Sample records for plaque radiation therapy

  1. The generalized geometry of eye plaque therapy.

    PubMed

    Kepka, A G; Johnson, P M; Kline, R W

    1988-01-01

    A calculation is described that enables the rapid assessment of dose rate at various points of interest within the eye (lens, optic nerve, etc.) for the treatment of choroidal melanoma by plaque therapy. 125I seeds are used as the radiation source. The location of the plaque and its associated seeds relative to the eye (in a Cartesian coordinate system) is determined from the description of the tumor, as drawn and dimensioned on a fundus-view diagram by the ophthalmologist. This requires a computer to numerically solve an equation, which is derived in the framework of spherical geometry. Further results of this calculation yield data files that serve as the input to a conventional brachytherapy treatment planning program. This enables the visualization of the dose distribution within a plane that contains the major axis of the tumor in order to assess the adequacy of the treated volume. PMID:3405140

  2. Radiation therapy

    MedlinePLUS

    Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells. ... radiation is most harmful to quickly growing cells, radiation therapy damages cancer cells more than normal cells. This ...

  3. Mycosis fungoides: radiation therapy.

    PubMed

    Hoppe, Richard T

    2003-01-01

    Radiation therapy is the most effective single agent for the treatment of mycosis fungoides. There are well-defined dose-response relationships for achieving a complete response as well as the durability of this response. Techniques of electron beam therapy have been developed that permit treatment of the entire skin. Total-skin electron beam therapy is an important form of management, especially for patients who have thick generalized plaque or tumorous disease. Radiation therapy may also be used selectively for treatment of extracutaneous disease. PMID:14686978

  4. A new inexpensive customized plaque for choroidal melanoma iodine-125 plaque therapy

    SciTech Connect

    Vine, A.K.; Tenhaken, R.K.; Diaz, R.F.; Maxson, B.B.; Lichter, A.S.

    1989-04-01

    The authors have developed a new inexpensive precious metal alloy plaque for use in customized iodine-125 plaque therapy. Each plaque is formed from two flat circular gold/palladium foils which are used in dental crown work. Using a simple manual mechanism, the two forms are stamped over a customized acrylic die shaped to the dimensions of the tumor base plus a 2-mm margin. Completed plaques consist of a back wall, a 2-mm side wall, and a 1.5-mm wide lip with holes for suture placement. Advantages include: simple construction from inexpensive components, customized shape, and iodine seeds that are readily visible on plane radiographs.

  5. Radiation Therapy

    MedlinePLUS

    ... esophagitis . Since your body uses a lot of energy to heal during radiation therapy, it is important ... surprised if you are more tired, have less energy, or feel weak. Once you have finished treatment, ...

  6. {sup 106}Ruthenium Plaque Therapy (RPT) for Retinoblastoma

    SciTech Connect

    Murakami, Naoya, E-mail: namuraka@ncc.go.jp [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)] [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Suzuki, Shigenobu [Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo (Japan)] [Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)] [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Yoshimura, Ryoichi [Department of Diagnostic Radiology and Oncology, Head and Neck Reconstruction Division, Graduate School, Tokyo Medical and Dental University, Tokyo (Japan)] [Department of Diagnostic Radiology and Oncology, Head and Neck Reconstruction Division, Graduate School, Tokyo Medical and Dental University, Tokyo (Japan); Inaba, Koji; Kuroda, Yuki; Morota, Madoka; Mayahara, Hiroshi; Sakudo, Mototake; Wakita, Akihisa; Okamoto, Hiroyuki; Sumi, Minako; Kagami, Yoshikazu [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)] [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Nakagawa, Keiichi; Ohtomo, Kuni [Department of Radiology, University of Tokyo Hospital, Tokyo (Japan)] [Department of Radiology, University of Tokyo Hospital, Tokyo (Japan); Itami, Jun [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)] [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2012-09-01

    Purpose: To evaluate the effectiveness of episcleral {sup 106}ruthenium plaque therapy (RPT) in the management of retinoblastoma. Methods and Materials: One hundred one RPTs were retrospectively analyzed that were performed in 90 eyes of 85 patients with retinoblastoma at National Cancer Center Hospital between 1998 and 2008. Each RPT had a corresponding tumor and 101 tumors were considered in the analysis of local control. Median follow-up length was 72.8 months. Median patient age at the RPT was 28 months. Median prescribed doses at reference depth and outer surface of the sclera were 47.4 Gy and 162.3 Gy, respectively. Results: Local control rate (LCR) and ocular retention rate (ORR) at 2 years were 33.7% and 58.7%, respectively. Unilateral disease, International Classification of Retinoblastoma group C or more advanced at the first presentation or at the time of RPT, vitreous and/or subretinal seeding, tumor size greater than 5 disc diameter (DD), reference depth greater than 5 mm, dose rate at reference depth lower than 0.7 Gy/hour, dose at the reference depth lower than 35 Gy, and (biologically effective dose with an {alpha}/{beta} ratio of 10 Gy) at the reference depth lower than 40 Gy{sub 10} were associated with unfavorable LCR. Two patients died of metastatic disease. Radiation complications included retinal detachment in 12 eyes (13.3%), proliferative retinopathy in 6 (6.7%), rubeosis iris in 2 (2.2%), and posterior subcapsular cataract in 23 (25.6%). Conclusion: RPT is an effective eye-preserving treatment for retinoblastoma.

  7. Radiation Therapy: Preventing and Managing Side Effects

    MedlinePLUS

    ... of radiation therapy outweigh the risks and side effects? How much does radiation treatment cost? Who gives radiation treatments? Informed consent for radiation therapy How is radiation therapy given? External radiation therapy Internal radiation therapy (brachytherapy) Systemic radiation ...

  8. Radiation therapy - skin care

    MedlinePLUS

    ... red, peel, or itch. You should treat your skin with care while receiving radiation therapy. ... When you have radiation treatment, a health care provider draws ... they come off, do not redraw them. Tell your provider instead. ...

  9. MR Imaging of Carotid Plaque Composition During Lipid-Lowering Therapy

    PubMed Central

    Zhao, Xue-Qiao; Dong, Li; Hatsukami, Tom; Phan, Binh An; Chu, Baocheng; Moore, Andrew; Lane, Trevor; Neradilek, Moni B.; Polissar, Nayak; Monick, Duane; Lee, Colin; Underhill, Hunter; Yuan, Chun

    2013-01-01

    OBJECTIVES The purpose of this study was to test the lipid depletion hypothesis and to establish the time course of change in carotid plaque morphology and composition during lipid therapy using high-resolution magnetic resonance imaging (MRI). BACKGROUND Lipid therapy is thought to improve plaque stability and reduce cardiovascular events by targeting the plaque rupture risk features such as large lipid core, thin fibrous cap, and high level of inflammatory infiltrates. However, the plaque stabilizing process during lipid therapy has not been clearly demonstrated in humans and in vivo. METHODS Subjects with coronary or carotid artery disease, apolipoprotein B ?120 mg/dl, and lipid treatment history <1 year, were randomly assigned to atorvastatin monotherapy or to atorvastatin-based combination therapies with appropriate placebos for 3 years. All subjects underwent high-resolution, multicontrast bilateral carotid MRI scans at baseline and annually for 3 years. All images were analyzed for quantification of wall area and plaque composition blinded to therapy, laboratory results, and clinical course. RESULTS After 3 years of lipid therapy, the 33 subjects with measurable lipid-rich necrotic core (LRNC) at baseline had a significant reduction in plaque lipid content: LRNC volume decreased from 60.4 ± 59.5 mm3 to 37.4 ± 69.5 mm3 (p < 0.001) and %LRNC (LRNC area/wall area in the lipid-rich regions) from 14.2 ± 7.0% to 7.4 ± 8.2% (p < 0.001). The time course showed that %LRNC decreased by 3.2 (p < 0.001) in the first year, by 3.0 (p = 0.005) in the second year, and by 0.91 (p = 0.2) in the third year. Changes in LRNC volume followed the same pattern. Percent wall volume (100 × wall/outer wall, a ratio of volumes) in the lipid-rich regions significantly decreased from 52.3 ± 8.5% to 48.6 ± 9.7% (p = 0.002). Slices containing LRNC had significantly more percent wall volume reduction than those without (?4.7% vs. ?1.4%, p = 0.02). CONCLUSIONS Intensive lipid therapy significantly depletes carotid plaque lipid. Statistically significant plaque lipid depletion is observed after 1 year of treatment and continues in the second year, and precedes plaque regression. (Using Magnetic Resonance Imaging to Evaluate Carotid Artery Plaque Composition in People Receiving Cholesterol-Lowering Medications [The CPC Study]; NCT00715273). PMID:21920335

  10. Effects of carbon dioxide, Nd-YAG, and argon laser radiation on coronary atheromatous plaques.

    PubMed

    Abela, G S; Normann, S; Cohen, D; Feldman, R L; Geiser, E A; Conti, C R

    1982-12-01

    Laser radiation has been successfully applied in several areas of medical practice. However, its use in cardiology and specifically its effects on obstructive atherosclerosis have largely been unexplored. To evaluate effects of laser radiation on atherosclerotic plaques 25 fresh necropsy atherosclerotic coronary artery segments were exposed to laser radiation with either a carbon dioxide, Nd-YAG, or argon laser. Split or intact segments were prepared under dry conditions or while immersed in saline solution or blood and exposed to laser radiation as power and duration of exposure varied. All 3 lasers were capable of creating controlled injury to atherosclerotic plaques. In general, the magnitude of injury varied according to the total energy delivered (that is, power times duration of exposure. Calcified and noncalcified plaques were penetrated with similar levels of injury. Histologic examination demonstrated that laser radiation produced a wedge incision in the atherosclerotic plaque which was surrounded by zones of thermal and acoustic injury. PMID:6816057

  11. Near-infrared spectroscopy for intracoronary detection of lipid-rich plaques to understand atherosclerotic plaque biology in man and guide clinical therapy.

    PubMed

    Erlinge, D

    2015-08-01

    Ischaemic heart disease is the leading cause of death worldwide. The common denominator for plaques causing acute coronary syndrome (ACS) is lipid accumulation, either as a lipid core or lipid pools. An intracoronary imaging device to detect lipid-rich plaques (LRPs) could therefore identify most of the plaques causing ACS and sudden death. Near-infrared spectroscopy combined with intravascular ultrasound (NIRS-IVUS) is a promising new intracoronary imaging method that is able to specifically quantify lipid accumulation measured as the lipid core burden index (LCBI). NIRS-IVUS is highly specific for the identification of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) culprit plaques usually in the form of a circular LRP. NIRS-IVUS may assist in defining the aetiology of coronary events. The effect of cholesterol-lowering therapy on the lipid core can be measured in coronary plaques in patients, and NIRS-IVUS may be a useful tool for drug development in phase II studies as a surrogate end-point for future ACS. Plaques with a high LCBI have an increased risk of peri-procedural events. NIRS-IVUS can help to define the diameter and length of stents to avoid procedure-related complications. Increased coronary LCBI predicts a higher risk of future cardiovascular events. Lipid core detection using NIRS may help to identify vulnerable plaques to treat them before they cause ACS or sudden death. PMID:26096457

  12. Microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Laissue, Jean A.; Lyubimova, Nadia; Wagner, Hans-Peter; Archer, David W.; Slatkin, Daniel N.; Di Michiel, Marco; Nemoz, Christian; Renier, Michel; Brauer, Elke; Spanne, Per O.; Gebbers, Jan-Olef; Dixon, Keith; Blattmann, Hans

    1999-10-01

    The central nervous system of vertebrates, even when immature, displays extraordinary resistance to damage by microscopically narrow, multiple, parallel, planar beams of x rays. Imminently lethal gliosarcomas in the brains of mature rats can be inhibited and ablated by such microbeams with little or no harm to mature brain tissues and neurological function. Potentially palliative, conventional wide-beam radiotherapy of malignant brain tumors in human infants under three years of age is so fraught with the danger of disrupting the functional maturation of immature brain tissues around the targeted tumor that it is implemented infrequently. Other kinds of therapy for such tumors are often inadequate. We suggest that microbeam radiation therapy (MRT) might help to alleviate the situation. Wiggler-generated synchrotron x-rays were first used for experimental microplanar beam (microbeam) radiation therapy (MRT) at Brookhaven National Laboratory's National Synchrotron Light Source in the early 1990s. We now describe the progress achieved in MRT research to date using immature and adult rats irradiated at the European Synchrotron Radiation Facility in Grenoble, France, and investigated thereafter at the Institute of Pathology of the University of Bern.

  13. Method for microbeam radiation therapy

    Microsoft Academic Search

    Daniel N. Slatkin; F. Avraham Dilmanian; Per O. Spanne

    1994-01-01

    A method of performing radiation therapy on a patient, involving exposing a target, usually a tumor, to a therapeutic dose of high energy electromagnetic radiation, preferably X-ray radiation, in the form of at least two non-overlapping microbeams of radiation, each microbeam having a width of less than about 1 millimeter. Target tissue exposed to the microbeams receives a radiation dose

  14. Ultrasound Assessment of Carotid Plaque Echogenicity Response to Statin Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Ibrahimi, Pranvera; Jashari, Fisnik; Bajraktari, Gani; Wester, Per; Henein, Michael Y.

    2015-01-01

    Objective: To evaluate in a systematic review and meta-analysis model the effect of statin therapy on carotid plaque echogenicity assessed by ultrasound. Methods: We have systematically searched electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to April, 2015, for studies evaluating the effect of statins on plaque echogenicity. Two researchers independently determined the eligibility of studies evaluating the effect of statin therapy on carotid plaque echogenicity that used ultrasound and grey scale median (GSM) or integrated back scatter (IBS). Results: Nine out of 580 identified studies including 566 patients’ carotid artery data were meta-analyzed for a mean follow up of 7.2 months. A consistent increase in the echogenicity of carotid artery plaques, after statin therapy, was reported. Pooled weighted mean difference % (WMD) on plaque echogenicity after statin therapy was 29% (95% CI 22%–36%), p < 0.001, I2 = 92.1%. In a meta-regression analysis using % mean changes of LDL, HDL and hsCRP as moderators, it was shown that the effects of statins on plaque echogenicity were related to changes in hsCRP, but not to LDL and HDL changes from the baseline. The effect of statins on the plaque was progressive; it showed significance after the first month of treatment, and the echogenicity continued to increase in the following six and 12 months. Conclusions: Statin therapy is associated with a favorable increase of carotid plaque echogenicity. This effect seems to be dependent on the period of treatment and hsCRP change from the baseline, independent of changes in LDL and HDL. PMID:25984600

  15. Method for microbeam radiation therapy

    Microsoft Academic Search

    D. N. Slatkin; F. A. Dilmanian; P. O. Spanne

    1994-01-01

    A method is disclosed of performing radiation therapy on a patient, involving exposing a target, usually a tumor, to a therapeutic dose of high energy electromagnetic radiation, preferably X-ray radiation. The dose is in the form of at least two non-overlapping microbeams of radiation, each microbeam having a width of less than about 1 millimeter. Target tissue exposed to the

  16. Wayne State University Radiation Therapy Technology

    E-print Network

    Cinabro, David

    Wayne State University Radiation Therapy Technology Memorandum TO: Applicants for Radiation Therapy of professional students in the radiation therapy technology program. We want you to be well informed about what\\2005apl\\tecmem06.sam #12;WAYNE STATE UNIVERSITY RADIATION THERAPY TECHNOLOGY Statement of Technical

  17. Direct photodynamic therapy for vulnerable plaque: investigation of light dosimetry for depth control

    NASA Astrophysics Data System (ADS)

    Ohmori, Sayaka; Yanagihara, Takeshi; Arai, Tsunenori

    2004-07-01

    Photodynamic therapy (PDT) mechanism with high-intensity pulsed laser excitation has not been well understood. We think complete understanding of this unknown effect in PDT leads perfect treated depth control at various lesions. To realize the depth controlled PDT for atheromatous plaque therapy with a fibrous cap intact and surrounding damage free, we studied PDT against murine macrophage-like cells in vitro with the second-generation chlorin photosensitizer manufactured by Photochemical Co. Ltd. (Okayama Japan). The relation between the excitation conditions (pulse energy density and repetition rate) and PDT photocytotoxicity was examined in vitro. The XeCl excimer laser pumped dye laser (wavelength: 669+/-3 nm, pulse duration: 7ns in FWHM) was used with the pulse energy density from 1.2 to 9.5 mJ/cm2, and the pulse repetition rate from 5 to 80 Hz. Under higher pulse energy density condition, no significant PDT photocytotoxicity was obtained. We examined the photobleaching of the protein containing photosensitizer medium solution, which is considered to correlates with the generation of singlet oxygen. Under higher pulse energy condition, the photobleaching efficiency decrease was observed and the measured PDT effect decrease in terms of laser pulse energy density could be explained by the photobleaching. We measured the oxygen partial pressure in photosensitizer medium solution immediately after the laser exposure. The decrease of oxygen partial pressure, i.e., the amount of the oxygen consumption during the laser exposure was observed 46 mmHg under the excitation condition of the pulse energy density of 9.5 mJ/cm2, the total fluence of 5 J/cm2, the repetition rate of 80Hz, and correlated with the bleaching efficiency 87% under the same condition. We calculated cell death distribution in depth direction based on measured photocytotoxicity under various pulse energy densities. The possibility of depth controlled PDT for safety atheromatous plaque therapy was suggested by the PDT effect alteration depending on pulse energy density.

  18. Advances in radiation therapy dosimetry.

    PubMed

    Paliwal, Bhudatt; Tewatia, Dinesh

    2009-07-01

    During the last decade, there has been an explosion of new radiation therapy planning and delivery tools. We went through a rapid transition from conventional three-dimensional (3D) conformal radiation therapy to intensity-modulated radiation therapy (IMRT) treatments, and additional new techniques for motion-adaptive radiation therapy are being introduced. These advances push the frontiers in our effort to provide better patient care; and with the addition of IMRT, temporal dimensions are major challenges for the radiotherapy patient dosimetry and delivery verification. Advanced techniques are less tolerant to poor implementation than are standard techniques. Mis-administrations are more difficult to detect and can possibly lead to poor outcomes for some patients. Instead of presenting a manual on quality assurance for radiation therapy, this manuscript provides an overview of dosimetry verification tools and a focused discussion on breath holding, respiratory gating and the applications of four-dimensional computed tomography in motion management. Some of the major challenges in the above areas are discussed. PMID:20098555

  19. Method for microbeam radiation therapy

    DOEpatents

    Slatkin, D.N.; Dilmanian, F.A.; Spanne, P.O.

    1994-08-16

    A method is disclosed of performing radiation therapy on a patient, involving exposing a target, usually a tumor, to a therapeutic dose of high energy electromagnetic radiation, preferably X-ray radiation. The dose is in the form of at least two non-overlapping microbeams of radiation, each microbeam having a width of less than about 1 millimeter. Target tissue exposed to the microbeams receives a radiation dose during the exposure that exceeds the maximum dose that such tissue can survive. Non-target tissue between the microbeams receives a dose of radiation below the threshold amount of radiation that can be survived by the tissue, and thereby permits the non-target tissue to regenerate. The microbeams may be directed at the target from one direction, or from more than one direction in which case the microbeams overlap within the target tissue enhancing the lethal effect of the irradiation while sparing the surrounding healthy tissue. No Drawings

  20. Method for microbeam radiation therapy

    SciTech Connect

    Slatkin, Daniel N. (Sound Beach, NY); Dilmanian, F. Avraham (Yaphank, NY); Spanne, Per O. (Shoreham, NY)

    1994-01-01

    A method of performing radiation therapy on a patient, involving exposing a target, usually a tumor, to a therapeutic dose of high energy electromagnetic radiation, preferably X-ray radiation, in the form of at least two non-overlapping microbeams of radiation, each microbeam having a width of less than about 1 millimeter. Target tissue exposed to the microbeams receives a radiation dose during the exposure that exceeds the maximum dose that such tissue can survive. Non-target tissue between the microbeams receives a dose of radiation below the threshold amount of radiation that can be survived by the tissue, and thereby permits the non-target tissue to regenerate. The microbeams may be directed at the target from one direction, or from more than one direction in which case the microbeams overlap within the target tissue enhancing the lethal effect of the irradiation while sparing the surrounding healthy tissue.

  1. Radiation therapy planning

    Microsoft Academic Search

    N. M. Bleehen; E. Glatstein; J. L. Haybittle

    1983-01-01

    This book presents papers on radiotherapy. Topics considered include clinical and biological aspects, general physics principles, dose measurement, treatment simulation, the role of computerized tomography in treatment planning, beam modification, computer calculations of dose distributions, beam direction, accuracy of treatment, dose prescription, electron beams, neutron therapy, unsealed radionuclides, total and partial body irradiation, the central nervous system, head and neck

  2. Topical therapies for the treatment of plaque psoriasis: systematic review and network meta-analyses.

    PubMed

    Samarasekera, E J; Sawyer, L; Wonderling, D; Tucker, R; Smith, C H

    2013-05-01

    The majority of people with psoriasis have localized disease, where topical therapy forms the cornerstone of treatment. We set out to summarize evidence on the relative efficacy, safety and tolerability of different topical treatments used in plaque psoriasis. We undertook a systematic review and meta-analyses of randomized trial data of U.K.-licensed topical therapies. The primary outcome was clear or nearly clear status stratified for (i) trunk and limbs; and (ii) scalp. Network meta-analyses allowed ranking of treatment efficacy. In total, 48 studies were available for trunk and limb psoriasis, and 17 for scalp psoriasis (22,028 patients in total); the majority included people with at least moderate severity psoriasis. Strategies containing potent corticosteroids (alone or in combination with a vitamin D analogue) or very potent corticosteroids dominated the treatment hierarchy at both sites (trunk and limbs, scalp); coal tar and retinoids were no better than placebo. No significant differences in achievement of clear or nearly clear status were observed between twice- and once-daily application of the same intervention or between any of the following: combined vitamin D analogue and potent corticosteroid (applied separately or in a single product), very potent corticosteroids, or potent corticosteroids (applied twice daily). Investigator and patient assessment of response differed significantly for some interventions (response rates to very potent corticosteroids: 78% and 39%, respectively). No significant differences were noted for tolerability or steroid atrophy, but data were limited. In conclusion, corticosteroids are highly effective in psoriasis when used continuously for up to 8 weeks and intermittently for up to 52 weeks. Coal tar and retinoids are of limited benefit. There is a lack of long-term efficacy and safety data available on topical interventions used for psoriasis. PMID:23413913

  3. Discipline of Radiation Therapy Trinity College Dublin

    E-print Network

    O'Mahony, Donal E.

    Professor, followed by Patient 14.10-14.40: Radiation Therapy for Breast Cancer: Professional and Patient and public outreach event about radiation therapy treatment for cancer Venue: Science Gallery Trinity College Therapist, Zagreb, Croatia 17.00-17.30: Radiation Therapy for Prostate Cancer: Professional and Patient

  4. Radiation therapy of esophageal cancer

    SciTech Connect

    Hancock, S.L.; Glatstein, E.

    1984-06-01

    Radiation therapy has been used extensively in the management of patients with cancer of the esophagus. It has demonstrated an ability to cure a small minority of patients. Cure is likely to be limited to patients who have lesions less than 5 cm in length and have minimal, if any, involvement of lymph nodes. Esophagectomy is likely to cure a similar, small percentage of patients with the same presentation of minimal disease but has a substantial acute postoperative mortality rate and greater morbidity than irradiation. Combining surgery and either preoperative or postoperative irradiation may cure a small percentage of patients beyond the number cured with either modality alone. Radiation has demonstrated benefit as an adjuvant to surgery following the resection of minimal disease. However, radiation alone has never been compared directly with surgery for the highly select, minimal lesions managed by surgery. Radiation provides good palliation of dysphagia in the majority of patients, and roughly one third may have adequate swallowing for the duration of their illness when ''radical'' doses have been employed. Surgical bypass procedures have greater acute morbidity but appear to provide more reliable, prolonged palliation of dysphagia. Several approaches to improving the efficacy of irradiation are currently under investigation. These approahces include fractionation schedules, radiosensitizers, neutron-beam therapy, and helium-ion therapy.

  5. Therapy of radiation injury.

    PubMed

    MacVittie, T J

    1997-01-01

    It is apparent from preclinical and clinical research to date that continued evaluation of new and alternative treatment strategies is required to eliminate the obligate periods of neutropenia and thrombocytopenia after acute high-dose irradiation. Future treatment strategies may involve new combinations of cytokines to affect hematopoietic stem cell proliferation and "engineered" cellular grafts to provide short-term in vivo expansion of neutrophils and platelets in an effort to bridge the cytopenic gap until endogenous or transplanted stem cells regenerate the hematopoietic and immune systems. Cytokine-mobilized peripheral blood and cord blood will provide alternative sources of allogeneic stem and progenitor cells in support of primary engraftment, delayed engraftment or secondary failure of the initial graft, as well as starting populations for various ex vivo expansion protocols. Further insights into the relative quality of stem cell populations and the factors that regulate their survival and self renewal, and the identification and roles of adhesion molecules in stem cell mobilization, engraftment, and interaction with the adult marrow microenvironment will provide the basis for future treatment strategies for the radiation-induced hematopoietic syndrome. As our ability to treat the hematopoietic syndrome improves, damage to other organ systems such as the skin, lung, and/or gastrointestinal tissue will emerge as dose-limiting. At the same time, the characterization of receptors for inflammatory cytokines, cytokine receptor antagonists, and anti-endotoxin antibodies has allowed significant insights into the mechanisms and pathogenesis of sepsis. However, translation of this knowledge into a treatment modality for septic patients is precluded by the lack of any clear-cut beneficial effect from the many clinical trials. The research and clinical results presented in this volume and recent conferences reflect the body of knowledge that will lead to further developments in assessment, prophylaxis, and treatment of radiation injuries in the areas of infectious disease and the hematopoietic, gastrointestinal, and cutaneous syndromes. PMID:9368312

  6. Radiation Therapy and Hearing Loss

    SciTech Connect

    Bhandare, Niranjan [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Jackson, Andrew [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Eisbruch, Avraham; Pan, Charlie C. [Department of Radiation Oncology, University of Michigan (United States); Flickinger, John C. [Department of Radiation Oncology, University of Pittsburgh Medical Center (United States); Antonelli, Patrick [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida (United States); Mendenhall, William M., E-mail: mendwm@shands.ufl.ed [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

    2010-03-01

    A review of literature on the development of sensorineural hearing loss after high-dose radiation therapy for head-and-neck tumors and stereotactic radiosurgery or fractionated stereotactic radiotherapy for the treatment of vestibular schwannoma is presented. Because of the small volume of the cochlea a dose-volume analysis is not feasible. Instead, the current literature on the effect of the mean dose received by the cochlea and other treatment- and patient-related factors on outcome are evaluated. Based on the data, a specific threshold dose to cochlea for sensorineural hearing loss cannot be determined; therefore, dose-prescription limits are suggested. A standard for evaluating radiation therapy-associated ototoxicity as well as a detailed approach for scoring toxicity is presented.

  7. THE RADIATION THERAPY PLANNING PROBLEM CHRISTOPH BORGERS

    E-print Network

    Börgers, Christoph

    THE RADIATION THERAPY PLANNING PROBLEM CHRISTOPH BORGERS 1. Introduction. The purpose of this paper is to describe mathemat- ical aspects of radiation therapy planning to readers with a background in applied mathematics. The use of X-rays for cancer therapy began a few days after their dis- covery. Wilhelm Rontgen

  8. Magnetic Tracking System for Radiation Therapy

    Microsoft Academic Search

    Wing-Fai Loke; Tae-Young Choi; Teimour Maleki; Lech Papiez; Babak Ziaie; Byunghoo Jung

    2010-01-01

    Intensity-modulated radiation therapy (IMRT) requires precise delivery of the prescribed dose of radiation to the target and surrounding tissue. Irradiation of moving body anatomy is possible only if stable, accurate, and reliable information about the moving body structures are provided in real time. This paper presents a magnetic position tracking system for radiation therapy. The proposed system uses only four

  9. Radiation complications and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement 1 1 Biostatistical consultation was provided by J. Cater, PhD

    Microsoft Academic Search

    Kaan Gündüz; Carol L Shields; Jerry A Shields; Jacqueline Cater; Jorge E Freire; Luther W Brady

    1999-01-01

    PURPOSE: To determine the outcome of plaque radiotherapy in the treatment of macular choroidal melanoma and to identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis.METHODS: Chart analysis of 630 consecutive patients (630 eyes) with macular choroidal melanoma managed by plaque radiotherapy between July 1976 and June 1992.RESULTS: The median largest basal tumor diameter

  10. Stereotactic body radiation therapy for oligometastases.

    PubMed

    Lo, Simon S; Teh, Bin S; Mayr, Nina A; Olencki, Thomas E; Wang, Jian Z; Grecula, John C; Lu, Jiade J; Timmerman, Robert D

    2010-09-01

    There are data in the literature to suggest the presence of an oligometastatic state, and local aggressive therapy of the oligometastases may improve outcomes including survival. Stereotactic body radiation therapy has emerged as one of the local therapy options for oligometastases in various body sites, most commonly in the lung and the liver. Retrospective studies and clinical trials have demonstrated promising results with the use of stereotactic body radiation therapy for oligometastases. However, most of the studies have relatively short follow-up intervals. Longer follow-up is necessary to better define the role of stereotactic body radiation therapy in the management of patients with oligometastases. Given the high propensity for distant progression, the combination of novel systemic therapy and stereotactic body radiation therapy is to be explored. PMID:20875346

  11. A Catheter-Based Intravascular Radiation Detector ofVulnerablePlaques

    Microsoft Academic Search

    Ryohei Hosokawa; Naoshige Kambara; Muneo Ohba; Takahiro Mukai; Mikako Ogawa; Hiroshi Motomura; Noriaki Kume; Hideo Saji; Toru Kit; Ryuji Nohara

    Detection of vulnerable plaques before rupture is important in preventing acute coronary events such as myocardial infarction. Althoughtherapeuticstrategiessuchaspercutaneoustranslumi- nal coronary angioplasty appear to prevent coronary occlusion and consequently may lead to improved prognosis in these pa- tients, a method of detecting vulnerable plaques has not been established. A nuclear method that uses an intravascular radia- tion detector (IVRD) with the

  12. Introduction Although chemotherapeutics and radiation therapy

    E-print Network

    Hemminki, Akseli

    Introduction Although chemotherapeutics and radiation therapy target various different cellular Replication component viruses for cancer therapy Anna Kanerva1,2,3 and Akseli Hemminki1,2 1Cancer Gene Therapy structures and pathways, most of them kill cancer cells by inducing apoptosis. As malignant cells

  13. Robust Biologically GuidedRobust Biologically Guided Radiation Therapy (BGRT)Radiation Therapy (BGRT)

    E-print Network

    Stewart, Robert D.

    Robust Biologically GuidedRobust Biologically Guided Radiation Therapy (BGRT)Radiation Therapy (BGRT) Robert D. Stewart, Ph.D.Robert D. Stewart, Ph.D. Associate Professor, Radiation Oncology and Medical Physics U i it f W hi t M di l C tUniversity of Washington Medical Center Department of Radiation

  14. Radiation Plus Hormone Therapy May Help Some Prostate Cancer Patients

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_152526.html Radiation Plus Hormone Therapy May Help Some Prostate Cancer Patients ... radiation therapy only, 52 percent received hormone therapy plus radiation, and 10 percent received neither treatment. The ...

  15. OPTIMIZING THE SCENARIO POSITIONS FOR ROBUST RADIATION THERAPY TREATMENT PLANNING

    E-print Network

    Forsgren, Anders

    OPTIMIZING THE SCENARIO POSITIONS FOR ROBUST RADIATION THERAPY TREATMENT PLANNING Albin FREDRIKSSON Royal Institute of Technology October 10, 2012 Abstract Complex external beam radiation therapy scenario positions. 1. Introduction In external beam radiation therapy, misalignment of the patient

  16. BIOLOGY CONTRIBUTION PREFERENTIAL EFFECT OF SYNCHROTRON MICROBEAM RADIATION THERAPY

    E-print Network

    BIOLOGY CONTRIBUTION PREFERENTIAL EFFECT OF SYNCHROTRON MICROBEAM RADIATION THERAPY: Synchrotron microbeam radiation therapy (MRT) relies on spatial fractionation of the incident photon beam by a novel form of radiosurgery, known as microbeam radiation therapy (MRT) (2), which uses a particular

  17. Galactic cosmic radiation leads to cognitive impairment and increased a? plaque accumulation in a mouse model of Alzheimer's disease.

    PubMed

    Cherry, Jonathan D; Liu, Bin; Frost, Jeffrey L; Lemere, Cynthia A; Williams, Jacqueline P; Olschowka, John A; O'Banion, M Kerry

    2012-01-01

    Galactic Cosmic Radiation consisting of high-energy, high-charged (HZE) particles poses a significant threat to future astronauts in deep space. Aside from cancer, concerns have been raised about late degenerative risks, including effects on the brain. In this study we examined the effects of (56)Fe particle irradiation in an APP/PS1 mouse model of Alzheimer's disease (AD). We demonstrated 6 months after exposure to 10 and 100 cGy (56)Fe radiation at 1 GeV/µ, that APP/PS1 mice show decreased cognitive abilities measured by contextual fear conditioning and novel object recognition tests. Furthermore, in male mice we saw acceleration of A? plaque pathology using Congo red and 6E10 staining, which was further confirmed by ELISA measures of A? isoforms. Increases were not due to higher levels of amyloid precursor protein (APP) or increased cleavage as measured by levels of the ? C-terminal fragment of APP. Additionally, we saw no change in microglial activation levels judging by CD68 and Iba-1 immunoreactivities in and around A? plaques or insulin degrading enzyme, which has been shown to degrade A?. However, immunohistochemical analysis of ICAM-1 showed evidence of endothelial activation after 100 cGy irradiation in male mice, suggesting possible alterations in A? trafficking through the blood brain barrier as a possible cause of plaque increase. Overall, our results show for the first time that HZE particle radiation can increase A? plaque pathology in an APP/PS1 mouse model of AD. PMID:23300905

  18. Neurogenic fibrosarcoma following radiation therapy for seminoma

    SciTech Connect

    O'Brien, W.M.; Abbondanzo, S.L.; Chun, B.K.; Manz, H.J.; Maxted, W.C.

    1989-05-01

    We report a case of radiation-induced neurogenic fibrosarcoma that developed in a patient who received radiation therapy for seminoma. The sarcoma developed within the irradiated field after a latency period of nineteen years. Although the occurrence of a secondary neoplasm is unusual, this possibility should be included in the differential diagnosis of patients who present with tumor growth after a long interval following radiation therapy.

  19. Ocular melanoma: Total dose and dose rate effects with Co-60 plaque therapy

    SciTech Connect

    Beitler, J.J.; McCormick, B.; Ellsworth, R.M.; Abramson, D.H.; Anderson, L.L.; Loffredo, C. (Memorial Sloan-Kettering Cancer Center, New York, NY (USA))

    1990-07-01

    From 1968 to 1987, 123 consecutive patients with nonmetastatic choroidal melanoma were treated with cobalt-60 plaques. One hundred sixteen patients were followed up for a mean of 3.8 years. Twenty patients had local failure, and 14 patients had distant failure. Complications included 32 cataracts, and seven enucleations were required. Local recurrence did not correlate with tumor height, tumor volume, dose, or dose rate. Increased volume (P = .004) and height (P = .01) correlated with increased rates of distant metastases. Dose adjusted for volume did not correlate with the rate of metastases.

  20. The role of radiation therapy in melanoma.

    PubMed

    Oxenberg, Jacqueline; Kane, John M

    2014-10-01

    Although melanoma was historically thought to be radiation resistant, there are limited data to support the use of adjuvant radiation therapy for certain situations at increased risk for locoregional recurrence. High-risk primary tumor features include thickness, ulceration, certain anatomic locations, satellitosis, desmoplastic/neurotropic features, and head and neck mucosal and anorectal melanoma. Lentigo maligna can be effectively treated with either adjuvant or definitive radiation therapy. Some retrospective and prospective randomized studies support the use of adjuvant radiation to improve regional control after lymph node dissection for high-risk nodal metastatic disease. Consensus on the optimal radiation doses and fractionation is lacking. PMID:25245966

  1. Synchrotron Radiation Therapy from a Medical Physics point of view

    Microsoft Academic Search

    Y. Prezado; J. F. Adam; P. Berkvens; I. Martinez-Rovira; G. Fois; S. Thengumpallil; M. Edouard; M. Vautrin; P. Deman; E. Bräuer-Krisch; M. Renier; H. Elleaume; F. Estève; A. Bravin

    2010-01-01

    Synchrotron radiation (SR) therapy is a promising alternative to treat brain tumors, whose management is limited due to the high morbidity of the surrounding healthy tissues. Several approaches are being explored by using SR at the European Synchrotron Radiation Facility (ESRF), where three techniques are under development Synchrotron Stereotactic Radiation Therapy (SSRT), Microbeam Radiation Therapy (MRT) and Minibeam Radiation Therapy

  2. Radiation therapy for renal transplant rejection reactions

    SciTech Connect

    Peeples, W.J.; Wombolt, D.G.; El-Mahdi, A.M.; Turalba, C.I.

    1982-01-01

    Forty-four renal transplant patients were given radiation therapy for severe rejection phenomena. The 29 patients who had only one course of irradiation had a 52.3% successful function rate. Fifteen patients received from two to four courses of irradiation with an ultimate 60% rate of sustained function. Fifty patients who received only steroid and other medical management but no irradiation had a 60% rate of successful renal function. In the irradiation group, no patient whose creatinine level did not respond to radiation therapy maintained a functioning kidney. The data indicate that the overall successful function rate is maintained by radiation therapy in patients who show severe allograft rejection phenomena.

  3. Hyperbaric oxygen therapy for radiation myelitis

    SciTech Connect

    Poulton, T.J.; Witcofski, R.L.

    1985-12-01

    Radiation therapy may damage healthy tissues adjacent to tumor. Hyperbaric oxygen therapy (HBO) is useful in treating soft tissue and osteoradionecrosis. In addition, HBO has been recommended to treat radiation-induced myelitis. We used radiation to induce a predictable myelitis in the spinal cords of rats who were randomized into treatment (HBO) and control groups 8 wk after irradiation. Serial neurologic examination showed no benefit or harm as a result of HBO. This small pilot study did not demonstrate any clinically significant benefit of HBO for radiation myelitis in rats.

  4. Stereotactic Radiation Therapy for Brain Tumors

    MedlinePLUS Videos and Cool Tools

    ... Stereotactic Radiation Therapy for brain tumors. As an alternative to surgical removal of tumors, the Trilogy system ... manufactured by Varian Medical Systems in Palo Alto, California, is a much more versatile machine using much ...

  5. Comparing Postoperative Radiation Therapies for Brain Metastases

    Cancer.gov

    In this clinical trial, patients with one to four brain metastases who have had at least one of the metastatic tumors removed surgically will be randomly assigned to undergo whole-brain radiation therapy or stereotactic radiosurgery.

  6. Palliative radiation therapy for primary gastric melanoma

    PubMed Central

    Slater, Jason M.; Ling, Ted C.; Slater, Jerry D.

    2014-01-01

    Introduction Primary gastric melanoma is an exceedingly rare cause of upper gastrointestinal bleeding (GI bleeding). Prior reports of primary gastric melanoma have mostly been treated with surgery with utilization of radiation therapy being unreported. Radiation therapy has been used to palliate bleeding of other cancers including lung, bladder, cervix, and more recently primary gastric cancers. Case presentation This case documents an 87-year-old male who presented with fatigue and melena, and was found to have severe anemia. Endoscopy with biopsy revealed an isolated focus of melanoma. After discharge, he presented two days later and was found to have continued bleeding. Because he was deemed a poor surgical candidate he elected to undergo palliative radiation therapy for bleeding control. Discussion The diagnosis of primary verses metastatic melanoma is a topic of debate. Case reports of patients with no known extra-gastric primary have undergone surgical treatment with varying outcomes. Patients with metastatic gastric melanoma have relied on chemotherapy and radiation in addition to surgery, with radiation being used in the palliative setting. The use of radiation to control bleeding in other cancers including primary gastric adenocarcinoma has been previously studied. This case documents the utilization of radiation therapy in bleeding due to primary gastric melanoma. Conclusions Radiation therapy can provide adequate bleeding palliation in patients with primary gastric melanoma. PMID:24490048

  7. Nursing care update: Internal radiation therapy

    SciTech Connect

    Lowdermilk, D.L.

    1990-01-01

    Internal radiation therapy has been used in treating gynecological cancers for over 100 years. A variety of radioactive sources are currently used alone and in combination with other cancer treatments. Nurses need to be able to provide safe, comprehensive care to patients receiving internal radiation therapy while using precautions to keep the risks of exposure to a minimum. This article discusses current trends and issues related to such treatment for gynecological cancers.20 references.

  8. Acoustic Radiation Force Beam Sequence Performance for Detection and Material Characterization of Atherosclerotic Plaques: Preclinical, Ex Vivo Results

    PubMed Central

    Behler, Russell H.; Czernuszewicz, Tomasz J.; Wu, Chih-Da; Nichols, Timothy C.; Zhu, Hongtu; Homeister, Jonathon W.; Merricks, Elizabeth P.; Caughey, Melissa C.; Gallippi, Caterina M.

    2014-01-01

    This work presents preclinical data demonstrating performance of acoustic radiation force (ARF) based elasticity imaging with five different beam sequences for atherosclerotic plaque detection and material characterization. Twelve trained, blinded readers evaluated parametric images taken ex vivo under simulated in vivo conditions of 22 porcine femoral arterial segments. Receiver operating characteristic (ROC) curve analysis was carried out to quantify reader performance using spatially-matched immunohistochemistry for validation. The beam sequences employed had high sensitivity and specificity for detecting Type III+ plaques (Sens: 85%, Spec: 79%), lipid pools (Sens: 80%, Spec: 86%), fibrous caps (Sens: 86%, spec: 82%), calcium (Sens: 96%, Spec: 85%), collagen (Sens: 78%, Spec: 77%), and disrupted internal elastic lamina (Sens: 92%, Spec: 75%). 1:1 single-receive tracking yielded the highest median areas under the ROC curve (AUC), but was not statistically significantly higher than 4:1 parallel-receive tracking. Excitation focal configuration did not result in statistically different AUCs. Overall, these results suggest ARF-based imaging is relevant to detecting and characterizing plaques and support its use for diagnosing and monitoring atherosclerosis. PMID:24297014

  9. Radiation Sensitization in Cancer Therapy.

    ERIC Educational Resources Information Center

    Greenstock, Clive L.

    1981-01-01

    Discusses various aspects of radiation damage to biological material, including free radical mechanisms, radiation sensitization and protection, tumor hypoxia, mechanism of hypoxic cell radiosensitization, redox model for radiation modification, sensitizer probes of cellular radiation targets, pulse radiolysis studies of free radical kinetics,…

  10. Migratory eosinophilic alveolitis caused by radiation therapy

    PubMed Central

    Lim, Jun Hyeok; Kim, Hun Jung; Choi, Chang-Hwan; Park, In-Suh; Cho, Jae Hwa; Ryu, Jeong-Seon; Kwak, Seung Min; Lee, Hong Lyeol

    2015-01-01

    Although radiation pneumonitis is usually confined to irradiated areas, some studies have reported that radiation-induced lymphocytic alveolitis can also spread to the non-irradiated lung. However, there have been few reports of radiation-induced eosinophilic alveolitis. We report the case of a 27-year-old female with radiation pneumonitis, occurring 4 months after radiation therapy for cancer of the left breast. Clinical and radiological relapse followed withdrawal of corticosteroids. Examination of bronchoalveolar lavage (BAL) in patchy airspace consolidations revealed increased eosinophil counts. Finally, clinical and radiological signs resolved rapidly after reintroduction of corticosteroids. Eosinophilic alveolitis may be promoted by radiation therapy. In the present case report, possible mechanisms for radiation-induced eosinophilic alveolitis are also reviewed.

  11. Changes in symptom clusters in patients undergoing radiation therapy

    E-print Network

    2009-01-01

    cancer . Prostate cancer . Radiation therapy . Sicknessradiation therapy a Mann–Whitney U test Support Care Cancer (Cancer (2009) 17:1383–1391 Table 4 Factor structure at the middle of radiation therapy (

  12. Treatment of pancreatic cancer by radiation therapy

    Microsoft Academic Search

    Ralph R. Dobelbower; Andrew J. Milligan

    1984-01-01

    The role of radiation therapy in the management of pancreatic malignancy was expanded dramatically in the last decade. Development of new tumor localization and dose delivery techniques permits safe delivery of increased radiation dose to upper abdominal tumors. Interstitial implantation of radioisotopes directly into tumors has increased the local control rate for pancreatic cancer as high as 80%, but the

  13. Radiologist, computed tomography, and radiation therapy

    SciTech Connect

    Goitein, M.; Meyer, J.

    1982-06-01

    The use of computed tomography (CT) in planning radiation therapy is discussed. The three major issues that involve collaboration between the diagnostic radiologist and the radiation therapist are identified as selection of equipment, logistics, and conduct of individual CT studies. The importance of cooperation between the diagnostic and therapeutic radiologist is stressed.

  14. Care of the patient receiving radiation therapy

    SciTech Connect

    Yasko, J.M.

    1982-12-01

    External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application.

  15. Glossary of Radiation Therapy Terms

    MedlinePLUS

    ... proper radiation dose for each patient’s cancer treatment Electron beam (ee- leck -tron): a stream of high-energy particles called electrons used to treat some skin cancers External radiation : ...

  16. Biologically Guided Radiation Therapy (BGRT)Biologically Guided Radiation Therapy (BGRT) Relative Biologically EffectivenessRelative Biologically Effectivenessg yg y

    E-print Network

    Stewart, Robert D.

    Biologically Guided Radiation Therapy (BGRT)Biologically Guided Radiation Therapy (BGRT) Relative(RBE) and Oxygen Effects in Particle TherapyTherapy Rob Stewart, Ph.D.Rob Stewart, Ph.D.Rob Stewart, Ph Department of Radiation OncologyDepartment of Radiation Oncology School of Health SciencesSchool of Health

  17. Radiation therapy in pediatric pineal tumors.

    PubMed

    Claude, L; Faure-Conter, C; Frappaz, D; Mottolèse, C; Carrie, C

    2015-01-01

    Pineal tumor management in pediatric patients must be based on close co-operation between oncologists, surgeons, radiation oncologists, neurologists, ophthalmologists, and endocrinologists. Radiation therapy (RT) remains critical in most situations and should be assessed as soon as the diagnosis is made, in order to optimize the radiation technique. This paper will focus on RT modalities, indications, as well as modalities in main pediatric pineal tumors (germ cell tumors and pineal parenchyma tumors). RT modalities are presently being debated and new RT techniques (intensity-modulated RT, proton therapy etc.) that are now available for pineal lesions need to be evaluated. Radiation strategies are also controversial for germ cell tumors: cranio-spinal radiation versus chemotherapy followed by focal radiation, which also requires discussion. PMID:25612810

  18. New therapeutic strategies in radiation therapy

    SciTech Connect

    Kinsella, T.J. (National Cancer Inst., Bethesda, MD); Bloomer, W.D.

    1981-04-24

    Radiation therapy has been an integral part of curative cancer therapy for many decades. The tolerance of normal tissues traversed by radiation and resistant tumor cell populations traditionally have limited the radiocurability of certain tumors, especially with higher clinical stages. However, research in radiobiology and radiation physics is providing ways to increase cure while limiting morbidity. Computer-controlled dynamic treatment, radioprotector drugs, hyperbaric oxygen, carbogen breathing during irradiation, particle irradiation, and hypoxic cell sensitizing drugs are presently undergoing clinical evaluation with some encouraging preliminary results. We review the fundamental concepts underlying these clinical trials and analyze the results.

  19. REVIEW Open Access Stereotactic body radiation therapy for abdominal

    E-print Network

    Paris-Sud XI, Université de

    REVIEW Open Access Stereotactic body radiation therapy for abdominal oligometastases: a biological of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New. Keywords: Cancer, Gastrointestinal, Liver, Radiotherapy, Radiation biology, Surgery Introduction

  20. Comparison of forward planned conformal radiation therapy and inverse planned intensity modulated radiation therapy for esthesioneuroblastoma

    Microsoft Academic Search

    A ZABEL; C THILMANN; I ZUNA; W SCHLEGEL; M WANNENMACHER; J DEBUS

    The purpose of this study was to compare dose distribution of inverse planned intensity modulated radiation therapy (IMRT) with that of conformal radiation therapy (SCRT) in the treatment of esthesioneuroblastoma, and to report initial clinical results. 13 patients with esthesioneuroblastoma were planned both with IMRT and SCRT using complete three- dimensional data sets. A target dose of 60 Gy was

  1. Impaired skin integrity related to radiation therapy

    SciTech Connect

    Ratliff, C.

    1990-09-01

    Skin reactions associated with radiation therapy require frequent nursing assessment and intervention. Preventive interventions and early management can minimize the severity of the skin reaction. With the understanding of the pathogenesis of radiation skin reactions, the ET nurse can determine who is at risk and then implement preventive measures. Because radiation treatment is fractionated, skin reactions do not usually occur until midway through the course of therapy and will subside within a few weeks after completion of radiation. Many patients and their families still fear that radiation causes severe burns. Teaching and anticipatory guidance by the ET nurse is needed to assist patients and their families to overcome this fear, and to educate them on preventive skin care regimens.

  2. Erythrosine is a potential photosensitizer for the photodynamic therapy of oral plaque biofilms

    Microsoft Academic Search

    Simon Wood; Daniel Metcalf; Deirdre Devine; Colin Robinson

    2006-01-01

    Results: The CLSM results showed that erythrosine is taken up into S. mutans biofilms, where it is associated with the biomass of the biofilm rather than the fluid-filled channels and voids. Comparison of the cell killing efficacy of erythrosine in S. mutans biofilms of different ages showed that erythrosine was1-2log10moreeffectiveatkillingbiofilmbacteriathanphotofrinand0.5-1log10moreeffectivethanMB. The results were statistically significant (P < 0.01). Photodynamic therapy

  3. Radiation Therapy for Pilocytic Astrocytomas of Childhood

    SciTech Connect

    Mansur, David B., E-mail: mansur@radonc.wustl.ed [Department of Radiation Oncology, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States); Rubin, Joshua B. [Division of Pediatric Hematology and Oncology, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States); Kidd, Elizabeth A. [Department of Radiation Oncology, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States); King, Allison A. [Division of Pediatric Hematology and Oncology, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States); Hollander, Abby S. [Endocrinology, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States); Smyth, Matthew D.; Limbrick, David D.; Park, T.S.; Leonard, Jeffrey R. [Department of Neurological Surgery, Washington University School of Medicine and Saint Louis Children's Hospital, Saint Louis, MO (United States)

    2011-03-01

    Purpose: Though radiation therapy is generally considered the most effective treatment for unresectable pilocytic astrocytomas in children, there are few data to support this claim. To examine the efficacy of radiation therapy for pediatric pilocytic astrocytomas, we retrospectively reviewed the experience at our institution. Methods and Materials: Thirty-five patients 18 years old or younger with unresectable tumors and without evidence of neurofibromatosis have been treated since 1982. Patients were treated with local radiation fields to a median dose of 54 Gy. Six patients were treated with radiosurgery to a median dose of 15.5 Gy. Five patients were treated with initial chemotherapy and irradiated after progression. Results: All patients were alive after a median follow-up of 5.0 years. However, progression-free survival was 68.7%. None of 11 infratentorial tumors progressed compared with 6 of 20 supratentorial tumors. A trend toward improved progression-free survival was seen with radiosurgery (80%) compared with external beam alone (66%), but this difference did not reach statistical significance. Eight of the 9 patients progressing after therapy did so within the irradiated volume. Conclusions: Although the survival of these children is excellent, almost one third of patients have progressive disease after definitive radiotherapy. Improvements in tumor control are needed in this patient population, and the optimal therapy has not been fully defined. Prospective trials comparing initial chemotherapy to radiation therapy are warranted.

  4. Postoperative Radiation Therapy for Parotid Mucoepidermoid Carcinoma

    PubMed Central

    Olsen, Meghan P.; Mitchell, Allen O.; Miles, Edward F.

    2014-01-01

    Salivary gland cancers are rare and represent approximately 5% of all head and neck cancers and only 0.3% of all malignancies. The majority (75%) of salivary gland tumors occur in the parotid gland, and while benign lesions are more common, mucoepidermoid carcinoma (MEC) makes up 40–50% of malignant parotid gland tumors. No randomized controlled trials exist regarding the role of adjuvant radiation for patients who undergo surgical resection of low-grade MECs. Herein, we report two cases of successful postoperative radiation therapy in low-grade, pT2N0 MEC of the parotid gland. The role of adjuvant radiation therapy for patients with MEC of the parotid gland is based on data from institution reviews and lacks data from randomized controlled trials. Per our review of the literature, the pathological findings of positive surgical margins and/or perineural invasion in two patients with low-grade MEC of the parotid gland warranted adjuvant radiation for improved local control after partial parotidectomy. Both patients tolerated postoperative radiation therapy with only mild side effects and, at last follow-up, five years after completion of therapy, had no clinical or radiographic evidence of either local recurrence or distant metastasis. PMID:25580323

  5. Stereotactic radiation therapy and selective internal radiation therapy for hepatocellular carcinoma

    Microsoft Academic Search

    A. Bujold; L. A. Dawson

    2011-01-01

    Recent technological advances allow precise and safe radiation delivery in hepatocellular carcinoma. Stereotactic body radiotherapy is a conformal external beam radiation technique that uses a small number of relatively large fractions to deliver potent doses of radiation therapy to extracranial sites. It requires stringent breathing motion control and image guidance. Selective internal radiotherapy or radioembolization refers to the injection of

  6. Radioprotective agents for radiation therapy: future trends.

    PubMed

    Johnke, Roberta M; Sattler, Jennifer A; Allison, Ron R

    2014-12-01

    Only two radioprotective compounds, amifostine and palifermin, currently have the US FDA approval for use in radiation therapy. However, several agents have been reported that show therapeutic promise. Many of these agents are free radical scavengers/antioxidants. Superoxide dismutase and superoxide dismutase mimetics, nitroxides and dietary antioxidants are all being investigated. Recently, alternative strategies of drug development have been evolving, which focus on targeting the series of cellular insult recognition/repair responses initiated following radiation. These agents, which include cytokines/growth factors, angiotensin-converting enzyme inhibitors and apoptotic modulators, show promise of having significant impact on the mitigation of radiation injury. Herein, we review current literature on the development of radioprotectors with emphasis on compounds with proven or potential usefulness in radiation therapy. PMID:25525844

  7. Radiation and the microenvironment – tumorigenesis and therapy

    Microsoft Academic Search

    Catherine Park; Eric G. Wright; Mary Helen Barcellos-Hoff

    2005-01-01

    Radiation rapidly and persistently alters the soluble and insoluble components of the tissue microenvironment. This affects the cell phenotype, tissue composition and the physical interactions and signalling between cells. These alterations in the microenvironment can contribute to carcinogenesis and alter the tissue response to anticancer therapy. Examples of these responses and their implications are discussed with a view to therapeutic

  8. Tetrahedral irradiation protocol for microbeam radiation therapy

    Microsoft Academic Search

    Daniel N Slatkin

    2006-01-01

    Optimizing microbeam radiation therapy requires that the patient be repositioned between exposures. Optional movements of a patient-gantry are described that would enable a lesion to be cross-fired pseudo-orthogonally in two, three or four exposures to a fixed, horizontally propagated array of vertical, parallel microplanar beams, with minimal tilting of the patient-gantry.

  9. Memory and survival after microbeam radiation therapy

    Microsoft Academic Search

    Elisabeth Schültke; Bernhard H. J. Juurlink; Khalid Ataelmannan; Jean Laissue; Hans Blattmann; Elke Bräuer-Krisch; Alberto Bravin; Joanna Minczewska; Jeffrey Crosbie; Hadi Taherian; Evan Frangou; Tomasz Wysokinsky; L. Dean Chapman; Robert Griebel; Daryl Fourney

    2008-01-01

    Background: Disturbances of memory function are frequently observed in patients with malignant brain tumours and as adverse effects after radiotherapy to the brain. Experiments in small animal models of malignant brain tumour using synchrotron-based microbeam radiation therapy (MRT) have shown a promising prolongation of survival times. Materials and methods: Two animal models of malignant brain tumour were used to study

  10. New irradiation geometry for microbeam radiation therapy

    Microsoft Academic Search

    E. Bräuer-Krisch; H. Requardt; P. Régnard; S. Corde; E. Siegbahn; G. LeDuc; T. Brochard; H. Blattmann; J. Laissue; A. Bravin

    2005-01-01

    Microbeam radiation therapy (MRT) has the potential to treat infantile brain tumours when other kinds of radiotherapy would be excessively toxic to the developing normal brain. MRT uses extraordinarily high doses of x-rays but provides unusual resistance to radioneurotoxicity, presumably from the migration of endothelial cells from 'valleys' into 'peaks', i.e., into directly irradiated microslices of tissues. We present a

  11. Memory and survival after microbeam radiation therapy

    Microsoft Academic Search

    Elisabeth Schültke; Bernhard H. J. Juurlink; Khalid Ataelmannan; Jean Laissue; Hans Blattmann; Elke Bräuer-Krisch; Alberto Bravin; Joanna Minczewska; Jeffrey Crosbie; Hadi Taherian; Evan Frangou; Tomasz Wysokinsky; L. Dean Chapman; Robert Griebel; Daryl Fourney

    2008-01-01

    BackgroundDisturbances of memory function are frequently observed in patients with malignant brain tumours and as adverse effects after radiotherapy to the brain. Experiments in small animal models of malignant brain tumour using synchrotron-based microbeam radiation therapy (MRT) have shown a promising prolongation of survival times.

  12. External and internal radiation therapy: past and future directions.

    PubMed

    Sadeghi, Mahdi; Enferadi, Milad; Shirazi, Alireza

    2010-01-01

    Cancer is a leading cause of morbidity and mortality in the modern world. Treatment modalities comprise radiation therapy, surgery, chemotherapy and hormonal therapy. Radiation therapy can be performed by using external or internal radiation therapy. However, each method has its unique properties which undertakes special role in cancer treatment, this question is brought up that: For cancer treatment, whether external radiation therapy is more efficient or internal radiation therapy one? To answer this question, we need to consider principles and structure of individual methods. In this review, principles and application of each method are considered and finally these two methods are compared with each other. PMID:21119247

  13. Comparison of particle-radiation-therapy modalities

    SciTech Connect

    Fairchild, R.G.; Bond, V.P.

    1981-01-01

    The characteristics of dose distribution, beam alignment, and radiobiological advantages accorded to high LET radiation were reviewed and compared for various particle beam radiotherapeutic modalities (neutron, Auger electrons, p, ..pi../sup -/, He, C, Ne, and Ar ions). Merit factors were evaluated on the basis of effective dose to tumor relative to normal tissue, linear energy transfer (LET), and dose localization, at depths of 1, 4, and 10 cm. In general, it was found that neutron capture therapy using an epithermal neutron beam provided the best merit factors available for depths up to 8 cm. The position of fast neutron therapy on the Merit Factor Tables was consistently lower than that of other particle modalities, and above only /sup 60/Co. The largest body of clinical data exists for fast neutron therapy; results are considered by some to be encouraging. It then follows that if benefits with fast neutron therapy are real, additional gains are within reach with other modalities.

  14. Protons -- The Future of Radiation Therapy?

    NASA Astrophysics Data System (ADS)

    Avery, Steven

    2007-03-01

    Cancer is the 2^nd highest cause of death in the United States. The challenges of controlling this disease remain more difficult as the population lives longer. Proton therapy offers another choice in the management of cancer care. Proton therapy has existed since the late 1950s and the first hospital based center in the United States opened in 1990. Since that time four hospital based proton centers are treating patients with other centers either under construction or under consideration. This talk will focus on an introduction to proton therapy: it's medical advantages over current treatment modalities, accelerators and beam delivery systems, applications to clinical radiation oncology and the future outlook for proton therapy.

  15. Current clinical coverage of Radiation Therapy Oncology Group-defined target volumes for postmastectomy radiation therapy

    Microsoft Academic Search

    Hiral P. Fontanilla; Wendy A. Woodward; Mary E. Lindberg; James E. Kanke; Gurpreet Arora; Rosalind R. Durbin; T. Kuan Yu; Lifei Zhang; Hadley J. Sharp; Eric A. Strom; Mohammad Salehpour; Julia White; Thomas A. Buchholz; Lei Dong

    PurposeThe Radiation Therapy Oncology Group (RTOG) has published consensus guidelines for contouring relevant anatomy for postmastectomy radiation therapy (RT). How these contours relate to current treatment practices is unknown. We analyzed the dose-volume histograms (DVHs) for these contours using current clinical practice at our institution and compared them with the proposed treatment plans to treat RTOG-defined targets to full dose.

