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Sample records for 60co radiotherapy unit

  1. Radiotherapy for eosinophilic granuloma of bone. [X-ray; /sup 60/Co

    SciTech Connect

    Pereslegin, I.A.; Ustinova, V.F.; Podlyaschuk, E.L.

    1981-03-01

    This paper presents a study of 93 patients with eosinophilic granuloma of bone of different locations, who received radiotherapy in our Institute from 1953 to 1978. One hundred eighty four lesions were irradiated. In 118 patients, radiotherapy was used alone; it was used as part of combined treatment in 68 patients. The results and methods of radiotherapy are discussed. The following radiotherapeutic methods were used depending on the lesion site: gammatherapy (Co-60), orthvoltage x ray therapy and short distance x ray therapy (100 kv, SSD-10 cm). The follow-up periods ranged from 1 to 25 years.

  2. Evaluation of adjuvant postoperative radiotherapy for lung cancer. [/sup 60/Co; X-ray

    SciTech Connect

    Chung, C.K.; Stryker, J.A.; O'Neill, M. Jr.; DeMuth, W.E. Jr.

    1982-11-01

    One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

  3. Doses in sensitive organs during prostate treatment with a 60Co unit.

    PubMed

    Vega-Carrillo, H R; Navarro Becerra, J A; Pérez Arrieta, M L; Pérez-Landeros, L H

    2014-01-01

    Using thermoluminiscent dosimeters the absorbed dose in the bladder, rectum and thyroid have been evaluated when 200 cGy was applied to the prostate. The treatment was applied with a (60)Co unit. A water phantom was built and thermoluminiscent dosimeters were located in the position where the prostate, bladder, rectum and thyroid are located. The therapeutic beam was applied in 4 irradiations at 0, 90, 180 and 270° with the prostate at the isocenter. The TLDs readouts were used to evaluate the absorbed dose in each organ. The absorbed doses were used to estimate the effective doses and the probability of developing secondary malignacies in thyroid, rectum and bladder.

  4. Effects of localized radiotherapy upon the cellular immune response. [/sup 60/Co; mice

    SciTech Connect

    Gerber, M.; Dubois, J.B.; Pioch, Y.; Serrou, B.

    1981-02-01

    We delivered two regimens of fractionated doses, one of 700 rad three times in 1 week, and one of 400 rad three times a week for 3 weeks, to the left hind limbs of tumor-bearing mice. We then assessed the effect of this localized radiotherapy on tumor growth and immunological function. The first protocol only slightly delayed tumor growth and was accompanied by a decrease in cytotoxic activity of the splenocytes. The second protocol enabled 50% of the tumor-bearing group to survive for more than 6 months. At the same time, there was no decrease in cytotoxic activity of the spleen even after the full course of nine irradiations. We assumed that the depressive effect of 700 rad was due to the scatter, and elicited a threshold dose of 12 to 15 rad from the dose-response studies in cytotoxicity.

  5. Fast Monte Carlo simulation for total body irradiation using a (60)Co teletherapy unit.

    PubMed

    Liu, Xiaodong; Lack, Danielle; Rakowski, Joseph T; Knill, Cory; Snyder, Michael

    2013-05-06

    Our institution delivers TBI using a modified Theratron 780 60Co unit. Due to limitations of our treatment planning system in calculating dose for this treatment, we have developed a fast Monte Carlo code to calculate dose distributions within the patient. The algorithm is written in C and uses voxel density information from CT images to calculate dose in heterogeneous media. To test the algorithm, film-based dose measurements were made separately in a simple water phantom with a high-density insert and a RANDO phantom and then compared to doses calculated by the Monte Carlo algorithm. In addition, a separate simulation in GEANT4 was run for the RANDO phantom and compared to both film and the in-house simulation. All results were analyzed using RIT113 film analysis software. Simulations in the water phantom accurately predict the depth of maximum dose in the phantom at 0.5 cm. The measured PDD along the central axis of the beam closely matches the PDD generated from the Monte Carlo code, deviating on average by only 3% along the depth of the water phantom. Dose measured at planes inside the high-density insert had a mean difference of 4.9% on cross-profile measurement. In the RANDO phantom, gamma pass rates vary between 91% and 99% at 3 mm, 3%, and were >99% at 5 mm, 5% for the four film planes measured. Profiles taken across the film and both simulations resulted in mean relative differences of < 2% for all profiles in each slice measured. The Monte Carlo algorithm presented here is potentially a viable method for calculating dose distributions delivered in TBI treatments at our center. While not yet refined enough to be the primary method of treatment planning, the algorithm at its current resolution determines the dose distribution for one patient within a few hours, and provides clinically useful information in planning TBI. With appropriate optimization, the Monte Carlo method presented here could potentially be implemented as a first-line treatment planning

  6. A 3D superposition pencil beam dose calculation algorithm for a 60Co therapy unit and its verification by MC simulation

    NASA Astrophysics Data System (ADS)

    Koncek, O.; Krivonoska, J.

    2014-11-01

    The MCNP Monte Carlo code was used to simulate the collimating system of the 60Co therapy unit to calculate the primary and scattered photon fluences as well as the electron contamination incident to the isocentric plane as the functions of the irradiation field size. Furthermore, a Monte Carlo simulation for the polyenergetic Pencil Beam Kernels (PBKs) generation was performed using the calculated photon and electron spectra. The PBK was analytically fitted to speed up the dose calculation using the convolution technique in the homogeneous media. The quality of the PBK fit was verified by comparing the calculated and simulated 60Co broad beam profiles and depth dose curves in a homogeneous water medium. The inhomogeneity correction coefficients were derived from the PBK simulation of an inhomogeneous slab phantom consisting of various materials. The inhomogeneity calculation model is based on the changes in the PBK radial displacement and on the change of the forward and backward electron scattering. The inhomogeneity correction is derived from the electron density values gained from a complete 3D CT array and considers different electron densities through which the pencil beam is propagated as well as the electron density values located between the interaction point and the point of dose deposition. Important aspects and details of the algorithm implementation are also described in this study.

  7. BEAM: a Monte Carlo code to simulate radiotherapy treatment units.

    PubMed

    Rogers, D W; Faddegon, B A; Ding, G X; Ma, C M; We, J; Mackie, T R

    1995-05-01

    This paper describes BEAM, a general purpose Monte Carlo code to simulate the radiation beams from radiotherapy units including high-energy electron and photon beams, 60Co beams and orthovoltage units. The code handles a variety of elementary geometric entities which the user puts together as needed (jaws, applicators, stacked cones, mirrors, etc.), thus allowing simulation of a wide variety of accelerators. The code is not restricted to cylindrical symmetry. It incorporates a variety of powerful variance reduction techniques such as range rejection, bremsstrahlung splitting and forcing photon interactions. The code allows direct calculation of charge in the monitor ion chamber. It has the capability of keeping track of each particle's history and using this information to score separate dose components (e.g., to determine the dose from electrons scattering off the applicator). The paper presents a variety of calculated results to demonstrate the code's capabilities. The calculated dose distributions in a water phantom irradiated by electron beams from the NRC 35 MeV research accelerator, a Varian Clinac 2100C, a Philips SL75-20, an AECL Therac 20 and a Scanditronix MM50 are all shown to be in good agreement with measurements at the 2 to 3% level. Eighteen electron spectra from four different commercial accelerators are presented and various aspects of the electron beams from a Clinac 2100C are discussed. Timing requirements and selection of parameters for the Monte Carlo calculations are discussed.

  8. Monitor Unit Checking in Heterogeneous Stereotactic Body Radiotherapy Treatment Planning

    SciTech Connect

    Higgins, Patrick D.; Adolfson, Troy; Cho, L. Chinsoo; Saxena, Rishik

    2011-10-01

    Treatment of lung cancer using very-high-dose fractionation in small fields requires well-tested dose modeling, a method for density-averaging compound targets constructed from different parts of the breathing cycle, and monitor unit verification of the heterogeneity-corrected treatment plans. The quality and safety of each procedure are dependent on these factors. We have evaluated the dosimetry of our first 26 stereotactic body radiotherapy (SBRT) patients, including 260 treatment fields, planned with the Pinnacle treatment planning system. All targets were combined from full expiration and inspiration computed tomography scans and planned on the normal respiration scan with 6-MV photons. Combined GTVs (cGTVs) have been density-averaged in different ways for comparison of the effect on total monitor units. In addition, we have compared planned monitor units against hand calculations using 2 classic 1D correction methods: (1) effective attenuation and (2) ratio of Tissue-Maximum Ratios (TMRs) to determine the range of efficacy of simple verification methods over difficult-to-perform measurements. Different methods of density averaging for combined targets have been found to have minimal impact on total dose as evidenced by the range of total monitor units generated for each method. Nondensity-corrected treatment plans for the same fields were found to require about 8% more monitor units on average. Hand calculations, using the effective attenuation method were found to agree with Pinnacle calculations for nonproblematic fields to within {+-}10% for >95% of the fields tested. The ratio of TMRs method was found to be unacceptable. Reasonable choices for density-averaging of cGTVs using full inspiration/expiration scans should not strongly affect the planning dose. Verification of planned monitor units, as a check for problematic fields, can be done for 6-MV fields with simple 1D effective attenuation-corrected hand calculations.

  9. Prevalence of Neuropathic Pain in Radiotherapy Oncology Units

    SciTech Connect

    Manas, Ana; Monroy, Jose Luis; Ramos, Avelino Alia; Cano, Carmen; Lopez-Gomez, Vanessa; Masramon, Xavier; Perez, Maria

    2011-10-01

    Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve

  10. The cancer burden in the United Kingdom in 2007 due to radiotherapy.

    PubMed

    Maddams, Jacob; Parkin, D Maxwell; Darby, Sarah C

    2011-12-15

    The number of long-term cancer survivors in the general population of the UK is substantial and increasing rapidly. Many cancer survivors have been treated with radiotherapy but the likely number of radiotherapy-related second cancers has not previously been estimated. We used estimates of the numbers of cancer survivors in the UK at the beginning of 2007, in conjunction with estimates of the relative risk of a second primary cancer associated with previous radiotherapy from the United States Surveillance Epidemiology and End Results (SEER) programme, to estimate the numbers of incident cancers in the UK in 2007 that were associated with radiotherapy for a previous cancer and that may have been caused by it. We estimated that 1,346 cases of cancer, or about 0.45% of the 298,000 new cancers registered in the UK in 2007, were associated with radiotherapy for a previous cancer. The largest numbers of radiotherapy-related second cancers were lung cancer (23.7% of the total), oesophageal cancer (13.3%), and female breast cancer (10.6%); 54% of radiotherapy-related second cancers were in individuals aged 75 or over. The highest percentages of second cancers related to radiotherapy were among survivors of Hodgkin's disease and cancers of the oral cavity and pharynx and cervix uteri; over 15% of second cancers among these survivors were associated with radiotherapy for the first cancer. These calculations, which involve a number of assumptions and approximations, provide a reasonable, if conservative, estimate of the fraction of incident cancers in the UK that are attributable to past radiation therapy.

  11. Experimental studies of combination of PDT and tumor chemotherapy or 60Co irradiation

    NASA Astrophysics Data System (ADS)

    Didziapetriene, Janina; Prasmickiene, Grazina; Sukeliene, Dalija; Rotomskis, Ricardas; Streckyte, Giedre; Atkocius, Vydmantas; Staciokiene, Laima; Smilgevicius, Valerijus

    1995-01-01

    We present experimental results obtained by combining photodynamic therapy (PDT) with tumor chemotherapy or radiotherapy. Dimethoxyhematoporphyrin (DMHp) and photosan (PS) were used as photosensitizers, pharanoxi and vincristine as antitumor drugs. The therapeutic effect of the combination of PDT and antitumor drugs (pharanoxi, vincristine) slightly increases as compared to the treatment of PDT or antitumor drug alone. The additive therapeutic effect is achieved under the combination of PDT and 60Co irradiation. It seems that the sensitizers DMHp and PS regulate lipid peroxidation in blood serum of experimental animals, which becomes more active under the influence of alkylating antitumor drugs. Therefore, they could protect an organism from negative influence of tumor chemotherapy.

  12. Distribution of 60Co in steel samples from Hiroshima.

    PubMed

    Hult, M; Marissens, G; Sahin, N; Hoshi, M; Hasai, H; Shizuma, K; Tanaka, K; Endo, S

    2012-09-01

    This paper describes ultra low-level gamma-ray spectrometry measurements of the (60)Co activity distribution inside one 52 mm and one 41 mm thick steel sample. The samples had been exposed to the Hiroshima atomic bomb and were from the Aioi bridge and the Yokogawa bridge. Both samples were measured in a recent study aiming to back up model calculation of Hiroshima dosimetry. The (60)Co activity distributions found in this study support the assumptions made in the previous study.

  13. Energy and integrated dose dependence of MOSFET dosimeter sensitivity for irradiation energies between 30 kV and {sup 60}Co

    SciTech Connect

    Lavallee, Marie-Claude; Gingras, Luc; Beaulieu, Luc

    2006-10-15

    Since metal-oxide-semiconductor field effect transistors (MOSFETs) medical applications in radiotherapy and radiology are gaining popularity, evaluating them under radiation of different energies is of major interest. This study aims at a characterization of MOSFET sensitivity with regard to total integrated dose. Sensitivity is expressed by the water calibration factor (CF{sub w}) and allows the user to associate the voltage difference reading displayed by the device to a dose value in water at the MOSFET location. The CF{sub w} of seven p-type dual-bias MOSFETs were measured for several accumulated doses. The radiation sources used were a {sup 60}Co unit ({sub {gamma}}:1.25 MeV), an {sup 192}Ir high dose rate unit ({sub {gamma}}:380 keV), and an orthovoltage unit providing two x-ray energy spectra for tube voltages of 30 kV({sub {gamma}}:14.8 KeV) and 150 kV({sub {gamma}}:70.1 keV). The CF{sub w} value diminishes with increasing threshold voltage, especially for low-energy radiation. It was stable for {sup 60}Co irradiations, while it decreased 6%, 5%, and 15% for beam energies of {sup 192}Ir, 150 kV, and 30 kV, respectively. The decrease rate is higher for the first half of the device lifetime. This behavior is explained by an alteration of the effective electric field applied to the MOSFET during irradiation, caused by the accumulation of holes at the Si-SiO{sub 2} interface. It is strongly dependent on the nature of the radiation, and particularly affects low x-ray energies. A frequent calibration of the device for this radiation type is essential in order to achieve adequate measurement accuracy, especially in low-energy applications, such as superficial therapy, brachytherapy, and diagnostic and interventional radiology.

  14. Calorimetric study on the effect of 60Co γ-rays on the growth of microorganisms

    NASA Astrophysics Data System (ADS)

    Wirkner, Sandra; Takahashi, Katsutada; Furuta, Masakazu; Hayashi, Toshio

    2002-03-01

    Using a calorimeter equipped with 24 sample units, the heat evolution from growing Saccharomyces cerevisiae, Escherichia coli and spores of Bacillus pumilus and Bacillus stearothermophilus was detected in the form of growth thermograms. Irradiation with 60Co γ-rays affected the growth pattern, which was used for a quantitative analysis of the effect on microorganisms. Irradiation of B. pumilus and B. stearothermophilus spores led to dose-dependent delays in growth, indicating a bactericidal effect. In case of 60Co γ-irradiated S. cerevisiae, a dose-dependent reduction of the growth rate constant was observed together with the retardation in growth, indicating a combination of bactericidal and bacteriostatic effects. An equation to determine the number of survivors on the basis of the retardation in growth tα and the growth rate constant μ was developed, which proved the opportunity to use the calorimetric technique in predictive microbiology.

  15. Melatonin attenuates (60) Co γ-ray-induced hematopoietic, immunological and gastrointestinal injuries in C57BL/6 male mice.

    PubMed

    Khan, Shahanshah; Adhikari, Jawahar Singh; Rizvi, Moshahid Alam; Chaudhury, Nabo Kumar

    2017-02-01

    Protection of hematopoietic, immunological, and gastrointestinal injuries from deleterious effects of ionizing radiation is prime rational for developing radioprotector. The objective of this study, therefore, was to evaluate the radioprotective potential of melatonin against damaging effects of radiation-induced hematopoietic, immunological, and gastrointestinal injuries in mice. C57BL/6 male mice were intraperitoneally administered with melatonin (50-150 mg/kg) 30 min prior to whole-body radiation exposure of 5 and 7.5 Gy using (60) Co-teletherapy unit. Thirty-day survival against 7.5 Gy was monitored. Melatonin (100 mg/kg) pretreatment showed 100% survival against 7.5 Gy radiation dose. Melatonin pretreatment expanded femoral HPSCs, and inhibited spleenocyte DNA strands breaks and apoptosis in irradiated mice. At this time, it also protected radiation-induced loss of T cell sub-populations in spleen. In addition, melatonin pretreatment enhanced crypts regeneration and increased villi number and length in irradiated mice. Translocation of gut bacteria to spleen, liver and kidney were controlled in irradiated mice pretreated with melatonin. Radiation-induced gastrointestinal DNA strand breaks, lipid peroxidation, and expression of proapoptotic-p53, Bax, and antiapoptotic-Bcl-xL proteins were reversed in melatonin pretreated mice. This increase of Bcl-xL was associated with the decrease of Bax/Bcl-xL ratio. ABTS and DPPH radical assays revealed that melatonin treatment alleviated total antioxidant capacity in hematopoietic and gastrointestinal tissues. Present study demonstrated that melatonin pretreatment was able to prevent hematopoietic, immunological, and gastrointestinal radiation-induced injury, therefore, overcoming lethality in mice. These results suggest potential of melatonin in developing radioprotector for protection of bone marrow, spleen, and gastrointestine in planned radiation exposure scenarios including radiotherapy. © 2016 Wiley

  16. Malignant lymphoma of the thyroid gland. [/sup 60/Co

    SciTech Connect

    Souhami, L.; Simpson, W.J.; Carruthers, J.S.

    1980-09-01

    We reviewed the records of 20 patients with malignant lymphoma present in the thyroid gland who were seen at The Princess Margaret Hospital between 1958 and 1977. The disease predominantly affected females of an older age group and clinically was characterized by a rapidly enlarging neck mass associated with obstructive symptoms. All patients were treated with radiotherapy. Adjuvant chemotherapy was used in only three patients. Overall survival rate at 5 years was 35%. Survival rate at 5 years from time of recurrence was 7%. Postmortem examination of eight patients showed widespread lymphoma in all; the lung, G.I. tract, liver and kidney were the most frequently affected distant sites. We conclude that radiotherapy to the neck and mediastinum is an adequate form of treatment in patients with lymphoma of the thyroid gland with Stage I or localized Stage II disease. More advanced disease should be managed with radiation and chemotherapy.

  17. Dose reconstruction for residents living in 60Co-contaminated rebar buildings.

    PubMed

    Tung, C J; Chao, T C; Chen, T R; Hsu, F Y; Lee, I T; Chang, S L; Liao, C C; Chen, W L

    1998-06-01

    The first 60Co-contaminated rebar building was discovered in Taipei city in 1992. As of 18 July 1997, 144 buildings with 1,327 housing units were confirmed to contain 60Co-contaminated rebars. All these reinforced concrete buildings were constructed between 1982 and 1984. Thousands of residents have been exposed to ionizing radiation of various degrees. Preliminary assessments by the Atomic Energy Council showed that the accumulated maximal doses ranged from a few mSv to several Sv. The purpose of this work was to reconstruct more reliable individual doses for epidemiologic and medical uses. This reconstruction provided the best estimated doses as well as conceivable upper and lower bounds. The variation of residential day-life activities by individual members in a family was considered according to their sex, age, profession, etc. Intensive data on exposure rates were collected using thermoluminescent dosimeters positioned at 1 m height and 1 m x 1 m intersections with additional measurements at special locations such as bed, sofa, dining table, etc. Thermoluminescent dosimeter measurements were performed in all 24 residences studied in this work. This showed that the Atomic Energy Council maximal doses were 2-6 times higher than the present best estimated doses. Among all family members, elders and housewives received the highest doses; children received the lowest doses. The difference in doses among all family members belonging to different cohort categories is within a factor of two.

  18. The use of high-density concretes in radiotherapy treatment room design.

    PubMed

    Facure, A; Silva, A X

    2007-09-01

    With the modernization of radiotherapic centers, medical linear accelerators are largely replacing (60)Co teletherapy units. In many cases, the same vault housing the (60)Co teletherapy unit is reused for the linear accelerator and, when space is at a premium, high-density concrete (3.0-5.0 g/cm(3)) is employed to provide shielding against the primary, scatter and leakage radiation. This work presents a study based on Monte Carlo simulations of transmission of some clinical photon spectra (of 4-10 MV accelerators) through some types of high-density concretes, normally used in the construction of radiotherapy bunkers. From the simulations, the initial and subsequent tenth-value layers (TVL) for these materials, taking into account realistic clinical photon spectra, are presented, for primary radiation.

  19. Characteristics of a dedicated linear accelerator-based stereotactic radiosurgery-radiotherapy unit.

    PubMed

    Das, I J; Downes, M B; Corn, B W; Curran, W J; Werner-Wasik, M; Andrews, D W

    1996-01-01

    A stereotactic radiosurgery and radiotherapy (SRS/SRT) system on a dedicated Varian Clinac-600SR linear accelerator with Brown-Roberts-Wells and Gill-Thomas-Cosman relocatable frames along with the Radionics (RSA) planning system is evaluated. The Clinac-600SR has a single 6-MV beam with the same beam characteristics as that of the mother unit, the Clinac-600C. The primary collimator is a fixed cone projecting to a 10-cm diameter at isocenter. The secondary collimator is a heavily shielded cylindrical collimator attached to the face plate of the primary collimator. The tertiary collimation consists of the actual treatment cones. The cone sizes vary from 12.5 to 40.0 mm diameter. The mechanical stability of the entire system was verified. The variations in isocenter position with table, gantry, and collimator rotation were found to be < 0.5 mm with a compounded accuracy of < or = 1.0 mm. The radiation leakage under the cones was < 1% measured at a depth of 5 cm in a phantom. The beam profiles of all cones in the x and y directions were within +/- 0.5 mm and match with the physical size of the cone. The dosimetric data such as tissue maximum ratio, off-axis ratio, and cone factor were taken using film, diamond detector, and ion chambers. The mechanical and dosimetric characteristics including dose linearity of this unit are presented and found to be suitable for SRS/SRT. The difficulty in absolute dose measurement for small cone is discussed.

  20. Single crystal diamond detector for radiotherapy

    NASA Astrophysics Data System (ADS)

    Schirru, F.; Kisielewicz, K.; Nowak, T.; Marczewska, B.

    2010-07-01

    The new generation of synthetic diamonds grown as a CVD single crystal on a high pressure high temperature substrate offers a wide range of applications. In particular, because of the near tissue equivalence and its small size (good spatial resolution), CVD single crystal diamond finds applicability in radiotherapy as a dosemeter of ionizing radiation. In this paper we report the electrical and dosimetric properties of a new diamond detector which was fabricated at IFJ based on a single crystal detector-grade CVD diamond provided with a novel contact metallization. Diamond properties were assessed at IFJ using a Theratron 680E therapeutic 60Co gamma rays unit and at COOK with 6 and 18 MV x-rays Varian Clinac CL2300 C/D accelerator. The new dosemeter showed high electric and dosimetric performances: low value of dark current, high current at the level of some nanoamperes during irradiation, very fast dynamic response with a rise time amounting to parts of a second, good stability and repeatability of the current and linearity of the detector signal at different dose and dose rate levels typically applied in radiotherapy. The results confirm the potential applicability of diamond material as a dosemeter for applications in radiotherapy.

  1. Effect of Acuros XB algorithm on monitor units for stereotactic body radiotherapy planning of lung cancer

    SciTech Connect

    Khan, Rao F. Villarreal-Barajas, Eduardo; Lau, Harold; Liu, Hong-Wei

    2014-04-01

    Stereotactic body radiotherapy (SBRT) is a curative regimen that uses hypofractionated radiation-absorbed dose to achieve a high degree of local control in early stage non–small cell lung cancer (NSCLC). In the presence of heterogeneities, the dose calculation for the lungs becomes challenging. We have evaluated the dosimetric effect of the recently introduced advanced dose-calculation algorithm, Acuros XB (AXB), for SBRT of NSCLC. A total of 97 patients with early-stage lung cancer who underwent SBRT at our cancer center during last 4 years were included. Initial clinical plans were created in Aria Eclipse version 8.9 or prior, using 6 to 10 fields with 6-MV beams, and dose was calculated using the anisotropic analytic algorithm (AAA) as implemented in Eclipse treatment planning system. The clinical plans were recalculated in Aria Eclipse 11.0.21 using both AAA and AXB algorithms. Both sets of plans were normalized to the same prescription point at the center of mass of the target. A secondary monitor unit (MU) calculation was performed using commercial program RadCalc for all of the fields. For the planning target volumes ranging from 19 to 375 cm{sup 3}, a comparison of MUs was performed for both set of algorithms on field and plan basis. In total, variation of MUs for 677 treatment fields was investigated in terms of equivalent depth and the equivalent square of the field. Overall, MUs required by AXB to deliver the prescribed dose are on an average 2% higher than AAA. Using a 2-tailed paired t-test, the MUs from the 2 algorithms were found to be significantly different (p < 0.001). The secondary independent MU calculator RadCalc underestimates the required MUs (on an average by 4% to 5%) in the lung relative to either of the 2 dose algorithms.

  2. Cytogenetic comparison of the responses of mouse and human peripheral blood lymphocytes to /sup 60/Co gamma radiation

    SciTech Connect

    Kligerman, A.D.; Halperin, E.C.; Erexson, G.L.; Honore, G.; Westbrook-Collins, B.; Allen, J.W.

    1988-08-01

    Experiments were conducted to compare the chromosome damaging effects of /sup 60/Co gamma radiation on mouse and human peripheral blood lymphocytes (PBLs). Either whole blood or isolated and pelleted mononuclear leucocytes (MNLs) were irradiated with a /sup 60/Co unit to yield exposures of 1, 2, 3, or 4 Gy. In addition, mice were whole-body irradiated in vivo with the same doses so that an in vitro-in vivo comparison could be made. The results indicate that mouse PBLs irradiated in whole blood, whether in vivo or in vitro, respond similarly to /sup 60/Co gamma rays as measured by dicentric chromosome formation. In addition, mouse and human PBLs showed a similar radiosensitivity, but because the mouse PBL data were best fitted to an exponential function and the human PBL data to a quadratic function, direct comparisons were difficult to make. Pelleted MNLs from mice were much less sensitive to the clastogenic effects of gamma radiation than whole blood. This is believed to be due to hypoxic conditions that developed during irradiation and transport. Human PBLs did not show a marked difference whether irradiated in whole blood or as pelleted MNLs in tissue culture medium.

  3. Development and evaluation of a technique for in vivo monitoring of 60Co in human lungs

    NASA Astrophysics Data System (ADS)

    de Mello, J. Q.; Lucena, E. A.; Dantas, A. L. A.; Dantas, B. M.

    2016-07-01

    60Co is a fission product of 235U and represents a risk of internal exposure of workers in nuclear power plants, especially those involved in the maintenance of potentially contaminated parts and equipment. The control of 60Co intake by inhalation can be performed through in vivo monitoring. This work describes the evaluation of a technique through the minimum detectable activity and the corresponding minimum detectable effective doses, based on biokinetic and dosimetric models of 60Co in the human body. The results allow to state that the technique is suitable either for monitoring of occupational exposures or evaluation of accidental intake.

  4. Relative biologic effectiveness in terms of tumor response of {sup 125}I implants compared with {sup 60}Co gamma rays

    SciTech Connect

    Lehnert, Shirley . E-mail: shirley.lehnert@mcgill.ca; Reniers, Brigitte; Verhaegen, Frank

    2005-09-01

    Purpose: To measure the relative biologic effectiveness (RBE) for {sup 125}I seeds compared with external beam radiotherapy using a clinically relevant in vivo system. Methods and Materials: Photon emission from a detailed source model was simulated using the Monte Carlo code MCNP4C, sampling from a {sup 125}I spectrum. The mouse RIF-1 tumor was treated with either temporary implant of an {sup 125}I seed or with {sup 60}Co gamma rays. The tumors were always the same size at the initiation of treatment, and the endpoint was growth inhibition. Results: The dose-response curve for both modalities was close to linear and was independent of the initial {sup 125}I activity (dose rate) for the range investigated. Calculation of the RBE for tumor response requires assigning a unique value for the tumor dose that is not homogenous but depends on the distance from the {sup 125}I source. Because tumor regrowth will depend on the subpopulation of cells that have the greatest probability of survival (i.e., those at the greatest distance from the {sup 125}I source), one approach is to use the dose to this population. On this basis, the RBE for {sup 125}I compared with {sup 60}Co gamma rays is 1.5. If the {sup 125}I dose is computed as the average dose to the tumor, corrected for the dose that is wasted as overkill in the cell population closest to the center of the {sup 125}I seed, the RBE is 1.4. Conclusion: The result, an RBE of 1.4-1.5 is similar to findings obtained by other methods, supporting the validity of this approach to derive an RBE with validity in a clinical context.

  5. Validation of in-house treatment planning system software for cobalt-60 teletherapy unit at two radiotherapy installations

    NASA Astrophysics Data System (ADS)

    Mu'minah, I. A. S.; Toresano, L. O. H. Z.; Wibowo, W. E.; Sugiyantari; Pawiro, S. A.

