ANALYSIS OF SUBJECTIVE WELL-BEING IN THE CONTEXT OF HUMAN DEVELOPMENT APPROACH

Conventionally, GDP or GNP is considered as a measure of well-being of a country. In spite of their simplicity and objectivity, voices are raised against these income-based measures on the ground that human well-being is primarily subjective in nature. According to human development approach, the perception of well-being covers different dimensions of well-being, viz., quality of education, healthcare quality, the standard of living and labor market, personal safety, overall satisfaction with freedom of choice and life and perceptions about community and government. This paper presents a brief overview of the concept of well-being in the context of human development approach and analyses the role of well-being indicators in determining the perception of overall human well-being for different countries, regions and at the global level on the basis of HDR 2016 published by UNDP.

A high-efficiency and versatile CRISPR/Cas9-mediated HDR-based biallelic editing system / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Clustered regulatory interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 nuclease (Cas9), the third-generation genome editing tool, has been favored because of its high efficiency and clear system composition. In this technology, the introduced double-strand breaks (DSBs) are mainly repaired by non-homologous end joining (NHEJ) or homology-directed repair (HDR) pathways. The high-fidelity HDR pathway is used for genome modification, which can introduce artificially controllable insertions, deletions, or substitutions carried by the donor templates. Although high-level knock-out can be easily achieved by NHEJ, accurate HDR-mediated knock-in remains a technical challenge. In most circumstances, although both alleles are broken by endonucleases, only one can be repaired by HDR, and the other one is usually recombined by NHEJ. For gene function studies or disease model establishment, biallelic editing to generate homozygous cell lines and homozygotes is needed to ensure consistent phenotypes. Thus, there is an urgent need for an efficient biallelic editing system. Here, we developed three pairs of integrated selection systems, where each of the two selection cassettes contained one drug-screening gene and one fluorescent marker. Flanked by homologous arms containing the mutated sequences, the selection cassettes were integrated into the target site, mediated by CRISPR/Cas9-induced HDR. Positively targeted cell clones were massively enriched by fluorescent microscopy after screening for drug resistance. We tested this novel method on the amyloid precursor protein (APP) and presenilin 1 (PSEN1) loci and demonstrated up to 82.0% biallelic editing efficiency after optimization. Our results indicate that this strategy can provide a new efficient approach for biallelic editing and lay a foundation for establishment of an easier and more efficient disease model.

The First Korean Case of HDR Syndrome Confirmed by Clinical and Molecular Investigation

Hypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is a rare condition inherited as autosomal dominant trait and characterized by hypoparathyroidism, sensorineural deafness, and renal dysplasia. HDR syndrome is caused by haploinsufficiency of the GATA3 gene located on chromosome 10p15. Here, we report the case of a 32-day-old Korean male with HDR syndrome. He was presented due to repeated seizures over previous 3 days. The patient was born after 40 weeks of gestation with birth weight of 2930 g, and was the first-born baby of healthy Korean parents. Hypoparathyroidism was first noticed due to seizure. A multicystic left dysplastic kidney and vesicoureteral reflux were detected by ultrasound after birth. Auditory brainstem response (ABR) testing revealed that the patient had moderate sensorineural deafness, with hearing losses of 80 dB at the mid and higher frequencies for both ears. Echocardiography finding revealed secundum atrial septal deftect. Based on biochemical results and clinical findings, a presumptive diagnosis of HDR syndrome was made. GATA3 mutation analysis identified a heterozygous deletion, c.153del (p.Phe51Leufs*144) in exon 1 causing a frameshift mutation, which is a novel de novo mutation. Therefore, we suggest that HDR syndrome should be considered in the differential diagnosis in symptomatic or asymptomatic patients with hypoparathyroidism, and that renal ultrasound or ABR testing be performed to prevent a missed diagnosis. This is the first report on Korean patient with confirmed HDR syndrome with novel mutation.