  16. Effectiveness of Conventional Drug Therapy of Plaque Psoriasis in the Context of Consensus Guidelines: A Prospective Observational Study in 150 Patients

    PubMed Central

    Gupta, Ashok Kumar; Pandey, Shyam Sunder

    2013-01-01

    Background Evidence for superior outcome by adhering to therapy guidelines is imperative to their acceptance and adaptation for the optimal management of disease variants. Objective Comparative study of prospective outcomes in simultaneous consideration of independent variables in groups of 150 patients of plaque psoriasis either treated adhering to or in digression of standard guidelines. Methods The psoriasis area severity index (PASI) and the dermatology life quality index (DLQI), prior to and after three months of uninterrupted therapy were examined in treatment groups among 150 patients. Recovery rates of 75% or more in PASI were compared. Independent variables were also examined for their bearing on the outcome. Results The vast majority was early onset disease phenotype. All three treatment regimens when administered in adherence to the guidelines yielded significantly superior rates of defined recovery both in PASI and DLQI. Compromise of the therapeutic outcome appeared in high stress profiles, obesity, female sex and alcohol, tobacco or smoking habit. Conclusion Conventional drug therapy of plaque psoriasis yields superior outcome by adhering to the consensus guidelines. Psychiatric address to stress must be integral and special considerations for phenotypic/syndromic variants is emphasized for effective therapy of psoriasis. PMID:23717005

  17. On Linear Infeasibility Arising in Intensity-Modulated Radiation Therapy

    E-print Network

    Censor, Yair

    On Linear Infeasibility Arising in Intensity-Modulated Radiation Therapy Inverse Planning Yair, 2007. Abstract Intensity--modulated radiation therapy (IMRT) gives rise to sys- tems of linear The fully-discretized feasibility model of the inverse problem of intensity- modulated radiation therapy

  18. Image-Guidance and Multimodal Dose Planning in Radiation Therapy

    E-print Network

    Paris-Sud XI, Université de

    Image-Guidance and Multimodal Dose Planning in Radiation Therapy A workshop held at MICCAI 2012 and image computing form the basis for radiation therapy. Examples range from pre-treatment delineation in radiation therapy have frequently been a driving force in the de- velopment of new image computing

  19. Intuitive Navigation in the Targeting of Radiation Therapy Treatment Beams

    E-print Network

    North Carolina at Chapel Hill, University of

    Intuitive Navigation in the Targeting of -----~------------------ Radiation Therapy Treatment Beams Che-Ming Chung ALL RIGHTS RESERVED ii #12;Intuitive Navigation in the Targeting of Radiation Therapy-mounted displays (HMDs) in the targeting of radiation therapy treatment beams. A tumor surrounded by various types

  20. Robust optimization for intensity modulated radiation therapy treatment planning under

    E-print Network

    Henderson, Shane

    Robust optimization for intensity modulated radiation therapy treatment planning under uncertainty.sharpe@rmp.uhn.on.ca Abstract. The recent development of Intensity Modulated Radiation Therapy (IMRT) allows the dose raised the accuracy and precision of radiation therapy delivery to new levels of sophistication

  1. Radiation therapy for orbital lymphoma

    SciTech Connect

    Zhou Ping [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States)]. E-mail: pzhou@partners.org; Ng, Andrea K. [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States); Silver, Barbara [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States); Li Sigui [Department of Biostatistical Sciences, Dana-Farber Cancer Institute, Boston, MA (United States); Hua Ling [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States); Mauch, Peter M. [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States)

    2005-11-01

    Purpose: To describe radiation techniques and evaluate outcomes for orbital lymphoma. Methods and Materials: Forty-six patients (and 62 eyes) with orbital lymphoma treated with radiotherapy between 1987 and 2003 were included. The majority had mucosa-associated lymphoid tissue (48%) or follicular (30%) lymphoma. Seventeen patients had prior lymphoma at other sites, and 29 had primary orbital lymphoma. Median follow-up was 46 months. Results: The median dose was 30.6 Gy; one-third received <30 Gy. Electrons were used in 9 eyes with disease confined to the conjunctiva or eyelid, and photons in 53 eyes with involvement of intraorbital tissues to cover entire orbit. Local control rate was 98% for all patients and 100% for those with indolent lymphoma. Three of the 26 patients with localized primary lymphoma failed distantly, resulting in a 5-year freedom-from-distant-relapse rate of 89%. The 5-year disease-specific and overall survival rates were 95% and 88%, respectively. Late toxicity was mainly cataract formation in patients who received radiation without lens block. Conclusions A dose of 30 Gy is sufficient for indolent orbital lymphoma. Distant relapse rate in patients with localized orbital lymphoma was lower than that reported for low-grade lymphoma presenting in other sites. Orbital radiotherapy can be used for salvage of recurrent indolent lymphoma.

  2. Laboratory Investigation Synergy of gene-mediated immunoprophylaxis and microbeam radiation therapy

    E-print Network

    Terasaki, Mark

    Laboratory Investigation Synergy of gene-mediated immunoprophylaxis and microbeam radiation therapy radiation therapy, rats Summary Purpose: Microbeam radiation therapy (MRT), a novel experimental, d21). On d14, the remaining 62 rats were given deliberately suboptimal microbeam radiation therapy

  3. Androgen deprivation with radiation therapy compared with radiation therapy alone for locally advanced prostatic carcinoma: a randomized comparative trial of the radiation therapy oncology group

    Microsoft Academic Search

    Miljenko V. Pilepich; William T. Sause; William U. Shipley; John M. Krall; Colleen A. Lawton; David Grignon; Muhyi Al-Sarraf; Ross A. Abrams; Richard Caplan; Madhu J. John; Marvin Rotman; James D. Cox; R. L. Scotte Doggett; Philip Rubin; Mark S. Soloway

    1995-01-01

    ObjectivesAndrogen deprivation therapy before and during radiation therapy could, by reducing tumor volume, increase local tumor control, disease-free survival, and overall survival in patients with locally advanced adenocarcinomas of the prostate.

  4. Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer

    PubMed Central

    Sheets, Nathan C.; Goldin, Gregg H.; Meyer, Anne-Marie; Wu, Yang; Chang, YunKyung; Stürmer, Til; Holmes, Jordan A.; Reeve, Bryce B.; Godley, Paul A.; Carpenter, William R.; Chen, Ronald C.

    2013-01-01

    Context There has been rapid adoption of newer radiation treatments such as intensitymodulated radiation therapy (IMRT) and proton therapy despite greater cost and limited demonstrated benefit compared with previous technologies. Objective To determine the comparative morbidity and disease control of IMRT, proton therapy, and conformal radiation therapy for primary prostate cancer treatment. Design, Setting, and Patients Population-based study using Surveillance, Epidemiology, and End Results–Medicare-linked data from 2000 through 2009 for patients with nonmetastatic prostate cancer. Main Outcome Measures Rates of gastrointestinal and urinary morbidity, erectile dysfunction, hip fractures, and additional cancer therapy. Results Use of IMRT vs conformal radiation therapy increased from 0.15% in 2000 to 95.9% in 2008. In propensity score–adjusted analyses (N=12 976), men who received IMRT vs conformal radiation therapy were less likely to receive a diagnosis of gastrointestinal morbidities (absolute risk, 13.4 vs 14.7 per 100 person-years; relative risk [RR], 0.91; 95% CI, 0.86–0.96) and hip fractures (absolute risk, 0.8 vs 1.0 per 100 person-years; RR, 0.78; 95% CI, 0.65–0.93) but more likely to receive a diagnosis of erectile dysfunction (absolute risk, 5.9 vs 5.3 per 100 person-years; RR, 1.12; 95% CI, 1.03–1.20). Intensitymodulated radiation therapy patients were less likely to receive additional cancer therapy (absolute risk, 2.5 vs 3.1 per 100 person-years; RR, 0.81; 95% CI, 0.73–0.89). In a propensity score–matched comparison between IMRT and proton therapy (n=1368), IMRT patients had a lower rate of gastrointestinal morbidity (absolute risk, 12.2 vs 17.8 per 100 person-years; RR, 0.66; 95% CI, 0.55–0.79). There were no significant differences in rates of other morbidities or additional therapies between IMRT and proton therapy. Conclusions Among patients with nonmetastatic prostate cancer, the use of IMRT compared with conformal radiation therapy was associated with less gastrointestinal morbidity and fewer hip fractures but more erectile dysfunction; IMRT compared with proton therapy was associated with less gastrointestinal morbidity. PMID:22511689

  5. Deciding on radiation therapy: a patient's perspective.

    PubMed

    Hilsman, W J

    2000-08-01

    This article describes my personal experience in dealing with the issue of decision-making for prostate cancer, and how I used available information on the disease to go about making my decision to have combined hormone therapy, external beam radiation, and brachytherapy. Many resources are available to patients today thanks to advances in technology. The guidance and information provided by my physicians was an essential element in my treatment decision, but I stress that the final decision was mine. PMID:10975492

  6. Gastrointestinal toxicity associated to radiation therapy

    Microsoft Academic Search

    Mario López Rodríguez; Margarita Martín Martín; Laura Cerezo Padellano; Alicia Marín Palomo; Yamile Ibáñez Puebla

    2010-01-01

    Radiation therapy in combination with other treatments, such as surgery and chemotherapy, increases locoregional control and\\u000a survival in patients with thoracic, abdominal and pelvic malignancies. Nevertheless, significant clinical toxicity with combined\\u000a treatments may be seen in these patients. With the advent of tridimensional conformal radiotherapy (3D-CRT), dose-volume histograms\\u000a (DVH) can be generated to assess the dose received by the organs

  7. Chronic neuroendocrinological sequelae of radiation therapy

    SciTech Connect

    Sklar, C.A. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States)] [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Constine, L.S. [Univ. of Rochester Medical Center, Rochester, NY (United States)] [Univ. of Rochester Medical Center, Rochester, NY (United States)

    1995-03-30

    A variety of neuroendocrine disturbances are observed following treatment with external radiation therapy when the hypothalamic-pituitary axis (HPA) is included in the treatment field. Radiation-induced abnormalities are generally dose dependent and may develop many years after irradiation. Growth hormone deficiency and premature sexual development can occur following doses as low as 18 Gy fractionated radiation and are the most common neuroendocrine problems noted in children. Deficiency of gonadotropins, thyroid stimulating hormone, and adrenocorticotropin are seen primarily in individuals treated with > 40 Gy HPA irradiation. Hyperprolactinemia can be seen following high-dose radiotherapy (>40 Gy), especially among young women. Most neuroendocrine disturbances that develop as a result of HPA irradiation are treatable; patients at risk require long-term endocrine follow-up. 23 refs., 6 figs., 2 tabs.

  8. Image-guided radiation therapy: Physician's perspectives.

    PubMed

    Gupta, T; Narayan, C Anand

    2012-10-01

    The evolution of radiotherapy has been ontogenetically linked to medical imaging. Over the years, major technological innovations have resulted in substantial improvements in radiotherapy planning, delivery, and verification. The increasing use of computed tomography imaging for target volume delineation coupled with availability of computer-controlled treatment planning and delivery systems have progressively led to conformation of radiation dose to the target tissues while sparing surrounding normal tissues. Recent advances in imaging technology coupled with improved treatment delivery allow near-simultaneous soft-tissue localization of tumor and repositioning of patient. The integration of various imaging modalities within the treatment room for guiding radiation delivery has vastly improved the management of geometric uncertainties in contemporary radiotherapy practice ushering in the paradigm of image-guided radiation therapy (IGRT). Image-guidance should be considered a necessary and natural corollary to high-precision radiotherapy that was long overdue. Image-guided radiation therapy not only provides accurate information on patient and tumor position on a quantitative scale, it also gives an opportunity to verify consistency of planned and actual treatment geometry including adaptation to daily variations resulting in improved dose delivery. The two main concerns with IGRT are resource-intensive nature of delivery and increasing dose from additional imaging. However, increasing the precision and accuracy of radiation delivery through IGRT is likely to reduce toxicity with potential for dose escalation and improved tumor control resulting in favourable therapeutic index. The radiation oncology community needs to leverage this technology to generate high-quality evidence to support widespread adoption of IGRT in contemporary radiotherapy practice. PMID:23293448

  9. Do Plaques Rapidly Progress Prior to Myocardial Infarction? The Interplay Between Plaque Vulnerability and Progression.

    PubMed

    Ahmadi, Amir; Leipsic, Jonathon; Blankstein, Ron; Taylor, Carolyn; Hecht, Harvey; Stone, Gregg W; Narula, Jagat

    2015-06-19

    There is a common misperception in the cardiology community that most acute coronary events arise from ruptures of mildly stenotic plaques. This notion has emanated from multiple studies that had measured the degree of angiographic luminal narrowing in culprit plaques months to years before myocardial infarction. However, angiographic studies within 3 months before myocardial infarction, immediately after myocardial infarction with thrombus aspiration or fibrinolytic therapy, and postmortem pathological observations have all shown that culprit plaques in acute myocardial infarction are severely stenotic. Serial angiographic studies also have demonstrated a sudden rapid lesion progression before most cases of acute coronary syndromes. The possible mechanisms for such rapid plaque progression and consequent luminal obstruction include recurrent plaque rupture and healing and intraplaque neovascularization and hemorrhage with deposition of erythrocyte-derived free cholesterol. Moreover, recent intravascular and noninvasive imaging studies have demonstrated that plaques which result in coronary events have larger plaque volume and necrotic core size with greater positive vessel remodeling compared with plaques, which remain asymptomatic during several years follow-up, although these large atheromatous vulnerable plaques may angiographically seem mild. As such, it is these vulnerable plaques which are more prone to rapid plaque progression or are those in which plaque progression is more likely to become clinically evident. Therefore, in addition to characterizing plaque morphology, inflammatory activity, and severity, detection of the rate of plaque progression might identify vulnerable plaques with an increased potential for adverse outcomes. PMID:26089367

  10. Radiation Therapy for Locally Recurrent Breast Cancer

    PubMed Central

    Siglin, Joshua; Champ, Colin E.; Vakhnenko, Yelena; Anne, Pramila R.; Simone, Nicole L.

    2012-01-01

    Approximately one-third of all breast cancer patients experience local recurrence of their tumor after initial treatment. As initial treatment often employs the use of radiation therapy (RT), the standard of care for local breast cancer recurrence after initial breast conserving therapy has traditionally been surgical intervention with mastectomy. However, recent attempts to preserve the intact breast after recurrence with local excision have revealed a potential need for RT in addition to repeat breast conserving surgery as rates of local failure with resection alone remain high. Additionally, local recurrence following initial mastectomy and chest wall RT can be treated with reirradiation to increase local control. Repeating RT, however, in a previously irradiated area, is a complex treatment strategy, as the clinician must carefully balance maximizing treatment effectiveness while minimizing treatment-related toxicity. As a result, physicians have been hesitant to treat recurrent disease with repeat RT with limited data. Results from the current literature are promising and current clinical trials are underway to explore reirradiation modalities which will provide additional information on treatment-related toxicity and outcomes. This paper will review the current literature on repeat radiation therapy for locally recurrent breast cancer. PMID:23091733

  11. Accelerated hypofractionated radiation therapy compared to conventionally fractionated radiation therapy for the treatment of inoperable non-small cell lung cancer

    E-print Network

    Amini, Arya; Lin, Steven H; Wei, Caimiao; Allen, Pamela; Cox, James D; Komaki, Ritsuko

    2012-01-01

    by the radiation therapy oncology group. Cancer 1980, 45(radiation therapy for the treatment of inoperable non-small cell lung cancer.radiation therapy in unresectable stage III non-small cell lung cancer.

  12. Molecular Pathways: Targeted ?-Particle Radiation Therapy

    PubMed Central

    Baidoo, Kwamena E.; Yong, Kwon; Brechbiel, Martin W.

    2012-01-01

    An ?-particle, a 4He nucleus, is exquisitely cytotoxic, and indifferent to many limitations associated with conventional chemo- and radiotherapy. The exquisite cytotoxicity of ? radiation, the result of its high mean energy deposition (high linear energy transfer, LET) and limited range in tissue, provides for a highly controlled therapeutic modality that can be targeted to selected malignant cells (targeted ?-therapy (TAT)) with minimal normal tissue effects. There is a burgeoning interest in the development of TAT that is buoyed by the increasing number of ongoing clinical trials worldwide. The short path length renders ?-emitters suitable for treatment and management of minimal disease such as micrometastases or residual tumor after surgical debulking, hematological cancers, infections, and compartmental cancers such as ovarian cancer or neoplastic meningitis. Yet, despite decades of study of high-LET radiation, the mechanistic pathways of the effects of this modality remain not well defined. The modality is effectively presumed to follow a simple therapeutic mechanism centered on catastrophic double strand (ds) DNA breaks without full examination of the actual molecular pathways and targets that are activated that directly impact cell survival or death. This Molecular Pathways article provides an overview of the mechanisms and pathways that are involved in the response to and repair of TAT induced DNA damage as currently understood. Finally, this article highlights the current state of clinical translation of TAT as well as other high-LET radionuclide radiation therapy using ?-emitters such as 225Ac, 211At, 213Bi, 212Pb and 223Ra. PMID:23230321

  13. Methods for implementing microbeam radiation therapy

    DOEpatents

    Dilmanian, F. Avraham; Morris, Gerard M.; Hainfeld, James F.

    2007-03-20

    A method of performing radiation therapy includes delivering a therapeutic dose such as X-ray only to a target (e.g., tumor) with continuous broad beam (or in-effect continuous) using arrays of parallel planes of radiation (microbeams/microplanar beams). Microbeams spare normal tissues, and when interlaced at a tumor, form a broad-beam for tumor ablation. Bidirectional interlaced microbeam radiation therapy (BIMRT) uses two orthogonal arrays with inter-beam spacing equal to beam thickness. Multidirectional interlaced MRT (MIMRT) includes irradiations of arrays from several angles, which interleave at the target. Contrast agents, such as tungsten and gold, are administered to preferentially increase the target dose relative to the dose in normal tissue. Lighter elements, such as iodine and gadolinium, are used as scattering agents in conjunction with non-interleaving geometries of array(s) (e.g., unidirectional or cross-fired (intersecting) to generate a broad beam effect only within the target by preferentially increasing the valley dose within the tumor.

  14. Intraoperative radiation therapy in recurrent ovarian cancer

    SciTech Connect

    Yap, O.W. Stephanie [Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Stanford University School of Medicine, Stanford, CA (United States)]. E-mail: stbeast@stanford.edu; Kapp, Daniel S. [Division of Radiation Therapy, Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Teng, Nelson N.H. [Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Stanford University School of Medicine, Stanford, CA (United States); Husain, Amreen [Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Stanford University School of Medicine, Stanford, CA (United States)

    2005-11-15

    Purpose: To evaluate disease outcomes and complications in patients with recurrent ovarian cancer treated with cytoreductive surgery and intraoperative radiation therapy (IORT). Methods and Materials: A retrospective study of 24 consecutive patients with ovarian carcinoma who underwent secondary cytoreduction and intraoperative radiation therapy at our institution between 1994 and 2002 was conducted. After optimal cytoreductive surgery, IORT was delivered with orthovoltage X-rays (200 kVp) using individually sized and beveled cone applications. Outcomes measures were local control of disease, progression-free interval, overall survival, and treatment-related complications. Results: Of these 24 patients, 22 were available for follow-up analysis. Additional treatment at the time of and after IORT included whole abdominopelvic radiation, 9; pelvic or locoregional radiation, 5; chemotherapy, 6; and no adjuvant treatment, 2. IORT doses ranged from 9-14 Gy (median, 12 Gy). The anatomic sites treated were pelvis (sidewalls, vaginal cuff, presacral area, anterior pubis), para-aortic and paracaval lymph node beds, inguinal region, or porta hepatitis. At a median follow-up of 24 months, 5 patients remain free of disease, whereas 17 patients have recurred, of whom 4 are alive with disease and 13 died from disease. Five patients recurred within the radiation fields for a locoregional relapse rate of 32% and 12 patients recurred at distant sites with a median time to recurrence of 13.7 months. Five-year overall survival was 22% with a median survival of 26 months from time of IORT. Nine patients (41%) experienced Grade 3 toxicities from their treatments. Conclusion: In carefully selected patients with locally recurrent ovarian cancer, combined IORT and tumor reductive surgery is reasonably tolerated and may contribute to achieving local control and disease palliation.

  15. Intensity Modulated Beam Radiation Therapy Dose Optimization with Multiobjective

    E-print Network

    Coello, Carlos A. Coello

    will be di- agnosed with cancer. Half of these will be treated with radiation therapy [1]. In teletherapyIntensity Modulated Beam Radiation Therapy Dose Optimization with Multiobjective Evolutionary or external radiotherapy beams of penetrating radiation are directed at the tumor. Along their path through

  16. HYPERBARIC OXYGEN THERAPY FOR RADIATION INDUCED HEMORRHAGIC CYSTITIS

    Microsoft Academic Search

    RANJIV MATHEWS; NATARAJAN RAJAN; LAURA JOSEFSON; ENRICO CAMPORESI; ZAHI MAKHULI

    1999-01-01

    PurposeRadiation therapy has been used successfully to treat pelvic malignancy but morbidity from hemorrhagic cystitis remains a major long-term sequela in 1 to 2% of patients. Obliterative endarteritis secondary to ionizing radiation leads to tissue hypoxia and poor healing. Hyperbaric oxygen therapy has been demonstrated to improve angiogenesis and promote healing in radiation injured tissue, including the bladder. We describe

  17. X3D IN RADIATION THERAPY PROCEDURE PLANNING

    Microsoft Academic Search

    Felix G. Hamza-Lup; Ivan Sopin; Dan Lipsa; Omar Zeidan

    Radiation therapy, an increasingly available and effective cancer treatment solution, involves sophisticated machinery as well as careful planning. Interactive 3D simulations combined with accurate 3D patient specific data can improve the planning process saving time and resources in generating the optimal treatment plan. We illustrate the potential of X3D in radiation therapy, specifically radiation treatment planning. Embedding patient specific data

  18. Geant4 simulations for microbeam radiation therapy (MRT) dosimetry

    Microsoft Academic Search

    J. Spiga; E. A. Siegbahn; E. Brauer-Krisch; P. Randaccio; A. Bravin

    2007-01-01

    Radiation therapy is one of the techniques most commonly used in the treatment of various types of tumors. The microbeam radiation therapy (MRT) is a very promising variant, which exploits the property that tissues can tolerate high doses of radiation in small volumes. The effectiveness of MRT is well represented by the peak-to-valley dose ratios (PVDRs), which are one of

  19. Microwave plaque thermoradiotherapy for choroidal melanoma.

    PubMed Central

    Finger, P. T.

    1992-01-01

    Microwave thermoradiotherapy was used as a primary treatment for 44 patients with choroidal melanoma. An episcleral dish-shaped microwave antenna was placed beneath the tumour at the time of plaque brachytherapy. While temperatures were measured at the sclera, the tumour's apex was targeted to receive a minimum of 42 degrees C for 45 minutes. In addition, the patients received full or reduced doses of plaque radiotherapy. No patients have been lost to follow-up. Two eyes have been enucleated: one for rubeotic glaucoma, and one for uveitic glaucoma. Though six patients have died, only one death was due to metastatic choroidal melanoma (39 months after treatment). Clinical observations suggest that the addition of microwave heating to plaque radiation therapy of choroidal melanoma has been well tolerated. There has been a 97.7% local control rate (with a mean follow-up of 22.2 months). We have reduced the minimum tumour radiation dose (apex dose) to levels used for thermoradiotherapy of cutaneous melanomas (50 Gy/5000 rad). Within the range of this follow-up period no adverse effects which might preclude the use of this microwave heat delivery system for treatment of choroidal melanoma have been noted. Images PMID:1622949

  20. New irradiation geometry for microbeam radiation therapy.

    PubMed

    Bräuer-Krisch, E; Requardt, H; Régnard, P; Corde, S; Siegbahn, E; LeDuc, G; Brochard, T; Blattmann, H; Laissue, J; Bravin, A

    2005-07-01

    Microbeam radiation therapy (MRT) has the potential to treat infantile brain tumours when other kinds of radiotherapy would be excessively toxic to the developing normal brain. MRT uses extraordinarily high doses of x-rays but provides unusual resistance to radioneurotoxicity, presumably from the migration of endothelial cells from 'valleys' into 'peaks', i.e., into directly irradiated microslices of tissues. We present a novel irradiation geometry which results in a tolerable valley dose for the normal tissue and a decreased peak-to-valley dose ratio (PVDR) in the tumour area by applying an innovative cross-firing technique. We propose an MRT technique to orthogonally crossfire two arrays of parallel, nonintersecting, mutually interspersed microbeams that produces tumouricidal doses with small PVDRs where the arrays meet and tolerable radiation doses to normal tissues between the microbeams proximal and distal to the tumour in the paths of the arrays. PMID:15972983

  1. New irradiation geometry for microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Bräuer-Krisch, E.; Requardt, H.; Régnard, P.; Corde, S.; Siegbahn, E.; LeDuc, G.; Brochard, T.; Blattmann, H.; Laissue, J.; Bravin, A.

    2005-07-01

    Microbeam radiation therapy (MRT) has the potential to treat infantile brain tumours when other kinds of radiotherapy would be excessively toxic to the developing normal brain. MRT uses extraordinarily high doses of x-rays but provides unusual resistance to radioneurotoxicity, presumably from the migration of endothelial cells from 'valleys' into 'peaks', i.e., into directly irradiated microslices of tissues. We present a novel irradiation geometry which results in a tolerable valley dose for the normal tissue and a decreased peak-to-valley dose ratio (PVDR) in the tumour area by applying an innovative cross-firing technique. We propose an MRT technique to orthogonally crossfire two arrays of parallel, nonintersecting, mutually interspersed microbeams that produces tumouricidal doses with small PVDRs where the arrays meet and tolerable radiation doses to normal tissues between the microbeams proximal and distal to the tumour in the paths of the arrays.

  2. Synchrotron Microbeam Radiation Therapy induces hypoxia in intracerebral gliosarcoma but not in the normal brain

    E-print Network

    Paris-Sud XI, Université de

    Synchrotron Microbeam Radiation Therapy induces hypoxia in intracerebral gliosarcoma University, 85748 Garching, Germany Key words: Synchrotron Microbeam Radiation Therapy - Brain Tumors. 2013 3 Introduction Synchrotron microbeam radiation therapy (MRT) uses high radiation doses delivered

  3. Primary radiation therapy for early breast cancer: the experience at the joint center for radiation therapy

    Microsoft Academic Search

    Jay R. Harris; Leslie Botnick; William D. Bloomer; John T. Chaffey; Samuel Hellman

    1981-01-01

    The results of primary radiation therapy in 176 consecutive patients with clinical State I and II carcinoma of the breast were reviewed. Median follow-up time was 47 months. The overall breast relapse rate was 7%. Patients undergoing interstitial implantation had a significantly lower breast relapse rate (1%) than patients not undergoing implantation (11%). Breast relapse was more common in patients

  4. Improved Toxicity Profile Following High-Dose Postprostatectomy Salvage Radiation Therapy With Intensity-Modulated Radiation Therapy

    Microsoft Academic Search

    Anuj Goenka; Juan Martin Magsanoc; Xin Pei; Michael Schechter; Marisa Kollmeier; Brett Cox; Peter T. Scardino; James A. Eastham; Michael J. Zelefsky

    2011-01-01

    BackgroundWith salvage radiation therapy (SRT) in the postprostatectomy setting, the need to deliver sufficient radiation doses to achieve a high probability of tumor control is balanced with the risk of increased toxicity. Intensity-modulated radiation therapy (IMRT) in the postprostatectomy salvage setting is gaining interest as a treatment strategy.

  5. Intravascular Photoacoustics for Image-Guidance and Temperature Monitoring During Plasmonic Photothermal Therapy of Atherosclerotic Plaques: A Feasibility Study

    PubMed Central

    Yeager, Doug; Chen, Yun-Sheng; Litovsky, Silvio; Emelianov, Stanislav

    2014-01-01

    Recently, combined intravascular ultrasound and photoacoustic (IVUS/IVPA) imaging has been demonstrated as a novel imaging modality capable of visualizing both morphology (via IVUS) and cellular/molecular composition (via IVPA) of atherosclerotic plaques, using both endogenous tissue absorbers and exogenous contrast agents. Plasmonic gold nanoparticles were previously utilized as IVPA contrast agents which co-localize with atherosclerotic plaques, particularly phagocytically active macrophages. The present work demonstrates the use of IVUS/IVPA imaging as a tool for localized temperature monitoring during laser heating. The temperature dependent change in IVPA signal intensity of silica-coated gold nanorod contrast agents absorbing within the near-infrared optical wavelength range is evaluated and shown to have a linear relationship, with a slope greater than that of endogenous tissue. A continuous wave laser was subsequently incorporated into the IVUS/IVPA integrated catheter and utilized to selectively heat the nanoparticles with simultaneous IVPA temperature monitoring. IVUS/IVPA, therefore, provides a platform for detection and temperature monitoring of atherosclerotic plaques through the selective heating of plasmonic gold nanoparticle contrast agents. PMID:24396514

  6. Mapping the literature of radiation therapy

    PubMed Central

    Delwiche, Frances A.

    2013-01-01

    Objective: This study characterizes the literature of the radiation therapy profession, identifies the journals most frequently cited by authors writing in this discipline, and determines the level of coverage of these journals by major bibliographic indexes. Method: Cited references from three discipline-specific source journals were analyzed according to the Mapping the Literature of Allied Health Project Protocol of the Nursing and Allied Health Resources Section of the Medical Library Association. Bradford's Law of Scattering was applied to all journal references to identify the most frequently cited journal titles. Results: Journal references constituted 77.8% of the total, with books, government documents, Internet sites, and miscellaneous sources making up the remainder. Although a total of 908 journal titles were cited overall, approximately one-third of the journal citations came from just 11 journals. MEDLINE and Scopus provided the most comprehensive indexing of the journal titles in Zones 1 and 2. The source journals were indexed only by CINAHL and Scopus. Conclusion: The knowledgebase of radiation therapy draws heavily from the fields of oncology, radiology, medical physics, and nursing. Discipline-specific publications are not currently well covered by major indexing services, and those wishing to conduct comprehensive literature searches should search multiple resources. PMID:23646027

  7. Collimator design for experimental minibeam radiation therapy

    SciTech Connect

    Babcock, Kerry; Sidhu, Narinder; Kundapur, Vijayananda; Ali, Kaiser [Saskatoon Cancer Centre, 20 Campus Drive, Saskatoon, Saskatchewan S7N 4H4 (Canada)

    2011-04-15

    Purpose: To design and optimize a minibeam collimator for minibeam radiation therapy studies using a 250 kVp x-ray machine as a simulated synchrotron source. Methods: A Philips RT250 orthovoltage x-ray machine was modeled using the EGSnrc/BEAMnrc Monte Carlo software. The resulting machine model was coupled to a model of a minibeam collimator with a beam aperture of 1 mm. Interaperture spacing and collimator thickness were varied to produce a minibeam with the desired peak-to-valley ratio. Results: Proper design of a minibeam collimator with Monte Carlo methods requires detailed knowledge of the x-ray source setup. For a cathode-ray tube source, the beam spot size, target angle, and source shielding all determine the final valley-to-peak dose ratio. Conclusions: A minibeam collimator setup was created, which can deliver a 30 Gy peak dose minibeam radiation therapy treatment at depths less than 1 cm with a valley-to-peak dose ratio on the order of 23%.

  8. Galactic Cosmic Radiation Leads to Cognitive Impairment and Increased A? Plaque Accumulation in a Mouse Model of Alzheimer’s Disease

    PubMed Central

    Cherry, Jonathan D.; Liu, Bin; Frost, Jeffrey L.; Lemere, Cynthia A.; Williams, Jacqueline P.; Olschowka, John A.; O’Banion, M. Kerry

    2012-01-01

    Galactic Cosmic Radiation consisting of high-energy, high-charged (HZE) particles poses a significant threat to future astronauts in deep space. Aside from cancer, concerns have been raised about late degenerative risks, including effects on the brain. In this study we examined the effects of 56Fe particle irradiation in an APP/PS1 mouse model of Alzheimer’s disease (AD). We demonstrated 6 months after exposure to 10 and 100 cGy 56Fe radiation at 1 GeV/µ, that APP/PS1 mice show decreased cognitive abilities measured by contextual fear conditioning and novel object recognition tests. Furthermore, in male mice we saw acceleration of A? plaque pathology using Congo red and 6E10 staining, which was further confirmed by ELISA measures of A? isoforms. Increases were not due to higher levels of amyloid precursor protein (APP) or increased cleavage as measured by levels of the ? C-terminal fragment of APP. Additionally, we saw no change in microglial activation levels judging by CD68 and Iba-1 immunoreactivities in and around A? plaques or insulin degrading enzyme, which has been shown to degrade A?. However, immunohistochemical analysis of ICAM-1 showed evidence of endothelial activation after 100 cGy irradiation in male mice, suggesting possible alterations in A? trafficking through the blood brain barrier as a possible cause of plaque increase. Overall, our results show for the first time that HZE particle radiation can increase A? plaque pathology in an APP/PS1 mouse model of AD. PMID:23300905

  9. Comparison of dose-volume histograms for Tomo therapy, linear accelerator-based 3D conformal radiation therapy, and intensity-modulated radiation therapy

    Microsoft Academic Search

    Youn-Sang Ji; Kyung-Rae Dong; Chang-Bok Kim; Seong-Kwan Choi; Woon-Kwan Chung; Jong-Woong Lee

    2011-01-01

    Evaluation of dose-volume histograms from three-dimensional conformal radiation therapy (3D CRT), intensity-modulated radiation therapy (IMRT), and Tomo therapy was conducted. These three modalities are among the diverse treatment systems available for tumor therapy. Three patients who received tumor therapy for a malignant oligodendroglioma in the cranium, nasopharyngeal carcinoma in the cervical neck, and prostate cancer in the pelvis were selected

  10. Pirfenidone enhances the efficacy of combined radiation and sunitinib therapy.

    PubMed

    Choi, Seo-Hyun; Nam, Jae-Kyung; Jang, Junho; Lee, Hae-June; Lee, Yoon-Jin

    2015-06-26

    Radiotherapy is a widely used treatment for many tumors. Combination therapy using anti-angiogenic agents and radiation has shown promise; however, these combined therapies are reported to have many limitations in clinical trials. Here, we show that radiation transformed tumor endothelial cells (ECs) to fibroblasts, resulting in reduced vascular endothelial growth factor (VEGF) response and increased Snail1, Twist1, Type I collagen, and transforming growth factor (TGF)-? release. Irradiation of radioresistant Lewis lung carcinoma (LLC) tumors greater than 250 mm(3) increased collagen levels, particularly in large tumor vessels. Furthermore, concomitant sunitinib therapy did not show a significant difference in tumor inhibition versus radiation alone. Thus, we evaluated multimodal therapy that combined pirfenidone, an inhibitor of TGF-induced collagen production, with radiation and sunitinib treatment. This trimodal therapy significantly reduced tumor growth, as compared to radiation alone. Immunohistochemical analysis revealed that radiation-induced collagen deposition and tumor microvessel density were significantly reduced with trimodal therapy, as compared to radiation alone. These data suggest that combined therapy using pirfenidone may modulate the radiation-altered tumor microenvironment, thereby enhancing the efficacy of radiation therapy and concurrent chemotherapy. PMID:25935484

  11. Radiation therapy and photodynamic therapy for biliary tract and ampullary carcinomas

    Microsoft Academic Search

    Hiroya Saito; Tadahiro Takada; Masaru Miyazaki; Shuichi Miyakawa; Kazuhiro Tsukada; Masato Nagino; Satoshi Kondo; Junji Furuse; Toshio Tsuyuguchi; Fumio Kimura; Hideyuki Yoshitomi; Satoshi Nozawa; Masahiro Yoshida; Keita Wada; Hodaka Amano; Fumihiko Miura

    2008-01-01

    The purpose of radiation therapy for unresectable biliary tract cancer is to prolong survival or prolong stent patency, and\\u000a to provide palliation of pain. For unresectable bile duct cancer, there are a number of studies showing that radiation therapy\\u000a is superior to the best supportive care. Although radiation therapy is used in many institutions, no large randomized controlled\\u000a trials (RCTs)

  12. Hyperbaric Oxygen Therapy for Radiation-induced Optic Neuropathy

    Microsoft Academic Search

    Richard L Levy; Neil R Miller

    Introduction: Radiation-induced optic neuropathy (RON) is an infrequent but devastating consequence of radiation exposure to the visual pathways, usually following months to years after the treatment of paranasal or intracranial tumours. Hyperbaric oxygen (HBO) therapy is one of several therapies that have been tried for this condition. The purpose of this review is to describe the clinical characteristics of RON,

  13. Implant Reconstruction in Breast Cancer Patients Treated with Radiation Therapy

    Microsoft Academic Search

    Jeffrey A. Ascherman; Matthew M. Hanasono; Martin I. Newman; Duncan B. Hughes

    2006-01-01

    Background: Implant reconstruction in breast cancer patients treated with radiation therapy is controversial. Prior studies are limited by older prosthetic devices, reconstructive techniques, and radiation therapy protocols. Methods: A retrospective review was performed of patients who underwent tissue expansion and implant breast reconstruction performed by a single sur- geon after mastectomy for breast cancer from 1996 to 2003. Complications and

  14. Intraoperative radiation therapy in integrated treatment of rectal cancers

    Microsoft Academic Search

    Luigi Sofo; Carlo Ratto; Giovanni Battista Doglietto; Vincenzo Valentini; Lucio Trodella; Massimo Ippoliti; Paolo Nucera; Marta Merico; Rocco Bellantone; Maurizio Bossola; Numa Cellini; Francesco Crucitti

    1996-01-01

    PURPOSE: Risk of local recurrence of rectal cancer remains high despite extensive therapeutic strategies, many of which have been tried to achieve better local control (i.e., external beam radiation therapy (EBRT)). Recently, intraoperative radiation therapy (IORT) has been introduced in clinical protocols to boost the areas at risk of local recurrence. METHODS: Between April 1990 and December 1995, 44 patients

  15. Strip detector for high spatial resolution dosimetry in radiation therapy

    Microsoft Academic Search

    Ashley James Cullen

    2009-01-01

    Radiation therapy is an established modality in the treatment of tumours. With treatments ever evolving and increasing in terms of their complexities, the need arises to ensure the best quality treatment is delivered; the survival of the patient relies upon it. A modern treatment such as Intensity Modulated Radiation Therapy employs steep dose gradients varying dynamically to deliver complex dose

  16. Radiation therapy in the treatment of oral neoplasia.

    PubMed

    Burk, R L

    1996-01-01

    Oral neoplasia occasionally may be treated adequately with a single modality. Multimodality therapy, however, more often is indicated. This article reviews the recommendations of treatment of oral neoplasia focusing on the role of radiation therapy both singly and as a part of multimodality therapy. PMID:8825574

  17. Combining antiangiogenic therapy and radiation in nasopharyngeal carcinoma

    PubMed Central

    Chen, Zhuo; Xu, Xin-Hua

    2015-01-01

    Radiation therapy is the primary treatment in nasopharyngeal carcinoma (NPC), and the effect of radiation therapy is strongly related to the oxygen content of cancer cells. That means, it is imperative to balance the interactions between radiotherapy and anti-angiogenesis therapy when giving combination therapy to improve clinical outcomes. The complicated mechanisms between antiangiogenic agents and radiation involve many interactions between the cancer cells, vasculature, and cancer stroma. The proliferation and metastasis of cancer depends on angiogenesis, while rapid growth of cancers will cause hypoxia, which contributes to radioresistance. Antiangiogenic agents can modulate the cancer blood flow and oxygenation through target cancer vasculature, leading to increased radiosensitivity. This study discusses the mechanisms of the synergistic effect of the antiangiogenic therapy with radiation therapy in metastatic NPC, and reviews the data supporting this strategy as a promising treatment for metastatic NPC. PMID:25987106

  18. Diagnosis of delayed cerebral radiation necrosis following proton beam therapy

    SciTech Connect

    Kaufman, M.; Swartz, B.E.; Mandelkern, M.; Ropchan, J.; Gee, M.; Blahd, W.H. (Wadsworth Veterans Administration Medical Center, Los Angeles, CA (USA))

    1990-04-01

    A 27-year-old man developed delayed cerebral radiation necrosis following proton beam therapy to an arteriovenous malformation. Neuroimaging with technetium 99m diethylenetriamine penta-acetic acid and positron emission tomographic scanning with fludeoxyglucose F 18 aided in his evaluation. Significant improvement of his neurologic deficits resulted from corticosteroid therapy. Clinical resolution was corroborated by serial computed tomographic scans demonstrating regression of the abnormality (a mass lesion). Various facets of radiation injury are discussed, including pathogenesis, risk factors, diagnosis, and therapy.

  19. Inherent Smoothness of Intensity Patterns for Intensity Modulated Radiation Therapy Generated by Simultaneous

    E-print Network

    Censor, Yair

    Inherent Smoothness of Intensity Patterns for Intensity Modulated Radiation Therapy Generated) Abstract The efficient delivery of intensity modulated radiation therapy (IMRT) de- pendends on finding technologies. I. INTRODUCTION Intensity modulated radiation therapy (IMRT) with two-dimensional (2D) modulated

  20. Ultraviolet radiation therapy and UVR dose models.

    PubMed

    Grimes, David Robert

    2015-01-01

    Ultraviolet radiation (UVR) has been an effective treatment for a number of chronic skin disorders, and its ability to alleviate these conditions has been well documented. Although nonionizing, exposure to ultraviolet (UV) radiation is still damaging to deoxyribonucleic acid integrity, and has a number of unpleasant side effects ranging from erythema (sunburn) to carcinogenesis. As the conditions treated with this therapy tend to be chronic, exposures are repeated and can be high, increasing the lifetime probability of an adverse event or mutagenic effect. Despite the potential detrimental effects, quantitative ultraviolet dosimetry for phototherapy is an underdeveloped area and better dosimetry would allow clinicians to maximize biological effect whilst minimizing the repercussions of overexposure. This review gives a history and insight into the current state of UVR phototherapy, including an overview of biological effects of UVR, a discussion of UVR production, illness treated by this modality, cabin design and the clinical implementation of phototherapy, as well as clinical dose estimation techniques. Several dose models for ultraviolet phototherapy are also examined, and the need for an accurate computational dose estimation method in ultraviolet phototherapy is discussed. PMID:25563284

  1. Cancer and radiation therapy: current advances and future directions.

    PubMed

    Baskar, Rajamanickam; Lee, Kuo Ann; Yeo, Richard; Yeoh, Kheng-Wei

    2012-01-01

    In recent years remarkable progress has been made towards the understanding of proposed hallmarks of cancer development and treatment. However with its increasing incidence, the clinical management of cancer continues to be a challenge for the 21st century. Treatment modalities comprise of radiation therapy, surgery, chemotherapy, immunotherapy and hormonal therapy. Radiation therapy remains an important component of cancer treatment with approximately 50% of all cancer patients receiving radiation therapy during their course of illness; it contributes towards 40% of curative treatment for cancer. The main goal of radiation therapy is to deprive cancer cells of their multiplication (cell division) potential. Celebrating a century of advances since Marie Curie won her second Nobel Prize for her research into radium, 2011 has been designated the Year of Radiation therapy in the UK. Over the last 100 years, ongoing advances in the techniques of radiation treatment and progress made in understanding the biology of cancer cell responses to radiation will endeavor to increase the survival and reduce treatment side effects for cancer patients. In this review, principles, application and advances in radiation therapy with their biological end points are discussed. PMID:22408567

  2. Cancer and Radiation Therapy: Current Advances and Future Directions

    PubMed Central

    Baskar, Rajamanickam; Lee, Kuo Ann; Yeo, Richard; Yeoh, Kheng-Wei

    2012-01-01

    In recent years remarkable progress has been made towards the understanding of proposed hallmarks of cancer development and treatment. However with its increasing incidence, the clinical management of cancer continues to be a challenge for the 21st century. Treatment modalities comprise of radiation therapy, surgery, chemotherapy, immunotherapy and hormonal therapy. Radiation therapy remains an important component of cancer treatment with approximately 50% of all cancer patients receiving radiation therapy during their course of illness; it contributes towards 40% of curative treatment for cancer. The main goal of radiation therapy is to deprive cancer cells of their multiplication (cell division) potential. Celebrating a century of advances since Marie Curie won her second Nobel Prize for her research into radium, 2011 has been designated the Year of Radiation therapy in the UK. Over the last 100 years, ongoing advances in the techniques of radiation treatment and progress made in understanding the biology of cancer cell responses to radiation will endeavor to increase the survival and reduce treatment side effects for cancer patients. In this review, principles, application and advances in radiation therapy with their biological end points are discussed. PMID:22408567

  3. Intestinal strictures complicating preoperative radiation therapy followed by radical cystectomy

    SciTech Connect

    Hillyard, R.W. Jr.; el-Mahdi, A.M.; Schellhammer, P.F.

    1986-07-01

    Between January 1975 and January 1981, 100 patients with invasive bladder cancer were evaluated for therapy. Of these patients 51 were selected for treatment with preoperative radiation therapy followed by radical cystectomy. Of 36 patients who actually completed the integrated therapy 4 (11 per cent) had clinical intestinal strictures. Three strictures occurred more than 24 months and 1 less than 6 months postoperatively. Strictures involved the colon in 3 cases and the ileum in 1. An operation was required in 2 cases. We present these 4 cases, and discuss the pathophysiology and treatment of the radiation-injured intestine. Our experience suggests that preoperative radiation therapy in conjunction with radical cystectomy may be associated with the development of clinically significant bowel injury. This factor should be considered in the decision to combine preoperative radiation therapy with radical cystectomy in the treatment of bladder cancer.

  4. OPTIMIZING THE DELIVERY OF RADIATION THERAPY TO CANCER PATIENTS \\Lambda

    E-print Network

    Ferris, Michael C.

    OPTIMIZING THE DELIVERY OF RADIATION THERAPY TO CANCER PATIENTS \\Lambda DAVID M. SHEPARD y patients with radiation. In recent years, new treatment machines have been developed that provide a much for optimizing each patient's treatment plan. One of the challenges is to quantify optimality in radiation

  5. Enhancement of radiation effects by gold nanoparticles for superficial radiation therapy.

    PubMed

    Rahman, Wan Nordiana; Bishara, Nour; Ackerly, Trevor; He, Cheng Fa; Jackson, Price; Wong, Christopher; Davidson, Robert; Geso, Moshi

    2009-06-01

    Iodinated contrast agents, which are routinely used to improve contrast in x-ray diagnostic radiography, have been successfully proven to enhance radiation effects in kilovoltage x-ray radiation therapy beams. The studies determined the influence of iodine on the level of radiation biotoxicity to cells as an indicator of the radiation dose enhancement. The use of other high-atomic-number materials such as gold nanoparticles (AuNPs) may also provide advantages in terms of radiation dose enhancement. In this work AuNPs have been used for the enhancement of radiation effects on bovine aortic endothelial cells of superficial x-ray radiation therapy and megavoltage electron radiation therapy beams. Results reveal an increase of cell damage with increasing concentration of AuNPs. At 1 mM concentration of AuNPs, enhancement of radiation peaked at 25 times for a kilovoltage x-ray beam. AuNPs showed similar effects on electron beams but to a lesser extent. This study showed that AuNPs can be used to enhance the effect of radiation doses from kilovoltage x-ray radiation therapy and megavoltage electron radiation therapy beams. In the prevailing clinical circumstances, wherein radiation therapy dose is constrained by normal tissue tolerance, this enhancement could in the future be used to improve local control in superficial x-ray treatments, megavoltage electron beam radiation therapy, microbeam radiation therapy, and intraoperative irradiation using kilovoltage x-rays or megavoltage electron beams. Moreover, the value of this work also stems from the fact that the damage to the endothelial cells lining the highly vasculature structure of tumors deprives tumors of their oxygen and nutrients supply and enhances the efficiency of radiation therapy treatment, where it has been proven that more of the AuNPs injected into animals ends up into the blood than in the tumor. PMID:19480049

  6. Radiation Therapy for Chloroma (Granulocytic Sarcoma)

    SciTech Connect

    Bakst, Richard; Wolden, Suzanne [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Yahalom, Joachim, E-mail: yahalomj@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-04-01

    Objectives: Chloroma (granulocytic sarcoma) is a rare, extramedullary tumor of immature myeloid cells related to acute nonlymphocytic leukemia or myelodysplastic syndrome. Radiation therapy (RT) is often used in the treatment of chloromas; however, modern studies of RT are lacking. We reviewed our experience to analyze treatment response, disease control, and toxicity associated with RT to develop treatment algorithm recommendations for patients with chloroma. Patients and Methods: Thirty-eight patients who underwent treatment for chloromas at our institution between February 1990 and June 2010 were identified and their medical records were reviewed and analyzed. Results: The majority of patients that presented with chloroma at the time of initial leukemia diagnosis (78%) have not received RT because it regressed after initial chemotherapy. Yet most patients that relapsed or remained with chloroma after chemotherapy are in the RT cohort (90%). Thirty-three courses of RT were administered to 22 patients. Radiation subsite breakdown was: 39% head and neck, 24% extremity, 9% spine, 9% brain, 6% genitourinary, 6% breast, 3% pelvis, and 3% genitourinary. Median dose was 20 (6-36) Gy. Kaplan-Meier estimates of progression-free survival and overall survival in the RT cohort were 39% and 43%, respectively, at 5 years. At a median follow-up of 11 months since RT, only 1 patient developed progressive disease at the irradiated site and 4 patients developed chloromas at other sites. RT was well tolerated without significant acute or late effects and provided symptom relief in 95% of cases. Conclusions: The majority of patients with chloromas were referred for RT when there was extramedullary progression, marrow relapse, or rapid symptom relief required. RT resulted in excellent local disease control and palliation of symptoms without significant toxicity. We recommend irradiating chloromas to at least 20 Gy, and propose 24 Gy in 12 fractions as an appropriate regimen.

  7. Scatter factors assessment in microbeam radiation therapy

    SciTech Connect

    Prezado, Y.; Martinez-Rovira, I.; Sanchez, M. [Laboratoire Imagerie et Modelisation en Neurobiologie et Cancerologie IMNC-UMR 8165, Centre National de la Recherche Scientifique (CNRS), Campus Universitaire, Bat. 440, 15 rue Georges Clemenceau, 91406 Orsay Cedex (France); Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, E-08028 Barcelona (Spain) and ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz, B.P. 220, 38043 Grenoble Cedex (France); Servicio de Radiofisica, Complejo Hospitalario de Santiago de Compostela, Rua Choupana S/N, 15706 Santiago de Compostela (Spain)

    2012-03-15

    Purpose: The success of the preclinical studies in Microbeam Radiation Therapy (MRT) paved the way to the clinical trials under preparation at the Biomedical Beamline of the European Synchrotron Radiation Facility. Within this framework, an accurate determination of the deposited dose is crucial. With that aim, the scatter factors, which translate the absolute dose measured in reference conditions (2 x 2 cm{sup 2} field size at 2 cm-depth in water) to peak doses, were assessed. Methods: Monte Carlo (MC) simulations were performed with two different widely used codes, PENELOPE and GEANT4, for the sake of safety. The scatter factors were obtained as the ratio of the doses that are deposited by a microbeam and by a field of reference size, at the reference depth. The calculated values were compared with the experimental data obtained by radiochromic (ISP HD-810) films and a PTW 34070 large area chamber. Results: The scatter factors for different microbeam field sizes assessed by the two MC codes were in agreement and reproduced the experimental data within uncertainty bars. Those correction factors were shown to be non-negligible for the future MRT clinical settings: an average 30% lower dose was deposited by a 50 {mu}m microbeam with respect to the reference conditions. Conclusions: For the first time, the scatter factors in MRT were systematically studied. They constitute an essential key to deposit accurate doses in the forthcoming clinical trials in MRT. The good agreement between the different calculations and the experimental data confirms the reliability of this challenging micrometric dose estimation.

  8. Managing Radiation Therapy Side Effects: What to Do about Hair Loss (Alopecia)

    MedlinePLUS

    ... out 2 to 3 weeks after your first radiation therapy session. If you are getting radiation to the ... gov/livehelp NCI has a series of 9 Radiation Therapy Side Effects Sheets at: www.cancer.gov/radiation- ...

  9. Radiation therapy of Waldeyer's ring lymphoma

    SciTech Connect

    Shimm, D.S.; Dosoretz, D.E.; Harris, N.L.; Pilch, B.Z.; Linggood, R.M.; Wang, C.C.

    1984-08-01

    Forty-nine patients with biopsy-proven Waldeyer's ring lymphoma were treated with radiation therapy between 1968 and 1979; 45 to 50 Gy were given to Waldeyer's ring structures with a 5- to 10-Gy boost to the primary site. Uninvolved low cervical nodes received 40 to 50 Gy. Chemotherapy was reserved for treatment failures. Actuarial 5-year survival was 53%, disease-free survival was 48%, and local control was 98%. Patients with Stage I disease fared better than patients with Stage II disease, and unilateral adenopathy conferred a better prognosis than bilateral adenopathy. When classified by the Rappaport system, nodular lymphomas had a better prognosis than diffuse lymphomas, and of the diffuse lymphomas, histiocytic lymphoma was a more lethal disease than lymphocytic lymphoma. Patients with diffuse undifferentiated lymphomas in the Rappaport system, or high-grade lymphomas in the Working Formulation, fared poorly. Most relapses were systemic, and actuarial 5-year survival after salvage was only 20%. A logical approach to the treatment of this disease can be based on these prognostic features.

  10. Second cancer after radiation therapy for cancer of the uterine cervix

    Microsoft Academic Search

    Tatsuo Arai; Takashi Nakano; Kenjiro Fukuhisa; Tatsuhiro Kasamatsu; Ryuichiro Tsunematsu; Kazumasa Masubuchi; Kazuhiro Yamauchi; Tatsuro Hamada; Tooru Fukuda; Hiroshi Noguchi; Motoi Murata

    1991-01-01

    Radiation-induced cancers after radiation therapy for cancer of the uterine cervix were investigated on 11,855 patients including 5725 patients treated with radiation therapy alone, 1969 postoperative radiation therapy and 4161 surgery alone. The observed-to-expected ratios of the second primary cancer was 0.933 for the patients with radiation therapy alone and 1.074 for the patients with postoperative radiation therapy, respectively. No

  11. Radiation effects on the optic nerve observed after brachytherapy of choroidal melanomas with 106 Ru\\/ 106 Rh plaques

    Microsoft Academic Search

    P. K. Lommatzsch; W. Alberti; R. Lommatzsch; F. Rohrwacher

    1994-01-01

    From 1966 to 1990 a total of 93 juxtapapillary choroidal melanomas were treated using 106Ru\\/106Rh plaques with a notch for the optic nerve. The choroidal melanoma was controlled after brachytherapy in 79 cases (85%). Fourteen eyes (15%) had to be enucleated because of tumor regrowth. Eye and optic nerve phantoms were fabricated, loaded with small-volume thermoluminescent dosimeters, treated with active

  12. The use of customized spreadsheets in radiation therapy

    Microsoft Academic Search

    J. P. Balog; C. H. Sibata; M. B. Podgorsak; K. H. Shin

    1995-01-01

    A number of radiation-therapy-related uses based on a commercially available spreadsheet program have been developed at our facility. The graphics and display capabilities inherent in these spreadsheet programs allow for concise visual results. The spreadsheets are used as an independent check for several types of radiation therapy dose calculations. External beam-a spreadsheet will verify the monitor units (MU) or time

  13. GafChromic ® Film Measurements for Microbeam Radiation Therapy (MRT)

    Microsoft Academic Search

    E. Bräuer-Krisch; E. A. Siegbahn; A. Bravin

    \\u000a Microbeam Radiation Therapy (MRT) is a preclinical synchrotron radiation based therapy technique in its preclinical stage\\u000a with the potential to treat brain tumours in children when other kinds of radiotherapy would be excessively toxic to the developing\\u000a normal brain. The most promising feature of MRT lies in its unusual resistance of MRT irradiated tissues to radioneurotoxicity\\u000a even for peak doses

  14. Persistence of endometrial activity after radiation therapy for cervical carcinoma

    SciTech Connect

    Barnhill, D.; Heller, P.; Dames, J.; Hoskins, W.; Gallup, D.; Park, R.

    1985-12-01

    Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy.

  15. A Shape Relationship Descriptor for Radiation Therapy Planning

    E-print Network

    Kazhdan, Michael

    A Shape Relationship Descriptor for Radiation Therapy Planning Michael Kazhdan1 , Patricio Simari1 the design of patient treatment plans in radio- therapy. To this end we propose a novel shape descriptor for such tasks by outperform- ing state of the art shape descriptors in the retrieval of patients with similar

  16. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

    SciTech Connect

    McHenry, C.; Jarosz, H.; Calandra, D.; McCall, A.; Lawrence, A.M.; Paloyan, E.

    1987-06-01

    The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently.

  17. Radiation therapy of pediatric brain tumors : comparison of long-term health effects and costs between proton therapy and IMRT

    E-print Network

    Vu, An T. (An Thien)

    2011-01-01

    Radiation therapy is an important component of pediatric brain tumor treatment. However, radiation-induced damage can lead to adverse long-term health effects. Proton therapy has the ability to reduce the dose delivered ...

  18. Large deformation 3D image registration in image-guided radiation therapy

    E-print Network

    Utah, University of

    -guided radiation therapy 2 1. Introduction In radiation cancer therapy, the problem of organ motion over the courseLarge deformation 3D image registration in image-guided radiation therapy Mark Foskey, Brad Davis processing of serial 3D CT images used in image- guided radiation therapy. A major assumption in deformable

  19. Does Hormone Therapy Reduce Disease Recurrence in Prostate Cancer Patients Receiving Dose-Escalated Radiation Therapy? An Analysis of Radiation Therapy Oncology Group 94-06

    Microsoft Academic Search

    Richard K. Valicenti; Kwounghwa Bae; Jeff Michalski; Howard Sandler; William Shipley; Alex Lin; James Cox

    2011-01-01

    Purpose: The purpose of this study was to evaluate the effect on freedom from biochemical failure (bNED) or disease-free survival (DFS) by adding hormone therapy (HT) to dose-escalated radiation therapy (HDRT). Methods and Materials: We used 883 analyzable prostate cancer patients who enrolled on Radiation Therapy Oncology Group (RTOG) 94-06, a Phase I\\/II dose escalation trial, and whose mean planning

  20. Histopathology of plaque rupture.

    PubMed

    Ravn, H B; Falk, E

    1999-05-01

    Plaque disruption occurs during the development of atherosclerotic lesions. During certain circumstances it may result in thrombosis and subsequent development of acute coronary syndromes. Several characteristics of the plaque appear to be associated with plaque disruption, including a large lipid rich core, superficial plaque inflammation, and a thin fibrous cap. The importance of these and other plaque components are discussed in this article. PMID:10384825

  1. An Investigation of Vascular Strategies to Augment Radiation Therapy

    NASA Astrophysics Data System (ADS)

    El Kaffas, Ahmed Nagy

    Radiation therapy is administered to more than 50% of patients diagnosed with cancer. Mechanisms of interaction between radiation and tumour cells are relatively well understood on a molecular level, but much remains uncertain regarding how radiation interacts with the tumour as a whole. Recent studies have suggested that tumour response to radiation may in fact be regulated by endothelial cell response, consequently stressing the role of tumour blood vessels in radiation treatment response. As a result, various treatment regimens have been proposed to strategically combine radiation with vascular targeting agents. A great deal of effort has been aimed towards developing efficient vascular targeting agents. Nonetheless, no optimal method has yet been devised to strategically deliver such agents. Recent evidence suggesting that these drugs may "normalize" tumour blood vessels and enhance radiosensitivity, is supporting experiments where anti-angiogenic drugs are combined with cytotoxic therapies such as radiotherapy. In contrast, ultrasound-stimulated microbubbles have recently been demonstrated to enhance radiation therapy by biophysically interacting with endothelial cells. When combined with single radiation doses, these microbubbles are believed to cause localized vascular destruction followed by tumour cell death. Finally, a new form of 'pro-angiogenics' has also been demonstrated to induce a therapeutic tumour response. The overall aim of this thesis is to study the role of tumour blood vessels in treatment responses to single-dose radiation therapy and to investigate radiation-based vascular targeting strategies. Using pharmacological and biophysical agents, blood vessels were altered to determine how they influence tumour cell death, clonogenicity, and tumour growth, and to study how these may be optimally combined with radiation. Three-dimensional high-frequency power Doppler ultrasound was used throughout these studies to investigate vascular response to therapy.