    2016-03-01

    DSSuperDose v.1.0 is an in-house treatment planning system (TPS) developed by Medical Physics and Biophysics Laboratory (LFMB) Universitas Indonesia as a treatment planning software for Cobalt-60 teletherapy unit. The main objective of this study was the validation of in-house TPS calculation as an essential part in quality assurance (QA) of radiotherapy. Validation of an in-house TPS was performed with two Cobalt-60 teletherapy units by comparison between in-house TPS and ISIS TPS and by measurements of absorbed dose. Mean dose deviations between in-house TPS and measurement were (1.97 ± 2.42)% for open field, (1.32 ± 1.30)% for tray field, and (2.91 ± 2.36)% for wedge field treatments. In-house TPS provide optimal planning for open and tray beam conditions with depth fewer than 10 cm (≤ 10 cm) and field sizes up to 20×20 cm2, while for wedge beam conditions with field sizes fewer than the physical size of the wedge. Comparison of in-house TPS and ISIS TPS demonstrated a good match of 96%. From the results, it is concluded that DSSuperDose v.1.0 is adequately accurate for treatment planning of radiotherapy.

  6. Comparative uptake from sea water and tissue distribution of 60Co in marine mollusks

    SciTech Connect

    Carvalho, F.P.

    1987-07-01

    Five different species of marine mollusks, Mytilus galloprovincialis Lmk., Tapes decussatus L., Cerastoderma (Cardium) edule (L.), Donax vittatus (da Costa) and Patella vulgata L., were exposed to /sup 60/Co-labelled sea water under laboratory conditions. After a 1-mo exposure, tested species reached different whole-body /sup 60/Co concentration factors (CF) over radioactive sea water of 73 +/- 27, 22 +/- 10, 84 +/- 25, 6.3 +/- 1.4 and 31 +/- 10, respectively, which are not dependent upon the size of mollusks. Equations for the experimental uptake curves, obtained using a multi-exponential model, indicate that /sup 60/Co uptake by mollusks involves two or three compartments, according to the species. In all species, the larger compartments turn over with long biological half-lives, dependent upon species. At the beginning of the experiment, /sup 60/CoCl2 added to sea water was mainly in cationic forms. These forms were progressively converted into anionic plus neutral forms most likely due to complex formation with organic ligands. With time this physico-chemical evolution had a lowering effect on /sup 60/Co bioaccumulation by mollusks. Analysis of /sup 60/Co in tissues revealed that Donax shell and mantle do not accumulate the radionuclide in great quantities, generating the low whole-body concentration factor found. In contrast, shell and mantle from all other species displayed variable but high CFs. Shell by itself accounts for more than half of the /sup 60/Co whole-body burden. Among soft tissues, gills and viscera displayed the highest CF and muscle the lowest. From these experiments, one may conclude that significant differences among species do exist regarding Co bioaccumulation potential.

  7. Aminothiol Receptors for Decorporation of Intravenously Administered 60Co in the Rat

    SciTech Connect

    Levitskaia, Tatiana G.; Morris, James E.; Creim, Jeffrey A.; Woodstock, Angela D.; Luders, Teresa; Curry, Terry L.; Thrall, Karla D.

    2010-01-01

    The reported investigation provides a comparison of the oral decorporation efficacy of L-glutathione (GSH), L-cysteine (Cys), and a liposomal GSH formulation (ReadiSorb) toward systemic cobalt-60 (60Co) to that observed following intravenous administration of GSH and Cys in F344 rats. L-histidine (His) was tested intravenously to compare in vivo efficacy of the aminothiol GSH and Cys chelators with that of aminoimidazole (His) chelator. 60Co was administered to animals by intravenous injection, followed by intravenous or oral gavage doses of a chelator repeated at 24 hour intervals for a total of 5 doses. The results suggest that GSH and Cys are potent decorporation agents for 60Co in the rat model, although the efficacy of treatment depends largely on systemic availability of a chelator. The intravenous GSH or Cys were most effective in reducing tissue 60Co levels and in increasing excretion of radioactivity compared to control animals. Liposomal encapsulation was found to markedly enhance the oral bioavailability of GSH compared to non-formulated GSH. Oral administration of ReadiSorb reduced 60Co levels in nearly all tissues by 12-43% compared to that observed for non-formulated GSH. Efficacy of oral Cys was only slightly reduced in comparison with intravenous Cys. Further studies to optimize the dosing regimen in order to maximize decorporation efficiency are warranted.

  8. Monitoring of 60Co radiation-source parameters by optoelectronic instrumentation

    NASA Astrophysics Data System (ADS)

    Medved Rogina, Branka; Vojnovic, Bozidar D.

    1995-10-01

    Problems of measurement of the radiation dose level and determining the position of the 60Co radiation source rods are discussed. The continuous gamma ray source 60Co is used for various scientific and industrial, food and medical, irradiation applications with doses up to 104 Gy. For a radiation sensor the PCS optical fiber could be used. By radiation effects testing PCS fiber is found to have adequate sensitivity in the visible range up to 1.47 multiplied by 10-1 dB/kmGy at high exposure, up to 103 Gy 60Co ionizing source irradiation. The position of the source rods is determined relative to the safety position, by the sensor linked with source position using a mechanical transmission system. The digital position sensor based on the optoelectronic impulse source is developed, with accuracy plus or minus 1 mm for the whole vertical position change of the source and great exploitation resistance particularly to vibrations.

  9. Impaired colony-forming ability following. gamma. irradiation of skin fibroblasts from tuberous scierosis patients. [/sup 60/Co

    SciTech Connect

    Paterson, M.C.; Sell, B.M.; Smith, B.P.; Bech-Hansen, N.T.

    1982-05-01

    The radiosensitivity of cultured dermal fibroblasts from human subjects afflicted with tuberous sclerosis (TS), a hereditary neurocutaneous syndrome, was assessed by assaying loss of colony-forming ability in response to acute ..gamma..-ray exposure. Related to control strains from clinically normal donors, three cell lines (GM1635, GM1643, GM2333) from two affected patients displayed enhanced sensitivity to inactivation by /sup 60/Co ..gamma..-ray treatment, whether administered oxically (air-saturated) or hypoxically (N/sub 2/-gassed); a fourth strain (GM1644) from a third patient exhibited normal radiosensitivity under both treatment conditions. The post-..gamma..-irradiaton colony-forming ability of the three hypersensitive TS strains was intermediate between that of normal controls and that of strains from patients inheriting the radiotherapy-sensitive neurovascular disorder ataxia telangiectasia. The variability in the radioresponse of the TS stains (three sensitive and one normal) is not surprising, considering the widely recognized clinical heterogeneity in the disease. Our findings, aside from providing a laboratory marker for early (possible presymptomatic) detection of persons at high risk for TS, may lead to a better understanding of the origin and progressive development of this multifaceted syndrome.

  10. Shielding considerations for an operating room based intraoperative electron radiotherapy unit.

    PubMed

    Mills, M D; Almond, P R; Boyer, A L; Ochran, T G; Madigan, W; Rich, T A; Dally, E B

    1990-05-01

    The leakage radiation characteristics of a dedicated intraoperative radiotherapy linear accelerator have been measured on a machine designed to minimize the shielding required to allow it to be placed in an operating room suite. The scattering foil design was optimized to produce a flat beam for the field sizes employed while generating minimal bremsstrahlung contamination over the available energy range. More lead shielding was used in the treatment head than is used in conventional accelerators. A small amount of borated polyethylene shielding was also employed since neutron production was present at measurable levels. The room shielding installed in the operating room was demonstrated to be adequate to treat at least 20 patients each month to an average dose of 20 Gy. The worst case exposure was found to be 73% maximum permissible exposure. Administrative control was required for adjoining areas when calibrations and maintenance were performed.

  11. Monte Carlo Dosimetry of the 60Co BEBIG High Dose Rate for Brachytherapy

    PubMed Central

    Campos, Luciana Tourinho; de Almeida, Carlos Eduardo Veloso

    2015-01-01

    Introduction The use of high-dose-rate brachytherapy is currently a widespread practice worldwide. The most common isotope source is 192Ir, but 60Co is also becoming available for HDR. One of main advantages of 60Co compared to 192Ir is the economic and practical benefit because of its longer half-live, which is 5.27 years. Recently, Eckert & Ziegler BEBIG, Germany, introduced a new afterloading brachytherapy machine (MultiSource®); it has the option to use either the 60Co or 192Ir HDR source. The source for the Monte Carlo calculations is the new 60Co source (model Co0.A86), which is referred to as the new BEBIG 60Co HDR source and is a modified version of the 60Co source (model GK60M21), which is also from BEBIG. Objective and Methods The purpose of this work is to obtain the dosimetry parameters in accordance with the AAPM TG-43U1 formalism with Monte Carlo calculations regarding the BEBIG 60Co high-dose-rate brachytherapy to investigate the required treatment-planning parameters. The geometric design and material details of the source was provided by the manufacturer and was used to define the Monte Carlo geometry. To validate the source geometry, a few dosimetry parameters had to be calculated according to the AAPM TG-43U1 formalism. The dosimetry studies included the calculation of the air kerma strength Sk, collision kerma in water along the transverse axis with an unbounded phantom, dose rate constant and radial dose function. The Monte Carlo code system that was used was EGSnrc with a new cavity code, which is a part of EGS++ that allows calculating the radial dose function around the source. The spectrum to simulate 60Co was composed of two photon energies, 1.17 and 1.33 MeV. Only the gamma part of the spectrum was used; the contribution of the electrons to the dose is negligible because of the full absorption by the stainless-steel wall around the metallic 60Co. The XCOM photon cross-section library was used in subsequent simulations, and the

  12. 60Co irradiation of Shiga toxin (Stx)-producing Escherichia coli induces Stx phage.

    PubMed

    Yamamoto, Tatsuo; Kojio, Seiichi; Taneike, Ikue; Nakagawa, Saori; Iwakura, Nobuhiro; Wakisaka-Saito, Noriko

    2003-05-16

    Shiga toxin (Stx)-producing Escherichia coli (STEC), an important cause of hemolytic uremic syndrome, was completely killed by (60)Co irradiation at 1 x l0(3) gray (1 kGy) or higher. However, a low dose of irradiation (0.1-0.3 kGy) markedly induced Stx phage from STEC. Stx production was observed in parallel to the phage induction. Inactivation of Stx phage required a higher irradiation dose than that for bacterial killing. Regarding Stx, cytotoxicity was susceptible to irradiation, but cytokine induction activity was more resistant than Stx phage. The findings suggest that (1). although (60)Co irradiation is an effective means to kill the bacteria, it does induce Stx phage at a lower irradiation dose, with a risk of Stx phage transfer and emergence of new Stx-producing strains, and (2). irradiation differentially inactivates some activities of Stx.

  13. A dose reconstruction of 60Co-contaminated window frames in a Taiwanese school.

    PubMed

    Brock, K M; Neumann, C M; Higley, K A; Chang, W P; Rossignol, A M

    2001-07-01

    Since 1992, hundreds of buildings in Taiwan were discovered to have 60Co contamination in the structural rebar. The contamination resulted from improper handling of 60Co-contaminated scrap metal in 1982 and 1983, which subsequently was recycled and used throughout Taiwan. Hsin-hsin Kindergarten school enrolled about 600 students over the 10-y period before the contamination was discovered. Hsin-hsin Kindergarten had three 60Co-contaminated steel window frames with measured dose rates on contact up to 150 microSv h(-1). In this study, a range of potential doses received by the Hsin-hsin Kindergarten students were estimated using ISOSHLD dose modeling software. ISOSHLD is a rapid, inexpensive screening tool to reconstruct dose ranges. To assess the potential risks to habitants of the school for the first year after construction, calculated dose rate ranges of 0.08 microSv h(-1) to 75.38 microSv h(-1) were then applied to the International Commission [corrected] on Radiation Protection 60 nominal detriment coefficients for stochastic effects. Risk estimates ranged from 1.46 x 10(-4) to 7.42 x 10(-4) excess fatal cancers per lifetime.

  14. Decoloration Kinetics of Waste Cooking Oil by 60Co γ-ray/H2O2

    NASA Astrophysics Data System (ADS)

    Xiang, Yulin; Xiang, Yuxiu; Wang, Lipeng

    2016-03-01

    In order to decolorize, waste cooking oil, a dark red close to black solution from homes and restaurants, was subjected to 60Co γ-ray/H2O2 treatment. By virtue of UV/Vis spectrophotometric method, the influence of Gamma irradiation to decoloration kinetics and rate constants of the waste cooking oil in the presence of H2O2 was researched. In addition, the influence of different factors such as H2O2 concentration and irradiation dose on the decoloration rate of waste cooking oil was investigated. Results indicated that the decoloration kinetics of waste cooking oil conformed to the first-order reaction. The decoloration rate increased with the increase of irradiation dose and H2O2 concentration. Saponification analysis and sensory evaluation showed that the sample by 60Co γ-ray/H2O2 treatment presented better saponification performance and sensory score. Furthermore, according to cost estimate, the cost of the 60Co γ-ray/H2O2 was lower and more feasible than the H2O2 alone for decoloration of waste cooking oil.

  15. Dosimetric evaluation of a widely used kilovoltage x-ray unit for endocavitary radiotherapy.

    PubMed

    Li, X A; Ma, C M; Salhani, D; Agboola, O

    1998-08-01

    In this paper we present the dosimetric data of a Therapax DTX300 kilovoltage x-ray unit for endocavitary rectal irradiation. The unit if operated at tube voltage of 40-60 kVp (30 mA) with an added filtration of 0.2-0.4 mm Al generates acceptable beam qualities comparable to those of the original Papillon technique. Relative dosimetric measurements were performed at the cone end (37.2 cm SSD) of a 3 cm diameter rectal cone using various detectors to ensure the accuracy. A Monte Carlo method was used to calculate correction factors for the diode used in the percentage depth-dose (PDD) measurement, and to study the effect of the detector size on the beam profile. The PDD data were determined using the diode measurement corrected for its energy and angular response. It was found that the PTW N23342 and Markus parallel-plate chamber can be used directly to measure the PDD for this beam quality with 2% uncertainty. Measurement and Monte Carlo results have shown that the detector size has a significant effect on the penumbral profile. Film and diode detectors have a better spatial resolution compared to ionization chambers, but they may give an incorrect profile tail due to either nonlinear response at low energy or angular dependence. This can be corrected using the ionization-chamber measurement, based on the Monte Carlo analysis. The isodose distributions for this x-ray unit are presented.

  16. Behavior of 60Co and 134Cs in a Canadian Shield lake over 5 years.

    PubMed

    Bird, G A; Schwartz, W J; Motycka, M; Rosentreter, J

    1998-04-08

    Radionuclides were added to the anoxic hypolimnion of a Canadian Shield lake to simulate the nuclear fuel waste disposal scenario where radionuclides might enter the bottom waters of a lake. The radionuclides remained in the hypolimnion until lake mixing at autumn turnover after which 60Co was rapidly lost and 134Cs was slowly lost from the water. Only 0.4% of the 60Co and 0.6% of the 134Cs remained in the water at year 5. Highest concentrations occurred in periphyton and filter feeders, Holopedium gibberum and clams (Anodonata grandis grandis). From maximum annual concentrations in clam tissues, it was estimated that the availability of 60Co for uptake had a half-time (t1/2) of 835 days in the lake, whereas that for 134Cs was 780 days. Loss rate coefficients, k, for the radionuclides from taxa ranged from 0.0008 to 0.0043 day-1 (t1/2 = 161-866 days) for 60Co and from 0.0009 to 0.005 day-1 (t1/2 = 139-770 days) for 134Cs. Cobalt-60 concentrations in forage fish were low, whereas 134Cs concentrations increased over the first year or two, then slowly declined. On the basis of k values measured for forage fish, the biological half-time of 134Cs in forage fish ranged from 428 to 630 days. Maximum 134Cs concentrations in forage fish were higher following hypolimnetic addition than epilimnetic addition. Relatively high 134Cs concentrations in periphyton at year 5 point to the importance of benthic pathways in the recycling of contaminants to higher trophic levels. The presence of 134Cs in biota 5 years after the addition, long after concentrations were no longer detectable in surface waters, is evidence of the persistence of Cs in aquatic systems. The k values (or t1/2 values) for the loss of 60Co and 134Cs from water and their uptake and loss from biota can be used to establish parameter values for assessment models. The results demonstrate that assessment models should account for the release of radionuclides from sediment and their subsequent recycling in the food

  17. Detection and temporal variation of (60)Co in the digestive glands of the common octopus, Octopus vulgaris, in the East China Sea.

    PubMed

    Morita, Takami; Otosaka, Shigeyoshi; Fujimoto, Ken; Nishiuchi, Kou; Kimoto, Katsunori; Yamada, Haruya; Kasai, Hiromi; Minakawa, Masayuki; Yoshida, Katsuhiko

    2010-08-01

    (60)Co were detected in common octopus specimens collected in the East China Sea in 1996-2005. The source of (60)Co has remained unclear yet. Stable isotope analyses showed that there was no difference in stable Co concentrations between octopus samples with (60)Co and without (60)Co. This result showed that the stable Co in the digestive gland of octopus potentially did not include a trace amount of (60)Co and the source of (60)Co existed independently. Furthermore, investigations of octopus in other area and other species indicated that the origin of the source of (60)Co occurred locally in the restricted area in the East China Sea and not in the coastal area of Japan. Concentrations of (60)Co have annually decreased with shorter half-life than the physical half-life. This decrease tendency suggests that the sources of (60)Co were identical and were temporary dumped into the East China Sea as a solid waste.

  18. Effect of 60Co-gamma radiation on the properties of furs

    NASA Astrophysics Data System (ADS)

    Raina, R. K.; Wali, B. K.; Wani, A. M.

    Furs pretanned with various combinations of vegetable tanning agents and retanned with alum have been irradiated with 60Co γ-radiation in the dose range 5.0-114.0 kGy. The physico-chemical modifications induced by the radiation have been assessed by measuring changes in tensile strength, absorption of water, elongation and shrinkage temperature. For investigations, samples have been taken from the same topographic region of the rabbit furs, belonging to the same age and sex. The results are discussed hereunder.

  19. Hypodontia in the beagle after perinatal whole-body /sup 60/Co gamma irradiation

    SciTech Connect

    Lee, A.C.; Angleton, G.M.; Benjamin, S.A.

    1989-06-01

    As part of a long-term study to evaluate health effects of pre- and postnatal irradiation, dental development was examined. Beagles were irradiated in utero at 8, 28, or 55 days postcoitus or postnatally at 2, 70, or 365 days postpartum. Whole-body /sup 60/Co gamma radiation doses ranged from 0 to 3.8 Gy. There was an age-dependent dose-related increase in premolar hypodontia for animals irradiated at 55 days postcoitus or 2 days postpartum with doses of 0.83 Gy or higher and for those irradiated at 28 days postcoitus with 1.2 Gy or higher.

  20. Repair of neoplastic transformation damage following protracted exposures to /sup 60/Co. gamma. -rays

    SciTech Connect

    Han, A.; Hill, C.K.; Elkind, M.M.

    1983-01-01

    The incidences of neoplastic transformation induced by /sup 60/Co ..gamma..-rays in exponentially growing mouse embryo 10T1/2 cells were measured following acute and protracted exposures. Delivery of /sup 60/Co ..gamma..-rays at a low dose rate (0.1, 0.5, 2.5 rad/min) compared with a high dose rate (100 rad/min) results in appreciable, dose rate dependent reductions in cell killing and, independent of the effect on cell survival, reduces significantly the incidence of neoplastic transformation. Exposure of exponentially growing 10T1/2 cells to a dose of ..gamma..-rays in five equal daily fractions also significantly reduces transformation frequency, compared with delivery in a single dose, throughout the dose range examined (25 to 300 rads). The initial parts of the induction curves are fitted quite well by a linear dose dependence. The slopes of the regression lines for multifractionation delivery or irradiation at 0.1 rad/min, are one-third and one-half, respectively, of those for single exposures at a high dose rate. Increasing the interfraction interval up to 48 hours, or reduction of the dose per fraction further reduce incidence of neoplastic transformation. We conclude that protracted exposures of low LET radiation result in a net error-free repair of subtransformation damage.

  1. Adsorption and desorption kinetics of (60)Co and (137)Cs in fresh water rivers.

    PubMed

    Fiengo Pérez, Fabricio; Sweeck, Lieve; Bauwens, Willy; Van Hees, May; Elskens, Marc

    2015-11-01

    Radionuclides released in water systems--as well as heavy metals and organic toxicants--sorb to both the suspended solid particles and the bed sediments. Sorption is usually represented mathematically by the distribution coefficient. This approach implies equilibrium between phases and instantaneous fixation (release) of the pollutant onto (from) the surface of the soil particle. However, empirical evidence suggests that for some radionuclides the fixation is not achieved instantaneously and that the reversibility of the process can be slow. Here the adsorption/desorption kinetics of (60)Co and (137)Cs in fresh water environments were simulated experimentally and later on modelled mathematically, while the influence of the most relevant factors affecting the sorption were taken into account. The experimental results suggest that for adsorption and the desorption more than 24 h are needed to reach equilibrium, moreover, It was observed that the desorption rate constants for (60)Co and (137)Cs lie within ranges which are of two to three orders of magnitude lower than the adsorption rate constants.

  2. Effects of contrast medium on radiation-induced chromosome aberrations. [X-ray; /sup 60/Co

    SciTech Connect

    Matsubara, S.; Suzuki, S.; Suzuki, H.; Kuwabara, Y.; Okano, T.

    1982-07-01

    The effects of contrast material (meglumine iothalamate) on radiation-induced chromosome aberrations were investigated in studies on the lymphocytes of patients who had undergone diagnostic radiography and in vitro experiments with diagnostic x rays and /sup 60/Co ..gamma.. rays. Chromosome and chromatic aberrations were found to increase significantly with increasing concentrations of contrast material that were added at irradiation. However, the aberrations were not associated with elevation of the ratio of dicentric and ring chromosomes to the number of cells with unstable chromosome aberrations at the first mitosis. Lymphocytes irradiated in the absence of contrast material did not show an increase in chromosome-type aberrations when the agent was given in increasing concentrations during subsequent incubation, but there were greater numbers of chromatid gaps and breaks. When lymphocytes were exposed to 400 R (103.2 mC/kg) of /sup 60/Co ..gamma.. rays, the presence of contrast agent did not increase the yield of dicentric and ring chromosomes, but induced a marked delay in cell proliferation, especially in lymphocytes with more heavily damaged chromosomes. In additional examination, the contrast agent itself induced sister chromatid exchanges in lymphocytes.

  3. Radiation quality of tritium: a comparison with 60Co gamma rays.

    PubMed

    Chen, Jing

    2013-09-01

    In a previous study, microdosimetric simulations were performed for tritium uniformly distributed in a medium, and for tritium bound to biologically critical sites of dimensions from 10 nm to 2 µm. Results of local energy density, i.e. energy deposition in microscopic regions, are different for these two cases. Based on the spatial distribution of energy deposition, dose mean lineal energies are calculated for tritium in the forms of tritiated water (HTO) and organically bound tritium (OBT). The dose mean lineal energies of OBT are about a factor of 1.7 higher than those of HTO in a wide range of target dimensions of biological interest. The results are consistent with radiobiological findings that OBT is about twice as effective as HTO. In this study, the same calculations were performed for (60)Co gamma rays in a wide range of target dimensions of biological interest (10 nm to 2 µm). Compared with (60)Co gamma rays, the estimated relative biological effectiveness could vary from 1.3 to 3.5 for HTO, and 2.3 to 5.6 for OBT. The results are consistent with radiobiological findings for various biological endpoints in different biological systems that OBT is about twice as effective as HTO.

  4. Measurements of 60Co in spoons activated by neutrons during the JCO criticality accident at Tokai-mura in 1999.

    PubMed

    Gasparro, J; Hult, M; Komura, K; Arnold, D; Holmes, L; Johnston, P N; Laubenstein, M; Neumaier, S; Reyss, J-L; Schillebeeckx, P; Tagziria, H; Van Britsom, G; Vasselli, R

    2004-01-01

    Neutron activated items from the vicinity of the place where the JCO criticality accident occurred have been used to determine the fluence of neutrons around the facility and in nearby residential areas. By using underground laboratories for measuring the activation products, it is possible to extend the study to also cover radionuclides with very low activities from long-lived radionuclides. The present study describes gamma-ray spectrometry measurements undertaken in a range of underground laboratories for the purpose of measuring (60)Co more than 2 years after the criticality event. The measurements show that neutron fluence determined from (60)Co activity is in agreement with previous measurements using the short-lived radionuclides (51)Cr and (59)Fe. Limits on contamination of the samples with (60)Co are evaluated and shown to not greatly affect the utility of neutron fluence determinations using (60)Co activation.

  5. Relation of structure to function for the US reference standard endotoxin after exposure to /sup 60/Co radiation

    SciTech Connect

    Csako, G.; Suba, E.A.; Ahlgren, A.; Tsai, C.M.; Elin, R.J.

    1986-01-01

    The structure and function of the highly purified US reference standard endotoxin (RSE) were studied after exposure to ionizing radiation from a /sup 60/Co source. With increasing doses of radiation, the trilaminar ribbon-like structure of untreated endotoxin exhibited focal swelling, after which only spherical particles were seen by electron microscopy. These morphological changes were paralleled by the respective loss of O-side chain repeating units and pieces of the R-core from the lipopolysaccharide molecules, as demonstrated by electrophoresis. The biologic function of the irradiated endotoxin was assessed with a variety of tests. At higher doses of radiation, a direct relation was observed between the degradation of the molecular and supramolecular structure and the loss of biologic function. At lower doses of radiation, however, there was variability among the functional assays in their rate of change with progressive irradiation of the RSE. The results suggest that the carbohydrate moiety plays an important role both in determining the supramolecular structure and in modulating certain biologic activities of bacterial endotoxins.

  6. Modification of the chemical composition and structure of the US Reference Standard Endotoxin (RSE) by /sup 60/Co radiation

    SciTech Connect

    Csako, G.; Tsai, C.M.; Slomiany, B.L.; Herp, A.; Elin, R.J.

    1986-03-01

    A highly purified bacterial lipopolysaccharide (LPS) preparation was exposed in water to megadoses of ionizing radiation from a /sup 60/Co source. As evidenced by electrophoresis, the radiation treatment progressively degraded the lipopolysaccharide molecules by removing first the O-side chain units and then components of the R-core. Chemical analysis of the irradiated (LPS) preparations showed that, in accord with the structural changes, the most profound effects of ionizing radiation occurred in the hydrophilic oligo/polysaccharide moieties (R-core and O-side chain). Progressively higher doses of radiation degraded the simple sugars in decreasing order of galactose, galactosamine, glucosamine, glucose, and heptose. The R-core component 2-keto-3-deoxyoctonate was the most resistant sugar derivative to ionizing radiation. Due to its central position in the LPS aggregates in water, even at comparatively high doses of radiation the hydrophobic lipid A moiety of endotoxin was less affected than the sugar components. Of the fatty acids of lipid A, however, either partial conversion of beta-hydroxymyristic acid into myristic acid or selective loss of the former occurred. The observed structural and chemical changes of LPS are consistent with the effect of active oxygen radicals of radiolysis. In addition, the extensive physicochemical changes explain the altered biological reactivity of radiation-treated endotoxins.

  7. APMP key comparison for the measurement of air kerma for 60Co (APMP.RI(I)-K1.1)

    NASA Astrophysics Data System (ADS)

    Webb, D. V.; Lee, J.-H.; Budiantari, C. T.; Laban, J.; Saito, N.; Srimanoroth, S.; Khaled, N. E.

    2016-01-01

    The results are reported for an APMP.R(I)-K1.1 comparison that extends the regional comparison of standards for air kerma APMP.R(I)-K1 to several laboratories unable to participate earlier. The comparison was conducted with the goal of supporting the relevant calibration and measurement capabilities (CMCs) planned for publication by the participant laboratories. The comparison was conducted by the pilot laboratory, the Australian Radiation Protection and Nuclear Safety (ARPANSA), Australia, supported by the Institute of Nuclear Energy Research (INER), Taiwan, in a modified ring-shaped arrangement from September 2009 to November 2010, in parallel with an APMP.R(I)-K4 comparison being piloted by the INER. The laboratories that took part in the comparison were the ARPANSA, the Centre of Technology of Radiation Safety and Metrology (PTKMR-BATAN), Indonesia, the Division of Radiation and Medical Devices (DMSC), Thailand, the INER, the National Centre for Radiation Science (NCRS), New Zealand, the National Institute for Standards (NIS), Egypt and the National Metrology Institute of Japan (NMIJ/AIST), Japan. The two primary laboratories, ARPANSA and NMIJ, were chosen as the linking laboratories. Three ionization chambers were used as transfer instruments to be calibrated in terms of air kerma in 60Co radiotherapy beams. The comparison result is based on the ratio between the air kerma calibration coefficients (NK) determined by the participants and the mean of the results of the linking laboratories. The mean comparison ratio was found to be within 0.5 % of the key comparison reference value KCRV. The largest deviation between any two comparison ratios for the three chambers in terms of air kerma was 2.0 %. An analysis of the participant uncertainty budgets enabled the calculation of degrees of equivalence (DoE) in terms of the deviations of the results and their associated uncertainties. As a result of this APMP comparison, the BIPM key comparison database (KCDB) should

  8. Radiation-induced pulmonary arterial perfusion defects: modification by D-penicillamine. [Rats; /sup 60/Co

    SciTech Connect

    Ward, W.F.

    1981-04-01

    D-penicillamine, previously shown to have a beneficial effect on radiation-induced pulmonary histopathology, was tested to determine its effect on function in the irradiated lung. Male rats were irradiated with /sup 60/Co gamma rays; half then received 10 mg D-penicillamine per day, and half received no further treatment. One to nine months after irradiation, animals were subjected to lung perfusion scans. Untreated irradiated rats exhibited hyperemia, hypoperfusion, and perfusion defects of the irradiated lung. In penicillamine-treated rats, the appearance of perfusion defects was delayed, the peak incidence and severity of the defects was reduced, and recovery from pulmonary hypoperfusion was accelerated. Thus, using functional criteria, penicillamine appears to improve arterial perfusion and to ameliorate radiation injury in the rat lung.