Evaluation of Factors Used in AAPM TG-43 Formalism Using Segmented Sources Integration Method and Monte Carlo Simulation: Implementation of microSelectron HDR Ir-192 Source / 의학물리

Currently, the dose distribution calculation used by commercial treatment planning systems (TPSs) for high-dose rate (HDR) brachytherapy is derived from point and line source approximation method recommended by AAPM Task Group 43 (TG-43). However, the study of Monte Carlo (MC) simulation is required in order to assess the accuracy of dose calculation around three-dimensional Ir-192 source. In this study, geometry factor was calculated using segmented sources integration method by dividing microSelectron HDR Ir-192 source into smaller parts. The Monte Carlo code (MCNPX 2.5.0) was used to calculate the dose rate D(r,theta) at a point (r,theta) away from a HDR Ir-192 source in spherical water phantom with 30 cm diameter. Finally, anisotropy function and radial dose function were calculated from obtained results. The obtained geometry factor was compared with that calculated from line source approximation. Similarly, obtained anisotropy function and radial dose function were compared with those derived from MCPT results by Williamson. The geometry factor calculated from segmented sources integration method and line source approximation was within 0.2% for r> or =0.5 cm and 1.33% for r=0.1 cm, respectively. The relative-root mean square error (R-RMSE) of anisotropy function obtained by this study and Williamson was 2.33% for r=0.25 cm and within 1% for r>0.5 cm, respectively. The R-RMSE of radial dose function was 0.46% at radial distance from 0.1 to 14.0 cm. The geometry factor acquired from segmented sources integration method and line source approximation was in good agreement for r> or =0.1 cm. However, application of segmented sources integration method seems to be valid, since this method using three-dimensional Ir-192 source provides more realistic geometry factor. The anisotropy function and radial dose function estimated from MCNPX in this study and MCPT by Williamson are in good agreement within uncertainty of Monte Carlo codes except at radial distance of r=0.25 cm. It is expected that Monte Carlo code used in this study could be applied to other sources utilized for brachytherapy.

Braquiterapia endobronquial de alta tasa de dosis en pacientes con obstrucción de la vía aérea central: experiencia en el Instituto Nacional del Cáncer y revisión de la literatura / High dose rate endobronchial brachytherapy in patients with central airway obstruction

Introduction: The main indication of modern high dose rate end bronchial brachyherapy (HDR EBBT) is the palliation of symptoms related to the growth of the endobronchial lung cancer. Methods: EBBT was performed to 27 patients who suffered symptomatic tumoral endobronchial or tracheal pathology, due to primary bronchial disease or secondary metastasis cancer, evaluating the rate of clinical benefit. The tumors were located at tracheal, carinal or proximal bronchial level. Fibrobronchoscopy was performed to all the patients to measure the degree of airway obstruction and to install brachytherapy endobronchial catheters. Between 1 to 4 fractions of 7 to 7.5 Gy were administered. Dyspnea, cough and hemoptysis were subjectively registered before and after treatment, according to an international validated scale. Results: After treatment, all symptoms considerably decreased, disappearing all of the severe categories. Hemoptysis and dyspnea resolved in a 100 percent and 40 percent of patients, respectively; and cough disappeared or was reduced to a minimum grade in 90 percent of cases.

Introducción: La indicación principal de la braquiterapia endobronquial moderna (BTEB) de alta tasa de dosis (HDR), es la paliación de síntomas por crecimiento endobronquial de cánceres pulmonares. Métodos: Se realizó BTEB HDR a 27 pacientes sintomáticos de patología tumoral endobronquial o traqueal, debido a patologías primarias bronquiales o secundarias metastásicas. Los tumores se ubicaban en tráquea, carina o a nivel bronquialproximal. Para observar mejorías en la sintomatología clínica, a todos se les realizó una fibrobroncoscopía (FBC) para medir el grado de obstrucción bronquial e instalar catéteres endobronquiales de braquiterapia. Se administraron entre 1 y 4 fracciones de 7 a 7,5 Gy. Se registró subjetivamente la disnea, tos y hemoptisis antes y después del tratamiento, de acuerdo a una escala internacionalmente validada. Resultados: Tras el tratamiento todos los síntomas disminuyeron considerablemente, desapareciendo toda sintomatología severa. La hemoptisis y disnea desaparecieron en el 100 por ciento y 40 por ciento de los pacientes respectivamente, y la tos desapareció o disminuyó a grado leve en el 90 por ciento de los pacientes.