  2. Approximation Algorithms for Minimizing Segments in Radiation Therapy

    E-print Network

    Saia, Jared

    modalities for modern cancer treatment. The key to successful IMRT treatment hinges on the delivery of a two (IMRT) is an advanced modality of modern cancer treat- ment aiming to deliver a high radiation doseApproximation Algorithms for Minimizing Segments in Radiation Therapy Shuang Luan Jared Saia

  3. Late effects of radiation therapy on the gastrointestinal tract

    Microsoft Academic Search

    Lawrence R. Coia; Robert J. Myerson; Joel E. Tepper

    1995-01-01

    Late gastrointestinal complications of radiation therapy have been recognized but not extensively studied. In this paper, the late effects of radiation on three gastrointestinal sites, the esophagus, the stomach, and the bowel, are described. Esophageal dysmotility and benign stricture following esophageal irradiation are predominantly a result of damage to the esophageal wall, although mucosal ulcerations also may persist following high-dose

  4. Radiation therapy for adjunctive treatment of adrenal cortical carcinoma

    SciTech Connect

    Markoe, A.M.; Serber, W.; Micaily, B.; Brady, L.W. (Hahnemann Univ. Medical School and Hospital, Philadelphia, PA (USA))

    1991-04-01

    Adrenocortical carcinoma is a rare disease which is primarily approached surgically. There have been few reports of the efficacy of radiation therapy and, for the most part, these have been anecdotal. This paper reports on the potential adjuvant role of radiation therapy after surgical excision of primary adrenal cortical carcinoma and also comments about the efficacy of palliative radiation therapy for metastases. We have identified eight patients treated for adrenal cortical carcinomas at Hahnemann University Hospital (HUH) from 1962 until the present and have also identified five patients with the same diagnosis at Philadelphia General Hospital (PGH) from 1962 until its close in 1975. These two groups are examined separately. In the PGH group, in which two patients were diagnosed at autopsy and only one patient was treated by radiation therapy, the median survival was between 0 and 1 month for Stage IV disease with the only patient surviving to 6 months being that patient receiving radiation therapy. In the HUH group, five of eight patients were treated adjunctively after diagnosis, one was not and two received palliative therapy. The median survival for treated Stage III patients was between 34 months and 7 years. The suggestion, based on a limited patient series, is that patients treated postoperatively to the tumor bed and nodal areas in Stage III disease may have improved survival over historic series and improved local control.

  5. Image-Guidance for Stereotactic Body Radiation Therapy

    SciTech Connect

    Fuss, Martin [Department of Radiation Medicine, Oregon Health and Science University, Portland, OR (United States) and Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX (United States) and Cancer Therapy and Research Center, San Antonio, TX (United States)]. E-mail: fussm@ohsu.edu; Boda-Heggemann, Judit [Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim (Germany); Papanikolau, Nikos [Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Cancer Therapy and Research Center, San Antonio, TX (United States); Salter, Bill J. [Department of Radiation Oncology, University of Utah, Salt Lake City, UT (United States); Huntsman Cancer Institute, Salt Lake City, UT (United States)

    2007-07-01

    The term stereotactic body radiation therapy (SBRT) describes a recently introduced external beam radiation paradigm by which small lesions outside the brain are treated under stereotactic conditions, in a single or few fractions of high-dose radiation delivery. Similar to the treatment planning and delivery process for cranial radiosurgery, the emphasis is on sparing of adjacent normal tissues through the creation of steep dose gradients. Thus, advanced methods for assuring an accurate relationship between the target volume position and radiation beam geometry, immediately prior to radiation delivery, must be implemented. Such methods can employ imaging techniques such as planar (e.g., x-ray) or volumetric (e.g., computed tomography [CT]) approaches and are commonly summarized under the general term image-guided radiation therapy (IGRT). This review summarizes clinical experience with volumetric and ultrasound based image-guidance for SBRT. Additionally, challenges and potential limitations of pre-treatment image-guidance are presented and discussed.

  6. Radiation Therapy and Cancer Treatment: From the Basics to Combination Therapies that Ignite Immunity

    Microsoft Academic Search

    Amanda Moretti; David A. Jaffray; Jeffrey A. Medin

    \\u000a Since its inception in the late nineteenth century, radiation therapy has been a mainstay in the clinic to treat and palliate\\u000a patients afflicted with cancer. With the rapid advancement in technology for radiation therapy equipment, delivery has improved\\u000a and late sequalae have been minimized. Alongside the technological advancements, several groundbreaking biological discoveries\\u000a have enabled scientists to delineate the cellular and

  7. Guidelines for respiratory motion management in radiation therapy

    PubMed Central

    Matsuo, Yukinori; Onishi, Hiroshi; Nakagawa, Keiichi; Nakamura, Mitsuhiro; Ariji, Takaki; Kumazaki, Yu; Shimbo, Munefumi; Tohyama, Naoki; Nishio, Teiji; Okumura, Masahiko; Shirato, Hiroki; Hiraoka, Masahiro

    2013-01-01

    Respiratory motion management (RMM) systems in external and stereotactic radiotherapies have been developed in the past two decades. Japanese medical service fee regulations introduced reimbursement for RMM from April 2012. Based on thorough discussions among the four academic societies concerned, these Guidelines have been developed to enable staff (radiation oncologists, radiological technologists, medical physicists, radiotherapy quality managers, radiation oncology nurses, and others) to apply RMM to radiation therapy for tumors subject to respiratory motion, safely and appropriately. PMID:23239175

  8. Prototype demonstration of radiation therapy planning code system

    SciTech Connect

    Little, R.C.; Adams, K.J.; Estes, G.P.; Hughes, L.S. III; Waters, L.S. [and others

    1996-09-01

    This is the final report of a one-year, Laboratory-Directed Research and Development project at the Los Alamos National Laboratory (LANL). Radiation therapy planning is the process by which a radiation oncologist plans a treatment protocol for a patient preparing to undergo radiation therapy. The objective is to develop a protocol that delivers sufficient radiation dose to the entire tumor volume, while minimizing dose to healthy tissue. Radiation therapy planning, as currently practiced in the field, suffers from inaccuracies made in modeling patient anatomy and radiation transport. This project investigated the ability to automatically model patient-specific, three-dimensional (3-D) geometries in advanced Los Alamos radiation transport codes (such as MCNP), and to efficiently generate accurate radiation dose profiles in these geometries via sophisticated physics modeling. Modem scientific visualization techniques were utilized. The long-term goal is that such a system could be used by a non-expert in a distributed computing environment to help plan the treatment protocol for any candidate radiation source. The improved accuracy offered by such a system promises increased efficacy and reduced costs for this important aspect of health care.

  9. Purine catabolism in advanced carotid artery plaque.

    PubMed

    Felici, C; Ciari, I; Terzuoli, L; Porcelli, B; Setacci, C; Giubbolini, M; Marinello, E

    2006-01-01

    This study was carried out on carotid artery plaque and plasma of 50 patients. We analyzed uric acid, hypoxanthine, xanthine, and allantoin levels to verify if enzymatic purine degradation occurs in advanced carotid plaque; we also determined free radicals and sulphydryl groups to check if there is a correlation between oxidant status and purine catabolism. Comparing plaque and plasma we found higher levels of free radicals, hypoxanthine, xanthine, and a decrease of some oxidant protectors, such as sulphydryl groups and uric acid, in plaque. We also observed a very important phenomenon in plaque, the presence of allantoin due to chemical oxidation of uric acid, since humans do not have the enzyme uricase. The hypothetical elevated activity of xanthine oxidase in atherosclerosis could be reduced by specific therapies using its inhibitors, such as oxypurinol or allopurinol. PMID:17065109

  10. Influence of radiation therapy on oral Candida albicans colonization: a quantitative assessment

    SciTech Connect

    Rossie, K.M.; Taylor, J.; Beck, F.M.; Hodgson, S.E.; Blozis, G.G.

    1987-12-01

    An increase in quantity of oral Candida albicans was documented in patients receiving head and neck radiation therapy during and after therapy, as assessed by an oral-rinse culturing technique. The amount of the increase was greater in denture wearers and directly related to increasing radiation dose and increasing volume of parotid gland included in the radiation portal. A significant number of patients who did not carry C. albicans prior to radiation therapy developed positive cultures by 1 month after radiation therapy. The percentage of patients receiving head and neck radiation therapy who carried C. albicans prior to radiation therapy did not differ significantly from matched dental patient controls.

  11. Role of radiation therapy in mycosis fungoides refractory to systemic therapy.

    PubMed

    de Sanctis, Vitaliana; Persechino, Severino; Fanelli, Alessandro; Valeriani, Maurizio; Bracci, Stefano; D'Arienzo, Marco; Monarca, Bruno; Caperchi, Cristiano; Raffa, Salvatore; Enrici, Riccardo Maurizi

    2011-01-01

    The long natural history of early stage mycosis fungoides (MF) makes its management a difficult problem. Skin lesions are sensitive to different therapies and a variety of treatment modalities have been used, such as topical nitrogen mustard, puvatherapy, UV-B, retinoids, radiation therapy, extracorporal photopheresis and systemic chemotherapy. For patients with refractory early stage MF, treatment selection is made by clinical parameters such as the age, sex and performance status of the patients, as well as the institutional expertise and the toxicity profiles of the different therapeutic approaches. We report radiation therapy in a relapsed/resistant stage IB patient with mycosis fungoides treated with local radiation therapy for symptomatic progression unresponsive to bexarotene therapy. Total skin electron beam therapy has been employed in early stage and for limited skin failure MF, while the role of local radiation therapy in MF is less defined. In our experience local radiotherapy has proved to be a very efficient, tolerable and cost effective approach in patients with MF unresponsive to systemic approaches. PMID:21489904

  12. Application of Histogram Analysis in Radiation Therapy (HART) in Intensity Modulation Radiation Therapy (IMRT) Treatments

    NASA Astrophysics Data System (ADS)

    Pyakuryal, Anil

    2009-03-01

    A carcinoma is a malignant cancer that emerges from epithelial cells in structures through out the body.It invades the critical organs, could metastasize or spread to lymph nodes.IMRT is an advanced mode of radiation therapy treatment for cancer. It delivers more conformal doses to malignant tumors sparing the critical organs by modulating the intensity of radiation beam.An automated software, HART (S. Jang et al.,2008,Med Phys 35,p.2812) was used for efficient analysis of dose volume histograms (DVH) for multiple targets and critical organs in four IMRT treatment plans for each patient. IMRT data for ten head and neck cancer patients were exported as AAPM/RTOG format files from a commercial treatment planning system at Northwestern Memorial Hospital (NMH).HART extracted DVH statistics were used to evaluate plan indices and to analyze dose tolerance of critical structures at prescription dose (PD) for each patient. Mean plan indices (n=10) were found to be in good agreement with published results for Linac based plans. The least irradiated volume at tolerance dose (TD50) was observed for brainstem and the highest volume for larynx in SIB treatment techniques. Thus HART, an open source platform, has extensive clinical implications in IMRT treatments.

  13. Biologically Guided Radiation Therapy (BGRT)Biologically Guided Radiation Therapy (BGRT) Effects InterEffects Inter Patient andPatient andEffects InterEffects Inter--Patient andPatient and

    E-print Network

    Stewart, Robert D.

    Biologically Guided Radiation Therapy (BGRT)Biologically Guided Radiation Therapy (BGRT) Effects beam radiation therapy (EBRT)· Fractionated external beam radiation therapy (EBRT) · Brachytherapy RD Stewart, JH Park, DJ Carlson, Isoeffect Calculations in Adaptive Radiation TherapyRD Stewart, JH Park, DJ

  14. Enhanced radiation therapy with multilayer microdisks containing radiosensitizing gold nanoparticles.

    PubMed

    Zhang, Peipei; Qiao, Yong; Xia, Junfei; Guan, Jingjiao; Ma, Liyuan; Su, Ming

    2015-03-01

    A challenge of X-ray radiation therapy is that high dose X-rays at therapeutic conditions damage normal cells. This paper describes the use of gold nanoparticle-loaded multilayer microdisks to enhance X-ray radiation therapy, where each microdisk contains over 10(5) radiosensitizing nanoparticles. The microdisks are attached on cell membranes through electrostatic interaction. Upon X-ray irradiation, more photoelectrons and Auger electrons are generated in the vicinity of the nanoparticles, which cause water ionization and lead to the formation of free radicals that damage the DNA of adjacent cancer cells. By attaching a large amount of gold nanoparticles on cancer cells, the total X-ray dose required for DNA damage and cell killing can be reduced. Due to their controllable structure and composition, multilayer microdisks can be a viable choice for enhanced radiation therapy with nanoparticles. PMID:25679345

  15. Radiation-induced bystander signalling in cancer therapy

    PubMed Central

    Prise, Kevin M.; O'Sullivan, Joe M.

    2010-01-01

    Our understanding of how radiation kills normal and tumour cells has been based on an intimate knowledge of the direct induction of DNA damage and its cellular consequences. What has become clear is that, as well as responses to direct DNA damage, cell–cell signalling — known as the bystander effect — mediated through gap junctions and inflammatory responses may have an important role in the response of cells and tissues to radiation exposure and also chemotherapy agents. This Review outlines the key aspects of radiation-induced intercellular signalling and assesses its relevance for existing and future radiation-based therapies. PMID:19377507

  16. Radiation beam therapy evolution: From X-rays to hadrons

    SciTech Connect

    Khoroshkov, V. S. [Institute of Theoretical and Experimental Physics (Russian Federation)], E-mail: khoroshkov@itep.ru

    2006-10-15

    The history of external radiation beam therapy (radiotherapy)-in particular, proton therapy (PT)-is brietly outlined. Two possible strategies in increasing the efficacy of radiotherapy are considered. The radiotherapy methods and techniques are brietly described. The possibilities of PT in providing effective treatment and the main achievements are demonstrated. The state of the art in the PT development involving the active creation of large clinical PT centers since 1990 is analyzed.

  17. Parallelization of Radiation Therapy Treatment Planning(RTTP) : A Case Study

    E-print Network

    Chaudhary, Vipin

    Parallelization of Radiation Therapy Treatment Planning(RTTP) : A Case Study V. Chaudhary, C. Xu, S Radiation therapy uses ionizing radiation to treat cancer- ous tumors. This paper reports our experiences Radiation therapy using external photon beams is an in- tegral part of the treatment of the majority

  18. Report from the Radiation Therapy Committee of the Southwest Oncology Group (SWOG): Research Objectives Workshop 2008.

    E-print Network

    2009-01-01

    of cancer care. Summary The Radiation Therapy Committeecancer phase II study that allows for the use of intensity-modulated radiation therapy,radiation, stan- dardization of radiation target delineation, and the assessment of new imaging techniques to individual- ize cancer therapy.

  19. Parallelization of Radiation Therapy Treatment Planning(RTTP) : A Case Study \\Lambda

    E-print Network

    Xu, Cheng-Zhong

    Abstract Radiation therapy uses ionizing radiation to treat cancer­ ous tumors. This paper reports ourParallelization of Radiation Therapy Treatment Planning(RTTP) : A Case Study \\Lambda V. Chaudhary experiences with the parallelization of a real­world 3­D radiation therapy treat­ ment planning (RTTP) system

  20. The thermoluminescence response of Ge-doped silica fibres for synchrotron microbeam radiation therapy dosimetry

    Microsoft Academic Search

    A. T. Abdul Rahman; D. A. Bradley; S. J. Doran; Brochard Thierry; Elke Bräuer-Krisch; A. Bravin

    2010-01-01

    In radiation cancer therapy, the aim is to destroy the tumour cells in the treated area while minimizing damage to the surrounding normal tissue. Synchrotron microbeam radiation therapy offers considerable promise in this respect, based on knowledge that normal tissue can tolerate high doses of radiation over small volumes. At the ESRF microbeam radiation therapy facility, one of the several

  1. Complications following radiation therapy to the head

    SciTech Connect

    Helpin, M.L.; Krejmas, N.L.; Krolls, S.O.

    1986-03-01

    A case is presented in which a child who received therapeutic radiation as part of his treatment regimen for rhabdomyosarcoma of the infratemporal and parapharyngeal region demonstrated undesirable sequelae in the dentition and the mandible.

  2. Optimization under uncertainty in radiation therapy

    E-print Network

    Chan, Timothy Ching-Yee

    2007-01-01

    In the context of patient care for life-threatening illnesses, the presence of uncertainty may compromise the quality of a treatment. In this thesis, we investigate robust approaches to managing uncertainty in radiation ...

  3. Enhanced radiation therapy with internalized polyelectrolyte modified nanoparticles

    NASA Astrophysics Data System (ADS)

    Zhang, Peipei; Qiao, Yong; Wang, Chaoming; Ma, Liyuan; Su, Ming

    2014-08-01

    A challenge of X-ray radiation therapy is that high dose X-ray under therapeutic conditions damages normal cells. This paper describes a nanoparticle-based method to enhance X-ray radiation therapy by delivering radio-sensitizing gold nanoparticles into cancer cells. The nanoparticles have been modified with cationic polyelectrolytes to allow internalization. Upon X-ray irradiation of nanoparticles, more photoelectrons and Auger electrons are generated to cause water ionization, leading to formation of free radicals that damage DNA of cancer cells. The X-ray dose required for DNA damage and cell killing is reduced by delivering gold nanoparticles inside cancer cells.

  4. Enhancement of radiation effects by gold nanoparticles for superficial radiation therapy

    Microsoft Academic Search

    Wan Nordiana Rahman; Nour Bishara; Trevor Ackerly; Cheng Fa He; Price Jackson; Christopher Wong; Robert Davidson; Moshi Geso

    2009-01-01

    Iodinated contrast agents, which are routinely used to improve contrast in x-ray diagnostic radiography, have been successfully proven to enhance radiation effects in kilovoltage x-ray radiation therapy beams. The studies determined the influence of iodine on the level of radiation biotoxicity to cells as an indicator of the radiation dose enhancement. The use of other high-atomic-number materials such as gold

  5. Synchrotron Radiation Therapy from a Medical Physics point of view

    SciTech Connect

    Prezado, Y.; Berkvens, P.; Braeuer-Krisch, E.; Renier, M.; Bravin, A. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Adam, J. F. [INSERM, U836, Equipe 6, BP 170, Grenoble Cedex 9, F-38042 (France); Universite Joseph Fourier, B.P. 51, Grenoble Cedex 9, F-38041 (France); ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Centre Hospitalier Universitaire, B.P. 217, Grenoble Cedex 9, F-38043 (France); Martinez-Rovira, I. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, E-08028 Barcelona (Spain); Fois, G. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Dipartimento di Fisica, Universita degli Studi di Cagliari, Strada Provinciale Monserrato Sestu km 0.700, Monserrato, Cagliari 09042 (Italy); Thengumpallil, S. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Dipartimento di Fisica E. Amaldi, Universita degli Studi Roma Tre, 84 Via della Vasca Navale, 00146 Roma (Italy); Edouard, M.; Deman, P. [INSERM, U836, Equipe 6, BP 170, Grenoble Cedex 9, F-38042 (France); Universite Joseph Fourier, B.P. 51, Grenoble Cedex 9, F-38041 (France); ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P. 220, 38043 Grenoble Cedex (France); Vautrin, M. [INSERM, U836, Equipe 6, BP 170, Grenoble Cedex 9, F-38042 (France); Universite Joseph Fourier, B.P. 51, Grenoble Cedex 9, F-38041 (France); DOSIsoft, Cachan (France)

    2010-07-23

    Synchrotron radiation (SR) therapy is a promising alternative to treat brain tumors, whose management is limited due to the high morbidity of the surrounding healthy tissues. Several approaches are being explored by using SR at the European Synchrotron Radiation Facility (ESRF), where three techniques are under development Synchrotron Stereotactic Radiation Therapy (SSRT), Microbeam Radiation Therapy (MRT) and Minibeam Radiation Therapy (MBRT).The sucess of the preclinical studies on SSRT and MRT has paved the way to clinical trials currently in preparation at the ESRF. With this aim, different dosimetric aspects from both theoretical and experimental points of view have been assessed. In particular, the definition of safe irradiation protocols, the beam energy providing the best balance between tumor treatment and healthy tissue sparing in MRT and MBRT, the special dosimetric considerations for small field dosimetry, etc will be described. In addition, for the clinical trials, the definition of appropiate dosimetry protocols for patients according to the well established European Medical Physics recommendations will be discussed. Finally, the state of the art of the MBRT technical developments at the ESRF will be presented. In 2006 A. Dilmanian and collaborators proposed the use of thicker microbeams (0.36-0.68 mm). This new type of radiotherapy is the most recently implemented technique at the ESRF and it has been called MBRT. The main advantage of MBRT with respect to MRT is that it does not require high dose rates. Therefore it can be more easily applied and extended outside synchrotron sources in the future.

  6. Synchrotron Radiation Therapy from a Medical Physics point of view

    NASA Astrophysics Data System (ADS)

    Prezado, Y.; Adam, J. F.; Berkvens, P.; Martinez-Rovira, I.; Fois, G.; Thengumpallil, S.; Edouard, M.; Vautrin, M.; Deman, P.; Bräuer-Krisch, E.; Renier, M.; Elleaume, H.; Estève, F.; Bravin, A.

    2010-07-01

    Synchrotron radiation (SR) therapy is a promising alternative to treat brain tumors, whose management is limited due to the high morbidity of the surrounding healthy tissues. Several approaches are being explored by using SR at the European Synchrotron Radiation Facility (ESRF), where three techniques are under development Synchrotron Stereotactic Radiation Therapy (SSRT), Microbeam Radiation Therapy (MRT) and Minibeam Radiation Therapy (MBRT). The sucess of the preclinical studies on SSRT and MRT has paved the way to clinical trials currently in preparation at the ESRF. With this aim, different dosimetric aspects from both theoretical and experimental points of view have been assessed. In particular, the definition of safe irradiation protocols, the beam energy providing the best balance between tumor treatment and healthy tissue sparing in MRT and MBRT, the special dosimetric considerations for small field dosimetry, etc will be described. In addition, for the clinical trials, the definition of appropiate dosimetry protocols for patients according to the well established European Medical Physics recommendations will be discussed. Finally, the state of the art of the MBRT technical developments at the ESRF will be presented. In 2006 A. Dilmanian and collaborators proposed the use of thicker microbeams (0.36-0.68 mm). This new type of radiotherapy is the most recently implemented technique at the ESRF and it has been called MBRT. The main advantage of MBRT with respect to MRT is that it does not require high dose rates. Therefore it can be more easily applied and extended outside synchrotron sources in the future.

  7. BGRT: Biologically guided radiation therapy - The future is fast approaching!

    Microsoft Academic Search

    X. Allen Li; Robert D. Stewart

    2007-01-01

    Rapid advances in functional and biological imaging, predictive assays, and our understanding of the molecular and cellular responses underpinning treatment outcomes herald the coming of the long-sought goal of implementing patient-specific biologically guided radiation therapy (BGRT) in the clinic. Biological imaging and predictive assays have the potential to provide patient-specific, three-dimensional information to characterize the radiation response characteristics of tumor

  8. Towards magnetic resonance imaging guided radiation therapy (MRIgRT)

    Microsoft Academic Search

    Teodor Marius Stanescu

    2008-01-01

    The goal of this work is to address key aspects of the magnetic resonance imaging guided radiation therapy (MRIgRT) process of cancer sites. MRIgRT is implemented by using a system comprised of a magnetic resonance imaging (MRI) scanner coupled with a radiation source, in our case a radiotherapy accelerator (Linac). The potential benefits of MRIgRT are the real-time tracking of

  9. Health-related quality-of-life after external beam radiation therapy for localized prostate cancer: intensity-modulated radiation therapy versus conformal radiation therapy

    Microsoft Academic Search

    K Yoshimura; T Kamoto; E Nakamura; T Segawa; T Kamba; T Takahashi; H Nishiyama; N Ito; K Takayama; T Mizowaki; M Mitsumori; M Hiraoka; O Ogawa

    2007-01-01

    We compared health-related quality-of-life (HRQL) after intensity-modulated radiotherapy (IMRT) with statuses obtained after old and new protocols of three-dimensional conformal radiation therapy (3DCRT) for localized prostate cancer. We measured the general and disease specific HRQL using the MOS 36-Item Health Survey (SF-36), and the University of California, Los Angeles Prostate Cancer Index (UCLA PCI), respectively. IMRT resulted in similar profiles

  10. Phototherapy cabinet for ultraviolet radiation therapy

    Microsoft Academic Search

    S. N. Horwitz; P. Frost

    1981-01-01

    A newly designed cabinet can be used for the treatment of psoriasis with fluorescent ultraviolet (UV) lamps. the new design provides more uniform distribution of UV radiation in both the horizontal and vertical axes, and several safety features have been added. The distribution and uniformity of UV output in this and in a previously described cabinet are compared. The UV

  11. Beam modification for cancer radiation therapy. Master's thesis

    Microsoft Academic Search

    1985-01-01

    A method for designing radiation-therapy beam modifiers is proposed in this thesis. The design is based on a calculated dose distribution in the patient from an unmodified treatment beam. The modifier alters the beam before it reaches the patient in a way that yields the desired dose profile at the tumor while minimizing the dose to healthy tissues. The design

  12. Pediatric meuroblastoma: postoperative radiation therapy using less than 2000 rad

    Microsoft Academic Search

    Hal M. Jacobson; Robert B. Marcus Jr.; Timothy L. Thar; Rodney R. Million; John R. Graham-Pole; James L. Talbert

    1983-01-01

    There is considerable controversy regarding the role of radiaiton therapy in the treatment of neuroblastoma. Postoperative irradiation in the range of 2500-4000 rad is commonly used in the treatment of Evans Stage II or III disease, but there are no data in the literature to suggest the optimum dose of radiation that is necessary. Because much lower doses have been

  13. Radiation therapy in the management of patients with mesothelioma

    SciTech Connect

    Gordon, W. Jr.; Antman, K.H.; Greenberger, J.S.; Weichselbaum, R.R.; Chaffey, J.T.

    1982-01-01

    The results of radiation therapy in the management of 27 patients with malignant mesothelioma were reviewed. Eight patients were treated with a curative intent combining attempted surgical excision of tumor (thoracic in 6 and peritoneal in 2), aggressive radiation therapy, and combination chemotherapy using an adriamycin-containing regimen. One patient achieved a 2-year disease-free inteval followed by recurrence of tumor above the thoracic irradiation field. This patient was retreated with localized irradiation and is disease-free after 5 years of initial diagnosis. One patient has persistent abdominal disease at 18 months; the other 6 patients suffered local recurrence within 8-13 months of initiation of treatment. Radiation therapy was used in 19 other patients who received 29 courses for palliation of dyspnea, superior vena cava syndrome, dysphagia, or neurological symptoms of brain metastasis. A palliation index was used to determine the effectiveness of irradiation and revealed that relief of symptoms was complete or substantial in 5 treatment courses, moderately effective in 6 courses and inadequate in 18 treatment courses. Adequate palliation strongly correlated with a dose at or above 4,000 rad in 4 weeks. The management of patients with mesothelioma requires new and innovative approaches to increase the effectiveness of radiation therapy and minimize the significant potential combined toxicity of pulmonary irradiation and adriamycin.

  14. Particle radiation therapy: current status and future potential.

    PubMed

    Parker, R G

    1977-02-01

    Radiation therapy with "heavy" particles offers potential biological and physical advantages compared to irradiation with low LET photons. Clinical studies are in progress with proton beams, which have dosimetric advantages, and fast neutron beams, which have potential biologic advantages. Clinical studies with negative pi mesons and heavy nuclei, which have combined dosimetric and biologic advantages are about to start. PMID:402196

  15. Hemodynamic responses to antivascular therapy and ionizing radiation assessed

    E-print Network

    Yodh, Arjun G.

    Hemodynamic responses to antivascular therapy and ionizing radiation assessed by diffuse optical. of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, 19104 Dept. of Radiology and Dept. of Physics and Astronomy, University of Pennsylvania, PA, 19104 Dept. of Medicine and the Abramson Cancer

  16. Megavoltage Beam Properties Affecting Patient Dose in Radiation Therapy

    Microsoft Academic Search

    Nnaemeka C. Ikoro

    1988-01-01

    Certain properties of megavoltage beams have remained of concern in radiation therapy. This investigation is directed towards a better characterization of the problems presented by contaminant electrons in these photon beams, by their spectral distribution and by their interaction in a specific target tissue where heterogeneity poses a particular clinical problem. Two megavoltage beams, a ^{60}CO and a 6 MV,

  17. High resolution optical calorimetry for synchrotron microbeam radiation therapy

    Microsoft Academic Search

    T. Ackerly; J. C. Crosbie; A. Fouras; G. J. Sheard; S. Higgins; R. A. Lewis

    2011-01-01

    We propose the application of optical calorimetry to measure the peak to valley ratio for synchrotron microbeam radiation therapy (MRT). We use a modified Schlieren approach known as reference image topography (RIT) which enables one to obtain a map of the rate of change of the refractive index in a water bath from which the absorbed dose can be determined

  18. NOTE: Tetrahedral irradiation protocol for microbeam radiation therapy

    Microsoft Academic Search

    Daniel N. Slatkin

    2006-01-01

    Optimizing microbeam radiation therapy requires that the patient be repositioned between exposures. Optional movements of a patient-gantry are described that would enable a lesion to be cross-fired pseudo-orthogonally in two, three or four exposures to a fixed, horizontally propagated array of vertical, parallel microplanar beams, with minimal tilting of the patient-gantry.

  19. NOTE: Tetrahedral irradiation protocol for microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Slatkin, Daniel N.

    2006-09-01

    Optimizing microbeam radiation therapy requires that the patient be repositioned between exposures. Optional movements of a patient-gantry are described that would enable a lesion to be cross-fired pseudo-orthogonally in two, three or four exposures to a fixed, horizontally propagated array of vertical, parallel microplanar beams, with minimal tilting of the patient-gantry.

  20. Roadmap: Radiologic Imaging Sciences -Radiation Therapy (with AAS Radiologic Technology)

    E-print Network

    Sheridan, Scott

    Roadmap: Radiologic Imaging Sciences - Radiation Therapy (with AAS Radiologic Technology Social Sciences and domestic diversity; see note 1 US 10097 Destination Kent State: First Year Experience note 1; See Kent Core Summary Semester One: [15 Credit Hours] COMM 15000 Introduction to Human

  1. Roadmap: Radiologic Imaging Sciences -Radiation Therapy (with AAS Radiologic Technology)

    E-print Network

    Sheridan, Scott

    Roadmap: Radiologic Imaging Sciences - Radiation Therapy (with AAS Radiologic Technology Experience 1 Not required of transfer students with 25 credits; see note 1 Kent Core Requirements 6-8 See note 1; See Kent Core Summary Semester One: [18 Credit Hours] COMM 15000 Introduction to Human

  2. Complementary strategies for the management of radiation therapy side effects.

    PubMed

    Stubbe, Christine E; Valero, Meighan

    2013-07-01

    Patients with cancer utilize complementary and alternative medicine (CAM) for a variety of purposes, one of which is the reduction of side effects of conventional treatment. With a large number of their patients using CAM, it is important for advanced practitioners in oncology to have an understanding of these therapies to better guide their patients. Side effects of radiation therapy that may have dose-limiting poten-tial include diarrhea, mucositis, skin toxicity, and xerostomia. A com-mon side effect that is not necessarily dose-limiting but considerably troublesome to patients is cancer- and treatment-related fatigue. The CAM therapies that may alleviate some of the side effects of radiation therapy include probiotics, psyllium, exercise, melatonin, honey, acu-puncture, and calendula. Therapies that require more research or have been shown to be ineffective include aloe vera, glutamine, and deglyc-yrrhizinated licorice. This article provides an overview of these thera-pies as well as related research and analysis. PMID:25032003

  3. Stem Cell Therapy Remediates Reconstruction of the Craniofacial Skeleton After Radiation Therapy

    PubMed Central

    Deshpande, Sagar S.; Gallagher, Kathleen K.; Donneys, Alexis; Tchanque-Fossuo, Catherine N.; Sarhaddi, Deniz; Sun, Hongli; Krebsbach, Paul H.

    2013-01-01

    This study utilized transplanted bone marrow stromal cells (BMSCs) as a cellular replacement therapy to remedy radiation-induced injury and restore impaired new bone formation during distraction osteogenesis (DO). BMSC therapy brought about the successful generation of new bone and significantly improved both the rate and quality of a bony union of irradiated, distracted [X-ray radiation therapy (XRT)/DO] murine mandibles to the level of nonirradiated DO animals. The bone mineral density and bone volume fraction were also significantly improved by the BMSC replacement therapy showing no difference when compared to nonirradiated animals. Finally, a biomechanical analysis examining the yield, failure load, and ultimate load also demonstrated a significantly improved structural integrity in BMSC-treated XRT/DO mandibles over XRT/DO alone. These results indicate that administration of BMSCs intraoperatively to a radiated distraction gap can function as an adequate stimulant to rescue the ability for irradiated bone to undergo DO and produce a healed regenerate of a vastly superior quality and strength. We believe that the fundamental information on the optimization of bone regeneration in the irradiated mandible provided by this work has immense potential to be translated from the bench to the bedside to lead to improved therapeutic options for patients suffering from the disastrous sequelae of radiation therapy. PMID:23282102

  4. Radiation therapy for primary optic nerve meningiomas

    SciTech Connect

    Smith, J.L.; Vuksanovic, M.M.; Yates, B.M.; Bienfang, D.C.

    1981-06-01

    Optic nerve sheath meningiomas, formerly thought to be rare, have been encountered with surprising frequency since the widespread use of computed tomography. Early diagnosis led to an enthusiastic surgical approach to these lesions, but this has been tempered by the realization that even in the best of hands, blindness followed such surgery with distressing frequency. Optic nerve sheath meningiomas may be divided into primary, secondary, and multiple meningioma groups. Five patients with primary optic nerve sheath meningiomas treated with irradiation therapy are presented in this report. Improvement in visual acuity, stabilization to increase in the visual field, and decrease in size to total regression of optociliary veins, have been documented following irradiation therapy of the posterior orbital and intracanalicular portions of the optic nerve in some of these cases. Although each patient must be carefully individualized, there is no question that visual palliation can be achieved in some cases of optic nerve sheath meningioma. Further investigation of this therapeutic modality in selected cases in advised.

  5. Rat liver tolerance for partial resection and intraoperative radiation therapy: Regeneration is radiation dose dependent

    Microsoft Academic Search

    Maurizio Bossola; Hollis W. Merrick; Ahmed Eltaki; Rocco Bellantone; Andrew J. Milligan; Glovanni B. Doglietto; Philip Conran; Ralph R. Dobelbower; Francesco Crucitti

    1990-01-01

    We studied the feasibility of delivering a large single dose of intraoperative radiation as an adjuvant to partial hepatic resection. Intraoperative radiation therapy (IORT) was delivered to the remaining liver of 84 rats after partial hepatectomy to determine the acute and chronic effects of treatment on blood chemistry values, histology, survival, hepatic regeneration, and cellular appearance of the normal liver.

  6. Carotid Plaque Hemodynamics

    PubMed Central

    Harloff, Andreas

    2012-01-01

    Internal carotid artery (ICA) plaques constitute one major source of retinal and cerebral brain embolism. Current guidelines recommend optimal treatment of cardiovascular risk factors and recanalization based on the degree of ICA stenosis. However, ICA plaque composition, motion, vascularization, and local hemodynamics have only received limited attention as potential and independent risk factors for plaque rupture. The European Carotid Surgery Trial (ECST) showed an increased risk of stroke recurrence even in moderate stenosis if the plaque surface was ulcerated in angiography. Further indicators of plaque instability and thus vulnerability were established by native or contrast-enhanced two-dimensional duplex ultrasound, CT, and MRI. Due to high soft tissue contrast, multi-contrast MRI seems to be ideally suited to identify plaque compositions that are prone to rupture, although data from large clinical trials proving the independent predictive value of plaque morphology are lacking. The role of cardiovascular risk factors for atherosclerosis of the common carotid artery is well established. Nevertheless, little is known concerning the impact of local hemodynamics on plaque development, progression, and rupture. Wall shear stress, the friction force acting on the endothelium of the vessel wall, was shown to be able to induce local atherosclerosis and vulnerable plaques in animal models. Plaque movement and deformation was limited to investigations using ultrasound in order to identify plaques at risk. Similarly, models to calculate tensile plaque stress seem to be able to identify peak mechanical stress acting on plaque surfaces that make such regions susceptible to rupture. In this review, current evidence regarding the correlation of plaque location, composition, and local hemodynamics at the carotid artery bifurcation will be presented. Moreover, the potential benefit of a future comprehensive and individual risk assessment will be discussed. PMID:25187766

  7. Phototherapy cabinet for ultraviolet radiation therapy

    SciTech Connect

    Horwitz, S.N.; Frost, P.

    1981-08-01

    A newly designed cabinet can be used for the treatment of psoriasis with fluorescent ultraviolet (UV) lamps. the new design provides more uniform distribution of UV radiation in both the horizontal and vertical axes, and several safety features have been added. The distribution and uniformity of UV output in this and in a previously described cabinet are compared. The UV output at the vertical center of the older UV light cabinet was six times greater than that at either the top or bottom, while the design of the present cabinet provides uniform UV radiation except for a slight increase at head height and at the level of the lower legs compared with the middle third of the cabinet. The variation in output of the older cabinet may, in part, explain the commonly encountered difficulty in the phototherapy of psoriasis of the scalp and lower extremities.

  8. Hepatocellular Carcinoma Radiation Therapy: Review of Evidence and Future Opportunities

    SciTech Connect

    Klein, Jonathan [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Dawson, Laura A., E-mail: laura.dawson@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada)

    2013-09-01

    Hepatocellular carcinoma (HCC) is a leading cause of global cancer death. Curative therapy is not an option for most patients, often because of underlying liver disease. Experience in radiation therapy (RT) for HCC is rapidly increasing. Conformal RT can deliver tumoricidal doses to focal HCC with low rates of toxicity and sustained local control in HCC unsuitable for other locoregional treatments. Stereotactic body RT and particle therapy have been used with long-term control in early HCC or as a bridge to liver transplant. RT has also been effective in treating HCC with portal venous thrombosis. Patients with impaired liver function and extensive disease are at increased risk of toxicity and recurrence. More research on how to combine RT with other standard and novel therapies is warranted. Randomized trials are also needed before RT will be generally accepted as a treatment option for HCC. This review discusses the current state of the literature and opportunities for future research.

  9. Study on neutron radiation field of carbon ions therapy

    E-print Network

    Xu, Jun-Kui; Li, Wu-Yuan; Yan, Wei-Wei; Chen, Xi-Meng; Mao, Wang; Pang, Cheng-Guo

    2015-01-01

    Carbon ions offer significant advantages for deep-seated local tumors therapy due to their physical and biological properties. Secondary particles, especially neutrons caused by heavy ion reactions should be carefully considered in treatment process and radiation protection. For radiation protection purposes, the FLUKA Code was used in order to evaluate the radiation field at deep tumor therapy room of HIRFL in this paper. The neutron energy spectra, neutron dose and energy deposition of carbon ion and neutron in tissue-like media was studied for bombardment of solid water target by 430MeV/u C ions. It is found that the calculated neutron dose have a good agreement with the experimental date, and the secondary neutron dose may not exceed one in a thousand of the carbon ions dose at Bragg peak area in tissue-like media.

  10. Study on neutron radiation field of carbon ions therapy

    E-print Network

    Jun-Kui Xu; You-Wu Su; Wu-Yuan Li; Wei-Wei Yan; Xi-Meng Chen; Wang Mao; Cheng-Guo Pang

    2015-03-18

    Carbon ions offer significant advantages for deep-seated local tumors therapy due to their physical and biological properties. Secondary particles, especially neutrons caused by heavy ion reactions should be carefully considered in treatment process and radiation protection. For radiation protection purposes, the FLUKA Code was used in order to evaluate the radiation field at deep tumor therapy room of HIRFL in this paper. The neutron energy spectra, neutron dose and energy deposition of carbon ion and neutron in tissue-like media was studied for bombardment of solid water target by 430MeV/u C ions. It is found that the calculated neutron dose have a good agreement with the experimental date, and the secondary neutron dose may not exceed one in a thousand of the carbon ions dose at Bragg peak area in tissue-like media.

  11. Research Findings on Radiation Hormesis and Radon Therapy

    SciTech Connect

    Hattori, Sadao

    1999-06-06

    Radiation hormesis research in Japan to determine the validity of Luckey's claims has revealed information on the health effects of low-level radiation. The scientific data of animal tests we obtained and successful results actually brought by radon therapy on human patients show us a clearer understanding of the health effects of low-level radiation. We obtained many animal test results and epidemiological survey data through our research activities cooperating with more than ten universities in Japan, categorized as follows: 1. suppression of cancer by enhancement of the immune system based on gene activation; 2. rejuvenation and suppression of aging by increasing cell membrane permeability and enzyme syntheses; 3. adaptive response by activation of gene expression on DNA repair and cell apoptosis; 4. pain relief and stress moderation by hormone formation in the brain and central nervous system; 5. avoidance and therapy of obstinate diseases by enhancing damage control systems and form one formation.

  12. High dose bystander effects in spatially fractionated radiation therapy.

    PubMed

    Asur, Rajalakshmi; Butterworth, Karl T; Penagaricano, Jose A; Prise, Kevin M; Griffin, Robert J

    2015-01-01

    Traditional radiotherapy of bulky tumors has certain limitations. Spatially fractionated radiation therapy (GRID) and intensity modulated radiotherapy (IMRT) are examples of advanced modulated beam therapies that help in significant reductions in normal tissue damage. GRID refers to the delivery of a single high dose of radiation to a large treatment area that is divided into several smaller fields, while IMRT allows improved dose conformity to the tumor target compared to conventional three-dimensional conformal radiotherapy. In this review, we consider spatially fractionated radiotherapy approaches focusing on GRID and IMRT, and present complementary evidence from different studies which support the role of radiation induced signaling effects in the overall radiobiological rationale for these treatments. PMID:24246848

  13. [The application of total quality management (TQM) in quality management of radiation therapy].

    PubMed

    Jiang, Rui-yao; Fu, Shen; Li, Bin

    2009-03-01

    The strategies and methods of the total quality management (TQM) need to applied in quality management of radiation therapy. We should improve the level of quality control and quality assurance in radiation therapy. By establishing quality control system in radiation therapy, standardization of radiation therapy workflow, strengthening quality control of devices and physical technique and paying attention to safety protection and staff training. PMID:19565799

  14. From Intensity Modulated Radiation Therapy to 4D Radiation Therapy - An Advance in Targeting Mobile Lung Tumors

    Microsoft Academic Search

    Yulin Song; B. Muller; C. Burman; B. Mychalczak

    2007-01-01

    Intensity modulated radiation therapy (IMRT) has been widely used in the treatment of lung cancer. The highly conformal dose distribution with steep gradients could miss the target if respiratory motion is not carefully considered during the treatment planning. The issue becomes particularly critical when dose escalation technique is used. To account for this periodical respiratory motion, the common practice is

  15. Integrated breast conservation and intraoperative radiation therapy.

    PubMed

    Orecchia, Roberto; Ivaldi, Giovanni Battista; Leonardi, Maria Cristina

    2009-10-01

    The introduction of innovative radiotherapy approaches for early breast cancer patients is rapidly changing the radiation oncologists' attitude and their expectations to obtain a good local control while decreasing morbidity therefore improving patient's quality of life. Intraoperative radiotherapy is a very attractive treatment modality in the multidisciplinary approach to breast conservation as is testified by the rapidly growing number of patients accrued in numerous studies all over Europe since 2000. A major advantage of intraoperative radiotherapy in breast cancer treatment is the administration of a large dose of radiation directly to the tumour bed, avoiding the possible geographic miss. Accurate localization and precise definition of the tumour bed volume is essential to achieve maximal efficacy in terms of local control while minimizing unnecessary damage to the normal breast tissue. Intraoperative radiotherapy reduces radiation exposure of the skin, lung, heart and normal subcutaneous tissues thus contributing to the low incidence of side effects and the generally excellent cosmetic results. Compared to other intraoperative techniques, the superiority of intraoperative radiotherapy appears to be the high homogeneity of dose distribution. The linear quadratic model used to calculate the biologic equivalent dose of intraoperative radiotherapy treatments for both tumour and normal tissue effects, is not considered totally reliable for large dose per fraction. The main concern is the potential increase in severe late side effects. Conversely, we expect an enhanced local control due to the radiobiologic efficacy of a large single dose delivered soon after tumour excision, with an immediate cell killing effect over any potential microscopic disease. The advantage of shortening the overall treatment time is that it avoids any delay in the administration of chemotherapy. The safety of intraoperative radiotherapy as a treatment modality in the context of breast conservation has been proved but conclusive data on local control and survival are expected from long term results of the ongoing studies. PMID:19914553

  16. Automatic Segmentation of Intra-Treatment CT Images for Adaptive Radiation Therapy of the

    E-print Network

    for prostate cancer is external beam radiation therapy, which uses high energy x-rays that are deliveredAutomatic Segmentation of Intra-Treatment CT Images for Adaptive Radiation Therapy of the Prostate for automatically quan- tifying organ motion for adaptive radiation therapy of the prostate. Our approach is based

  17. Enhancement of Cancer Radiation Therapy by Use of Adenovirus-Mediated Secretable Glucose-Regulated

    E-print Network

    Nicchitta, Chris

    Enhancement of Cancer Radiation Therapy by Use of Adenovirus-Mediated Secretable Glucose immunotherapy to enhance cancer radiation therapy. The main goal is to achieve both local tumor control explored the therapeutic efficacy of a combined GRP94/gp96-based genetic immuno- therapy and radiation

  18. Tumor trailing strategy for intensity-modulated radiation therapy of moving targets

    E-print Network

    of radiation therapy of cancer affects the distribution of the delivered dose and, generally, reduces itsTumor trailing strategy for intensity-modulated radiation therapy of moving targets Alexei motion in intensity-modulated radiation therapy IMRT included expansion of the target margins, motion

  19. PRE-RADIATION THERAPY College of Liberal Arts & Sciences Advising Center

    E-print Network

    PRE-RADIATION THERAPY College of Liberal Arts & Sciences Advising Center 387 Cramer Hall, (503) 725-3822, askclas@pdx.edu PORTLAND STATE UNIVERSITY Radiation Therapy is a highly specialized branch of medicine member of a radiation therapy team that includes physicians, nurses, dosimetrists, and physicists

  20. Optimization Under Uncertainty: Methods and Applications in Radiation Therapy Weldon Lodwick *

    E-print Network

    Neumaier, Arnold

    1 Optimization Under Uncertainty: Methods and Applications in Radiation Therapy Weldon Lodwick uncertainty to radiation therapy planning, where it is natural and useful to model the uncertainty The use of particle beams to treat tumors is called the radiation therapy problem (RTP). Beams

  1. Iterative regularization in intensity-modulated radiation therapy optimization Fredrik Carlssona

    E-print Network

    Forsgren, Anders

    Iterative regularization in intensity-modulated radiation therapy optimization Fredrik Carlssona; published 28 December 2005 A common way to solve intensity-modulated radiation therapy IMRT optimization in Medicine. DOI: 10.1118/1.2148918 Key words: intensity-modulated radiation therapy, quasi-Newton method

  2. Accelerating Monte Carlo simulations of radiation therapy dose distributions using wavelet threshold de-noising

    E-print Network

    Wickerhauser, M. Victor

    Accelerating Monte Carlo simulations of radiation therapy dose distributions using wavelet.1118/1.1508112 Key words: Monte Carlo, wavelet threshold de-noising I. INTRODUCTION Radiation therapy utilizes of radiation therapy treatment planning systems have recently announced plans to develop MC-based dose

  3. Preferential effect of synchrotron microbeam radiation therapy on intracerebral 9L gliosarcoma vascular networks

    E-print Network

    Paris-Sud XI, Université de

    Preferential effect of synchrotron microbeam radiation therapy on intracerebral 9L gliosarcoma.06.021 #12;Bouchet et al. 2010 2 Abstract Purpose. Synchrotron Microbeam Radiation Therapy (MRT) relies on the vasculature. Key words: Synchrotron Microbeam radiation therapy/intracerebral 9L gliosarcoma/tumor vasculature

  4. Optimization of radiation therapy treatment planning

    SciTech Connect

    Ezzell, G.

    1994-12-31

    Radiation oncology is a medical specialty which uses ionizing radiation to treat disease, usually cancer, with the goal being to produce the highest probability of tumor control with the least likelihood of causing complications in the surrounding organs. The process of choosing suitable combinations of treatment beams, each with appropriate shape, intensity, energy, and direction, has come to be called {open_quotes}treatment planning,{close_quotes} and it is an exercise in computer modeling. Recent advances in computer and treatment technology have made it possible to consider evaluate novel arrangements of beams and compute the pattern of dose which would result throughout the three dimensional volume of the patient. Evaluating the resulting mass of data is daunting, and so algorithms for optimizing beam selection are urgently needed. This presentation reviews the optimization techniques which have been applied to the problem, starting from the earliest effort in the late 1960`s. Linear programming, quadratic programming, and random search methods such as simulated annealing have all been developed by different research groups. This presentation reviews the most promising efforts reported and suggests possible areas for additional research.

  5. [Cutaneous radiation syndrome: clinical features, diagnosis and therapy].

    PubMed

    Gottlöber, P; Krähn, G; Peter, R U

    2000-08-01

    Accidental exposure to ionizing radiation may occur during such catastrophic events as the Chernobyl accident in 1986 or over days to weeks as in Goiania in 1987 and in the military camp during the training of soldiers in Lilo/Georgia in 1997, as well as in medical institutions. The cutaneous symptoms after radiation exposure are based on a combination of inflammatory processes and alteration of cellular proliferation as a result of a specific pattern of transcriptionally activated proinflammatory cytokines and growth factors. They follow a time course consisting of prodromal erythema, latency period, acute stage, chronic stage and late stage. The entire complex is referred to as cutaneous radiation syndrome. The time course depends on several factors such as the radiation dose, radiation quality, individual radiation sensitivity, the extent of contamination and absorption and amount of skin exposed. For the diagnosis of the cutaneous radiation syndrome the following procedures are used: 7.5 MHz to 20 MHz-B-scan sonography, thermography, capillary microscopy, profilometry, nuclear magnetic resonance imaging, bone scintigraphy and histology. Based on the results of experimental and clinical research, today treatment may include topical or systemic corticosteroids, gamma-interferon, pentoxifylline, vitamin E and superoxide dismutase. The treatment depends on the stage of the cutaneous radiation syndrome. Due to the complexity of the clinical manifestations of radiation disease, most patients require interdisciplinary treatment in specialized centres. Dermatologists are essential partners in the life-long follow-up and therapy of such patients. PMID:10997311

  6. Radiation therapy-associated invasive bladder tumors

    SciTech Connect

    Sella, A.; Dexeus, F.H.; Chong, C.; Ro, J.Y.; Logothetis, C.J.

    1989-03-01

    Radiotherapy-associated bladder carcinoma was found in 3.7 percent of 244 cases of advanced urothelial carcinoma. Average age at diagnosis of the bladder tumor was 63.1 years, with a mean of 20.5 years between radiation treatment and diagnosis. All 9 patients presented with gross hematuria. Eight patients had transitional cell carcinoma, 7/8 (87.5%) also had vascular or lymphatic invasion, and 1 was adenocarcinoma. Mean survival was 15.4 months (range 1-40 mos.), with a 55.5 percent one-year disease-free survival after diagnosis. Four patients died of bladder tumor, 4 were alive with no evidence of disease, and 1 was alive with metastasis.

  7. Stereotactic Body Radiation Therapy in Spinal Metastases

    SciTech Connect

    Ahmed, Kamran A. [Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN (United States); Stauder, Michael C.; Miller, Robert C.; Bauer, Heather J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Rose, Peter S. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Olivier, Kenneth R. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Brinkmann, Debra H. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Laack, Nadia N., E-mail: laack.nadia@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    2012-04-01

    Purpose: Based on reports of safety and efficacy, stereotactic body radiotherapy (SBRT) for treatment of malignant spinal tumors was initiated at our institution. We report prospective results of this population at Mayo Clinic. Materials and Methods: Between April 2008 and December 2010, 85 lesions in 66 patients were treated with SBRT for spinal metastases. Twenty-two lesions (25.8%) were treated for recurrence after prior radiotherapy (RT). The mean age of patients was 56.8 {+-} 13.4 years. Patients were treated to a median dose of 24 Gy (range, 10-40 Gy) in a median of three fractions (range, 1-5). Radiation was delivered with intensity-modulated radiotherapy (IMRT) and prescribed to cover 80% of the planning target volume (PTV) with organs at risk such as the spinal cord taking priority over PTV coverage. Results: Tumor sites included 48, 22, 12, and 3 in the thoracic, lumbar, cervical, and sacral spine, respectively. The mean actuarial survival at 12 months was 52.2%. A total of 7 patients had both local and marginal failure, 1 patient experienced marginal but not local failure, and 1 patient had local failure only. Actuarial local control at 1 year was 83.3% and 91.2% in patients with and without prior RT. The median dose delivered to patients who experienced local/marginal failure was 24 Gy (range, 18-30 Gy) in a median of three fractions (range, 1-5). No cases of Grade 4 toxicity were reported. In 1 of 2 patients experiencing Grade 3 toxicity, SBRT was given after previous radiation. Conclusion: The results indicate SBRT to be an effective measure to achieve local control in spinal metastases. Toxicity of treatment was rare, including those previously irradiated. Our results appear comparable to previous reports analyzing spine SBRT. Further research is needed to determine optimum dose and fractionation to further improve local control and prevent toxicity.

  8. Prevention of normal tissue complications in radiation therapy of head and neck cancer : the role of 3D conformal radiation therapy (3DCRT)

    Microsoft Academic Search

    Wijers O. B

    2002-01-01

    In The Netherlands. head and neck cancer (3.9%) ranks the eighth most frequemly diagnoscd\\u000amalignant tumor. Radiation therapy (IIT) plays an important role in the treatmem of\\u000apatients with head and neck cancer, as they constitute approximately 6% of those treated in\\u000aa routine radiation therapy department. Radiation therapy can be used as a single treatment\\u000amodality. but is also

  9. Stereotactic Body Radiation Therapy for Patients With Lung Cancer Previously Treated With Thoracic Radiation

    SciTech Connect

    Kelly, Patrick [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Balter, Peter A. [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Rebueno, Neal; Sharp, Hadley J.; Liao Zhongxing; Komaki, Ritsuko [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chang, Joe Y., E-mail: jychang@mdanderson.or [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2010-12-01

    Purpose: Stereotactic body radiation therapy (SBRT) provides excellent local control with acceptable toxicity for patients with early-stage non-small cell lung cancer. However, the efficacy and safety of SBRT for patients previously given thoracic radiation therapy is not known. In this study, we retrospectively reviewed outcomes after SBRT for recurrent disease among patients previously given radiation therapy to the chest. Materials and Methods: A search of medical records for patients treated with SBRT to the thorax after prior fractionated radiation therapy to the chest at The University of Texas M. D. Anderson Cancer Center revealed 36 such cases. The median follow-up time after SBRT was 15 months. The endpoints analyzed were overall survival, local control, and the incidence and severity of treatment-related toxicity. Results: SBRT provided in-field local control for 92% of patients; at 2 years, the actuarial overall survival rate was 59%, and the actuarial progression-free survival rate was 26%, with the primary site of failure being intrathoracic relapse. Fifty percent of patients experienced worsening of dyspnea after SBRT, with 19% requiring oxygen supplementation; 30% of patients experienced chest wall pain and 8% Grade 3 esophagitis. No Grade 4 or 5 toxic effects were noted. Conclusions: SBRT can provide excellent in-field tumor control in patients who have received prior radiation therapy. Toxicity was significant but manageable. The high rate of intrathoracic failure indicates the need for further study to identify patients who would derive the most benefit from SBRT for this purpose.

  10. [Diet and plaque].

    PubMed

    Banoczy, J

    1989-06-01

    In summary, many sugar substitutes have a direct effect on dental plaque formation and, therefore, also an indirect effect on hard tooth substance. Short-and long-term clinical studies have shown that xylitol reduces dental plaque. Short-term clinical tests have also demonstrated that sorbitol reduces plaque formation, probably due to retardation of acid formation. With time, this effect, however, diminishes due to adaptation of the microorganisms. Streptococcus mutans count and acid formation in dental plaque are favourably influenced by sugar substitutes, especially by the consumption of xylitol. The effect of sugar substitutes on dental plaque plays an important role for the anticariogenic and caries-reducing mode of action. The development of both caries and periodontal diseases can be favourably influenced by reduced plaque formation. PMID:2635961

  11. Old but new methods in radiation oncology: hyperbaric oxygen therapy.

    PubMed

    Ogawa, Kazuhiko; Kohshi, Kiyotaka; Ishiuchi, Syogo; Matsushita, Masayuki; Yoshimi, Naoki; Murayama, Sadayuki

    2013-06-01

    The presence of hypoxic tumor cells is widely regarded as one of the main reasons behind the failure to control malignant tumors with radiotherapy treatments. Since hyperbaric oxygenation (HBO) improves the oxygen supply to the hypoxic tumor cells, HBO therapy has previously been used in combination with simultaneous radiotherapy to treat malignant tumors. In some clinical trials, significant improvements in local control and survival have been seen in cancers of the head and neck and the uterine cervix. However, the delivery of simultaneous HBO therapy and radiotherapy is both complex and time-consuming, with some trials reporting increased side effects. As a result, the regimen of HBO therapy in combination with simultaneous radiotherapy has yet to be used as a standard treatment for malignant tumors. In recent years, however, radiotherapy immediately after HBO therapy has been emerging as an attractive approach for overcoming hypoxia in cancer treatment. Several studies have reported that radiotherapy immediately after HBO therapy was safe and seemed to be effective in patients with high-grade gliomas. Also, this approach may protect normal tissues from radiation injury. To accurately estimate whether the delivery of radiotherapy immediately after HBO therapy can be beneficial in patients with high-grade gliomas and other cancers, further prospective studies are warranted. PMID:23463521

  12. Frontiers of radiation therapy and oncology. Volume 8. Radiation therapy and the cancer center. Proceedings of the eighth annual West Coast cancer symposium, San Francisco, California, September 1972

    Microsoft Academic Search

    Vaeth

    1973-01-01

    Twenty-four papers presented by world authorities discuss the concepts, ; organization, funding, and operation of multidisciplinary cancer centers in which ; radiation therapy plays an indispensable role. (CH);

  13. Internal dosimetry for systemic radiation therapy

    SciTech Connect

    Fisher, Darrell R. (BATTELLE (PACIFIC NW LAB))

    1999-12-01

    The key to effective use of the medical internal radiation dose (MIRD) schema in radioimmunotherapy (RIT) is to understand how it works and what the essential data input requirements are. The fundamental data are acquired from medical imaging. Image interpretation involves (1) collecting data to determine the source-organ activities, (2) plotting the source-organ time-activity curves, (3) integrating the time-activity curves for an estimate of the residence time, and (4) applying the residence time values (for each important source organ) within the MIRD schema to calculate the tissue absorbed dose to target organs and tumors of interest. This article reviews methods for calculating internal dose. It also describes methods for selecting sampling times, integrating the area under the data curves, and customizing a dose assessment for a patient who does not resemble the MIRD phantom. A sample dose assessment is given, together with common mistakes to avoid. Three approaches to red marrow dosimetry are described. With the increased use of RIT agents for cancer treatment, a solid understanding of internal dose methods is essential for treatment planning and follow-up evaluations.

  14. Gold nanoparticles and their alternatives for radiation therapy enhancement

    PubMed Central

    Cooper, Daniel R.; Bekah, Devesh; Nadeau, Jay L.

    2014-01-01

    Radiation therapy is one of the most commonly used treatments for cancer. The dose of delivered ionizing radiation can be amplified by the presence of high-Z materials via an enhancement of the photoelectric effect; the most widely studied material is gold (atomic number 79). However, a large amount is needed to obtain a significant dose enhancement, presenting a challenge for delivery. In order to make this technique of broader applicability, the gold must be targeted, or alternative formulations developed that do not rely solely on the photoelectric effect. One possible approach is to excite scintillating nanoparticles with ionizing radiation, and then exploit energy transfer between these particles and attached dyes in a manner analogous to photodynamic therapy (PDT). Doped rare-earth halides and semiconductor quantum dots have been investigated for this purpose. However, although the spectrum of emitted light after radiation excitation is usually similar to that seen with light excitation, the yield is not. Measurement of scintillation yields is challenging, and in many cases has been done only for bulk materials, with little understanding of how the principles translate to the nanoscale. Another alternative is to use local heating using gold or iron, followed by application of ionizing radiation. Hyperthermia pre-sensitizes the tumors, leading to an improved response. Another approach is to use chemotherapeutic drugs that can radiosensitize tumors. Drugs may be attached to high-Z nanoparticles or encapsulated. This article discusses each of these techniques, giving an overview of the current state of nanoparticle-assisted radiation therapy and future directions. PMID:25353018

  15. Intensity-modulated radiation therapy in gynecologic malignancies: current status and future directions.

    PubMed

    Kochanski, Joel D; Mell, Loren K; Roeske, John C; Mundt, Arno J

    2006-05-01

    Radiation therapy is used as either definitive or adjuvant therapy following surgery in many gynecologic malignancies. Though effective, radiation therapy is limited by the adverse sequelae that result from normal tissues receiving external-beam radiation. A novel approach, intensity-modulated radiation therapy, can overcome these limitations by sparing the tissue surrounding the malignancy through conforming the dose to the shape of the target in three dimensions. This review provides an overview of current use, published research, and ongoing studies of intensity-modulated radiation therapy. PMID:16728946

  16. A unified approach for inversion problems in intensity-modulated radiation therapy

    E-print Network

    Censor, Yair

    A unified approach for inversion problems in intensity-modulated radiation therapy Yair Censor1-modulated radiation therapy (IMRT), see, e.g., Palta and Mackie 2003, beams of penetrating radiation are directed, Mt. Carmel, Haifa 31905, Israel 2 Department of Radiation Oncology, Massachusetts General Hospital

  17. Verification of synchrotron microbeam radiation therapy using a purpose-built optical CT microscope

    Microsoft Academic Search

    A. T. Abdul Rahman; Elke Bräuer-Krisch; Thierry Brochard; John Adamovics; David Bradley; Simon Doran

    2010-01-01

    This study presents an investigation of the use of 3-D dosimetry using optical computed tomography to provide verification of synchrotron microbeam radiation therapy (MRT). MRT is based on the remarkable tolerance of normal tissues to high doses of radiation when this dose is constrained to very narrow beams. At beamline ID17 of the European Synchrotron Radiation Facility, pre-clinical radiation therapy

  18. Impact of dose calculation algorithm on radiation therapy

    PubMed Central

    Chen, Wen-Zhou; Xiao, Ying; Li, Jun

    2014-01-01

    The quality of radiation therapy depends on the ability to maximize the tumor control probability while minimize the normal tissue complication probability. Both of these two quantities are directly related to the accuracy of dose distributions calculated by treatment planning systems. The commonly used dose calculation algorithms in the treatment planning systems are reviewed in this work. The accuracy comparisons among these algorithms are illustrated by summarizing the highly cited research papers on this topic. Further, the correlation between the algorithms and tumor control probability/normal tissue complication probability values are manifested by several recent studies from different groups. All the cases demonstrate that dose calculation algorithms play a vital role in radiation therapy. PMID:25431642

  19. Radiation therapy for advanced gastric cancer

    SciTech Connect

    Tsukiyama, I.; Akine, Y.; Kajiura, Y.; Ogino, T.; Yamashita, K.; Egawa, S.; Hijikata, J.; Kitagawa, T.