  9. Radiation esophagitis in the opossum: radioprotection with indomethacin. [/sup 60/Co

    SciTech Connect

    Northway, M.G.; Libshitz, H.I.; Osborne, B.M.; Feldman, M.S.; Mamel, J.J.; West, J.H.; Szwarc, I.A.

    1980-05-01

    Twenty-five opossums were evaluated before irradiation by fiberoptic endoscopy and air-contrast barium esophagram examination. All animals received 2250 rad /sup 60/Co-irradiated in a single exposure to the entire esophagus and lower exophageal sphincter. Animals received treatment with indomethacin. Acute esophagitis occurred 7 to 10 days postirradiation in control animals and was characterized by erythema, ulceration, and sloughing of esophageal mucosa as determined by air-contrast barium esophagram, endoscopy, and histology. Prostaglandin-treated animals showed more severe evidence of esophagitis than control animals. Indomethacin-treated animals showed no signs or only mild esophagitis posttreatment. It is concluded that indomethacin treatment may significantly reduce the severity of radiation esophagitis perhaps by blockade of prostaglandin synthesis.

  10. Measurements of (60)Co in massive steel samples exposed to the Hiroshima atomic bomb explosion.

    PubMed

    Gasparro, Joël; Hult, Mikael; Marissens, Gerd; Hoshi, Masaharu; Tanaka, Kenichi; Endo, Satoru; Laubenstein, Matthias; Dombrowski, Harald; Arnold, Dirk

    2012-04-01

    To study discrepancies in retrospective Hiroshima dosimetry, the specific activity of (60)Co in 16 steel samples from Hiroshima was measured using gamma-ray spectrometry in underground laboratories. There is general agreement between these new activity measurements and the specific activities derived from previously calculated dose values on the one hand and former measurements of samples gathered at distances less than 1,000 m from the center of the explosion (< 1,000 m slant range) on the other. It was found that activities at long range (> 1,300 m slant range) were mainly cosmogenically induced. Furthermore, at long range, these results are in disagreement with older measurements whose specific activity values were 10 to 100 times higher than predicted by computer model calculations in DS86 and DS02. As a consequence, the previously reported discrepancy is not confirmed.

  11. Grafting of HEMA onto dopamine coated stainless steel by 60Co-γ irradiation method

    NASA Astrophysics Data System (ADS)

    Jin, Wanqin; Yang, Liming; Yang, Wei; Chen, Bin; Chen, Jie

    2014-12-01

    A novel method for grafting of 2-hydroxyethyl methacrylate (HEMA) onto the surface of stainless steel (SS) was explored by using 60Co-γ irradiation. The surface of SS was modified by coating of dopamine before radiation grafting. The grafting reaction was performed in a simultaneous irradiation condition. The chemical structures change of the surface before and after grafting was demonstrated by Fourier transform infrared (FTIR) spectrometer. The hydrophilicity of the samples was determined by water contact angle measurement in the comparison of the stainless steel in the conditions of pristine, dopamine coated and HEMA grafted. Surface morphology of the samples was characterized by atomic force microscope (AFM) and scanning electron microscope (SEM). The corrosion resistance properties of the samples were evaluated by Tafel polarization curve. The hemocompatibility of the samples were tested by platelet adhesion assay.

  12. EVALUATION OF THE MIGRATION POTENTIAL FOR 60Co AND 137Cs AT THE MAINE YANKEE SITE.

    SciTech Connect

    FUHRMANN,M.SULLIVAN,T.

    2002-08-08

    The objective of this report is to discuss the degree of sorption and desorption of {sup 137}Cs and {sup 60}Co that may be associated with the granite bedrock and the ''popcorn'' cement drain system that underlie the Maine Yankee Containment Foundation. The purpose is to estimate how much retardation of these two radionuclides takes place in groundwater that flows in the near-field of the Containment Foundation, specifically with respect to contamination originating at the PAB Test Pit. Specific concerns revolve around the potential for the contamination originating near the PAB to create a radioactive dose to a hypothetical ''resident farmer'' using a well intercepting this water to exceed 4 millirems/yr.

  13. Measurements and calculations of the absorbed dose distribution around a 60Co source.

    PubMed

    Tiourina, T B; Dries, W J; van der Linden, P M

    1995-05-01

    The data from Meisberger et al. [Radiology 90, 953-957 (1968)] are often used as a basis for dose calculations in brachytherapy. In order to describe the absorbed dose in water around a brachytherapy point source, Meisberger provided a polynomial fit for different isotopes taking into account the effect of attenuation and scattering. The validity of the Meisberger coefficients is restricted to distances up to 10 cm from the source, which is regarded to be satisfactory for most brachytherapy applications. However, for more distant organs it may lead to errors in calculated absorbed dose. For this reason dose measurements have been performed in air and in water around a high activity 60Co source used in high dose rate brachytherapy. Measurements were carried out to distances of 20 cm, using ionization chambers. These data show that at a distance of about 15 cm the amount of scattered radiation virtually equals the amount of primary radiation. This emphasizes the contribution of scattered radiation to the dose in healthy tissue far from the target volume, even with relatively high energy photon radiation of 60Co. It is also shown that the Meisberger data as well as the approach of Van Kleffens and Star [Int. J. Radiat. Oncol. Phys. 5, 557-563 (1979)] lead to significant errors in absorbed dose between distances of 10 and 20 cm from the source. In addition to these measurements, the Monte Carlo code has been used to calculate separately primary dose and scattered dose from a cobalt point source. The calculated results agree with the experimental data within 1% for a most distant dose scoring region.

  14. 60Co irradiation for sterilization of veterinary mastitis products containing antibiotics and steroids

    NASA Astrophysics Data System (ADS)

    Tsuji, K.; Kane, M. P.; Rahn, P. D.; Steindler, K. A.

    Effects of 60Co irradiation for sterilization of veterinary mastitis products were evaluated. The mastitis products which were examined contained various combinations of antibiotics and steroids suspended in peanut oil vehicle. Bioburden data indicated that the unirradiated products were only occasionally contaminated with microorganisms. The D-values of the nonsterile product and environmental isolates were 0.028, 0.15, 0.017, and 0.018 Mrads for Aspergillus fumigatus, Penicillium oxalicum, Pseudomonas aeruginosa, and Pseudomonas maltophilia, respectively. The D-value of the biological indicator organism, Bacillus pumilus spores, in the vehicle was 0.27 Mrads. Thus, an irradiation dose of 1.6 Mrads would be sufficient to achieve six log cycles of destruction of the biological indicator organism. The minimum absorbed irradiation dose of 2.5 Mrads preferred by many countries for sterilization would achieve 9.3 log cycle destruction of the indicator organism and guarantee a probability of 1 × 10 -15 assurance for the most radio-resistant product isolate, Penicillium oxalicum. In order to examine short and long term chemical stabilities of active components, stability indicating high-performance liquid chromatographic (HPLC) methods for the determination of the following antibiotics and steroids were developed. They were: dihydrostreptomycin, neomycin, novobiocin, penicillin G, hydrocortisone acetate, hydrocortisone sodium succinate, and prednisolone. The rates of degradation and radiolytic degradation schemes for the majority of these compounds were elucidated. Formation of new compounds was not observed in these antibiotics and steroids upon 60Co irradiation. The compounds that increased by irradiation were inherently present in commercially available non-irradiated lots and/or can easily be formed by either acidic, basic, or thermal treatment.

  15. Characteristics of nucleoplasmic bridges induced by 60Co γ-rays in human peripheral blood lymphocytes.

    PubMed

    Zhao, Hua; Lu, Xue; Li, Shuang; Chen, De-Qing; Liu, Qing-Jie

    2013-12-16

    Few studies have shown that the yields of ionising-radiation-induced nucleoplasmic bridges (NPBs) in human cells are dose dependent. However, a dose-response curve between the NPB frequency and the absorbed dose of ionising radiation has not yet been established. This study aimed to investigate NPB frequencies in human peripheral blood lymphocytes induced by cobalt-60 ((60)Co) γ-rays and to establish a dose-response curve. Human peripheral blood samples were collected from three healthy males, and some of these samples were irradiated with 0-6 Gy (60)Co γ-rays. A cytokinesis-block micronucleus cytome assay was then carried out to analyse NPBs and micronuclei (MN) in binucleated cells. The remaining blood samples were irradiated with 0, 2 and 5 Gy of γ-rays, and unstable chromosome aberrations (dicentric chromosome, ring chromosome and acentric chromosome fragment) were analysed. The correlation between NPBs and dicentric plus ring chromosome (dic+r) induced by the same γ-ray dose was also analysed. Results showed that the NPB yields among the three subjects at each dose level were not significantly different. NPBs in binucleated cells at all γ-ray doses conformed to Poisson distribution. The dose-response curve of the γ-ray-induced NPB frequencies followed the linear-quadratic model y = (1.39×10(-3))x (2) + (4.94×10(-3))x. A positive correlation was observed between the frequencies of NPB and dic+r, as well as between the frequencies of MN and acentric fragments. Therefore, NPB is an important biomarker of early chromosome damage event induced by ionising radiation.

  16. [The characteristics of a low-melting-point alloy (Lipowitz's metal) for use in radiotherapy].

    PubMed

    Fiume, A; Belletti, S

    1991-11-01

    Lipowitz's metal is widely employed in radiotherapy to create shielding blocks and compensators for X- and gamma-rays. Its effect in modifying radiation beams cannot be evaluated in a simple manner: therefore, in our opinion, an experimental approach to the problem is the most suitable one. Attenuation for Lipowitz's metal and lead was measured in some different geometrical setups, for a 5 MV linac and a 60Co unit. Transmitted fraction vs attenuator thickness curves were obtained. The influence of attenuators on depth-dose curves in a phantom was also evaluated: the results confirm the need to use data obtained in conditions as close as possible to the operative ones, in treatment planning as well as in studying and realizing calculation models.

  17. Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a {sup 60}Co Magnetic Resonance Image Guidance Radiation Therapy System

    SciTech Connect

    Wooten, H. Omar Green, Olga; Yang, Min; DeWees, Todd; Kashani, Rojano; Olsen, Jeff; Michalski, Jeff; Yang, Deshan; Tanderup, Kari; Hu, Yanle; Li, H. Harold; Mutic, Sasa

    2015-07-15

    Purpose: This work describes a commercial treatment planning system, its technical features, and its capabilities for creating {sup 60}Co intensity modulated radiation therapy (IMRT) treatment plans for a magnetic resonance image guidance radiation therapy (MR-IGRT) system. Methods and Materials: The ViewRay treatment planning system (Oakwood Village, OH) was used to create {sup 60}Co IMRT treatment plans for 33 cancer patients with disease in the abdominal, pelvic, thorax, and head and neck regions using physician-specified patient-specific target coverage and organ at risk (OAR) objectives. Backup plans using a third-party linear accelerator (linac)-based planning system were also created. Plans were evaluated by attending physicians and approved for treatment. The {sup 60}Co and linac plans were compared by evaluating conformity numbers (CN) with 100% and 95% of prescription reference doses and heterogeneity indices (HI) for planning target volumes (PTVs) and maximum, mean, and dose-volume histogram (DVH) values for OARs. Results: All {sup 60}Co IMRT plans achieved PTV coverage and OAR sparing that were similar to linac plans. PTV conformity for {sup 60}Co was within <1% and 3% of linac plans for 100% and 95% prescription reference isodoses, respectively, and heterogeneity was on average 4% greater. Comparisons of OAR mean dose showed generally better sparing with linac plans in the low-dose range <20 Gy, but comparable sparing for organs with mean doses >20 Gy. The mean doses for all {sup 60}Co plan OARs were within clinical tolerances. Conclusions: A commercial {sup 60}Co MR-IGRT device can produce highly conformal IMRT treatment plans similar in quality to linac IMRT for a variety of disease sites. Additional work is in progress to evaluate the clinical benefit of other novel features of this MR-IGRT system.

  18. Migration of radioactive {sup 85}Sr, {sup 134}Cs and {sup 60}Co through a loess soil layer

    SciTech Connect

    Li, Z.; Wang, H.; Takebe, Shinichi; Tanaka, Tadao

    1995-12-31

    Column experiments have been completed on the migration of {sup 85}Sr, {sup 134}Cs and {sup 60}Co through a loess layer in order to examine the migration behavior of radionuclides in an aerated soil layer. Radionuclide concentration distributions between the effluent and the soil layer were measured after the solution containing the radionuclides was introduced into the column from the top of the soil layer and fifty liters of the underground water were introduced at a constant flow. Results indicate most of the {sup 85}Sr, {sup 134}Cs and {sup 60}Co remained attached to the soil layer, and only a small amount of radionuclide was released from the soil layer. Within the soil layer, the migration depths of three radionuclides are {sup 85}Sr > {sup 134}Cs = {sup 60}Co.

  19. Effect of chronic HTO. beta. or /sup 60/Co. gamma. radiation on preimplantation mouse development in vitro

    SciTech Connect

    Yamada, T.; Yukawa, O.; Asami, K.; Nakazawa, T.

    1982-11-01

    Response of pronuclear, early 2-cell, and late 2-cell mouse embryos to chronic HTO ..beta.. and /sup 60/Co ..gamma.. irradiation was investigated. The pronuclear embryos fertilized in vitro and 2-cell stage embryos of BC3F/sub 1/ (C3H/C57BL) mice were grown in vitro in chemically defined medically defied media containing tritium oxide. Activity levels ranged from 100 to 2000 ..mu..Ci/ml. With development to blastocyst as the end point, the LD/sub 50/ was determined to be 118, 230, and 426 ..mu..Ci/ml for pronuclear, early 2-cell, and late 2-cell embryos, respectively. Similar embryos were exposed in vitro to chronic ..gamma.. radiation from /sup 60/Co during the same period of development, and RBE values of HTO ..beta.. radiation relative to /sup 60/Co ..gamma.. rays were calculated to be within the range of 1.0 to 1.7.

  20. Dosimetric characterization of the (60)Co BEBIG Co0.A86 high dose rate brachytherapy source using PENELOPE.

    PubMed

    Guerrero, Rafael; Almansa, Julio F; Torres, Javier; Lallena, Antonio M

    2014-12-01

    (60)Co sources are being used as an alternative to (192)Ir sources in high dose rate brachytherapy treatments. In a recent document from AAPM and ESTRO, a consensus dataset for the (60)Co BEBIG (model Co0.A86) high dose rate source was prepared by using results taken from different publications due to discrepancies observed among them. The aim of the present work is to provide a new calculation of the dosimetric characteristics of that (60)Co source according to the recommendations of the AAPM and ESTRO report. Radial dose function, anisotropy function, air-kerma strength, dose rate constant and absorbed dose rate in water have been calculated and compared to the results of previous works. Simulations using the two different geometries considered by other authors have been carried out and the effect of the cable density and length has been studied.

  1. HeLa cell tumor response to 60Co, Cs-137, Cf-252 radiations and cisplatin chemotherapy in nude mice.

    PubMed

    Maruyama, Y; Feola, J M; Beach, J L

    1984-07-15

    HeLa cells were implanted into athymic nude mice from tissue culture and solid tumors established (HeLa cell tumor or HCT). Large cell numbers of 1 X 10(7) were required to obtain consistent and progressive growth, and tumor growth followed a Gompertzian mode. Irradiation studies were carried out using acute Cobalt-60 (60Co), low-dose-rate (LDR) Cs-137 and LDR Cf-252. Cf-252, a neutron-emitting radioisotope, produced an immediate tumor shrinkage and regression response after a dose of 279 cGy. Acute 60Co or LDR Cs-137 irradiation with 1000 cGy had little effect on the HCT. After a dose of 2000 cGy of 60Co radiation tumor shrinkage followed a latent period of approximately 5 days. Cisplatin had no effect on the HCT in nude mice in stationary or late exponential growth.

  2. HeLa cell tumor response to 60Co, Cs-137, Cf-252 radiations and cisplatin chemotherapy in nude mice

    SciTech Connect

    Maruyama, Y.; Feola, J.M.; Beach, J.L.

    1984-07-15

    HeLa cells were implanted into athymic nude mice from tissue culture and solid tumors established (HeLa cell tumor or HCT). Large cell numbers of 1 X 10/sup 7/ were required to obtain consistent and progressive growth, and tumor growth followed a Gompertzian mode. Irradiation studies were carried out using acute Cobalt-60 (60Co), low-dose-rate (LDR) Cs-137 and LDR Cf-252. Cf-252, a neutron-emitting radioisotope, produced an immediate tumor shrinkage and regression response after a dose of 279 cGy. Acute 60Co or LDR Cs-137 irradiation with 1000 cGy had little effect on the HCT. After a dose of 2000 cGy of 60Co radiation tumor shrinkage followed a latent period of approximately 5 days. Cisplatin had no effect on the HCT in nude mice in stationary or late exponential growth.

  3. Calibration of GafChromic EBT3 for absorbed dose measurements in 5 MeV proton beam and {sup 60}Co γ-rays

    SciTech Connect

    Vadrucci, M. Ronsivalle, C.; Marracino, F.; Montereali, R. M.; Picardi, L.; Piccinini, M.; Vincenti, M. A.; Esposito, G.; De Angelis, C.; Cherubini, R.; Pimpinella, M.

    2015-08-15

    Purpose: To study EBT3 GafChromic film in low-energy protons, and for comparison purposes, in a reference {sup 60}Co beam in order to use it as a calibrated dosimetry system in the proton irradiation facility under construction within the framework of the Oncological Therapy with Protons (TOP)-Intensity Modulated Proton Linear Accelerator for RadioTherapy (IMPLART) Project at ENEA-Frascati, Italy. Methods: EBT3 film samples were irradiated at the Istituto Nazionale di Fisica Nucleare—Laboratori Nazionali di Legnaro, Italy, with a 5 MeV proton beam generated by a 7 MV Van de Graaff CN accelerator. The nominal dose rates used were 2.1 Gy/min and 40 Gy/min. The delivered dose was determined by measuring the particle fluence and the energy spectrum in air with silicon surface barrier detector monitors. A preliminary study of the EBT3 film beam quality dependence in low-energy protons was conducted by passively degrading the beam energy. EBT3 films were also irradiated at ENEA-National Institute of Ionizing Radiation Metrology with gamma radiation produced by a {sup 60}Co source characterized by an absorbed dose to water rate of 0.26 Gy/min as measured by a calibrated Farmer type ionization chamber. EBT3 film calibration curves were determined by means of a set of 40 film pieces irradiated to various doses ranging from 0.5 Gy to 30 Gy absorbed dose to water. An EPSON Expression 11000XL color scanner in transmission mode was used for film analysis. Scanner response stability, intrafilm uniformity, and interfilm reproducibility were verified. Optical absorption spectra measurements were performed on unirradiated and irradiated EBT3 films to choose the most sensitive color channel to the dose range used. Results: EBT3 GafChromic films show an under response up to about 33% for low-energy protons with respect to {sup 60}Co gamma radiation, which is consistent with the linear energy transfer dependence already observed with higher energy protons, and a negligible dose

  4. Gamma 60Co-irradiation of organic matter in the Phosphoria Retort Shale

    NASA Astrophysics Data System (ADS)

    Lewan, M. D.; Ulmishek, G. F.; Harrison, W.; Schreiner, F.

    1991-04-01

    Irradiation experiments were conducted on a thermally immature rock sample of the Phosphoria Retort Shale and its isolated kerogen. A 60Co-source for gamma radiation was employed at dosages ranging from 81 to 885 Mrads, which are attainable by Paleozoic and Precambrian black shales with syngenetic uranium enrichments. Kerogen elemental, isotopic, and pyrolysate compositions are not affected at these dosages, but the bitumens extracted from the irradiated rock are affected. The major effects are reductions in the amounts of bitumen, acyclic isoprenoids, and high-molecular weight acyclic carboxylic acids. Natural differences in the amounts of bitumen and acyclic isoprenoid due to regional and stratigraphie variations in organic source input and depositional conditions make the radiation-induced reductions in these parameters difficult to use as indicators of natural radiation damage in black shales. However, the preferential reduction in the high-molecular weight acyclic carboxylic acids, which are ubiquitous in the living precursory organic matter, is diagnostic of experimental γ-irradiation but may not be diagnostic of natural irradiation. The overall process associated with radiation damage is polymerization by cross-linking through a free radical mechanism. As a result, irradiation of organic matter in black shales is more likely to retard rather than enhance petroleum generation.

  5. Whole-thorax radiation lethality in penicillamine-treated mice. [/sup 60/Co

    SciTech Connect

    Ward, W.F.; Shih-Hoellwarth, A.; Pearlman, H.G.; Kepka, A.G.

    1982-01-01

    A total of 451 male mice received a single exposure of 0-20 Gy of /sup 60/Co ..gamma.. rays to the whole thorax. Half the animals consumed control diet, and half consumed diet supplemented with the collagen antagonist D-penicllamine (2 mg/day, po). Survival was observed daily, and body weight was recorded biweekly for 1 year after irradiation. The LD /sub 50;60-180 days/ of untreated and penicillamine-treated mice was 15.9 +/- 0.7 and 16.5 +/- 0.9 Gy, respectively, yielding a drug DRF of 1.04 (P > 0.05). In contrast, LD/sub 50;181-360 days/ of the two groups was 12.0 +/- 1.3 and 14.4 +/- 0.9 Gy, respectively, yielding a penicillamine DRF of 1.20 (P < 0.05). Thus it appears that penicillamine is ineffective against fatal radiation pneumonitis but significantly reduces mortality resulting from radiation-induced pulmonary fibrosis in mice irradiated to the whole thorax. While penicillamine did not reduce the incidence of early (<6 months) lung deaths, drug-treated mice weighed significantly (P < 0.05) more than their untreated counterparts during that time.

  6. The ultrastructure of radiation injury in rat lung: modification by D-penicillamine. [/sup 60/Co

    SciTech Connect

    Port, C.D.; Ward, W.F.

    1982-10-01

    The present study compared the ultrastructure of radiation injury in the lungs of penicillamine-treated and untreated male rats sacrificed 3, 6, 9, or 12 months after a single exposure of 25 Gy of /sup 60/Co ..gamma..-rays to the right hemithorax. All morphological components of the irradiated lungs exhibited injury typical of pneumonitis progressing to interstitial fibrosis. In addition to these well-documented responses, several less common ultrastructural changes were noted, including capillary recanalization; focal disappearance of interstitial collagen fibers, initially perivascularly, then throughout some septa; and a low-grade but significant cellular reaction in the shielded left lung. Radiation reactions in the lungs of penicillamine-treated rats were qualitatively similar to those of untreated animals, but differed in the degree of change: collagen deposition was less extensive and less highly organized into fibers, capillary recanalization and disappearance of interstitial collagen were more common, and arterial wall thickening was reduced in the drug-treated rats. Thus the beneficial effect of penicillamine on the histopathology of irradiated rat lung does not appear to be attributable to unique ultrastructural phenomena. Rather, penicillamine treatment produces a generalized inhibition of pathologic events such as collagen accumulation and arterial wall thickening, and acceleration of restorative processes such as revascularization and collagen degradation.

  7. (56)Mn, (60)Co, (18)F and (22)Na activity measurements by coincidence technique at VNIIM.

    PubMed

    Evgeny, Tereshchenko; Nikolay, Moiseev; Alexander, Kolodka

    2016-03-01

    For modernization of the Russian national activity standard at the Ionizing Radiation Department of the D.I. Mendeleyev Institute for Metrology, a prototype 4π(LS)-γ(NaI) coincidence arrangement was created, and applied to the standardization of long-lived (60)Co and (22)Na and short-lived (56)Mn and (18)F. Efficiency variation was performed using "grey filters", high voltage variation and variation of low threshold. The main metrological characteristics of the setup were determined: long-term stability, background, dead time, resolution time and temperature dependence. The results obtained have practical applications. The (18)F solution with well-known activity is required for calibration of ionizing chamber used in nuclear medicine. The (56)Mn is used for calibration of manganese bath equipment used in neutron laboratory. The results obtained are in good agreement with 4πγ(NaI)-counting and 4πβ(PC)-γ(NaI) methods of Russian national radioactivity standard. The combined uncertainty (k=2) of results was estimated in the range 1-2%.

  8. Effect of 60Co gamma-irradiation on the nonspecific cytotoxicity of alveolar macrophages in vitro.

    PubMed Central

    Gong, Y; Hu, L; Wu, D

    1992-01-01

    This paper reports on the effect of radiation on the nonspecific cytotoxicity of rat alveolar macrophages (AM). AM (effector cells) of bacille Calmette-Guerin-activated Wistar rats were irradiated with 60Co gamma rays in vitro to give doses of 0, 100, 300, and 500 Gy. Three hours after irradiation, the AM were cultured with human lung adenocarcinoma AGZY83-a and HeLa target cells in 125I-deoxyuridine-containing media for 6 hr and the cytotoxicity indexes determined. The results indicated that the cytotoxicity indexes of AM against human lung adenocarcinoma cells and HeLa cells were 94.3 +/- 0.3% and 81.3 +/- 1.9%, respectively. The cytotoxicity indexes using an effector/target cell ratio (E/T) of 10 seemed to be greater than with ratios of 20 and 30. The cytotoxicity indexes of AM (7 rats), irradiated to give doses of 0, 100, 300, and 500 Gy, against adenocarcinoma cells at an E/T ratio of 10 were 87.9 +/- 8.4%, 65.4 +/- 14.1%, 47.5 +/- 17.5%, and 36.7 +/- 9.7%, respectively. The significance of the nonspecific cytotoxicity of AM in the immunological elimination of tumors and the inhibitory effect of radiation on AM cytotoxicity are discussed. PMID:1396453

  9. Succinylcholine-induced hyperkalemia in the rat following radiation injury to muscle. [60Co

    SciTech Connect

    Cairoli, V.J.; Ivankovich, A.D.; Vucicevic, D.; Patel, K.

    1982-02-01

    During anesthetic preparation of a patient who had received routine radiation therapy of sarcoma of the leg, cardiac collapse occurred following succinylcholine (SCh) administration. Experiments were designed to test the hypothesis that radiation injury to muscle might cause increased sensitivity to SCh similar to that reported in patients with muscle trauma, severe burns, and lesions causing muscle denervation. Venous plasma potassium levels and arterial blood gas tensions were measured in rats after they were given SCh (3 mg/kg) at various times following 60Co irradiation of the hind legs. Nonirradiated rats responded to SCh with a slight but statistically significant increase in plasma K+. Rats subjected to high levels of radiation (10,000 to 20,000 R) and given SCh 4 to 7 days later responded in the same way as the control rats. Plasma K+ levels in rats exposed to a fractionated irradiated dosage (25000 R given twice with a 1-week interval) followed by SCh 1 week later were similar to those in the control group, but when SCh was given 2 weeks later (3 weeks after initial irradiation) there was a marked elevation of plasma K+, from 3.6 to 7.7 meq/L, a statistically significant increase.

  10. Studying the Effect of Ionization Radiation of 60Co on the Spirulina

    NASA Astrophysics Data System (ADS)

    Ai, Weidang; Guo, Shuang-Sheng; Ai, Weidang; Dong, Wen-Ping; Qin, Li-Feng; Tang, Yong-Kang

    It studied the effect of ionization radiation on the Spirulina plastensis(No.6) by using the γ-rays of 60 Co. In the experiment, Spirulina were irradiated, and the dose of the ionization radiation covered 0, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0kGy. After irradiating, these Spirulina were cultured under the same conditions. During the course of the experiment, the growth rate, photosynthetic efficiency and nutrition quality of the Spirulina, were analyzed. From the results, low dose of γ-rays (less than 1.5kGy) could improve the content of phycobilin and protein of Spirulina. Only small changes in the morphology of algae filament were found at dose less than 1.0kGy. But with the increase of the dose of γ-rays (more than 1.5kGy), the filaments would break up or even disintegrate. Spirulina had stronger ionization radiation proof and self-rehabilitation capacity, but the growth of Spirulina was stagnated. The LD50 (i.e. the dose resulted in 50% death of the Spirulina) of the colony was 2.0kGy. Considering the capacity of being resistant to γ-rays irradiation, Spirulina can be considered as one of the key biological components in the Controlled Ecological Life Support System (CELSS) for future long-term space missions. Keywords: Controlled Ecological Life Support System (CELSS); Spirulina; ionization radiation; biological component

  11. A review of the (60)Co internal dosimetry at Devonport Royal Dockyard.

    PubMed

    Vickers, J M A; Collison, R; Collision, R

    2010-03-01

    The physico-chemical properties of (60)Co contaminants arising from the UK Naval Nuclear Propulsion Programme (NNPP) pressurised water reactor (PWR) plants have been investigated in order to review individual monitoring requirements at Devonport Royal Dockyard (DRD). This has been achieved through laboratory tests on NNPP primary component samples and interpretation of direct bioassay measurements using internal dosimetry modelling software. Interpretation of lung measurements was completed for two inhalation events involving material originating from a PWR plant and post-primary circuit decontamination. Initial estimates of intake and dose were calculated using International Commission on Radiological Protection default parameter values. However, a good fit could only be achieved by fitting the data to alternative absorption parameters where 90-95% of the material dissolved and absorbed rapidly at a rate of 1 day(-1). As a consequence of this review, a number of improvements have been made to monitoring arrangements at DRD. A minimum of three direct measurements are now taken during the 0-30 day period after an intake, the capability of the Canberra Accuscan has been enhanced and dissolution tests are being carried out by the Health Protection Agency (HPA) on samples taken from PWR plants.