Avaliação da dose no reto em pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do câncer do colo uterino / Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer

OBJETIVO: O objetivo deste trabalho foi desenvolver um sistema dosimétrico termoluminescente capaz de avaliar as doses administradas ao reto de pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do câncer do colo uterino. MATERIAIS E MÉTODOS: O material termoluminescente utilizado para a avaliação da dose no reto foi o LiF:Mg,Ti,Na na forma de pó. O pó foi separado em pequenas porções de 34 mg, que foram acomodadas em um tubo capilar. Este tubo foi colocado em uma sonda retal, que era introduzida no reto da paciente. RESULTADOS: As doses administradas ao reto de seis pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do câncer do colo uterino foram avaliadas com dosímetros termoluminescentes e apresentaram boa concordância com os valores planejados, com base em duas radiografias ortogonais da paciente, imagens ântero-posterior e lateral. CONCLUSÃO: O sistema de dosimetria termoluminescente utilizado no presente trabalho é simples e de fácil utilização quando comparado a outros métodos de dosimetria do reto. Ele mostrou-se eficiente na avaliação da dose no reto de pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do câncer do colo uterino.

OBJECTIVE: The present study was aimed at developing a thermoluminescent dosimetric system capable of assessing the doses delivered to the rectum of patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. MATERIALS AND METHODS: LiF:Mg,Ti,Na powder was the thermoluminescent material utilized for evaluating the rectal dose. The powder was divided into small portions (34 mg) which were accommodated in a capillary tube. This tube was placed into a rectal probe that was introduced into the patient's rectum. RESULTS: The doses delivered to the rectum of six patients submitted to high-dose-rate brachytherapy for uterine cervix cancer evaluated by means of thermoluminescent dosimeters presented a good agreement with the planned values based on two orthogonal (anteroposterior and lateral) radiographic images of the patients. CONCLUSION: The thermoluminescent dosimetric system developed in the present study is simple and easy to be utilized as compared to other rectal dosimetry methods. The system has shown to be effective in the evaluation of rectal doses in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer.

Dose Comparison of Treatment Plans Using Different Ir-192 Sources and Treatment Planning Systems for Intracavitary HDR Brachytherapy / 의학물리

For HDR intracavitary brachytherapy with ovoids and a tandem, we compared the dose discrepancy of treatment plans using two different Ir-192 sources (microSelectron, Varian) and generated on two different treatment planning systems (PLATO, BrachyVision). The treatment plans of ten patient treated from Oct. 2007 to Jan. 2008 were selected for these comparisons. For the comparison of dose calculation using different sources, the average discrepancies were -0.91+/-0.09%, 0.27+/-0.07%, 0.22+/-0.39%, and 0.88+/-0.37% in total treatment time and at B-point and ICRU bladder and rectum reference point, respectively. Comparing the two systems, the average dose discrepancies between treatment planning programs were -0.22+/-0.42%, -0.25+/-0.29%, -0.23+/-0.63%, and -0.17+/-0.76%, and the average dose discrepancies between positioning methods (PLATO with film and BrachyVision with digitial image) were -0.61+/-0.59%, -0.77+/-0.45%, -0.72+/-1.70%, and 0.35+/-2.82% at A-point, B-point, and ICRU bladder and rectum reference points, respectively. The rectal dose discrepancies between two systems were reached 5.87%. The difference in the dwell position expected by each TPS are mainly affected by the differences in the positioning method in TPSs and have an effect on dose calculations of rectal and bladder located in AP direction.

Analysis of Accuracy of Apparent Activity According to Calibration Method for High Dose Rate Brachytherapy Source / 의학물리

The aim of this study is to introduce the accuracy of Ir-192 source's apparent activity using the well-type chamber and the Farmer-type ionization chamber in the high dose rate brachytherapy. We measured the apparent activity of Ir-192 that each medical center in the country has and the apparent activity of calibration certificate provided by manufacturer is compared with that by our experimental measurement. The number of sources used for the activity comparison was 5. The accuracy of the measured activity was in the range of -2.8% to -1.0% and -2.1% to 0.2% for the Farmer-type chamber system (Jig) and for the well-type, respectively. The maximum difference was within 1.0% for comparison with two calibration's tool. Our results demonstrate that well-type chamber as wall as Farmer-type chamber is a appropriate system as the routine source calibration procedures in HDR brachytherapy. Whenever a new source is installed to use in clinics, by periods, a source calibration should be carried out.

Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer / 대한방사선종양학회지

PURPOSE: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. MATERIALS AND METHODS: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range 34~74) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of 45~50.4 Gy (median: 50.4 Gy) over 5~5.5 weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: 16~32 Gy) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was 88 Gy10 (range: 77~94 Gy10). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was 131 Gy3 (range: 122~140 Gy3) at point A, 109 Gy3 (range: 88~125 Gy3) at the rectum and 111 Gy3 (range: 91~123 Gy3) at the urinary bladder. Cisplatin (60 mg/m2) and 5-FU (1,000 mg/m2) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: 2~6) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: 8~50 months). RESULTS: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. CONCLUSION: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.

Independent Verification Program for High-Dose-Rate Brachytherapy Treatment Plans / 대한방사선종양학회지

PURPOSE: The planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. MATERIALS AND METHODS: As primary input data, the program takes patients' planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were performed in a 10x12x10 cm3 grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans performed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients' plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. RESULTS: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of 2.8% in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip region of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a 3.4% deviation from the TPS plans. CONCLUSION: The accurate validation of complicate treatment plans is possible with the developed software and the quality of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

Radiotherapy Results of Uterine Cervix Cancer Stape IIB : Overall Survival, Prognostic Facters, Patterns of Failure and Late Complications / 대한방사선종양학회지

PURPOSE: Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications. MATERIALS AND METHODS: This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months (mean 60 months) and age of patients ranged from 31 to 78 years at presentation (mean : 55 years). RESULTS: Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight (16.8%) patients developed late rectal and urinary complications. There were tendency to increasing severity and frequency according to increased fractional dose and total (rectal and bladder) dose. CONCLUSIONS: Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder doseaffected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.

Late Rectal Complication in Patients Treated with High Dose Rate Brachytherapy for Stage IIB Carcinoma of the Cervix / 대한치료방사선과학회지

PURPOSE: This paper reports a dosimetric study of 88 patients treated with a combination of external radiotherapy and high dose rate ICR for FIGO stage IIB carcinoma of the cervix. The purpose is to investigate the correlation between the radiation doses to the rectum. external radiation dose to the whole pelvis. ICR reference volume. TDF, BED and the incidence of late rectal complications, retrospectively METHODS AND MATERIALS: From November 1989 through December 1992, 88 patients with stage IIB cervical carcinoma received radical radiotherapy at Department or Radiation Oncology in Yonsei University Hospital. Radiotherapy consisted of 44-54 Gy(median 49 Gy) external beam irradiation plus high dose rate intracavitary brachy therapy with 5 Gy per fraction twice a week to a total dose of 30 Gy on point A. The maximum dose to the rectum by contrast(r,R) and reference rectal dose by ICRU 38(dr, DR) were calculated. The ICR reference volume was calculated by Gamma Dot 3.11 HDR planning system, retrospectively. The time-dose factor(TDF) and the biologically effective dose (BED) were calculated. RESULTS: Twenty seven(30.7%) of the 88 patients developed late rectal complications : 12 patients(13.6%) for grade 1, 12 patients(13.6%) for grade 2 and 3 patients(3.4%) for grade 3. We found a significant correlation between the external whole pelvis irradiation dose and grade 2, 3 rectal complicaition. The mean dose to the whole pelvis for the group of patients with grade 2, 3 complication was higher, 4093.3+/-453.1 cGy, than that for the patients without complication 3873.8+/-415.6 (0.05p<0.1). The gradual increase in the frequency of grade 2, 3 rectal compication increased as a function of the dose of external beam therapyto the whole pelvis(midline shielding start dose) and total rectal dose. The mean total rectal dose by rectal barium(R) for the group of patients with grade 2, 3 rectal complication was higher, 7163.0+/-838.5 cGy, than that for the patients without rectal complication, 6772.7+/-884.0(p<0.05). There was no correlation of the rate of grade 2, 3 rectal complication with the ICR rectal doses(r,dr), ICR reference volume, TDF and BED. CONCLUSION: This investigation has revealed a significant correlation between the dose calculated at the rectal dose by ICRU 38(DR) or the most anterior rectal dose by contrast(R), dose to the whole pelvis and the incidence of grade 2,3 late rectal complications in patients with stage IIB cervical cancer undergoing external beam radiotherapy and HDR ICR. Thus there rectal reference points doses and whole pelvis dose appear to be useful prognostic indicators of late rectal complication in high dose rate ICR treatment in cervical carcinoma.