    1988-07-01

    A retrospective study of 75 patients with advanced inoperable gastric cancers, referred to the National Cancer Center Hospital between 1962 and 1982, was performed. According to the Borrmann classification based on X ray findings, Type 1 was found in 3 patients, Type 2 in 5, Type 3 in 40, and Type 4 in 15. Twelve patients could not be classified. The histological type was papillary adenocarcinoma in 7 patients, tubular adenocarcinoma in 23, mucinous carcinoma in 6, poorly differentiated adenocarcinoma in 14, signet ring cell carcinoma in 12 and others in 13. The site of remote metastasis in 19 patients was Virchow's lymph node in 8 patients, Douglas pouch in 3, liver and lung in 2 each and others in 4. All patients were treated by a either telecobalt 60 unit or a linear accelerator using 6 Mv photon and the total dose to primary lesion was 4000 cGy in 5 weeks to 7000 cGy in 8-9 weeks. Complete response (CR) was achieved in 6 patients or 8.0%, partial response (PR) in 46 or 61.3%, and no change (NC) in 23 or 30.7%. The response rate based on the sum of CR and PR was about 70%. The 50% survival period in months was 26.5, 7.3, and 3.2, respectively for patients with CR, PR, and NC. For the response of advanced gastric cancer to chemotherapy in the National Cancer Center Hospital, the combined use of UFT and Mitomycin C gave the highest rate, 46%. As for as local response is concerned, the response rate to radiation was 70%, a better result than that of chemotherapy alone.

  20. Boron neutron capture therapy (BNCT): A radiation oncology perspective

    SciTech Connect

    Dorn, R.V. III (Mountain States Tumor Institute, Boise, ID (United States) Idaho National Engineering Lab., Idaho Falls, ID (United States))

    1994-03-30

    Boron neutron capture therapy (BNCT) offers considerable promise in the search for the ideal cancer therapy, a therapy which selectively and maximally damages malignant cells while sparing normal tissue. This bimodal treatment modality selectivity concentrates a boron compound in malignant cells, and then [open quotes]activates[close quotes] this compound with slow neutrons resulting in a highly lethal event within the cancer cell. This article reviews this treatment modality from a radiation oncology, biology, and physics perspective. The remainder of the articles in this special issue provide a survey of the current [open quotes]state-of-the-art[close quotes] in this rapidly expanding field, including information with regard to boron compounds and their localization. 118 refs., 3 figs.

  1. Topometric data presentation errors in planning systems for radiation therapy

    Microsoft Academic Search

    V. N. Vasil'ev

    1995-01-01

    Conclusions  1. The error of effective radiological thickness calculation in planning systems of radiation therapy was estimated for the\\u000a topometric information presentation (map of patient's anatomical cross-section) as a set of contours outlining organs and\\u000a tissues of uniform density. The error dependence on depth was obtained for different degrees of image detail. The error was\\u000a shown to be appropriate when only

  2. Combining radiation therapy with interleukin-3 gene immunotherapy

    Microsoft Academic Search

    Chi-Shiun Chiang; Ji-Hong Hong; Yuan Chou Wu; William H McBride; Graeme J Dougherty

    2000-01-01

    The goal of this study was to explore immunological strategies to increase local and systemic tumor control in patients receiving radiation therapy. In previous studies, interleukin-3 (IL-3) gene expression within murine tumors was shown to increase their response to irradiation through immune mechanisms. In this study, the efficacy of systemically administered IL-3 gene-transduced irradiated tumor cell vaccines was tested for

  3. Wound healing after radiation therapy: Review of the literature

    PubMed Central

    2012-01-01

    Radiation therapy is an established modality in the treatment of head and neck cancer patients. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. The pathophysiology and underlying cellular mechanisms including the complex interaction of cytokines and growth factors are still not understood completely. In this review, the current state of research regarding the pathomechanisms of compromised wound healing in irradiated tissues is presented. Current and possible future treatment strategies are critically reviewed. PMID:23006548

  4. Massive osteolysis of the right clavicle developing after radiation therapy

    SciTech Connect

    Skinner, W.L.; Buzdar, A.U.; Libshitz, H.I.

    1988-07-15

    This report describes an unusual case of clavicular osteolysis, a late complication of radiation therapy for breast cancer, and demonstrates the diagnostic implications that radiotherapy changes can pose. Radiotherapy to the chest wall produces a spectrum of alterations in bone over time, ranging from early roentgenographic findings of osteoporosis and trabecular thickening to spontaneous fractures and changes that may be confused with metastatic disease or postirradiation sarcoma.

  5. NOTE: Uniaxial and biaxial irradiation protocols for microbeam radiation therapy

    Microsoft Academic Search

    Daniel N. Slatkin

    2004-01-01

    Synchrotron-generated x-ray beams for microbeam radiation therapy (MRT) are fixed in space, so three-dimensional treatment planning would require that a patient be secured to, and moved in a gantry between exposures. Two protocols for such movements are proposed: one for uniaxial opposing-fields cross-planar MRT, the other for biaxial orthogonal-fields co-planar MRT.

  6. NOTE: Uniaxial and biaxial irradiation protocols for microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Slatkin, Daniel N.

    2004-07-01

    Synchrotron-generated x-ray beams for microbeam radiation therapy (MRT) are fixed in space, so three-dimensional treatment planning would require that a patient be secured to, and moved in a gantry between exposures. Two protocols for such movements are proposed: one for uniaxial opposing-fields cross-planar MRT, the other for biaxial orthogonal-fields co-planar MRT.

  7. Uniaxial and biaxial irradiation protocols for microbeam radiation therapy

    Microsoft Academic Search

    Daniel N Slatkin

    2004-01-01

    Synchrotron-generated x-ray beams for microbeam radiation therapy (MRT) are fixed in space, so three-dimensional treatment planning would require that a patient be secured to, and moved in a gantry between exposures. Two protocols for such movements are proposed: one for uniaxial opposing-fields cross-planar MRT, the other for biaxial orthogonal-fields co-planar MRT.

  8. Radiation therapy oncology group gynecologic oncology working group: comprehensive results.

    PubMed

    Gaffney, David K; Jhingran, Anuja; Portelance, Lorraine; Viswanathan, Akila; Schefter, Tracey; Weidhaas, Joanne; Small, William

    2014-06-01

    The purpose of this report was to comprehensively describe the activities of the Gynecologic Oncology Working Group within the Radiation Therapy Oncology Group (RTOG). Clinical trials will be reviewed as well as translational science and ancillary activities. During the past 40 years, a myriad of clinical trials have been performed within the RTOG with the aim of improving overall survival (OS) and decreasing morbidity in women with cervical or endometrial cancer. Major study questions have included hyperbaric oxygen, neutron radiotherapy, altered fractionation, hypoxic cell sensitization, chemosensitization, and volume-directed radiotherapy.RTOG 7920 demonstrated improvement in OS in patients with stages IB through IIB cervical carcinoma receiving prophylactic para-aortic irradiation compared to pelvic radiation alone. RTOG 9001 demonstrated that cisplatin and 5-FU chemoradiotherapy to the pelvis for advanced cervix cancer markedly improved OS compared to extended field radiotherapy alone. More recent trials have used radioprotectors, molecular-targeted therapy, and intensity-modulated radiation therapy. Ancillary studies have developed clinical target volume atlases for research protocols and routine clinical use. Worldwide practice patterns have been investigated in cervix, endometrial, and vulvar cancer through the Gynecologic Cancer Intergroup. Translational studies have focused on immunohistochemical markers, changes in gene expression, and miRNA patterns impacting prognosis.The RTOG gynecologic working group has performed clinical trials that have defined the standard of care, improved survival, and added to our understanding of the biology of cervical and endometrial cancers. PMID:24819663

  9. Medical factors influencing decision making regarding radiation therapy for breast cancer

    PubMed Central

    Dilaveri, Christina A; Sandhu, Nicole P; Neal, Lonzetta; Neben-Wittich, Michelle A; Hieken, Tina J; Mac Bride, Maire Brid; Wahner-Roedler, Dietlind L; Ghosh, Karthik

    2014-01-01

    Radiation therapy is an important and effective adjuvant therapy for breast cancer. Numerous health conditions may affect medical decisions regarding tolerance of breast radiation therapy. These factors must be considered during the decision-making process after breast-conserving surgery or mastectomy for breast cancer. Here, we review currently available evidence focusing on medical conditions that may affect the patient–provider decision-making process regarding the use of radiation therapy. PMID:25429241

  10. Androgen Deprivation Therapy Toxicity and Management for Men Receiving Radiation Therapy

    PubMed Central

    Johnson, Matthew E.; Buyyounouski, Mark K.

    2012-01-01

    Androgen deprivation therapy is commonly used in combination with radiotherapy as part of the definitive treatment for men with clinically localized and locally advanced prostate cancer. Androgen deprivation has been associated with a wide range of iatrogenic effects impacting a variety of body systems including metabolic, musculoskeletal, cardiovascular, neurocognitive, and sexual. This review aims to provide the radiation oncology community with the knowledge to monitor and manage androgen deprivation therapy toxicity in an effort to provide the highest level of care for patients and to minimize the iatrogenic effects of androgen deprivation as much as possible. PMID:23326671

  11. Adaptive radiation therapy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Wen, Ning

    ART is a close-loop feedback algorithm which evaluates the organ deformation and motion right before the treatment and takes into account dose delivery variation daily to compensate for the difference between planned and delivered dose. It also has potential to allow further dose escalation and margin reduction to improve the clinical outcome. This retrospective study evaluated ART for prostate cancer treatment and radiobiological consequences. An IRB approved protocol has been used to evaluate actual dose delivery of patients with prostate cancer undergoing treatment with daily CBCT. The dose from CBCT was measured in phantom using TLD and ion chamber techniques in the pelvic scan setting. There were two major findings from the measurements of CBCT dose: (1) the lateral dose distribution was not symmetrical, with Lt Lat being ˜40% higher than Rt Lat and (2) AP skin dose varies with patient size, ranging 3.2--6.1 cGy for patient's AP separation of 20--33 cm (the larger the separation, the less the skin dose) but lateral skin doses depend little on separations. Dose was recalculated on each CBCT set under the same treatment plan. DIR was performed between SIM-CT and evaluated for each CT sets. Dose was reconstructed and accumulated to reflect the actual dose delivered to the patient. Then the adaptive plans were compared to the original plan to evaluate tumor control and normal tissue complication using radiobiological model. Different PTV margins were also studied to access margin reduction techniques. If the actual dose delivered to the PTV deviated significantly from the prescription dose for the given fractions or the OAR received higher dose than expected, the treatment plan would be re-optimized based on the previously delivered dose. The optimal schedule was compared based on the balance of PTV dose coverage and inhomogeneity, OAR dose constraints and labor involved. DIR was validated using fiducial marker position, visual comparison and UE. The mean and standard deviation of markers after rigid registration in L-R direction was 0 and 1 mm. But the mean was 2--4 mm in the A-P and S-I direction and standard deviation was about 2 mm. After DIR, the mean in all three directions became 0 and standard deviation was within sub millimeter. UE images were generated for each CT set and carefully reviewed in the prostate region. DIR provided accurate transformation matrix to be used for dose reconstruction. The delivered dose was evaluated with radiobiological models. TCP for the CTV was calculated to evaluate tumor control in different margin settings. TCP calculated from the reconstructed dose agreed within 5% of the value in the plan for all patients with three different margins. EUD and NTCP were calculated to evaluate reaction of rectum to radiation. Similar biological evaluation was performed for bladder. EUD of actual dose was 3%--9% higher than that of planned dose of patient 1--3, 11%--20% higher of patient 4--5. Smaller margins could not reduce late GU toxicity effectively since bladder complication was directly related to Dmax which was at the same magnitude in the bladder no matter which margin was applied. Re-optimization was performed at the 10th, 20th , 30th, and 40th fraction to evaluate the effectiveness to limit OAR dose while maintaining the target coverage. Reconstructed dose was added to dose from remaining fractions after optimization to show the total dose patient would receive. It showed that if the plan was re-optimized at 10th or 20th fraction, total dose to rectum and bladder were very similar to planned dose with minor deviations. If the plan was re-optimized at the 30th fraction, since there was a large deviation between reconstructed dose and planned dose to OAR, optimization could not limit the OAR dose to the original plan with only 12 fractions left. If the re-optimization was done at the 40th fraction, it was impossible to compensate in the last 2 fractions. Large deviations of total dose to bladder and rectum still existed while dose inhomogeneity to PTV was significantly increased due to

  12. A Phase III Study of Conventional Radiation Therapy Plus Thalidomide Versus Conventional Radiation Therapy for Multiple Brain Metastases (RTOG 0118)

    Microsoft Academic Search

    Jonathan P. S. Knisely; Brian Berkey; Arnab Chakravarti; Al W. K. Yung; Walter J. Curran; H. Ian Robins; Benjamin Movsas; David G. Brachman; Randall H. Henderson; Minesh P. Mehta

    2008-01-01

    Purpose: To compare whole-brain radiation therapy (WBRT) with WBRT combined with thalidomide for patients with brain metastases not amenable to resection or radiosurgery. Patients and Methods: Patients with Zubrod performance status 0-1, MRI-documented multiple (>3), large (>4 cm), or midbrain brain metastases arising from a histopathologically confirmed extracranial primary tumor, and an anticipated survival of >8 weeks were randomized to

  13. TLD dosimetry for microbeam radiation therapy at the European Synchrotron Radiation Facility

    Microsoft Academic Search

    M. Ptaszkiewicz; E. Braurer-Kirsch; M. Klosowski; L. Czopyk; P. Olko

    2008-01-01

    A two-dimensional (2-D) thermoluminescence (TL) dosimetry system consisting of LiF:Mg,Cu,P (MCP-N)-based TL foils and a TLD reader equipped with a CCD camera and the large size (72mm in diameter) planchete heater, developed at the Institute of Nuclear Physics (IFJ PAN, was applied for 2-D dosimetry of X-ray microbeam radiation therapy (MRT) at the European Synchrotron Radiation Facility (ESRF) in Grenoble,

  14. Detection of High-Risk Atherosclerotic Plaque

    PubMed Central

    Fleg, Jerome L.; Stone, Gregg W.; Fayad, Zahi A.; Granada, Juan F.; Hatsukami, Thomas S.; Kolodgie, Frank D.; Ohayon, Jacques; Pettigrew, Roderic; Sabatine, Marc S.; Tearney, Guillermo; Waxman, Sergio; Domanski, Michael J.; Srinivas, Pothur R.; Narula, Jagat

    2013-01-01

    The leading cause of major morbidity and mortality in most countries around the world is atherosclerotic cardiovascular disease, most commonly caused by thrombotic occlusion of a high-risk coronary plaque resulting in myocardial infarction or cardiac death, or embolization from a high-risk carotid plaque resulting in stroke. The lesions prone to result in such clinical events are termed vulnerable or high-risk plaques, and their identification may lead to the development of pharmacological and mechanical intervention strategies to prevent such events. Autopsy studies from patients dying of acute myocardial infarction or sudden death have shown that such events typically arise from specific types of atherosclerotic plaques, most commonly the thin-cap fibroatheroma. However, the search in human beings for vulnerable plaques before their becoming symptomatic has been elusive. Recently, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study demonstrated that coronary plaques that are likely to cause future cardiac events, regardless of angiographic severity, are characterized by large plaque burden and small lumen area and/or are thin-cap fibroatheromas verified by radiofrequency intravascular ultrasound imaging. This study opened the door to identifying additional invasive and noninvasive imaging modalities that may improve detection of high-risk atherosclerotic lesions and patients. Beyond classic risk factors, novel biomarkers and genetic profiling may identify those patients in whom noninvasive imaging for vulnerable plaque screening, followed by invasive imaging for risk confirmation is warranted, and in whom future pharmacological and/or device-based focal or regional therapies may be applied to improve long-term prognosis. PMID:22974808

  15. Dosimetry for quantitative analysis of the effects of low-dose ionizing radiation in radiation therapy patients

    E-print Network

    2006-01-01

    Dosimetry for Quantitative Analysis of the Effects of Low-Dose Ionizing Radiation in Radiation Therapy Patientspatients can be a study population if the phys- ics and dosimetrydosimetry. The phantom measurements had demonstrated that patient

  16. Melanoma Therapy via Peptide-Targeted a-Radiation

    SciTech Connect

    Miao, Yubin; Hylarides, Mark; Fisher, Darrell R.; Shelton, Tiffani; Moore, Herbert A.; Wester, Dennis W.; Fritzberg, Alan R.; Winkelmann, Christopher T.; Hoffman, Timothy J.; Quinn, Thomas P.

    2005-08-01

    Malignant melanoma is the most lethal form of skin cancer. Current chemotherapy and external beam radiation therapy regimens are ineffective agents against melanoma, as shown by a 10-year survival rate for patients with disseminated disease of approximately 5% (reference?). In this study, the unique combination of a melanoma targeting peptide and an in vivo generated a-particle emitting radioisotope was investigated for its melanoma therapy potential. Alpha-radiation is densely ionizing and energy is locally absorbed, resulting in high concentrations of destructive free radicals and irreparable DNA double strand breaks. This high linear-energy-transfer overcomes radiation resistant tumor cells and oxygen-enhancement effects. The melanoma targeting peptide DOTA-Re(Arg11)CCMSH was radiolabeled with 212Pb, the parent of 212Bi, which decays via alpha and beta decay. Biodistribution and therapy studies were performed in the B16/F1 melanoma bearing C57 mouse flank tumor model. 212Pb[DOTA]-R e(Arg11)CCMSH exhibited rapid tumor uptake and extended retention coupled with rapid whole body disappearance. Radiation dose delivered to the tumor was estimated to be 61 cGy/uCi 212Pb administered. Treatment of melanoma-bearing mice with 50, 100 and 200 uCi of 212Pb[DOTA]-Re(Arg11)CCMSH extended mean survival of mice to 22, 28, and 49.8 days, respectively, compared to the 14.6 day mean survival of the placebo control group. Forty-five percent of the mice receiving 200 uCi survived the study disease-free.

  17. Anonymization of DICOM electronic medical records for radiation therapy.

    PubMed

    Newhauser, Wayne; Jones, Timothy; Swerdloff, Stuart; Newhauser, Warren; Cilia, Mark; Carver, Robert; Halloran, Andy; Zhang, Rui

    2014-10-01

    Electronic medical records (EMR) and treatment plans are used in research on patient outcomes and radiation effects. In many situations researchers must remove protected health information (PHI) from EMRs. The literature contains several studies describing the anonymization of generic Digital Imaging and Communication in Medicine (DICOM) files and DICOM image sets but no publications were found that discuss the anonymization of DICOM radiation therapy plans, a key component of an EMR in a cancer clinic. In addition to this we were unable to find a commercial software tool that met the minimum requirements for anonymization and preservation of data integrity for radiation therapy research. The purpose of this study was to develop a prototype software code to meet the requirements for the anonymization of radiation therapy treatment plans and to develop a way to validate that code and demonstrate that it properly anonymized treatment plans and preserved data integrity. We extended an open-source code to process all relevant PHI and to allow for the automatic anonymization of multiple EMRs. The prototype code successfully anonymized multiple treatment plans in less than 1min/patient. We also tested commercial optical character recognition (OCR) algorithms for the detection of burned-in text on the images, but they were unable to reliably recognize text. In addition, we developed and tested an image filtering algorithm that allowed us to isolate and redact alpha-numeric text from a test radiograph. Validation tests verified that PHI was anonymized and data integrity, such as the relationship between DICOM unique identifiers (UID) was preserved. PMID:25147130

  18. Conservative treatment of rectal cancer with local excision and postoperative radiation therapy

    Microsoft Academic Search

    B. D Minsky

    1995-01-01

    The conventional surgical treatment for patients with potentially curable transmural and\\/or node positive rectal cancer is a low anterior resection or abdominoperineal resection. Recently, there has been increasing interest in the use of local excision and postoperative radiation therapy as primary therapy for selected rectal cancers. The limited data suggest that the approach of local excision and postoperative radiation therapy

  19. Intensity-modulated radiation therapy for oropharyngeal cancer: Radiation dosage constraint at the anterior mandible

    Microsoft Academic Search

    Henk W. D. Verdonck; Jos M. A. de Jong; Marlies E. P. G. Granzier; Fred H. Nieman; Cees de Baat; Paul J. W. Stoelinga

    2009-01-01

    summary Because the survival of endosseous implants in irradiated bone is lower than in non-irradiated bone, par- ticularly if the irradiation dose exceeds 50 Gy, a study was carried out to assess the irradiation dose in the anterior mandible, when intensity modulated radiation therapy (IMRT) is used. The hypothesis was that adequate IMRT planning in oropharyngeal cancer patients is allowing

  20. Overview of Radiation Therapy for Treating Rectal Cancer

    PubMed Central

    Kye, Bong-Hyeon

    2014-01-01

    A major outcome of importance for rectal cancer is local control. Parallel to improvements in surgical technique, adjuvant therapy regimens have been tested in clinical trials in an effort to reduce the local recurrence rate. Nowadays, the local recurrence rate has been reduced because of both good surgical techniques and the addition of radiotherapy. Based on recent reports in the literature, preoperative chemoradiotherapy is now considered the standard of care for patients with stages II and III rectal cancer. Also, short-course radiotherapy appears to provide effective local control and the same overall survival as more long-course chemoradiotherapy schedules and, therefore, may be an appropriate choice in some situations. Capecitabine is an acceptable alternative to infusion fluorouracil in those patients who are able to manage the responsibilities inherent in self-administered, oral chemotherapy. However, concurrent administration of oxaliplatin and radiotherapy is not recommended at this time. Radiation therapy has long been considered an important adjunct in the treatment of rectal cancer. Although no prospective data exist for several issues, we hope that in the near future, patients with rectal cancer can be treated by using the best combination of surgery, radiation therapy, and chemotherapy in near future. PMID:25210685

  1. Changes in T-cell subsets after radiation therapy

    SciTech Connect

    Yang, S.J.; Rafla, S.; Youssef, E.; Selim, H.; Salloum, N.; Chuang, J.Y.

    1988-08-01

    The T-cell subsets of 129 patients with cancer were counted before and after radiation therapy. The cells were labeled with monoclonal antibodies that were specific for each type of T cell. Significant changes after therapy were decreases in the proportion of T-helper/inducer cells, pan-T cells, and in the ratio of T-helper/inducer to T-suppressor/cytotoxic cells. There was an increase in the percentage of T-suppressor/cytotoxic cells. When the site of the primary cancer was considered, genitourinary cancer and cancer of the head and neck both showed a decreased percentage of T-helper/inducer cells and a reduced ratio of T-helper/inducer to T-suppressor/cytotoxic cells. The percentage of pan-T cells in head and neck cancer and the ratio of T-helper/inducer to T-suppressor/cytotoxic cells in breast cancer were decreased. The percentage of T-helper cells was particularly decreased by radiation therapy in advanced stages of cancer, in higher grade tumors, and in larger tumors. The absolute numbers of various T-cell subsets were decreased in all groups.

  2. Combining molecular targeted agents with radiation therapy for malignant gliomas

    PubMed Central

    Scaringi, Claudia; Enrici, Riccardo Maurizi; Minniti, Giuseppe

    2013-01-01

    The expansion in understanding the molecular biology that characterizes cancer cells has led to the rapid development of new agents to target important molecular pathways associated with aberrant activation or suppression of cellular signal transduction pathways involved in gliomagenesis, including epidermal growth factor receptor, vascular endothelial growth factor receptor, mammalian target of rapamycin, and integrins signaling pathways. The use of antiangiogenic agent bevacizumab, epidermal growth factor receptor tyrosine kinase inhibitors gefitinib and erlotinib, mammalian target of rapamycin inhibitors temsirolimus and everolimus, and integrin inhibitor cilengitide, in combination with radiation therapy, has been supported by encouraging preclinical data, resulting in a rapid translation into clinical trials. Currently, the majority of published clinical studies on the use of these agents in combination with radiation and cytotoxic therapies have shown only modest survival benefits at best. Tumor heterogeneity and genetic instability may, at least in part, explain the poor results observed with a single-target approach. Much remains to be learned regarding the optimal combination of targeted agents with conventional chemoradiation, including the use of multipathways-targeted therapies, the selection of patients who may benefit from combined treatments based on molecular biomarkers, and the verification of effective blockade of signaling pathways. PMID:23966794

  3. Implementation of Remote 3-Dimensional Image Guided Radiation Therapy Quality Assurance for Radiation Therapy Oncology Group Clinical Trials

    SciTech Connect

    Cui Yunfeng [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States)] [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Galvin, James M. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States) [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Radiation Therapy Oncology Group, American College of Radiology, Philadelphia, Pennsylvania (United States); Parker, William [Department of Medical Physics, McGill University Health Center, Montreal, QC (Canada)] [Department of Medical Physics, McGill University Health Center, Montreal, QC (Canada); Breen, Stephen [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada)] [Department of Radiation Physics, Princess Margaret Hospital, Toronto, ON (Canada); Yin Fangfang; Cai Jing [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States)] [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Papiez, Lech S. [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States)] [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)] [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Bednarz, Greg [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)] [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Chen Wenzhou [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States)] [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Xiao Ying, E-mail: ying.xiao@jefferson.edu [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Radiation Therapy Oncology Group, American College of Radiology, Philadelphia, Pennsylvania (United States)

    2013-01-01

    Purpose: To report the process and initial experience of remote credentialing of three-dimensional (3D) image guided radiation therapy (IGRT) as part of the quality assurance (QA) of submitted data for Radiation Therapy Oncology Group (RTOG) clinical trials; and to identify major issues resulting from this process and analyze the review results on patient positioning shifts. Methods and Materials: Image guided radiation therapy datasets including in-room positioning CT scans and daily shifts applied were submitted through the Image Guided Therapy QA Center from institutions for the IGRT credentialing process, as required by various RTOG trials. A centralized virtual environment is established at the RTOG Core Laboratory, containing analysis tools and database infrastructure for remote review by the Physics Principal Investigators of each protocol. The appropriateness of IGRT technique and volumetric image registration accuracy were evaluated. Registration accuracy was verified by repeat registration with a third-party registration software system. With the accumulated review results, registration differences between those obtained by the Physics Principal Investigators and from the institutions were analyzed for different imaging sites, shift directions, and imaging modalities. Results: The remote review process was successfully carried out for 87 3D cases (out of 137 total cases, including 2-dimensional and 3D) during 2010. Frequent errors in submitted IGRT data and challenges in the review of image registration for some special cases were identified. Workarounds for these issues were developed. The average differences of registration results between reviewers and institutions ranged between 2 mm and 3 mm. Large discrepancies in the superior-inferior direction were found for megavoltage CT cases, owing to low spatial resolution in this direction for most megavoltage CT cases. Conclusion: This first experience indicated that remote review for 3D IGRT as part of QA for RTOG clinical trials is feasible and effective. The magnitude of registration discrepancy between institution and reviewer was presented, and the major issues were investigated to further improve this remote evaluation process.

  4. Third generation gold nanoplatform optimized for radiation therapy

    PubMed Central

    Kumar, Rajiv; Korideck, Houari; Ngwa, Wilfred; Berbeco, Ross I.; Makrigiorgos, G. Mike; Sridhar, Srinivas

    2013-01-01

    We report the design and fabrication of third generation ultrasmall PEGylated gold nanoparticles based platform (AuRad™) optimized for applications in radiation therapy. The AuRad™ nanoplatform has the following key features: (I) surface coating of hetero-bifunctional-PEG with amine, carboxyl, methoxy functional groups, which make this a versatile nanoplatform to conjugate various moieties like fluorophores, peptides, drugs, radiolabels; (II) size that is optimized for longer circulation, higher tumor uptake and modulated clearance; (III) high radiation enhancement. We have synthesized ultrasmall 2–3 nm gold nanoparticles, followed by attachment of hetero-bifunctional PEG and further conjugation of fluorophore AlexaFlour 647 for optical imaging, with a stability of more than 6 months. Confocal bioimaging with HeLa cells showed robust uptake of biocompatible nanoparticles in cells. Irradiation experiments X-rays showed greater than 2.8-fold cell kill enhancement as demonstrated by clonogenic survival assays. The results indicate that AuRad nanoplatform can act as potential theranostic agent in radiation therapy. PMID:24392307

  5. Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy

    Microsoft Academic Search

    J. B. Epstein; P. Stevenson-Moore

    1986-01-01

    Benzydamine hydrochloride rinse reduced pain associated with radiation mucositis when it was used during the course of radiation therapy. Fewer patients using benzydamine rinse required systemic analgesics. All patients using benzydamine tolerated the rinse well and continued with regular rinsing throughout the course of radiation therapy. Benzydamine hydrochloride is currently undergoing clinical trials in the United States for application for

  6. Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity

    Microsoft Academic Search

    Eugene Huang; Bin S Teh; Douglas R Strother; Quillin G Davis; J. Kam Chiu; Hsin H Lu; L. Steven Carpenter; Wei-Yuan Mai; Murali M Chintagumpala; Michael South; Walter H Grant III; E. Brian Butler; Shiao Y Woo

    2002-01-01

    Purpose: The combination of cisplatin chemotherapy and radiation therapy for the treatment of medulloblastoma has been shown to cause significant ototoxicity, impairing a child’s cognitive function and quality of life. Our purpose is to determine whether the new conformal technique of intensity-modulated radiation therapy (IMRT) can achieve lower rates of hearing loss by decreasing the radiation dose delivered to the

  7. Program Announcement Effective immediately the Radiation Therapy Program has changed our Pre-Requisites for

    E-print Network

    MacMillan, Andrew

    Program Announcement Effective immediately the Radiation Therapy Program has changed our Pre in the winter term of Year Two of the Program. Please contact the Radiation Therapy Program with any questions: www.med.ualberta.ca/programs/radth General E-mail: radth@ualberta.ca Phone: 780-492-6918 Radiation

  8. Phase II Radiation Therapy Oncology Group trial of conventional radiation therapy followed by treatment with recombinant interferon-? for supratentorial glioblastoma: Results of RTOG 9710

    Microsoft Academic Search

    Howard. Colman; Brian A. Berkey; Moshe H. Maor; Morris D. Groves; Christopher J. Schultz; Sandra Vermeulen; Diana F. Nelson; Minesh P. Mehta; W. K. Alfred Yung

    2006-01-01

    Purpose: The aim of this study was to determine whether recombinant human interferon β-1a (rhIFN-β), when given after radiation therapy, improves survival in glioblastoma. Methods and Materials: After surgery, 109 patients with newly diagnosed supratentorial glioblastoma were enrolled and treated with radiation therapy (60 Gy). A total of 55 patients remained stable after radiation and were treated with rhIFN-β (6

  9. Presentation Cardiovascular Effects of Radiation Therapy - Office of Cancer Survivorship

    Cancer.gov

    Cardiovascular disease is a major long-term health risk in cancer survivors who have received cardiac irradiation. Hodgkin’s Disease (HD) serves as a paradigm for studying late cardiac effects of radiation therapy in survivors, due to the high rate of cure and the availability of well-documented, standardized mantle treatment protocols. Studies published, only in the last few years, have highlighted that cardiovascular disease and atherosclerosis are the leading causes of non-cancer mortality for long-term survivors cured of HD.

  10. Lineal energy and radiation quality in radiation therapy: model calculations and comparison with experiment.

    PubMed

    Lindborg, L; Hultqvist, M; Carlsson Tedgren, Å; Nikjoo, H

    2013-05-21

    Microdosimetry is a recommended method for characterizing radiation quality in situations when the biological effectiveness under test is not well known. In such situations, the radiation beams are described by their lineal energy probability distributions. Results from radiobiological investigations in the beams are then used to establish response functions that relate the lineal energy to the relative biological effectiveness (RBE). In this paper we present the influence of the size of the simulated volume on the relation to the clinical RBE values (or weighting factors). A single event probability distribution of the lineal energy is approximated by its dose average lineal energy (y[overline](D)) which can be measured or calculated for volumes from a few micrometres down to a few nanometres. The clinical RBE values were approximated as the ratio of the ?-values derived from the LQ-relation. Model calculations are presented and discussed for the SOBP of a (12)C ion (290 MeV u(-1)) and the reference (60)Co ? therapy beam. Results were compared with those for a conventional x-ray therapy beam, a 290 MeV proton beam and a neutron therapy beam. It is concluded that for a simulated volume of about 10 nm, the ?-ratio increases approximately linearly with the y[overline](D)-ratio for all the investigated beams. The correlation between y and ? provides the evidence to characterize a radiation therapy beam by the lineal energy when, for instance, weighting factors are to be estimated. PMID:23594445

  11. Monte Carlo dose enhancement studies in microbeam radiation therapy

    SciTech Connect

    Martinez-Rovira, I.; Prezado, Y. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), B.P. 220, 6 rue Jules Horowitz, F-38043 Grenoble Cedex, France and Institut de Tecniques Energetiques, Universitat Politecnica de Catalunya, Diagonal 647, E-08028 Barcelona (Spain); ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), B.P. 220, 6 rue Jules Horowitz, F-38043 Grenoble Cedex (France)

    2011-07-15

    Purpose: A radical radiation therapy treatment for gliomas requires extremely high absorbed doses resulting in subsequent deleterious side effects in healthy tissue. Microbeam radiation therapy (MRT) is an innovative technique based on the fact that normal tissue can withstand high radiation doses in small volumes without any significant damage. The synchrotron-generated x-ray beam is collimated and delivered to an array of narrow micrometer-sized planar rectangular fields. Several preclinical experiments performed at the Brookhaven National Laboratory (BNL) and at the European Synchrotron Radiation Facility (ESRF) confirmed that MRT yields a higher therapeutic index than nonsegmented beams of the same characteristics. This index can be greatly improved by loading the tumor with high atomic number (Z) contrast agents. The aim of this work is to find the high-Z element that provides optimum dose enhancement. Methods: Monte Carlo simulations (PENELOPE/penEasy) were performed to assess the peak and valley doses as well as their ratio (PVDR) in healthy tissue and in the tumor, loaded with different contrast agents. The optimization criteria used were maximization of the ratio between the PVDR values in healthy tissue respect to the PVDR in the tumor and minimization of bone and brain valley doses. Results: Dose enhancement factors, PVDR, and valley doses were calculated for different high-Z elements. A significant decrease of PVDR values in the tumor, accompanied by a gain in the valley doses, was found in the presence of high-Z elements. This enables the deposited dose in the healthy tissue to be reduced. The optimum high-Z element depends on the irradiation configuration. As a general trend, the best outcome is provided by the highest Z contrast agents considered, i.e., gold and thallium. However, lanthanides (especially Lu) and hafnium also offer a satisfactory performance. Conclusions: The remarkable therapeutic index in microbeam radiation therapy can be further improved by loading the tumor with a high-Z element. This study reports quantitative data on several dosimetric magnitudes in order to find the optimum contrast agent. Although the final choice of the element will also depend on possible cytotoxicity, three elements were found to be worthy of mention: gold, thallium, and lutetium.

  12. Limited-Field Radiation Therapy in the Management of Early-Stage Breast Cancer

    Microsoft Academic Search

    Frank A. Vicini; Larry Kestin; Peter Chen; Pamela Benitez; Neal S. Goldstein; Alvaro Martinez

    2003-01-01

    Background: Several phase III trials have demonstrated equivalent long-term survival between breast conserving surgery plus radiation therapy and mastectomy in patients with early-stage breast cancer but have not provided infor- mation on the optimal volume of breast tissue requiring post-lumpectomy radiation therapy. Therefore, we exam- ined the 5-year results of a single institution's experience with radiation therapy limited to the

  13. Prospective study of the long term change of the oral flora after radiation therapy

    Microsoft Academic Search

    B. Al-Nawas; K. A. Grötz

    2006-01-01

    Objectives  The aim of this prospective study was to evaluate the long term change in oral pathogens following radiation therapy.Methods  Twenty-two patients with planned radiation therapy (>30 Gy) of head and neck squamous cell carcinoma were included. Before radiation therapy, after 3, 6, and 12 months samples from the deepest periodontal pocket were drawn. Five major periodontal pathogens were studied using DNA probes

  14. Focused radiation hepatitis after Bragg-peak proton therapy for hepatocellular carcinoma: CT findings

    SciTech Connect

    Okumura, Toshiyuki; Itai, Yuji; Tsuji, Hiroshi [Central Hospital of Ibaraki (Japan)] [and others

    1994-09-01

    Radiation hepatitis is clearly demonstrated by noncontrast and contrast enhanced CT following radiotherapy for liver diseases. Radiation hepatitis is dependent on dose distribution and is usually demonstrated as nonsegmental bandlike lesion after photon therapy. We report a case of focused, oval-shaped radiation hepatitis that was induced by photon therapy. The attenuation difference was localized in a high-dose area caused by Bragg-peak proton therapy. 17 refs., 2 figs.

  15. Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy.

    PubMed

    Kunos, Charles A; Fabien, Jeffrey M; Shanahan, John P; Collen, Christine; Gevaert, Thierry; Poels, Kenneth; Van den Begin, Robbe; Engels, Benedikt; De Ridder, Mark

    2015-01-01

    Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time ±4 cm pan-and-tilt action. Robot-driven ±60° pivots of an integrated ±185° rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[(18)F] fluoro-2-deoxy-?-glucose ((18)F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less(1). In this article, we describe new radiation plans for the treatment of moving lung tumors. PMID:26131774

  16. Expression of NPP1 is regulated during atheromatous plaque calcification

    PubMed Central

    Nitschke, Yvonne; Hartmann, Simone; Torsello, Giovanni; Horstmann, Rüdiger; Seifarth, Harald; Weissen-Plenz, Gabriele; Rutsch, Frank

    2011-01-01

    Abstract Mutations of the ENPP1 gene encoding ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (NPP1) are associated with medial calcification in infancy. While the inhibitory role of matrix proteins such as osteopontin (OPN) with respect to atherosclerotic plaque calcification has been established, the role of NPP1 in plaque calcification is not known. We assessed the degree of plaque calcification (computed tomography), NPP1 and OPN localization (immunohistochemistry) and expression (RT-PCR) in a cohort of 45 patients undergoing carotid endatherectomy for significant stenosis of the internal carotid artery and in normal arteries (N= 50). We correlated NPP1 and OPN expression levels to the degree of plaque calcification, to pro-atherogenic factors and statin therapy. NPP1 was demonstrated in the base and in the shoulder of atherosclerotic plaques. Compared to normal arteries and non-calcified plaques, in calcified plaques NPP1 mRNA was decreased (P < 0.0001). OPN mRNA levels were up-regulated in carotid atheroma. NPP1 and OPN expression levels positively correlated with the degree of plaque calcification (R= 0.54, P= 0.00019 and R= 0.46, P= 0.017, respectively) and with risk factors of atherosclerosis. Expression of the calcification inhibitor NPP1 is down-regulated in calcified atherosclerotic plaques. Our correlation data point to a counter-active mechanism, which in the end turns out to be insufficient to prevent further progression of calcification. PMID:20015201

  17. The Arginine/ADMA Ratio Is Related to the Prevention of Atherosclerotic Plaques in Hypercholesterolemic Rabbits When Giving a Combined Therapy with Atorvastatine and Arginine

    PubMed Central

    Brinkmann, Saskia J. H.; Wörner, Elisabeth A.; Buijs, Nikki; Richir, Milan; Cynober, Luc; van Leeuwen, Paul A. M.; Couderc, Rémy

    2015-01-01

    Supplementation with arginine in combination with atorvastatin is more efficient in reducing the size of an atherosclerotic plaque than treatment with a statin or arginine alone in homozygous Watanabe heritable hyperlipidemic (WHHL) rabbits. We evaluated the mechanism behind this feature by exploring the role of the arginine/asymmetric dimethylarginine (ADMA) ratio, which is the substrate and inhibitor of nitric oxide synthase (NOS) and thereby nitric oxide (NO), respectively. Methods: Rabbits were fed either an arginine diet (group A, n = 9), standard rabbit chow plus atorvastatin (group S, n = 8), standard rabbit chow plus an arginine diet with atorvastatin (group SA, n = 8) or standard rabbit chow (group C, n = 9) as control. Blood was sampled and the aorta was harvested for topographic and histological analysis. Plasma levels of arginine, ADMA, cholesterol and nitric oxide were determined and the arginine/ADMA ratio was calculated. Results: The decrease in ADMA levels over time was significantly correlated to fewer aortic lesions in the distal aorta and total aorta. The arginine/ADMA ratio was correlated to cholesterol levels and decrease in cholesterol levels over time in the SA group. A lower arginine/ADMA ratio was significantly correlated to lower NO levels in the S and C group. Discussion: A balance between arginine and ADMA is an important indicator in the prevention of the development of atherosclerotic plaques. PMID:26035753

  18. Radiation therapy plan checks in a paperless clinic.

    PubMed

    Siochi, R Alfredo; Pennington, Edward C; Waldron, Timothy J; Bayouth, John E

    2009-01-01

    Traditional quality assurance checks of a patient's radiation therapy plan involve printing out treatment parameters from the treatment planning system and the "record and verify" (R&V) system and visually checking the information for one-to-one correspondence. In a paperless environment, one can automate this process through independent software that can read the treatment planning data directly and compare it against the parameters in the R&V system's database. In addition to verifying the data integrity, it is necessary to check the logical consistency of the data and the accuracy of various calculations. The results are then imported into the patient's electronic medical record. Appropriate workflows must be developed to ensure that no steps of the QA process are missed. This paper describes our electronic QA system (EQS), consisting of in-house software and workflows. The EQS covers 3D conformal and intensity modulated radiation therapy, electrons, stereotactic radiosurgery, total body irradiation, and clinical set ups with and without virtual simulation. The planning systems handled by our EQS are ADAC Pinnacle and Varian FASTPLAN, while the R&V systems are LANTIS and VARIS. The improvement in our plan check process over the paperless system is described in terms of the types of detected errors. The potential problems with the implementation and use of the EQS, as well as workarounds for data that are not easily accessible through electronic means, are described. PMID:19223840

  19. Interference detection in implantable defibrillators induced by therapeutic radiation therapy

    PubMed Central

    Uiterwaal, G.J.; Springorum, B.G.F.; Scheepers, E.; de Ruiter, G.S.; Hurkmans, C.W.

    2006-01-01

    Background Electromagnetic fields and ionising radiation during radiotherapy can influence the functioning of ICDs. Guidelines for radiotherapy treatment were published in 1994, but only based on experience with pacemakers. Data on the influence of radiotherapy on ICDs is limited. Objectives We determined the risk to ICDs of interference detection induced by radiotherapy. Methods In our study we irradiated 11 ICDs. The irradiation was performed with a 6 megavolt photon beam. In each individual device test, a total of 20 Gray was delivered in a fractionated fashion. During each irradiation the output stimulation rate was monitored and electrogram storage was activated. In case of interference the test was repeated with the ICD outside and the lead(s) inside and outside the irradiation field. Results With the ICD inside the irradiation field, interference detection was observed in all ICDs. This caused pacing inhibition or rapid ventricular pacing. Ventricular tachycardia (VT) or ventricular fibrillation (VF) detection occurred, which would have caused tachycardia-terminating therapy. If the ICD was placed outside the irradiation field, no interference was observed. Conclusion Interference by ionising radiation on the ICDs is demonstrated both on bradycardia and tachycardia therapy. This can have consequences for patients. Recommendations for radiotherapy are presented in this article. ImagesFigure 1Figure 5 PMID:25696559

  20. Outcome and Prognostic Factors of Radiation Therapy for Medulloblastoma

    SciTech Connect

    Rieken, Stefan, E-mail: Stefan.Rieken@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Mohr, Angela; Habermehl, Daniel; Welzel, Thomas; Lindel, Katja [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Witt, Olaf; Kulozik, Andreas E. [Department of Pediatric Oncology, Hematology, Immunology, and Pneumatology, University of Heidelberg, Heidelberg (Germany); Wick, Wolfgang [Department of Neurooncology, University of Heidelberg, Heidelberg (Germany); Debus, Juergen; Combs, Stephanie E. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

    2011-11-01

    Purpose: To investigate treatment outcome and prognostic factors after radiation therapy in patients with medulloblastomas (MB). Methods and Materials: Sixty-six patients with histologically confirmed MB were treated at University Hospital of Heidelberg between 1985 and 2009. Forty-two patients (64%) were pediatric ({<=}18 years), and 24 patients (36%) were adults. Tumor resection was performed in all patients and was complete in 47%. All patients underwent postoperative craniospinal irradiation (CSI) delivering a median craniospinal dose of 35.5 Gy with additional boosts to the posterior fossa up to 54.0 Gy. Forty-seven patients received chemotherapy, including 21 in whom chemotherapy was administered before CSI. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. Results: Median follow-up was 93 months. Overall survival (OS) and local and distant progression-free survival (LPFS and DPFS) were 73%, 62%, and 77% at 60 months. Both local and distant recurrence predisposed for significantly reduced OS. Macroscopic complete tumor resection, desmoplastic histology and early initiation of postoperative radiation therapy within 28 days were associated with improved outcome. The addition of chemotherapy did not improve survival rates. Toxicity was moderate. Conclusions: Complete resection of MB followed by CSI yields long survival rates in both children and adults. Delayed initiation of CSI is associated with poor outcome. Desmoplastic histology is associated with improved survival. The role of chemotherapy, especially in the adult population, must be further investigated in clinical studies.

  1. Hyperbaric Oxygen Therapy for Radiation-Induced Cystitis and Proctitis

    SciTech Connect

    Oliai, Caspian; Fisher, Brandon; Jani, Ashish; Wong, Michael; Poli, Jaganmohan; Brady, Luther W. [Department of Radiation Oncology, Drexel University College of Medicine, Philadelphia, Pennsylvania (United States)] [Department of Radiation Oncology, Drexel University College of Medicine, Philadelphia, Pennsylvania (United States); Komarnicky, Lydia T., E-mail: lydia.komarnicky-kocher@drexelmed.edu [Department of Radiation Oncology, Drexel University College of Medicine, Philadelphia, Pennsylvania (United States)

    2012-11-01

    Purpose: To provide a retrospective analysis of the efficacy of hyperbaric oxygen therapy (HBOT) for treating hemorrhagic cystitis (HC) and proctitis secondary to pelvic- and prostate-only radiotherapy. Methods and Materials: Nineteen patients were treated with HBOT for radiation-induced HC and proctitis. The median age at treatment was 66 years (range, 15-84 years). The range of external-beam radiation delivered was 50.0-75.6 Gy. Bleeding must have been refractory to other therapies. Patients received 100% oxygen at 2.0 atmospheres absolute pressure for 90-120 min per treatment in a monoplace chamber. Symptoms were retrospectively scored according to the Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic (LENT-SOMA) scale to evaluate short-term efficacy. Recurrence of hematuria/hematochezia was used to assess long-term efficacy. Results: Four of the 19 patients were lost to follow-up. Fifteen patients were evaluated and received a mean of 29.8 dives: 11 developed HC and 4 proctitis. All patients experienced a reduction in their LENT-SOMA score. After completion of HBOT, the mean LENT-SOMA score was reduced from 0.78 to 0.20 in patients with HC and from 0.66 to 0.26 in patients with proctitis. Median follow-up was 39 months (range, 7-70 months). No cases of hematuria were refractory to HBOT. Complete resolution of hematuria was seen in 81% (n = 9) and partial response in 18% (n = 2). Recurrence of hematuria occurred in 36% (n = 4) after a median of 10 months. Complete resolution of hematochezia was seen in 50% (n = 2), partial response in 25% (n = 1), and refractory bleeding in 25% (n = 1). Conclusions: Hyperbaric oxygen therapy is appropriate for radiation-induced HC once less time-consuming therapies have failed to resolve the bleeding. In these conditions, HBOT is efficacious in the short and long term, with minimal side effects.

  2. Radiation Therapy Alone for Imaging-Defined Meningiomas

    SciTech Connect

    Korah, Mariam P., E-mail: mariam@radonc.emory.or [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States); Nowlan, Adam W. [Department of Radiation Oncology, Piedmont Hospital, Atlanta, GA (United States); Johnstone, Peter A.S. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Crocker, Ian R. [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States)

    2010-01-15

    Purpose: To assess local control and treatment-related toxicity of single-modality radiation therapy (RT) in the treatment of imaging-defined meningiomas. Methods and Materials: The records of Emory University School of Medicine, Atlanta, GA, were reviewed between 1985 and 2003. We identified 41 patients with 42 meningiomas treated with RT alone for lesions diagnosed on imaging alone. No patients received a histologic diagnosis. Patients in whom there was uniform agreement that the tumor represented a meningioma were accepted for therapy. Of the patients, 22 were treated with stereotactic radiosurgery (SRS), 11 with fractionated stereotactic radiotherapy (FSR), and 9 with three-dimensional conformal therapy (3DCRT). The median doses of SRS, FSR, and 3DCRT were 14 Gy, 50.4 Gy, and 52.2 Gy, respectively. Results: Median follow-up was 60 months. Of 42 meningiomas, 39 were locally controlled. The 8-year actuarial local control rate by Kaplan-Meier methods was 94%. One failure occurred 6 months after 3DCRT, a second at 34 months after FSR, and a third at 125 months after SRS. A temporary symptomatic radiation-related neurologic sequela developed in 1 patient treated with SRS. No fatal treatment complications occurred. The 8-year rate for actuarial freedom from complication survival by Kaplan-Meier methods was 97%. Conclusions: RT alone is an attractive alternative to surgery for imaging-defined meningiomas without significant mass effect. It offers local control comparable to surgical resection with minimal morbidity. RT should be considered as a viable alternative to surgery for tumors in various locations.

  3. Hyperbaric Oxygen Therapy in Treating Long-Term Gastrointestinal Adverse Effects Caused by Radiation Therapy in Patients With Pelvic Cancer

    ClinicalTrials.gov

    2011-07-14

    Bladder Cancer; Cervical Cancer; Colorectal Cancer; Endometrial Cancer; Gastrointestinal Complications; Long-term Effects Secondary to Cancer Therapy in Adults; Ovarian Cancer; Prostate Cancer; Radiation Toxicity; Sarcoma; Testicular Germ Cell Tumor; Vaginal Cancer

  4. Radiation hardness of the storage phosphor europium doped potassium chloride for radiation therapy dosimetry

    PubMed Central

    Driewer, Joseph P.; Chen, Haijian; Osvet, Andres; Low, Daniel A.; Li, H. Harold

    2011-01-01

    Purpose: An important property of a reusable dosimeter is its radiation hardness, that is, its ability to retain its dosimetric merits after irradiation. The radiation hardness of europium doped potassium chloride (KCl:Eu2+), a storage phosphor material recently proposed for radiation therapy dosimetry, is examined in this study. Methods: Pellet-style KCl:Eu2+ dosimeters, 6 mm in diameter, and 1 mm thick, were fabricated in-house for this study. The pellets were exposed by a 6 MV photon beam or in a high dose rate 137Cs irradiator. Macroscopic properties, such as radiation sensitivity, dose response linearity, and signal stability, were studied with a laboratory photostimulated luminescence (PSL) readout system. Since phosphor performance is related to the state of the storage centers and the activator, Eu2+, in the host lattice, spectroscopic and temporal measurements were carried out in order to explore radiation-induced changes at the microscopic level. Results: KCl:Eu2+ dosimeters retained approximately 90% of their initial signal strength after a 5000 Gy dose history. Dose response was initially supralinear over the dose range of 100–700 cGy but became linear after 60 Gy. Linearity did not change significantly in the 0–5000 Gy dose history spanned in this study. Annealing high dose history chips resulted in a return of supralinearity and a recovery of sensitivity. There were no significant changes in the PSL stimulation spectra, PSL emission spectra, photoluminescence spectra, or luminescence lifetime, indicating that the PSL signal process remains intact after irradiation but at a reduced efficiency due to reparable radiation-induced perturbations in the crystal lattice. Conclusions: Systematic studies of KCl:Eu2+ material are important for understanding how the material can be optimized for radiation therapy dosimetry purposes. The data presented here indicate that KCl:Eu2+ exhibits strong radiation hardness and lends support for further investigations of this novel material. PMID:21928642

  5. MOSFET dosimetry for microbeam radiation therapy at the European Synchrotron Radiation Facility

    Microsoft Academic Search

    E. Brauer-Krisch; A. Bravin; M. L. Lerch; A. Rosenfeld; J. Stepanek; M. Di Michiel; J. A. Laissue

    2003-01-01

    Preclinical experiments are carried out with ;20–30 mm wide, ;10 mm high parallel microbeams of hard, broad-‘‘white’’-spectrum x rays ~;50–600 keV! to investigate microbeam radiation therapy ~MRT! of brain tumors in infants for whom other kinds of radiotherapy are inadequate and\\/or unsafe. Novel physical microdosimetry ~implemented with MOSFET chips in the ‘‘edge-on’’ mode! and Monte Carlo computer-simulated dosimetry are described

  6. Pioneer F Plaque Symbology

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The Pioneer F spacecraft, destined to be the first man made object to escape from the solar system into interstellar space, carries this pictorial plaque. It is designed to show scientifically educated inhabitants of some other star system, who might intercept it millions of years from now, when Pioneer was launched, from where, and by what kind of beings. (With the hope that they would not invade Earth.) The design is etched into a 6 inch by 9 inch gold-anodized aluminum plate, attached to the spacecraft's attenna support struts in a position to help shield it from erosion by interstellar dust. The radiating lines at left represents the positions of 14 pulsars, a cosmic source of radio energy, arranged to indicate our sun as the home star of our civilization. The '1-' symbols at the ends of the lines are binary numbers that represent the frequencies of these pulsars at the time of launch of Pioneer F relative of that to the hydrogen atom shown at the upper left with a '1' unity symbol. The hydrogen atom is thus used as a 'universal clock,' and the regular decrease in the frequencies of the pulsars will enable another civilization to determine the time that has elapsed since Pioneer F was launched. The hydrogen is also used as a 'universal yardstick' for sizing the human figures and outline of the spacecraft shown on the right. The hydrogen wavelength, about 8 inches, multiplied by the binary number representing '8' shown next to the woman gives her height, 64 inches. The figures represent the type of creature that created Pioneer. The man's hand is raised in a gesture of good will. Across the bottom are the planets, ranging outward from the Sun, with the spacecraft trajectory arching away from Earth, passing Mars, and swinging by Jupiter.

  7. Ultrasound Thermometry for Therapy-level Radiation Dosimetry

    NASA Astrophysics Data System (ADS)

    Taylor, Courtney

    2010-03-01

    Radiation oncology is the process of administering a specified dose of radiation to a patient currently receiving treatment for a form of cancer. In this process, it is vital to know the delivered dose for a given radiation beam to correctly treat a patient. The primary reference standard for absorbed dose is established using water calorimetry. The absorbed dose, typically of order 1 Gy (J/kg) at therapy levels, is realized by measuring sub-millikelvin temperature changes using a thermistor in a sensitive Wheatstone bridge. Ultrasound technology has been investigated as an alternative to thermistor measurements since the speed of sound propagation in water varies with temperature. With ultrasonic time-of-flight and highly sensitive phase detection techniques, temperature sensitivity comparable to that of the thermistor bridge has been achieved without introducing non-water materials into the test area. A single ultrasound transducer transmitting and receiving at 5.0 MHz throughout the length of the water phantom, and the phase change of the sound wave was used to determine temperature increase from an irradiative source at specified depths of the phantom. In this experiment, the exposure period was varied from 15s to 160s cyclically by modulating a heat lamp, and a profile of the measured temperature response as a function of the period was obtained using Fourier analysis. Due to the large temperature gradient in the water phantom, measurements are prone to convection which was indeed observed and will be discussed.

  8. Skeletal sequelae of radiation therapy for malignant childhood tumors

    SciTech Connect

    Butler, M.S.; Robertson, W.W. Jr.; Rate, W.; D'Angio, G.J.; Drummond, D.S. (UMDNJ Robert Wood Johnson Medical School, New Brunswick (USA))

    1990-02-01

    One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy.

  9. Stereotactic multibeam radiation therapy system in a PACS environment

    NASA Astrophysics Data System (ADS)

    Fresne, Francoise; Le Gall, G.; Barillot, Christian; Gibaud, Bernard; Manens, Jean-Pierre; Toumoulin, Christine; Lemoine, Didier; Chenal, C.; Scarabin, Jean-Marie

    1991-05-01

    A Multibeam radiation therapy treatment is a non-invasive technique devoted to treat a lesion within the cerebral medium by focusing photon-beams on the same target from a high number of entrance points. We present here a computer assisted dosimetric planning procedure which includes: (1) an analysis module to define the target volume by using 2D and 3D displays, (2) a planing module to issue a treatment strategy including the dosimetric simulations and (3) a treatment module setting up the parameters to order the robotized treatment system (i.e. chair- framework, radiation unit machine). Another important feature of this system is its connection to the PACS system SIRENE settled in the University hospital of Rennes which makes possible the archiving and the communication of the multimodal images (CT, MRI, Angiography) used by this application. The corporate use of stereotactic methods and the multimodality imagery ensures spatial coherence and makes the target definition and the cognition of the structures environment more accurate. The dosimetric planning suited to the spatial reference (i.e. the stereotactic frame) guarantees an optimal distribution of the dose computed by an original 3D volumetric algorithm. The robotic approach of the treatment stage has consisted to design a computer driven chair-framework cluster to position the target volume at the radiation unit isocenter.

  10. Novel Multicompartment 3-Dimensional Radiochromic Radiation Dosimeters for Nanoparticle-Enhanced Radiation Therapy Dosimetry

    SciTech Connect

    Alqathami, Mamdooh, E-mail: malq7704@uni.sydney.edu.au [Discipline of Medical Radiations, The Royal Melbourne Institute of Technology University, Victoria (Australia)] [Discipline of Medical Radiations, The Royal Melbourne Institute of Technology University, Victoria (Australia); Blencowe, Anton [Department of Chemical and Biomolecular Engineering, University of Melbourne, Victoria (Australia)] [Department of Chemical and Biomolecular Engineering, University of Melbourne, Victoria (Australia); Yeo, Un Jin [School of Applied Sciences and Health Innovations Research Institute, The Royal Melbourne Institute of Technology University, Victoria (Australia)] [School of Applied Sciences and Health Innovations Research Institute, The Royal Melbourne Institute of Technology University, Victoria (Australia); Doran, Simon J. [CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton (United Kingdom)] [CRUK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton (United Kingdom); Qiao, Greg [Department of Chemical and Biomolecular Engineering, University of Melbourne, Victoria (Australia)] [Department of Chemical and Biomolecular Engineering, University of Melbourne, Victoria (Australia); Geso, Moshi [Discipline of Medical Radiations, The Royal Melbourne Institute of Technology University, Victoria (Australia)] [Discipline of Medical Radiations, The Royal Melbourne Institute of Technology University, Victoria (Australia)

    2012-11-15

    Purpose: Gold nanoparticles (AuNps), because of their high atomic number (Z), have been demonstrated to absorb low-energy X-rays preferentially, compared with tissue, and may be used to achieve localized radiation dose enhancement in tumors. The purpose of this study is to introduce the first example of a novel multicompartment radiochromic radiation dosimeter and to demonstrate its applicability for 3-dimensional (3D) dosimetry of nanoparticle-enhanced radiation therapy. Methods and Materials: A novel multicompartment phantom radiochromic dosimeter was developed. It was designed and formulated to mimic a tumor loaded with AuNps (50 nm in diameter) at a concentration of 0.5 mM, surrounded by normal tissues. The novel dosimeter is referred to as the Sensitivity Modulated Advanced Radiation Therapy (SMART) dosimeter. The dosimeters were irradiated with 100-kV and 6-MV X-ray energies. Dose enhancement produced from the interaction of X-rays with AuNps was calculated using spectrophotometric and cone-beam optical computed tomography scanning by quantitatively comparing the change in optical density and 3D datasets of the dosimetric measurements between the tissue-equivalent (TE) and TE/AuNps compartments. The interbatch and intrabatch variability and the postresponse stability of the dosimeters with AuNps were also assessed. Results: Radiation dose enhancement factors of 1.77 and 1.11 were obtained using 100-kV and 6-MV X-ray energies, respectively. The results of this study are in good agreement with previous observations; however, for the first time we provide direct experimental confirmation and 3D visualization of the radiosensitization effect of AuNps. The dosimeters with AuNps showed small (<3.5%) interbatch variability and negligible (<0.5%) intrabatch variability. Conclusions: The SMART dosimeter yields experimental insights concerning the spatial distributions and elevated dose in nanoparticle-enhanced radiation therapy, which cannot be performed using any of the current methods. The authors concluded that it can be used as a novel independent method for nanoparticle-enhanced radiation therapy dosimetry.