  12. The effect of perinatal sup 60 Co gamma radiation on brain weight in beagles

    SciTech Connect

    Hamilton, B.F.; Benjamin, S.A.; Angleton, G.M.; Lee, A.C. )

    1989-08-01

    Beagle dogs were given single, whole-body {sup 60}Co gamma-radiation exposures at one of three prenatal (8, 28, or 55 days postcoitus) or three postnatal (2, 70, or 365 days postpartum) ages to evaluate the relative radiosensitivity of various stages of brain development. A total of 387 dogs received mean doses ranging from 0.16 to 3.83 Gy, and 120 dogs were sham-irradiated. Groups of dogs were sacrificed at preselected times from 70 days to 11 years of age. Brain weight decreased significantly with increasing dose in dogs irradiated at 28 or 55 days postcoitus or at 2 days postpartum. Irradiations at 28 days postcoitus were dramatically more effective in causing a reduction in brain weight than those at 55 days postcoitus or 2 days postpartum. Among dogs given 1.0 Gy or more and followed for up to 4 years, there was a radiation effect evident at all three sensitive exposure ages. Among dogs given lower doses and followed for up to 11 years, there was a significant decrease in brain weight in dogs given 0.80-0.88 Gy at 28 days postcoitus. All decreases in brain weight were present after normalization for radiation-induced reductions in skeletal (body) size. No specific morphologic changes were noted in the brains which showed the radiation-related reductions in size.

  13. Diagnosis and treatment of olfactory neuroblastomas in seven patients. [/sup 60/Co

    SciTech Connect

    Daly, N.J.; Voigt, J.J.; Combes, P.F.

    1980-12-01

    A group of 7 patients with olfactory neuroblastomas (ON) treated at Centre Claudius Regaud (CCR) from 1966 to 1978 are presented. Clinical and radiological evaluation showed 4/7 patients with endocranial extension of tumor (stage C disease). All patients were treated by external irradiation (Co60) after biopsies (3), surgical curettage (3) or whole ethmoidectomy (1). No patient had tumor failures in irradiated volumes where doses were above 4000 rad. Four patients had tumor relapses outside treated volumes, two in cervical nodes. Five patients were alive without clinical disease from 2 to 12.5 years after initial treatment. The role of external radiotherapy in the management of ON is particularly discussed.

  14. Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

    SciTech Connect

    Gladstone, D. J.; Li, S.; Jarvis, L. A.; Hartford, A. C.

    2011-07-15

    Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging, the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.

  15. [The estimation of appropriateness of chromosomal aberration assay as a biological dosimetry based on cytogenetic investigation of lung cancer patients given non-uniform fractional exposures to high doses of therapeutic 60Co gamma-rays].

    PubMed

    Khvostunov, I K; Kursova, L V; Shepel', N N; Ragulin, Iu A; Sevan'kaev, A V; Gulidov, I A; Glazyrin, D A; Ivanova, I N

    2012-01-01

    The objective of this study was to investigate in vivo the dose response of radiation induced chromosomal aberrations in human blood lymphocytes of lung cancer patients given non-uniform fractional exposures to high doses of therapeutic 60Co gamma-rays delivered synchronously with polychemotherapy. The chromosome aberration analysis was carried out in peripheral blood lymphocytes of 13 lung cancer patients who manifested II to IV developmental clinical stage. During the course of radiotherapy they received the accumulated tumor dose ranged 47.5 to 70 Gy. The yield ofdicentrics, centric rings and fragments was measured in the blood samples taken before treatment, after the first day and after the complete course of radiotherapy. Based on cytogenetic measurements of 3 patients, the average tumor dose after the first day was estimated to be 2.1 to 3.0 Gy given that the corresponding physical dose was (1.0 Gy + 1.5 Gy). The quotient of the individual dose estimated by the frequency of aberrations to the physical dose after the complete course of radiotherapy was calculated for all 13 patients. The mean quotient was shown to be equal to 93 +/- 9% ranged 50 to 154%.

  16. Preoperative irradiation in carcinoma of the pancreas. [/sup 60/Co or 46 MeV photons

    SciTech Connect

    Pilepich, M.V.; Miller, H.H.

    1980-11-01

    Seventeen patients with carcinoma confined to the pancreas and the peripancreatic area received preoperative radiation therapy in an attempt to increase the resectability rate and to reduce the incidence of recurrence. The tumors were considered either unresectable or of borderline resectability. The radiation dose ranged between 4000 to 5000 rads, the majority of patients (75%) receiving 4400 to 4600 rads in 4 1/2 to 5 weeks. After a period averaging six weeks the patients were reevaluated for surgery. Eleven patients were explored and six underwent radical resection. Two patients remained disease free after five years. Pancreatic resection is feasible following a course of preoperative radiotherpy to a moderately high dose. It is suggested that the response of the primary tumor to radiotherapy be used as a criterion for selecting patients for reexploration and resection.

  17. Dosimetric comparison between the microSelectron HDR 192Ir v2 source and the BEBIG 60Co source for HDR brachytherapy using the EGSnrc Monte Carlo transport code

    PubMed Central

    Islam, M. Anwarul; Akramuzzaman, M. M.; Zakaria, G. A.

    2012-01-01

    Manufacturing of miniaturized high activity 192Ir sources have been made a market preference in modern brachytherapy. The smaller dimensions of the sources are flexible for smaller diameter of the applicators and it is also suitable for interstitial implants. Presently, miniaturized 60Co HDR sources have been made available with identical dimensions to those of 192Ir sources. 60Co sources have an advantage of longer half life while comparing with 192Ir source. High dose rate brachytherapy sources with longer half life are logically pragmatic solution for developing country in economic point of view. This study is aimed to compare the TG-43U1 dosimetric parameters for new BEBIG 60Co HDR and new microSelectron 192Ir HDR sources. Dosimetric parameters are calculated using EGSnrc-based Monte Carlo simulation code accordance with the AAPM TG-43 formalism for microSlectron HDR 192Ir v2 and new BEBIG 60Co HDR sources. Air-kerma strength per unit source activity, calculated in dry air are 9.698×10-8 ± 0.55% U Bq-1 and 3.039×10-7 ± 0.41% U Bq-1 for the above mentioned two sources, respectively. The calculated dose rate constants per unit air-kerma strength in water medium are 1.116±0.12% cGy h-1U-1 and 1.097±0.12% cGy h-1U-1, respectively, for the two sources. The values of radial dose function for distances up to 1 cm and more than 22 cm for BEBIG 60Co HDR source are higher than that of other source. The anisotropic values are sharply increased to the longitudinal sides of the BEBIG 60Co source and the rise is comparatively sharper than that of the other source. Tissue dependence of the absorbed dose has been investigated with vacuum phantom for breast, compact bone, blood, lung, thyroid, soft tissue, testis, and muscle. No significant variation is noted at 5 cm of radial distance in this regard while comparing the two sources except for lung tissues. The true dose rates are calculated with considering photon as well as electron transport using appropriate cut

  18. Investigation of Chitosan for Decorporation of 60Co in the Rat

    SciTech Connect

    Levitskaia, Tatiana G.; Creim, Jeffrey A.; Curry, Terry L.; Luders, Teresa; Morris, James E.; Sinkov, Sergey I.; Woodstock, Angela D.; Thrall, Karla D.

    2009-08-01

    Purpose: The reported investigation is a part of our on-going research aimed at identifying effective in vivo non-toxic decorporation agents and developing new therapies to treat internal contamination with radionuclides. The non-toxic nature of chitosan makes it an especially attractive candidate for unsupervised treatment of the general population in case of radiological/nuclear emergency. In this study, chemically unmodified water-soluble chitosan oligosaccharide of low molecular weight was tested for decorporation of cobalt-60 (Co-60) using a rodent model. Methods: Affinity of chitosan oligosaccharide for Co(II) was tested in vitro under conditions of physiological pH range and ionic strength using combined spectrophotometric and potentiometric titration techniques. Fisher F344 rat model was used for in vivo studies. To evaluate effect of chitosan on ingested Co-60, animals received single oral dose of Co-60 chloride (7 – 13.2 kBq per animal) followed by oral administration of chitosan material (288 – 366 mg per kg body weight); chitosan dosing was repeated in 24 hours. Chitosan was also tested for removal of internalized Co-60. In this study, Co-60 single intravenous injection (7 – 8 kBq per animal) was followed by repetitive oral (300 mg per kg body weight) or intravenous (195 mg per kg body weight) administration of the chitosan material once daily for 5 days. Control animal groups received a single dose of Co-60 without chelator treatment. Excreta was collected daily. Tissues were collected postmortem and analyzed for radioactivity by gamma counting technique. Results: In vitro experiments confirmed binding of Co(II) by chitosan oligosaccharide, formation of mixed cobalt-chitosan-hydroxide complex species was proposed, and stability constants was calculated. Control in vivo studies indicated that about 71% of ingested Co-60 was excreted in two days predominantly through the gastrointestinal tract. For intravenously administered Co-60, urinal excretion

  19. Clinical impact of IMPORT HIGH trial (CRUK/06/003) on breast radiotherapy practices in the United Kingdom

    PubMed Central

    Ciurlionis, Laura; Kirby, Anna M; Locke, Imogen; Venables, Karen; Yarnold, John R; Titley, Jenny; Bliss, Judith; Coles, Charlotte E

    2015-01-01

    Objective: IMPORT HIGH is a multicentre randomized UK trial testing dose-escalated intensity-modulated radiotherapy (IMRT) after tumour excision in females with early breast cancer and higher than average local recurrence risk. A survey was carried out to investigate the impact of this trial on the adoption of advanced breast radiotherapy (RT) techniques in the UK. Methods: A questionnaire was sent to all 26 IMPORT HIGH recruiting RT centres to determine whether the trial has influenced non-trial breast RT techniques in terms of volume delineation, dosimetry, treatment delivery and verification. In order to compare the clinical practice of breast RT between IMPORT HIGH and non–IMPORT HIGH centres, parts of the Royal College of Radiologists (RCR) breast RT audit result were used in this study. Results: 26/26 participating centres completed the questionnaire. After joining the trial, the number of centres routinely using tumour bed clips to guide whole-breast RT rose from 5 (19%) to 21 (81%). 20/26 (77%) centres now contour target volumes and organs at risk (OARs) in some or all patients compared with 14 (54%) before the trial. 14/26 (54%) centres offer inverse-planned IMRT for selected non-trial patients with breast cancer, and 10/14 (71%) have adopted the IMPORT HIGH trial protocol for target volume and OARs dose constraints. Only 2/26 (8%) centres used clip information routinely for breast treatment verification prior to IMPORT HIGH, a minority that has since risen to 7/26 (27%). Data on 1386 patients was included from the RCR audit. This suggested that more cases from IMPORT HIGH centres had surgical clips implanted (83 vs 67%), were treated using CT guided planning with full three-dimensional dose compensation (100 vs 75%), and were treated with photon boost RT (30 vs 8%). Conclusion: The study suggests that participation in the IMPORT HIGH trial has played an important part in providing the guidance and support networks needed for the safe integration of

  20. Carcinoma of the tonsillar region - results of external irradiation. [/sup 60/Co; 2MV photons

    SciTech Connect

    Tong, D.; Laramore, G.E.; Griffin, T.W.; Russel, A.H.; Tesh, D.W.; Taylor, W.J.; Martenson, J.A.

    1982-05-15

    A retrospective analysis is made of 104 patients treated with photon megavoltage radiotherapy for squamous cell carcinoma of the tonsillar region during the period 1965-1976. Moderately differentiated squamous cell carcinoma was the most common histological grade. Fifty-three per cent of the cases presented with cervical lymphadenopathy with three cases of bilateral involvement. The three year local control rate was 100% for Stage I, 74% Stage II, 49% Stage III, and 33% Stage IV. Two Stage III cases and one Stage IV case developed subsequent contralateral neck disease. No patient with either T/sub 1/N/sub 0/ or T/sub 2/N/sub 0/ tumor failed in the ipsilateral or contralateral neck despite the fact that 42% of the T/sub 1/N/sub 0/ cases and 37% of the T/sub 2/N/sub 0/ cases were treated with unilateral portals. The prognostic significance of the T and N stages, treatment techniques, as well as dose response relationships are analyzed and the literature is reviewed.

  1. Accumulation of radioactive corrosion products on steel surfaces of VVER-type nuclear reactors. II. 60Co

    NASA Astrophysics Data System (ADS)

    Varga, Kálmán; Hirschberg, Gábor; Németh, Zoltán; Myburg, Gerrit; Schunk, János; Tilky, Péter

    2001-10-01

    In the case of intact fuel claddings, the predominant source of radioactivity in the primary circuits of water-cooled nuclear reactors is the activation of corrosion products in the core. The most important corrosion product radionuclides in the primary coolant of pressurized water reactors (PWRs) are 60Co, 58Co, 51Cr, 54Mn, 59Fe (as well as 110mAg in some Soviet-made VVER-type reactor). The second part of this series is focused on the complex studies of the formation and build-up of 60Co-containing species on an austenitic stainless steel type 08X18H10T (GOST 5632-61) and magnetite-covered carbon steel often to be used in Soviet-planned VVERs. The kinetics and mechanism of the cobalt accumulation were studied by a combination (coupling) of an in situ radiotracer method and voltammetry in a model solution of the primary circuit coolant. In addition, independent techniques such as X-ray photoelectron spectroscopic (XPS) and ICP-OES are also used to analyze the chemical state of Co species in the passive layer formed on stainless steel as well as the chemical composition of model solution. The experimental results have revealed that: (i) The passive behavior of the austenitic stainless steel at open-circuit conditions, the slightly alkaline pH and the reducing water chemistry can be considered to be optimal to minimize the 60Co contamination. (ii) The highly potential dependent deposition of various Co-oxides at E>1.10 V (vs. RHE) offers a unique possibility to elaborate a novel electrochemical method for the decrease or removal of cobalt traces from borate-containing coolants contaminated with 60Co and/or 58Co radionuclides.

  2. Combined reactor neutron beam and {sup 60}Co γ-ray radiation effects on CMOS APS image sensors

    SciTech Connect

    Wang, Zujun Chen, Wei; Sheng, Jiangkun; Liu, Yan; Xiao, Zhigang; Huang, Shaoyan; Liu, Minbo

    2015-02-15

    The combined reactor neutron beam and {sup 60}Co γ-ray radiation effects on complementary metal-oxide semiconductor (CMOS) active pixel sensors (APS) have been discussed and some new experimental phenomena are presented. The samples are manufactured in the standard 0.35-μm CMOS technology. Two samples were first exposed to {sup 60}Co γ-rays up to the total ionizing dose (TID) level of 200 krad(Si) at the dose rates of 50.0 and 0.2 rad(Si)/s, and then exposed to neutron fluence up to 1 × 10{sup 11} n/cm{sup 2} (1-MeV equivalent neutron fluence). One sample was first exposed to neutron fluence up to 1 × 10{sup 11} n/cm{sup 2} (1-MeV equivalent neutron fluence), and then exposed to {sup 60}Co γ-rays up to the TID level of 200 krad(Si) at the dose rate of 0.2 rad(Si)/s. The mean dark signal (K{sub D}), the dark signal non-uniformity (DSNU), and the noise (V{sub N}) versus the total dose and neutron fluence has been investigated. The degradation mechanisms of CMOS APS image sensors have been analyzed, especially for the interaction induced by neutron displacement damage and TID damage.

  3. Similar Treatment Outcomes for Radical Cystectomy and Radical Radiotherapy in Invasive Bladder Cancer Treated at a United Kingdom Specialist Treatment Center

    SciTech Connect

    Kotwal, Sanjeev; Choudhury, Ananya; Johnston, Colin; Paul, Alan B.; Whelan, Peter; Kiltie, Anne E.

    2008-02-01

    Purpose: To conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer. Patients and Methods: Between March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data. Results: There was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age of radiotherapy patients but not the cystectomy patients was higher than in the 1996-2000 cohort (78.4 years vs. 75.3 years for radiotherapy and 67.9 years vs. 68.2 years for surgery). Conclusions: Although the patients undergoing radical cystectomy were significantly younger than the radiotherapy patients, treatment modality did not influence survival. Bladder cancer patients are an increasingly elderly group. Radical radiotherapy is a viable treatment option for these patients, with the advantage of organ preservation.

  4. Transfer of 137Cs and 60Co in a waste retention pond with emphasis on aquatic insects

    SciTech Connect

    Voshell, J.R. Jr.; Eldridge, J.S.; Oakes, T.W.

    1985-11-01

    The objectives of this research were (1) to analyze the transfers of 137Cs and 60Co in a retention pond, with emphasis on aquatic insects and (2) to determine if detectable concentrations of these radionuclides are exported by emerging aquatic insects. We analyzed the radionuclide concentrations in the following components: water solution, bottom sediments, suspended particulate matter, plankton, floating mats of filamentous algae, benthic macroinvertebrates, and emerging aquatic insects. Samples were collected quarterly from June 1981 to April 1982. The lowest concentrations (in picocuries per milliliter) occurred in solution (range: 1.4 X 10(2) to 3.2 X 10(2) for 137Cs and 8.1 X 10(-1) to 2.2 X 10(0) for 60Co). The highest concentrations (in picocuries per gram dry weight) occurred in the sediments (range: 1.5 X 10(4) to 1.1 X 10(8) for 137Cs and 1.0 X 10(2) to 4.3 X 10(6) for 60Co). The primary producers and aquatic insect consumers had concentrations of both radionuclides that were two to four orders of magnitude higher than the respective concentrations dissolved in water but two to three orders of magnitude lower than the concentrations in the sediments. The concentrations of both radionuclides decreased successively at higher trophic levels. There were considerable temporal variations as the radionuclides cycled among the abiotic and biotic components of the pond. Emerging adult aquatic insects had lower concentrations of both radionuclides than the immature stages that lived in the pond (adult/immature ratio about 0.25). Because the emerging adult insects contain detectable concentrations of radionuclides, have relatively long life spans, and disperse away from the aquatic habitat, we conclude that adult aquatic insects would be effective biological monitors.

  5. Steroid hormone production in testis, ovary, and adrenal gland of immature rats irradiated in utero with /sup 60/Co

    SciTech Connect

    Inano, H.; Suzuki, K.; Ishii-Ohba, H.; Imada, Y.; Kumagai, R.; Kurihara, S.; Sato, A.

    1989-02-01

    Pregnant rats received whole-body irradiation at 20 days of gestation with 2.6 Gy lambda rays from a 60Co source. Endocrinological effects before maturation were studied using testes and adrenal glands obtained from male offspring and ovaries from female offspring irradiated in utero. Seminiferous tubules of the irradiated male offspring were remarkably atrophied with free germinal epithelium and containing only Sertoli cells. Female offspring also had atrophied ovaries. Testicular tissue obtained from intact and 60Co-irradiated rats was incubated with 14C-labeled pregnenolone, progesterone, 17 alpha-hydroxyprogesterone, and androstenedione as a substrate. Intermediates for androgen production and catabolic metabolites were isolated after the incubation. The amounts of these metabolites produced by the irradiated testes were low in comparison with the control. The activities of delta 5-3 beta-hydroxysteroid dehydrogenase, 17 alpha-hydroxylase, C17,20-lyase, and delta 4-5 alpha-reductase in the irradiated testes were 30-40% of those in nonirradiated testes. Also, the activities of 17 beta- and 20 alpha-hydroxysteroid dehydrogenases were 72 and 52% of the control, respectively. In adrenal glands, the 21-hydroxylase activity of the irradiated animals was 38% of the control, but the delta 5-3 beta-hydroxysteroid dehydrogenase activity was comparable to that of the control. On the other hand, the activity of delta 5-3 beta-hydroxysteroid dehydrogenase of the irradiated ovary was only 19% of the control. These results suggest that 60Co irradiation of the fetus in utero markedly affects the production of steroid hormones in testes, ovaries, and adrenal glands after birth.

  6. Transfer of 137Cs and 60Co in a waste retention pond with emphasis on aquatic insects.

    PubMed

    Voshell, J R; Eldridge, J S; Oakes, T W

    1985-11-01

    The objectives of this research were (1) to analyze the transfers of 137Cs and 60Co in a retention pond, with emphasis on aquatic insects and (2) to determine if detectable concentrations of these radionuclides are exported by emerging aquatic insects. We analyzed the radionuclide concentrations in the following components: water solution, bottom sediments, suspended particulate matter, plankton, floating mats of filamentous algae, benthic macroinvertebrates, and emerging aquatic insects. Samples were collected quarterly from June 1981 to April 1982. The lowest concentrations (in picocuries per milliliter) occurred in solution (range: 1.4 X 10(2) to 3.2 X 10(2) for 137Cs and 8.1 X 10(-1) to 2.2 X 10(0) for 60Co). The highest concentrations (in picocuries per gram dry weight) occurred in the sediments (range: 1.5 X 10(4) to 1.1 X 10(8) for 137Cs and 1.0 X 10(2) to 4.3 X 10(6) for 60Co). The primary producers and aquatic insect consumers had concentrations of both radionuclides that were two to four orders of magnitude higher than the respective concentrations dissolved in water but two to three orders of magnitude lower than the concentrations in the sediments. The concentrations of both radionuclides decreased successively at higher trophic levels. There were considerable temporal variations as the radionuclides cycled among the abiotic and biotic components of the pond. Emerging adult aquatic insects had lower concentrations of both radionuclides than the immature stages that lived in the pond (adult/immature ratio about 0.25). Because the emerging adult insects contain detectable concentrations of radionuclides, have relatively long life spans, and disperse away from the aquatic habitat, we conclude that adult aquatic insects would be effective biological monitors.

  7. Commissioning of an NRC-type sealed water calorimeter at METAS using 60Co gamma-rays.

    PubMed

    Medin, J; Ross, C K; Stucki, G; Klassen, N V; Seuntjens, J P

    2004-09-07

    As part of a collaborative project between the National Research Council of Canada (NRC) and the Swiss Federal Office of Metrology and Accreditation (METAS), a sealed water calorimeter was built at NRC and transferred to METAS. The calorimeter is operated at 4 degrees C and uses two thermistor probes in a sealed glass vessel containing high-purity water to measure the radiation-induced temperature rise. The various correction factors have been evaluated and the estimated standard uncertainty on the absorbed dose to water is 0.41%. An extensive set of measurements using 60Co gamma-rays was carried out at NRC and two ionization chambers were calibrated against the absorbed dose determined calorimetrically. The chambers were also calibrated against the NRC standard for absorbed dose. After transferring the calorimeter to METAS, a similar set of measurements was carried out using their 60Co beam and the same two ionization chambers were calibrated against the absorbed dose to water established at METAS. The discrepancy between the three sets of calibration coefficients was smaller than the estimated standard uncertainty of 0.47% on the ratio of any pair of calibration coefficients.

  8. 60Co-irradiation as an alternate method for sterilization of penicillin G, neomycin, novobiocin, and dihydrostreptomycin

    SciTech Connect

    Tsuji, K.; Rahn, P.D.; Steindler, K.A.

    1983-01-01

    The effects of the use of 60Co-irradiation to sterilize antibiotics were evaluated. The antibiotic powders were only occasionally contaminated with microorganisms. The D-values of the products and environmental isolates were 0.028, 0.027, 0.015, 0.046, 0.15, 0.018, and 0.19 Mrads for Aspergillus species (UC 7297, 7298), A. fumigatus (UC 7299), Rhodotorula species (UC 7300), Penicillium oxalicum (UC 7269), Pseudomonas maltophilia (UC 6855), and a biological indicator microorganism, Bacillus pumilus spores (ATCC 27142). An irradiation dose of 1.14 Mrads, therefore, was sufficient to achieve a six-log cycle destruction of B. pumilus spores. Based on the bioburden data, a minimum irradiation dose of 1.05 Mrads was calculated to be sufficient to obtain a 10(-6) probability of sterilizing the most radioresistant isolate, Pen. oxalicum. To determine the radiolytic degradation scheme and the stability of the antibiotics following irradiation, high-performance liquid chromatographic (HPLC) methods were developed. The resulting rates of degradation for the antibiotics were 0.6, 1.2, 2.3, and 0.95%/Mrad for penicillin G, neomycin, novobiocin, and dihydrostreptomycin, respectively. Furthermore, radiolytic degradation pathways for the antibiotics were identified and found to be similar to those commonly encountered when antibiotics are subjected to acidic, basic, hydrolytic, or oxidative treatments. No radiolytic compounds unique to 60Co-irradiation were found.

  9. Radioprotective effects of sodium tungstate on hematopoietic injury by exposure to 60Co gamma-rays in Wistar rats.

    PubMed

    Sato, K; Ichimasa, M; Miyahara, K; Shiomi, M; Nishimura, Y; Ichimasa, Y

    1999-06-01

    Radioprotective effects of sodium tungstate (ST) on 60Co gamma-ray induced decrease in hematocrit value and in survival rate in Wistar strain male rats were examined. A long-term administration of ST (less than 150 mg/kg body weight/day) for 60-300 days had no significant effects on body and organs weights and survival days. The LD50/60 in 20 weeks old rats was 220 mg/kg body weight/day. Daily administration of 38, 75 or 150 mg from 7 days before and after irradiation to 60 days significantly mitigated the decrease in hematocrit values, especially at 23 days after irradiation (P < 0.05). The highest mitigation rate of the decrease in hematocrit value was observed in rats administered at a dose of 38 mg ST/day. Simultaneously, a dose of 38 mg ST/day inhibited lethal effect of 60Co gamma-rays significantly. The dose-reduction factor for survival of 38 mg ST administered rats was 1.14.

  10. DETECTORS AND EXPERIMENTAL METHODS: A comparison of ionizing radiation damage in CMOS devices from 60Co gamma rays, electrons and protons

    NASA Astrophysics Data System (ADS)

    He, Bao-Ping; Yao, Zhi-Bin; Zhang, Feng-Qi

    2009-06-01

    Radiation hardened CC4007RH and non-radiation hardened CC4011 devices were irradiated using 60Co gamma rays, 1 MeV electrons and 1-9 MeV protons to compare the ionizing radiation damage of the gamma rays with the charged particles. For all devices examined, with experimental uncertainty, the radiation induced threshold voltage shifts (ΔVth) generated by 60Co gamma rays are equal to that of 1 MeV electron and 1-7 MeV proton radiation under 0 gate bias condition. Under 5 V gate bias condition, the distinction of threshold voltage shifts (ΔVth) generated by 60Co gamma rays and 1 MeV electrons irradiation are not large, and the radiation damage for protons below 9 MeV is always less than that of 60Co gamma rays. The lower energy the proton has, the less serious the radiation damage becomes.

  11. Is rural radiation oncology practice quality as good as the big smoke? Results of the Australian radiotherapy single machine unit trial.

    PubMed

    Shakespeare, T P; Turner, M; Chapman, A

    2007-08-01

    Radiotherapy utilization rates in rural Australia are suboptimal, with one solution being the building of single machine units (SMUs). One concern raised with such an approach is the quality of care delivered in SMUs. The Australian and Victorian governments have established two SMUs in the state of Victoria, with each SMU operated as a satellite service of a major 'hub' site. We report on the planned evaluation of practice quality. Radiation oncologist (RO) clinical practice was externally audited using the Royal Australian and New Zealand College of Radiologists Peer Review Audit instrument. This tool splits RO clinical practice into documentation/quality assurance (QA) criteria and decision-making criteria. Over the four sites, 130 patients were randomly selected for audit. At hub sites, 79.6% of all criteria audited were adequate, compared with 84.4% of criteria audited at SMUs (P = 0.0002). This difference was largely because of better adherence to documentation/QA criteria at the SMU sites. RO decision-making and protocol adherence were routinely very high and consistent with other clinical practice audits. There were no significant differences between hubs and SMUs for adherence to decision-making criteria; however, the few potential deficiencies in patient care identified occurred only at the hub sites. In at least one of these cases, potential suboptimal management was as a direct result of inadequate documentation. This audit found that SMUs provide as high a standard of radiotherapeutic care as larger hub departments. The findings also emphasize the need for all departments to target clinical documentation.

  12. Relation of structure to function for the US reference standard endotoxin after exposure to /sup 60/Co radiation, Interim report, September 1984-December 1985

    SciTech Connect

    Suba, E.A.; Elin, R.J.

    1986-01-01

    The structure and function of the highly purified U.S. reference standard endotoxin (RSE) were studied after exposure to ionizing radiation from a /sup 60/Co source. With increasing doses of radiation, the trilaminar ribbon-like structure of untreated endotoxin exhibited focal swelling, after which only spherical particles were seen by electron microscopy. These morphological changes were paralleled by the respective loss of O-side chain-repeating units and pieces of the R-core from the lipopolysaccharide molecules, as demonstrated by electrophoresis. The biologic function of the irradiated endotoxin was assessed with a variety of tests. At higher doses of radiation, a direct relation was observed between the degradation of the molecular and supramolecular structure and the loss of biologic function. At lower doses of radiation, however, there was variability among the functional assays in their rate of change with progressive irradiation of the RSE. The results suggest that the carbohydrate moiety plays an important role both in determining the supramolecular structure and in modulating certain biologic activities of bacterial endotoxins.

  13. Historical aspects of heavy ion radiotherapy

    SciTech Connect

    Raju, M.R.

    1995-03-01

    This paper presents historical developments of heavy-ion radiotherapy including discussion of HILAC and HIMAC and discussion of cooperation between Japan and the United States, along with personal reflections.

  14. Direct MC conversion of absorbed dose to graphite to absorbed dose to water for 60Co radiation.

    PubMed

    Lye, J E; Butler, D J; Franich, R D; Harty, P D; Oliver, C P; Ramanathan, G; Webb, D V; Wright, T

    2013-06-01

    The ARPANSA calibration service for (60)Co gamma rays is based on a primary standard graphite calorimeter that measures absorbed dose to graphite. Measurements with the calorimeter are converted to the absorbed dose to water using the calculation of the ratio of the absorbed dose in the calorimeter to the absorbed dose in a water phantom. ARPANSA has recently changed the basis of this calculation from a photon fluence scaling method to a direct Monte Carlo (MC) calculation. The MC conversion uses an EGSnrc model of the cobalt source that has been validated against water tank and graphite phantom measurements, a step that is required to quantify uncertainties in the underlying interaction coefficients in the MC code. A comparison with the Bureau International des Poids et Mesures (BIPM) as part of the key comparison BIPM.RI(I)-K4 showed an agreement of 0.9973 (53).