The Rofe of High Dose Rate(HDR) Intracavitary Radiation Therapy for the Management of Nasopharyngeal Carcinoma / 대한치료방사선과학회지

From September 1989 to June 1992, 22 patients with nasopharyngeal carcinoma were treated in Asan Medical Center with an external beam of 60 Gy followed by a boost dose of 15 Gy HDR brachytherapy. There were 5 females and 17 males with median age of 44 years (range: 20-69 years). All patients were histologically confirmed and staged by physical examination, CT scan and/or MRI. By the AJCC TNM staging system, there were 2 patients with stage II (T2NO), 4 with stage III(T3NO, T1-3N1), and 16 with stage IV(T4 or N2-3). Four patients received chemotherapy with 5-FU and cisplatin prior to radiotherapy. All patients were followed up periodically by a telescopic examination and radiologic imaging study of CT scan or MRI with a median follow-up time of 13 months (range: 3-34 mouths). Twenty ore patients showed a complete response one month after completing therapy and one patient showed a complete response after three months. At the time of this analysis, seventeen patients remain alive without evidence of disease, but four patients developed distant metastasis and one patient died a month after treatment. The local control rate was 100% in a median follow-up time of 13 months. The two year overall and disease free survival rates by the Kaplan-Meier method were 94% and 67%, respectively. Serious radiation sequelae have not been observed yet. Although longer follow-up is needed, this retrospective analysis suggests that HDR brachytherap given as a boost therapy for nasoharyngeal carcinoma may improve the local control. To reduce the incidence of distant metastasis, we need to develop a more effective systemic chemotherapy.

Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES / 대한치료방사선과학회지

Remote afterloading high dose rate brachytherapy(HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures performed at Asan Medical Center for 3 years. From Sep. 1985 to Aug 1992, 471 procedures of intracavitary radiation in 55 patients of cervical cancer and 26 of nasopharyngeal cancer, 79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range 1~31 months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, 80% achieves palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

Remote After Loading HDR Brachytherapy for female Urethral Cancer / 대한치료방사선과학회지

In our institution, a 76-year-old woman with primary urethral carcinoma was treated with remote afterloading high dose rate (HDR) interstitial brachytherapy using micro selectron Ir-192. In this paper, authors described the technical aspect of remote afterloading HDR interstitial brachytherapy for female urethal cancer.

Remote Afterloading Hish Dose Rate (HDR) Endobronchial Brachytherapy / 대한치료방사선과학회지

Authors described the remote afterloading endobronchial brachytherapy (EBBT) technique using the microSelectron HDR Ir-192 and the Asan Medical Center experience. Total 28 EBBT in 9 patients were performed since November 1989 and 24 EBBT in 8 patients were emploiyed for palliation and 3 EBBT in 1 patient was treated curatively. Authors observed a significant relief of obstructive symptom with tumor regression in 7 patients out of 8 who were treated palliatively but one of them died of pulmonary congestion in 3 weeks after EBBT. One patient with prior therapy of extensive electrocautery expired within 1 day after 2nd EBBT procedure with massive hemorrhage from the lesion. EBBT procedure has been tolerable and can be performed as an outpatient

Radiation Therapy of Head and Neck Cancer with CO-6O HDR Transcatheteric Irradiation / 영남의대학술지

The basic strategy of irradiation is to deliver a dose to the cancer that is high enough to make cancer cells incapable of reproduction, while keeping the doses to the various healthy tissues below tolerable levels. In order to improve local control and survival, as a boost therapy after external radiotherapy, high dose rate transcatheteric irradiation using remote control after loading system (RALSTRON-20B) was used for twelve patients with head and neck cancers. Present results showed complete remission of cancer in 9 out of 112 patients without treatment related complications. Although this procedure is easy to operate, well trained skillful hand in essential for good results. Furthermore out experience suggested that meticulous treatment planning should be developed for better results.