  11. Accelerated hypofractionated radiation therapy compared to conventionally fractionated radiation therapy for the treatment of inoperable non-small cell lung cancer

    E-print Network

    Amini, Arya; Lin, Steven H; Wei, Caimiao; Allen, Pamela; Cox, James D; Komaki, Ritsuko

    2012-01-01

    treatment of inoperable non-small cell lung cancer. Radiationradiation therapy for the treatment of inoperable non-small cell lung cancercancer patients also noted potentially worse outcomes with prolonged radiation treatment

  12. Scatter correction for cone-beam CT in radiation therapy

    SciTech Connect

    Zhu Lei; Xie Yaoqin; Wang Jing; Xing Lei [Department of Radiation Oncology, Stanford University, Stanford, California 94305 (United States)

    2009-06-15

    Cone-beam CT (CBCT) is being increasingly used in modern radiation therapy for patient setup and adaptive replanning. However, due to the large volume of x-ray illumination, scatter becomes a rather serious problem and is considered as one of the fundamental limitations of CBCT image quality. Many scatter correction algorithms have been proposed in literature, while a standard practical solution still remains elusive. In radiation therapy, the same patient is scanned repetitively during a course of treatment, a natural question to ask is whether one can obtain the scatter distribution on the first day of treatment and then use the data for scatter correction in the subsequent scans on different days. To realize this scatter removal scheme, two technical pieces must be in place: (i) A strategy to obtain the scatter distribution in on-board CBCT imaging and (ii) a method to spatially match a prior scatter distribution with the on-treatment CBCT projection data for scatter subtraction. In this work, simple solutions to the two problems are provided. A partially blocked CBCT is used to extract the scatter distribution. The x-ray beam blocker has a strip pattern, such that partial volume can still be accurately reconstructed and the whole-field scatter distribution can be estimated from the detected signals in the shadow regions using interpolation/extrapolation. In the subsequent scans, the patient transformation is determined using a rigid registration of the conventional CBCT and the prior partial CBCT. From the derived patient transformation, the measured scatter is then modified to adapt the new on-treatment patient geometry for scatter correction. The proposed method is evaluated using physical experiments on a clinical CBCT system. On the Catphan(c)600 phantom, the errors in Hounsfield unit (HU) in the selected regions of interest are reduced from about 350 to below 50 HU; on an anthropomorphic phantom, the error is reduced from 15.7% to 5.4%. The proposed method is attractive in applications where a high CBCT image quality is critical, for example, dose calculation in adaptive radiation therapy.

  13. Three-Dimensional Conformal Radiation Therapy and Intensity-Modulated Radiation Therapy Combined With Transcatheter Arterial Chemoembolization for Locally Advanced Hepatocellular Carcinoma: An Irradiation Dose Escalation Study

    Microsoft Academic Search

    Zhi-Gang Ren; Jian-Dong Zhao; Ke Gu; Zhen Chen; Jun-Hua Lin; Zhi-Yong Xu; Wei-Gang Hu; Zhen-Hua Zhou; Lu-Ming Liu; Guo-Liang Jiang

    2011-01-01

    Purpose: To determine the maximum tolerated dose (MTD) of three-dimensional conformal radiation therapy (3DCRT)\\/intensity-modulated radiation therapy (IMRT) combined with transcatheter arterial chemoembolization for locally advanced hepatocellular carcinoma. Methods and Materials: Patients were assigned to two subgroups based on tumor diameter: Group 1 had tumors <10 cm; Group II had tumors {>=}10 cm. Escalation was achieved by increments of 4.0 Gy

  14. Radiation-Induced Leukemia at Doses Relevant to Radiation Therapy: Modeling Mechanisms and Estimating Risks

    NASA Technical Reports Server (NTRS)

    Shuryak, Igor; Sachs, Rainer K.; Hlatky, Lynn; Mark P. Little; Hahnfeldt, Philip; Brenner, David J.

    2006-01-01

    Because many cancer patients are diagnosed earlier and live longer than in the past, second cancers induced by radiation therapy have become a clinically significant issue. An earlier biologically based model that was designed to estimate risks of high-dose radiation induced solid cancers included initiation of stem cells to a premalignant state, inactivation of stem cells at high radiation doses, and proliferation of stem cells during cellular repopulation after inactivation. This earlier model predicted the risks of solid tumors induced by radiation therapy but overestimated the corresponding leukemia risks. Methods: To extend the model to radiation-induced leukemias, we analyzed in addition to cellular initiation, inactivation, and proliferation a repopulation mechanism specific to the hematopoietic system: long-range migration through the blood stream of hematopoietic stem cells (HSCs) from distant locations. Parameters for the model were derived from HSC biologic data in the literature and from leukemia risks among atomic bomb survivors v^ ho were subjected to much lower radiation doses. Results: Proliferating HSCs that migrate from sites distant from the high-dose region include few preleukemic HSCs, thus decreasing the high-dose leukemia risk. The extended model for leukemia provides risk estimates that are consistent with epidemiologic data for leukemia risk associated with radiation therapy over a wide dose range. For example, when applied to an earlier case-control study of 110000 women undergoing radiotherapy for uterine cancer, the model predicted an excess relative risk (ERR) of 1.9 for leukemia among women who received a large inhomogeneous fractionated external beam dose to the bone marrow (mean = 14.9 Gy), consistent with the measured ERR (2.0, 95% confidence interval [CI] = 0.2 to 6.4; from 3.6 cases expected and 11 cases observed). As a corresponding example for brachytherapy, the predicted ERR of 0.80 among women who received an inhomogeneous low-dose-rate dose to the bone marrow (mean = 2.5 Gy) was consistent with the measured ERR (0.62, 95% Cl =-0.2 to 1.9). Conclusions: An extended, biologically based model for leukemia that includes HSC initiation, inactivation, proliferation, and, uniquely for leukemia, long-range HSC migration predicts, %Kith reasonable accuracy, risks for radiationinduced leukemia associated with exposure to therapeutic doses of radiation.

  15. Applicability of a mobile accelerator for intraoperative radiation therapy to colorectal cancer

    Microsoft Academic Search

    Yojiro Hashiguchi; Takeshi Sekine; Shingo Kato; Hirohiko Sakamoto; Tomoko Kazumoto; Mizuyoshi Sakura; Yoichi Tanaka

    2001-01-01

    PURPOSE: Intraoperative radiation therapy is reportedly effective for local control and pain relief in colorectal cancer. However, this treatment requires a large number of medical personnel, which hinders expanded use of this method. A mobile electron linear accelerator for intraoperative radiation therapy has been developed and is now commercially available. This report analyzes the applicability of this accelerator to colorectal

  16. Radical Radiation Therapy for Prostate Cancer in Japan: a Patterns of Care Study Report

    Microsoft Academic Search

    Katsumasa Nakamura; Teruki Teshima; Yutaka Takahashi; Atsushi Imai; Masahiko Koizumi; Norio Mitsuhashi; Toshihiko Inoue; Japanese PCS

    Background: The patterns of radical radiation therapy for prostate cancer are unclear in Japan. A Patterns of Care Study was performed throughout Japan to examine the patterns of radiation therapy for prostate cancer. Methods: From 1999 to 2000, extramural audits were performed on 50 randomly selected institutions (~7% of all institutions in Japan). Detailed information was collected on a total

  17. Fundamental biophysical aspects of high-energy radiations in cancer therapy

    Microsoft Academic Search

    Orton

    1974-01-01

    The limitations of conventional therapy with x and $gamma$ radiations ; are reported, and high-energy particulate radiations that exhibit physical and\\/or ; biological properties more suitable for cancer therapy are discussed. ; Specifically, future prospects for radiotherapy with beams of electrons, ; neutrons, negative pions, protons, $alpha$ particles, and heavy ions are ; surveyed, and some of the results of

  18. Linac-based stereotactic body radiation therapy for treatment of glomus jugulare tumors

    Microsoft Academic Search

    Rodney E. Wegner; Kenneth D. Rodriguez; Dwight E. Heron; Barry E. Hirsch; Robert L. Ferris; Steven A. Burton

    2010-01-01

    Background: Glomus jugulare tumors are rare, typically benign, tumors that arise from the neural crest cells that are associated with the autonomic ganglia in and around the jugular bulb. Treatment options for glomus jugulare tumors include embolization followed by resection, fractionated external beam radiation therapy (EBRT), stereotactic radiosurgery (SRS), and\\/or stereotactic body radiation therapy (SBRT). Materials and methods: 18 patients

  19. Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis

    Microsoft Academic Search

    Kian Tai Chong; Neil B. Hampson; John M. Corman

    2005-01-01

    ObjectivesTo assess the clinical factors that affect the efficacy of hyperbaric oxygen (HBO2) therapy in treating radiation-induced hemorrhagic cystitis. HBO2 therapy is an effective treatment for radiation-induced hemorrhagic cystitis, with reported response rates ranging from 76% to 100%.

  20. Two-year follow-up after intracoronary gamma radiation therapy

    Microsoft Academic Search

    José A Condado; Ron Waksman; Carlos Calderas; Jorge Saucedo; Alexandra Lansky

    1999-01-01

    Background. Neointimal hyperplasia and unfavorable remodeling have been demonstrated to be the major limitation to endovascular revascularization procedures. Intracoronary gamma radiation therapy has been shown to reduce the restenosis index. However, the late effects of these novel procedures are unknown.Materials and Methods. To evaluate the long-term effects on clinical and angiographic outcome of endovascular gamma radiation therapy following percutaneous transluminal

  1. Dynamic optical modulation of the electron beam for the high performance intensity modulated radiation therapy

    Microsoft Academic Search

    T. Kondoh; H. Kashima; J. Yang; Y. Yoshida

    2007-01-01

    The radiation therapy of cancer is developing to non-uniform irradiation as intensity modulated radiation therapy (IMRT), reducing the dose to normal tissue and concentrating the dose to cancer tissue. A photocathode RF gun is able to generate a low emittance electron beam pulse using laser light. We thought that a photocathode RF gun can generate an intensity-modulated electron beam by

  2. Primary lung cancer after breast cancer: The role of radiation therapy and cigarette smoking

    Microsoft Academic Search

    Melissa Belle Ford

    2000-01-01

    The magnitude of the interaction between cigarette smoking, radiation therapy, and primary lung cancer after breast cancer remains unresolved. This case control study further examines the main and joint effects of cigarette smoking and radiation therapy (XRT) among breast cancer patients who subsequently developed primary lung cancer, at The University of Texas M. D. Anderson Cancer Center (MDACC) in Houston,

  3. The efficacy of sucralfate suspension in the prevention of oral mucositis due to radiation therapy

    Microsoft Academic Search

    Joel B. Epstein; Frances L. W. Wong

    1994-01-01

    The purpose of this study was to assess the value of sucralfate suspension in prevention of oral mucositis and for reduction of oral pain in patients who develop mucositis during radiation therapy. The study was a double-blind, placebo-controlled, randomized prospective trial of a sucralfate suspension in the prevention and management of oral mucositis during radiation therapy. Oral mucositis was assessed

  4. Calcified basal ganglionic mass 12 years after radiation therapy for medulloblastoma

    SciTech Connect

    Lichtor, T.; Wollmann, R.L.; Brown, F.D.

    1984-04-01

    A patient treated 12 years previously with an operation and radiation therapy for a medulloblastoma developed weakness of the left hand and perivascular calcification involving the right internal capsule and caudate nucleus. These findings are considered possible long-term complications of the radiation therapy.

  5. Late-onset spinal deformities in children treated by laminectomy and radiation therapy for malignant tumours

    Microsoft Academic Search

    Tamas de Jonge; Hernan Slullitel; Jean Dubousset; Lotfi Miladi; Philip Wicart; Tamás Illés

    2005-01-01

    This is a retrospective study of 76 children who had had malignant tumours treated with laminectomy or laminoplasty and\\/or radiation therapy affecting the spine. Spinal tumours in children are extremely rare. However, their treatment can result in progressive spinal deformity. Radiation therapy affecting the growing spine can lead to asymmetric vertebral growth, causing kyphosis and\\/or scoliosis. These spinal deformities pose

  6. Microdosimetry for Microbeam Radiation Therapy (MRT): theoretical calculations using the Monte Carlo toolkit

    Microsoft Academic Search

    J. Spiga; E. A. Siegbahn; E. Brauer-Krisch; P. Randaccio; A. Bravin

    2006-01-01

    Radiation therapy is widely used in the treatment of very different types of cancer. Recent developments in this field are aiming at delivering high doses to the target volume while sparing the surrounding healthy tissues. The microbeam radiation therapy (MRT) is a new kind of radiotherapy which could be used for treating infantile brain tumors, as other kinds of radiotherapy

  7. A hybrid approach to beam angle optimization in intensity-modulated radiation therapy

    E-print Network

    Bertsimas, Dimitris

    Linear programming Computational experiments a b s t r a c t Intensity-Modulated Radiation Therapy Optimization) is an important problem and is today often based on human experience. In this context, we faceA hybrid approach to beam angle optimization in intensity-modulated radiation therapy D. Bertsimas

  8. Cancer of the glottis: prognostic factors in radiation therapy

    SciTech Connect

    Mantravadi, R.V.; Liebner, E.J.; Haas, R.E.; Skolnik, E.M.; Applebaum, E.L.

    1983-10-01

    The authors conducted a multivariate analysis of the prognostic factors in 96 patients with early glottic cancer treated by radiation therapy. Of these, 73 had T1 and 23 had T2 tumor. The primary tumor was controlled in 82% of T1 and 74% of T2 lesions. Actuarial five-year survival rates were 87% for T1 and 74% for T2. Carcinoma of the anterior commissure associated with bilateral vocal cord involvement, subglottic tumor extension, persistent or recurrent laryngeal edema, and impaired cord mobility was found to adversely influence the prognosis. The data suggest that irradiation is the treatment of choice for glottic cancer limited to the vocal cords or with minimal extension to the anterior commissure or supraglottic larynx.

  9. Cancer of the glottis: prognostic factors in radiation therapy

    SciTech Connect

    Mantravadi, R.V.P.; Liebner, E.J.; Haas, R.E.; Skolnik, E.M.; Applebaum, E.L.

    1983-10-01

    The authors conducted a multivariate analysis of the prognostic factors in 96 patients with early glottic cancer treated by radiation therapy. Of these, 73 had T/sub 1/ and 23 had T/sub 2/ tumor. The primary tumor was controlled in 82% of T/sub 1/ amd 74% for T/sub 2/. Carcinoma of the anterior commissure associated with bilateral vocal cord involvement, subglottic tumor extension, persistent or recurrent laryngeal edema, and impaired cord mobility was found to adversely influence the prognosis. The data suggest that irradiation is the treatment of choice for glottic cancer limited to the vocal cords or with minimal extension to the anterior commissure or gupraglottic larynx.

  10. Nanoparticles for Radiation Therapy Enhancement: the Key Parameters

    PubMed Central

    Retif, Paul; Pinel, Sophie; Toussaint, Magali; Frochot, Céline; Chouikrat, Rima; Bastogne, Thierry; Barberi-Heyob, Muriel

    2015-01-01

    This review focuses on the radiosensitization strategies that use high-Z nanoparticles. It does not establish an exhaustive list of the works in this field but rather propose constructive criticisms pointing out critical factors that could improve the nano-radiation therapy. Whereas most reviews show the chemists and/or biologists points of view, the present analysis is also seen through the prism of the medical physicist. In particular, we described and evaluated the influence of X-rays energy spectra using a numerical analysis. We observed a lack of standardization in preclinical studies that could partially explain the low number of translation to clinical applications for this innovative therapeutic strategy. Pointing out the critical parameters of high-Z nanoparticles radiosensitization, this review is expected to contribute to a larger preclinical and clinical development. PMID:26155318

  11. [Radiation therapy in simultaneous choroidal and brain metastases].

    PubMed

    Conill, C; Jorcano, S; Planas, I; Marruecos, J; Casas, F; Fontenla, J R

    2005-09-01

    Choroidal metastases from lung cancer can be the initial clinical manifestation of metastasic disease, although they generally coexist with at least two more metastasic sites. The most common symptom is decreased vision, however 20% of brain metastases can present with visual alterations. A differential diagnosis within brain metastases and/or choroidal is necessary. We present the case of a patient with lung cancer and decreased vision who was diagnosed as simultaneous choroidal and brain metastases. Radiation therapy (20Gy/5fractions) significantly improves decreased vision. This case shows that, although life expectancy of patients with metastasic lung cancer is short, an adequate diagnosis and treatment, can improve the quality of life of those patients. PMID:16386076

  12. X-ray energy optimization in minibeam radiation therapy

    SciTech Connect

    Prezado, Y.; Thengumpallil, S.; Renier, M.; Bravin, A. [ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P.220, 38043 Grenoble (France); ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P.220, 38043 Grenoble, France and Dipartimento di Fisica ''E. Amaldi'', Universita degli Studi Roma Tre, 84 Via della Vasca Navale, 00146 Rome (Italy); ID17 Biomedical Beamline, European Synchrotron Radiation Facility (ESRF), 6 Rue Jules Horowitz B.P.220, 38043 Grenoble (France)

    2009-11-15

    Purpose: The purpose of this work is to assess which energy in minibeam radiation therapy provides the best compromise between the deposited dose in the tumor and the sparing of the healthy tissues. Methods: Monte Carlo simulations (PENELOPE 2006) have been used as a method to calculate the ratio of the peak-to-valley doses (PVDR) in the healthy tissues and in the tumor for different beam energies. The maximization of the ratio of PVDR in the healthy tissues and in the tumor has been used as a criterion. Results: The main result of this work is that, for the parameters being used in preclinical trials (minibeam sizes of 600 {mu}m and 1200 {mu}m center-to-center separation), the optimum beam energy is 375 keV. Conclusions: The conclusion is that this is the energy of minibeams that should be used in the preclinical studies.

  13. [Equipment and positioning technologies in stereotactic body radiation therapy].

    PubMed

    Marchesi, V; Dedieu, V; Lacornerie, T; Buchheit, I

    2014-01-01

    Strereotactic body radiation therapy needs adapted or dedicated equipment to allow fulfilling the particular conditions of the stereotactic treatments: submillimetric accuracy during the treatment delivery, high doses for a reduced number of sessions. This kind of treatment can be either performed using delivery equipment conceived and dedicated to the technique, or performed on conventional machines adapted to meet the criteria. Contrary to intracranial treatments, the positioning of the target volume raises new difficulties, mainly due to the diversity of localization to treat and also due to inter- and intrafraction movements that can occur. To reduce these effects that could affect the irradiation accuracy, positioning or movement compensation, mostly due to respiration, tools have been developed. PMID:24837350

  14. Very High Energy Electrons (VHEE) have the potential to be an alternative or complementary radiation therapy

    E-print Network

    Strathclyde, University of

    radiation therapy to x-ray and ions for cancer treatment. Background Despite numerous studies showing discouraged further investigation of using VHEE in radiotherapy. The electron energy required for VHEE therapy energy required for VHEE therapy could only be produced by very large and very expensive devices

  15. Ultrasound-based guidance of intensity-modulated radiation therapy

    SciTech Connect

    Fung, Albert Y.C. [Department of Radiation Oncology, Nebraska Medical Center, Omaha, NE (United States)]. E-mail: afung@unmc.edu; Ayyangar, Komanduri M. [Department of Radiation Oncology, Nebraska Medical Center, Omaha, NE (United States); Djajaputra, David [Department of Radiation Oncology, Nebraska Medical Center, Omaha, NE (United States); Nehru, Ramasamy M. [Department of Radiation Oncology, Nebraska Medical Center, Omaha, NE (United States); Enke, Charles A. [Department of Radiation Oncology, Nebraska Medical Center, Omaha, NE (United States)

    2006-04-01

    In ultrasound-guided intensity-modulated radiation therapy (IMRT) of prostate cancer, ultrasound imaging ascertains the anatomical position of patients during x-ray therapy delivery. The ultrasound transducers are made of piezoelectric ceramics. The same crystal is used for both ultrasound production and reception. Three-dimensional (3D) ultrasound devices capture and correlate series of 2-dimensional (2D) B-mode images. The transducers are often arranged in a convex array for focusing. Lower frequency reaches greater depth, but results in low resolution. For clear image, some gel is usually applied between the probe and the skin contact surface. For prostate positioning, axial and sagittal scans are performed, and the volume contours from computed tomography (CT) planning are superimposed on the ultrasound images obtained before radiation delivery at the linear accelerator. The planning volumes are then overlaid on the ultrasound images and adjusted until they match. The computer automatically deduces the offset necessary to move the patient so that the treatment area is in the correct location. The couch is translated as needed. The currently available commercial equipment can attain a positional accuracy of 1-2 mm. Commercial manufacturer designs differ in the detection of probe coordinates relative to the isocenter. Some use a position-sensing robotic arm, while others have infrared light-emitting diodes or pattern-recognition software with charge-couple-device cameras. Commissioning includes testing of image quality and positional accuracy. Ultrasound is mainly used in prostate positioning. Data for 7825 daily fractions of 234 prostate patients indicated average 3D inter-fractional displacement of about 7.8 mm. There was no perceivable trend of shift over time. Scatter plots showed slight prevalence toward superior-posterior directions. Uncertainties of ultrasound guidance included tissue inhomogeneities, speckle noise, probe pressure, and inter-observer variation. Some published studies detected improvement in treatment based on gastrointestinal toxicity and the reduction of prostate movement.

  16. Proton-minibeam radiation therapy: A proof of concept

    SciTech Connect

    Prezado, Y. [IMNC-UMR 8165, CNRS, Paris 7 and Paris 11 Universities, 15 rue Georges Clemenceau, 91406 Orsay Cedex (France); Fois, G. R. [Dipartimento di Fisica, Universita degli Studi di Cagliari, Strada provinciale Monserrato Sestu km 0.700, Monserrato, Cagliari 09042 (Italy)

    2013-03-15

    Purpose: This Monte Carlo simulation work aims at studying a new radiotherapy approach called proton-minibeam radiation therapy (pMBRT). The main objective of this proof of concept was the evaluation of the possible gain in tissue sparing, thanks to the spatial fractionation of the dose, which could be used to deposit higher and potentially curative doses in clinical cases where tissue tolerances are a limit for conventional methods. Methods: Monte Carlo simulations (GATE v.6) have been used as a method to calculate the ratio of the peak-to-valley doses (PVDR) for arrays of proton minibeams of 0.7 mm width and several center-to-center distances, at different depths in a water phantom. The beam penumbras were also evaluated as an important parameter for tissue sparing, for example, in the treatment of non-cancer diseases like epilepsy. Two proton energies were considered in this study: a clinically relevant energy (105 MeV) and a very high energy (1 GeV), to benefit from a reduced lateral scattering. For the latter case, an interlaced geometry was also evaluated. Results: Higher or similar PVDR than the ones obtained in x-rays minibeam radiation therapy were achieved in several pMBRT configurations. In addition, for the two energies studied, the beam penumbras are smaller than in the case of Gamma Knife radiosurgery. Conclusions: The high PVDR obtained for some configurations and the small penumbras in comparison with existing radiosurgery techniques, suggest a potential gain in healthy tissue sparing in this new technique. Biological studies are warranted to assess the effects of pMBRT on both normal and tumoral tissues.

  17. Has the use of computers in radiation therapy improved the accuracy in radiation dose delivery?

    NASA Astrophysics Data System (ADS)

    Van Dyk, J.; Battista, J.

    2014-03-01

    Purpose: It is well recognized that computer technology has had a major impact on the practice of radiation oncology. This paper addresses the question as to how these computer advances have specifically impacted the accuracy of radiation dose delivery to the patient. Methods: A review was undertaken of all the key steps in the radiation treatment process ranging from machine calibration to patient treatment verification and irradiation. Using a semi-quantitative scale, each stage in the process was analysed from the point of view of gains in treatment accuracy. Results: Our critical review indicated that computerization related to digital medical imaging (ranging from target volume localization, to treatment planning, to image-guided treatment) has had the most significant impact on the accuracy of radiation treatment. Conversely, the premature adoption of intensity-modulated radiation therapy has actually degraded the accuracy of dose delivery compared to 3-D conformal radiation therapy. While computational power has improved dose calibration accuracy through Monte Carlo simulations of dosimeter response parameters, the overall impact in terms of percent improvement is relatively small compared to the improvements accrued from 3-D/4-D imaging. Conclusions: As a result of computer applications, we are better able to see and track the internal anatomy of the patient before, during and after treatment. This has yielded the most significant enhancement to the knowledge of "in vivo" dose distributions in the patient. Furthermore, a much richer set of 3-D/4-D co-registered dose-image data is thus becoming available for retrospective analysis of radiobiological and clinical responses.

  18. Role of stereotactic body radiation therapy for hepatocellular carcinoma

    PubMed Central

    Sanuki, Naoko; Takeda, Atsuya; Kunieda, Etsuo

    2014-01-01

    The integration of new technologies has raised an interest in liver tumor radiotherapy, with literature evolving to support its efficacy. These advances, particularly stereotactic body radiation therapy (SBRT), have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation. Active investigation of SBRT, particularly for hepatocellular carcinoma (HCC), has recently started, yielding promising local control rates. In addition, data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies. However, information on optimal treatment indications, doses, and methods remains limited. In HCC, significant differences in patient characteristics and treatment availability exist by country. In addition, the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage. Since they are closely linked to treatment approach, it is important to understand these differences in interpreting outcomes from various reports. Further studies are required to validate and maximize the efficacy of SBRT by a large, multi-institutional setting. PMID:24696597

  19. Fluence field modulated CT on a clinical TomoTherapy radiation therapy machine

    NASA Astrophysics Data System (ADS)

    Szczykutowicz, Timothy P.; Hermus, James

    2015-03-01

    Purpose: The multi-leaf collimator (MLC) assembly present on TomoTherapy (Accuray, Madison WI) radiation therapy (RT) and mega voltage CT machines is well suited to perform fluence field modulated CT (FFMCT). In addition, there is a demand in the RT environment for FFMCT imaging techniques, specifically volume of interest (VOI) imaging. Methods: A clinical TomoTherapy machine was programmed to deliver 30% imaging dose outside predefined VOIs. Four different size ROIs were placed at varying distances from isocenter. Projections intersecting the VOI received "full dose" while those not intersecting the VOI received 30% of the dose (i.e. the incident fluence for non VOI projections was 30% of the incident fluence for projections intersecting the VOI). Additional scans without fluence field modulation were acquired at "full" and 30% dose. The noise (pixel standard deviation) was measured inside the VOI region and compared between the three scans. Results: The VOI-FFMCT technique produced an image noise 1.09, 1.05, 1.05, and 1.21 times higher than the "full dose" scan for ROI sizes of 10 cm, 13 cm, 10 cm, and 6 cm respectively within the VOI region. Conclusions: Noise levels can be almost unchanged within clinically relevant VOIs sizes for RT applications while the integral imaging dose to the patient can be decreased, and/or the image quality in RT can be dramatically increased with no change in dose relative to non-FFMCT RT imaging. The ability to shift dose away from regions unimportant for clinical evaluation in order to improve image quality or reduce imaging dose has been demonstrated. This paper demonstrates that FFMCT can be performed using the MLC on a clinical TomoTherapy machine for the first time.

  20. The efficacy of sucralfate suspension in the prevention of oral mucositis due to radiation therapy

    SciTech Connect

    Epstein, J.B.; Wong, F.L.W. (British Columbia Cancer Agency, Vancouver (Canada))

    1994-02-01

    The purpose of this study was to assess the value of sucralfate suspension in prevention of oral mucositis and for reduction of oral pain in patients who develop mucositis during radiation therapy. The study was a double-blind, placebo-controlled, randomized prospective trial of a sucralfate suspension in the prevention and management of oral mucositis during radiation therapy. Oral mucositis was assessed using a quantitative scale and symptoms were assessed using visual analogue scales. The statistical model was developed to detect a 40% reduction in mucositis. No statistically significant reduction in mucositis was seen. Early during radiation therapy less oral pain was reported in the sucralfate group, but as treatment progressed all patients experienced pain. Patients in the sucralfate group were prescribed topical and systemic analgesics later in the course of radiation therapy. Prophylactic oral rinsing with sucralfate did not prevent oral ulcerative mucositis. Sucralfate may reduce the experience of pain during radiation therapy. 32 refs., 3 tabs.

  1. Patient Specification Quality Assurance for Glioblastoma Multiforme Brain Tumors Treated with Intensity Modulated Radiation Therapy

    PubMed Central

    Al-Mohammed, H. I.

    2011-01-01

    The aim of this study was to evaluate the significance of performing patient specification quality assurance for patients diagnosed with glioblastoma multiforme treated with intensity modulated radiation therapy. The study evaluated ten intensity modulated radiation therapy treatment plans using 10 MV beams, a total dose of 60 Gy (2 Gy/fraction, five fractions a week for a total of six weeks treatment). For the quality assurance protocol we used a two-dimensional ionization-chamber array (2D-ARRAY). The results showed a very good agreement between the measured dose and the pretreatment planned dose. All the plans passed >95% gamma criterion with pixels within 5% dose difference and 3 mm distance to agreement. We concluded that using the 2D-ARRAY ion chamber for intensity modulated radiation therapy is an important step for intensity modulated radiation therapy treatment plans, and this study has shown that our treatment planning for intensity modulated radiation therapy is accurately done. PMID:21850196

  2. A review on photoneutrons characteristics in radiation therapy with high-energy photon beams

    PubMed Central

    Naseri, Alireza; Mesbahi, Asghar

    2010-01-01

    In radiation therapy with high-energy photon beams (E > 10 MeV) neutrons are generated mainly in linacs head thorough (?,n) interactions of photons with nuclei of high atomic number materials that constitute the linac head and the beam collimation system. These neutrons affect the shielding requirements in radiation therapy rooms and also increase the out-of-field radiation dose of patients undergoing radiation therapy with high-energy photon beams. In the current review, the authors describe the factors influencing the neutron production for different medical linacs based on the performed measurements and Monte Carlo studies in the literature. PMID:24376940

  3. Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

    SciTech Connect

    Kelly, Patrick; Das, Prajnan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Varadhachary, Gauri R. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Fontanilla, Hiral P.; Krishnan, Sunil; Delclos, Marc E.; Jhingran, Anuja; Eifel, Patricia J. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Crane, Christopher H., E-mail: ccrane@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2012-04-01

    Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.

  4. Local control after fractionated stereotactic radiation therapy for brain metastases.

    PubMed

    Rajakesari, Selvan; Arvold, Nils D; Jimenez, Rachel B; Christianson, Laura W; Horvath, Margaret C; Claus, Elizabeth B; Golby, Alexandra J; Johnson, Mark D; Dunn, Ian F; Lee, Eudocia Q; Lin, Nancy U; Friesen, Scott; Mannarino, Edward G; Wagar, Matthew; Hacker, Fred L; Weiss, Stephanie E; Alexander, Brian M

    2014-11-01

    Stereotactic radiosurgery (SRS) is frequently used in the management of brain metastases, but concerns over potential toxicity limit applications for larger lesions or those in eloquent areas. Fractionated stereotactic radiation therapy (SRT) is often substituted for SRS in these cases. We retrospectively analyzed the efficacy and toxicity outcomes of patients who received SRT at our institution. Seventy patients with brain metastases treated with SRT from 2006-2012 were analyzed. The rates of local and distant intracranial progression, overall survival, acute toxicity, and radionecrosis were determined. The SRT regimen was 25 Gy in 5 fractions among 87 % of patients. The most common tumor histologies were non-small cell lung cancer (37 %), breast cancer (20 %) and melanoma (20 %), and the median tumor diameter was 1.7 cm (range 0.4-6.4 cm). Median survival after SRT was 10.7 months. Median time to local progression was 17 months, with a local control rate of 68 % at 6 months and 56 % at 1 year. Acute toxicity was seen in 11 patients (16 %), mostly grade 1 or 2 with the most common symptom being mild headache. Symptomatic radiation-induced treatment change was seen on follow-up MRIs in three patients (4.3 %). SRT appears to be a safe and reasonably effective technique to treat brain metastases deemed less suitable for SRS, though dose intensification strategies may further improve local control. PMID:25059451

  5. Stereotactic Body Radiation Therapy Boost in Locally Advanced Pancreatic Cancer

    SciTech Connect

    Seo, Young Seok [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Mi-Sook, E-mail: mskim@kcch.re.k [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Yoo, Sung Yul; Cho, Chul Koo; Yang, Kwang Mo; Yoo, Hyung Jun; Choi, Chul Won [Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Lee, Dong Han [CyberKnife Center, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Jin [Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, Min Suk [Department of Pathology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kang, Hye Jin [Department of Hemato-Oncology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Kim, YoungHan [Department of Radiology, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2009-12-01

    Purpose: To investigate the clinical application of a stereotactic body radiation therapy (SBRT) boost in locally advanced pancreatic cancer patients with a focus on local efficacy and toxicity. Methods and Materials: We retrospectively reviewed 30 patients with locally advanced and nonmetastatic pancreatic cancer who had been treated between 2004 and 2006. Follow-up duration ranged from 4 to 41 months (median, 14.5 months). A total dose of 40 Gy was delivered in 20 fractions using a conventional three-field technique, and then a single fraction of 14, 15, 16, or 17 Gy SBRT was administered as a boost without a break. Twenty-one patients received chemotherapy. Overall and local progression-free survival were calculated and prognostic factors were evaluated. Results: One-year overall survival and local progression-free survival rates were 60.0% and 70.2%, respectively. One patient (3%) developed Grade 4 toxicity. Carbohydrate antigen 19-9 response was found to be an independent prognostic factor for survival. Conclusions: Our findings indicate that a SBRT boost provides a safe means of increasing radiation dose. Based on the results of this study, we recommend that a well controlled Phase II study be conducted on locally advanced pancreatic cancer.

  6. Gadolinium dose enhancement studies in microbeam radiation therapy.

    PubMed

    Prezado, Y; Fois, G; Le Duc, G; Bravin, A

    2009-08-01

    Microbeam radiation therapy (MRT) is an innovative technique to treat brain tumors. The synchrotron generated x-ray beam, used for the treatment, is collimated and delivered in an array of narrow micrometer-sized planar rectangular fields. Several preclinical experiments performed at the Brookhaven National Laboratory (BNL) and at the European Synchrotron Radiation Facility (ESRF) have shown the sparing effect of the healthy tissue and the ablation of tumors in several animal models. It has also been determined that MRT yields a higher therapeutic index than nonsegmented beams of the same energy. This therapeutic index could be greatly improved by loading the tumor with high atomic number (Z) contrast agents. In this work, the dose enhancement factors and the peak to valley dose ratios (PVDRs) are assessed for different gadolinium (Z = 64) concentrations in the tumor and different microbeam energies by using Monte Carlo simulations (PENELOPE 2006 code). A significant decrease in the PVDR values in the tumor, and therefore a relevant increase in the dose deposition, is found in the presence of gadolinium. The optimum energy for the dose deposition in the tumor while keeping a high PVDR in the healthy tissues, which guaranties their sparing, has been investigated. PMID:19746791

  7. Antibacterial effect of taurolidine (2%) on established dental plaque biofilm

    Microsoft Academic Search

    Nicole Birgit Arweiler; Thorsten Mathias Auschill; Anton Sculean

    Preliminary data have suggested that taurolidine may bear promising disinfectant properties for the therapy of bacterial infections.\\u000a However, at present, the potential antibacterial effect of taurolidine on the supragingival plaque biofilm is unknown. To\\u000a evaluate the antibacterial effect of taurolidine on the supragingival plaque biofilm using the vital fluorescence technique\\u000a and to compare it with the effect of NaCl and

  8. A Phase III Study of Conventional Radiation Therapy Plus Thalidomide Versus Conventional Radiation Therapy for Multiple Brain Metastases (RTOG 0118)

    SciTech Connect

    Knisely, Jonathan P.S. [Department of Therapeutic Radiology, Yale University School of Medicine and Yale Cancer Center, New Haven, CT (United States)], E-mail: jonathan.knisely@yale.edu; Berkey, Brian [Radiation Therapy Oncology Group, Philadelphia, PA (United States); Chakravarti, Arnab [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Yung, Al W.K. [Department of Neuro-Oncology and Brain Tumor Center, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Curran, Walter J. [Department of Radiation Oncology, Emory University, Atlanta, GA (United States); Robins, H. Ian [Department of Human Oncology, University of Wisconsin Medical School, Madison, WI (United States); Department of Medicine, University of Wisconsin Medical School, Madison, WI (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Brachman, David G. [Department of Radiation Oncology, AZ Oncology Services and St. Joseph's Hospital, Phoenix, AZ (United States); Henderson, Randall H. [University of Florida Proton Therapy Institute, Jacksonville, FL (United States); Mehta, Minesh P. [Department of Medicine, University of Wisconsin Medical School, Madison, WI (United States)

    2008-05-01

    Purpose: To compare whole-brain radiation therapy (WBRT) with WBRT combined with thalidomide for patients with brain metastases not amenable to resection or radiosurgery. Patients and Methods: Patients with Zubrod performance status 0-1, MRI-documented multiple (>3), large (>4 cm), or midbrain brain metastases arising from a histopathologically confirmed extracranial primary tumor, and an anticipated survival of >8 weeks were randomized to receive WBRT to a dose of 37.5 Gy in 15 fractions with or without thalidomide during and after WBRT. Prerandomization stratification used Radiation Therapy Oncology Group (RTOG) Recursive Partitioning Analysis (RPA) Class and whether post-WBRT chemotherapy was planned. Endpoints included overall survival, progression-free survival, time to neurocognitive progression, the cause of death, toxicities, and quality of life. A protocol-planned interim analysis documented that the trial had an extremely low probability of ever showing a significant difference favoring the thalidomide arm given the results at the time of the analysis, and it was therefore closed on the basis of predefined statistical guidelines. Results: Enrolled in the study were 332 patients. Of 183 accrued patients, 93 were randomized to receive WBRT alone and 90 to WBRT and thalidomide. Median survival was 3.9 months for both arms. No novel toxicities were seen, but thalidomide was not well tolerated in this population. Forty-eight percent of patients discontinued thalidomide because of side effects. Conclusion: Thalidomide provided no survival benefit for patients with multiple, large, or midbrain metastases when combined with WBRT; nearly half the patients discontinued thalidomide due to side effects.

  9. Direct aperture optimization for online adaptive radiation therapy

    SciTech Connect

    Mestrovic, Ante; Milette, Marie-Pierre; Nichol, Alan; Clark, Brenda G.; Otto, Karl [Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada and Medical Physics, BC Cancer Agency-Vancouver Centre, Vancouver, British Columbia (Canada); Physics and Astronomy, University of British Columbia, Vancouver, British Columbia (Canada) and Medical Physics, BC Cancer Agency-Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Radiation Oncology, BC Cancer Agency-Vancouver Centre, Vancouver, British Columbia (Canada); Medical Physics, Ottawa Hospital Regional Cancer Centre, Ottawa, Ontario (Canada); Medical Physics, BC Cancer Agency-Vancouver Centre, Vancouver, British Columbia (Canada)

    2007-05-15

    This paper is the first investigation of using direct aperture optimization (DAO) for online adaptive radiation therapy (ART). A geometrical model representing the anatomy of a typical prostate case was created. To simulate interfractional deformations, four different anatomical deformations were created by systematically deforming the original anatomy by various amounts (0.25, 0.50, 0.75, and 1.00 cm). We describe a series of techniques where the original treatment plan was adapted in order to correct for the deterioration of dose distribution quality caused by the anatomical deformations. We found that the average time needed to adapt the original plan to arrive at a clinically acceptable plan is roughly half of the time needed for a complete plan regeneration, for all four anatomical deformations. Furthermore, through modification of the DAO algorithm the optimization search space was reduced and the plan adaptation was significantly accelerated. For the first anatomical deformation (0.25 cm), the plan adaptation was six times more efficient than the complete plan regeneration. For the 0.50 and 0.75 cm deformations, the optimization efficiency was increased by a factor of roughly 3 compared to the complete plan regeneration. However, for the anatomical deformation of 1.00 cm, the reduction of the optimization search space during plan adaptation did not result in any efficiency improvement over the original (nonmodified) plan adaptation. The anatomical deformation of 1.00 cm demonstrates the limit of this approach. We propose an innovative approach to online ART in which the plan adaptation and radiation delivery are merged together and performed concurrently--adaptive radiation delivery (ARD). A fundamental advantage of ARD is the fact that radiation delivery can start almost immediately after image acquisition and evaluation. Most of the original plan adaptation is done during the radiation delivery, so the time spent adapting the original plan does not increase the overall time the patient has to spend on the treatment couch. As a consequence, the effective time allotted for plan adaptation is drastically reduced. For the 0.25, 0.5, and 0.75 cm anatomical deformations, the treatment time was increased by only 2, 4, and 6 s, respectively, as compared to no plan adaptation. For the anatomical deformation of 1.0 cm the time increase was substantially larger. The anatomical deformation of 1.0 cm represents an extreme case, which is rarely observed for the prostate, and again demonstrates the limit of this approach. ARD shows great potential for an online adaptive method with minimal extension of treatment time.

  10. Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy

    SciTech Connect

    Epstein, J.B.; Stevenson-Moore, P.

    1986-08-01

    Benzydamine hydrochloride rinse reduced pain associated with radiation mucositis when it was used during the course of radiation therapy. Fewer patients using benzydamine rinse required systemic analgesics. All patients using benzydamine tolerated the rinse well and continued with regular rinsing throughout the course of radiation therapy. Benzydamine hydrochloride is currently undergoing clinical trials in the United States for application for approval from the Food and Drug Administration.

  11. A Case of Bladder Cancer after Radiation Therapy for Prostate Cancer

    PubMed Central

    Kaburaki, Naoto; Kosaka, Takeo; Yazawa, Satoshi; Oya, Mototsugu

    2014-01-01

    An 86-year-old male who presented with the chief complaint of clot retention and had a history of prostate cancer treated with external beam radiation therapy 11 years previously is described. Cystoscopy revealed radiation cystitis in coexistence with bladder cancer. Since bladder cancer may be present in patients with macroscopic hematuria who have a history of radiation therapy, referral to an urologist is recommended. PMID:24803918

  12. Ostial stenosis of the left main coronary artery in a young woman 10 years after radiation therapy.

    PubMed

    Orzan, F; Bellis, D; Mollo, F; Brusca, A

    1995-01-01

    A 26-year-old woman developed critical stenosis of the left main coronary artery 10 years after radiation treatment for Hodgkins disease. She was operated on but died in the immediate postoperative period. At autopsy the pathological findings were indistinguishable from those described in "typical" atherosclerotic plaques. PMID:25850782

  13. 286. Therapeutic Approach Using External Radiation and Suicide Gene Therapy Transduced by Chimeric Adenovirus Vector for Bladder Cancer

    Microsoft Academic Search

    Kazumasa Matsumoto; Norihiko Okuno; Bin S. Teh; Christian T. F. Freund; Julie X. Zhu; Maria T. Vlachaki; Alan R. Davis; Brian E. Butler; Seth P. Lerner

    2005-01-01

    Background: Radiation therapy is an established therapy for advanced bladder cancer. Interestingly, radiation therapy has been shown to improve both transduction efficiency and transgene expression. However, alteration of the coxsackie and adenovirus receptor (CAR) poses a barrier to adenovirus-mediated gene therapy, particularly in higher grade and stage bladder cancers with potential for metastasis. We have previously shown the efficacy of

  14. Assessment of secondary radiation and radiation protection in laser-driven proton therapy.

    PubMed

    Faby, Sebastian; Wilkens, Jan J

    2015-06-01

    This work is a feasibility study of a radiation treatment unit with laser-driven protons based on a state-of-the-art energy selection system employing four dipole magnets in a compact shielded beamline. The secondary radiation emitted from the beamline and its energy selection system and the resulting effective dose to the patient are assessed. Further, it is evaluated whether or not such a compact system could be operated in a conventional treatment vault for clinical linear accelerators under the constraint of not exceeding the effective dose limit of 1 mSv per year to the general public outside the treatment room. The Monte Carlo code Geant4 is employed to simulate the secondary radiation generated while irradiating a hypothetical tumor. The secondary radiation inevitably generated inside the patient is taken into account as well, serving as a lower limit. The results show that the secondary radiation emanating from the shielded compact therapy system would pose a serious secondary dose contamination to the patient. This is due to the broad energy spectrum and in particular the angular distribution of the laser-driven protons, which make the investigated beamline together with the employed energy selection system quite inefficient. The secondary radiation also cannot be sufficiently absorbed in a conventional linear accelerator treatment vault to enable a clinical operation. A promising result, however, is the fact that the secondary radiation generated in the patient alone could be very well shielded by a regular treatment vault, allowing the application of more than 100 fractions of 2Gy per day with protons. It is thus theoretically possible to treat patients with protons in such treatment vaults. Nevertheless, the results show that there is a clear need for alternative more efficient energy selection solutions for laser-driven protons. PMID:25267383

  15. A toolbox for intensity modulated radiation therapy optimization D. M. Shepard, Z. Jiang, and M. A. Earl

    E-print Network

    Ferris, Michael C.

    A toolbox for intensity modulated radiation therapy optimization D. M. Shepard, Z. Jiang, and M. A techniques and formulations for intensity modulated radiation therapy and 3D conformal radiotherapy. © 2003, pencil beam, toolbox I. INTRODUCTION For both intensity modulated radiation therapy IMRT and three

  16. Synchrotron microbeam radiation therapy for rat brain tumor palliation--influence of the microbeam width at constant valley dose

    E-print Network

    Synchrotron microbeam radiation therapy for rat brain tumor palliation--influence of the microbeam. Biol. 54 (2009) 6711­6724 doi:10.1088/0031-9155/54/21/017 Synchrotron microbeam radiation therapy tissues in normal rats after microbeam radiation therapy (MRT), 9L gliosarcomas implanted in rat brains

  17. Hypofractionated Radiation Therapy for Breast Ductal Carcinoma In Situ

    SciTech Connect

    Hathout, Lara [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l'Université de Montréal, Montreal, Quebec (Canada); Hijal, Tarek [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Théberge, Valérie [Department of Radiation Oncology, Centre hospitalier universitaire de Québec, L'Hôtel-Dieu de Québec, Quebec (Canada); Centre des maladies du sein Deschênes-Fabia, Quebec (Canada); Fortin, Bernard [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l'Université de Montréal, Montreal, Quebec (Canada); Vulpe, Horia [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Hogue, Jean-Charles [Centre des maladies du sein Deschênes-Fabia, Quebec (Canada); Centre hospitalier universitaire de Québec, Hôpital St-Sacrement, Quebec (Canada); Lambert, Christine [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Bahig, Houda [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l'Université de Montréal, Montreal, Quebec (Canada); and others

    2013-12-01

    Purpose: Conventional radiation therapy (RT) administered in 25 fractions after breast-conserving surgery (BCS) is the standard treatment for ductal carcinoma in situ (DCIS) of the breast. Although accelerated hypofractionated regimens in 16 fractions have been shown to be equivalent to conventional RT for invasive breast cancer, few studies have reported results of using hypofractionated RT in DCIS. Methods and Materials: In this multicenter collaborative effort, we retrospectively reviewed the records of all women with DCIS at 3 institutions treated with BCS followed by hypofractionated whole-breast RT (WBRT) delivered in 16 fractions. Results: Between 2003 and 2010, 440 patients with DCIS underwent BCS followed by hypofractionated WBRT in 16 fractions for a total dose of 42.5 Gy (2.66 Gy per fraction). Boost RT to the surgical bed was given to 125 patients (28%) at a median dose of 10 Gy in 4 fractions (2.5 Gy per fraction). After a median follow-up time of 4.4 years, 14 patients had an ipsilateral local relapse, resulting in a local recurrence-free survival of 97% at 5 years. Positive surgical margins, high nuclear grade, age less than 50 years, and a premenopausal status were all statistically associated with an increased occurrence of local recurrence. Tumor hormone receptor status, use of adjuvant hormonal therapy, and administration of additional boost RT did not have an impact on local control in our cohort. On multivariate analysis, positive margins, premenopausal status, and nuclear grade 3 tumors had a statistically significant worse local control rate. Conclusions: Hypofractionated RT using 42.5 Gy in 16 fractions provides excellent local control for patients with DCIS undergoing BCS.

  18. Rat liver tolerance for partial resection and intraoperative radiation therapy: Regeneration is radiation dose dependent

    SciTech Connect

    Bossola, M.; Merrick, H.W.; Eltaki, A.; Bellantone, R.; Milligan, A.J.; Doglietto, G.B.; Conran, P.; Dobelbower, R.R. Jr.; Crucitti, F. (Universita Cattolica del S. Cuore, Rome (Italy))

    1990-11-01

    We studied the feasibility of delivering a large single dose of intraoperative radiation as an adjuvant to partial hepatic resection. Intraoperative radiation therapy (IORT) was delivered to the remaining liver of 84 rats after partial hepatectomy to determine the acute and chronic effects of treatment on blood chemistry values, histology, survival, hepatic regeneration, and cellular appearance of the normal liver. Transient elevations in SGOT, SGPT, and alkaline phosphatase were attributed both to hepatectomy and to liver parenchymal damage induced by IORT. Microscopic examination upon necropsy, performed at frequent intervals post-treatment revealed hepatic capsular thickening with some alteration of liver architecture mainly underneath the capsule, with localized inflammation and some areas of necrosis. Survival in all groups was 100% at 45 days. Liver weight increase proved to be dose-dependent and displayed a bisphasic pattern. This study demonstrated that IORT is a feasible adjunct to surgical resection of the liver in the rat model.

  19. A white-beam fast-shutter for microbeam radiation therapy at the ESRF

    Microsoft Academic Search

    M. Renier; T. Brochard; C. Nemoz; W. Thomlinson

    2002-01-01

    The ID17 Medical Beamline port at the European Synchrotron Radiation Facility (ESRF) delivers white beam generated by a 1.4T wiggler. It is devoted to medical applications of synchrotron radiation. One major program of the beamline is called Microbeam Radiation Therapy (MRT). In this radiotherapy technique, still under development, the white beam fan is divided into several microbeams before reaching the

  20. A practical three-dimensional dosimetry system for radiation therapy

    SciTech Connect

    Guo Pengyi; Adamovics, John; Oldham, Mark [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States); Department of Chemistry and Biology, Rider University, Lawrenceville, New Jersey 08648 (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2006-10-15

    There is a pressing need for a practical three-dimensional (3D) dosimetry system, convenient for clinical use, and with the accuracy and resolution to enable comprehensive verification of the complex dose distributions typical of modern radiation therapy. Here we introduce a dosimetry system that can achieve this challenge, consisting of a radiochromic dosimeter (PRESAGE trade mark sign ) and a commercial optical computed tomography (CT) scanning system (OCTOPUS trade mark sign ). PRESAGE trade mark sign is a transparent material with compelling properties for dosimetry, including insensitivity of the dose response to atmospheric exposure, a solid texture negating the need for an external container (reducing edge effects), and amenability to accurate optical CT scanning due to radiochromic optical contrast as opposed to light-scattering contrast. An evaluation of the performance and viability of the PRESAGE trade mark sign /OCTOPUS, combination for routine clinical 3D dosimetry is presented. The performance of the two components (scanner and dosimeter) was investigated separately prior to full system test. The optical CT scanner has a spatial resolution of {<=}1 mm, geometric accuracy within 1 mm, and high reconstruction linearity (with a R{sup 2} value of 0.9979 and a standard error of estimation of {approx}1%) relative to independent measurement. The overall performance of the PRESAGE trade mark sign /OCTOPUS system was evaluated with respect to a simple known 3D dose distribution, by comparison with GAFCHROMIC[reg] EBT film and the calculated dose from a commissioned planning system. The 'measured' dose distribution in a cylindrical PRESAGE trade mark sign dosimeter (16 cm diameter and 11 cm height) was determined by optical-CT, using a filtered backprojection reconstruction algorithm. A three-way Gamma map comparison (4% dose difference and 4 mm distance to agreement), between the PRESAGE trade mark sign , EBT and calculated dose distributions, showed full agreement in measurable region of PRESAGE trade mark sign dosimeter ({approx}90% of radius). The EBT and PRESAGE trade mark sign distributions agreed more closely with each other than with the calculated plan, consistent with penumbral blurring in the planning data which was acquired with an ion chamber. In summary, our results support the conclusion that the PRESAGE trade mark sign optical-CT combination represents a significant step forward in 3D dosimetry, and provides a robust, clinically effective and viable high-resolution relative 3D dosimetry system for radiation therapy.

  1. Aortic Arch Plaques and Risk of Recurrent Stroke and Death

    PubMed Central

    Di Tullio, Marco R.; Russo, Cesare; Jin, Zhezhen; Sacco, Ralph L.; Mohr, J.P.; Homma, Shunichi

    2010-01-01

    Background Aortic arch plaques are a risk factor for ischemic stroke. Although the stroke mechanism is conceivably thromboembolic, no randomized studies have evaluated the efficacy of antithrombotic therapies in preventing recurrent events. Methods and Results The relationship between arch plaques and recurrent events was studied in 516 patients with ischemic stroke, double–blindly randomized to treatment with warfarin or aspirin as part of the Patent Foramen Ovale in Cryptogenic Stroke Study (PICSS), based on the Warfarin-Aspirin Recurrent Stroke Study (WARSS). Plaque thickness and morphology was evaluated by transesophageal echocardiography. End-points were recurrent ischemic stroke or death over a 2-year follow-up. Large plaques (?4mm) were present in 19.6% of patients, large complex plaques (those with ulcerations or mobile components) in 8.5 %. During follow-up, large plaques were associated with a significantly increased risk of events (adjusted Hazard Ratio 2.12, 95% Confidence Interval 1.04-4.32), especially those with complex morphology (HR 2.55, CI 1.10-5.89). The risk was highest among cryptogenic stroke patients, both for large plaques (HR 6.42, CI 1.62-25.46) and large-complex plaques (HR 9.50, CI 1.92-47.10). Event rates were similar in the warfarin and aspirin groups in the overall study population (16.4% vs. 15.8%; p=0.43). Conclusions In patients with stroke, and especially cryptogenic stroke, large aortic plaques remain associated with an increased risk of recurrent stroke and death at two years despite treatment with warfarin or aspirin. Complex plaque morphology confers a slight additional increase in risk. PMID:19380621

  2. Biochemical Response to Androgen Deprivation Therapy Before External Beam Radiation Therapy Predicts Long-term Prostate Cancer Survival Outcomes

    SciTech Connect

    Zelefsky, Michael J., E-mail: zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gomez, Daniel R.; Polkinghorn, William R.; Pei, Xin; Kollmeier, Marisa [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)] [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-07-01

    Purpose: To determine whether the response to neoadjuvant androgen deprivation therapy (ADT) defined by a decline in prostate-specific antigen (PSA) to nadir values is associated with improved survival outcomes after external beam radiation therapy (EBRT) for prostate cancer. Methods and Materials: One thousand forty-five patients with localized prostate cancer were treated with definitive EBRT in conjunction with neoadjuvant and concurrent ADT. A 6-month course of ADT was used (3 months during the neoadjuvant phase and 2 to 3 months concurrently with EBRT). The median EBRT prescription dose was 81 Gy using a conformal-based technique. The median follow-up time was 8.5 years. Results: The 10-year PSA relapse-free survival outcome among patients with pre-radiation therapy PSA nadirs of ?0.3 ng/mL was 74.3%, compared with 57.7% for patients with higher PSA nadir values (P<.001). The 10-year distant metastases-free survival outcome among patients with pre-radiation therapy PSA nadirs of ?0.3 ng/mL was 86.1%, compared with 78.6% for patients with higher PSA nadir values (P=.004). In a competing-risk analysis, prostate cancer-related deaths were also significantly reduced among patients with pre-radiation therapy PSA nadirs of <0.3 ng/mL compared with higher values (7.8% compared with 13.7%; P=.009). Multivariable analysis demonstrated that the pre-EBRT PSA nadir value was a significant predictor of long-term biochemical tumor control, distant metastases-free survival, and cause-specific survival outcomes. Conclusions: Pre-radiation therapy nadir PSA values of ?0.3 ng/mL after neoadjuvant ADT were associated with improved long-term biochemical tumor control, reduction in distant metastases, and prostate cancer-related death. Patients with higher nadir values may require alternative adjuvant therapies to improve outcomes.

  3. Hematopoietic toxicity of regional radiation therapy. Correlations for combined modality therapy with systemic chemotherapy

    SciTech Connect

    Abrams, R.A.; Lichter, A.S.; Bromer, R.H.; Minna, J.D.; Cohen, M.H.; Deisseroth, A.B.

    1985-04-01

    Using circulating granulocyte-monocyte precursor colony-forming units in culture (CFUc) numbers as a probe along with standard blood count (CBC), the authors have quantitatively examined the hematopoietic toxicity of conventionally fractionated radiation therapy (RT) when combined with concurrent systemic chemotherapy or when used alone. Among 20 patients with limited stage small cell lung cancer receiving systemic chemotherapy with cyclophosphamide, CCNU, and methotrexate, the addition of involved field chest RT resulted in increased hematopoietic toxicity as judged by increased need for platelet transfusion (P less than 0.05) and decreased frequency of measurable CFUc (P less than 0.04). Among 22 patients receiving regional radiotherapy alone consistent hematopoietic toxicity was also observed. This toxicity, although generally of only mild to moderate clinical significance, was detected earlier and to a greater degree in patients who required radiation to larger treatment volumes, who had significant amounts of bone marrow in the port, and who had a high percentage of cardiac output flowing through the port. These data suggest that the hematopoietic toxicity of regional radiotherapy may be additive to that of concurrent systemic chemotherapy and may occur more promptly and to a greater degree when treatment volumes are larger or incorporate increased amounts of marrow volume or cardiac output.

  4. The role of total skin electron beam radiation therapy in the management of mycosis fungoides.

    PubMed

    Strohl, R A

    1994-06-01

    Total skin electron therapy is a complex method of delivering superficial radiation therapy to the entire skin surface. It is an effective means of treating cutaneous malignancies which involve large surface areas of the skin. Mycosis fungoides is the most common malignancy treated in this manner. Understanding the rational and technique of total skin electron beam therapy, the characteristics of mycosis fungoides, and nursing interventions for related patient problems will enable dermatology nurses to better educate patients afflicted with MF who may be undergoing or considering radiation therapy. PMID:7946838

  5. Accuracy of Real-time Couch Tracking During 3-dimensional Conformal Radiation Therapy, Intensity Modulated Radiation Therapy, and Volumetric Modulated Arc Therapy for Prostate Cancer

    SciTech Connect

    Wilbert, Juergen; Baier, Kurt [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany)] [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany); Hermann, Christian [Department of Computer Sciences VII, Robotics, and Telematics, University of Wuerzburg, Wuerzburg (Germany)] [Department of Computer Sciences VII, Robotics, and Telematics, University of Wuerzburg, Wuerzburg (Germany); Flentje, Michael [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany)] [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany); Guckenberger, Matthias, E-mail: guckenberger_m@klinik.uni-wuerzburg.de [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany)] [Department of Radiation Oncology, University of Wuerzburg, Wuerzburg (Germany)

    2013-01-01

    Purpose: To evaluate the accuracy of real-time couch tracking for prostate cancer. Methods and Materials: Intrafractional motion trajectories of 15 prostate cancer patients were the basis for this phantom study; prostate motion had been monitored with the Calypso System. An industrial robot moved a phantom along these trajectories, motion was detected via an infrared camera system, and the robotic HexaPOD couch was used for real-time counter-steering. Residual phantom motion during real-time tracking was measured with the infrared camera system. Film dosimetry was performed during delivery of 3-dimensional conformal radiation therapy (3D-CRT), step-and-shoot intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). Results: Motion of the prostate was largest in the anterior-posterior direction, with systematic ( N-Ary-Summation ) and random ({sigma}) errors of 2.3 mm and 2.9 mm, respectively; the prostate was outside a threshold of 5 mm (3D vector) for 25.0%{+-}19.8% of treatment time. Real-time tracking reduced prostate motion to N-Ary-Summation =0.01 mm and {sigma} = 0.55 mm in the anterior-posterior direction; the prostate remained within a 1-mm and 5-mm threshold for 93.9%{+-}4.6% and 99.7%{+-}0.4% of the time, respectively. Without real-time tracking, pass rates based on a {gamma} index of 2%/2 mm in film dosimetry ranged between 66% and 72% for 3D-CRT, IMRT, and VMAT, on average. Real-time tracking increased pass rates to minimum 98% on average for 3D-CRT, IMRT, and VMAT. Conclusions: Real-time couch tracking resulted in submillimeter accuracy for prostate cancer, which transferred into high dosimetric accuracy independently of whether 3D-CRT, IMRT, or VMAT was used.