  15. Determination of late-time Gamma-Ray (60Co) sensitivity of single diffusion Lot 2N2222A transistors.

    SciTech Connect

    DePriest, Kendall Russell; Kajder, Karen C.; Peters, Curtis D.

    2008-08-01

    Sandia National Laboratories (SNL) has embarked on a program to develop a methodology to use damage relations techniques (alternative experimental facilities, modeling, and simulation) to understand the time-dependent effects in transistors (and integrated circuits) caused by neutron irradiations in the Sandia Pulse Reactor-III (SPR-III) facility. The development of these damage equivalence techniques is necessary since SPR-III was shutdown in late 2006. As part of this effort, the late time {gamma}-ray sensitivity of a single diffusion lot of 2N2222A transistors has been characterized using one of the {sup 60}Co irradiation cells at the SNL Gamma Irradiation Facility (GIF). This report summarizes the results of the experiments performed at the GIF.

  16. Effect of 60Co-irradiation on the development and immunogenicity of Plasmodium berghei sporozoites in Anopheles stephensi mosquitoes

    SciTech Connect

    Smrkovski, L.L.; McConnell, E.; Tubergen, T.A.

    1983-10-01

    Protection conferred to mice by Plasmodium berghei sporozoites increased significantly when the time interval between 60Co-irradiation of the infected mosquitoes and harvest of sporozoites increased. One thousand sporozoites conferred no protection against challenge if harvested on the day of irradiation, but protected 60% of recipient mice when harvested 28 days postirradiation. When the time between feeding of mosquitoes and irradiation was varied, sporozoites from mosquitoes irradiated 3 days after feeding were infective for mice. Sporozoites from mosquitoes irradiated on day 10 postfeeding were not infective, but were immunogenic. In all experiments a decline occurred in the number of recoverable sporozoites over a 28-day period postirradiation to less than 10% of the yield on the day of irradiation.

  17. Determination of 137Cs and 60Co pollution in the area of the Laguna Verde Nuclear Power Plant, Mexico.

    PubMed

    Salas Mar, Bernardo

    2015-11-01

    The project 'Radiological Analysis of Environmental Samples in the Gulf of Mexico and the coast of Quintana Roo', had the aim of identifying and quantifying anthropogenic radionuclides in environmental samples consisting of silt, sand and sea water. This paper presents the results of the radiological analysis of these samples, which was made in the multichannel system for gamma spectrometry with hyperpure germanium detector in the Laboratory of Radiological Analysis of Environmental Samples, located at the Physics Department, Faculty of Sciences, of the Autonomous National University of Mexico (UNAM). The sampled points are along the coast of the contiguous states of Tamaulipas, Veracruz, Tabasco, Campeche, Yucatan and Quintana Roo. This paper presents the qualitative and quantitative concentrations of the main identified anthropogenic radionuclides (60)Co and (137)Cs.

  18. Time resolution of a 1-inch cylindrical CeBr{sub 3} crystal at {sup 60}Co energies

    SciTech Connect

    Vedia, V.; Fraile, L. M.; Olaizola, B.; Paziy, V.; Picado, E.; Udias, J. M.; Mach, H.

    2013-06-10

    We have measured time resolutions of a cylindrical CeBr{sub 3} scintillator of 1-inch in height and 1-inch in diameter coupled to two different fast photomultiplier tubes, Hamamatsu R9779 and Photonis XP20D0, as a function of applied high voltages and different settings of a Constant Fraction Discriminator ORTEC 935. The time resolution was measured using a time-delayed coincidence set-up involving a fast reference detector. The best result of 119(2) ps at {sup 60}Co energies was obtained for the CeBr{sub 3} crystal coupled to the Hamamatsu PMT. This result is comparable to the resolution of 107 ps reported for a LaBr{sub 3}(Ce) crystal of the same size. For the coupling of the CeBr{sub 3} scintillator to the Photonis PMT we got the time resolution of 146(2) ps.

  19. An investigation on the radiation sensitivity of DNA conformations to 60Co gamma rays by using Geant4 toolkit

    NASA Astrophysics Data System (ADS)

    Semsarha, F.; Goliaei, B.; Raisali, G.; Khalafi, H.; Mirzakhanian, L.

    2014-03-01

    To investigate the impact of conformational properties of genetic material of living cells on radiation-induced DNA damage, single strand breaks (SSB), double strand breaks (DSB) and some microdosimetric quantities of A, B and Z-DNA conformations caused by 60Co gamma rays, have been calculated. Based on a previous B-DNA geometrical model, models of A and Z forms have been developed. Simple 34 base pairs segments of each model repeated in high number and secondary electron spectrum of 60Co gamma rays have been simulated in a volume of a typical animal cell nucleus. All simulations in this study have been performed by using the Geant4 (GEometry ANd Tracking 4)-DNA extension of the Geant4 toolkit. The results showed that, B-DNA has the lowest yield of simple strand breaks with 2.23 × 10-10 Gy-1 Da-1 and 1.0 × 10-11 Gy-1 Da-1 for the SSB and DSB damage yield, respectively. The A-DNA has the highest SSB yield with 3.59 × 10-10 Gy-1 Da-1 and the Z-DNA has the highest DSB yields with 1.8 × 10-11 Gy-1 Da-1. It has been concluded that there is a direct correlation between the hit probability, mean specific imparted energy and SSB yield in each model of DNA. Moreover, there is a direct correlation between the DSB yield and both the mean lineal energy and topological characteristics of each model.

  20. Development, physical properties and clinical applicability of a mechanical Multileaf Collimator for the use in Cobalt-60 radiotherapy.

    PubMed

    Langhans, Marco; Echner, Gernot; Runz, Armin; Baumann, Martin; Xu, Mark; Ueltzhöffer, Stefan; Häring, Peter; Schlegel, Wolfgang

    2015-04-21

    According to the Directory of Radiotherapy Centres (DIRAC) there are 2348 Cobalt-60 (Co-60) teletherapy units worldwide, most of them in low and middle income countries, compared to 11046 clinical accelerators. To improve teletherapy with Co-60, a mechanical Multi-Leaf Collimator (MLC) was developed, working with pneumatic pressure and thus independent of electricity supply. Instead of tungsten, brass was used as leaf material to make the mechanical MLC more affordable. The physical properties and clinical applicability of this mechanical MLC are presented here. The leakage strongly depends on the fieldsize of the therapy unit due to scatter effects. The maximum transmission through the leaves measured 2.5 cm from the end-to-end gap, within a field size of 20 cm × 30 cm defined by jaws of the therapy unit at 80 cm SAD, amounts 4.2%, normalized to an open 10 cm × 10 cm field, created by the mechanical MLC. Within a precollimated field size of 12.5 cm × 12.5 cm, the end-to-end leakage is 6.5% normalized to an open 10 cm × 10 cm field as well. This characteristic is clinically acceptable considering the criteria for non-IMRT MLCs of the International Electrotechnical Commission (IEC 60601-2-1). The penumbra for a 10 cm × 10 cm field was measured to be 9.14 mm in plane and 8.38 mm cross plane. The clinical applicability of the designed mechanical MLC was affirmed by measurements relating to all relevant clinical properties such as penumbra, leakage, output factors and field widths. Hence this novel device presents an apt way forward to make radiotherapy with conformal fields possible in low-infrastructure environments, using gantry based Co-60 therapy units.

  1. Development, physical properties and clinical applicability of a mechanical Multileaf Collimator for the use in Cobalt-60 radiotherapy

    NASA Astrophysics Data System (ADS)

    Langhans, Marco; Echner, Gernot; Runz, Armin; Baumann, Martin; Xu, Mark; Ueltzhöffer, Stefan; Häring, Peter; Schlegel, Wolfgang

    2015-04-01

    According to the Directory of Radiotherapy Centres (DIRAC) there are 2348 Cobalt-60 (Co-60) teletherapy units worldwide, most of them in low and middle income countries, compared to 11046 clinical accelerators. To improve teletherapy with Co-60, a mechanical Multi-Leaf Collimator (MLC) was developed, working with pneumatic pressure and thus independent of electricity supply. Instead of tungsten, brass was used as leaf material to make the mechanical MLC more affordable. The physical properties and clinical applicability of this mechanical MLC are presented here. The leakage strongly depends on the fieldsize of the therapy unit due to scatter effects. The maximum transmission through the leaves measured 2.5 cm from the end-to-end gap, within a field size of 20 cm × 30 cm defined by jaws of the therapy unit at 80 cm SAD, amounts 4.2%, normalized to an open 10 cm × 10 cm field, created by the mechanical MLC. Within a precollimated field size of 12.5 cm × 12.5 cm, the end-to-end leakage is 6.5% normalized to an open 10 cm × 10 cm field as well. This characteristic is clinically acceptable considering the criteria for non-IMRT MLCs of the International Electrotechnical Commission (IEC 60601-2-1). The penumbra for a 10 cm × 10 cm field was measured to be 9.14 mm in plane and 8.38 mm cross plane. The clinical applicability of the designed mechanical MLC was affirmed by measurements relating to all relevant clinical properties such as penumbra, leakage, output factors and field widths. Hence this novel device presents an apt way forward to make radiotherapy with conformal fields possible in low-infrastructure environments, using gantry based Co-60 therapy units.

  2. Serum creatine kinase (CK) activity following exposure to cadmium and/or /sup 60/CO gamma irradiation

    SciTech Connect

    Morgan, R.M.; Kundomal, Y.R.; Hupp, E.W.

    1985-01-01

    Two hundred and sixteen young adult male Sprague-Dawley rats were injected IP every 3 days for 29 days for a total of 9 injections with 0, 1.0, or 2.5 mg CdCl/sub 2//kg body weight. Total cumulative doses were 0, 9.0 or 22.5 mg CdCl/sub 2//kg body weight. Twenty-four hours after the last cadmium injection (day 30), each rat was irradiated with a total-body exposure of 0, 3.62, or 5.43 Gray of gamma (/sup 60/Co) radiation at a dose rate of 3.04 Gray/min. Eight rats from each of the 9 groups were sacrificed on day 1, 7, or 21. Highest levels of the creatine kinase enzyme were seen in radiation groups at day 1, indicating an immediate radiotoxic response. Enzyme levels decreased through day 21 indicating clearance of the enzyme from the plasma. Although statistically significant differences between the groups, cadmium, radiation, or days were not seen, cadmium did protect against radiation. This protective function is not explainable; however, it is speculated that different conformations of metal-induced metallothionein clusters exist to accommodate various metal ions. Further, that each kind of metal ion may have different and unique distribution patterns between the cluster centers which account for different functions.

  3. Vertical migration of 60Co, 137Cs and 226Ra in agricultural soils as observed in lysimeters under crop rotation.

    PubMed

    Shinonaga, T; Schimmack, W; Gerzabek, M H

    2005-01-01

    In most studies quantifying the migration parameters - apparent migration velocity and apparent dispersion coefficient - of radionuclides in the soil by model calculations, these parameters are determined for undisturbed soils. For soils disturbed by ploughing, however, no such data are available in the literature. Therefore, in the present study, the migration parameters of (137)Cs, (60)Co and (226)Ra were estimated for ploughed soils by means of a convection-dispersion model. The depth distributions of the radionuclides were determined in four lysimeters (area: 1m(2), depth of soil monolith: 0.75m) filled with artificially contaminated soils of different types in July 1990. The lysimeters were cropped with agricultural plants. The soil in each lysimeter was ploughed manually once a year until 1996 (plough depth 20cm). In July 1999, soil samples were collected from three pits in each lysimeter. The depth distributions of all radionuclides proved to be very similar in each soil pit. The spatial variability of the depth distributions of a given radionuclide within the lysimeters was about the same as their variability between the four lysimeters. Evaluation of the migration parameters revealed that the convective transport of the radionuclides was always rather small or even zero, while the dispersive transport caused a "melting" process of the initially sharp activity edge at the lower border of the Ap horizon. These results are explained by the high evapotranspiration (80-90% of the total precipitation plus irrigation) and the small amounts of seepage water during the observation period of 9 years.

  4. Effects of prenatal /sup 60/Co irradiation on postnatal neural, learning, and hormonal development of the squirrel monkey

    SciTech Connect

    Ordy, J.M.; Brizzee, K.R.; Dunlap, W.P.; Knight, C.

    1982-02-01

    The goals of this study were to examine the effects of 0, 50, and 100 rad of /sup 60/Co administered prenatally on postnatal development of neuromuscular coordination, visual discrimination learning, spontaneous light-dark stabilimeter activity, plasma cortisol, and somatometric growth rates of diurnal squirrel monkeys from birth to 90 days. In terms of accuracy, completeness, and time required for performance of reflexes and neuromuscular coordination, the performance of 50- and 100-rad offspring was less accurate and poorly coordinated and required more time for completion to that of controls. In visual orientation, discrimination, and reversal learning, the percentage correct responses of the 50- and 100-rad offspring were significantly lower than those of controls. Spontaneous light-dark stabilimeter activity of 50- and 100-rad offspring was significantly higher in the dark session than that of controls. Plasma cortisol was significantly higher in 100-rad infants than in controls. Comparisons of somatometric growth rates indicated that postnatal head circumference, crown-rump length, and to a lesser extent body weight increased at significantly slower rates in 50- and 100-rad offspring. These findings should provide essential information for formulating and carrying out multivariate behavioral, biochemical, and morphometric assessments of low-dose effects on the brain of primate offspring within demonstrable dose-response curves.

  5. Effect of 60Co gamma irradiation on dielectric and complex impedance properties of Dy3+ substituted Ni-Zn nanoferrites

    NASA Astrophysics Data System (ADS)

    Veena, M.; Somashekarappa, A.; Shankaramurthy, G. J.; Jayanna, H. S.; Somashekarappa, H. M.

    2016-12-01

    Nanocrystalline Ni1-xZnxFe2-yDyyO4 (x=0.0, 0.2, 0.4, 0.6, 0.8, 1.0; y=0.0 and 0.1) ferrites were synthesized by combustion method. Ni-Zn-Dy nanoferrites were investigated by X-ray diffraction, scanning electron microscopy, dielectric and impedance properties, before and after γ-irradiation process by 60Co γ-radiation with a dose rate of 310 kGy. The lattice parameter of irradiated samples increased attributed to the conversion of smaller size Fe3+ ions to larger size Fe2+ ions on ionizing effect of gamma radiation. Experimental results reveal that reduction in dielectric constant (ε‧), loss tangent (tan δ), real (Z‧) and imaginary (Z‧‧) impedance and increase in ac conductivity (σac) have been increased with increasing in frequency. It was found that ε‧, tan δ, σac increase, Z‧‧ and Z‧‧ reach a maximum value and thereafter decrease with further Zn ion substitution. The values of ε‧, tan δ and σac decrease with Dy3+ substitution and enhanced after irradiation. The complex impedance analysis suggesting predominant contribution to conduction was through the grain boundary.

  6. Radiation damage of contact structures with diffusion barriers exposed to irradiation with {sup 60}Co{gamma}-ray photons

    SciTech Connect

    Belyaev, A. E.; Boltovets, N. S.; Konakova, R. V. Milenin, V. V.; Sveshnikov, Yu. N.; Sheremet, V. N.

    2010-04-15

    The effect of ionizing radiation of {sup 60}Co {gamma}-ray photons in the dose range 10{sup 4}-2 x 10{sup 9} rad on metal-semiconductor Au-ZrB{sub x}-AlGaN/GaN and Au-TiB{sub x}-Al-Ti-n-GaN contacts and Au-ZrB{sub x}-n-GaN Schottky diodes is examined. The contacts with the TiB{sub x} and ZrB{sub x} diffusion barriers do not degrade under the effect of ionizing radiation if the dose does not exceed 10{sup 8} rad. The Au-ZrB{sub x}-n-GaN Schottky diodes remain stable in the dose range 10{sup 4}-10{sup 6} rad. As the radiation dose is increased to {>=}10{sup 8} rad, the damage to the contact metallization increases and is accompanied by formation of through pores, which is conducive to accumulation of oxygen at the Au-ZrB{sub x}(TiB{sub x}) interfaces and to an increase in mass transport of atoms in contact-forming layers. In this case, irradiation-caused degradation of the Schottky diodes is observed. Possible mechanisms of radiation damage of contact structures with diffusion barriers are analyzed.

  7. The effects of 60Co γ-ray on poly(ethylene-co-vinyl acetate)/carbon black composites

    NASA Astrophysics Data System (ADS)

    Lee, Kyoung-Yong; Kim, Ki-Yup

    2008-04-01

    Cables used in a nuclear power plant are irradiation suppressing ones. Until now, researches on the irradiation suppressing cables have mainly been focused on insulation materials. Therefore, in this paper, the non-isothermal crystallization behaviors and degradation characteristics of ethylene vinyl acetate-carbon black (EVA-CB), used as a shielding material, were investigated by means of the Differential scanning calorimetry (DSC) and chemiluminescence analyzer (CL). The specimens were cooled after removing thermal history at 150 °C for 5 min by changing the cooling rates to 5, 7.5, 10, 15 and 20 °C/min with DSC. In addition, after maintaining a thermal equilibrium at each temperature of 25, 50, 75, 100, 125, 150 and 175 °C, their thermoluminescence was measured for 20 min with CL equipment. The 60Co γ-ray was used for irradiation. Tc, T0, T∞ and t1/2 in the DSC experiments are found to decrease gradually as radiation dose increases. Secondly, with the CL experiment, the 0.1, 0.25 and 0.5 MGy EVA-CB composites were found to show a much smaller thermoluminescence than the intact EVA-CB composites, while the 0.75 and 1 MGy EVA-CB composites were found to show a much higher thermoluminescence than ones.

  8. Effect of low /sup 60/Co dose rates on sister chromatid exchange incidence in the benthic worm. Neanthes arenaceodentata

    SciTech Connect

    Harrison, F.L.; Rice, D.W. Jr.

    1981-10-13

    The usefulness of sister chromatid exchange (SCE) induction as a measure of low-level radiation effect was examined in a benthic marine worm, Neanthes arenaceodentata. Larvae were exposed to /sup 60/Co radiation for 12 to 24 h at total doses ranging from 0.5 to 309 R and at dose rates from 0.04 to 13 R/h. Animals exposed at intermediate dose rates (0.5, 0.6, 1.25, 2.0, and 2.5 R/h) had SCE frequencies per chromosome about twice that of those receiving no radiation (controls), whereas those exposed at the higher dose rates (7.0 and 13 R/h) had SCE frequencies lower than the controls. Animals exposed at the lower dose rates (0.04 and 0.1 R/h) had lower SCE frequencies than those exposed at intermediate dose rates (and higher SCE frequencies than controls). The length of chromosome pair number one differed among metaphase spreads and was used as an index of chromosome condensation in a given metaphase. Because there is a possibility that chromosome morphology may affect the ability to resolve SCEs, morphology will be monitored in future studies. A preliminary experiment was performed to assess the effects of 2.2 and 11.5 R/h for 24 h on growth and development. Larvae observed at 6 and 17 d after irradiation did not have significantly different numbers of abnormal larvae or survival rates.

  9. Radiotherapy of spontaneous fibrous connective-tissue sarcomas in animals.

    PubMed

    Hilmas, D E; Gillette, E L

    1976-02-01

    The clinical records and follow-up data obtained over 13 years on the results of radiotherapy of spontaneous fibrous connective-tissue sarcomas in dogs, cats, and horses were reviewed. The results obtained from the treatment of fibrosarcomas and sarcoids of horses indicated that radiation administered with 60Co is important in the medical and surgical management of these tumors. Fibrous connective-tissue sarcomas in horses were radioresponsive. When radiotherapy was applied postoperatively, the probability of a 2-year cure approached 50% for all prescribed radiation doses of less than 2,000 to greater than 4,000 rads. If radiation doses of 4,500-6,000 rads were used, a 2-year cure rate may approach or exceed 60%.

  10. Thermoluminescence characteristics of Nd-doped SiO2 optical fibers irradiated with the (60)Co gamma rays.

    PubMed

    Refaei, Azadeh; Wagiran, Husin; Saeed, M A; Hosssain, I

    2014-12-01

    Thermoluminescence (TL) properties (radiation sensitivity, dose response, signal fading) of Nd-doped SiO2 optical fibers irradiated with 1.25MeV photons to 1-50Gy were studied. The peak of the glow curve is around 190°C regardless of the dose. The dose response is linear up to 50Gy. The radiation sensitivity is 219nCmg(-1)Gy(-1). The fiber can be a potential candidate for photon radiotherapy dosimetry due to its high radiation sensitivity, linear dose response in a wide range, slow fading, and high spatial resolution due to the small size of the fiber.

  11. Imaging in radiotherapy

    NASA Astrophysics Data System (ADS)

    Calandrino, R.; Del Maschio, A.; Cattaneo, G. M.; Castiglioni, I.

    2009-09-01

    The diagnostic methodologies used for the radiotherapy planning have undergone great developments in the last 30 years. Since the 1980s, after the introduction of the CT scanner, the modality for the planning moved beyond the planar 2D assessment to approach a real and more realistic volumetric 3D definition. Consequently the dose distribution, previously obtained by means of an overly simple approximation, became increasingly complex, better tailoring the true shape of the tumour. The final therapeutic improvement has been obtained by a parallel increase in the complexity of the irradiating units: the Linacs for therapy have, in fact, been equipped with a full accessory set capable to modulate the fluence (IMRT) and to check the correct target position continuously during the therapy session (IMRT-IGRT). The multimodal diagnostic approach, which integrates diagnostic information, from images of the patient taken with CT, NMR, PET and US, further improves the data for a biological and topological optimization of the radiotherapy plan and consequently of the dose distribution in the Planning Target Volume. Proteomic and genomic analysis will be the next step in tumour diagnosis. These methods will provide the planners with further information, for a true personalization of the treatment regimen and the assessment of the predictive essays for each tumour and each patient.

  12. [Radiotherapy of bone metastases].

    PubMed

    Thureau, S; Vieillard, M-H; Supiot, S; Lagrange, J-L

    2016-09-01

    Radiotherapy plays a major role in palliative treatment of bone metastases. Recent developments of stereotactic radiotherapy and intensity modulated radiation therapy give the possibility to treat oligometastatic diseases. The objective of this paper is to report indications and treatment modalities of radiotherapy in these situations.

  13. Dosimetric comparison of brachytherapy sources for high-dose-rate treatment of endometrial cancer: 192Ir, 60Co and an electronic brachytherapy source

    PubMed Central

    Nguyen, Alex; Packianathan, Satyaseelan; He, Rui; Yang, Claus C

    2016-01-01

    Objective: To compare high-dose-rate (HDR) brachytherapy systems with 192Ir, 60Co and electronic brachytherapy source (EBS) for treatment of endometrial cancers. Methods: Two additional plans were generated per patient fraction using a 60Co source and Xoft-EBS on 10 selected patients, previously treated with a vaginal cylinder applicator using a 192Ir source. Dose coverage of “PTV_CYLD”, a 5-mm shell surrounding the cylinder, was evaluated. Doses to the following organs at risk (OARs) the rectum, bladder and sigmoid were evaluated in terms of V35% and V50%, the percentage volume receiving 35% and 50% of the prescription dose, respectively, and D2cm3, the highest dose to a 2-cm3 volume of an OAR. Results: Xoft-EBS reduces doses to all OARs in the lower dose range, but it does not always provide better sparing of the rectum in higher dose range as does evaluation using D2cm3. V150% and V200% for PTV_CYLD was up to four times greater for Xoft-EBS plans than for plans generated with 192Ir or 60Co. Surface mucosal (vaginal cylinder surface) doses were also 23% higher for Xoft-EBS than for 192Ir or 60Co plans. Conclusion: Xoft-EBS is a suitable HDR source for vaginal applicator treatment with advantages of reducing radiation exposure to OARs in the lower dose range, while simultaneously increasing the vaginal mucosal dose. Advances in knowledge: This work presents newer knowledge in dosimetric comparison between 192Ir or 60Co and Xoft-EBS sources for endometrial vaginal cylinder HDR planning. PMID:26743941

  14. Radiotherapy dosimetry using a commercial OSL system

    SciTech Connect

    Viamonte, A.; Rosa, L. A. R. da; Buckley, L. A.; Cherpak, A.; Cygler, J. E.

    2008-04-15

    A commercial optically stimulated luminescence (OSL) system developed for radiation protection dosimetry by Landauer, Inc., the InLight microStar reader, was tested for dosimetry procedures in radiotherapy. The system uses carbon-doped aluminum oxide, Al{sub 2}O{sub 3}:C, as a radiation detector material. Using this OSL system, a percent depth dose curve for {sup 60}Co gamma radiation was measured in solid water. Field size and SSD dependences of the detector response were also evaluated. The dose response relationship was investigated between 25 and 400 cGy. The decay of the response with time following irradiation and the energy dependence of the Al{sub 2}O{sub 3}:C OSL detectors were also measured. The results obtained using OSL dosimeters show good agreement with ionization chamber and diode measurements carried out under the same conditions. Reproducibility studies show that the response of the OSL system to repeated exposures is 2.5% (1sd), indicating a real possibility of applying the Landauer OSL commercial system for radiotherapy dosimetric procedures.

  15. Diffuse intrinsic pontine glioma treated with prolonged temozolomide and radiotherapy--results of a United Kingdom phase II trial (CNS 2007 04).

    PubMed

    Bailey, S; Howman, A; Wheatley, K; Wherton, D; Boota, N; Pizer, B; Fisher, D; Kearns, P; Picton, S; Saran, F; Gibson, M; Glaser, A; Connolly, D J A; Hargrave, D

    2013-12-01

    Diffuse intrinsic pontine glioma (DIPG) has a dismal prognosis with no chemotherapy regimen so far resulting in any significant improvement over standard radiotherapy. In this trial, a prolonged regimen (21/28d) of temozolomide was studied with the aim of overcoming O(6)-methylguanine methyltransferase (MGMT) mediated resistance. Forty-three patients with a defined clinico-radiological diagnosis of DIPG received radiotherapy and concomitant temozolomide (75 mg/m(2)) after which up to 12 courses of 21d of adjuvant temozolomide (75-100mg/m(2)) were given 4 weekly. The trial used a 2-stage design and passed interim analysis. At diagnosis median age was 8 years (2-20 years), 81% had cranial nerve abnormalities, 76% ataxia and 57% long tract signs. Median Karnofsky/Lansky score was 80 (10-100). Patients received a median of three courses of adjuvant temozolomide, five received all 12 courses and seven did not start adjuvant treatment. Three patients were withdrawn from study treatment due to haematological toxicity and 10 had a dose reduction. No other significant toxicity related to temozolomide was noted. Overall survival (OS) (95% confidence interval (CI)) was 56% (40%, 69%) at 9 months, 35% (21%, 49%) at 1 year and 17% (7%, 30%) at 2 years. Median survival was 9.5 months (range 7.5-11.4 months). There were five 2-year survivors with a median age of 13.6 years at diagnosis. This trial demonstrated no survival benefit of the addition of dose dense temozolomide, to standard radiotherapy in children with classical DIPG. However, a subgroup of adolescent DIPG patients did have a prolonged survival, which needs further exploration.

  16. Geant4 simulation of the Elekta XVI kV CBCT unit for accurate description of potential late toxicity effects of image-guided radiotherapy.

    PubMed

    Brochu, F M; Burnet, N G; Jena, R; Plaistow, R; Parker, M A; Thomas, S J

    2014-12-21

    This paper describes the modelisation of the Elekta XVI Cone Beam Computed Tomography (CBCT) machine components with Geant4 and its validation against calibration data taken for two commonly used machine setups. Preliminary dose maps of simulated CBCTs coming from this modelisation work are presented. This study is the first step of a research project, GHOST, aiming to improve the understanding of late toxicity risk in external beam radiotherapy patients by simulating dose depositions integrated from different sources (imaging, treatment beam) over the entire treatment plan. The second cancer risk will then be derived from different models relating irradiation dose and second cancer risk.

  17. Geant4 simulation of the Elekta XVI kV CBCT unit for accurate description of potential late toxicity effects of image-guided radiotherapy

    NASA Astrophysics Data System (ADS)

    Brochu, F. M.; Burnet, N. G.; Jena, R.; Plaistow, R.; Parker, M. A.; Thomas, S. J.

    2014-12-01

    This paper describes the modelisation of the Elekta XVI Cone Beam Computed Tomography (CBCT) machine components with Geant4 and its validation against calibration data taken for two commonly used machine setups. Preliminary dose maps of simulated CBCTs coming from this modelisation work are presented. This study is the first step of a research project, GHOST, aiming to improve the understanding of late toxicity risk in external beam radiotherapy patients by simulating dose depositions integrated from different sources (imaging, treatment beam) over the entire treatment plan. The second cancer risk will then be derived from different models relating irradiation dose and second cancer risk.

  18. Pineal region tumors: results of radiation therapy and indications for elective spinal irradiation. [/sup 60/Co; x ray

    SciTech Connect

    Griffin, B.R.; Griffin, T.W.; Tong, D.Y.K.; Russell, A.H.; Kurtz, J.; Laramore, G.E.; Groudine, M.

    1981-05-01

    Eighteen patients with pineal region tumors seen from November 1960 to November 1978 were reviewed. Thirteen patients treated with radiation therapy received tumor doses in the 4000 to 5500 rad range. The five year survival and five year disease-free survival were 73 and 63% respectively. Spinal cord metastasis occurred in 2 of 13 (15%) patients. Attempts at salvage radiotherapy for these patients were unsuccessful. Computerized tomography (CT) scan provides an excellent method of evaluating the response of pineal region tumors to radiation. Rapid regression of the tumor mass on CT scan reflects the highly radioresponsive nature of germinomas, the tumor type most likely to disseminate throughout the neuraxis. This principle can be exploited to select unbiopsied patients with a high risk of spinal cord metastasis for prophylactic spinal radiation at an early stage of treatment.

