapeutic Radiology.1997;15(3):207-214.

PURPOSE: Intracranial germinoma is the most radiocurable tumor of the primary intracranial neoplasm. But, the optimum radiation dose and target volume remain controversial. In this retrospective study, we analysed the spreading pattern at presentation and the pattern of the failure and survival of intracranial germinoma. MATERIALS AND METHODS: From 1989 to 1996, 23 patients were treated for intracranial germinoma at Department of Radiation Oncology. Twenty-one patients were treated at their initial presentation and 2 patients were treated for recurrent disease. Six patients had multiple tumor masses on MRI and 7 patients had ventricular seeding on MRI. The examination of cerebrospinal fluid cytology was done in 15 patients and 3 out of 15 patients had positive cerebrospinal cytology. In tumor marker study of alpha-FP and beta-hCG, 6 patients had mildly elevated beta-hCG in serum or cerebrospinal fluid. Twenty-one patients were treated with whole craniospinal axis irradiation and 2 patients were given whole ventricular radiation therapy. The total dose was ranged between 4500cGy and 5600cGy to primary tumor site (median 5580 cGy). Dose to the entire ventricular system ranged from 1980cGy to 3960 cGy (median 2700cGy) and dose to the spinal axis ranged from 2160cGy to 3900cGy (median 2700cGy). RESULTS: Of 23 patients, 21 patients are alive without evidence of disease for median 4 years follow-up. One patient who had markedly elevated alpha-FP and beta-hCG suffered from persistent disease after radiation therapy and received 2 cycles of chemotherapy. She died 9 months after chemotherapy. One patient who developed ventricular seeding after gamma-knife was treated with whole craniospinal irradiation, he died after 1 year due to probably brain necrosis. The hematologic toxicity of 3 or 4 grade were seen in 7 patients, and patient's endocrinologic dysfunction was not deteriorated after radiation therapy. One patient had been treated with growth hormone replacement due to short stature. CONCLUSIONS: This retrospective study has confirmed the excellent result of radiation therapy in intracranial germinoma. The complication rate during or after radiation therapy is considered within acceptable range. It is necessary to further investigate the optimal dose and treatment volume of radiation therapy. The role of chemotherapy in the treatment of intracranial germinoma should be further investigated.
Axis, Cervical Vertebra ; Brain ; Brain Neoplasms ; Cerebrospinal Fluid ; Craniospinal Irradiation ; Drug Therapy ; Follow-Up Studies ; Germinoma* ; Growth Hormone ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Radiation Oncology ; Retrospective Studies

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