  6. Patterns of clinical care in radiation therapy in the United States

    SciTech Connect

    Kramer, S.

    1984-06-01

    Results of the first nationwide evaluation of radiation therapy in the United States with respect to its quality and accessibility are presented. The Patterns of Care Study (PCS) is financially supported by the National Cancer Institute and has served as a model for other oncology-related disciplines. The PCS has determined criteria by which to evaluate radiation therapy care in 10 disease sites in which curative radiation therapy plays a major role. The sampling design identified the institution to be surveyed and included all types of practice in the U.S. This paper examines results related to carcinomas of the cervix, larynx and prostate.

  7. Radiation Therapy Is Associated With Improved Survival in the Adjuvant and Definitive Treatment of Intrahepatic Cholangiocarcinoma

    SciTech Connect

    Shinohara, Eric T. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)], E-mail: Shinohara@xrt.upenn.edu; Mitra, Nandita; Guo Mengye [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA (United States); Metz, James M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2008-12-01

    Purpose: Intrahepatic cholangiocarcinomas (IHC) are rare tumors for which large randomized studies regarding the use of radiation are not available. The purpose of this study was to examine the role of adjuvant and definitive radiation therapy in the treatment of IHC in a large group of patients. Methods and Materials: This is a retrospective analysis of 3,839 patients with IHC collected from the Surveillance, Epidemiology, and End Results (SEER) database. The primary endpoint was overall survival (OS). Results: Patients received either surgery alone (25%), radiation therapy alone (10%), surgery and adjuvant radiation therapy (7%) or no treatment (58%). The median age of the patient population was 73 years (range, 22-102 years); 52% of patients were male and 81% were Caucasian. Median OS was 11 (95% confidence interval [CI], 9-13), 6 (95% CI, 5-6), 7 (95% CI, 6-8), and 3 months for surgery and adjuvant radiation therapy, sugery alone, radiation therapy alone, and no treatment, respectively. The OS was significantly different between surgery alone and surgery and adjuvant radiation therapy (p = 0.014) and radiation therapy alone and no treatment (p < 0.0001). Use of surgery and adjuvant radiation therapy conferred the greatest benefit on OS (HR = 0.40; 95% CI, 0.34-0.47), followed by surgery alone (hazard ratio [HR], 0.49; 95% CI, 0.44-0.54) and radiation therapy alone (HR, 0.68; 95% CI, 0.59-0.77) compared with no treatment, on multivariate analysis. Propensity score adjusted hazard ratios (controlling for age, race/ethnicity, stage, and year of diagnosis) were also significant (surgery and adjuvant radiation therapy vs. surgery alone (HR, 0.82; 95% CI, 0.70-0.96); radiation therapy alone vs. no treatment (HR, 0.67; 95% CI, 0.58-0.76)). Conclusions: The study results suggest that adjuvant and definitive radiation treatment prolong survival, although cure rates remain low. Future studies should evaluate the addition of chemotherapy and biologics to the treatment of IHC.

  8. Intensity-Modulated Radiation Therapy in Childhood Ependymoma

    SciTech Connect

    Schroeder, Thomas M. [Department of Radiation Oncology, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM (United States); Chintagumpala, Murali; Okcu, M. Fatih [Division of Pediatric Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Division of Pediatric Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Houston, TX (United States); Chiu, J. Kam; Teh, Bin S. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Division of Radiation Oncology, Department of Radiology, Baylor College of Medicine, Houston, TX (United States); Woo, Shiao Y. [Department of Radiation Oncology, M.D. Anderson Cancer Center, Houston, TX (United States); Paulino, Arnold C. [Department of Radiation Oncology, Methodist Hospital, Houston, TX (United States); Division of Radiation Oncology, Department of Radiology, Baylor College of Medicine, Houston, TX (United States)], E-mail: apaulino@tmhs.org

    2008-07-15

    Purpose: To determine the patterns of failure after intensity-modulated radiation therapy (IMRT) for localized intracranial ependymoma. Methods and Materials: From 1994 to 2005, 22 children with pathologically proven, localized, intracranial ependymoma were treated with adjuvant IMRT. Of the patients, 12 (55%) had an infratentorial tumor and 14 (64%) had anaplastic histology. Five patients had a subtotal resection (STR), as evidenced by postoperative magnetic resonance imaging. The clinical target volume encompassed the tumor bed and any residual disease plus margin (median dose 54 Gy). Median follow-up for surviving patients was 39.8 months. Results: The 3-year overall survival rate was 87% {+-} 9%. The 3-year local control rate was 68% {+-} 12%. There were six local recurrences, all in the high-dose region of the treatment field. Median time to recurrence was 21.7 months. Of the 5 STR patients, 4 experienced recurrence and 3 died. Patients with a gross total resection had significantly better local control (p = 0.024) and overall survival (p = 0.008) than those with an STR. At last follow-up, no patient had developed visual loss, brain necrosis, myelitis, or a second malignancy. Conclusions: Treatment with IMRT provides local control and survival rates comparable with those in historic publications using larger treatment volumes. All failures were within the high-dose region, suggesting that IMRT does not diminish local control. The degree of surgical resection was shown to be significant for local control and survival.

  9. Radiant{trademark} Liquid Radioisotope Intravascular Radiation Therapy System

    SciTech Connect

    Eigler, N.; Whiting, J.; Chernomorsky, A.; Jackson, J.; Knapp, F.F., Jr.; Litvack, F.

    1998-01-16

    RADIANT{trademark} is manufactured by United States Surgical Corporation, Vascular Therapies Division, (formerly Progressive Angioplasty Systems). The system comprises a liquid {beta}-radiation source, a shielded isolation/transfer device (ISAT), modified over-the-wire or rapid exchange delivery balloons, and accessory kits. The liquid {beta}-source is Rhenium-188 in the form of sodium perrhenate (NaReO{sub 4}), Rhenium-188 is primarily a {beta}-emitter with a physical half-life of 17.0 hours. The maximum energy of the {beta}-particles is 2.1 MeV. The source is produced daily in the nuclear pharmacy hot lab by eluting a Tungsten-188/Rhenium-188 generator manufactured by Oak Ridge National Laboratory (ORNL). Using anion exchange columns and Millipore filters the effluent is concentrated to approximately 100 mCi/ml, calibrated, and loaded into the (ISAT) which is subsequently transported to the cardiac catheterization laboratory. The delivery catheters are modified Champion{trademark} over-the-wire, and TNT{trademark} rapid exchange stent delivery balloons. These balloons have thickened polyethylene walls to augment puncture resistance; dual radio-opaque markers and specially configured connectors.

  10. Objective Assessment of Image Quality VI: Imaging in Radiation Therapy

    PubMed Central

    Barrett, Harrison H.; Kupinski, Matthew A.; Müeller, Stefan; Halpern, Howard J.; Morris, John C.; Dwyer, Roisin

    2015-01-01

    Earlier work on Objective Assessment of Image Quality (OAIQ) focused largely on estimation or classification tasks in which the desired outcome of imaging is accurate diagnosis. This paper develops a general framework for assessing imaging quality on the basis of therapeutic outcomes rather than diagnostic performance. By analogy to Receiver Operating Characteristic (ROC) curves and their variants as used in diagnostic OAIQ, the method proposed here utilizes the Therapy Operating Characteristic or TOC curves, which are plots of the probability of tumor control vs. the probability of normal-tissue complications as the overall dose level of a radiotherapy treatment is varied. The proposed figure of merit is the area under the TOC curve, denoted AUTOC. This paper reviews an earlier exposition of the theory of TOC and AUTOC, which was specific to the assessment of image-segmentation algorithms, and extends it to other applications of imaging in external-beam radiation treatment as well as in treatment with internal radioactive sources. For each application, a methodology for computing the TOC is presented. A key difference between ROC and TOC is that the latter can be defined for a single patient rather than a population of patients. PMID:24200954

  11. Deformation field validation and inversion applied to adaptive radiation therapy

    NASA Astrophysics Data System (ADS)

    Vercauteren, Tom; De Gersem, Werner; Olteanu, Luiza A. M.; Madani, Indira; Duprez, Fréderic; Berwouts, Dieter; Speleers, Bruno; De Neve, Wilfried

    2013-08-01

    Development and implementation of chronological and anti-chronological adaptive dose accumulation strategies in adaptive intensity-modulated radiation therapy (IMRT) for head-and-neck cancer. An algorithm based on Newton iterations was implemented to efficiently compute inverse deformation fields (DFs). Four verification steps were performed to ensure a valid dose propagation: intra-cell folding detection finds zero or negative Jacobian determinants in the input DF; inter-cell folding detection is implemented on the resolution of the output DF; a region growing algorithm detects undefined values in the output DF; DF domains can be composed and displayed on the CT data. In 2011, one patient with nonmetastatic head and neck cancer selected from a three phase adaptive DPBN study was used to illustrate the algorithms implemented for adaptive chronological and anti-chronological dose accumulation. The patient received three 18F-FDG-PET/CTs prior to each treatment phase and one CT after finalizing treatment. Contour propagation and DF generation between two consecutive CTs was performed in Atlas-based autosegmentation (ABAS). Deformable image registration based dose accumulations were performed on CT1 and CT4. Dose propagation was done using combinations of DFs or their inversions. We have implemented a chronological and anti-chronological dose accumulation algorithm based on DF inversion. Algorithms were designed and implemented to detect cell folding.

  12. High resolution optical calorimetry for synchrotron microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Ackerly, T.; Crosbie, J. C.; Fouras, A.; Sheard, G. J.; Higgins, S.; Lewis, R. A.

    2011-03-01

    We propose the application of optical calorimetry to measure the peak to valley ratio for synchrotron microbeam radiation therapy (MRT). We use a modified Schlieren approach known as reference image topography (RIT) which enables one to obtain a map of the rate of change of the refractive index in a water bath from which the absorbed dose can be determined with sufficient spatial accuracy to determine the peak to valley ratio. We modelled the calorimetric properties of X-rays using a heated wire in a water bath. Our RIT system comprised a light source, a textured reference object and a camera and lens combination. We measured temperature contours and showed a plume rising from the heated wire. The total temperature change in water was 12 degrees C, 500 times greater than the calculated change from a 1 ms exposure on a synchrotron. At 1.0 ms, thermal diffusion will be the major cause of uncertainty in determining the peak to valley ratio, and we calculate thermal diffusion will reduce the measured peak to valley ratio to 76% of its initial value, but the individual microbeams will still resolve. We demonstrate proof of concept for measuring X-ray dose using a modified RIT method.

  13. The renaissance in basic cellular radiobiology and its significance for radiation therapy

    SciTech Connect

    Lett, J.T. [Colorado State Univ., Fort Collins, CO (United States)

    1994-12-31

    Cellular radiobiology is undergoing a renaissance. The renaissance provides the impetus for change in the content of graduate courses in basic cellular radiobiology, and especially those designed for residents in radiation therapy. Emphasis on radiation physics should be reduced to a bare minimum; emphasis on the roles of biochemistry, chemistry, molecular biology, molecular genetics, and so forth in the cellular radiation response must be accentuated. Improvements in radiation therapy should follow a major shift in research emphasis to the identification of enzymes involved in cellular recovery. Theoretically, it is possible to change a survival curve by modulating or inhibiting the enzymatic processes involved in the amelioration of radiation damage to DNA. Split-dose recovery at the cellular level would be eliminated. Effective clinical utilization of specific enzyme inhibitors would increase the fiscal and logistic advantages of `conventional` therapy with sparsely ionizing radiations. 59 refs., 10 figs., 1 tab.

  14. Optimization and quality assurance of an image-guided radiation therapy system for intensity-modulated radiation therapy radiotherapy

    SciTech Connect

    Tsai, Jen-San, E-mail: jen-san.tsai@verizon.net [Department of Radiation Oncology, Temple University Hospital, Philadelphia, PA (United States); Micaily, Bizhan; Miyamoto, Curtis [Department of Radiation Oncology, Temple University Hospital, Philadelphia, PA (United States)

    2012-10-01

    To develop a quality assurance (QA) of XVI cone beam system (XVIcbs) for its optimal imaging-guided radiotherapy (IGRT) implementation, and to construe prostate tumor margin required for intensity-modulated radiation therapy (IMRT) if IGRT is unavailable. XVIcbs spatial accuracy was explored with a humanoid phantom; isodose conformity to lesion target with a rice phantom housing a soap as target; image resolution with a diagnostic phantom; and exposure validation with a Radcal ion chamber. To optimize XVIcbs, rotation flexmap on coincidency between gantry rotational axis and that of XVI cone beam scan was investigated. Theoretic correlation to image quality of XVIcbs rotational axis stability was elaborately studied. Comprehensive QA of IGRT using XVIcbs has initially been explored and then implemented on our general IMRT treatments, and on special IMRT radiotherapies such as head and neck (H and N), stereotactic radiation therapy (SRT), stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). Fifteen examples of prostate setup accounted for 350 IGRT cone beam system were analyzed. IGRT accuracy results were in agreement {+-} 1 mm. Flexmap 0.25 mm met the manufacturer's specification. Films confirmed isodose coincidence with target (soap) via XVIcbs, otherwise not. Superficial doses were measured from 7.2-2.5 cGy for anatomic diameters 15-33 cm, respectively. Image quality was susceptible to rotational stability or patient movement. IGRT using XVIcbs on general IMRT treatments such as prostate, SRT, SRS, and SBRT for setup accuracy were verified; and subsequently coordinate shifts corrections were recorded. The 350 prostate IGRT coordinate shifts modeled to Gaussian distributions show central peaks deviated off the isocenter by 0.6 {+-} 3.0 mm, 0.5 {+-} 4.5 mm in the X(RL)- and Z(SI)-coordinates, respectively; and 2.0 {+-} 3.0 mm in the Y(AP)-coordinate as a result of belly and bladder capacity variations. Sixty-eight percent of confidence was within {+-} 4.5 mm coordinates shifting. IGRT using XVIcbs is critical to IMRT for prostate and H and N, especially SRT, SRS, and SBRT. To optimize this modality of IGRT, a vigilant QA program is indispensable. Prostate IGRT reveals treatment accuracy as subject to coordinates' adjustments; otherwise a 4.5-mm margin is required to allow for full dose coverage of the clinical target volume, notwithstanding toxicity to normal tissues.

  15. Dose as a function of liver volume and planning target volume in helical tomotherapy, intensity-modulated radiation therapy–based stereotactic body radiation therapy for hepatic metastasis

    Microsoft Academic Search

    Joseph M. Baisden; Andrew G. Reish; Ke Sheng; James M. Larner; Brian D. Kavanagh; Paul W.. Read

    2006-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been shown to be an effective, well-tolerated treatment for local control of tumors metastatic to the liver. Multi-institutional Phase II trials are examining 60 Gy in 3 fractions delivered by linac-based, 3D-conformal IMRT. HiArt Helical TomoTherapy is a treatment unit that delivers co-planar helical IMRT that is capable of image-guided SBRT. We hypothesized

  16. Bone marrow endothelial progenitors in atherosclerotic plaque resolution

    PubMed Central

    Yao, Longbiao; Heuser-Baker, Janet; Herlea-Pana, Oana; Barlic-Dicen, Jana

    2013-01-01

    Atherosclerosis is a major cause of morbidity and mortality in the United States. Persistently elevated circulating low-density lipoprotein, or hypercholesterolemia, and deposition of low-density lipoprotein in the vascular wall are the main inducers of atherosclerosis, which manifests itself as arterial lesions or plaques. Some plaques become thrombosis-prone and rupture, causing acute myocardial infarction or stroke. Lowering plasma cholesterol through the use of statins is the primary intervention against atherosclerosis. Treatment with statins slows progression of atherosclerosis but can only support limited plaque regression. Partially regressed plaques continue to pose a serious threat due to their remaining potential to rupture. Thus, new interventions inducing complete reversal of atherosclerosis are being sought. Implementation of new therapies will require clear understanding of the mechanisms driving plaque resolution. In this Commentary, we highlight the role of bone marrow endothelial progenitors in atherosclerotic plaque regression and discuss how regenerative cell-based interventions could be used in combination with plasma lipid-lowering to induce plaque reversal in order to prevent and/or reduce adverse cardiovascular events. PMID:23538778

  17. Outcomes of Pediatric Low-grade Gliomas Treated With Radiation Therapy: A Single-institution Study

    PubMed Central

    Raikar, Sunil S.; Halloran, Donna R.; Elliot, Michael; McHugh, Michele; Patel, Shaun; Gauvain, Karen M.

    2014-01-01

    Summary Radiation therapy is often considered the treatment of choice for low-grade gliomas. However, given the long-term effects of radiation on the developing brain, the appropriate use of radiation therapy in pediatric patients remains controversial. The purpose of this study was to evaluate progression-free survival (PFS) of pediatric low-grade glioma patients treated with radiation therapy. Data were obtained through a retrospective chart review of patients treated between 1991 and 2008 from a single tertiary care center in the midwest. The study population consisted of 17 patients, of whom 8 (47%) had tumor recurrence after radiation therapy. The median follow-up time was 8.2 years, with a range of 2.3 to 17.2 years. The median age at diagnosis was 5.4 years, and the median age at radiation therapy was 9.4 years. The 3- and the 10-year PFS were 69% ± 11.7% and 46% ± 13.3%, respectively. A significant difference in PFS was seen when comparing brainstem tumors with hypothalamic/optic pathway tumors (P = 0.019). Differences in PFS based on the age at diagnosis, the extent of initial surgery, and indication for radiation therapy were not significant. A larger multicenter study is needed to better assess PFS in these patients. PMID:24714505

  18. Complete response to radiation therapy in a patient with chemotherapy-resistant ovarian clear cell adenocarcinoma.

    PubMed

    Takai, N; Utsunomiya, H; Kawano, Y; Nasu, K; Narahara, H; Miyakawa, I

    2002-12-01

    Recurrent ovarian cancer after front-line chemotherapy is incurable. In most institutions, chemotherapy is continued as salvage therapy after primary chemotherapy failure and despite the fact that long-term survival and complete responses are infrequent. Radiation therapy for patients with recurrent ovarian cancer has often been done with palliative intent. A patient with ovarian clear cell adenocarcinoma received irradiation with palliative intent to the whole pelvis after chemotherapy (paclitaxel, carboplatin, and irinotecan) produced no effect. Although she developed a rectovaginal fistula due to cancer invasion during radiation therapy. One year and half after the therapy, she is still alive with no evidence of disease. In an effort to maximize salvage potential and quality of life while minimizing toxicity, selected patients with ovarian cancer should be treated with radiation therapy directed to residual or recurrent sites. PMID:12439556

  19. Optimization of radiation therapy techniques for prostate cancer with prostate-rectum spacers: a systematic review.

    PubMed

    Mok, Gary; Benz, Eileen; Vallee, Jean-Paul; Miralbell, Raymond; Zilli, Thomas

    2014-10-01

    Dose-escalated radiation therapy for localized prostate cancer improves disease control but is also associated with worse rectal toxicity. A spacer placed between the prostate and rectum can be used to displace the anterior rectal wall outside of the high-dose radiation regions and potentially minimize radiation-induced rectal toxicity. This systematic review focuses on the published data regarding the different types of commercially available prostate-rectum spacers. Dosimetric results and preliminary clinical data using prostate-rectum spacers in patients with localized prostate cancer treated by curative radiation therapy are compared and discussed. PMID:25304788

  20. Proteomic analysis of atherosclerotic plaque.

    PubMed

    Porcelli, B; Ciari, I; Felici, C; Pagani, R; Banfi, C; Brioschi, M; Giubbolini, M; de Donato, G; Setacci, C; Terzuoli, L

    2010-05-01

    Proteins play a fundamental role in the formation and progression of plaque, but proteomic analysis of plaque as a whole is difficult, due to its heterogeneous cellular composition and an abundance of plasma proteins. Several approaches to this problem are reported in the literature; they include proteomic analysis of vascular tissues, analysis of proteins released by normal and pathological arterial walls, proteomic analysis of vascular cells and proteomic analysis of blood. In a previous study, we proposed a new strategy for studying of proteome of plaque, which permits to select the proteins exclusive to plaque by the constructing of a reference synthetic gel. In the present work, we matched the spots of the reference synthetic gel with the spots of a pool of carotid plaque, in order to select only spots exclusive to plaque from the 2-dimensional electrophoresis of the pool of plaque. We selected some spots between those exclusive and identified them by mass spectrometry. Some proteins identified are involved in transport, others take part in elimination of toxic radicals, others are metabolic enzymes or structural proteins. This study represents an example of application of the new approach which we have proposed: the reference gel of proteome of plaque permits to select, on every sample of interest, only the spots exclusive to plaque; once selected, spots can be identified by mass spectrometry and, being typical of plaque composition, could represent novel markers of lesions and vascular risk. PMID:20005669

  1. Factors associated with program utilization of radiation therapy treatment for VHA and medicare dually enrolled patients.

    PubMed

    French, Dustin D; Bradham, Douglas D; Campbell, Robert R; Haggstrom, David A; Myers, Laura J; Chumbler, Neale R; Hagan, Michael P

    2012-08-01

    We examine how distance to a Veterans Health Administration (VHA) facility, patient hometown classification (e.g., small rural town), and service-connected disability are associated with veterans' utilization of radiation therapy services across the VHA and Medicare. In 2008, 45,914 dually-enrolled veteran patients received radiation therapy. Over 3-quarters (35,513) of the patients received radiation therapy from the Medicare program. Younger age, male gender, shorter distance to a VHA facility, and VHA priority or disability status increased the odds of utilizing the VHA. However, veterans residing in urban areas were less likely to utilize the VHA. Urban dwelling patients' utilization of Medicare instead of the VHA suggests a complex decision that incorporates geographic access to VHA services, financial implications of veteran priority status, and the potential availability of multiple sources of radiation therapy in competitive urban markets. PMID:22139021

  2. Managing Radiation Therapy Side Effects: What to Do about Changes When You Urinate

    MedlinePLUS

    ... told me about medicine that could help.” About urination changes Radiation therapy can irritate the bladder and ... foods that you may need to avoid. Some things can make these problems worse. Your doctor or ...

  3. Phase II Radiation Therapy Oncology Group trial of conventional radiation therapy followed by treatment with recombinant interferon-{beta} for supratentorial glioblastoma: Results of RTOG 9710

    SciTech Connect

    Colman, Howard [Department of Neuro-Oncology, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States) and Department of Brain Tumor Center, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: hcolman@mdanderson.org; Berkey, Brian A. [Statistics Department, Radiation Therapy Oncology Group Headquarters, Philadelphia, PA (United States); Maor, Moshe H. [Department of Radiation Oncology, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States); Department of Brain Tumor Center, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States); Groves, Morris D. [Department of Neuro-Oncology, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States); Department of Brain Tumor Center, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States); Schultz, Christopher J. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Vermeulen, Sandra [Swedish Cancer Institute-Department of Radiation Oncology/Northwest Hospital Gamma Knife Center, Seattle, WA (United States); Nelson, Diana F. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Mehta, Minesh P. [Department of Human Oncology, University of Wisconsin Medical School, Madison, WI (United States); Yung, W.K. Alfred [Department of Neuro-Oncology, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States); Department of Brain Tumor Center, University of Texas-M.D. Anderson Cancer Center, Houston, TX (United States)

    2006-11-01

    Purpose: The aim of this study was to determine whether recombinant human interferon {beta}-1a (rhIFN-{beta}), when given after radiation therapy, improves survival in glioblastoma. Methods and Materials: After surgery, 109 patients with newly diagnosed supratentorial glioblastoma were enrolled and treated with radiation therapy (60 Gy). A total of 55 patients remained stable after radiation and were treated with rhIFN-{beta} (6 MU/day i.m., 3 times/week). Outcomes were compared with Radiation Therapy Oncology Group glioma historical database. Results: RhIFN-{beta} was well tolerated, with 1 Grade 4 toxicity and 8 other patients experiencing Grade 3 toxicity. Median survival time (MST) of the 55 rhIFN-{beta}-treated patients was 13.4 months. MST for the 34 rhIFN-{beta}-treated in RPA Classes III and IV was 16.9 vs. 12.4 months for historical controls (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 0.89-1.81). There was also a trend toward improved survival across all RPA Classes comparing the 55 rhIFN-{beta} treated patients and 1,658 historical controls (HR = 1.24, 95% CI = 0.94-1.63). The high rate of early failures (54/109) after radiation and before initiation of rhIFN-{beta} was likely caused by stricter interpretation of early radiographic changes in the current study. Matched-pair and intent-to-treat analyses performed to try to address this bias showed no difference in survival between study patients and controls. Conclusion: RhIFN-{beta} given after conventional radiation therapy was well tolerated, with a trend toward survival benefit in patients who remained stable after radiation therapy. These data suggest that rhIFN-{beta} warrants further evaluation in additional studies, possibly in combination with current temozolomide-based regimens.

  4. Sacropelvic resection and intraoperative radiation therapy: feasibility, technical description and early clinical results

    Microsoft Academic Search

    Daniel Vega Menéndez; Felipe A. Calvo Manuel; José Luis García Sabrido; José Ángel López Baena; Luis Rodríguez-Bachiller; Luis González Bayón; Miguel Ángel Lozano

    2001-01-01

    Sarcomas and locally recurrent colorectal carcinomas are disease entities in which sacral resection is an effective alternative\\u000a for meaningful palliation with a limited cure expectation.\\u000a \\u000a To provide local control, pain palliation and a marginal expectation of definitive cure, a multimodality approach including\\u000a external beam radiation therapy, surgical resection, and intraoperative radiation therapy (IORT), has been developed for patients\\u000a with locally

  5. LONG-TERM RESULTS OF RADIATION THERAPY FOR PROSTATE CANCER RECURRENCE FOLLOWING RADICAL PROSTATECTOMY

    Microsoft Academic Search

    Jeffrey A. Cadeddu; Alan W. Partin; Theodore L. DeWeese; Patrick C. Walsh

    1998-01-01

    PurposeFollowing radical prostatectomy, radiation therapy may be beneficial in select patients with isolated local recurrence. Pathological stage, Gleason score and the timing of prostate specific antigen (PSA) elevation are useful in distinguishing men with local recurrence from those with distant metastases. We test the ability of these criteria to predict long-term suppression of PSA recurrence following post-prostatectomy radiation therapy.

  6. Promising survival with three-dimensional conformal radiation therapy for non-small cell lung cancer

    Microsoft Academic Search

    John Armstrong; Adam Raben; Michael Zelefsky; Michael Burt; Steve Leibel; Chandra Burman; Gerard Kutcher; Louis Harrison; Cathy Hahn; Robert Ginsberg; Valerie Rusch; Mark Kris; Zvi Fuks

    1997-01-01

    Purpose: Local failure is a major obstacle to the cure of locally advanced non small-cell lung cancer. Three-dimensional conformal radiation therapy (3-DCRT) selects optimal treatment parameters to increase dose to tumor and reduce normal tissue dose, potentially representing an enhancement of the therapeutic ratio of radiation therapy for lung cancer. We performed this analysis of 45 non-small cell lung cancer

  7. A New Synchrotron Radiotherapy Technique with Future Clinical Potential: Minibeams Radiation Therapy

    Microsoft Academic Search

    Y. Prezado; M. Renier; A. Bravin

    Several synchrotrons around the world are currently developing innovative radiotherapy techniques with the aim of palliating\\u000a and possibly curing human brain tumours. Amongst them the Microbeam Radiation Therapy (MRT) and more recently the Minibeam\\u000a Radiation Therapy (MBRT) showed promising results. In the MBRT, the beam thickness ranges from 500 to 700 micrometers with\\u000a a separation between two adjacent minibeams of

  8. Estimation of isodose curves in radiation therapy and related response analysis

    E-print Network

    Goodlett, James Campbell

    1967-01-01

    ESTIMATION OF ISODOSE CURVES IN RADIATION THERAPY AND RELATED RESPONSE ANALYSIS A Thesis By JAMES CAMPBELL GOODLETT Submitted to the Graduate College oi' the Texas A@M University in partial fulfillment of the requirements for the degree... of MASTER OF SCIENCE May 1967 Major Subject: Statistic s ESTIMATION OF ISODOSE CURVES IN RADIATION THERAPY AND RELATED RESPONSE ANALYSIS A Thesis By JAMES CAMPBELL GOODLETT Approved as and content by: ( airm n of Committee) Ot~+ (Head...

  9. Locally ablative therapies for primary radiation failures: A review and critical assessment of the efficacy

    Microsoft Academic Search

    William C. Huang; Courtney L. Lee; James A. Eastham

    2007-01-01

    A significant number of men with prostate cancer will experience biochemical failure following treatment with primary radiation\\u000a therapy. For patients with biopsyproven recurrent cancer confined to the prostate, local salvage therapy may be a potentially\\u000a curative treatment option. Most men, however, do not undergo local salvage therapy owing to difficulties in diagnosis as well\\u000a as concerns over treatment-related complications in

  10. Integrated Therapy in the Treatment of Ovarian Cancer with Surgery, Radiation and Chemotherapy

    Microsoft Academic Search

    M. E. Speckhard; J. D. Hurley; W. C. Fetherston; A. J. Grueninger

    1972-01-01

    The role of chemotherapy in the treatment of ovarian cancer is not independent of the other modalities utilized. Rather surgery, radiation therapy and chemotherapy must be integrated into a unified program. Some of the factors that we feel influence the role that each plays in the treatment of cancer of the ovary are discussed. Our program of therapy which integrates

  11. Multibeam tomotherapy: A new treatment unit devised for multileaf collimation, intensity-modulated radiation therapy

    Microsoft Academic Search

    Nils Achterberg; Reinhold G. Mueller

    2007-01-01

    A fully integrated system for treatment planning, application, and verification for automated multileaf collimator (MLC) based, intensity-modulated, image-guided, and adaptive radiation therapy (IMRT, IGRT and ART, respectively) is proposed. Patient comfort, which was the major development goal, will be achieved through a new unit design and short treatment times. Our device for photon beam therapy will consist of a new

  12. Successful treatment of radiation-induced brain necrosis by hyperbaric oxygen therapy

    Microsoft Academic Search

    Kiyotaka Kohshi; Hajime Imada; Satoshi Nomoto; Raizoh Yamaguchi; Haruhiko Abe; Haruaki Yamamoto

    2003-01-01

    We describe a 68-year-old man who underwent hyperbaric oxygen (HBO) therapy to manage radiation necrosis of the brain, which developed after two treatments with stereotactic radiosurgery (SRS) to the same lesion. The necrosis was subsequently treated with steroids alone for 2 months; however, he progressed clinically and radiographically. Improvement again was noted with the reinstitution of HBO therapy. This case

  13. Radiation therapy alone in the treatment of carcinoma of the uterine cervix: a 20-year experience

    Microsoft Academic Search

    Carlos A. Perez; H. Marvin Camel; Robert R. Kuske; Ming-Shian Kao; Andrew Galakatos; Mary Ann Hederman; William E. Powers

    1986-01-01

    A retrospective analysis is reported on the results of irradiation alone in the treatment of 970 patients with histologically proven invasive carcinoma of the uterine cervix. The development of the radiation therapy techniques, survival, pelvic tumor control, and major sequelae of therapy are described in detail. The tumor-free 5-year survival rate was 100% in 29 patients with stage IA, 85%

  14. Multiscale registration of planning CT and daily cone beam CT images for adaptive radiation therapy

    E-print Network

    Levy, Doron

    therapy ART is the incorporation of daily images in the radiotherapy treatment process soMultiscale registration of planning CT and daily cone beam CT images for adaptive radiation therapy images is thus an important component of ART. In this article, the authors report their research

  15. Comparative analysis of 60Co intensity-modulated radiation therapy

    NASA Astrophysics Data System (ADS)

    Fox, Christopher; Romeijn, H. Edwin; Lynch, Bart; Men, Chunhua; Aleman, Dionne M.; Dempsey, James F.

    2008-06-01

    In this study, we perform a scientific comparative analysis of using 60Co beams in intensity-modulated radiation therapy (IMRT). In particular, we evaluate the treatment plan quality obtained with (i) 6 MV, 18 MV and 60Co IMRT; (ii) different numbers of static multileaf collimator (MLC) delivered 60Co beams and (iii) a helical tomotherapy 60Co beam geometry. We employ a convex fluence map optimization (FMO) model, which allows for the comparison of plan quality between different beam energies and configurations for a given case. A total of 25 clinical patient cases that each contain volumetric CT studies, primary and secondary delineated targets, and contoured structures were studied: 5 head-and-neck (H&N), 5 prostate, 5 central nervous system (CNS), 5 breast and 5 lung cases. The DICOM plan data were anonymized and exported to the University of Florida optimized radiation therapy (UFORT) treatment planning system. The FMO problem was solved for each case for 5-71 equidistant beams as well as a helical geometry for H&N, prostate, CNS and lung cases, and for 3-7 equidistant beams in the upper hemisphere for breast cases, all with 6 MV, 18 MV and 60Co dose models. In all cases, 95% of the target volumes received at least the prescribed dose with clinical sparing criteria for critical organs being met for all structures that were not wholly or partially contained within the target volume. Improvements in critical organ sparing were found with an increasing number of equidistant 60Co beams, yet were marginal above 9 beams for H&N, prostate, CNS and lung. Breast cases produced similar plans for 3-7 beams. A helical 60Co beam geometry achieved similar plan quality as static plans with 11 equidistant 60Co beams. Furthermore, 18 MV plans were initially found not to provide the same target coverage as 6 MV and 60Co plans; however, adjusting the trade-offs in the optimization model allowed equivalent target coverage for 18 MV. For plans with comparable target coverage, critical structure sparing was best achieved with 6 MV beams followed closely by 60Co beams, with 18 MV beams requiring significantly increased dose to critical structures. In this paper, we report in detail on a representative set of results from these experiments. The results of the investigation demonstrate the potential for IMRT radiotherapy employing commercially available 60Co sources and a double-focused MLC. Increasing the number of equidistant beams beyond 9 was not observed to significantly improve target coverage or critical organ sparing and static plans were found to produce comparable plans to those obtained using a helical tomotherapy treatment delivery when optimized using the same well-tuned convex FMO model. While previous studies have shown that 18 MV plans are equivalent to 6 MV for prostate IMRT, we found that the 18 MV beams actually required more fluence to provide similar quality target coverage. This work was supported by the National Science Foundation under grant no. DMI-0457394 and the National Cancer Institute under grant no. R01 CA100636.

  16. A prospective randomized comparison of radiation therapy plus lonidamine versus radiation therapy plus placebo as initial treatment of clinically localized but nonresectable nonsmall cell lung cancer

    Microsoft Academic Search

    Charles W. Scarantino; Ann J. McCunniff; Greg Evans; Charles W. Young; Dario A. Paggiarino

    1994-01-01

    The purpose was, by means of a multicenter, prospective randomized, placebo-controlled study, to assess the impact of adding the radiation-enhancing agent lonidamine to standard {open_quotes}curative-intent{close_quotes} radiation therapy upon overall survival, progression-free survival, and local progression-free survival of patients with clinically localized but nonresectable nonsmall cell lung cancer. Lonidamine, or the lonidamine-placebo, was administered at a dose of 265 mg\\/m² in

  17. Intensity Modulated Radiation Therapy With Dose Painting to Treat Rhabdomyosarcoma

    SciTech Connect

    Yang, Joanna C.; Dharmarajan, Kavita V. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)] [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wexler, Leonard H. [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)] [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); La Quaglia, Michael P. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)] [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Happersett, Laura [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)] [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Wolden, Suzanne L., E-mail: woldens@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2012-11-01

    Purpose: To examine local control and patterns of failure in rhabdomyosarcoma patients treated with intensity modulated radiation therapy (RT) with dose painting (DP-IMRT). Patients and Methods: A total of 41 patients underwent DP-IMRT with chemotherapy for definitive treatment. Nineteen also underwent surgery with or without intraoperative RT. Fifty-six percent had alveolar histologic features. The median interval from beginning chemotherapy to RT was 17 weeks (range, 4-25). Very young children who underwent second-look procedures with or without intraoperative RT received reduced doses of 24-36 Gy in 1.4-1.8-Gy fractions. Young adults received 50.4 Gy to the primary tumor and lower doses of 36 Gy in 1.8-Gy fractions to at-risk lymph node chains. Results: With 22 months of median follow-up, the actuarial local control rate was 90%. Patients aged {<=}7 years who received reduced overall and fractional doses had 100% local control, and young adults had 79% (P=.07) local control. Three local failures were identified in young adults whose primary target volumes had received 50.4 Gy in 1.8-Gy fractions. Conclusions: DP-IMRT with lower fractional and cumulative doses is feasible for very young children after second-look procedures with or without intraoperative RT. DP-IMRT is also feasible in adolescents and young adults with aggressive disease who would benefit from prophylactic RT to high-risk lymph node chains, although dose escalation might be warranted for improved local control. With limited follow-up, it appears that DP-IMRT produces local control rates comparable to those of sequential IMRT in patients with rhabdomyosarcoma.

  18. Improved Efficacy of ?-Particle–Targeted Radiation Therapy

    PubMed Central

    Milenic, Diane E.; Brady, Erik D.; Garmestani, Kayhan; Albert, Paul S.; Abdulla, Alia; Brechbiel, Martin W.

    2009-01-01

    BACKGROUND Human epidermal growth factor receptor–2 (HER-2) and tumor-associated glycoprotein 72 (TAG-72) have proven to be excellent molecular targets for cancer imaging and therapy. Trastuzumab, which binds to HER-2, is effective in the treatment of disseminated intraperitoneal disease when labeled with 213Bi or 212Pb. 213Bi-humanized CC49 monoclonal antibody (HuCC49?CH2), which binds to TAG-72, inhibits the growth of subcutaneous xenografts. A next logical step to improve therapeutic benefit would be to target tumors with both molecules simultaneously. METHODS Athymic mice bearing intraperitoneal human colon carcinoma xenografts were treated with a combination of trastuzumab and HuCC49?CH2 labeled with 213Bi administered through an intraperitoneal route. The sequence of administration also was examined. RESULTS Before combining the 2 monoclonal antibodies, the effective doses of 213Bi-CC49?CH2 and 213Bi-trastuzumab for the treatment of peritoneal disease were determined to be 500 ?Ci for each labeled antibody. Treatment with 213Bi-HuCC49?CH2 resulted in a median survival of 45 days and was comparable to the median survival achieved with 213Bi-trastuzumab. Each combination provided greater therapeutic efficacy than either of the agents given alone. However, the greatest therapeutic benefit was achieved when 213Bi-HuCC49?CH2 and 213Bi-trastuzumab were coinjected, and a median survival of 147 days was obtained. CONCLUSIONS Dual targeting of 2 distinct molecules in tumors such as TAG-72 and HER-2 with ?-particle radiation resulted in an enhanced, additive, therapeutic benefit. The authors also observed that this radioimmunotherapeutic strategy was well tolerated. PMID:20127951

  19. Auto-propagation of contours for adaptive prostate radiation therapy

    NASA Astrophysics Data System (ADS)

    Chao, Ming; Xie, Yaoqin; Xing, Lei

    2008-09-01

    The purpose of this work is to develop an effective technique to automatically propagate contours from planning CT to cone beam CT (CBCT) to facilitate CBCT-guided prostate adaptive radiation therapy. Different from other disease sites, such as the lungs, the contour mapping here is complicated by two factors: (i) the physical one-to-one correspondence may not exist due to the insertion or removal of some image contents within the region of interest (ROI); and (ii) reduced contrast to noise ratio of the CBCT images due to increased scatter. To overcome these issues, we investigate a strategy of excluding the regions with variable contents by a careful design of a narrow shell signifying the contour of an ROI. For rectum, for example, a narrow shell with the delineated contours as its interior surface was constructed to avoid the adverse influence of the day-to-day content change inside the rectum on the contour mapping. The corresponding contours in the CBCT were found by warping the narrow shell through the use of BSpline deformable model. Both digital phantom experiments and clinical case testing were carried out to validate the proposed ROI mapping method. It was found that the approach was able to reliably warp the constructed narrow band with an accuracy better than 1.3 mm. For all five clinical cases enrolled in this study, the method yielded satisfactory results even when there were significant rectal content changes between the planning CT and CBCT scans. The overlapped area of the auto-mapped contours over 90% to the manually drawn contours is readily achievable. The proposed approach permits us to take advantage of the regional calculation algorithm yet avoiding the nuisance of rectum/bladder filling and provide a useful tool for adaptive radiotherapy of prostate in the future.

  20. Maintenance of Sorafenib following combined therapy of three-dimensional conformal radiation therapy\\/intensity-modulated radiation therapy and transcatheter arterial chemoembolization in patients with locally advanced hepatocellular carcinoma: a phase I\\/II study

    Microsoft Academic Search

    Jian-Dong Zhao; Jin Liu; Zhi-Gang Ren; Ke Gu; Zhen-Hua Zhou; Wen-Tao Li; Zhen Chen; Zhi-Yong Xu; Lu-Ming Liu; Guo-Liang Jiang

    2010-01-01

    BACKGROUND: Three-dimensional conformal radiation therapy (3DCRT)\\/intensity-modulated radiation therapy (IMRT) combined with or without transcatheter arterial chemoembolization (TACE) for locally advanced hepatocellular carcinoma (HCC) has shown favorable outcomes in local control and survival of locally advanced HCC. However, intra-hepatic spreading and metastasis are still the predominant treatment failure patterns. Sorafenib is a multikinase inhibitor with effects against tumor proliferation and angiogenesis.

  1. Digital phantoms for the evaluation of a software used for an automatic analysis of the Winston-Lutz test in image guided radiation therapy

    E-print Network

    Boyer, Edmond

    -Lutz test in image guided radiation therapy Tarraf Torfeha, b , Stéphane Beaumontb , David Bonnetb , Yves for the radiation therapy process, especially in stereotactic radio surgery and in image guided radiation therapy irradiated. Furthermore, the emerging image guided radiation therapy gives this test a new actuality. Here

  2. Economic analysis of a phase III clinical trial evaluating the addition of total androgen suppression to radiation versus radiation alone for locally advanced prostate cancer (Radiation Therapy Oncology Group protocol 86-10)

    Microsoft Academic Search

    Andre. Konski; Eric Sherman; Murray Krahn; Karen Bremner; J. Robert Beck; Deborah Watkins-Bruner; Michael Pilepich

    2005-01-01

    Purpose: To evaluate the cost-effectiveness of adding hormone therapy to radiation for patients with locally advanced prostate cancer, using a Monte Carlo simulation of a Markov Model. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 86-10 randomized patients to receive radiation therapy (RT) alone or RT plus total androgen suppression (RTHormones) 2 months before and during RT for the

  3. Tobacco Smoking During Radiation Therapy for Head-and-Neck Cancer Is Associated With Unfavorable Outcome

    SciTech Connect

    Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.ed [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Chen, Leon M.; Vaughan, Andrew; Sreeraman, Radhika [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Farwell, D. Gregory; Luu, Quang [Department of Otolaryngology-Head and Neck Surgery, University of California Davis Cancer Center, Sacramento, CA (United States); Lau, Derick H. [Department of Medical Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Stuart, Kerri; Purdy, James A.; Vijayakumar, Srinivasan [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States)

    2011-02-01

    Purpose: To evaluate the effect of continued cigarette smoking among patients undergoing radiation therapy for head-and-neck cancer by comparing the clinical outcomes among active smokers and quitters. Methods and Materials: A review of medical records identified 101 patients with newly diagnosed squamous cell carcinoma of the head and neck who continued to smoke during radiation therapy. Each active smoker was matched to a control patient who had quit smoking before initiation of radiation therapy. Matching was based on tobacco history (pack-years), primary site, age, sex, Karnofsky Performance Status, disease stage, radiation dose, chemotherapy use, year of treatment, and whether surgical resection was performed. Outcomes were compared by use of Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer toxicity criteria. Results: With a median follow-up of 49 months, active smokers had significantly inferior 5-year overall survival (23% vs. 55%), locoregional control (58% vs. 69%), and disease-free survival (42% vs. 65%) compared with the former smokers who had quit before radiation therapy (p < 0.05 for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of Grade 3 or greater late complications was also significantly increased among active smokers compared with former smokers (49% vs. 31%, p = 0.01). Conclusions: Tobacco smoking during radiation therapy for head-and-neck cancer is associated with unfavorable outcomes. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

  4. Combined Modality Treatment for Prostate Cancer With Dynamic Adaptive Radiation Therapy Using Four-Dimensional Image-Guided Intensity-Modulated Radiation Therapy and Brachytherapy

    Microsoft Academic Search

    Jennifer C. Cash; Jone Fay; Michael J. Dattoli

    2009-01-01

    Prostate cancer can be successfully treated using dynamic adaptive external beam radiation techniques along with interstitial brachytherapy to deliver curative therapies with low urinary, rectal and erectile function morbidity. Through the use of sophisticated, state-of-the art radiographic imaging for staging and treatment planning, a precise, individual design for treatment is accomplished. Symptom management and patient education are of paramount importance

  5. A Note on Improving the Performance of Approximation Algorithms for Radiation Therapy

    E-print Network

    Saia, Jared

    Intensity-modulated radiation therapy (IMRT) is an effective form of cancer treatment in which the region applications to an effective form of cancer treatment. Using several insights, we extend previous results to be treated is discretized into a grid. A treatment plan specifies the amount of radiation to be delivered

  6. Simultaneous Nonrigid Registration, Segmentation, and Tumor Detection in MRI Guided Cervical Cancer Radiation Therapy

    Microsoft Academic Search

    Chao Lu; Sudhakar Chelikani; David A. Jaffray; Michael F. Milosevic; Lawrence H. Staib; James S. Duncan

    2012-01-01

    External beam radiation therapy (EBRT) for the treatment of cancer enables accurate placement of radiation dose on the cancerous region. However, the deformation of soft tissue during the course of treatment, such as in cervical cancer, presents significant challenges for the delineation of the target volume and other structures of interest. Furthermore, the presence and regression of pathologies such as

  7. Hyperbaric oxygen therapy for late sequelae in women receiving radiation after breast-conserving surgery

    Microsoft Academic Search

    Ulrich M Carl; John J Feldmeier; Gerd Schmitt; K. Axel Hartmann

    2001-01-01

    Purpose: Persisting symptomatology after breast-conserving surgery and radiation is frequently reported. In most cases, symptoms in the breast resolve without further treatment. In some instances, however, pain, erythema, and edema can persist for years and can impact the patient’s quality of life. Hyperbaric oxygen therapy was shown to be effective as treatment for late radiation sequelae. The objective of this

  8. Continuing Education Course Use of CT and PET in Radiation Therapy

    Microsoft Academic Search

    Sasa Mutic

    The modern practice of radiation therapy relies on volumetric patient images. Computed tomography (CT) imaging has been the primary imaging modality used in radiation oncology for over two decades. However, magnetic resonance imaging (MRI) and positron emission tomography (PET) are increasingly becoming an important component of the treatment planning process. CT studies provide information not only about target volumes but

  9. Tooth extraction by orthodontic force after radiation therapy: report of case

    SciTech Connect

    Rodu, B.; Filler, S.J.; Woodfin, G.K.

    1985-12-01

    This report presents a therapeutic approach to orthodontic tooth extraction in a patient at high risk for the development of osteoradionecrosis with conventional techniques. The rationale for this procedure is discussed in detail, combining principles of radiation biology, clinical radiation therapy, and biomechanics of tooth movement.

  10. New technology enables high precision multislit collimators for microbeam radiation therapy

    Microsoft Academic Search

    E. Bräuer-Krisch; H. Requardt; T. Brochard; G. Berruyer; M. Renier; J. A. Laissue; A. Bravin

    2009-01-01

    During the past decade microbeam radiation therapy has evolved from preclinical studies to a stage in which clinical trials can be planned, using spatially fractionated, highly collimated and high intensity beams like those generated at the x-ray ID17 beamline of the European Synchrotron Radiation Facility. The production of such microbeams typically between 25 and 100 mum full width at half

  11. The effect of beam polarization in Microbeam Radiation Therapy (MRT): Monte Carlo simulations using Geant4

    Microsoft Academic Search

    J. Spiga; Y. Prezado; E. Brauer-Krisch; V. Fanti; P. Randaccio; A. Bravin

    2009-01-01

    Microbeam Radiation Therapy (MRT) is an innovative experimental technique potentially able to overcome the limitations of conventional radiotherapy for infantile brain tumors. Its effectiveness seems to be related to the ability of normal tissues to tolerate a very high radiation dose in small volumes, resulting in the preservation of the tissues' architecture. The effectiveness of MRT is well represented by

  12. Dosimetric studies of microbeam radiation therapy (MRT) with Monte Carlo simulations

    Microsoft Academic Search

    E. A. Siegbahn; E. Bräuer-Krisch; J. Stepanek; H. Blattmann; J. A. Laissue; A. Bravin

    2005-01-01

    Microbeam Radiation Therapy (MRT) is a technique utilizing the fact that normal tissue can sustain high doses of radiation in small volumes without significant damage. The synchrotron generated X-ray beam, used for the treatment, is collimated and delivered in an array of narrow micrometer-sized planar rectangular fields. In this work, the Monte Carlo code PENELOPE was used for simulating the

  13. Monte Carlo code comparison of dose delivery prediction for microbeam radiation therapy

    Microsoft Academic Search

    M. DeFelici; E. A. Siegbahn; J. Spiga; A. L. Hanson; R. Felici; C. Ferrero; A. Tartari; M. Gambaccini; J. Keyriläinen; E. Bräuer-Krisch; P. Randaccio; A. Bravin

    2008-01-01

    Preclinical Microbeam Radiation Therapy (MRT) research programs are carried out at the European Synchrotron Radiation Facility (ESRF) and at a few other synchrotron facilities. MRT needs an accurate evaluation of the doses delivered to biological tissues for carrying out pre-clinical studies. This point is crucial for determining the effect induced by changing any of the physical irradiation parameters. The doses

  14. Biological-based optimization and volumetric modulated arc therapy delivery for stereotactic body radiation therapy

    SciTech Connect

    Diot, Quentin; Kavanagh, Brian; Timmerman, Robert; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States); Department of Radiation Oncology, University of Texas Southwestern Medical School, Dallas, Texas 75390 (United States); Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States)

    2012-01-15

    Purpose: To describe biological-based optimization and Monte Carlo (MC) dose calculation-based treatment planning for volumetric modulated arc therapy (VMAT) delivery of stereotactic body radiation therapy (SBRT) in lung, liver, and prostate patients. Methods: Optimization strategies and VMAT planning parameters using a biological-based optimization MC planning system were analyzed for 24 SBRT patients. Patients received a median dose of 45 Gy [range, 34-54 Gy] for lung tumors in 1-5 fxs and a median dose of 52 Gy [range, 48-60 Gy] for liver tumors in 3-6 fxs. Prostate patients received a fractional dose of 10 Gy in 5 fxs. Biological-cost functions were used for plan optimization, and its dosimetric quality was evaluated using the conformity index (CI), the conformation number (CN), the ratio of the volume receiving 50% of the prescription dose over the planning target volume (Rx/PTV50). The quality and efficiency of the delivery were assessed according to measured quality assurance (QA) passing rates and delivery times. For each disease site, one patient was replanned using physical cost function and compared to the corresponding biological plan. Results: Median CI, CN, and Rx/PTV50 for all 24 patients were 1.13 (1.02-1.28), 0.79 (0.70-0.88), and 5.3 (3.1-10.8), respectively. The median delivery rate for all patients was 410 MU/min with a maximum possible rate of 480 MU/min (85%). Median QA passing rate was 96.7%, and it did not significantly vary with the tumor site. Conclusions: VMAT delivery of SBRT plans optimized using biological-motivated cost-functions result in highly conformal dose distributions. Plans offer shorter treatment-time benefits and provide efficient dose delivery without compromising the plan conformity for tumors in the prostate, lung, and liver, thereby improving patient comfort and clinical throughput. The short delivery times minimize the risk of patient setup and intrafraction motion errors often associated with long SBRT treatment delivery times.

  15. Reirradiation After Radical Radiation Therapy: A Survey of Patterns of Practice Among Canadian Radiation Oncologists

    SciTech Connect

    Joseph, Kurian Jones [Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada)], E-mail: kurianjo@cancerboard.ab.ca; Al-Mandhari, Zahid; Pervez, Nadeem; Parliament, Matthew [Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Wu, Jackson [Tom Baker Cancer Center and University of Calgary, Calgary, Alberta (Canada); Ghosh, Sunita [Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Tai, Patricia [Allan Blair Cancer Centre and University of Saskatchewan, Saskatchewan (Canada); Lian Jidong [Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Levin, Wilfred [University of Toronto and Princess Margaret Hospital, Toronto (Canada)

    2008-12-01

    Purpose: The objective of this study was to survey the use of reirradiation (Re-RT) for in-field failures after previous radical radiation treatment (RT) among Canadian radiation oncologists (ROs). Methods and Materials: An electronic survey was sent to 271 ROs in Canada. The completed surveys were received electronically via e-mail and the data were analyzed using SAS 9.1.3 software. Results: A total of 183 ROs (67.5%) completed and returned the survey. The majority of the respondents were involved in the practice of either breast (48%) or genitourinary (43%) tumor sites. A total of 49% of the participants were interested in using Re-RT for the management of in-field recurrences. The goals of the therapy would be improvement of quality of life (99%), locoregional control (80%), or cure (32%). Most of the physicians believed that patients should have a minimum Karnofsky performance status of 50 or Eastern Cooperative Oncology Group performance status of 3, a minimum life expectancy of 3 months, and a minimum interval from initial treatment of 3 months if Re-RT were to be given with curative intent. Conclusions: This survey showed that a wide variation existed among ROs in their approach to Re-RT. Newer technologies in RT planning and delivery would be employed to facilitate normal tissue avoidance. The results of this study suggested that a consensus meeting was needed to establish guidelines for the practice and prospective evaluation of Re-RT.

  16. Mathematical Optimization of the Combination of Radiation and Differentiation Therapies for Cancer

    PubMed Central

    Bachman, Jeff W. N.; Hillen, Thomas

    2013-01-01

    Cancer stem cells (CSC) are considered to be a major driver of cancer progression and successful therapies must control CSCs. However, CSC are often less sensitive to treatment and they might survive radiation and/or chemotherapies. In this paper we combine radiation treatment with differentiation therapy. During differentiation therapy, a differentiation promoting agent is supplied (e.g., TGF-beta) such that CSCs differentiate and become more radiosensitive. Then radiation can be used to control them. We consider three types of cancer: head and neck cancer, brain cancers (primary tumors and metastatic brain cancers), and breast cancer; and we use mathematical modeling to show that combination therapy of the above type can have a large beneficial effect for the patient; increasing treatment success and reducing side effects. PMID:23508300

  17. NECROSIS IN TREATMENT OF INTRAORAL CANCER BY RADIATION THERAPY

    Microsoft Academic Search

    MacComb

    1962-01-01

    Discussion is given on the treatment of necrosis developing from ; radiotherapy of intraoral cancer. The best treatment of radiation necrosis is ; prophylactic. The time of appearance of radiation necrosis is also discussed. ; The incidence of radiation necrosis in treatment of patients with cancer of the ; intraoral cavity at M. D. Anderson Hospital during the past nine

  18. Functional and quality-of-life outcomes in patients with rectal cancer after combined modality therapy, intraoperative radiation therapy, and sphincter preservation

    Microsoft Academic Search

    David Shibata; Jose G. Guillem; Nicole Lanouette; Phillip Paty; Bruce Minsky; Louis Harrison; W. Douglas Wong; Alfred Cohen

    2000-01-01

    PURPOSE: Locally advanced primary and recurrent rectal cancers treated with external beam radiation therapy, intraoperative radiation therapy, and chemotherapy represent a complex group of patients in the setting of extensive pelvic surgery and sphincter preservation. We sought to define functional outcome and quality of life in this subset of patients. METHODS: We retrospectively reviewed our experience with locally advanced primary

  19. Hyperbaric oxygen therapy for carcinoma of the cervix - Stages IIB, IIIA, IIIB, and IVA: results of a randomized study by the radiation therapy oncology group

    Microsoft Academic Search

    Luther W. Brady; Henry P. Plenk; James A. Hanley; John R. Glassburn; Simon Kramer; Robert G. Parker

    1981-01-01

    A total of 65 patients with Stage IIB, IIIA, IIIB or IVA carcinoma of the cervix were randomized to receive conventional radiation therapy in air or hyperbaric oxygen therapy with radiation at optimal schedules. Seven patients could not be evaluated. Of the 19 patients treated in oxygen, 14 (73%) were living or had died without evidence of disease. Of the

  20. Technological Advancements and Error Rates in Radiation Therapy Delivery

    SciTech Connect

    Margalit, Danielle N., E-mail: dmargalit@partners.org [Harvard Radiation Oncology Program, Boston, MA (United States); Harvard Cancer Consortium and Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA (United States); Chen, Yu-Hui; Catalano, Paul J.; Heckman, Kenneth; Vivenzio, Todd; Nissen, Kristopher; Wolfsberger, Luciant D.; Cormack, Robert A.; Mauch, Peter; Ng, Andrea K. [Harvard Cancer Consortium and Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA (United States)

    2011-11-15

    Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)-conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system at Brigham and Women's Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher's exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01-0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08-0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique. There was a lower error rate with IMRT compared with 3D/conventional RT, highlighting the need for sustained vigilance against errors common to more traditional treatment techniques.

  1. A computer aided treatment event recognition system in radiation therapy

    SciTech Connect

    Xia, Junyi, E-mail: junyi-xia@uiowa.edu; Mart, Christopher [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)] [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Bayouth, John [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Human Oncology, University of Wisconsin - Madison, 600 Highland Avenue, K4/B55, Madison, Wisconsin 53792-0600 (United States)] [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Human Oncology, University of Wisconsin - Madison, 600 Highland Avenue, K4/B55, Madison, Wisconsin 53792-0600 (United States)

    2014-01-15

    Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when executed on either a desktop computer or a mobile device. Conclusions: CATERS offers an effective tool to detect and report treatment events. Automation and rapid processing enables electronic record interrogation daily, alerting the medical physicist of deviations potentially days prior to performing weekly check. The output of CATERS could also be utilized as an important input to failure mode and effects analysis.

  2. Radiation Therapy Planning: an Uncommon Application of Lisp Ira J. Kalet, Robert S. Giansiracusa, Craig Wilcox, and Matthew Lease

    E-print Network

    Yetisgen-Yildiz, Meliha

    1 shows a typical radiation therapy machine. Radiation, such as X-rays (high energy photonsRadiation Therapy Planning: an Uncommon Application of Lisp Ira J. Kalet, Robert S. Giansiracusa in the Univer- sity of Washington Cancer Center a complex med- ical application of Common Lisp, the Prism radia

  3. Twice-a-day radiation therapy for cancer of the head and neck

    SciTech Connect

    Wang, C.C.; Blitzer, P.H.; Suit, H.D.

    1985-05-01

    Experience with the twice-a-day (BID) radiation therapy program for carcinomas of the head and neck areas is presented. The program consists of 1.6 Gy per fraction, two fractions per day with 4 hours between fractions, for 12 days, 5 days a week. After 38.4 Gy, the patient is given a 2-week break for symptoms of acute mucositis to subside and then twice-a-day radiation therapy is resumed with similar fraction size, two fractions a day for an additional 8 days to bring the total dose to 64 Gy. In some instances the primary site was boosted to an additional BID day with a maximum of 67.2 Gy. The spinal cord dose was limited to 38.4 Gy. A subset of 321 patients with squamous cell carcinoma of the oral cavity (61 patients), oropharynx (74 patients), and larynx (186 patients) treated by this program is reported. Marked improvement in local control rate at 36 months was observed for advanced tumors (T3 and T4) and with nodal disease by BID radiation therapy program as compared to conventional once-a-day (QD) radiation therapy program. The improvement in local control for early lesions, T1 and T2 when treated with BID radiation therapy was not noted to reach a statistically significant level. However, the successful results are quite different when compared to QD radiation therapy program, with a trend suggesting that significant differences might exist if additional patients had been entered into the studies. Acute mucosal reactions are generally more severe than those produced by QD continuous radiation therapy, but the duration of symptoms is shorter.

  4. Characterization of a tungsten\\/gas multislit collimator for microbeam radiation therapy at the European Synchrotron Radiation Facility

    Microsoft Academic Search

    E. Braeuer-Krisch; A. Bravin; L. Zhang; E. Siegbahn; J. Stepanek; H. Blattmann; D. N. Slatkin; J.-O. Gebbers; M. Jasmin; J. A. Laissue

    2005-01-01

    Clinical microbeam radiation therapy (MRT) will require a multislit collimator with adjustable uniform slit widths to enable reliable Monte Carlo-based treatment planning. Such a collimator has been designed, fabricated of >99% tungsten [W] by Tecomet\\/Viasys (Woburn, Massachusetts, USA) and installed at the 6 GeV electron-wiggler-generated hard x-ray ID17 beamline of the European Synchrotron Radiation Facility. Its pair of 125 parallel,

  5. Measurements of the neutron dose equivalent for various radiation qualities, treatment machines and delivery techniques in radiation therapy.