  19. LiF:Mg,Ti TLD response as a function of photon energy for moderately filtered x-ray spectra in the range of 20-250 kVp relative to {sup 60}Co

    SciTech Connect

    Nunn, A. A.; Davis, S. D.; Micka, J. A.; DeWerd, L. A.

    2008-05-15

    The response of LiF:Mg,Ti thermoluminescent dosimeters (TLDs) as a function of photon energy was determined using irradiations with moderately filtered x-ray beams in the energy range of 20-250 kVp relative to the response to irradiations with {sup 60}Co photons. To determine if the relative light output from LiF:Mg,Ti TLDs per unit air kerma as a function of photon energy can be predicted using calculations such as Monte Carlo (MC) simulations, measurements from the x-ray beam irradiations were compared with MC calculated results, similar to the methodology used by Davis et al. [Radiat. Prot. Dosim. 106, 33-43 (2003)]. TLDs were irradiated in photon beams with well-known air kerma rates using the National Institute of Standards and Technology traceable M-series x-ray beams in the range of 20-250 kVp. For each x-ray beam, several sets of TLDs were irradiated for times corresponding to different air kerma levels to take into account any dose nonlinearity. TLD light output was then compared to that from several sets of TLDs irradiated at similar corresponding air kerma levels using a {sup 60}Co irradiator. The MC code MCNP5 was used to account for photon scatter and attenuation in the holder and TLDs and was used to calculate the predicted relative TLD light output per unit air kerma for irradiations with each of the experimentally used photon beams. The measured relative TLD response as a function of photon energy differed by up to 13% from the MC calculations. We conclude that MC calculations do not accurately predict the relative response of TLDs as a function of photon energy, consistent with the conclusions of Davis et al. [Radiat. Prot. Dosim. 106, 33-43 (2003)]. This is likely due to complications in the solid state physics of the thermoluminescence process that are not incorporated into the simulation.

  20. SU-E-T-380: Evaluation of BEBIG HDR 60Co System for AccuBoost Therapy

    SciTech Connect

    Zehtabian, M; Sina, S; Rivard, M; Meigooni, A Soleimani

    2015-06-15

    Purpose: In this project, the possibility of utilizing the BEBIG 60Co HDR system for AccuBoostTM treatment has been evaluated. Methods: Dose distributions in various breast sizes have been calculated for both Co-60 and Ir-192 sources using the MCNP5 code. These calculations were performed in breast tissues with thicknesses of 4cm, 6cm, and 8cm. The initial calculations were performed with the same applicator dimensions as the existing applicators used with the HDR Ir-192 system. The activity of the Co-60 source was selected such that the dose at the breast center was the same as the values from 192Ir. Then, the applicator thicknesses were increased to twice of those used with HDR Ir-192 system, for reducing skin and chest doses by Co-60 system. Dose to breast skin and chest wall were compared for both applicators types, with and without inclusion of a focusing cone at the applicator center. Results: The results showed that loading HDR Co-60 source inside the thin applicators impose higher doses to breast skin and chest wall compared to the 192Ir source. The area of the chest wall covered by 10Gy when treated by Co-60 with the thin and thick applicators, or treated by Ir-192 with thin applicator are 79cm2, 39cm2, and 3.8cm2, respectively. These values are reduced to 34cm2, 0cm2, and 0cm2 by using the focusing cone. It is worth noting that the breast skin areas covered by the 60Gy isodose line are 9.9cm2 and 7.8cm2 for Co-60 with the thin and thick applicators, respectively, while it is 20cm2 for Ir-192 when no focusing cone is present. These values are 0cm2, 0cm2, and 11cm2 in the presence of the focusing cone. Conclusion: The results indicate that using Co-60 with the thicker applicators is beneficial because of the higher half-life of Co-60, and the reduced maximum skin dose when compared with Ir-192.

  1. (60)Co in cast steel matrix: A European interlaboratory comparison for the characterisation of new activity standards for calibration of gamma-ray spectrometers in metallurgy.

    PubMed

    Tzika, Faidra; Burda, Oleksiy; Hult, Mikael; Arnold, Dirk; Marroyo, Belén Caro; Dryák, Pavel; Fazio, Aldo; Ferreux, Laurent; García-Toraño, Eduardo; Javornik, Andrej; Klemola, Seppo; Luca, Aurelian; Moser, Hannah; Nečemer, Marijan; Peyrés, Virginia; Reis, Mario; Silva, Lidia; Šolc, Jaroslav; Svec, Anton; Tyminski, Zbigniew; Vodenik, Branko; Wätjen, Uwe

    2016-08-01

    Two series of activity standards of (60)Co in cast steel matrix, developed for the calibration of gamma-ray spectrometry systems in the metallurgical sector, were characterised using a European interlaboratory comparison among twelve National Metrology Institutes and one international organisation. The first standard, consisting of 14 disc shaped samples, was cast from steel contaminated during production ("originally"), and the second, consisting of 15 similar discs, from artificially-contaminated ("spiked") steel. The reference activity concentrations of (60)Co in the cast steel standards were (1.077±0.019) Bqg(-1) on 1 January 2013 12h00 UT and (1.483±0.022) Bqg(-1) on 1 June 2013 12h00 UT, respectively.

  2. A water calorimeter for on-site absorbed dose to water calibrations in 60Co and MV-photon beams including MRI incorporated treatment equipment

    NASA Astrophysics Data System (ADS)

    de Prez, Leon; de Pooter, Jacco; Jansen, Bartel; Aalbers, Tony

    2016-07-01

    In reference dosimetry the aim is to establish the absorbed dose to water, D w, under reference conditions. However, existing dosimetry protocols are not always applicable for rapidly emerging new treatment modalities. For primary standard dosimetry laboratories it is generally not feasible to acquire such modalities. Therefore it is strongly desired that D w measurements with primary standards can be performed on-site in clinical beams for the new treatment modalities in order to characterize and calibrate detectors. To serve this need, VSL has developed a new transportable water calorimeter serving as a primary D w standard for 60Co and MV-photons including MRI incorporated treatment equipment. Special attention was paid to its operation in different beam geometries and beam modalities including the application in magnetic fields. The new calorimeter was validated in the VSL 60Co beam and on-site in clinical MV-photon beams. Excellent agreement of 0.1% was achieved with previous 60Co field calibrations, i.e. well within the uncertainty of the previous calorimeter, and with measurements performed in horizontal and vertical MV-photon beams. k Q factors, determined for two PTW 30013 ionization chambers, agreed very well with available literature data. The relative combined standard uncertainty (k  =  1) for D w measurements in 60Co and MV-photons is 0.37%. Calibrations are carried out with a standard uncertainty of 0.42% and k Q -factors are determined with a relative standard uncertainty of 0.40%.

  3. The 60Co- γ ray-initiated seeded-emulsion polymerization of methyl methacrylate in the presence of waterborne polyurethane seeds

    NASA Astrophysics Data System (ADS)

    Zhang, Guixi; Zhang, Zhicheng

    2004-09-01

    In this work, the waterborne polyurethane (WPU)/poly (methyl methacrylate) (PMMA) composite material was successfully prepared via 60Co- γ ray radiation-induced seeded emulsion polymerization. The kinetic curves of the synthesis of WPU have been obtained in MMA medium and in acetone medium, respectively. The FT-IR spectra were used to investigate the grafting efficiency of the PMMA on WPU backbone.

  4. Genotoxic and cytotoxic effects of 60Co gamma-rays and 90Sr/90Y beta-rays on Chinese hamster ovary cells (CHO-K1).

    PubMed

    Murakami, Daniella; Suzuki, Miriam Fussae; da Silva Dias, Mauro; Okazaki, Kayo

    2004-07-01

    Among various types of ionizing radiation, the beta emitter radionuclides are involved in many sectors of human activity, such as nuclear medicine, nuclear industries and biomedicine, with a consequently increased risk of accidental, occupational or therapeutic exposure. Despite their recognized importance, there is little information about the effect of beta particles at the cellular level when compared to other types of ionizing radiation. Thus, the objective of the present study was to evaluate the genotoxic and cytotoxic effects of (90)Sr/(90)Y-a pure, highly energetic beta source-on Chinese hamster ovary (CHO) cells and to compare them with data obtained with (60)Co. CHO cells irradiated with different doses of (60)Co (0.34 Gy min(-1)) and (90)Sr/(90)Y (0.23 Gy min(-1)) were processed for analysis of clonogenic death, induction of micronuclei (MN) and interphase death. The survival curves obtained for both types of radiation were fitted by the exponential quadratic model and were found to be similar. Also, the cytogenetic results showed similar frequencies of radio-induced MN between gamma and beta radiations and the MN distribution pattern among cells did not follow the expected Poisson probability pattern. The relative variance values were significantly higher in cells irradiated with (90)Sr/(90)Y than with (60)Co in all exposure doses. The irradiated cells showed more necrotic cells 72 h and 96 h after exposure to beta than to gamma radiation. In general, the (90)Sr/(90)Y beta-radiation was more damaging than (60)Co gamma-rays. The data obtained also demonstrated the need to use several parameters for a better estimate of cellular sensitivity to the action of genotoxic agents, which would be important in terms of radiobiology, oncology and therapeutics.

  5. Areal distribution of /sup 60/Co, /sup 137/Cs, and /sup 90/Sr in streambed gravels of White Oak Creek Watershed, Oak Ridge, Tennessee

    SciTech Connect

    Cerling, T.E.; Spalding, B.P.

    1981-01-01

    The concentrations of /sup 90/Sr, /sup 60/Co, and /sup 137/Cs in streambed gravels from contaminated drainages in White Oak Creek Watershed were determined. Methods to determine the relative contributions of various sources to the total discharge from the watershed were developed. Principal sources of /sup 90/Sr were: ORNL plant effluents (50%), leaching from solid waste disposal area (SWDA) 4 (30%), and leaching from SWDA 5 (10%). Minor sources included SWDA 3, the Molten Salt Reactor Facility, and intermediate-level liquid waste pit 1 with each representing 4% or less of the total basin discharge. The cooling water effluent from the High-Flux Isotope Reactor was the dominant source of /sup 60/Co contamination in the watershed. ORNL plant effluents accounted for almost all the /sup 137/Cs discharge from White Oak Creek basin. Downstream radionuclide concentrations were constant until significant dilution by other tributaries occurred. Any future activities giving rise to additional contamination can now be identified. Distribution coefficients between streambed gravels and streamwater for /sup 85/Sr, /sup 60/Co, and /sup 137/Cs were 50, 560, and 8460 ml/g, respectively. An abridged radiochemical fractionation developed for /sup 90/Sr was found to be as accurate and precise for these samples as the standard /sup 90/Sr method above levels of 2 dpm/g. (ERB)

  6. Pre-assessment of dose rates of (134)Cs, (137)Cs, and (60)Co for marine biota from discharge of Haiyang Nuclear Power Plant, China.

    PubMed

    Li, Jingjing; Liu, Senlin; Zhang, Yongxing; Chen, Ling; Yan, Yuan; Cheng, Weiya; Lou, Hailin; Zhang, Yongbao

    2015-09-01

    Haiyang Nuclear Power Plant to be built in China was selected as a case for the dose pre-assessment for marine biota in this study. The concentrations of Cs and Co in organisms (turbot, yellow croaker, swimming crab, abalone, sea cucumber, and sea lettuce), seawater, and bottom sediment sampled on-site were measured by neutron activation analysis, and the site-specific transfer parameters (concentration ratios and distribution coefficients) of Cs and Co were calculated. (134)Cs, (137)Cs, and (60)Co activity concentrations in the organisms and the sediment at the site were calculated with the site-specific transfer parameters and the anticipated activity concentrations in the liquid effluent of the nuclear power plant. The ERICA tool was used to estimate the dose rates of (134)Cs, (137)Cs, and (60)Co to the selected organisms based on the biological models developed. The total dose rates of (134)Cs, (137)Cs, and (60)Co to the six organisms were all <0.001 μGy h(-1).

  7. DNA double-strand break misrejoining after exposure of primary human fibroblasts to CK characteristic X rays, 29 kVp X rays and 60Co gamma rays.

    PubMed

    Kühne, Martin; Urban, Gerhard; Frankenberg, Dieter; Löbrich, Markus

    2005-11-01

    The efficiency of ionizing photon radiation for inducing mutations, chromosome aberrations, neoplastic cell transformation, and cell killing depends on the photon energy. We investigated the induction and rejoining of DNA double-strand breaks (DSBs) as possible contributors for the varying efficiencies of different photon energies. A specialized pulsed-field gel electrophoresis assay based on Southern hybridization of single Mbp genomic restriction fragments was employed to assess DSB induction and rejoining by quantifying the restriction fragment band. Unrejoined and misrejoined DSBs were determined in dose fractionation protocols using doses per fraction of 2.2 and 4.4 Gy for CK characteristic X rays, 4 and 8 Gy for 29 kVp X rays, and 5, 10 and 20 Gy for 60Co gamma rays. DSB induction by CK characteristic X rays was about twofold higher than for 60Co gamma rays, whereas 29 kVp X rays showed only marginally elevated levels of induced DSBs compared with 60Co gamma rays (a factor of 1.15). Compared with these modest variations in DSB induction, the variations in the levels of unrejoined and misrejoined DSBs were more significant. Our results suggest that differences in the fidelity of DSB rejoining together with the different efficiencies for induction of DSBs can explain the varying biological effectiveness of different photon energies.

  8. [Radiotherapy of hypopharynx cancers].

    PubMed

    Pointreau, Y; Lafond, C; Trémolières, P; Legouté, F; Servagi-Vernat, S; Giraud, P; Maingon, P; Calais, G; Lapeyre, M

    2016-09-01

    The intensity-modulated radiotherapy is the gold standard in the treatment of hypopharynx cancers. Early T1 and T2 tumours could be treated by exclusive radiotherapy or surgery. For tumours requiring total pharyngolaryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy are possible. For T4 tumours, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, curative dose is 70Gy and prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used for locally advanced cancers with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation is based on guidelines.

  9. Heavy-ion radiotherapy

    NASA Astrophysics Data System (ADS)

    Kanai, Tatsuaki

    2000-11-01

    Heavy-ion radiotherapy using high-energy carbon beams has been performed at the National Institute of Radiological Sciences, Japan. The physical frame works for heavy-ion radiotherapy are established using physical understandings of radiation physics. In order to increase the accuracy of heavy-ion radiotherapy, many physical problems should be solved. Unsolved problems, such as the depth dose distributions, range of heavy-ion in patients and heavy-ion dosimetry in the radiation therapy, are discussed. .

  10. [Radiotherapy of oropharynx carcinoma].

    PubMed

    Servagi Vernat, S; Tochet, F; Vieillevigne, L; Pointreau, Y; Maingon, P; Giraud, P

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  11. [Radiotherapy of skin cancers].

    PubMed

    Hennequin, C; Rio, E; Mahé, M-A

    2016-09-01

    The indications of radiotherapy for skin cancers are not clearly defined because of the lack of randomised trials or prospective studies. For basal cell carcinomas, radiotherapy frequently offers a good local control, but a randomized trial showed that surgery is more efficient and less toxic. Indications of radiotherapy are contra-indications of surgery for patients older than 60, non-sclerodermiform histology and occurring in non-sensitive areas. Adjuvant radiotherapy could be proposed to squamous cell carcinomas, in case of poor prognostic factors. Dose of 60 to 70Gy are usually required, and must be modulated to the size of the lesions. Adjuvant radiotherapy seems beneficial for desmoplastic melanomas but not for the other histological types. Prophylactic nodal irradiation (45 to 50Gy), for locally advanced tumours (massive nodal involvement), decreases the locoregional failure rate but do not increase survival. Adjuvant radiotherapy (50 to 56Gy) for Merckel cell carcinomas increases also the local control rate, as demonstrated by meta-analysis and a large epidemiological study. Nodal areas must be included, if there is no surgical exploration (sentinel lymph node dissection). Kaposi sarcomas are radiosensitive and could be treated with relatively low doses (24 to 30Gy). Also, cutaneous lymphomas are good indications for radiotherapy: B lymphomas are electively treated with limited fields. The role of total skin electron therapy for T-lymphomas is still discussed; but palliative radiotherapy is very efficient in case of cutaneous nodules.

  12. Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd, 125I, 192Ir, 137Cs, and 60Co

    NASA Astrophysics Data System (ADS)

    Villegas, Fernanda; Tilly, Nina; Bäckström, Gloria; Ahnesjö, Anders

    2014-09-01

    Analysing the pattern of energy depositions may help elucidate differences in the severity of radiation-induced DNA strand breakage for different radiation qualities. It is often claimed that energy deposition (ED) sites from photon radiation form a uniform random pattern, but there is indication of differences in RBE values among different photon sources used in brachytherapy. The aim of this work is to analyse the spatial patterns of EDs from 103Pd, 125I, 192Ir, 137Cs sources commonly used in brachytherapy and a 60Co source as a reference radiation. The results suggest that there is both a non-uniform and a uniform random component to the frequency distribution of distances to the nearest neighbour ED. The closest neighbouring EDs show high spatial correlation for all investigated radiation qualities, whilst the uniform random component dominates for neighbours with longer distances for the three higher mean photon energy sources (192Ir, 137Cs, and 60Co). The two lower energy photon emitters (103Pd and 125I) present a very small uniform random component. The ratio of frequencies of clusters with respect to 60Co differs up to 15% for the lower energy sources and less than 2% for the higher energy sources when the maximum distance between each pair of EDs is 2 nm. At distances relevant to DNA damage, cluster patterns can be differentiated between the lower and higher energy sources. This may be part of the explanation to the reported difference in RBE values with initial DSB yields as an endpoint for these brachytherapy sources.

  13. The US radiation dosimetry standards for 60Co therapy level beams, and the transfer to the AAPM accredited dosimetry calibration laboratories.

    PubMed

    Minniti, R; Chen-Mayer, H; Seltzer, S M; Huq, M Saiful; Bryson, L; Slowey, T; Micka, J A; DeWerd, L A; Wells, N; Hanson, W F; Ibbott, G S

    2006-04-01

    This work reports the transfer of the primary standard for air kerma from the National Institute of Standards and Technology (NIST) to the secondary laboratories accredited by the American Association of Physics in Medicine (AAPM). This transfer, performed in August of 2003, was motivated by the recent revision of the NIST air-kerma standards for 60Co gamma-ray beams implemented on July 1, 2003. The revision involved a complete recharacterization of the two NIST therapy-level 60Co gamma-ray beam facilities, resulting in new values for the air-kerma rates disseminated by the NIST. Some of the experimental aspects of the determination of the new air-kerma rates are briefly summarized here; the theoretical aspects have been described in detail by Seltzer and Bergstrom ["Changes in the U.S. primary standards for the air-kerma from gamma-ray beams," J. Res. Natl. Inst. Stand. Technol. 108, 359-381 (2003)]. The standard was transferred to reference-class chambers submitted by each of the AAPM Accredited Dosimetry Calibration Laboratories (ADCLs). These secondary-standard instruments were then used to characterize the 60Co gamma-ray beams at the ADCLs. The values of the response (calibration coefficient) of the ADCL secondary-standard ionization chambers are reported and compared to values obtained prior to the change in the NIST air-kerma standards announced on July 1, 2003. The relative change is about 1.1% for all of these chambers, and this value agrees well with the expected change in chambers calibrated at the NIST or at any secondary-standard laboratory traceable to the new NIST standard.

  14. Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd, 125I, 192Ir, 137Cs, and 60Co.

    PubMed

    Villegas, Fernanda; Tilly, Nina; Bäckström, Gloria; Ahnesjö, Anders

    2014-09-21

    Analysing the pattern of energy depositions may help elucidate differences in the severity of radiation-induced DNA strand breakage for different radiation qualities. It is often claimed that energy deposition (ED) sites from photon radiation form a uniform random pattern, but there is indication of differences in RBE values among different photon sources used in brachytherapy. The aim of this work is to analyse the spatial patterns of EDs from 103Pd, 125I, 192Ir, 137Cs sources commonly used in brachytherapy and a 60Co source as a reference radiation. The results suggest that there is both a non-uniform and a uniform random component to the frequency distribution of distances to the nearest neighbour ED. The closest neighbouring EDs show high spatial correlation for all investigated radiation qualities, whilst the uniform random component dominates for neighbours with longer distances for the three higher mean photon energy sources (192Ir, 137Cs, and 60Co). The two lower energy photon emitters (103Pd and 125I) present a very small uniform random component. The ratio of frequencies of clusters with respect to 60Co differs up to 15% for the lower energy sources and less than 2% for the higher energy sources when the maximum distance between each pair of EDs is 2 nm. At distances relevant to DNA damage, cluster patterns can be differentiated between the lower and higher energy sources. This may be part of the explanation to the reported difference in RBE values with initial DSB yields as an endpoint for these brachytherapy sources.

  15. Real-Time Telemetric Monitoring in Whole-Body 60Co Gamma-Photon Irradiated Rhesus Macaques (Macaca mulatta)

    DTIC Science & Technology

    2010-01-01

    stress-related situations [1, 8, 9, 11, 16, 17, 21]. A key aspect of United States (US) animal welfare regula- tions [18, 19] is that pain, distress...provided by the National Institute of Allergy and Infectious Diseases , National Institutes of Health, Contract Y1-A1-4827-01 and by AFRRI Project RAB3AG-1...physiologic and behavioral signs of pain and distress. Telemetry permits close monitoring of these parameters for early and effective management during

  16. Separation of iron and cobalt using 59Fe and 60Co by dialysis of polyvinylpyrrolidone-metal complexes: a greener approach.

    PubMed

    Lahiri, Susanta; Sarkar, Soumi

    2007-04-01

    An environmentally benign method to separate iron and cobalt has been developed using a safe chemical, polyvinylpyrrolidone (PVP). The method involves dialysis of PVP-Fe and PVP-Co complexes against triple-distilled water. (59)Fe and (60)Co were used as radioactive tracers of iron and cobalt throughout the experiment. No other chemicals are required for clean separation of cobalt from iron. The optimum condition for separation has been obtained at pH 5 using 10% aqueous solution of PVP. The method is applicable from trace scale to macro-scale. Very high separation factors have been obtained.

  17. [Effect of tonicity of the medium on the sensitivity of Escherichia coli bacteria to gamma-quantum 60Co, ultrasound and hyperthermia].

    PubMed

    Morozov, I I; Petin, V G; Morozova, G V

    1998-01-01

    The cell lethality and permeability induced in Escherichia coli B/r and Escherichia coli BS-1 by 60Co gamma-ray irradiation, ultrasound and hyperthermia in media containing different concentrations of NaCl have been investigated. It was shown that independently from the nature of damaging factors hypotonic media increase while hypertonic media in certain range of osmolyte concentration decrease sensitivity of cells to action of this factors. It was proposed that discovered phenomenology was caused by salt modification of status of the cell osmotic homeostasis destabilizing by ionizing radiation, ultrasound or hyperthermia and was not related with the system of dark repair of DNA.

  18. [Effect of combined treatment of 60Co gamma-ray and EMS on antioxidase activity and ODAP content in Lathyrus sativus].

    PubMed

    Qin, X; Wang, F; Wang, X; Zhou, G; Li, Z

    2000-12-01

    Lathyrus sativus seeds were treated with 60Co gamma-ray and EMS(ethyl methane sulfonate), and their emergence rate and SOD, POD and CAT activities were determined. The result indicated that the treatment decreased the emergence rate. The activities of SOD and POD were changed in accordance with the increase of irradiation dose and EMS concentration, while that of CAT had no obvious change. After treatment, the ODAP content in Lathyrus sativus decreased. Amutant was developed, with toxin content of 0.1%, compared to 0.2% in control.

  19. [Prostate cancer external beam radiotherapy].

    PubMed

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy.

  20. SU-E-J-129: A Strategy to Consolidate the Image Database of a VERO Unit Into a Radiotherapy Management System

    SciTech Connect

    Yan, Y; Medin, P; Yordy, J; Zhao, B; Jiang, S

    2014-06-01

    Purpose: To present a strategy to integrate the imaging database of a VERO unit with a treatment management system (TMS) to improve clinical workflow and consolidate image data to facilitate clinical quality control and documentation. Methods: A VERO unit is equipped with both kV and MV imaging capabilities for IGRT treatments. It has its own imaging database behind a firewall. It has been a challenge to transfer images on this unit to a TMS in a radiation therapy clinic so that registered images can be reviewed remotely with an approval or rejection record. In this study, a software system, iPump-VERO, was developed to connect VERO and a TMS in our clinic. The patient database folder on the VERO unit was mapped to a read-only folder on a file server outside VERO firewall. The application runs on a regular computer with the read access to the patient database folder. It finds the latest registered images and fuses them in one of six predefined patterns before sends them via DICOM connection to the TMS. The residual image registration errors will be overlaid on the fused image to facilitate image review. Results: The fused images of either registered kV planar images or CBCT images are fully DICOM compatible. A sentinel module is built to sense new registered images with negligible computing resources from the VERO ExacTrac imaging computer. It takes a few seconds to fuse registered images and send them to the TMS. The whole process is automated without any human intervention. Conclusion: Transferring images in DICOM connection is the easiest way to consolidate images of various sources in your TMS. Technically the attending does not have to go to the VERO treatment console to review image registration prior delivery. It is a useful tool for a busy clinic with a VERO unit.

  1. Mutant frequency of radiotherapy technicians appears to be associated with recent dose of ionizing radiation

    SciTech Connect

    Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M. )

    1989-10-01

    The frequency of hypoxanthine phosphoribosyl transferase (HPRT) mutants among peripheral T-lymphocytes of radiotherapy technicians primarily exposed to 60Co was measured by the T-cell cloning method. Mutant frequencies of these technicians in 1984 and 1986 were significantly higher than those of physiotherapy technicians who worked in a neighboring service, and correlated significantly with thermoluminescence dosimeter readings recorded during the 6 mo preceding mutant frequency determination. Correlations decreased when related to dose recorded over longer time intervals. HPRT mutant frequency determination in peripheral lymphocytes is a good measure of recently received biologically effective radiation dose in an occupationally exposed population.

  2. Antagonistic effects of Lycium barbarum polysaccharides on the impaired reproductive system of male rats induced by local subchronic exposure to 60Co-γ irradiation.

    PubMed

    Luo, Qiong; Cui, Xiaoyan; Yan, Jun; Yang, Mingliang; Liu, Jun; Jiang, Yuanhai; Li, Jingjing; Zhou, Yinzhu

    2011-05-01

    Lycium barbarum, a famous Chinese medicinal herb, has a long history of use in traditional medicine as an antioxidant and to promote sexual fertility. Polysaccharides are the most important functional constituents in L. barbarum fruits. In this study, male rats were exposed to subchronic (60)Co-γ irradiation to investigate the effects of LBP on sperm quantity and motility, sexual ability, serum hormone levels, oxidative status and testicular tissue DNA damage on days 1, 7 and 14 of treatment. It was found that LBP significantly increased the sperm quantity and motility, shortened the erection, capture and ejaculation latencies, increased the number of captures and ejaculations, and improved the sexual ability of male rats. LBP also played a significant role in the recovery of serum testosterone levels, increased superoxide dismutase activity, decreased malondialdehyde levels, promoted oxidative balance and rescued testicular DNA damage. In conclusion, LBP has significant protective effects against damage induced by local subchronic exposure to (60)Co-γ irradiation, allowing rats to achieve near-complete recovery with LBP treatment.

  3. Calculation of direct effects of 60Co gamma rays on the different DNA structural levels: A simulation study using the Geant4-DNA toolkit

    NASA Astrophysics Data System (ADS)

    Tajik, Marjan; Rozatian, Amir S. H.; Semsarha, Farid

    2015-03-01

    In this study, simple single strand breaks (SSB) and double strand breaks (DSB) due to direct effects of the secondary electron spectrum of 60Co gamma rays on different organizational levels of a volume model of the B-DNA conformation have been calculated using the Geant4-DNA toolkit. Result of this study for the direct DSB yield shows a good agreement with other theoretical and experimental results obtained by both photons and their secondary electrons; however, in the case of SSB a noticeable difference can be observed. Moreover, regarding the almost constant yields of the direct strand breaks in the different structural levels of the DNA, calculated in this work, and compared with some theoretical studies, it can be deduced that the direct strand breaks yields depend mainly on the primary double helix structure of the DNA and the higher-order structures cannot have a noticeable effect on the direct DNA damage inductions by 60Co gamma rays. In contrast, a direct dependency between the direct SSB and DSB yields and the volume of the DNA structure has been found. Also, a further study on the histone proteins showed that they can play an important role in the trapping of low energy electrons without any significant effect on the direct DNA strand breaks inductions, at least in the range of energies used in the current study.

  4. [Development of the 60Co gamma-ray standard field for therapy-level dosimeter calibration in terms of absorbed dose to water (N(D,w))].

    PubMed

    Fukumura, Akifumi; Mizuno, Hideyuki; Fukahori, Mai; Sakata, Suoh

    2012-01-01

    A primary standard for the absorbed dose rate to water in a 60Co gamma-ray field was established at National Metrology Institute of Japan (NMIJ) in fiscal year 2011. Then, a 60Co gamma-ray standard field for therapy-level dosimeter calibration in terms of absorbed dose to water was developed at National Institute of Radiological Sciences (NIRS) as a secondary standard dosimetry laboratory (SSDL). The results of an IAEA/WHO TLD SSDL audit demonstrated that there was good agreement between NIRS stated absorbed dose to water and IAEA measurements. The IAEA guide based on the ISO standard was used to estimate the relative expanded uncertainty of the calibration factor for a therapy-level Farmer type ionization chamber in terms of absorbed dose to water (N(D,w)) with the new field. The uncertainty of N(D,w) was estimated to be 1.1% (k = 2), which corresponds to approximately one third of the value determined in the existing air kerma field. The dissemination of traceability of the calibration factor determined in the new field is expected to diminish the uncertainty of dose delivered to patients significantly.

  5. Differential Expression of Retrotransposon WIS 2-1A Response to Vacuum, Low-Energy N+ Implantation and 60Coγ-ray Irradiation in Wheat

    NASA Astrophysics Data System (ADS)

    Zhao, Huiru; Gu, Yunhong; Ya, Huiyuan; Jiao, Zhen; Qin, Guangyong

    2009-02-01

    Mutagenesis and retrotransposons have a close relationship, but little attention has been paid yet to the activity of retrotransposons produced by physical mutagens. The variation of retrotransposon WIS 2-1A activity in wheat (Triticum aestivum L.) embryos at three different growth times (30 h, 45 h and 60 h) was investigated after they had been treated with N+ implantation in a vacuum of 5 × 10-2 Pa and irradiation by 60Coγ-ray respectively. For each of the three growth times the expression of WIS 2-1A showed almost entirely a same trend of downregulation, upregulation, then downregulation, and upregulation again with the increase in dose of N+ implantation, but the expression appeared irregular with the increase in irradiation of 60Coγ-ray. In conclusion, the acutely activating effect of WIS 2-1A stimulated by vacuum and high dose N+ implantation within a shorter incubation time may provide a convenient tool to advance the research on mutagenic breeding and function genes.

  6. Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy 125I and 192Ir sources and 60Co cell irradiation.

    PubMed

    Villegas, Fernanda; Tilly, Nina; Ahnesjö, Anders

    2013-09-07

    The stochastic nature of ionizing radiation interactions causes a microdosimetric spread in energy depositions for cell or cell nucleus-sized volumes. The magnitude of the spread may be a confounding factor in dose response analysis. The aim of this work is to give values for the microdosimetric spread for a range of doses imparted by (125)I and (192)Ir brachytherapy radionuclides, and for a (60)Co source. An upgraded version of the Monte Carlo code PENELOPE was used to obtain frequency distributions of specific energy for each of these radiation qualities and for four different cell nucleus-sized volumes. The results demonstrate that the magnitude of the microdosimetric spread increases when the target size decreases or when the energy of the radiation quality is reduced. Frequency distributions calculated according to the formalism of Kellerer and Chmelevsky using full convolution of the Monte Carlo calculated single track frequency distributions confirm that at doses exceeding 0.08 Gy for (125)I, 0.1 Gy for (192)Ir, and 0.2 Gy for (60)Co, the resulting distribution can be accurately approximated with a normal distribution. A parameterization of the width of the distribution as a function of dose and target volume of interest is presented as a convenient form for the use in response modelling or similar contexts.

  7. Energy response of GR-200A thermoluminescence dosemeters to 60Co and to monoenergetic synchrotron radiation in the energy range 28-40 keV.

    PubMed

    Emiro, F; Di Lillo, F; Mettivier, G; Fedon, C; Longo, R; Tromba, G; Russo, P

    2016-01-01

    The response of LiF:Mg,Cu,P thermoluminescence dosemeters (type GR-200A) to monoenergetic radiation of energy 28, 35, 38 and 40 keV was evaluated with respect to irradiation with a calibrated (60)Co gamma-ray source. High-precision measurements of the relative air kerma response performed at the SYRMEP beamline of the ELETTRA synchrotron radiation facility (Trieste, Italy) showed a significant deviation of the average response to low-energy X-rays from that to (60)Co, with an over-response from 6 % (at 28 keV) to 22 % (at 40 keV). These data are not consistent with literature data for these dosemeters, where model predictions gave deviation from unity of the relative air kerma response of about 10 %. The authors conclude for the need of additional determinations of the low-energy relative response of GR-200A dosemeters, covering a wider range of monoenergetic energies sampled at a fine energy step, as planned in future experiments by their group at the ELETTRA facility.

  8. Characterization of the Natural Organic Matter (NOM) in groundwater contaminated with (60)Co and (137)Cs using ultrafiltration, Solid Phase Extraction and fluorescence analysis.

    PubMed

    Caron, François; Siemann, Stefan; Riopel, Rémi

    2014-12-01

    Spot samples of shallow groundwaters have been taken between the years 2004 and 2010 near a site formerly used for the dispersal of radioactive liquid wastes. Three sampling points, one clean (upstream), and two downstream of the contamination source, were processed by ultrafiltration (5000 Da cut-off) and Solid Phase Extraction (SPE) to determine the association of selected artificial radionuclides ((60)Co, (137)Cs) with Natural Organic Matter (NOM). The last two sampling episodes (2008 and 2010) also benefited from fluorescence analysis to determine the major character of the NOM. The fluorescence signals are reported as humic-like, fulvic-like and protein-like, which are used to characterize the different NOM types. The NOM from the clean site comprised mostly fine material, whereas the colloidal content (retained by ultrafiltration) was higher (e.g., 15-40% of the Total Organic Carbon - TOC). Most of the 137Cs was present in the colloidal fraction, whereas (60)Co was found in the filtered fraction. Fluorescence analysis, on the other hand, indicated a contrasting behavior between the clean and contaminated sites, with a dominance of protein-like material, a feature usually associated with human impacts. Finally, SPE removed almost quantitatively the protein-like material (>90%), whereas it removed a much smaller fraction of the (137)Cs (<28%). This finding indicates that the (137)Cs preferential binding occurs with a fraction other than the protein-like NOM, likely the fulvic-like or humic-like portion.

  9. Optimization of foaming properties of sludge protein solution by 60Co γ-ray/H2O2 using response surface methodology

    NASA Astrophysics Data System (ADS)

    Xiang, Yulin; Xiang, Yuxiu; Wang, Lipeng; Zhang, Zhifang

    2016-10-01

    Response surface methodology and Box-Behnken experimental design were used to model and optimize the operational parameters of foaming properties of the sludge protein solution by 60Co γ-ray/H2O2 treatment. The four variables involved in this research were the protein solution concentration, H2O2, pH and dose. In the range studied, statistical analysis of the results showed that selected variables had a significant effect on protein foaming properties. The optimized conditions contained: protein solution concentration 26.50% (v/v), H2O2 concentration 0.30% (v/v), pH value 9.0, and dose 4.81 kGy. Under optimal conditions, the foamability and foam stability approached 23.3 cm and 21.3 cm, respectively. Regression analysis with R2 value of 0.9923 (foamability) and 0.9922 (foam stability) indicated a satisfactory correlation between the experimental data and predicted values (response). In addition, based on a feasibility analysis, the 60Co γ-ray/H2O2 method can improve odor and color of the protein foaming solution.

  10. A study on transfer factors of 60Co and 65Zn from soil to plants in the tropical environment of Bangladesh.

    PubMed

    Mollah, A S; Begum, A

    2001-04-01

    Soil to plant transfer factor (TF) of 60Co and 65Zn was determined from radioisotope experiments on plants grown in pots under outdoor ambient tropical conditions for three growing seasons (1995-1998). The TFs were obtained for different plants/crops such as, rice, bean, peanuts pineapple, cabbage, tomato, spinach and grass. The average TF values of 60Co are found to be 0.087. 0.15, 0.12, 0.67, 0.28, 0.79, 1.03 and 0.34 respectively for the above mentioned plants/crops. In case of 65Zn, the average TF values are found to be 2.24, 1.17. 0.89, 1.09, 0.78, 1.34, 2.92 and 1.78, respectively, for the above mentioned plants/crops. The data will be useful to assess the radiation exposure to man associated with the releases of radionuclides from nuclear facilities by means of radiological assessment models that require transfer factors as input parameters to predict the contamination of radionuclides in foodchain.

  11. Evaluation of endogenous control gene(s) for gene expression studies in human blood exposed to 60Co γ-rays ex vivo.

    PubMed

    Vaiphei, S Thangminlal; Keppen, Joshua; Nongrum, Saibadaiahun; Chaubey, R C; Kma, L; Sharan, R N

    2015-01-01

    In gene expression studies, it is critical to normalize data using a stably expressed endogenous control gene in order to obtain accurate and reliable results. However, we currently do not have a universally applied endogenous control gene for normalization of data for gene expression studies, particularly those involving (60)Co γ-ray-exposed human blood samples. In this study, a comparative assessment of the gene expression of six widely used housekeeping endogenous control genes, namely 18S, ACTB, B2M, GAPDH, MT-ATP6 and CDKN1A, was undertaken for a range of (60)Co γ-ray doses (0.5, 1.0, 2.0 and 4.0 Gy) at 8.4 Gy min(-1) at 0 and 24 h post-irradiation time intervals. Using the NormFinder algorithm, real-time PCR data obtained from six individuals (three males and three females) were analyzed with respect to the threshold cycle (Ct) value and abundance, ΔCt pair-wise comparison, intra- and inter-group variability assessments, etc. GAPDH, either alone or in combination with 18S, was found to be the most suitable endogenous control gene and should be used in gene expression studies, especially those involving qPCR of γ-ray-exposed human blood samples.

  12. Recruitment in Radiotherapy

    ERIC Educational Resources Information Center

    Deeley, T. J.; And Others

    1976-01-01

    The Faculty Board of Radiotherapy and Oncology of the Royal College of Radiobiologists surveyed the factors thought to influence recruitment into the specialty. Possible factors listed in replies of 36 questionnaires are offered. (LBH)

  13. Evaluation of the EGSnrc Monte Carlo code for interface dosimetry near high-Z media exposed to kilovolt and 60Co photons.

    PubMed

    Verhaegen, Frank

    2002-05-21

    High atomic number (Z) heterogeneities in tissue exposed to photons with energies of up to about 1 MeV can cause significant dose perturbations in their immediate vicinity. The recently released Monte Carlo (MC) code EGSnrc (Kawrakow 2000a Med. Phys. 27 485-98) was used to investigate the dose perturbation of high-Z heterogeneities in tissue in kilovolt (kV) and 60Co photon beams. Simulations were performed of measurements with a dedicated thin-window parallel-plate ion chamber near a high-Z interface in a 60Co photon beam (Nilsson et al 1992 Med. Phys. 19 1413-21). Good agreement was obtained between simulations and measurements for a detailed set of experiments in which the thickness of the ion chamber window, the thickness of the air gap between ion chamber and heterogeneity, the depth of the ion chamber in polystyrene and the material of the interface was varied. The EGSnrc code offers several improvements in the electron and photon production and transport algorithms over the older EGS4/PRESTA code (Nelson et al 1985 Stanford Linear Accelerator Center Report SLAC-265. Bielajew and Rogers 1987 Nucl. Instrum. Methods Phys. Res. B 18 165-81). The influence of the new EGSnrc features was investigated for simulations of a planar slab of a high-Z medium embedded in water and exposed to kV or 60Co photons. It was found that using the new electron transport algorithm in EGSnrc, including relativistic spin effects in elastic scattering, significantly affects the calculation of dose distribution near high-Z interfaces. The simulations were found to be independent of the maximum fractional electron energy loss per step (ESTEPE), which was often a cause for concern in older EGS4 simulations. Concerning the new features of the photon transport algorithm sampling of the photoelectron angular distribution was found to have a significant effect, whereas the effect of binding energies in Compton scatter was found to be negligible. A slight dose artefact very close to high

  14. Monte Carlo-based energy response studies of diode dosimeters in radiotherapy photon beams.

    PubMed

    Arun, C; Palani Selvam, T; Dinkar, Verma; Munshi, Prabhat; Kalra, Manjit Singh

    2013-01-01

    This study presents Monte Carlo-calculated absolute and normalized (relative to a (60)Co beam) sensitivity values of silicon diode dosimeters for a variety of commercially available silicon diode dosimeters for radiotherapy photon beams in the energy range of (60)Co-24 MV. These values were obtained at 5 cm depth along the central axis of a water-equivalent phantom of 10 cm × 10 cm field size. The Monte Carlo calculations were based on the EGSnrc code system. The diode dosimeters considered in the calculations have different buildup materials such as aluminum, brass, copper, and stainless steel + epoxy. The calculated normalized sensitivity values of the diode dosimeters were then compared to previously published measured values for photon beams at (60)Co-20 MV. The comparison showed reasonable agreement for some diode dosimeters and deviations of 5-17 % (17 % for the 3.4 mm brass buildup case for a 10 MV beam) for some diode dosimeters. Larger deviations of the measurements reflect that these models of the diode dosimeter were too simple. The effect of wall materials on the absorbed dose to the diode was studied and the results are presented. Spencer-Attix and Bragg-Gray stopping power ratios (SPRs) of water-to-diode were calculated at 5 cm depth in water. The Bragg-Gray SPRs of water-to-diode compare well with Spencer-Attix SPRs for ∆ = 100 keV and above at all beam qualities.

  15. Key comparison BIPM.RI(I)-K1 of the air-kerma standards of the ININ, Mexico and the BIPM in 60Co gamma radiation

    NASA Astrophysics Data System (ADS)

    Kessler, C.; Alvarez Romero, J. T.; Tovar-Muñoz, V. M.

    2013-01-01

    A direct comparison of the standards for air kerma of the Instituto Nacional de Investigaciones Nucleares (ININ), Mexico, and of the Bureau International des Poids et Mesures (BIPM) was carried out in the 60Co radiation beam of the BIPM in 2012. The comparison result, evaluated as a ratio of the ININ and the BIPM standards for air kerma, is 1.0035 with a combined standard uncertainty of 2.1 × 10-3. The results are analysed and presented in terms of degrees of equivalence for entry in the BIPM key comparison database. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  16. Comment on 'Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy (125)I and (192)Ir sources and (60)Co cell irradiation'.

    PubMed

    Lindborg, Lennart; Lillhök, Jan; Grindborg, Jan-Erik

    2015-11-07

    The relative standard deviation, σr,D, of calculated multi-event distributions of specific energy for (60)Co ϒ rays was reported by the authors F Villegas, N Tilly and A Ahnesjö (Phys. Med. Biol. 58 6149-62). The calculations were made with an upgraded version of the Monte Carlo code PENELOPE. When the results were compared to results derived from experiments with the variance method and simulated tissue equivalent volumes in the micrometre range a difference of about 50% was found. Villegas et al suggest wall-effects as the likely explanation for the difference. In this comment we review some publications on wall-effects and conclude that wall-effects are not a likely explanation.

  17. The depth-dependence of the biological effectiveness of 60Co gamma rays in a large absorber determined by dicentric chromosomes in human lymphocytes.

    PubMed

    Schmid, Ernst; Roos, Hartmut; Kramer, Hans-Michael

    2008-01-01

    Radiobiological evidence is shown concerning a significant depth-dependence of the maximum relative biological effectiveness at limiting low doses (RBE(M)) of (60)Co gamma rays in a cubic polymethylmethacrylate (PMMA) phantom of 30 cm edge length. Using the dose-response curve for the dicentric data in human lymphocytes obtained in the present experiment at a depth of 20 cm, together with the comprehensive and consistent data set determined earlier at smaller depths of the PMMA phantom, there is an increase in the RBE(M) value by a factor of 2.18 +/- 1.25 at a depth of 20 cm relative to 1 cm in the phantom. All the dicentric data are based on identical exposure durations and irradiation temperatures as well as identical culture and evaluation conditions, with blood from the same donor.

  18. Key comparison BIPM.RI(I)-K1 of the air-kerma standards of the NIM, China and the BIPM in 60Co gamma radiation

    NASA Astrophysics Data System (ADS)

    Kessler, C.; Burns, D.; Wang, K.; Fan, Y.; Jin, S.; Yang, X.

    2016-01-01

    An indirect comparison of the standards for air kerma of the National Institute of Metrology (NIM), China and of the Bureau International des Poids et Mesures (BIPM) was carried out in the 60Co radiation beam of the BIPM in November 2015. The comparison result, evaluated as a ratio of the NIM and the BIPM standards for air kerma, is 0.9997 with a combined standard uncertainty of 2.7 × 10-3. The results are analysed and presented in terms of degrees of equivalence for entry in the BIPM key comparison database. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  19. Relative biological effectiveness of 144 keV neutrons in producing dicentric chromosomes in human lymphocytes compared with 60Co gamma rays under head-to-head conditions.

    PubMed

    Schmid, E; Regulla, D; Guldbakke, S; Schlegel, D; Roos, M

    2002-04-01

    The RBE for neutrons was assessed in a head-to-head experiment in which cultures of lymphocytes from the same male donor were irradiated simultaneously with 144 keV neutrons and with 60Co gamma rays as the reference radiation and evaluated using matched time, culture conditions, and the end point of chromosomal aberrations to avoid potential confounding factors that would influence the outcome of the experiment. In addition, the irradiation time was held constant at 2 h for the high-dose groups for both radiation types, which resulted in rather low dose rates. For the induction of dicentric chromosomes, the exposure to the 144 keV neutrons was found to be almost equally as effective (yield coefficient alpha(dic) = 0.786 +/- 0.066 dicentrics per cell per gray) as that found previously for irradiation with monoenergetic neutrons at 565 keV (alpha(dic) = 0.813 +/- 0.052 dicentrics per cell per gray) under comparable exposure and culture conditions (Radiat. Res. 154, 307-312, 2000). However, the values of the maximum low-dose RBE (RBE(m)) relative to 60Co gamma rays that were determined in the present and previous studies show an insignificant but conspicuous difference: 57.0 +/- 18.8 and 76.0 +/- 29.5, respectively. This difference is mainly due to the difference in the alpha(dic) value of the 60Co gamma rays, the reference radiation, which was 0.0138 +/- 0.0044 Gy(-1) in the present study and 0.0107 +/- 0.0041 Gy(-1) in the previous study. In the present experiment, irradiations with 144 keV neutrons and 60Co gamma rays were both performed at 21 degrees C, while in the earlier experiment irradiations with 565 keV neutrons were performed at 21 degrees C and the corresponding reference irradiation with gamma rays was performed at 37 degrees C. However, the temperature difference between 21 degrees C and 37 degrees C has a minor influence on the yield of chromosomal alterations and hence RBE values. The large cubic PMMA phantom that was used for the gamma irradiations

  20. Combination of /sup 60/Co. gamma. -radiation, misonidazole, and maltose tetrapalmitate in the treatment of Dunning prostatic tumor in the rat

    SciTech Connect

    Pageau, R.; Nigam, V.N.; Fisher, G.J.; Brailovsky, C.A.; Fathi, M.A.; Corcos, J.; Tahan, T.W.; Elhilali, M.M.

    1985-08-01

    Maltose tetrapalmitate (MTP), a synthetic nontoxic immunoadjuvant, the radiosensitizer misonidazole (MISO), and /sup 60/Co ..gamma..-radiation, alone or in combination, were used in the management of Dunning prostatic tumor in the rat. Nine groups of 10 rats each were used to assess the efficacy of various therapeutic modalities. Tumor growth rates and animal survival times were determined for each group. Radiation was more effective when combined with MTP, but the adjuvant must be present when radiation is given for synergism to occur. MISO was as effective as MTP when used with radiation, but combining them cancels out their individual effects. In a clinical situation it would be advantageous to use separately the synergisms existing between MISO and radiation on the one hand and MTP and radiation on the other hand.

  1. [Radiotherapy of larynx cancers].

    PubMed

    Pointreau, Y; Lafond, C; Legouté, F; Trémolières, P; Servagi-Vernat, S; Giraud, P; Maingon, P; Calais, G; Lapeyre, M

    2016-09-01

    Intensity-modulated radiotherapy is the gold standard in the treatment of larynx cancers (except T1 glottic tumour). Early T1 and T2 tumours may be treated by exclusive radiation or surgery. For tumours requiring total laryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy is possible. For T4 tumour, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, the curative dose is 70Gy and the prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used in locally advanced cancer with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation was based on guidelines.

  2. Determination of the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co

    SciTech Connect

    Reed, J. L. Micka, J. A.; Culberson, W. S.; DeWerd, L. A.; Rasmussen, B. E.; Davis, S. D.

    2014-12-15

    Purpose: To determine the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co. Methods: LiF:Mg,Ti TLDs were irradiated with low-energy brachytherapy sources and with a {sup 60}Co teletherapy source. The brachytherapy sources measured were the Best 2301 {sup 125}I seed, the OncoSeed 6711 {sup 125}I seed, and the Best 2335 {sup 103}Pd seed. The TLD light output per measured air-kerma strength was determined for the brachytherapy source irradiations, and the TLD light output per air kerma was determined for the {sup 60}Co irradiations. Monte Carlo (MC) simulations were used to calculate the dose-to-TLD rate per air-kerma strength for the brachytherapy source irradiations and the dose to TLD per air kerma for the {sup 60}Co irradiations. The measured and MC-calculated results for all irradiations were used to determine the TLD intrinsic energy dependence for {sup 125}I and {sup 103}Pd relative to {sup 60}Co. Results: The relative TLD intrinsic energy dependences (relative to {sup 60}Co) and associated uncertainties (k = 1) were determined to be 0.883 ± 1.3%, 0.870 ± 1.4%, and 0.871 ± 1.5% for the Best 2301 seed, OncoSeed 6711 seed, and Best 2335 seed, respectively. Conclusions: The intrinsic energy dependence of TLD-100 is dependent on photon energy, exhibiting changes of 13%–15% for {sup 125}I and {sup 103}Pd sources relative to {sup 60}Co. TLD measurements of absolute dose around {sup 125}I and {sup 103}Pd brachytherapy sources should explicitly account for the relative TLD intrinsic energy dependence in order to improve dosimetric accuracy.

  3. [Radiotherapy for retroperitoneal sarcomas].

    PubMed

    Sargos, P; Stoeckle, E; Henriques de Figueiredo, B; Antoine, M; Delannes, M; Mervoyer, A; Kantor, G

    2016-10-01

    The management of retroperitoneal sarcoma can be very challenging, and the quality of initial treatment strategy appears to be a crucial prognostic factor. En bloc surgery is currently the standard of care for these rare tumours and perioperative treatments such as chemotherapy or radiotherapy have not been validated yet. However, local-regional relapse constitutes the most common disease course. While adjuvant radiotherapy is less and less common due to gastrointestinal toxicities, preoperative radiation therapy offers numerous advantages and is being evaluated as part of a national multicentre phase II study (TOMOREP trial) and is the subject of a European randomized phase III study (STRASS trial). The objective of this article is to present data on preoperative irradiation in terms of dose, volumes and optimal radiotherapy techniques for the treatment of this rare disease.

  4. Radiotherapy for lung cancer

    SciTech Connect

    Bleehen, N.M.; Cox, J.D.

    1985-05-01

    The role of radiation therapy in the management of lung cancer was reviewed at a workshop held in Cambridge, England, in June 1984. It was concluded that there was a continuing role for radiation therapy in the primary management of small cell lung cancer, including the loco-regional treatment for patients with limited disease. Radical radiotherapy for patients with non-small cell carcinoma could be curative for a proportion of patients with limited disease. Careful planning and quality control was essential. Palliative radiotherapy provided useful treatment for many other patients. Other related aspects of treatment are also presented.

  5. Adaptive hormetic response of pre-exposure of mouse brain with low-dose 12C 6+ ion or 60Co γ-ray on growth hormone (GH) and body weight induced by subsequent high-dose irradiation

    NASA Astrophysics Data System (ADS)

    Zhang, Hong; Xie, Yi; Zhou, Qingming; Liu, Bing; Li, Wenjian; Li, Xiaoda; Duan, Xin; Yuan, Zhigang; Zhou, Guangming; Min, Fengling

    2006-01-01

    The brain of the Kun-Ming strain mice were irradiated with 0.05 Gy of 12C 6+ ion or 60Co γ-ray as the pre-exposure dose, and were then irradiated with 2 Gy of 12C 6+ ion or 60Co γ-ray as challenging irradiation dose at 4 h after per-exposure. Body weight and serum growth hormone (GH) concentration were measured at 35th day after irradiation. The results showed that irradiation of mouse brain with 2 Gy of 12C 6+ ion or 60Co γ-ray significantly diminished mouse body weight and level of serum GH. The relative biological effectiveness values of a 2 Gy dose of 12C 6+ ion calculated with respect to 60Co γ-ray were 1.47 and 1.34 for body weight and serum GH concentration, respectively. Pre-exposure with a low-dose (0.05 Gy) of 12C 6+ ion or 60Co γ-ray significantly alleviated reductions of mouse body weight and level of serum GH induced by a subsequent high-dose (2 Gy) irradiation. The data suggested that low-dose ionizing irradiation can induce adaptive hormetic responses to the harmful effects of pituitary by subsequent high-dose exposure.

  6. Californium versus cobalt brachytherapy combined with external-beam radiotherapy for IIB stage cervical cancer: long-term experience of a single institute

    PubMed Central

    Janulionis, Ernestas; Valuckas, Konstantinas Povilas; Samerdokiene, Vitalija; Atkocius, Vydmantas

    2015-01-01

    Purpose The purpose of this paper was to observe and compare long-term curative effects and complications of FIGO stage IIB cervical cancer patients (n = 232) treated with high-dose-rate (HDR) californium (252Cf) neutron or cobalt (60Co) photon intracavitary brachytherapy (ICBT) combined with external-beam radiotherapy (EBRT). Material and methods The EBRT dose to the small pelvis was 50 Gy in both groups. The brachytherapy component of 252Cf or 60Co was added in the 3rd week of EBRT, 5 fractions were performed once per week resulting in a total ICBT dose of 40 Gy/Gyeq (point A). Results Overall survival (OS) at 5, 10 and 15 years was 63.6%, 50.4% and 38.8% in the 252Cf group and 62.2%, 50.5%, 39.9%, in the 60Co group, respectively (p = 0.74). The percentage of tumour recurrence was statistically significantly lower in the 252Cf group with 7.4% versus 17.1% in the 60Co group (p = 0.02). Second primary cancers have developed similarly 9.1% and 8.1% cases for 252Cf and 60Co groups, respectively. Conclusions Our long-term retrospective study comparing 252Cf and 60Co isotopes with brachytherapy in combined treatment of FIGO IIB stage cervix carcinoma patients shows, that overall survival in the both groups are similar. However, the recurrence of tumour was significantly lower in the 252Cf group. The incidence of second primary cancers was similar in both groups. PMID:26622239

  7. Precision radiotherapy for brain tumors

    PubMed Central

    Yan, Ying; Guo, Zhanwen; Zhang, Haibo; Wang, Ning; Xu, Ying

    2012-01-01

    OBJECTIVE: Precision radiotherapy plays an important role in the management of brain tumors. This study aimed to identify global research trends in precision radiotherapy for brain tumors using a bibliometric analysis of the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for precision radiotherapy for brain tumors containing the key words cerebral tumor, brain tumor, intensity-modulated radiotherapy, stereotactic body radiation therapy, stereotactic ablative radiotherapy, imaging-guided radiotherapy, dose-guided radiotherapy, stereotactic brachytherapy, and stereotactic radiotherapy using the Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed articles on precision radiotherapy for brain tumors which were published and indexed in the Web of Science; (b) type of articles: original research articles and reviews; (c) year of publication: 2002-2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) Corrected papers or book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to country; (3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on precision radiotherapy for brain tumors. RESULTS: The stereotactic radiotherapy, intensity-modulated radiotherapy, and imaging-guided radiotherapy are three major methods of precision radiotherapy for brain tumors. There were 260 research articles addressing precision radiotherapy for brain tumors found within the Web of Science. The USA published the most papers on precision radiotherapy for brain tumors, followed by Germany and France. European Synchrotron Radiation Facility, German Cancer Research Center and Heidelberg University were the most prolific research institutes for publications on precision radiotherapy for brain tumors. Among the top 13 research institutes publishing in this field, seven

  8. [Radiotherapy of breast cancer].

    PubMed

    Hennequin, C; Barillot, I; Azria, D; Belkacémi, Y; Bollet, M; Chauvet, B; Cowen, D; Cutuli, B; Fourquet, A; Hannoun-Lévi, J M; Leblanc, M; Mahé, M A

    2016-09-01

    In breast cancer, radiotherapy is an essential component of the treatment. After conservative surgery for an infiltrating carcinoma, radiotherapy must be systematically performed, regardless of the characteristics of the disease, because it decreases the rate of local recurrence and by this way, specific mortality. Partial breast irradiation could not be proposed routinely but only in very selected and informed patients. For ductal carcinoma in situ, adjuvant radiotherapy must be also systematically performed after lumpectomy. After mastectomy, chest wall irradiation is required for pT3-T4 tumours and if there is an axillary nodal involvement, whatever the number of involved lymph nodes. After neo-adjuvant chemotherapy and mastectomy, in case of pN0 disease, chest wall irradiation is recommended if there is a clinically or radiologically T3-T4 or node positive disease before chemotherapy. Axillary irradiation is recommended only if there is no axillary surgical dissection and a positive sentinel lymph node. Supra and infra-clavicular irradiation is advised in case of positive axillary nodes. Internal mammary irradiation must be discussed case by case, according to the benefit/risk ratio (cardiac toxicity). Dose to the chest wall or the breast must be between 45-50Gy with a conventional fractionation. A boost dose over the tumour bed is required if the patient is younger than 60 years old. Hypofractionation (42.5 Gy in 16 fractions, or 41.6 Gy en 13 or 40 Gy en 15) is possible after tumorectomy and if a nodal irradiation is not mandatory. Delineation of the breast, the chest wall and the nodal areas are based on clinical and radiological evaluations. 3D-conformal irradiation is the recommended technique, intensity-modulated radiotherapy must be proposed only in case of specific clinical situations. Respiratory gating could be useful to decrease the cardiac dose. Concomitant administration of chemotherapy in unadvised, but hormonal treatment could be start with

  9. Dosimetric and geometric evaluation of a novel stereotactic radiotherapy device for breast cancer: The GammaPod Trade-Mark-Sign

    SciTech Connect

    Mutaf, Yildirim D.; Yi, Byong Yong; Prado, Karl; D'Souza, Warren D.; Regine, William F.; Feigenberg, Steven J.; Zhang Jin; Yu, Cedric X.