    PubMed

    Hälg, R A; Besserer, J; Boschung, M; Mayer, S; Lomax, A J; Schneider, U

    2014-05-21

    In radiation therapy, high energy photon and proton beams cause the production of secondary neutrons. This leads to an unwanted dose contribution, which can be considerable for tissues outside of the target volume regarding the long term health of cancer patients. Due to the high biological effectiveness of neutrons in regards to cancer induction, small neutron doses can be important. This study quantified the neutron doses for different radiation therapy modalities. Most of the reports in the literature used neutron dose measurements free in air or on the surface of phantoms to estimate the amount of neutron dose to the patient. In this study, dose measurements were performed in terms of neutron dose equivalent inside an anthropomorphic phantom. The neutron dose equivalent was determined using track etch detectors as a function of the distance to the isocenter, as well as for radiation sensitive organs. The dose distributions were compared with respect to treatment techniques (3D-conformal, volumetric modulated arc therapy and intensity-modulated radiation therapy for photons; spot scanning and passive scattering for protons), therapy machines (Varian, Elekta and Siemens linear accelerators) and radiation quality (photons and protons). The neutron dose equivalent varied between 0.002 and 3 mSv per treatment gray over all measurements. Only small differences were found when comparing treatment techniques, but substantial differences were observed between the linear accelerator models. The neutron dose equivalent for proton therapy was higher than for photons in general and in particular for double-scattered protons. The overall neutron dose equivalent measured in this study was an order of magnitude lower than the stray dose of a treatment using 6 MV photons, suggesting that the contribution of the secondary neutron dose equivalent to the integral dose of a radiotherapy patient is small. PMID:24778349

  6. Measurements of the neutron dose equivalent for various radiation qualities, treatment machines and delivery techniques in radiation therapy

    NASA Astrophysics Data System (ADS)

    Hälg, R. A.; Besserer, J.; Boschung, M.; Mayer, S.; Lomax, A. J.; Schneider, U.

    2014-05-01

    In radiation therapy, high energy photon and proton beams cause the production of secondary neutrons. This leads to an unwanted dose contribution, which can be considerable for tissues outside of the target volume regarding the long term health of cancer patients. Due to the high biological effectiveness of neutrons in regards to cancer induction, small neutron doses can be important. This study quantified the neutron doses for different radiation therapy modalities. Most of the reports in the literature used neutron dose measurements free in air or on the surface of phantoms to estimate the amount of neutron dose to the patient. In this study, dose measurements were performed in terms of neutron dose equivalent inside an anthropomorphic phantom. The neutron dose equivalent was determined using track etch detectors as a function of the distance to the isocenter, as well as for radiation sensitive organs. The dose distributions were compared with respect to treatment techniques (3D-conformal, volumetric modulated arc therapy and intensity-modulated radiation therapy for photons; spot scanning and passive scattering for protons), therapy machines (Varian, Elekta and Siemens linear accelerators) and radiation quality (photons and protons). The neutron dose equivalent varied between 0.002 and 3 mSv per treatment gray over all measurements. Only small differences were found when comparing treatment techniques, but substantial differences were observed between the linear accelerator models. The neutron dose equivalent for proton therapy was higher than for photons in general and in particular for double-scattered protons. The overall neutron dose equivalent measured in this study was an order of magnitude lower than the stray dose of a treatment using 6 MV photons, suggesting that the contribution of the secondary neutron dose equivalent to the integral dose of a radiotherapy patient is small.

  7. A prospective randomized comparison of radiation therapy plus lonidamine versus radiation therapy plus placebo as initial treatment of clinically localized but nonresectable nonsmall cell lung cancer

    SciTech Connect

    Scarantino, C.W. [Rex Cancer Center, Raleigh, NC (United States); McCunniff, A.J.; Evans, G. [Bowman-Gray School of Medicine, Winston-Salem, NC (United States); Young, C.W. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Paggiarino, D.A. [Angelini Pharmaceuticals, Inc., River Edge, NJ (United States)

    1994-07-30

    The purpose was, by means of a multicenter, prospective randomized, placebo-controlled study, to assess the impact of adding the radiation-enhancing agent lonidamine to standard {open_quotes}curative-intent{close_quotes} radiation therapy upon overall survival, progression-free survival, and local progression-free survival of patients with clinically localized but nonresectable nonsmall cell lung cancer. Lonidamine, or the lonidamine-placebo, was administered at a dose of 265 mg/m{sup 2} in three divided daily doses. Drug therapy began 2 days prior to the initiation of radiation therapy and continued until progression of disease mandated a change in therapy. The radiation therapy dose was 55-60 Gy, at a daily dose of 1.8 Gy and five treatments per week. Patients with clinical Stage II or III nonsmall cell lung cancer were stratified within the treatment center, and within two histologic strata: epidermoid vs. other nonsmall cell cancers. A total of 310 patients were enlisted on study, 152 on the placebo arm and 158 on the lonidamine arm. The median survival durations were 326 and 392 days for the placebo and lonidamine-treated groups respectively, p = 0.41 for a comparison of the survival curves. Median progression-free survival and median local progression-free survival durations were 197 days and 341 days for placebo + radiation therapy vs. 230 days and 300 days for lonidamine + radiation therapy; p-values for the respective curves were 0.75 and 0.42. Although there were proportionately more lonidamine-treated patients than placebo-treated patients demonstrating continued local control in excess of 12 months, the numbers of patients still at risk after 24 months were too small for meaningful statistical analysis. This multicenter Phase III study failed to demonstrate a significant advantage in the lonidamine-treated population in overall patient survival, in progression-free survival, or in the median duration of local control. 25 refs., 3 figs., 3 tabs.

  8. Proteomic analysis of atherosclerotic plaque

    Microsoft Academic Search

    B. Porcelli; I. Ciari; C. Felici; R. Pagani; C. Banfi; M. Brioschi; M. Giubbolini; G. de Donato; C. Setacci; L. Terzuoli

    2010-01-01

    Proteins play a fundamental role in the formation and progression of plaque, but proteomic analysis of plaque as a whole is difficult, due to its heterogeneous cellular composition and an abundance of plasma proteins. Several approaches to this problem are reported in the literature; they include proteomic analysis of vascular tissues, analysis of proteins released by normal and pathological arterial

  9. Routes to chemical plaque control

    Microsoft Academic Search

    D. Cummins

    1991-01-01

    A logical approach to the prevention of periodontal disease is through excellent supragingival plaque control. Such control is not generally achieved by mechanical oral hygiene procedures alone. Thus, there is a clear rationale for the use of antiplaque agents to augment mechanical means. The principle routes to chemical plaque control are to prevent colonization of the tooth surface, to inhibit

  10. Function of the parotid gland following radiation therapy for head and neck cancer

    SciTech Connect

    Cheng, V.S.T.; Downs, J.; Herbert, D.; Aramany, M.

    1981-02-01

    The parotid gland was selected for study of its salivary output before and after radiation therapy for head and neck cancer. Before radiation therapy, a sialogram of the parotid gland was performed with the patient's head positioned for radiation therapy; a lateral radiographic view of the parotid gland was used to compare with the radiation treatment portal to determine the portion of the parotid gland to be irradiated. Samples of stimulated saliva were collected from the parotid gland before and at 1 and 6 months post-radiation. Eighteen patients with head and neck cancer who received radiation therapy were studied. The data showed that in the irradiation of nasopharyngeal, advanced oropharyngeal and Waldeyer's ring lesions, 100% of the parotid gland was irradiated; for the early oropharyngeal and hypopharyngeal lesions, from 30 to 90% of the parotid gland was irradiated and for the supraglottic and oral cavity lesions, 25 to 30% of the parotid gland was irradiated. When 100% of the parotid gland was irradiated, no saliva was produced at 1 month post-radiation; this remained the same when re-tested at 4 to 8 months, however, when any portion of the parotid gland was not irradiated, there was residual salivary function.

  11. Bevacizumab as Therapy for Radiation Necrosis in Four Children With Pontine Gliomas

    SciTech Connect

    Liu, Arthur K., E-mail: arthur.liu@ucdenver.ed [University of Colorado Denver, Department of Radiation Oncology, Aurora, CO (United States); Macy, Margaret E.; Foreman, Nicholas K. [Children's Hospital, Denver, Department of Neuro-Oncology, Aurora, CO (United States)

    2009-11-15

    Purpose: Diffuse pontine gliomas are a pediatric brain tumor that is fatal in nearly all patients. Given the poor prognosis for patients with this tumor, their quality of life is very important. Radiation therapy provides some palliation, but can result in radiation necrosis and associated neurologic decline. The typical treatment for this necrosis is steroid therapy. Although the steroids are effective, they have numerous side effects that can often significantly compromise quality of life. Bevacizumab, an antibody against vascular endothelial growth factor, has been suggested as a treatment for radiation necrosis. We report on our initial experience with bevacizumab therapy for radiation necrosis in pediatric pontine gliomas. Materials and Methods: Four children with pontine gliomas treated at the Children's Hospital in Denver and the University of Colorado Denver developed evidence of radiation necrosis both clinically and on imaging. Those 4 children then received bevacizumab as a treatment for the radiation necrosis. We reviewed the clinical outcome and imaging findings. Results: After bevacizumab therapy, 3 children had significant clinical improvement and were able to discontinue steroid use. One child continued to decline, and, in retrospect, had disease progression, not radiation necrosis. In all cases, bevacizumab was well tolerated. Conclusions: In children with pontine gliomas, bevacizumab may provide both therapeutic benefit and diagnostic information. More formal evaluation of bevacizumab in these children is needed.

  12. Purine bases and atheromatous plaque.

    PubMed

    Terzuoli, L; Marinello, E; Felici, C; Frosi, B; Setacci, C; Giubbolini, M; Porcelli, B

    2004-01-01

    In this work we determined hypoxanthine (HX), xanthine (X), uric acid (UA), allantoin (ALL) and free radicals in atheromatous plaques to improve the comprehension of oxidative stress, a phenomenon which characterizes the evolution of atherosclerotic lesions. Carotid artery plaque were obtained from subjects undergoing endoarterectomy. Pulverized plaque, extracted by water, was used for analysis of oxidative stress factors (allantoin, uric acid, xanthine, hypoxanthine, free radicals). The peroxidation UA-->ALL was very high in the plaque, as was the level of free radicals. The results show that oxidative degradation of nucleotides, such as LDL oxidation, plays a specific role not only in the progression of atherosclerotic lesions but also in the advanced plaque. PMID:16857104

  13. International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

    SciTech Connect

    Dennis, Kristopher; Zhang Liying [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lutz, Stephen [Blanchard Valley Health Systems, Findlay, Ohio (United States)] [Blanchard Valley Health Systems, Findlay, Ohio (United States); Baardwijk, Angela van [Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands)] [Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Linden, Yvette van der [Leiden University Medical Center, Leiden (Netherlands)] [Leiden University Medical Center, Leiden (Netherlands); Holt, Tanya [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia)] [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia); Arnalot, Palmira Foro [Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain)] [Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain); Lagrange, Jean-Leon [AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France)] [AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France); Maranzano, Ernesto ['S. Maria' Hospital, Terni (Italy)] ['S. Maria' Hospital, Terni (Italy); Liu, Rico [Queen Mary Hospital, Hong Kong (China)] [Queen Mary Hospital, Hong Kong (China); Wong, Kam-Hung [Queen Elizabeth Hospital, Hong Kong (Hong Kong)] [Queen Elizabeth Hospital, Hong Kong (Hong Kong); Wong, Lea-Choung [National University Cancer Institute (Singapore)] [National University Cancer Institute (Singapore); Vassiliou, Vassilios [Bank of Cyprus Oncology Centre, Nicosia (Cyprus)] [Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Corn, Benjamin W. [Tel Aviv Medical Center, Tel Aviv (Israel)] [Tel Aviv Medical Center, Tel Aviv (Israel); De Angelis, Carlo; Holden, Lori; Wong, C. Shun [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)] [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT){sub 3} receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk assessment and to refine antiemetic guideline management recommendations.

  14. Numerical assessment of radiation binary targeted therapy for HER-2 positive breast cancers: advanced calculations and radiation dosimetry.

    PubMed

    Sztejnberg Gonçalves-Carralves, Manuel L; Jevremovic, Tatjana

    2007-07-21

    In our previous publication (Mundy et al 2006 Phys. Med. Biol. 51 1377) we have described the theoretical assessment of our novel approach in radiation binary targeted therapy for HER-2 positive breast cancers and summarized the future directions in this area of research. In this paper we advanced the numerical analysis to show the detailed radiation dose distribution for various neutron sources in combination with the required boron concentration and allowed radiation skin doses. We once again proved the feasibility of the concept and will use these data and conclusions to start with the experimental verifications. PMID:17664606

  15. Delivery of therapeutic radioisotopes using nanoparticle platforms: potential benefit in systemic radiation therapy

    PubMed Central

    Zhang, Longjiang; Chen, Hongwei; Wang, Liya; Liu, Tian; Yeh, Julie; Lu, Guangming; Yang, Lily; Mao, Hui

    2010-01-01

    Radiation therapy is an effective cancer treatment option in conjunction with chemotherapy and surgery. Emerging individualized internal and systemic radiation treatment promises significant improvement in efficacy and reduction of normal tissue damage; however, it requires cancer cell targeting platforms for efficient delivery of radiation sources. With recent advances in nanoscience and nanotechnology, there is great interest in developing nanomaterials as multifunctional carriers to deliver therapeutic radioisotopes for tumor targeted radiation therapy, to monitor their delivery and tumor response to the treatment. This paper provides an overview on developing nanoparticles for carrying and delivering therapeutic radioisotopes for systemic radiation treatment. Topics discussed in the review include: selecting nanoparticles and radiotherapy isotopes, strategies for targeting nanoparticles to cancers, together with challenges and potential solutions for the in vivo delivery of nanoparticles. Some examples of using nanoparticle platforms for the delivery of therapeutic radioisotopes in preclinical studies of cancer treatment are also presented. PMID:24198480

  16. Probabilities of Radiation Myelopathy Specific to Stereotactic Body Radiation Therapy to Guide Safe Practice

    SciTech Connect

    Sahgal, Arjun, E-mail: arjun.sahgal@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada) [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Weinberg, Vivian [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States)] [University of California San Francisco Helen Diller Family Comprehensive Cancer Center Biostatistics Core, San Francisco, California (United States); Ma, Lijun [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States); Chang, Eric [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States)] [Department of Radiation Oncology, University of Southern California and University of Texas MD Anderson Cancer Center, University of Texas, Houston, Texas (United States); Chao, Sam [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Muacevic, Alexander [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany)] [European Cyberknife Center Munich in affiliation with University Hospitals of Munich, Munich (Germany); Gorgulho, Alessandra [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States)] [Department of Neurosurgery, University of California at Los Angeles, Los Angeles, California (United States); Soltys, Scott [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gerszten, Peter C. [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)] [Departments of Neurological Surgery and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Ryu, Sam [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)] [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Angelov, Lilyana [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)] [Department of Radiation Oncology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Gibbs, Iris [Department of Radiation Oncology, Stanford University, Stanford, California (United States)] [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada)] [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Larson, David A. [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)] [Department of Radiation Oncology, University of California at San Francisco, San Francisco, California (United States)

    2013-02-01

    Purpose: Dose-volume histogram (DVH) results for 9 cases of post spine stereotactic body radiation therapy (SBRT) radiation myelopathy (RM) are reported and compared with a cohort of 66 spine SBRT patients without RM. Methods and Materials: DVH data were centrally analyzed according to the thecal sac point maximum (Pmax) volume, 0.1- to 1-cc volumes in increments of 0.1 cc, and to the 2 cc volume. 2-Gy biologically equivalent doses (nBED) were calculated using an {alpha}/{beta} = 2 Gy (units = Gy{sub 2/2}). For the 2 cohorts, the nBED means and distributions were compared using the t test and Mann-Whitney test, respectively. Significance (P<.05) was defined as concordance of both tests at each specified volume. A logistic regression model was developed to estimate the probability of RM using the dose distribution for a given volume. Results: Significant differences in both the means and distributions at the Pmax and up to the 0.8-cc volume were observed. Concordant significance was greatest for the Pmax volume. At the Pmax volume the fit of the logistic regression model, summarized by the area under the curve, was 0.87. A risk of RM of 5% or less was observed when limiting the thecal sac Pmax volume doses to 12.4 Gy in a single fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. Conclusion: We report the first logistic regression model yielding estimates for the probability of human RM specific to SBRT.

  17. Method and devices for performing stereotactic microbeam radiation therapy

    Microsoft Academic Search

    Dilmanian; F. Avraham

    2010-01-01

    A radiation delivery system generally includes either a synchrotron source or a support frame and a plurality of microbeam delivery devices supported on the support frame, both to deliver a beam in a hemispherical arrangement. Each of the microbeam delivery devices or synchrotron irradiation ports is adapted to deliver at least one microbeam of radiation along a microbeam delivery axis,

  18. The PEREGRINETM program: using physics and computer simulation to improve radiation therapy for cancer

    NASA Astrophysics Data System (ADS)

    Hartmann Siantar, Christine L.; Moses, Edward I.

    1998-11-01

    When using radiation to treat cancer, doctors rely on physics and computer technology to predict where the radiation dose will be deposited in the patient. The accuracy of computerized treatment planning plays a critical role in the ultimate success or failure of the radiation treatment. Inaccurate dose calculations can result in either insufficient radiation for cure, or excessive radiation to nearby healthy tissue, which can reduce the patient's quality of life. This paper describes how advanced physics, computer, and engineering techniques originally developed for nuclear weapons and high-energy physics research are being used to predict radiation dose in cancer patients. Results for radiation therapy planning, achieved in the Lawrence Livermore National Laboratory (LLNL) 0143-0807/19/6/005/img2 program show that these tools can give doctors new insights into their patients' treatments by providing substantially more accurate dose distributions than have been available in the past. It is believed that greater accuracy in radiation therapy treatment planning will save lives by improving doctors' ability to target radiation to the tumour and reduce suffering by reducing the incidence of radiation-induced complications.

  19. A challenge for high-precision radiation therapy: the case for hadrons.

    PubMed

    Wambersie, A; Auberger, T; Gahbauer, R A; Jones, D T; Pötter, R

    1999-06-01

    Developments in Hadron therapy, i.e., fast neutrons, protons, pions, heavy ions and boron neutron capture therapy are reviewed. For each type of particle, operational and closed facilities are listed as well as planned new facilities. Improvements in clinical results have always been linked to technological developments and better physical selectivity of the irradiation. Exploring the benefit of further improvement in dose localization expected from protons and conformal therapy is the challenge for the coming years. The radiobiological rationale for high-LET radiation in cancer treatment, proposed in the fifties, is still valid and has not been contradicted by recent radiobiological findings. This justifies the planning of a therapy facility where protons and heavy ions (carbon ions) could be applied, under optimal physical and technical conditions. Appropriate selection between low- and high-LET radiation for a particular tumor is indeed a radiobiological problem, independent of technical development. PMID:10394420

  20. Verification of light & radiation field coincidence quality assurance for radiation therapy by using a-Se based DR system

    NASA Astrophysics Data System (ADS)

    Kim, Jin-Young; Park, Eun-Tae; Choi, Yun-Seon; Cho, Heung-Lae; Ahn, Ki-Jung; Park, Sung-Kwang; Kim, Ji-Na; Suh, Tae-Suk; Kim, Jin-Seon; Hong, Ju-Yeon; Park, Jeong-Eun; Kim, Kyo-Tae; Oh, Kyung-Min; Kim, Hyunjung; Jo, Sun-Mi; Oh, Won-Yong; Jin, Seong-Jin; Cho, Woong

    2015-04-01

    Currently, the American Association of Physicists in Medicine (AAPM) recommends measuring the surface field size once a week by using an analog film in order to verify light and radiation field coincidence in the Quality Assurance (QA) of radiotherapy. However, the use of the film does not allow for a quantitative method of evaluation, and measuring the light field with radiation field detectors in a 2D array is difficult. Therefore, we used an amorphous-Se (a-Se) digital radiation detection system to measure the light and radiation fields simultaneously for a quantitative QA system, and the feasibility of using such a system was confirmed by ensuring the coincidence of the light and the radiation field measurements. The characteristics of the analog film and the a-Se digital radiation detection system were compared by delivering to each doses of 100, 10 monitor units(MU) of radiation at a rate of 400 MU/min to a radiation field 100 × 100 mm2 in size from a 100 cm source-surface distance (SSD). A 0.5 mm to 0.6 mm difference was measured in the X-axis, and a 0.3 mm difference was measured in the Y-axis. The difference in the measurements of the coincidence of light and the radiation field was less than 0.3 mm, which is relatively insignificant. These results indicate that the use of an a-Se digital radiation detection system is adequate for quality assurance of radiotherapy using light and radiation field coincidence. In addition, the experiment is considered to have provided valuable results in that the a-Se based digital radiation detection system enables simple and accurate QA for clinical radiation therapy by assessing the coincidence in the alignment of the light and the radiation fields.

  1. Development of a Fast and Highly Efficient Gas Ionization Chamber For Patient Imaging and Dosimetry in Radiation Therapy

    E-print Network

    Hinderler, R; Keller, H; Mackie, T R

    2003-01-01

    In radiation therapy of cancer, more accurate delivery techniques spur the need for improved patient imaging during treatment. To this purpose, the megavoltage radiation protocol that is used for treatment is also used for imaging.

  2. Development of Fast and Highly Efficient Gas Ionization Chamber For Patient Imaging and Dosimetry in Radiation Therapy

    SciTech Connect

    R. Hinderler; H. Keller; T.R. Mackie; M.L. Corradini

    2003-09-08

    In radiation therapy of cancer, more accurate delivery techniques spur the need for improved patient imaging during treatment. To this purpose, the megavoltage radiation protocol that is used for treatment is also used for imaging.

  3. Radiation therapy after breast augmentation or reconstruction in early or recurrent breast cancer

    SciTech Connect

    Ryu, J.; Yahalom, J.; Shank, B.; Chaglassian, T.A.; McCormick, B. (Memorial Sloan Kettering Cancer Center, New York, NY (USA))

    1990-09-01

    Fourteen patients whose augmented or reconstructed breasts were treated with radiation therapy were analyzed. Silicone gel implants were used in 13 patients and free-injected silicone in one patient. The total radiation dose ranged from 4400 to 6200 cGy using tangential photon fields or an en face electron field by megavoltage equipment. In several cases, electron boost radiation was added to the tumor bed. The majority of the patients tolerated therapy well with minimal transient skin reactions; only three patients required a treatment break secondary to moist desquamation. Three patients developed documented implant encapsulation, although the majority retained good to excellent cosmesis. In summary, when breast carcinoma arises in the augmented or reconstructed breast, conservative management (i.e., limited surgery and definitive irradiation) is feasible without compromising the therapy or the cosmetic result. Thus, conservative management should be offered as an option to patients who are interested in breast prosthesis conservation.

  4. Cobalt, linac, or other: what is the best solution for radiation therapy in developing countries?

    PubMed

    Page, Brandi R; Hudson, Alana D; Brown, Derek W; Shulman, Adam C; Abdel-Wahab, May; Fisher, Brandon J; Patel, Shilpen

    2014-07-01

    The international growth of cancer and lack of available treatment is en route to become a global crisis. With >60% of cancer patients needing radiation therapy at some point during their treatment course, the lack of available facilities and treatment programs worldwide is extremely problematic. The number of deaths from treatable cancers is projected to increase to 11.5 million deaths in 2030 because the international population is aging and growing. In this review, we present how best to answer the need for radiation therapy facilities from a technical standpoint. Specifically, we examine whether cobalt teletherapy machines or megavoltage linear accelerator machines are best equipped to handle the multitudes in need of radiation therapy treatment in the developing world. PMID:24929157

  5. Effects of radiation therapy on T-lymphocyte subpopulations in patients with head and neck cancer

    SciTech Connect

    Gray, W.C.; Chretien, P.B.; Suter, C.M.; Revie, D.R.; Tomazic, V.T.; Blanchard, C.L.; Aygun, C.; Amornmarn, R.; Ordonez, J.V.

    1985-10-01

    Cellular immunity was assessed in 85 patients with head and neck cancer with monoclonal antibodies to lymphocyte surface antigens that identify total T cells, helper cells, and suppressor cells. The control group consisted of 22 healthy volunteers. Nine patients who had surgical procedures for benign diseases were also studied. Compared with the controls, the patients with cancer who received radiation therapy had a significant decrease in total lymphocytes, T cells, helper cells, suppressor cells, and decreased helper/suppressor cell ratio. Significant decreases in lymphocyte subpopulations were not detected in patients tested before treatment or in patients treated with surgery alone. The immune deficits observed were prolonged in duration, with some present in the patients studied up to 11 years after radiation therapy. This long-lasting immune depression may have relevance to tumor recurrences and second primaries in patients with head and neck cancer treated by radiation therapy and to attempts at increasing cure rates with adjuvant agents that improve immune reactivity.

  6. Phase contrast portal imaging for image-guided microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Umetani, Keiji; Kondoh, Takeshi

    2014-03-01

    High-dose synchrotron microbeam radiation therapy is a unique treatment technique used to destroy tumors without severely affecting circumjacent healthy tissue. We applied a phase contrast technique to portal imaging in preclinical microbeam radiation therapy experiments. Phase contrast portal imaging is expected to enable us to obtain higherresolution X-ray images at therapeutic X-ray energies compared to conventional portal imaging. Frontal view images of a mouse head sample were acquired in propagation-based phase contrast imaging. The phase contrast images depicted edge-enhanced fine structures of the parietal bones surrounding the cerebrum. The phase contrast technique is expected to be effective in bony-landmark-based verification for image-guided radiation therapy.

  7. Radiation dosimetry predicts IQ after conformal radiation therapy in pediatric patients with localized ependymoma

    SciTech Connect

    Merchant, Thomas E. [Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States)]. E-mail: thomas.merchant@stjude.org; Kiehna, Erin N. [Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States); Li Chenghong [Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN (United States); Xiong Xiaoping [Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN (United States); Mulhern, Raymond K. [Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN (United States)

    2005-12-01

    Purpose: To assess the effects of radiation dose-volume distribution on the trajectory of IQ development after conformal radiation therapy (CRT) in pediatric patients with ependymoma. Methods and Materials: The study included 88 patients (median age, 2.8 years {+-} 4.5 years) with localized ependymoma who received CRT (54-59.4 Gy) that used a 1-cm margin on the postoperative tumor bed. Patients were evaluated with tests that included IQ measures at baseline (before CRT) and at 6, 12, 24, 36, 48, and 60 months. Differential dose-volume histograms (DVH) were derived for total-brain, supratentorial-brain, and right and left temporal-lobe volumes. The data were partitioned into three dose intervals and integrated to create variables that represent the fractional volume that received dose over the specified intervals (e.g., V{sub 0-20Gy}, V{sub 20-40Gy}, V{sub 40-65Gy}) and modeled with clinical variables to develop a regression equation to estimate IQ after CRT. Results: A total of 327 IQ tests were performed in 66 patients with infratentorial tumors and 20 with supratentorial tumors. The median follow-up was 29.4 months. For all patients, IQ was best estimated by age (years) at CRT; percent volume of the supratentorial brain that received doses between 0 and 20 Gy, 20 and 40 Gy, and 40 and 65 Gy; and time (months) after CRT. Age contributed significantly to the intercept (p > 0.0001), and the dose-volume coefficients were statistically significant (V{sub 0-20Gy}, p = 0.01; V{sub 20-40Gy}, p < 0.001; V{sub 40-65Gy}, p = 0.04). A similar model was developed exclusively for patients with infratentorial tumors but not supratentorial tumors. Conclusion: Radiation dosimetry can be used to predict IQ after CRT in patients with localized ependymoma. The specificity of models may be enhanced by grouping according to tumor location.

  8. Complete response to radiation therapy in a patient with chemotherapy-resistant ovarian clear cell adenocarcinoma

    Microsoft Academic Search

    N. Takai; H. Utsunomiya; Y. Kawano; K. Nasu; H. Narahara; I. Miyakawa

    2002-01-01

    Recurrent ovarian cancer after front-line chemotherapy is incurable. In most institutions, chemotherapy is continued as salvage\\u000a therapy after primary chemotherapy failure and despite the fact that long-term survival and complete responses are infrequent.\\u000a Radiation therapy for patients with recurrent ovarian cancer has often been done with palliative intent. A patient with ovarian\\u000a clear cell adenocarcinoma received irradiation with palliative intent

  9. Nd: YAG laser therapy of rectosigmoid bleeding due to radiation injury

    SciTech Connect

    Leuchter, R.S.; Petrilli, E.S.; Dwyer, R.M.; Hacker, N.F.; Castaldo, T.W.; Lagasse, L.D.

    1982-06-01

    The Nd:YAG laser was used to treat a patient bleeding from the rectosigmoid as a result of radiation injury related to therapy for cervical carcinoma. Successful laser therapy was performed after a diverting colostomy failed to control persistent bleeding. Further surgical procedures were not required. Characteristics of Nd:YAG laser as compared with those of the carbon dioxide and argon lasers are considered.

  10. Rural-urban differences in radiation therapy for ductal carcinoma in-situ of the breast

    Microsoft Academic Search

    Mario Schootman; Rebecca Aft

    2001-01-01

    Purpose. Rural women in the United States are at a documented disadvantage with regard to breast cancer detection, diagnosis, and treatment and generally do not receive state-of-the-art therapy. The objective of the study was to determine if, and to what extent, rural women were less likely to receive radiation therapy (XRT) following breast conserving surgery (BCS) for ductal carcinoma in-situ

  11. Fatal pneumonitis associated with intensity-modulated radiation therapy for mesothelioma

    Microsoft Academic Search

    Aaron M.. Allen; Maria Czerminska; Pasi A. Jaenne; David J. Sugarbaker; Raphael Bueno; Jay R. Harris; Laurence Court; Elizabeth H. Baldini

    2006-01-01

    Purpose: To describe the initial experience at Dana-Farber Cancer Institute\\/Brigham and Women's Hospital with intensity-modulated radiation therapy (IMRT) as adjuvant therapy after extrapleural pneumonectomy (EPP) and adjuvant chemotherapy. Methods and Materials: The medical records of patients treated with IMRT after EPP and adjuvant chemotherapy were retrospectively reviewed. IMRT was given to a dose of 54 Gy to the clinical target

  12. Nonisocentric Treatment Strategy for Breast Radiation Therapy: A Proof of Concept Study

    PubMed Central

    Li, Ruijiang; Xing, Lei; Horst, Kathleen C.; Bush, Karl

    2014-01-01

    Purpose To propose a nonisocentric treatment strategy as a special form of station parameter optimized radiation therapy, to improve sparing of critical structures while preserving target coverage in breast radiation therapy. Methods and Materials To minimize the volume of exposed lung and heart in breast irradiation, we propose a novel nonisocentric treatment scheme by strategically placing nonconverging beams with multiple isocenters. As its name suggests, the central axes of these beams do not intersect at a single isocenter as in conventional breast treatment planning. Rather, the isocenter locations and beam directions are carefully selected, in that each beam is only responsible for a certain subvolume of the target, so as to minimize the volume of irradiated normal tissue. When put together, the beams will provide an adequate coverage of the target and expose only a minimal amount of normal tissue to radiation. We apply the nonisocentric planning technique to 2 previously treated clinical cases (breast and chest wall). Results The proposed nonisocentric technique substantially improved sparing of the ipsilateral lung. Compared with conventional isocentric plans using 2 tangential beams, the mean lung dose was reduced by 38% and 50% using the proposed technique, and the volume of the ipsilateral lung receiving ?20 Gy was reduced by a factor of approximately 2 and 3 for the breast and chest wall cases, respectively. The improvement in lung sparing is even greater compared with volumetric modulated arc therapy. Conclusions A nonisocentric implementation of station parameter optimized radiation therapy has been proposed for breast radiation therapy. The new treatment scheme overcomes the limitations of existing approaches and affords a useful tool for conformal breast radiation therapy, especially in cases with extreme chest wall curvature. PMID:24606852

  13. Etoposide sensitizes CT26 colorectal adenocarcinoma to radiation therapy in BALB/c mice

    PubMed Central

    Liu, Chia-Yuan; Liao, Hui-Fen; Wang, Tsang-En; Lin, Shee-Chan; Shih, Shou-Chuan; Chang, Wen-Hsuing; Yang, Yuh-Cheng; Lin, Ching-Chung; Chen, Yu-Jen

    2005-01-01

    AIM: To investigate the combined effect of etoposide and radiation on CT26 colorectal adenocarcinoma implanted into BALB/c mice. METHODS: We evaluated the radiosensitizing effect of etoposide on CT26 colorectal adenocarcinoma in a syngeneic animal model. BALB/c mice were subcutaneously implanted with CT26 cells and divided into four groups: control (intra-peritoneal saline2) group, etoposide (5 mg/kg intra-peritoneally2) group, radiation therapy (RT 5 Gy2 fractions) group, and combination therapy with etoposide (5 mg/kg intra-peritoneally 1 h before radiation) group. RESULTS: Tumor growth was significantly inhibited by RT and combination therapy. The effect of combination therapy was better than that of RT. No significant changes were noted in body weight, plasma alanine aminotransferase, or creatinine in any group. The leukocyte count significantly but transiently decreased in the RT and combination therapy groups, but not in the etoposide and control groups. There was no skin change or hair loss in the RT and combination therapy groups. CONCLUSION: Etoposide can sensitize CT26 colorectal adenocarcinoma in BALB/c mice to RT without significant toxicity. PMID:16097067

  14. The Frank Stinchfield Award. Inhibition of heterotopic ossification with radiation therapy in an animal model.

    PubMed

    Schneider, D J; Moulton, M J; Singapuri, K; Chinchilli, V; Deol, G S; Krenitsky, G; Pellegrini, V D

    1998-10-01

    An animal model for the study of heterotopic ossification was developed and the effects of perioperative radiation were analyzed. In Phase I, New Zealand White rabbits (n = 18) underwent surgery either with or without muscle injury on each hip to establish the most reliable model in which to study heterotopic ossification. In Phase II, rabbits (n = 36) underwent either 400, 800, or 1200 cGy radiation to one hip 24 hours after bilateral hip surgery to establish a dose response relationship for postoperative radiation therapy. In Phase III, rabbits (n = 24) underwent preoperative radiation therapy (800 cGy) at 4, 16, or 24 hours preoperatively to investigate the mechanism of action and efficacy of preoperative radiation therapy. Monthly radiographs were graded by blinded observers for severity of heterotopic ossification. Mean grade, intraobserver and interobserver variability, and statistical significance were evaluated. In Phase II, 17 of 18 rabbits generated heterotopic ossification in both hips, and the mean grade of heterotopic ossification was always greater on the operative side with intentional muscle injury. Variability in the grading was considered excellent. Phase II revealed that 800 cGy was the minimal effective dose. Contrary to hypothesis, Phase III revealed an increasing grade of heterotopic ossification coinciding with a decreasing preoperative time interval, with the difference in heterotopic ossification grade with 24-hour versus 4-hour preoperative radiation being significant. The rabbit model is reliable and reproducible and closely resembles the human clinical situation after hip surgery. Preoperative and postoperative radiation effectively prevented heterotopic ossification formation. The results support the use of preoperative radiation and establish a need for additional investigation regarding the mechanism of action and timing of preoperative radiation therapy. PMID:9917589

  15. Radiation Therapy after Radical Prostatectomy for Prostate Cancer: Evaluation of Complications and Influence of Radiation Timing on Outcomes in a Large, Population-Based Cohort

    PubMed Central

    Hegarty, Sarah E.; Hyslop, Terry; Dicker, Adam P.; Showalter, Timothy N.

    2015-01-01

    Purpose To evaluate the influence of timing of salvage and adjuvant radiation therapy on outcomes after prostatectomy for prostate cancer. Methods Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified prostate cancer patients diagnosed during 1995–2007 who had one or more adverse pathological features after prostatectomy. The final cohort of 6,137 eligible patients included men who received prostatectomy alone (n = 4,509) or with adjuvant (n = 894) or salvage (n = 734) radiation therapy. Primary outcomes were genitourinary, gastrointestinal, and erectile dysfunction events and survival after treatment(s). Results Radiation therapy after prostatectomy was associated with higher rates of gastrointestinal and genitourinary events, but not erectile dysfunction. In adjusted models, earlier treatment with adjuvant radiation therapy was not associated with increased rates of genitourinary or erectile dysfunction events compared to delayed salvage radiation therapy. Early adjuvant radiation therapy was associated with lower rates of gastrointestinal events that salvage radiation therapy, with hazard ratios of 0.80 (95% CI, 0.67–0.95) for procedure-defined and 0.70 (95% CI, 0.59, 0.83) for diagnosis-defined events. There was no significant difference between ART and non-ART groups (SRT or RP alone) for overall survival (HR = 1.13 95% CI = (0.96, 1.34) p = 0.148). Conclusions Radiation therapy after prostatectomy is associated with increased rates of gastrointestinal and genitourinary events. However, earlier radiation therapy is not associated with higher rates of gastrointestinal, genitourinary or sexual events. These findings oppose the conventional belief that delaying radiation therapy reduces the risk of radiation-related complications. PMID:25706657

  16. [Trends in radiation therapy for the treatment of metastatic and oligometastatic disease in 2010].

    PubMed

    Thariat, J; Marcy, P Y; Lagrange, J L

    2010-12-01

    The role of radiation therapy in metastatic disease has evolved from palliative to potentially curative intent for selected oligometastases using highly conformal radiation techniques, including extracranial stereotactic body radiotherapy (SBRT) in the last decade. SBRT has a potential to use small numbers of large doses aiming at achieving high rates of local control while preserving the quality of life even in highly pretreated patients. A wide range of techniques, doses, and dose fractionation schedules can be found. However, the 2-year local control is around 80% for lung metastases with corresponding 2-year survival of 50%, and a 5% rate of grade III or higher radiation toxicities. The 2-year local control varies between 57 and 92% for liver metastases and radiation-induced liver disease is exceptional provided that 700 cm3 of healthy liver are irradiated to less than 15 Gy in three fractions or more. Stereotactic radiation is also particularly interesting for spinal, and cranial metastases and reirradiations. Also, it has come into focus that associations of chemotherapy or targeted therapies and radiation may be used for optimized treatment of limited metastatic disease and that irradiation of the primary tumor may be recommended in the context of metastatic disease. It also appears that the definition of target volumes for palliative radiation therapy and scores to assess for life expectancy-based need for irradiation should be improved. PMID:21220224

  17. Radiation Therapy in Management of Sporadic and Neurofibromatosis Type 1-Associated Malignant Peripheral Nerve Sheath Tumors

    PubMed Central

    Kahn, Jenna; Gillespie, Andy; Tsokos, Maria; Ondos, John; Dombi, Eva; Camphausen, Kevin; Widemann, Brigitte C.; Kaushal, Aradhana

    2014-01-01

    Introduction: Malignant peripheral nerve sheath tumors (MPNSTs) are highly aggressive soft tissue sarcomas in which complete surgical resection is the mainstay of therapy. However, the recurrence rate is high and few options remain for refractory or metastatic MPNST. This study examines the outcomes of adjuvant radiation therapy in MPNST in patients with and without neurofibromatosis type 1 (NF1) and reviews the literature on use of radiation for MPNST. Methods: A retrospective review of 33 MPNST patients between 1990 and 2012 evaluated at the NIH. All diagnoses were pathologically confirmed at the NCI. Clinical presentation, treatment, and survival were analyzed. Results: Thirty-three patients were included 18 NF1-associated, 15 sporadic tumors. Tumor location included extremity (58%), trunk (36%), and head/neck (6%). Histologic grade showed 25 high-grade tumors compared to 7 low-grade tumors. Twenty patients were treated with radiation therapy (median total dose of 58.5?Gy with 1.8?Gy/fraction). A median survival of all patients was 46.5?months and 43.7% overall 5-year survival. Prognostic factors include extent of resection, tumor location, and histology grade. Radiation was not found to be a prognostic factor for overall survival. Conclusion: This study is consistent with previous studies regarding the role of radiation in the management of MPNST. Prospective evaluation of adjuvant radiation will allow to more fully define the role of radiation in MPNST. PMID:25452937

  18. Primary Radiation Therapy for Head-and-Neck Cancer in the Setting of Human Immunodeficiency Virus

    SciTech Connect

    Klein, Emily A.; Guiou, Michael [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Farwell, D. Gregory; Luu, Quang [Department of Otolaryngology-Head and Neck Surgery, University of California Davis Cancer Center, Sacramento, CA (United States); Lau, Derick H. [Department of Medical Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Stuart, Kerri; Vaughan, Andrew; Vijayakumar, Srinivasan [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States); Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.ed [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, CA (United States)

    2011-01-01

    Purpose: To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV). Methods and Materials: The medical records of 12 patients with serologic evidence of HIV who subsequently underwent radiation therapy to a median dose of 68 Gy (range, 64-72 Gy) for newly diagnosed squamous cell carcinoma of the head and neck were reviewed. Six patients (50%) received concurrent chemotherapy. Intensity-modulated radiotherapy was used in 6 cases (50%). All patients had a Karnofsky performance status of 80 or 90. Nine patients (75%) were receiving antiretroviral therapies at the time of treatment, and the median CD4 count was 460 (range, 266-800). Toxicity was graded according to the Radiation Therapy Oncology Group / European Organization for the Treatment of Cancer toxicity criteria. Results: The 3-year estimates of overall survival and local-regional control were 78% and 92%, respectively. Acute Grade 3+ toxicity occurred in 7 patients (58%), the most common being confluent mucositis (5 patients) and moist skin desquamation (4 patients). Two patients experienced greater than 10% weight loss, and none experienced more than 15% weight loss from baseline. Five patients (42%) experienced treatment breaks in excess of 10 cumulative days, although none required hospitalization. There were no treatment-related fatalities. Conclusions: Radiation therapy for head-and-neck cancer seems to be relatively well tolerated among appropriately selected patients with HIV. The observed rates of toxicity were comparable to historical controls without HIV.

  19. An investigation of intensity-modulated radiation therapy versus conventional two-dimensional and 3D-conformal radiation therapy for early stage larynx cancer

    Microsoft Academic Search

    Daniel Gomez; Oren Cahlon; James Mechalakos; Nancy Lee

    2010-01-01

    Introduction  Intensity modulated radiation therapy (IMRT) has been incorporated at several institutions for early stage laryngeal cancer\\u000a (T1\\/T2N0M0), but its utility is controversial.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In three representative patients, multiple plans were generated: 1) Conventional 2D planning, with the posterior border placed\\u000a at either the anterior aspect (\\

  20. Measurement of density and calcium in human atherosclerotic plaque and implications for arterial brachytherapy

    Microsoft Academic Search

    David A. Rahdert; William L. Sweet; Fermin O. Tio; Christian Janicki; Dennis M. Duggan

    1999-01-01

    Purpose. To measure density of arterial plaque specimens for purposes of improving calculation of intravascular radiation dose.Methods and Materials. In the described technique, the mass of the specimen submerged in water is compared with its mass in air. Thirty-three plaque specimens harvested from cadavers and subsequently histologically classified (18 coronary, 15 noncoronary) were subjected to density measurement, and were also

  1. Surgeons' Knowledge and Practices Regarding the Role of Radiation Therapy in Breast Cancer Management

    SciTech Connect

    Zhou, Jessica [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Hawley, Sarah T.; Zikmund-Fisher, Brian J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Janz, Nancy K. [Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan (United States); Sabel, Michael S. [Department of Surgery, University of Michigan, Ann Arbor, Michigan (United States); Katz, Steven J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-12-01

    Purpose: Population-based studies suggest underuse of radiation therapy, especially after mastectomy. Because radiation oncology is a referral-based specialty, knowledge and attitudes of upstream providers, specifically surgeons, may influence patients' decisions regarding radiation, including whether it is even considered. Therefore, we sought to evaluate surgeons' knowledge of pertinent risk information, their patterns of referral, and the correlates of surgeon knowledge and referral in specific breast cancer scenarios. Methods and Materials: We surveyed a national sample of 750 surgeons, with a 67% response rate. We analyzed responses from those who had seen at least 1 breast cancer patient in the past year (n=403), using logistic regression models to identify correlates of knowledge and appropriate referral. Results: Overall, 87% of respondents were general surgeons, and 64% saw >10 breast cancer patients in the previous year. In a scenario involving a 45-year-old undergoing lumpectomy, only 45% correctly estimated the risk of locoregional recurrence without radiation therapy, but 97% would refer to radiation oncology. In a patient with 2 of 20 nodes involved after mastectomy, 30% would neither refer to radiation oncology nor provide accurate information to make radiation decisions. In a patient with 4 of 20 nodes involved after mastectomy, 9% would not refer to radiation oncology. Fewer than half knew that the Oxford meta-analysis revealed a survival benefit from radiation therapy after lumpectomy (45%) or mastectomy (32%). Only 16% passed a 7-item knowledge test; female and more-experienced surgeons were more likely to pass. Factors significantly associated with appropriate referral to radiation oncology included breast cancer volume, tumor board participation, and knowledge. Conclusions: Many surgeons have inadequate knowledge regarding the role of radiation in breast cancer management, especially after mastectomy. Targeted educational interventions may improve the quality of care.

  2. Preoperative radiation therapy for sarcoma of soft tissue

    SciTech Connect

    Suit, H.D.; Proppe, K.H.; Mankin, H.J.; Wood, W.C.

    1981-05-01

    Experience at the Massachusetts General Hospital in the management of 36 patients with sarcoma of soft tissue who were accepted for treatment by radiation followed by surgery is described. The tumors in these patients were extensive: greater than 5 cm in 33. Actual radiation doses covered a broad range for a variety of technical and medical reasons. The general dose aim has been 5000 to 6000 rad (200 rad 5 times a week) followed in approximately three weeks by conservative resection; a boost dose to the tumor bed has been given intraoperatively (interstitial or electron beam technique) or postoperatively (small field external beam, fractionated dose technique). Histologic change in the operative specimen increased with histologic grade of tumor. Local control has been achieved in 31 of 33 patients (follow-up of three months to eight years) treated by radiation followed by surgery. Wound healing was delayed in six of the 33 treated by radiation followed by resection.

  3. Method and devices for performing stereotactic microbeam radiation therapy

    DOEpatents

    Dilmanian, F. Avraham (Yaphank, NY)

    2010-01-05

    A radiation delivery system generally includes either a synchrotron source or a support frame and a plurality of microbeam delivery devices supported on the support frame, both to deliver a beam in a hemispherical arrangement. Each of the microbeam delivery devices or synchrotron irradiation ports is adapted to deliver at least one microbeam of radiation along a microbeam delivery axis, wherein the microbeam delivery axes of the plurality of microbeam delivery devices cross within a common target volume.

  4. TGF? Is a Master Regulator of Radiation Therapy-Induced Antitumor Immunity.

    PubMed

    Vanpouille-Box, Claire; Diamond, Julie M; Pilones, Karsten A; Zavadil, Jiri; Babb, James S; Formenti, Silvia C; Barcellos-Hoff, Mary Helen; Demaria, Sandra

    2015-06-01

    T cells directed to endogenous tumor antigens are powerful mediators of tumor regression. Recent immunotherapy advances have identified effective interventions to unleash tumor-specific T-cell activity in patients who naturally develop them. Eliciting T-cell responses to a patient's individual tumor remains a major challenge. Radiation therapy can induce immune responses to model antigens expressed by tumors, but it remains unclear whether it can effectively prime T cells specific for endogenous antigens expressed by poorly immunogenic tumors. We hypothesized that TGF? activity is a major obstacle hindering the ability of radiation to generate an in situ tumor vaccine. Here, we show that antibody-mediated TGF? neutralization during radiation therapy effectively generates CD8(+) T-cell responses to multiple endogenous tumor antigens in poorly immunogenic mouse carcinomas. Generated T cells were effective at causing regression of irradiated tumors and nonirradiated lung metastases or synchronous tumors (abscopal effect). Gene signatures associated with IFN? and immune-mediated rejection were detected in tumors treated with radiation therapy and TGF? blockade in combination but not as single agents. Upregulation of programmed death (PD) ligand-1 and -2 in neoplastic and myeloid cells and PD-1 on intratumoral T cells limited tumor rejection, resulting in rapid recurrence. Addition of anti-PD-1 antibodies extended survival achieved with radiation and TGF? blockade. Thus, TGF? is a fundamental regulator of radiation therapy's ability to generate an in situ tumor vaccine. The combination of local radiation therapy with TGF? neutralization offers a novel individualized strategy for vaccinating patients against their tumors. Cancer Res; 75(11); 2232-42. ©2015 AACR. PMID:25858148

  5. Current perspectives on radiation therapy in autologous and prosthetic breast reconstruction

    PubMed Central

    Clemens, Mark W.

    2015-01-01

    Background Postmastectomy radiation therapy (PMRT) has a well-established deleterious effect on both prosthetic and autologous breast reconstruction. The purpose of this study was to perform a literature review of the effects of PMRT on breast reconstruction and to determine predictive or protective factors for complications. Methods The MEDLINE and EMBASE databases were reviewed for articles published between January 2008 and January 2015 including the keywords “breast reconstruction” and “radiation therapy” to identify manuscripts focused on the effects of radiation on both prosthetic and autologous breast reconstruction. This subgroup of articles was reviewed in detail. Results Three hundred and twenty articles were identified and 43 papers underwent full text review. The 16 papers provided level III evidence; 10 manuscripts provided level I or II evidence. Seventeen case series provided level IV evidence and were included because they presented novel perspectives. The majority of studies focused on the injurious effects of radiation therapy and increased complications and concomitant lower patient satisfaction. Conclusions Prosthetic based breast reconstruction and immediate autologous reconstruction are associated with lower patient satisfaction in the setting of radiation therapy. Autologous reconstructions can improve patient satisfaction as well as lower revision surgery and long term complications when performed in a delayed fashion after PMRT. PMID:26161307

  6. Intravascular probe for detection of vulnerable plaque

    NASA Astrophysics Data System (ADS)

    Patt, Bradley E.; Iwanczyk, Jan S.; MacDonald, Lawrence R.; Yamaguchi, Yuko; Tull, Carolyn R.; Janecek, Martin; Hoffman, Edward J.; Strauss, H. William; Tsugita, Ross; Ghazarossian, Vartan

    2001-12-01

    Coronary angiography is unable to define the status of the atheroma, and only measures the luminal dimensions of the blood vessel, without providing information about plaque content. Up to 70% of heart attacks are caused by minimally obstructive vulnerable plaques, which are too small to be detected adequately by angiography. We have developed an intravascular imaging detector to identify vulnerable coronary artery plaques. The detector works by sensing beta or conversion electron radiotracer emissions from plaque-binding radiotracers. The device overcomes the technical constraints of size, sensitivity and conformance to the intravascular environment. The detector at the distal end of the catheter uses six 7mm long by 0.5mm diameter scintillation fibers coupled to 1.5m long plastic fibers. The fibers are offset from each other longitudinally by 6mm and arranged spirally around a guide wire in the catheter. At the proximal end of the catheter the optical fibers are coupled to an interface box with a snap on connector. The interface box contains a position sensitive photomultiplier tube (PSPMT) to decode the individual fibers. The whole detector assembly fits into an 8-French (2.7 mm in diameter) catheter. The PSPMT image is further decoded with software to give a linear image, the total instantaneous count rate and an audio output whose tone corresponds to the count rate. The device was tested with F-18 and Tl-204 sources. Spectrometric response, spatial resolution, sensitivity and beta to background ratio were measured. System resolution is 6 mm and the sensitivity is >500 cps / micrometers Ci when the source is 1 mm from the detector. The beta to background ratio was 11.2 for F-18 measured on a single fiber. The current device will lead to a system allowing imaging of labeled vulnerable plaque in coronary arteries. This type of signature is expected to enable targeted and cost effective therapies to prevent acute coronary artery diseases such as: unstable angina, acute myocardial infarction, and sudden cardiac death.

  7. Modulation of c-Met signaling and cellular sensitivity to radiation: potential implications for therapy

    PubMed Central

    Bhardwaj, Vikas; Cascone, Tina; Cortez, M Angelica; Amini, Arya; Evans, Jaden; Komaki, Ritusko U; Heymach, John V; Welsh, James W

    2013-01-01

    The c-Met/hepatocyte growth factor (HGF) receptor and its family members are known to promote cancer cell migration and invasion. Signaling within and beyond this pathway contributes to the systemic spread of metastases through induction of the epithelial-mesenchymal transition (EMT), a process also implicated in mediating resistance to current anticancer therapies, including radiation. Induction of c-Met has also been observed upon irradiation, suggesting that c-Met participates in radiation-induced progression through the EMT. Hence c-Met inhibition is an attractive target for potentially mitigating radiation resistance. This article summarizes key findings regarding cross-talk between radiation therapy and c-Met and discusses studies done to date in which c-Met inhibition was used as a strategy to increase cellular radiosensitivity. PMID:23423860

  8. Application of GEANT4 in the Development of New Radiation Therapy Treatment Methods

    NASA Astrophysics Data System (ADS)

    Brahme, Anders; Gudowska, Irena; Larsson, Susanne; Andreassen, Björn; Holmberg, Rickard; Svensson, Roger; Ivanchenko, Vladimir; Bagulya, Alexander; Grichine, Vladimir; Starkov, Nikolay

    2006-04-01

    There is a very fast development of new radiation treatment methods today, from advanced use of intensity modulated photon and electron beams to light ion therapy with narrow scanned beam based treatment units. Accurate radiation transport calculations are a key requisite for these developments where Geant4 is a very useful Monte Carlo code for accurate design of new treatment units. Today we cannot only image the tumor by PET-CT imaging before the treatment but also determine the tumor sensitivity to radiation and even measure in vivo the delivered absorbed dose in three dimensions in the patient. With such methods accurate Monte Carlo calculations will make radiation therapy an almost exact science where the curative doses can be calculated based on patient individual response data. In the present study results from the application of Geant4 are discussed and the comparisons between Geant4 and experimental and other Monte Carlo data are presented.

  9. GPU-based High-Performance Computing for Radiation Therapy

    PubMed Central

    Jia, Xun; Ziegenhein, Peter; Jiang, Steve B.

    2014-01-01

    Recent developments in radiotherapy therapy demand high computation powers to solve challenging problems in a timely fashion in a clinical environment. Graphics processing unit (GPU), as an emerging high-performance computing platform, has been introduced to radiotherapy. It is particularly attractive due to its high computational power, small size, and low cost for facility deployment and maintenance. Over the past a few years, GPU-based high-performance computing in radiotherapy has experienced rapid developments. A tremendous amount of studies have been conducted, in which large acceleration factors compared with the conventional CPU platform have been observed. In this article, we will first give a brief introduction to the GPU hardware structure and programming model. We will then review the current applications of GPU in major imaging-related and therapy-related problems encountered in radiotherapy. A comparison of GPU with other platforms will also be presented. PMID:24486639

  10. GPU-based high-performance computing for radiation therapy

    NASA Astrophysics Data System (ADS)

    Jia, Xun; Ziegenhein, Peter; Jiang, Steve B.

    2014-02-01

    Recent developments in radiotherapy therapy demand high computation powers to solve challenging problems in a timely fashion in a clinical environment. The graphics processing unit (GPU), as an emerging high-performance computing platform, has been introduced to radiotherapy. It is particularly attractive due to its high computational power, small size, and low cost for facility deployment and maintenance. Over the past few years, GPU-based high-performance computing in radiotherapy has experienced rapid developments. A tremendous amount of study has been conducted, in which large acceleration factors compared with the conventional CPU platform have been observed. In this paper, we will first give a brief introduction to the GPU hardware structure and programming model. We will then review the current applications of GPU in major imaging-related and therapy-related problems encountered in radiotherapy. A comparison of GPU with other platforms will also be presented.

  11. GPU-based high-performance computing for radiation therapy.

    PubMed

    Jia, Xun; Ziegenhein, Peter; Jiang, Steve B

    2014-02-21

    Recent developments in radiotherapy therapy demand high computation powers to solve challenging problems in a timely fashion in a clinical environment. The graphics processing unit (GPU), as an emerging high-performance computing platform, has been introduced to radiotherapy. It is particularly attractive due to its high computational power, small size, and low cost for facility deployment and maintenance. Over the past few years, GPU-based high-performance computing in radiotherapy has experienced rapid developments. A tremendous amount of study has been conducted, in which large acceleration factors compared with the conventional CPU platform have been observed. In this paper, we will first give a brief introduction to the GPU hardware structure and programming model. We will then review the current applications of GPU in major imaging-related and therapy-related problems encountered in radiotherapy. A comparison of GPU with other platforms will also be presented. PMID:24486639

  12. Disappearance of La Caille Plaque

    NASA Astrophysics Data System (ADS)

    2010-04-01

    A bronze plaque erected to the memory of N.-L. de La Caille near the site of his observatory in Central Cape Town, has been stolen by metal thieves. It was designed by the famous architect Sir Herbert Baker.

  13. Laser-driven beam lines for delivering intensity modulated radiation therapy with particle beams

    NASA Astrophysics Data System (ADS)

    Hofmann, K. M.; Schell, S.; Wilkens, J. J.

    2013-07-01

    Laser-accelerated particles can provide a promising opportunity for radiation therapy of cancer. Potential advantages arise from combining a compact, cost-efficient treatment unit with the physical advantages in dose delivery of charged particle beams. We consider different dose delivery schemes and the required devices to design a possible treatment unit. The secondary radiation produced in several beam line elements remains a challenge to be addressed.

  14. Laser-driven beam lines for delivering intensity modulated radiation therapy with particle beams

    SciTech Connect

    Hofmann, K. M.; Schell, S.; Wilkens, J. J. [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München (Germany)] [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München (Germany)

    2013-07-26

    Laser-accelerated particles can provide a promising opportunity for radiation therapy of cancer. Potential advantages arise from combining a compact, cost-efficient treatment unit with the physical advantages in dose delivery of charged particle beams. We consider different dose delivery schemes and the required devices to design a possible treatment unit. The secondary radiation produced in several beam line elements remains a challenge to be addressed.

  15. Intracoronary g-Radiation Therapy After Angioplasty Inhibits Recurrence in Patients With In-Stent Restenosis

    Microsoft Academic Search

    Ron Waksman; R. Larry White; Rosanna C. Chan; Bill G. Bass; Lisa Geirlach; Gary S. Mintz; Lowell F. Satler; Roxana Mehran; Patrick W. Serruys; Alexandra J. Lansky; Peter Fitzgerald; Balram Bhargava; Kenneth M. Kent; Augusto D. Pichard; Martin B. Leon

    were then blindly randomized to receive either intracoronary g-radiation with 192Ir (15 Gy) or placebo. Four independent core laboratories blinded to the treatment protocol analyzed the angiographic and intravascular ultrasound end points of restenosis. Procedural success and in-hospital and 30-day complications were similar among the groups. At 6 months, patients assigned to radiation therapy required less target lesion revascularization and

  16. Incorporating Patient Breathing Variability into a Stochastic Model of Dose Deposition for Stereotactic Body Radiation Therapy

    Microsoft Academic Search

    Sarah E. Geneser; Robert M. Kirby; Brian Wang; Bill Salter; Sarang C. Joshi

    2009-01-01

    Hypo-fractionated stereotactic body radiation therapy (SBRT) employs precisely-conforming high-level radiation dose delivery\\u000a to improve tumor control probabilities and sparing of healthy tissue. However, the delivery precision and conformity of SBRT\\u000a renders dose accumulation particularly susceptible to organ motion, and respiratory-induced motion in the abdomen may result\\u000a in significant displacement of lesion targets during the breathing cycle. Given the maturity of

  17. Intracoronary b-Radiation Therapy Inhibits Recurrence of In-Stent Restenosis

    Microsoft Academic Search

    Ron Waksman; Balram Bhargava; Larry White; Rosanna C. Chan; Roxana Mehran; Alexandra J. Lansky; Gary S. Mintz; Lowell F. Satler; Augusto D. Pichard; Martin B. Leon; Kenneth K. Kent

    Background—Intracoronary g-radiation therapy reduces recurrent in-stent restenosis (ISR). This study, BETA WRIST (Washington Radiation for In-Stent restenosis Trial) was designed to examine the efficacy and safety of the b-emitter 90-yttrium for the prevention of recurrent ISR. Methods and Results—A total of 50 consecutive patients with ISR in native coronaries underwent percutaneous transluminal coronary angioplasty, laser angioplasty, rotational atherectomy, and\\/or stent

  18. Biophysical characteristics of HIMAC clinical irradiation system for heavy-ion radiation therapy

    Microsoft Academic Search

    Tatsuaki Kanai; Masahiro Endo; Shinichi Minohara; Nobuyuki Miyahara; Hiroko Koyama-ito; Hiromi Tomura; Naruhiro Matsufuji; Yasuyuki Futami; Akifumi Fukumura; Takeshi Hiraoka; Yoshiya Furusawa; Koichi Ando; Masao Suzuki; Fuminori Soga; Kiyomitsu Kawachi

    1999-01-01

    Purpose: The irradiation system and biophysical characteristics of carbon beams are examined regarding radiation therapy.Methods and Materials: An irradiation system was developed for heavy-ion radiotherapy. Wobbler magnets and a scatterer were used for flattening the radiation field. A patient-positioning system using X ray and image intensifiers was also installed in the irradiation system. The depth-dose distributions of the carbon beams

  19. Monte Carlo modelling of a silicon strip detector for microbeam radiation therapy

    Microsoft Academic Search

    Ashley Cullen; Michael Lerch; Marco Petasecca; Anatoly Rosenfeld

    Microbeam radiation therapy is an experimental technique utilising synchrotron X-rays collimated into a planar array of microbeams. Due to the complex structure of the radiation field and high dose rate, this introduces dosimetric challenges. Current dosimetric methods are inadequate in that they lack either real-time readout, or high spatial resolution. A detector system, consisting of the Silicon Multi-Strip Detector and

  20. First trial of spatial and temporal fractionations of the delivered dose using synchrotron microbeam radiation therapy.

    PubMed

    Serduc, Raphaël; Bräuer-Krisch, Elke; Bouchet, Audrey; Renaud, Luc; Brochard, Thierry; Bravin, Alberto; Laissue, Jean Albert; Le Duc, Géraldine

    2009-07-01

    The technical feasibility of temporal and spatial fractionations of the radiation dose has been evaluated using synchrotron microbeam radiation therapy for brain tumors in rats. A significant increase in lifespan (216%, p < 0.0001) resulted when three fractions of microbeam irradiation were applied to the tumor through three different ports, orthogonal to each other, at 24 h intervals. However, there were no long-term survivors, and immunohistological studies revealed that 9 L tumors were not entirely ablated. PMID:19535875

  1. X-Tream: a novel dosimetry system for Synchrotron Microbeam Radiation Therapy

    Microsoft Academic Search

    M Petasecca; A Cullen; I Fuduli; A Espinoza; C Porumb; C Stanton; A H Aldosari; E Bräuer-Krisch; H Requardt; A Bravin; V Perevertaylo; A B Rosenfeld; M L F Lerch

    2012-01-01

    Microbeam Radiation Therapy (MRT) is a radiation treatment technique under development for inoperable brain tumors. MRT is based on the use of a synchrotron generated X-ray beam with an extremely high dose rate ( ? 20 kGy\\/sec), striated into an array of X-ray micro-blades. In order to advance to clinical trials, a real-time dosimeter with excellent spatial resolution must be

  2. Spatially resolved measurement of high doses in microbeam radiation therapy using samarium doped fluorophosphate glasses

    Microsoft Academic Search

    Go Okada; Brian Morrell; Cyril Koughia; Andy Edgar; Chris Varoy; George Belev; Tomasz Wysokinski; Dean Chapman; Safa Kasap

    2011-01-01

    The measurement of spatially resolved high doses in microbeam radiation therapy has always been a challenging task, where a combination of high dose response and high spatial resolution (microns) is required for synchrotron radiation peaked around 50 keV. The x-ray induced Sm3+ --> Sm2+ valence conversion in Sm3+ doped fluorophosphates glasses has been tested for use in x-ray dosimetry for

  3. Future directions in therapy of whole body radiation injury

    SciTech Connect

    Cronkite, E.P.

    1989-01-01

    Clinicians have long known that marked granulocytopenia predisposed patients to bacterial infections either from pathogens or commensal organisms with which an individual usually lives in harmony. Evidence that infection was of major importance derives from several observations: (a) clinical observations of bacterial infection in human beings exposed to atomic bomb radiation in Hiroshima and Nagasaki, in reactor accidents, and in large animals dying from radiation exposure, (b) correlative studies on mortality rate, time of death, and incidence of positive culture in animals, (c) challenge of irradiated animals with normally non-virulent organisms, (d) studies of germ free mice and rats, and (e) studies of the effectiveness of antibiotics in reducing mortality rate. General knowledge and sound experimental data on animals and man clearly demonstrated that the sequelae of pancytopenia (bacterial infection, thrombopenic hemorrhage, and anemia) are the lethal factors. A lot of research was required to demonstrate that there were no mysterious radiations toxins, that hyperheparinemia was not a cause of radiation hemorrhage and that radiation hemorrhage could be prevented by fresh platelet transfusions.

  4. Implications of Intercellular Signaling for Radiation Therapy: A Theoretical Dose-Planning Study

    SciTech Connect

    McMahon, Stephen J., E-mail: stephen.mcmahon@qub.ac.uk [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom); McGarry, Conor K. [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom); Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland (United Kingdom); Butterworth, Karl T. [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom); O'Sullivan, Joe M. [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom); Clinical Oncology, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland (United Kingdom); Hounsell, Alan R. [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom); Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland (United Kingdom); Prise, Kevin M. [Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland (United Kingdom)

    2013-12-01

    Purpose: Recent in vitro results have shown significant contributions to cell killing from signaling effects at doses that are typically used in radiation therapy. This study investigates whether these in vitro observations can be reconciled with in vivo knowledge and how signaling may have an impact on future developments in radiation therapy. Methods and Materials: Prostate cancer treatment plans were generated for a series of 10 patients using 3-dimensional conformal therapy, intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy techniques. These plans were evaluated using mathematical models of survival following modulated radiation exposures that were developed from in vitro observations and incorporate the effects of intercellular signaling. The impact on dose–volume histograms and mean doses were evaluated by converting these survival levels into “signaling-adjusted doses” for comparison. Results: Inclusion of intercellular communication leads to significant differences between the signalling-adjusted and physical doses across a large volume. Organs in low-dose regions near target volumes see the largest increases, with mean signaling-adjusted bladder doses increasing from 23 to 33 Gy in IMRT plans. By contrast, in high-dose regions, there is a small decrease in signaling-adjusted dose due to reduced contributions from neighboring cells, with planning target volume mean doses falling from 74 to 71 Gy in IMRT. Overall, however, the dose distributions remain broadly similar, and comparisons between the treatment modalities are largely unchanged whether physical or signaling-adjusted dose is compared. Conclusions: Although incorporating cellular signaling significantly affects cell killing in low-dose regions and suggests a different interpretation for many phenomena, their effect in high-dose regions for typical planning techniques is comparatively small. This indicates that the significant signaling effects observed in vitro are not contradicted by comparison with clinical observations. Future investigations are needed to validate these effects in vivo and to quantify their ranges and potential impact on more advanced radiation therapy techniques.

  5. Four-Week Course of Radiation for Breast Cancer Using Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost

    SciTech Connect

    Freedman, Gary M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)]. E-mail: Gary.Freedman@FCCC.edu; Anderson, Penny R. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Goldstein, Lori J. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Ma Changming [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Li Jinsheng [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Swaby, Ramona F. [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Litwin, Samuel [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States); Watkins-Bruner, Deborah [School of Nursing, University of Pennsylvania, Philadelphia, PA (United States); Sigurdson, Elin R. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Morrow, Monica [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)

    2007-06-01

    Purpose: Standard radiation for early breast cancer requires daily treatment for 6 to 7 weeks. This is an inconvenience to many women, and for some a barrier for breast conservation. We present the acute toxicity of a 4-week course of hypofractionated radiation. Methods and Materials: A total of 75 patients completed radiation on a Phase II trial approved by the hospital institutional review board. Eligibility criteria were broad to include any patient normally eligible for standard radiation: age {>=}18 years, invasive or in situ cancer, American Joint Committee on Cancer Stage 0 to II, breast-conserving surgery, and any systemic therapy not given concurrently. The median age was 52 years (range, 31-81 years). Of the patients, 15% had ductal carcinoma in situ, 67% T1, and 19% T2; 71% were N0, 17% N1, and 12% NX. Chemotherapy was given before radiation in 44%. Using photon intensity-modulated radiation therapy and incorporated electron beam boost, the whole breast received 45 Gy and the lumpectomy bed 56 Gy in 20 treatments over 4 weeks. Results: The maximum acute skin toxicity by the end of treatment was Grade 0 in 9 patients (12%), Grade 1 in 49 (65%) and Grade 2 in 17 (23%). There was no Grade 3 or higher skin toxicity. After radiation, all Grade 2 toxicity had resolved by 6 weeks. Hematologic toxicity was Grade 0 in most patients except for Grade 1 neutropenia in 2 patients, and Grade 1 anemia in 11 patients. There were no significant differences in baseline vs. 6-week posttreatment patient-reported or physician-reported cosmetic scores. Conclusions: This 4-week course of postoperative radiation using intensity-modulated radiation therapy is feasible and is associated with acceptable acute skin toxicity and quality of life. Long-term follow-up data are needed. This radiation schedule may represent an alternative both to longer 6-week to 7-week standard whole-breast radiation and more radically shortened 1-week, partial-breast treatment schedules.

  6. Dose-Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer

    SciTech Connect

    Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Shibuya, Keiko; Nakamura, Mitsuhiro; Narabayashi, Masaru; Sakanaka, Katsuyuki; Ueki, Nami; Miyagi, Ken; Norihisa, Yoshiki; Mizowaki, Takashi [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Nagata, Yasushi [Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan)

    2012-07-15

    Purpose: To identify dose-volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials: This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose-volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results: With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose-volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder (p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV {>=}37.7 ml and V25 <4.2%; and patients with PTV {>=}37.7 ml and V25 {>=}4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively (p = 0.013). Conclusions: Lung V25 and PTV volume were significant factors associated with RP after SBRT.

  7. Intra-operative radiation therapy in the treatment of pelvic malignancies: a preliminary report.

    PubMed

    Yordan, E L; Jurado, M; Kiel, K; Reddy, S; Kramer, T; Calvo, F; Roseman, D L; Graham, J E; Wilbanks, G D

    1988-12-01

    Local control of advanced pelvic malignancies, particularly when complete surgical resection is not feasible, is often impeded by dosage limitations in radiation therapy and the intolerance to radiation of normal tissues. This is a preliminary report on the feasibility of improved local control in pelvic malignancies treated by intra-operative radiation therapy, as a radiation boost, in addition to conventional surgical resection and external beam radiation therapy. Fifteen gynaecological malignancies (five cervix, five uterus, four ovary, and one vulva) from Rush Medical College and the University of Navarre, as well as 36 other pelvic malignancies (32 colorectal, 4 genito-urinary) from Rush Medical College were reviewed. All tumours were advanced or recurrent, and all patients were felt to be at high risk of local failure. IORT was administered at a dose range of 10-26 Gy. Our data suggest that the probability of local control improves when IORT is used for primary and for microscopic disease, when the tumour is at least partially resectable, and when the total dose given in IORT and external beam radiation exceeds 70 Gy. PMID:3229050

  8. Evidence of energy transfer in nanoparticle-porphyrins conjugates for radiation therapy enhancement

    NASA Astrophysics Data System (ADS)

    Kudinov, Konstantin; Cooper, Daniel; Tyagi, Pooja; Bekah, Devesh; Bhattacharyya, Dhrittiman; Hill, Colin; Ha, Jonathan Kin; Nadeau, Jay; Bradforth, Stephen

    2015-03-01

    We report progress towards combining radiation therapy (RT) and photodynamic therapy (PDT) using scintillating nanoparticle (NP)-photosensitizer conjugates. In this approach, scintillating NPs are excited by clinically relevant ionizing radiation sources and subsequently transfer energy to conjugated photosensitizers via FRET, acting as an energy mediator between ionizing radiation and photosensitizer molecules. The excited photosensitizers generate reactive oxygen species that can induce local damage and immune response. Advantages of the scheme include: 1) Compared with traditional radiation therapy, a possible decrease of the total radiation dose needed to eliminate the lesion; 2) Compared with traditional PDT, the ability to target deeper and more highly pigmented lesions; 3) The possibility of additional photosensitizing effects due to the scintillation of the nanoparticles. In this work, the photosensitizer molecule chlorin e6 was covalently bound to the surface of LaF3:Ce NPs. After conjugation, the photoluminescence intensity of NPs decreased, and fluorescence lifetime of conjugated chlorin e6 became sensitive to excitation wavelength, suggesting rapid FRET. In addition, scintillation spectra of nanoparticles were measured. Preliminary calculations suggest that the observed scintillation efficiencies are sufficient to enhance RT. In vitro cancer cell studies suggest conjugates are taken up by cells. Survival curves with radiation exposure suggest that the particles alone cause radiosensitization comparable to that seen with gold nanoparticles.

  9. [The effectiveness of magnetic therapy of grade I-II radiation pneumofibrosis].

    PubMed

    Grushina, T I

    2014-01-01

    Radiation therapy of malignant tumours of the chest organs may result in radiation damage of the lungs. To prevent and reduce radiation-induced lung injuries, new types of radiation therapy have been developed, a number of various modifiers investigated, the methods of pharmacotherapy and physiotherapy proposed. The present study involved 37 patients presenting with radiation pneumofibrosis, including 7 ones with lung cancer and 30 patients with breast cancer. Based on the results of clinical, radiographic, and functional investigations, grade 1 and II pneumofibrosis was diagnosed in 20 and 17 patients respectively. After the application of an alternating magnetic field during 15 days, all the patients experience the overall regression of clinical symptoms and disorders of respiratory biomechanics. However, it seems premature to draw a definitive conclusion about the effectiveness of magnetic therapy of grade 1 and II radiation pneumofibrosis before the extensive in-depth investigations are carried out based on a large clinical material including the results of long-term follow-up studies and continuous monitoring. PMID:25314763

  10. Quality Assurance of Positron Emission Tomography/Computed Tomography for Radiation Therapy

    SciTech Connect

    Xing Lei [Department of Radiation Oncology, Stanford University, Stanford, CA (United States)], E-mail: lei@reyes.stanford.edu

    2008-05-01

    Recent advances in radiation delivery techniques, such as intensity-modulated radiation therapy, provide unprecedented ability to exquisitely control three-dimensional dose distribution. Development of on-board imaging and other image-guidance methods significantly improved our ability to better target a radiation beam to the tumor volume. However, in reality, accurate definition of the location and boundary of the tumor target is still problematic. Biologic and physiologic imaging promises to solve the problem in a fundamental way and has a more and more important role in patient staging, treatment planning, and therapeutic assessment in radiation therapy clinics. The last decade witnessed a dramatic increase in the use of positron emission tomography and computed tomography in radiotherapy practice. To ensure safe and effective use of nuclide imaging, a rigorous quality assurance (QA) protocol of the imaging tools and integration of the imaging data must be in place. The application of nuclide imaging in radiation oncology occurs at different levels of sophistication. Quantitative use of the imaging data in treatment planning through image registration and standardized uptake value calculation is often involved. Thus, QA should not be limited to the performance of the scanner, but should also include the process of implementing image data in treatment planning, such as data transfer, image registration, and quantitation of data for delineation of tumors and sensitive structures. This presentation discusses various aspects of nuclide imaging as applied to radiotherapy and describes the QA procedures necessary for the success of biologic image-guided radiation therapy.

  11. Effective Dose from Stray Radiation for a Patient Receiving Proton Therapy for Liver Cancer

    PubMed Central

    Taddei, Phillip J; Krishnan, Sunil; Mirkovic, Dragan; Yepes, Pablo; Newhauser, Wayne D

    2010-01-01

    Because of its advantageous depth-dose relationship, proton radiotherapy is an emerging treatment modality for patients with liver cancer. Although the proton dose distribution conforms to the target, healthy tissues throughout the body receive low doses of stray radiation, particularly neutrons that originate in the treatment unit or in the patient. The aim of this study was to calculate the effective dose from stray radiation and estimate the corresponding risk of second cancer fatality for a patient receiving proton beam therapy for liver cancer. Effective dose from stray radiation was calculated using detailed Monte Carlo simulations of a double-scattering proton therapy treatment unit and a voxelized human phantom. The treatment plan and phantom were based on CT images of an actual adult patient diagnosed with primary hepatocellular carcinoma. For a prescribed dose of 60 Gy to the clinical target volume, the effective dose from stray radiation was 370 mSv; 61% of this dose was from neutrons originating outside of the patient while the remaining 39% was from neutrons originating within the patient. The excess lifetime risk of fatal second cancer corresponding to the total effective dose from stray radiation was 1.2%. The results of this study establish a baseline estimate of the stray radiation dose and corresponding risk for an adult patient undergoing proton radiotherapy for liver cancer and provide new evidence to corroborate the suitability of proton beam therapy for the treatment of liver tumors. PMID:20865142

  12. Treatment of superficial esophageal cancer by external radiation therapy alone: results of a multi-institutional experience

    Microsoft Academic Search

    Kenji Nemoto; Yasuo Matsumoto; Michitaka Yamakawa; Seiya Jo; Yoshihiro Ito; Masahiko Oguchi; Naoki Kokubo; Yasumasa Nishimura; Shogo Yamada; Tomohiko Okawa

    2000-01-01

    Purpose: To assess the effectiveness and toxicity of external radiation therapy for superficial esophageal cancer.Methods and Materials: During the period from March 1979 to November 1996, 78 patients with superficial esophageal cancer received radiation therapy without intracavitary irradiation at nine radiotherapy institutions in Japan. All patients had histologically-proven squamous cell carcinoma. Endoscopic ultrasonography was performed in 34 patients to discriminate

  13. New approaches in the use of radiation therapy in the treatment of infiltrative transitional-cell cancer of the bladder

    Microsoft Academic Search

    P. Warde; M. K. Gospodarowicz

    1997-01-01

    Summary Organ preservation using primary radical radiation therapy (RT) is a viable treatment option for many patients with invasive bladder cancer, and there is no evidence that survival is compromised by this approach. However, the survival and local control rates in patients with bladder cancer currently treated with radical RT are not optimal. Combined modality therapy, altered radiation-fractionation approaches, and

  14. X-ray microbeam radiation therapy calculations, including polarisation effects, with the Monte Carlo code EGS5

    Microsoft Academic Search

    Richard P. Hugtenburg; A. S. Adegunloye; David A. Bradley

    2010-01-01

    Microbeam radiation therapy (MRT) is currently being considered for the treatment of glioblastoma multiforme. A high degree of dosimetric accuracy (around 5%) is known to be required for a successful outcome in conventional radiation therapy, Modelling of MRT beams, measurements and treatments have been performed with Monte Carlo methods using the code EGS5, which features improved physics models for low

  15. Method for decreasing radiation load in puva therapy

    SciTech Connect

    Wolff, K.

    1987-02-10

    An improved method is described for treating a psoriatic subject undergoing treatment with a psoralen in conjection with ultraviolet A radiation of from wavelength of 3200 to 4000 angstroms. The improved method comprises prior to initiation of the treatment, pretreating the subject for a period of from 4 to 10 days with an effective amount of an anti-psoriatic polyene compound, and thereafter initiating the treatment with a psoralen in conjunction with ultraviolet A radiation and continuing the treatment concurrently with the administration of the anti-psoriatic polyene compound.

  16. Bevacizumab, Oxaliplatin, and Capecitabine With Radiation Therapy in Rectal Cancer: Phase I Trial Results

    SciTech Connect

    Czito, Brian G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)]. E-mail: czito001@mc.duke.edu; Bendell, Johanna C. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Willett, Christopher G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Morse, Michael A. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Blobe, Gerard C. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Tyler, Douglas S. [Department of General Surgery, Duke University Medical Center, Durham, NC (United States); Thomas, John [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Ludwig, Kirk A. [Department of General Surgery, Duke University Medical Center, Durham, NC (United States); Mantyh, Christopher R. [Department of General Surgery, Duke University Medical Center, Durham, NC (United States); Ashton, Jill [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States); Yu Daohai [Department of Biostatistics, Duke University Medical Center, Durham, NC (United States); Hurwitz, Herbert I. [Department of Internal Medicine, Division of Medical Oncology and Transplantation, Duke University Medical Center, Durham, NC (United States)

    2007-06-01

    Purpose: The overexpression of vascular endothelial growth factor (VEGF) is associated with poor outcomes in colorectal cancer patients. Bevacizumab, a VEGF inhibitor, enhances the effects of chemotherapy and radiation therapy on tumor cytotoxicity in preclinical models, including colorectal cancer. A Phase I trial was undertaken to evaluate the combination of bevacizumab, capecitabine, oxaliplatin, and radiation therapy in patients with rectal cancer. Methods and Materials: Patients with pathologically confirmed adenocarcinoma of the rectum were eligible. Pretreatment staging included computerized tomography, endoscopic ultrasound, and surgical evaluation. Patients received 50.4 Gy of external beam radiation therapy (EBRT) to the tumor in 28 fractions. Capecitabine, oxaliplatin, and bevacizumab were administered concurrently with radiation therapy. After EBRT completion, patients were restaged and evaluated for surgery. Primary endpoints included the determination of dose-limiting toxicity and a recommended Phase II dose, non dose-limiting toxicity, and preliminary radiographic and pathologic response rates. Results: Eleven patients were enrolled. All were evaluable for toxicity and efficacy. Dose level 2 was associated with unacceptable toxicity (primarily diarrhea). Dose level 1 had an acceptable toxicity profile. The recommended Phase II dose in our study was bevacizumab 15 mg/kg Day 1 + 10 mg/kg Days 8 and 22, oxaliplatin 50 mg/m{sup 2} weekly, and capecitabine 625 mg/m{sup 2} bid during radiation days. Six patients had clinical responses. Two patients had a pathologic complete response, and 3 had microscopic disease only. One patient experienced a postoperative abscess, one a syncopal episode during adjuvant chemotherapy, and one a subclinical myocardial infarction during adjuvant chemotherapy. Conclusions: The combination of bevacizumab, capecitabine, oxaliplatin, and radiation therapy in rectal cancer was tolerable, with encouraging response rates. Further investigation with this regimen is being pursued in a Phase II setting.

  17. Second Solid Cancers After Radiation Therapy: A Systematic Review of the Epidemiologic Studies of the Radiation Dose-Response Relationship

    SciTech Connect

    Berrington de Gonzalez, Amy, E-mail: berringtona@mail.nih.gov [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Gilbert, Ethel; Curtis, Rochelle; Inskip, Peter; Kleinerman, Ruth; Morton, Lindsay; Rajaraman, Preetha; Little, Mark P. [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)] [Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

    2013-06-01

    Rapid innovations in radiation therapy techniques have resulted in an urgent need for risk projection models for second cancer risks from high-dose radiation exposure, because direct observation of the late effects of newer treatments will require patient follow-up for a decade or more. However, the patterns of cancer risk after fractionated high-dose radiation are much less well understood than those after lower-dose exposures (0.1-5 Gy). In particular, there is uncertainty about the shape of the dose-response curve at high doses and about the magnitude of the second cancer risk per unit dose. We reviewed the available evidence from epidemiologic studies of second solid cancers in organs that received high-dose exposure (>5 Gy) from radiation therapy where dose-response curves were estimated from individual organ-specific doses. We included 28 eligible studies with 3434 second cancer patients across 11 second solid cancers. Overall, there was little evidence that the dose-response curve was nonlinear in the direction of a downturn in risk, even at organ doses of ?60 Gy. Thyroid cancer was the only exception, with evidence of a downturn after 20 Gy. Generally the excess relative risk per Gray, taking account of age and sex, was 5 to 10 times lower than the risk from acute exposures of <2 Gy among the Japanese atomic bomb survivors. However, the magnitude of the reduction in risk varied according to the second cancer. The results of our review provide insights into radiation carcinogenesis from fractionated high-dose exposures and are generally consistent with current theoretical models. The results can be used to refine the development of second solid cancer risk projection models for novel radiation therapy techniques.

  18. A Framework for Comprehensive Electronic QA in Radiation Therapy

    Microsoft Academic Search

    J. Kildea; M. Evans; W. Parker

    2010-01-01

    We describe a framework for comprehensive electronic QA currently under development in the department of Radiation Oncology at the Montreal General Hospital. When complete, the system will incorporate all data generated within the department. It will allow for easy access to all aspects of a patient's treatment and to the state of all relevant equipment at the time of treatment.

  19. Surface reconstruction from structured-light images for radiation therapy

    Microsoft Academic Search

    Olesya Peshko; Christopher K. Anand; Tamás Terlaky

    2005-01-01

    To design and deliver proper radiation treatment for cancer patients, knowledge of the body's surface in the affected area is required. Currently, surface information is obtained by using a manually operated tracer. The drawbacks of this contact method include slow operation, and errors in repositioning the patient in an x-ray machine. Utilization of MRI or CT is also possible but

  20. Establishing radiation therapy advanced practice in New Zealand

    PubMed Central

    Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

    2014-01-01

    Introduction:?Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods:?All registered RTs in New Zealand (n?=?260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results:?RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion:?The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

  1. Additive Fuzzy Enhancement and an Associative Memory for Feature Tracking in Radiation Therapy Images

    Microsoft Academic Search

    Hamid R. Tizhoosh; Gerald Krell; Bernd Michaelis

    1997-01-01

    Medical images in radiation therapy, especially electronic portal images, are often very poor in quality because of imaging physics. For a reliable patient set-up verification by tracking of relevant features, better in-treatment images are necessary. In this work, we present the prototype of an additive fuzzy system for a locally adaptive image enhancement and a modified associative memory for image

  2. Utilization of a Photon Transport Code to Investigate Radiation Therapy Treatment Planning Quantities and Techniques.

    NASA Astrophysics Data System (ADS)

    Palta, Jatinder Raj

    A versatile computer program MORSE, based on neutron and photon transport theory has been utilized to investigate radiation therapy treatment planning quantities and techniques. A multi-energy group representation of transport equation provides a concise approach in utilizing Monte Carlo numerical techniques to multiple radiation therapy treatment planning problems. A general three dimensional geometry is used to simulate radiation therapy treatment planning problems in configurations of an actual clinical setting. Central axis total and scattered dose distributions for homogeneous and inhomogeneous water phantoms are calculated and the correction factor for lung and bone inhomogeneities are also evaluated. Results show that Monte Carlo calculations based on multi-energy group transport theory predict the depth dose distributions that are in good agreement with available experimental data. Improved correction factors based on the concepts of lung-air-ratio and bone-air-ratio are proposed in lieu of the presently used correction factors that are based on tissue-air-ratio power law method for inhomogeneity corrections. Central axis depth dose distributions for a bremsstrahlung spectrum from a linear accelerator is also calculated to exhibit the versatility of the computer program in handling multiple radiation therapy problems. A novel approach is undertaken to study the dosimetric properties of brachytherapy sources. Dose rate constants for various radionuclides are calculated from the numerically generated dose rate versus source energy curves. Dose rates can also be generated for any point brachytherapy source with any arbitrary energy spectrum at various radial distances from this family of curves.

  3. SALVAGE CRYOTHERAPY FOR RECURRENT PROSTATE CANCER AFTER RADIATION THERAPY: THE COLUMBIA EXPERIENCE

    Microsoft Academic Search

    ALEXANDRE DE LA TAILLE; OMAR HAYEK; MITCHELL C. BENSON; EMILIA BAGIELLA; CARL A. OLSSON; MARIE FATAL; AARON E. KATZ

    Objectives. Cryotherapy of the prostate represents a potential treatment for localized recurrent prostate cancer after radiation therapy. We report our experience and evaluate the predictive factors for prostate- specific antigen (PSA) recurrence. Methods. Between October 1994 and April 1999, 43 patients underwent salvage cryoablation. All patients had biopsy-proven recurrent prostate cancer without seminal vesicle invasion, negative bone scans, and negative

  4. In vivo measurements with MOSFET detectors in oropharynx and nasopharynx intensity-modulated radiation therapy

    Microsoft Academic Search

    Serge. Marcie; Elisabeth Charpiot; René-Jean Bensadoun; Gaston Ciais; Joel Hérault; André Costa; Jean-Pierre Gérard

    2005-01-01

    Purpose: To evaluate the feasibility of in vivo measurements with metal oxide semiconductor field effect transistor (MOSFET) dosimeters for oropharynx and nasopharynx intensity-modulated radiation therapy (IMRT). Methods and Materials: During a 1-year period, in vivo measurements of the dose delivered to one or two points of the oral cavity by IMRT were obtained with MOSFET dosimeters. Measurements were obtained during

  5. Deformation estimated using a multiresolution wavelet representation for adaptive radiation therapy

    Microsoft Academic Search

    Dengwang Li; Xiuying Wang; Hongjun Wang; Yong Yin; David Dagan Feng

    2010-01-01

    Registration of planning CT (PCT) images with daily cone beam CT (CBCT) images is an important task for adaptive radiation therapy (ART). Considering that both global and local deformation are existing in image pairs to be registered, estimation of deformation in a coarse-to-fine strategy with the optimization process can prevent convergence into local minima traps. In this paper, deformation is

  6. Rapid block matching based nonlinear registration on GPU for image guided radiation therapy

    Microsoft Academic Search

    An Wang; Brandon Disher; Greg Carnes; Terry M. Peters

    2010-01-01

    To compensate for non-uniform deformation due to patient motion within and between fractions in image guided radiation therapy, a block matching technique was adapted and implemented on a standard graphics processing unit (GPU) to determine the displacement vector field that maps the nonlinear transformation between successive CT images. Normalized cross correlation (NCC) was chosen as the similarity metric for the

  7. Radiation Therapy for Idiopathic Orbital Myositis: Two Case Reports and Literature Review

    Microsoft Academic Search

    Koichi Isobe; Takashi Uno; Hiroyuki Kawakami; Naoyuki Ueno; Tetsuya Kawata; Hideki Abe; Katsuyuki Minowa; Shuichi Yamamoto; Hisao Ito

    We report two cases of idiopathic orbital myositis treated with radiation therapy (RT). Both patients visited our hospital with complaints of orbital pain on eye movement and eyelid swelling. There was no history of thyroid disease or trauma, and no signs of infection, neoplasm, or collagen disease. The laboratory investigations, including a thyroid function test, showed no abnormalities in either

  8. 3-D-Conformal Radiation Therapy for Pediatric Giant Cell Tumors of the Skull Base

    Microsoft Academic Search

    Eugen B. Hug; Marc W. Muenter; Judy A. Adams; Alexander de Vries; Andrew E. Rosenberg; John E. Munzenrider

    2002-01-01

    Background: Giant cell tumors (GCT) of the base of skull are rare neoplasms. This report reviews the treatment of four pediatric patients presenting with aggressive giant cell tumor, using fractionated and combined, conformal proton and photon radiation therapy at Massachusetts General Hospital and Harvard Cyclotron Laboratory. Patients and Methods: Three female patients and one adolescent male, ages 10-15 years, had

  9. Improved functionality of the vasculature during conventionally fractionated radiation therapy of prostate cancer.

    PubMed

    Potiron, Vincent A; Abderrahmani, Rym; Clément-Colmou, Karen; Marionneau-Lambot, Séverine; Oullier, Thibauld; Paris, François; Supiot, Stéphane

    2013-01-01

    Although endothelial cell apoptosis participates in the tumor shrinkage after single high-dose radiotherapy, little is known regarding the vascular response after conventionally fractionated radiation therapy. Therefore, we evaluated hypoxia, perfusion and vascular microenvironment changes in an orthotopic prostate cancer model of conventionally fractionated radiation therapy at clinically relevant doses (2 Gy fractions, 5 fractions/week). First, conventionally fractionated radiation therapy decreased tumor cell proliferation and increased cell death with kinetics comparable to human prostate cancer radiotherapy. Secondly, the injection of Hoechst 33342 or fluorescent-dextrans showed an increased tumor perfusion within 14 days in irradiated tumors, which was correlated with a clear reduction of hypoxia. Improved perfusion and decreased hypoxia were not explained by increased blood vessel density, size or network morphology. However, a tumor vascular maturation defined by perivascular desmin+/SMA+ cells coverage was clearly observed along with an increase in endothelial, zonula occludens (ZO)-1 positive, intercellular junctions. Our results show that, in addition to tumor cell killing, vascular maturation plays an uncovered role in tumor reoxygenation during fractionated radiation therapy. PMID:24391887

  10. Improved Functionality of the Vasculature during Conventionally Fractionated Radiation Therapy of Prostate Cancer

    PubMed Central

    Potiron, Vincent A.; Abderrahmani, Rym; Clément-Colmou, Karen; Marionneau-Lambot, Séverine; Oullier, Thibauld

    2013-01-01

    Although endothelial cell apoptosis participates in the tumor shrinkage after single high-dose radiotherapy, little is known regarding the vascular response after conventionally fractionated radiation therapy. Therefore, we evaluated hypoxia, perfusion and vascular microenvironment changes in an orthotopic prostate cancer model of conventionally fractionated radiation therapy at clinically relevant doses (2 Gy fractions, 5 fractions/week). First, conventionally fractionated radiation therapy decreased tumor cell proliferation and increased cell death with kinetics comparable to human prostate cancer radiotherapy. Secondly, the injection of Hoechst 33342 or fluorescent-dextrans showed an increased tumor perfusion within 14 days in irradiated tumors, which was correlated with a clear reduction of hypoxia. Improved perfusion and decreased hypoxia were not explained by increased blood vessel density, size or network morphology. However, a tumor vascular maturation defined by perivascular desmin+/SMA+ cells coverage was clearly observed along with an increase in endothelial, zonula occludens (ZO)-1 positive, intercellular junctions. Our results show that, in addition to tumor cell killing, vascular maturation plays an uncovered role in tumor reoxygenation during fractionated radiation therapy. PMID:24391887

  11. Roadmap: Radiologic Imaging Sciences Radiation Therapy (with certification and ATS Radiologic Technology) -

    E-print Network

    Sheridan, Scott

    Roadmap: Radiologic Imaging Sciences ­ Radiation Therapy ­ (with certification and ATS Radiologic Technology) - Bachelor of Radiologic Imaging Sciences Technology [RE-BRIT-RIS-RTHB] Regional College Catalog Hours] Note: Students must have graduated from a hospital-based certificate program in radiologic

  12. Radiochromic film dosimetry: Recommendations of AAPM Radiation Therapy Committee Task Group 55

    Microsoft Academic Search

    Azam Niroomand-Rad; Charles Robert Blackwell; Bert M. Coursey; Kenneth P. Gall; James M. Galvin; William L. McLaughlin; Ali S. Meigooni; Ravinder Nath; James E. Rodgers; Christopher G. Soares

    1998-01-01

    Recommendations of the American Association of Physicists in Medicine (AAPM) for the radio- chromic film dosimetry are presented. These guidelines were prepared by a task group of the AAPM Radiation Therapy Committee and have been reviewed and approved by the AAPM Science Council. © 1998 American Association of Physicists in Medicine. (S0094-2405(98)00211-9)

  13. Fostering a culture of interprofessional education for radiation therapy and medical dosimetry students

    SciTech Connect

    Lavender, Charlotte, E-mail: charlavender@gmail.com; Miller, Seth; Church, Jessica; Chen, Ronald C.; Muresan, Petronella A.; Adams, Robert D.

    2014-04-01

    A less-studied aspect of radiation therapy and medical dosimetry education is experiential learning through attendance at interprofessional conferences. University of North Carolina radiation therapy and medical dosimetry students regularly attended morning conferences and daily pretreatment peer review, including approximately 145 hours of direct interaction with medical attending physicians and residents, medical physicists, and other faculty. We herein assessed the effect of their participation in these interprofessional conferences on knowledge and communication. The students who graduated from our radiation therapy and medical dosimetry programs who were exposed to the interprofessional education initiative were compared with those who graduated in the previous years. The groups were compared with regard to their knowledge (as assessed by grades on end-of-training examinations) and team communication (assessed via survey). The results for the 2 groups were compared via exact tests. There was a trend for the examination scores for the 2012 cohort to be higher than for the 2007 to 2011 groups. Survey results suggested that students who attended the interprofessional education sessions were more comfortable speaking with attending physicians, residents, physicists, and faculty compared with earlier students who did not attend these educational sessions. Interprofessional education, particularly vertical integration, appears to provide an enhanced educational experience both in regard to knowledge (per the examination scores) and in building a sense of communication (via the survey results). Integration of interprofessional education into radiation therapy and medical dosimetry educational programs may represent an opportunity to enrich the learning experience in multiple ways and merits further study.

  14. Managing Radiation Therapy Side Effects: What to Do When You Feel Weak or Tired (Fatigue)

    MedlinePLUS

    ... ride an exercise bike. ? Choose an exercise or sport that you enjoy. National Cancer Institute U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Managing Radiation Therapy Side Effects What To Do When You Feel Weak or Tired (Fatigue) “I had no energy. I asked my doctor ...

  15. Formal Safety Analysis of the Control Program for a Radiation Therapy Machine

    Microsoft Academic Search

    Jonathan Jacky

    A central problem in software development is to assure that a complex program actually meets its requirements. This problem is most urgent in applications such as the control of radiation therapy machines, where execution of the program can have ir-reversible human consequences. The problem is difficult for at least two reasons. First, there is the sheer mass of detail that

  16. Flat-panel cone-beam computed tomography for image-guided radiation therapy

    Microsoft Academic Search

    David A Jaffray; Jeffrey H Siewerdsen; John W Wong; Alvaro A Martinez

    2002-01-01

    Purpose: Geometric uncertainties in the process of radiation planning and delivery constrain dose escalation and induce normal tissue complications. An imaging system has been developed to generate high-resolution, soft-tissue images of the patient at the time of treatment for the purpose of guiding therapy and reducing such uncertainties. The performance of the imaging system is evaluated and the application to

  17. Factors Associated With Surgical and Radiation Therapy for Early Stage Breast Cancer in Older Women

    Microsoft Academic Search

    Rachel Ballard-Barbash; Arnold L. Potosky; Linda C. Harlan; Susan G. Nayfield; Larry G. Kessler

    1996-01-01

    years of age and OR of 033 (95% CI = 0.24-0.46) for women with two or more comorbid conditions versus no comorbid conditions). Conclusions: After adjustment for multiple clinical and nonclinical factors influencing treatment, chronologic age remains an important independent factor associated with the receipt of radiation therapy after breast- conserving surgery among women aged 65 years or more who

  18. Relationship between mood disturbance and sleep quality in oncology outpatients at the initiation of radiation therapy

    Microsoft Academic Search

    Christina Van Onselen; Laura B. Dunn; Kathryn Lee; Marylin Dodd; Theresa Koetters; Claudia West; Steven M. Paul; Bradley E. Aouizerat; William Wara; Patrick Swift; Christine Miaskowski

    2010-01-01

    Purpose of the researchThe purpose of this study was to describe the occurrence of significant mood disturbance and evaluate for differences in sleep quality among four mood groups (i.e., neither anxiety nor depression, only anxiety, only depression, anxiety and depression) prior to the initiation of radiation therapy (RT).

  19. The GEANT4 toolkit for microdosimetry calculations: Application to microbeam radiation therapy (MRT)

    Microsoft Academic Search

    J. Spiga; E. A. Siegbahn; E. Braeuer-Krisch; P. Randaccio; A. Bravin

    2007-01-01

    Theoretical dose distributions for microbeam radiation therapy (MRT) are computed in this paper using the GEANT4 Monte Carlo (MC) simulation toolkit. MRT is an innovative experimental radiotherapy technique carried out using an array of parallel microbeams of synchrotron-wiggler-generated x rays. Although the biological mechanisms underlying the effects of microbeams are still largely unknown, the effectiveness of MRT can be traced

  20. Preferential Effect of Synchrotron Microbeam Radiation Therapy on Intracerebral 9L Gliosarcoma Vascular Networks

    Microsoft Academic Search

    Audrey Bouchet; Benjamin Lemasson; Géraldine Le Duc; Cécile Maisin; Elke Braeuer-Krisch; Erik Albert Siegbahn; Luc Renaud; Enam Khalil; Chantal Rémy; Cathy Poillot; Alberto Bravin; Jean A. Laissue; Emmanuel L. Barbier; Raphaël Serduc

    2010-01-01

    Purpose: Synchrotron microbeam radiation therapy (MRT) relies on spatial fractionation of the incident photon beam into parallel micron-wide beams. Our aim was to analyze the effects of MRT on normal brain and 9L gliosarcoma tissues, particularly on blood vessels. Methods and Materials: Responses to MRT (two arrays, one lateral, one anteroposterior (2 x 400 Gy), intersecting orthogonally in the tumor

  1. Monte Carlo Study of a Mosfet Detector Response Applied to X-Ray Microbeam Radiation Therapy

    Microsoft Academic Search

    M. de Felici; R. Felici; M. Sanchez Del Rio; A. Dilmanian; C. Ferreo

    2004-01-01

    EGS4 Monte Carlo calculations of the dose deposited by array of microbeams, used for the Microbeam Radiation Therapy technique, are presented. The sensitivity of the results to the experimental parameters (incident beam energy, beam array dimensions and spacing) has been assessed. The effects of the photon beam polarization and energy cut-off have also been investigated. The response of a Silicon

  2. Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy

    Microsoft Academic Search

    Raphaël Serduc; Yohan van de Looij; Gilles Francony; Olivier Verdonck; Boudewijn van der Sanden; Jean Laissue; Régine Farion; Elke Bräuer-Krisch; Erik Albert Siegbahn; Alberto Bravin; Yolanda Prezado; Christoph Segebarth; Chantal Rémy; Hana Lahrech

    2008-01-01

    Cerebral edema is one of the main acute complications arising after irradiation of brain tumors. Microbeam radiation therapy (MRT), an innovative experimental radiotherapy technique using spatially fractionated synchrotron x-rays, has been shown to spare radiosensitive tissues such as mammal brains. The aim of this study was to determine if cerebral edema occurs after MRT using diffusion-weighted MRI and microgravimetry. Prone

  3. Brain tumor vessel response to synchrotron microbeam radiation therapy: a short-term in vivo study

    Microsoft Academic Search

    Raphaël Serduc; Thomas Christen; Jean Laissue; Régine Farion; Audrey Bouchet; Boudewijn van der Sanden; Christoph Segebarth; Elke Bräuer-Krisch; Géraldine LeDuc; Alberto Bravin; Chantal Rémy; Emmanuel L. Barbier

    2008-01-01

    The aim of this work focuses on the description of the short-term response of a 9L brain tumor model and its vasculature to microbeam radiation therapy (MRT) using magnetic resonance imaging (MRI). Rat 9L gliosarcomas implanted in nude mice brains were irradiated by MRT 13 days after tumor inoculation using two orthogonal arrays of equally spaced 28 planar microbeams (25

  4. Roadmap: Radiologic Imaging Sciences Radiation Therapy (Freshman or AS degree) Bachelor of Radiologic Imaging Sciences Technology

    E-print Network

    Sheridan, Scott

    Roadmap: Radiologic Imaging Sciences ­ Radiation Therapy (Freshman or AS degree) ­ Bachelor diversity US 10097 Destination Kent State: First Year Experience 1 Not required of transfer students with 25 Not required for AS degree holders Semester Four: [13 Credit Hours] COMM 15000 Introduction to Human

  5. Impact of Quality Assurance Rounds in a Canadian Radiation Therapy Department

    SciTech Connect

    Lefresne, Shilo; Olivotto, Ivo A.; Joe, Howard; Blood, Paul A. [Radiotherapy Department, BC Cancer Agency, Vancouver Island Centre, Vancouver, British Columbia (Canada) [Radiotherapy Department, BC Cancer Agency, Vancouver Island Centre, Vancouver, British Columbia (Canada); Radiotherapy Department, University of British Columbia, Vancouver, British Columbia (Canada); Olson, Robert A., E-mail: rolson2@bccancer.bc.ca [Radiotherapy Department, University of British Columbia, Vancouver, British Columbia (Canada); Radiotherapy Department, BC Cancer Agency, Centre for the North, Prince George, British Columbia (Canada)

    2013-03-01

    Purpose: Quality assurance (QA) programs aim to identify inconsistencies that may compromise patient care. Radiation treatment planning is a well-documented source of variation in radiation oncology, leading many organizations to recommend the implementation of QA rounds in which radiation therapy plans are peer reviewed. This study evaluates the outcome of QA rounds that have been conducted by a radiation therapy department since 2004. Methods and Materials: Prospectively documented records of QA rounds, from 2004 to 2010, were obtained. During rounds, randomly selected radiation therapy plans were peer reviewed and assigned a grade of A (adequate), B (minor suggestions of change to a plan for a future patient), or C (significant change required before the next fraction). The proportion of plans that received each recommendation was calculated, and the relationship between recommendations for each plan, tumor site, and mean years of experience of the radiation oncologist (RO) were explored. Chart reviews were performed for each plan that received a C. Results: During the study period, 1247 plans were evaluated; 6% received a B and 1% received a C. The mean RO years of experience were lower for plans graded C versus those graded A (P=.02). The tumor sites with the highest proportion of plans graded B or C were gastrointestinal (14%), lung (13%), and lymphoma (8%). The most common reasons for plans to receive a grade of C were inadequate target volume coverage (36%), suboptimal dose or fractionation (27%), errors in patient setup (27%), and overtreatment of normal tissue (9%). Conclusions: This study demonstrated that QA rounds are feasible and an important element of a radiation therapy department's QA program. Through peer review, plans that deviate from a department's expected standard can be identified and corrected. Additional benefits include identifying patterns of practice that may contribute to inconsistencies in treatment planning and the continuing education of staff members who attend.

  6. Radiation-induced malignant meningioma following proton beam therapy for a choroidal melanoma.

    PubMed

    Scaringi, Claudia; Minniti, Giuseppe; Bozzao, Alessandro; Giangaspero, Felice; Falco, Teresa; Greco, Alessandro; De Sanctis, Vitaliana; Romano, Andrea; Enrici, Riccardo Maurizi

    2015-06-01

    We report a woman with malignant meningioma diagnosed 9years after the treatment of a choroidal melanoma with proton beam therapy. The risk of secondary cancers is a well-known adverse late effect of radiation therapy, especially with the use of advanced techniques such as intensity-modulated radiation therapy. However, this risk may be less with the use of proton beam therapy. A 79-year-old woman presented with symptoms of enophthalmos, ptosis and paralysis of the left medial rectus muscle. She had previously been successfully treated for a choroidal melanoma of the left eye with proton beam therapy (total dose: 60 cobalt gray equivalents) following local resection. MRI showed a lesion in the left cavernous sinus with extension into the orbit and a subsequent biopsy revealed a papillary meningioma. The cavernous tumor was treated with photon radiotherapy (total dose: 54Gy) which achieved an initial partial response. However, 8months later the tumor extensively metastasized to the skull and the spine and the patient died 1year after the treatment. The incidence of secondary malignancies after proton beam therapy is low but not negligible, therefore, it must be taken into account when planning a treatment as secondary tumors may present with a highly aggressive behaviour. PMID:25861886

  7. Monte Carlo modelling of acute and late effects in radiation therapy.

    PubMed

    Hugtenburg, Richard P

    2012-07-01

    Physical models are increasingly used to predict acute and late effects resulting from radiation therapy. These models utilise measured and calculated microdosimetric quantities, and are increasingly used to determine the significant corrections for effective dose used in ion-beam therapy, neutron therapy and boron neutron-capture therapy. The relative biological effect (RBE) of differing radiation sources is predicted using measurable quantities such as lineal energy, which have been also generally been reproduced with calculations using Monte Carlo methods. In addition to the physical data provided by Monte Carlo modelling, in vitro studies and epidemiological data derived from cancer treatments and other exposed populations, are used in the prediction of the risk of late effects such as secondary malignancies. Monte Carlo methods are used in particular to model contaminant components. This work focuses on our understanding of the variation in RBE in photon and electron radiotherapy, how it might affect precision in the treatment of cancer, and how it provides an accurate starting point in extrapolating to prescribed doses with new therapies. In vitro transformation assays and Monte Carlo based calculations of bioeffect used for conventional photon therapy treatments over a range of energies are examined and their utility in the refinement of bioeffect models for both early and late effects are discussed. PMID:22209776

  8. [A case of prednisolone therapy for radiation-induced hemorrhagic cystitis].

    PubMed

    Yanagi, Masato; Nishimura, Taiji; Kurita, Susumu; Lee, Chorsu; Kondo, Yukihiro; Yamazaki, Keiichi

    2011-05-01

    Hemorrhagic cystitis resulting from radiation to pelvic visceral malignant lesions often might be incurable and there have been no established definitive treatment. We experienced a case with severe radiation-induced hemorrhagic cystitis refractory to conventional therapy. The treatment with oral administration of prednisolone was performed and obtained a successful result. Gross hematuria disappeared in 2 weeks in this case. This experience suggested that oral administration of prednisolone could be considered the treatment for patients with radiation-induced hemorrhagic cystitis when usual treatments including transurethral electro-coagulation are unsuccessful. PMID:21846069

  9. Clinical Implementation of Tangential Field Intensity Modulated Radiation Therapy (IMRT) Using Sliding Window Technique and Dosimetric Comparison with 3D Conformal Therapy (3DCRT) in Breast Cancer

    Microsoft Academic Search

    Raj N. Selvaraj; Sushil Beriwal; Roya J. Pourarian; Ron J. Lalonde; Alex Chen; Kiran Mehta; Gwendolyn Brunner; Kathy A. Wagner; Ning J. Yue; Saiful M. Huq; Dwight E. Heron

    2007-01-01

    The purpose of this study was to evaluate the clinical implementation of tangential field IMRT using sliding window technique and to compare dosimetric parameters with 3-dimensional conformal radiation therapy (3DCRT). Twenty breast cancer patients were randomly selected for comparison of intensity modulated radiation therapy (IMRT)-based treatment plan with 3DCRT. Inverse treatment was performed using the sliding window technique, employing the

  10. Hyperthermia and radiation in cancer therapy: A review

    NASA Astrophysics Data System (ADS)

    Hetzel, Fred W.; Dunn, Joseph A.

    This paper attempts to provide a brief and concise summary of the underlying scientific principles for the use of hyperthermia as an anti-cancer treatment modality. The effects of hyperthermia on mammalian cells are described and compared to the known effects of ionizing radiation. Some biochemical and subcellular responses to hyperthermia and their resultant role in overall cellular response are also presented. The physiological changes induced, particularly in tumors, by the application of hyperthermia and their subsequent effects on overall tumor response are described as is the rationale for combining heat with ionizing radiation into a single treatment regime. Finally, some preliminary clinical results are presented which describe the potential for the clinical use of hyperthermia.

  11. Asymmetric Thoracic Metaiodobenzylguanidine (MIBG) Activity Due to Prior Radiation Therapy.

    PubMed

    Bai, Xia; Yang, Hua; Zhuang, Hongming

    2015-06-01

    A 5-year-old patient suffered Horner syndrome, which was caused by a neuroblastoma in the left apex of the lung shown on the initial I-MIBG scan. After the surgical resection and external radiation to the left lung field, a follow-up I-MIBG scan revealed significantly less MIBG activity in the left upper chest compared to the contralateral right upper chest. PMID:25742240

  12. Determinants of Patient Satisfaction During Receipt of Radiation Therapy

    SciTech Connect

    Famiglietti, Robin M., E-mail: rfamigli@mdanderson.org; Neal, Emily C.; Edwards, Timothy J.; Allen, Pamela K.; Buchholz, Thomas A.

    2013-09-01

    Purpose: To evaluate the correlations and relative contributions of components of a radiation oncology-specific patient satisfaction survey to their overall satisfaction scores. Methods and Materials: From September 2006 through August 2012, we prospectively collected data from 8069 patients receiving radiation treatments with a 26-question survey. Each question was rated on a 10-point Likert scale. We analyzed the correlation between scores for each question and the overall satisfaction question. We also dichotomized the scores to reflect satisfaction versus dissatisfaction and used logistic regression to assess the relationship between items in 4 domains (the patient–provider relationship, access and environmental issues, wait times, and educational information) and overall satisfaction. Results: Scores on all questions correlated with overall patient satisfaction scores (P<.0001). Satisfaction with patient–provider relationships had the greatest influence on overall satisfaction (R{sup 2}=0.4219), followed by wait times (R{sup 2}=0.4000), access/environment (R{sup 2}=0.3837), and patient education (R{sup 2}=0.3700). The specific variables with the greatest effect on patient satisfaction were the care provided by radiation therapists (odds ratio 1.91) and pain management (odds ratio 1.29). Conclusions: We found that patients' judgment of provider relationships in an outpatient radiation oncology setting were the greatest contributors to their overall satisfaction ratings. Other measures typically associated with patient satisfaction (phone access, scheduling, and ease of the check-in process) correlated less strongly with overall satisfaction. These findings may be useful for other practices preparing to assess patient ratings of quality of care.

  13. Radiation therapy in the management of cutaneous T-cell lymphomas.

    PubMed

    Hoppe, R T; Fuks, Z; Bagshaw, M A

    1979-04-01

    The lesions of mycosis fungoides (MF), a neoplasm of T lymphocytes, are extremely radiosensitive. The history of ionizing radiation in the treatment of MF is discussed in this paper. Low-energy X-rays have long been successful in the treatment of individual lesions and in the effective palliation of patients with this disease. The major breakthrough in the treatment of MF with ionizing radiation came with the development of the ability to treat the total skin by means of electrons which penetrate to depths of only 1--2 cm, thereby treating the epidermis and dermis while sparing more deeply situated tissues. The complications and results of this therapy are reviewed. The aggressive use of electron-beam therapy has resulted in many long-term remissions. It is important to use high initial doses of radiation and to treat patients when they are still in the early stages of disease. The potential use of other modalities of radiation, including total-lymphoid radiation with megavoltage photons, low-dose fractionated total-body radiation, and sequential hemibody radiation, are reviewed. PMID:87276

  14. Nanotube x-ray for cancer therapy: a compact microbeam radiation therapy system for brain tumor treatment.

    PubMed

    Zhang, Lei; Yuan, Hong; Inscoe, Christina; Chtcheprov, Pavel; Hadsell, Michael; Lee, Yueh; Lu, Jianping; Chang, Sha; Zhou, Otto

    2014-12-01

    Microbeam radiation therapy (MRT) is a promising preclinical modality for cancer treatment, with remarkable preferential tumoricidal effects, that is, tumor eradication without damaging normal tissue functions. Significant lifespan extension has been demonstrated in brain tumor-bearing small animals treated with MRT. So far, MRT experiments can only be performed in a few synchrotron facilities around the world. Limited access to MRT facilities prevents this enormously promising radiotherapy technology from reaching the broader biomedical research community and hinders its potential clinical translation. We recently demonstrated, for the first time, the feasibility of generating microbeam radiation in a laboratory environment using a carbon nanotube x-ray source array and performed initial small animal studies with various brain tumor models. This new nanotechnology-enabled microbeam delivery method, although still in its infancy, has shown promise for achieving comparable therapeutic effects to synchrotron MRT and has offered a potential pathway for clinical translation. PMID:25417729

  15. Role of External Beam Radiation Therapy in Management of Hepatocellular Carcinoma

    PubMed Central

    Sharma, Hanish

    2014-01-01

    Diagnosis at advanced disease stage and early vascular invasion are the bane of majority of patients with hepatocellular carcinoma (HCC) in India. The currently standardized curative and palliative treatment modalities [surgery, ablative techniques, trans-catheter chemotherapy, systemic chemotherapy] are suboptimal for a significant proportion of disease stages. Interest in radiotherapy for hepatocellular carcinoma has seen a resurgence with revolutionary improvements in targeting radiation doses safely. Encouraging results have been reported with a host of radiation techniques from conformal radiotherapy, stereotactic whole body radiation therapy to charged particle based therapies. The dissemination of this knowledge has been slow across other specialties involved in care of patients with HCC. However the increasing availability of radiotherapy services predicts a hopeful future for wider evaluation of radiotherapy in HCC. PMID:25755603

  16. Role of external beam radiation therapy in management of hepatocellular carcinoma.

    PubMed

    Sharma, Hanish

    2014-08-01

    Diagnosis at advanced disease stage and early vascular invasion are the bane of majority of patients with hepatocellular carcinoma (HCC) in India. The currently standardized curative and palliative treatment modalities [surgery, ablative techniques, trans-catheter chemotherapy, systemic chemotherapy] are suboptimal for a significant proportion of disease stages. Interest in radiotherapy for hepatocellular carcinoma has seen a resurgence with revolutionary improvements in targeting radiation doses safely. Encouraging results have been reported with a host of radiation techniques from conformal radiotherapy, stereotactic whole body radiation therapy to charged particle based therapies. The dissemination of this knowledge has been slow across other specialties involved in care of patients with HCC. However the increasing availability of radiotherapy services predicts a hopeful future for wider evaluation of radiotherapy in HCC. PMID:25755603

  17. Whole-brain radiation therapy in breast cancer patients with brain metastases.

    PubMed

    Chargari, Cyrus; Campana, François; Pierga, Jean-Yves; Védrine, Lionel; Ricard, Damien; Le Moulec, Sylvestre; Fourquet, Alain; Kirova, Youlia M

    2010-11-01

    Over the past 10 years, improving the outcome of breast cancer patients with brain metastases has become an important challenge. The suboptimal results of whole-brain radiation therapy (WBRT) in these patients have led to the development of irradiation modalities with new technical and biological approaches. By ensuring better sparing of critical organs such as the hippocampus, highly conformal irradiation therapy may partially preserve long-term neurocognitive functions. An additional radiation boost to the tumor bed improves local control. Radiosensitizing agents and radioprotectors that modify response to radiation have also been designed to improve the efficacy of treatment or prevent neurological toxicity. This Review outlines the current strategies and novel developments in WBRT, with a particular focus on new irradiation modalities and experiences of radiosensitization. PMID:20625374

  18. Spatially resolved measurement of high doses in microbeam radiation therapy using samarium doped fluorophosphate glasses

    SciTech Connect

    Okada, Go; Morrell, Brian; Koughia, Cyril; Kasap, Safa [Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9 (Canada); Edgar, Andy; Varoy, Chris [School of Chemical and Physical Sciences and MacDiarmid Institute, Victoria University of Wellington, Kelburn Parade (New Zealand); Belev, George; Wysokinski, Tomasz [Canadian Light Source Inc., University of Saskatchewan, Saskatoon, SK S7N 0X4 (Canada); Chapman, Dean [Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK S7N 5E5 (Canada)

    2011-09-19

    The measurement of spatially resolved high doses in microbeam radiation therapy has always been a challenging task, where a combination of high dose response and high spatial resolution (microns) is required for synchrotron radiation peaked around 50 keV. The x-ray induced Sm{sup 3+}{yields} Sm{sup 2+} valence conversion in Sm{sup 3+} doped fluorophosphates glasses has been tested for use in x-ray dosimetry for microbeam radiation therapy. The conversion efficiency depends almost linearly on the dose of irradiation up to {approx}5 Gy and saturates at doses exceeding {approx}80 Gy. The conversion shows strong correlation with x-ray induced absorbance of the glass which is related to the formation of phosphorus-oxygen hole centers. When irradiated through a microslit collimator, a good spatial resolution and high ''peak-to-valley'' contrast have been observed by means of confocal photoluminescence microscopy.

  19. Spatially resolved measurement of high doses in microbeam radiation therapy using samarium doped fluorophosphate glasses

    NASA Astrophysics Data System (ADS)

    Okada, Go; Morrell, Brian; Koughia, Cyril; Edgar, Andy; Varoy, Chris; Belev, George; Wysokinski, Tomasz; Chapman, Dean; Kasap, Safa

    2011-09-01

    The measurement of spatially resolved high doses in microbeam radiation therapy has always been a challenging task, where a combination of high dose response and high spatial resolution (microns) is required for synchrotron radiation peaked around 50 keV. The x-ray induced Sm3+ ? Sm2+ valence conversion in Sm3+ doped fluorophosphates glasses has been tested for use in x-ray dosimetry for microbeam radiation therapy. The conversion efficiency depends almost linearly on the dose of irradiation up to ˜5 Gy and saturates at doses exceeding ˜80 Gy. The conversion shows strong correlation with x-ray induced absorbance of the glass which is related to the formation of phosphorus-oxygen hole centers. When irradiated through a microslit collimator, a good spatial resolution and high "peak-to-valley" contrast have been observed by means of confocal photoluminescence microscopy.

  20. Advances in image-guided radiation therapy-the role of PET-CT

    SciTech Connect

    Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)]. E-mail: heronD2@upmc.edu; Smith, Ryan P. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Andrade, Regiane S. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

    2006-04-01

    In the era of image-guided radiation therapy (IGRT), the greatest challenge remains target delineation, as the opportunity to maximize cures while simultaneously decreasing radiation dose to the surrounding normal tissues is to be realized. Over the last 2 decades, technological advances in radiographic imaging, biochemistry, and molecular biology have played an increasing role in radiation treatment planning, delivery, and evaluation of response. Previously, fluoroscopy formed the basis of radiation treatment planning. Beginning in the late 1980s, computed tomography (CT) has become the basis for modern radiation treatment planning and delivery, coincident with the rise of 3-dimensional conformal radiation therapy (3DCRT). Additionally, multi-modality anatomic imaging registration was the solution pursued to augment delineation of tumors and surrounding structures on CT-based treatment planning. Although these imaging modalities provide the customary anatomic details necessary for radiation treatment planning, they have limitations, including difficulty with identification of small tumor deposits, tumor extension, and distinction from scar tissues. To overcome these limitations, PET and, more recently, PET-CT have been innovative regarding the extent of disease appraisal, target delineation in the treatment planning, and assessment of therapy response. We review the role of functional imaging in IGRT as it reassures transformations on the field of radiation oncology. As we move toward the era of IGRT, the use of multi-modality imaging fusion, and the introduction of more sensitive and specific PET-CT tracers may further assist target definition. Furthermore, the potential to predict early outcome or even detect early recurrence of tumor, may allow for the tailoring of intervention in cancer patients. The convergence of a biological target volume, and perhaps multi-tracer tumor, molecular, and genetic profile tumors will probably be vital in cancer treatment selection. Nevertheless, prospective clinical experience with outcome is encouraged and needs to be expanded to entirely exploit the benefits of the IGRT.