    2013-04-15

    Purpose: A dedicated stereotactic gamma irradiation device, the GammaPod Trade-Mark-Sign from Xcision Medical Systems, was developed specifically to treat small breast cancers. This study presents the first evaluation of dosimetric and geometric characteristics from the initial prototype installed at University of Maryland Radiation Oncology Department. Methods: The GammaPod Trade-Mark-Sign stereotactic radiotherapy device is an assembly of a hemi-spherical source carrier containing 36 {sup 60}Co sources, a tungsten collimator, a dynamically controlled patient support table, and the breast immobilization system which also functions as a stereotactic frame. The source carrier contains the sources in six columns spaced longitudinally at 60 Degree-Sign intervals and it rotates together with the variable-size collimator to form 36 noncoplanar, concentric arcs focused at the isocenter. The patient support table enables motion in three dimensions to position the patient tumor at the focal point of the irradiation. The table moves continuously in three cardinal dimensions during treatment to provide dynamic shaping of the dose distribution. The breast is immobilized using a breast cup applying a small negative pressure, where the immobilization cup is embedded with fiducials also functioning as the stereotactic frame for the breast. Geometric and dosimetric evaluations of the system as well as a protocol for absorbed dose calibration are provided. Dosimetric verifications of dynamically delivered patient plans are performed for seven patients using radiochromic films in hypothetical preop, postop, and target-in-target treatment scenarios. Results: Loaded with 36 {sup 60}Co sources with cumulative activity of 4320 Ci, the prototype GammaPod Trade-Mark-Sign unit delivers 5.31 Gy/min at the isocenter using the largest 2.5 cm diameter collimator. Due to the noncoplanar beam arrangement and dynamic dose shaping features, the GammaPod Trade-Mark-Sign device is found to deliver

  10. Monitoring of tritium, 60Co and 137Cs in the vicinity of the warm water outlet of the Paks Nuclear Power Plant, Hungary.

    PubMed

    Janovics, R; Bihari, Á; Papp, L; Dezső, Z; Major, Z; Sárkány, K E; Bujtás, T; Veres, M; Palcsu, L

    2014-02-01

    Danube water, sediment and various aquatic organisms (snail, mussel, predatory and omnivorous fish) were collected upstream (at a background site) and downstream of the outlet of the warm water channel of Paks Nuclear Power Plant. Gamma emitters, tissue free-water tritium (TFWT) and total organically-bound tritium (T-OBT) measurements were performed. A slight contribution of the power plant to the natural tritium background concentration was measured in water samples from the Danube section downstream of the warm water channel. Sediment samples also contained elevated tritium concentrations, along with a detectable amount of (60)Co. In the case of biota samples, TFWT exhibited only a very slight difference compared to the tritium concentration of the Danube water, however, the OBT was higher than the tritium concentration in the Danube, independent of the origin of the samples. The elevated OBT concentration in the mollusc samples downstream of the warm water channel may be attributed to the excess emission from the nuclear power plant. The whole data set obtained was used for dose rate calculations and will be contributed to the development of the ERICA database.

  11. Comparative effects of protracted exposures to 60Co gamma-radiation and 239Pu alpha-radiation on breeding performance in female mice..

    PubMed

    Searle, A G; Beechey, C V; Green, D; Howells, G R

    1980-02-01

    Breeding performances are compared of hybrid female mice given 239Pu (5 or 10 mu Cikg-1 body mass in 1% trisodium citrate via the tail-vein), or kept in a 10 rad/day or 20 rad/day 60Co gamma-irradiation field (but mated in the control area), or unirradiated. Ovarian dose-rates from the injected plutonium were initially 0.8 and 1.7 rad/day, changing little thereafter; actual gamma-ray dose-rates to breeding females averaged around 8 and 16 rad/day respectively. Both gamma-ray treatments affected reproductive performance more than the plutonium injections, with respet to duration of fertility and to offspring per litter in successive 4-weekly periods, though overall mean litter-sizes were not significantly less than controls. The r.b.e. for these effects on reproduction, attributed to germ-cell killing, is about 2.5 for the alpha-particles vs. gamma-rays, lower than for testis mass reduction in males. This low r.b.e. may be connected with inhomogeneity of alpha-particle dose within the ovary, but it is known that fission neutron versus gamma r.b.e.'s for impairment of female fertility are also lower than those for impairment of male fertility.

  12. The effect of. gamma. irradiation and cystamine on superoxide dismutase activity in the bone marrow and erythocytes of rats. [/sup 60/Co

    SciTech Connect

    Krizala, J.; Stoklasova, A.; Kovarova, H.; Ledvina, M.

    1982-09-01

    The effect of a single dose of cystamine (50 mg/kg body wt; ip) on superoxide dismutase activity (E.C. 1.15.1.1; SOD) was studied in the cytosol fraction of bone marrow cells and erythrocytes of peripheral blood. The experiments were carried out on irradiated (8.0 Gy /sup 60/Co) and nonirradiated male Wistar rats. Whole-body irradiation caused a decrease in the specific activity of superoxide dismutase in the bone marrow which persisted for more than 14 days, whereas an increased activity occurred in erythrocytes at the same intervals. Cystamine administration to rats prior to irradiation led to decreased SOD activity in the bone marrow that was less pronounced than in the nonprotected, irradiated animals. In erythrocytes, treatment with cystamine prior to irradiation considerably increased SOD activity (especially on Day 14); this increase was much more pronounced than that after either cystamine administration or irradiation. The administration of cystamine to nonirradiated animals led to a decrease in SOD activity in the bone marrow on the third day only; however, in erythrocytes the activity increased (mostly on Day 14). Irradiation of the bone marrow was reflected in a substantial decrease of its cellularity that was, to a certain extent, normalized after cystamine treatment. The SOD activity per bone marrow cell (expressed in U/10/sup 6/ cells) was increased in the protected rats on the third day after irradiation, but this increase was not as pronounced as in nonprotected, irradiated rats.

  13. Key comparison BIPM.RI(I)-K4 of the absorbed dose to water standards of the PTB, Germany and the BIPM in 60Co gamma radiation

    NASA Astrophysics Data System (ADS)

    Kessler, C.; Burns, D. T.; Kapsch, R.-P.; Krauss, A.

    2016-01-01

    An indirect comparison has been made of the standards for absorbed dose to water in 60Co radiation of the Physikalisch-Technische Bundesanstalt, (PTB), Germany and of the Bureau International des Poids et Mesures (BIPM). The measurements at the BIPM were carried out in October 2015. The comparison result, based on the calibration coefficients for two transfer standards and evaluated as a ratio of the PTB and the BIPM standards for absorbed dose to water, is 0.9977 with a combined standard uncertainty of 3.8 × 10-3. The results are analysed and presented in terms of degrees of equivalence for entry in the BIPM key comparison database. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  14. Optimization of process parameters for the inactivation of Lactobacillus sporogenes in tomato paste with ultrasound and 60Co- γ irradiation using response surface methodology

    NASA Astrophysics Data System (ADS)

    Ye, Sheng-Ying; Qiu, Yuan-Xin; Song, Xian-Liang; Luo, Shu-Can

    2009-03-01

    The processing parameters for ultrasound and 60Co- γ irradiation were optimized for their ability to inactivate Lactobacillus sporogenes in tomato paste using a systematic experimental design based on response surface methodology. Ultrasonic power, ultrasonic processing time and irradiation dose were explored and a central composite rotation design was adopted as the experimental plan, and a least-squares regression model was obtained. The significant influential factors for the inactivation rate of L. sporogenes were obtained from the quadratic model and the t-test analyses for each process parameter. Confirmation of the experimental results indicated that the proposed model was reasonably accurate and could be used to describe the efficacy of the treatments for inactivating L. sporogenes within the limits of the factors studied. The optimized processing parameters were found to be an ultrasonic power of 120 W with a processing time of 25 min and an irradiation dose of 6.5 kGy. These were measured under the constraints of parameter limitation, based on the Monte Carlo searching method and the quadratic model of the response surface methodology, including the a/ b value of the Hunter color scale of tomato paste. Nevertheless, the ultrasound treatment prior to irradiation for the inactivation of L. sporogenes in tomato paste was unsuitable for reducing the irradiation dose.

  15. Key comparison BIPM.RI(I)-K1 of the air-kerma standards of the SCK.CEN, Belgium and the BIPM in 60Co gamma radiation

    NASA Astrophysics Data System (ADS)

    Kessler, C.; Burns, D.; Mihailescu, L. C.; Chiriotti, S.

    2017-01-01

    A first key comparison of the standards for air kerma of the Laboratory for Nuclear Calibrations (LNK) from the Studiecentrum voor Kernenergie—Centre d'Etude de l'Energie Nucleaire (SCK.CEN), Belgium and of the Bureau International des Poids et Mesures (BIPM) was carried out in the 60Co radiation beam of the BIPM in September 2016. The comparison result, evaluated as a ratio of the SCK.CEN and the BIPM standards for air kerma, is 1.0021 with a combined standard uncertainty of 2.6 × 10-3. The results for an indirect comparison made at the same time are consistent with the direct results at the level of 7 parts in 104. The results are analysed and presented in terms of degrees of equivalence, suitable for entry in the BIPM key comparison database. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  16. Evaluation of transport and storage of 60Co, 134Cs, 137Cs and 65Zn by river sediments in the lower Susquehanna River.

    PubMed

    McLean, R I; Summers, J K

    1990-01-01

    The Peach Bottom Atomic Power Station (PBAPS) has contributed measurable quantities of radioactivity to Conowingo Reservoir, an impoundment of the lower Susquehanna River. As part of an ongoing radiological assessment program, concentrations of plant-related radionuclides in sediments have been monitored in spring and fall since 1980. Mass balance estimates derived from grab samples of surface sediments (< 10 cm) indicate that less than 20% of reactor released (60)Co, (65)Zn, (134)Cs and (137)Cs is present in these sediments. Significant seasonal variations in radionuclide trapping efficiency by the reservoir are not apparent. Deep core samples (c. 200 cm) confirm that some, but not all, of this surface sediment radionuclide inventory remains within the reservoir-trapped in discrete locations by subsequent sediment accumulation. The remaining radionuclide mass, in dissolved or particle-associated form, appears to be transported downstream, through Conowingo Dam, to upper Chesapeake Bay. The detection of PBAPS-derived radionuclides in the sediments of upper Chesapeake Bay, primarily the Susquehanna Flats, confirms the transport of these radionuclides from the lower Susquehanna River.

  17. [Radiotherapy for Graves' ophthalmopathy].

    PubMed

    Kuhnt, T; Müller, A C; Janich, M; Gerlach, R; Hädecke, J; Duncker, G I W; Dunst, J

    2004-11-01

    Graves' ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease, an autoimmune disorder of the thyroid, whereas the precise pathogenesis still remains unclear. In Hashimoto's thyroiditis the occurrence of proptosis is an extremely rare event. The therapy for middle and severe courses of GO shows in partly disappointing results, although several therapy modalities are possible (glucocorticoid therapy, radiotherapy, antithyroid drug treatment, surgery). All these therapies lead in only 40 - 70 % to an improvement of the pathogenic symptoms. An intensive interdisciplinary cooperation is necessary to satisfy the requirements for the treatment of Graves' ophthalmopathy. As a consequence of the very different results of the few of clinical studies that were accomplished with reference to this topic, treatment by radiotherapy in the management of the disease is presently controversially discussed. In the German-speaking countries the radiotherapy is, however, firmly established as a therapy option in the treatment of the moderate disease classes (class 2-5 according to NO SPECS), especially if diplopia is present. This article describes the sequences, dosages and fractionation schemes as well as the risks and side effects of the radiotherapy. Altogether, radiotherapy is assessed as an effective and sure method. The administration of glucocorticoids can take place before the beginning of or during the radiotherapy. For the success of treatment the correct selection of patients who may possibly profit from a radiotherapy is absolutely essential. By realising that GO proceeds normally over a period of 2-5 years, which is followed by a period of fibrotic alteration, the application of the radiotherapy in the early, active phase is indispensable. A precise explanation for the effects of radiotherapy in treatment of the GO does not exist at present. The determination of the most effective irradiation doses was made from retrospectively evaluated

  18. Radiotherapy for bone pain.

    PubMed Central

    Needham, P R; Mithal, N P; Hoskin, P J

    1994-01-01

    Painful bone metastases are a common problem for cancer patients. Although current evidence supports the use of a single fraction of radiotherapy as the treatment of choice, many radiotherapists, for a variety of reasons, continue to use fractionated regimens. Over one six month period 105 patients received external beam irradiation for painful bone metastases at the Royal London Hospital (RLH). Thirty-one per cent of the patients were aged 70 or over. The treatment of 97 of these patients was assessed. They had a total of 280 sites treated over the course of their disease. Fifty-nine per cent of sites treated received a fractionated course of radiotherapy. Site significantly influenced fractionation. Overall response rates of 82% were achieved. Fractionation did not appear to influence this. Ten patients received large field irradiation. Fifteen patients had five or more sites irradiated, of whom only one received hemibody irradiation. PMID:7523672

  19. Melanoma: Last call for radiotherapy.

    PubMed

    Espenel, Sophie; Vallard, Alexis; Rancoule, Chloé; Garcia, Max-Adrien; Guy, Jean-Baptiste; Chargari, Cyrus; Deutsch, Eric; Magné, Nicolas

    2017-02-01

    Melanoma is traditionally considered to be a radioresistant tumor. However, radiotherapy and immunotherapy latest developments might upset this radiobiological dogma. Stereotactic radiotherapy allows high dose per fraction delivery, with high dose rate. More DNA lethal damages, less sublethal damages reparation, endothelial cell apoptosis, and finally clonogenic cell dysfunction are produced, resulting in improved local control. Radiotherapy can also enhance immune responses, inducing neoantigens formation, tumor antigen presentation, and cytokines release. A synergic effect of radiotherapy with immunotherapy is expected, and might lead to abscopal effects. If hadrontherapy biological properties seem able to suppress hypoxia-induced radioresistance and increase biological efficacy, ballistic advantages over photon radiations might also improve radiotherapy outcomes on usually poor prognosis locations. The present review addresses biological and clinical effects of high fraction dose, bystander effect, abscopal effect, and hadrontherapy features in melanoma. Clinical trials results are warranted to establish indications of innovative radiotherapy in melanoma.

  20. Accident prevention in radiotherapy

    PubMed Central

    Holmberg, O

    2007-01-01

    In order to prevent accidents in radiotherapy, it is important to learn from accidents that have occurred previously. Lessons learned from a number of accidents are summarised and underlying patterns are looked for in this paper. Accidents can be prevented by applying several safety layers of preventive actions. Categories of these preventive actions are discussed together with specific actions belonging to each category of safety layer. PMID:21614274

  1. [Radiotherapy of bladder cancer].

    PubMed

    Riou, O; Chauvet, B; Lagrange, J-L; Martin, P; Llacer Moscardo, C; Charissoux, M; Lauche, O; Aillères, N; Fenoglietto, P; Azria, D

    2016-09-01

    Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.

  2. Radiotherapy DICOM packet sniffing.

    PubMed

    Ackerly, T; Gesoand, M; Smith, R

    2008-09-01

    The Digital Imaging and Communications in Medicine (DICOM) standard is meant to allow communication of medical images between equipment provided by different vendors, but when two applications do not interact correctly in a multi-vendor environment it is often first necessary to demonstrate non-compliance of either the sender or the receiver before a resolution to the problem can be progressed. Sometimes the only way to do this is to monitor the network communication between the two applications to find out which one is not complying with the DICOM standard. Packet sniffing is a technique of network traffic analysis by passive observation of all information transiting a point on the network, regardless of the specified sender or receiver. DICOM packet sniffing traps and interprets the network communication between two DICOM applications to determine which is non compliant. This is illustrated with reference to three examples, a radiotherapy planning system unable to receive CT data from a particular CT scanner, a radiotherapy simulator unable to print correctly on a DICOM printer, and a PACS unable to respond when queried about what images it has in its archive by a radiotherapy treatment planning system. Additionally in this work it has been proven that it is feasible to extract DICOM images from the intercepted network data. This process can be applied to determine the cause of a DICOM image being rendered differently by the sender and the receiver.

  3. Imaging in radiotherapy.

    PubMed

    Van den Berge, D L; De Ridder, M; Storme, G A

    2000-10-01

    Radiotherapy, more then any other treatment modality, relies heavily and often exclusively on medical imaging to determine the extent of disease and the spatial relation between target region and neighbouring healthy tissues. Radically new approaches to radiation delivery are inspired on CT scanning and treat patients in a slice-by-slice fashion using intensity modulated megavoltage fan beams. For quality assurance of complex 3-D dose distributions, MR based 3-D verificative dosimetry on irradiated phantoms has been described. As treatment delivery becomes increasingly refined, the need for accurate target definition increases as well and sophisticated imaging tools like image fusion and 3-D reconstruction are routinely used for treatment planning. While in the past patients were positioned on the treatment machines based exclusively on surface topography and the well-known skin marks, such approach is no longer sufficient for high-accuracy radiotherapy and special imaging tools like on-line portal imaging are used to verify and correct target positioning. Much of these applications rely on digital image processing, transmission and storage, and the development of standards, like DICOM and PACS have greatly contributed to these applications. Digital imaging plays an increasing role in many areas in radiotherapy and has been fundamental in new developments that have demonstrated impact on patient care.

  4. Living/controlled free radical copolymerization of chlorotrifluoroethene and butyl vinyl ether under 60Co γ-ray irradiation in the presence of S-benzyl O-ethyl dithiocarbonate.

    PubMed

    Liu, Lei; Lu, Dan; Wang, Hu; Dong, Qibao; Wang, Pucheng; Bai, Ruke

    2011-07-21

    Living/controlled free radical copolymerization of chlorotrifluoroethene and butyl vinyl ether has been successfully achieved at room temperature under (60)Co γ-ray irradiation in the presence of S-benzyl O-ethyl dithiocarbonate. The alternating and block copolymers have been obtained with well-defined molecular weights and narrow molecular weight distributions.

  5. The RBE of 3.4 MeV alpha-particles and 0.565 MeV neutrons relative to 60Co gamma-rays for neoplastic transformation of human hybrid cells and the impact of culture conditions.

    PubMed

    Frankenberg-Schwager, M; Spieren, S; Pralle, E; Giesen, U; Brede, H J; Thiemig, M; Frankenberg, D

    2010-01-01

    The neoplastic transformation of human hybrid CGL1 cells is affected by perturbations from external influences such as serum batch and concentration, the number of medium changes during the 21-day expression period and cell seeding density. Nevertheless, for doses up to 1.5 Gy, published transformation frequencies for low linear energy transfer (LET) radiations (gamma-rays, MeV electrons or photons) are in good agreement, whereas for higher doses larger variations are reported. The (60)Co gamma-ray data here for doses up to 1.5 Gy, using a low-yield serum batch and only one medium change, are in agreement with published frequencies of neoplastic transformation of human hybrid cells. For 3.4 MeV alpha-particles (LET = 124 keV/mum) and 0.565 MeV monoenergetic neutrons relative to low doses of (60)Co gamma-rays, a maximum relative biological effectiveness (RBE(M)) of 2.8 +/- 0.2 and 1.5 +/- 0.2, respectively, was calculated. Surprisingly, at higher doses of (60)Co gamma-rays lower frequencies of neoplastic transformation were observed. This non-monotonic dose relationship for neoplastic transformation by (60)Co gamma-rays is likely due to the lack of a G2/M arrest observed at low doses resulting in higher transformation frequencies per dose, whereas the lower frequencies per dose observed for higher doses are likely related to the induction of a G2/M arrest.

  6. Consecutive C[subscript 60] Fullerene Dissociation from Ir([eta][superscript 2]-C[subscript 60])(CO)(Cl)(PPh[subscript 3])[subscript 2] and the Oxidative Addition of Benzene

    ERIC Educational Resources Information Center

    Felix, Tamara; Cortes-Figueroa, Jose E.

    2010-01-01

    This laboratory activity is a mechanistic exploration of the interactions between electronically deficient organometallic compounds and solvent molecules. Simple kinetics experiments designed to explore the mechanism of C[subscript 60] fullerene-benzene exchange on Ir(([eta][superscript 2]-C[subscript 60])(CO)(Cl)(PPh[subscript 3])[subscript 2]…

  7. Synergistic Effects of Incubation in Rotating Bioreactors and Cumulative Low Dose 60Co γ-ray Irradiation on Human Immortal Lymphoblastoid Cells

    NASA Astrophysics Data System (ADS)

    Wei, Lijun; Han, Fang; Yue, Lei; Zheng, Hongxia; Yu, Dan; Ma, Xiaohuan; Cheng, Huifang; Li, Yu

    2012-11-01

    The complex space environments can influence cell structure and function. The research results on space biology have shown that the major mutagenic factors in space are microgravity and ionizing radiation. In addition, possible synergistic effects of radiation and microgravity on human cells are not well understood. In this study, human immortal lymphoblastoid cells were established from human peripheral blood lymphocytes and the cells were treated with low dose (0.1, 0.15 and 0.2 Gy) cumulative 60Co γ-irradiation and simulated weightlessness [obtained by culturing cells in the Rotating Cell Culture System (RCCS)]. The commonly used indexes of cell damage such as micronucleus rate, cell cycle and mitotic index were studied. Previous work has proved that Gadd45 (growth arrest and DNA-damage-inducible protein 45) gene increases with a dose-effect relationship, and will possibly be a new biological dosimeter to show irradiation damage. So Gadd45 expression is also detected in this study. The micronucleus rate and the expression of Gadd45α gene increased with irradiation dose and were much higher after incubation in the rotating bioreactor than that in the static irradiation group, while the cell proliferation after incubation in the rotating bioreactor decreased at the same time. These results indicate synergetic effects of simulated weightlessness and low dose irradiation in human cells. The cell damage inflicted by γ-irradiation increased under simulated weightlessness. Our results suggest that during medium- and long-term flight, the human body can be damaged by cumulative low dose radiation, and the damage will even be increased by microgravity in space.

  8. [Protective effects of WR2721 on early bone marrow hematopoietic function in mice exposed to 6.5 Gy of (60)Co γ-rays].

    PubMed

    Deng, Zi-Liang; Zhang, Liu-Zhen; Cong, Yue; Liu, Xiao-Lan; Yu, Zu-Ying; Shan, Ya-Jun; Cui, Yu; Wang, Li-Mei; Xing, Shuang; Cong, Yu-Wen; Luo, Qing-Liang

    2014-06-01

    The aim of this study was to investigate the effect of WR2721(amifostine) against bone marrow hematopoietic damage of mice exposed to 6.5 Gy of (60)Co-γ ray. A total of 60 C57/BL6J mice was divided into 3 groups:normal group (mice were injected with physiological salt solution), irradiation group (mice were injected with physiologic salt solution before irradiation) and WR2721 group (mice were injected with WR2721 before irradiation). The WBC, neutrophil (Neut), Plt and RBC levels in peripheral blood of 3 group mice were counted within 60 days after irradiation; the bone marrow nuclear cells (BMNC) were counted at 2 and 24 hours after irradiation; the hematopoietic stem/progenitor cell (LK/LSK) level and colony formation capability were detected by flow cytometry at 2 and 24 hours after irradiation. The results indicated that the counts of WBC and neut at 4 and 18 days, Plt at 7-18 days and RBC at 10-30 day after irradiation in WR2721 group were higher than those in irradiation group (P < 0.05); the BMNC, LSK and LK levels obviously increased at 24 hours after irradiation (P < 0.05), the CFU-GEMM, CFU-GM, CFU-MK BFU-E and CFU-E all significantly increased at 2 and 24 hours after irradiation (P < 0.01), as compared with irradiation group. It is concluded that WR2721 can effectively alleviate early hematopoietic damage and promote the fast recovery of peripheral blood cells in mice exposed to γ-ray, suggesting that the WR2721 has significant radioprotective effect on hematopoietic system.

  9. [Radiotherapy for primary lung carcinoma].

    PubMed

    Giraud, P; Lacornerie, T; Mornex, F

    2016-09-01

    Indication, doses, technique of radiotherapy and concomitant chemotherapy, for primary lung carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.

  10. Radiological assessment of the structural shielding adequacy of the radiotherapy facility at Korle-Bu Teaching Hospital, Accra, Ghana.

    PubMed

    Adu, Simon; Emi-Reynolds, Geoffrey; Schandorf, Cyril; Darko, Emmanuel O; Gyekye, Prince K

    2012-04-01

    A (60)Co radiotherapy source with an initial activity of 185 TBq has exhausted its useful half-life and has been replaced with a 222 TBq (60)Co source at the Korle-Bu Teaching Hospital; a radiological assessment was performed to ascertain the shielding integrity of the facility. Dose rate at selected critical positions were calculated for the old and new sources. Dose rate measurements were also performed at these critical locations for the new source. The dose rates at all the critical locations of the public and staff access areas were within the recommended dose rate limit of 0.5 and 7.5 µSv h(-1) for the public and controlled area, respectively. The concrete biological shielding at the facility at the moment is adequate enough to attenuate the gamma photons from the new 222 TBq (60)Co source. High dose rates were recorded at the entrance to the treatment room, it is therefore recommended that optimisation of procedures should be encouraged to restrict activities in this area.

  11. Particle radiotherapy for prostate cancer.

    PubMed

    Shioyama, Yoshiyuki; Tsuji, Hiroshi; Suefuji, Hiroaki; Sinoto, Makoto; Matsunobu, Akira; Toyama, Shingo; Nakamura, Katsumasa; Kudo, Sho

    2015-01-01

    Recent advances in external beam radiotherapy have allowed us to deliver higher doses to the tumors while decreasing doses to the surrounding tissues. Dose escalation using high-precision radiotherapy has improved the treatment outcomes of prostate cancer. Intensity-modulated radiation therapy has been widely used throughout the world as the most advanced form of photon radiotherapy. In contrast, particle radiotherapy has also been under development, and has been used as an effective and non-invasive radiation modality for prostate and other cancers. Among the particles used in such treatments, protons and carbon ions have the physical advantage that the dose can be focused on the tumor with only minimal exposure of the surrounding normal tissues. Furthermore, carbon ions also have radiobiological advantages that include higher killing effects on intrinsic radio-resistant tumors, hypoxic tumor cells and tumor cells in the G0 or S phase. However, the degree of clinical benefit derived from these theoretical advantages in the treatment of prostate cancer has not been adequately determined. The present article reviews the available literature on the use of particle radiotherapy for prostate cancer as well as the literature on the physical and radiobiological properties of this treatment, and discusses the role and the relative merits of particle radiotherapy compared with current photon-based radiotherapy, with a focus on proton beam therapy and carbon ion radiotherapy.

  12. SU-E-T-102: Determination of Dose Distributions and Water-Equivalence of MAGIC-F Polymer Gel for 60Co and 192Ir Brachytherapy Sources

    SciTech Connect

    Quevedo, A; Nicolucci, P

    2014-06-01

    Purpose: Analyse the water-equivalence of MAGIC-f polymer gel for {sup 60}Co and {sup 192}Ir clinical brachytherapy sources, through dose distributions simulated with PENELOPE Monte Carlo code. Methods: The real geometry of {sup 60} (BEBIG, modelo Co0.A86) and {sup 192}192Ir (Varian, model GammaMed Plus) clinical brachytherapy sources were modelled on PENELOPE Monte Carlo simulation code. The most probable emission lines of photons were used for both sources: 17 emission lines for {sup 192}Ir and 12 lines for {sup 60}. The dose distributions were obtained in a cubic water or gel homogeneous phantom (30 × 30 × 30 cm{sup 3}), with the source positioned in the middle of the phantom. In all cases the number of simulation showers remained constant at 10{sup 9} particles. A specific material for gel was constructed in PENELOPE using weight fraction components of MAGIC-f: wH = 0,1062, wC = 0,0751, wN = 0,0139, wO = 0,8021, wS = 2,58×10{sup −6} e wCu = 5,08 × 10{sup −6}. The voxel size in the dose distributions was 0.6 mm. Dose distribution maps on the longitudinal and radial direction through the centre of the source were used to analyse the water-equivalence of MAGIC-f. Results: For the {sup 60} source, the maximum diferences in relative doses obtained in the gel and water were 0,65% and 1,90%, for radial and longitudinal direction, respectively. For {sup 192}Ir, the maximum difereces in relative doses were 0,30% and 1,05%, for radial and longitudinal direction, respectively. The materials equivalence can also be verified through the effective atomic number and density of each material: Zef-MAGIC-f = 7,07 e .MAGIC-f = 1,060 g/cm{sup 3} and Zef-water = 7,22. Conclusion: The results showed that MAGIC-f is water equivalent, consequently being suitable to simulate soft tissue, for Cobalt and Iridium energies. Hence, gel can be used as a dosimeter in clinical applications. Further investigation to its use in a clinical protocol is needed.

  13. Effect of Brazilian propolis (AF-08) on genotoxicity, cytotoxicity and clonogenic death of Chinese hamster ovary (CHO-K1) cells irradiated with (60)Co gamma-radiation.

    PubMed

    Santos, Geyza Spigoti; Tsutsumi, Shigetoshi; Vieira, Daniel Perez; Bartolini, Paolo; Okazaki, Kayo

    2014-03-01

    The present study was conducted in order to evaluate the effect of Brazilian propolis (AF-08; 5, 10, 15, 30, 50, 100, and 200μg/mL) in protecting CHO-K1 cells against genotoxic and cytotoxic damage and clonogenic death induced by (60)Co gamma-radiation (1.0, 2.0, 4.0, and 6.0Gy). For this purpose, three interlinked endpoints were analyzed: induction of DNA damage by use of the micronucleus (MN) test (genotoxic damage), cell viability by means of the MTS assay, and differential staining (cytotoxic damage) and clonogenic death via the colony-formation test (cytotoxic damage). The MN test revealed that propolis alone (5-100μg/mL) was not genotoxic up to 100μg/mL and that 30μg/mL of propolis reduced the radiation-induced DNA damage (∼56% reduction, p<0.05), exhibiting a radio-protective effect on irradiated CHO-K1 cells. On the other hand, analysis of cytotoxicity showed that a concentration of 50μg/mL presented a significant proliferative effect (p<0.001) when associated with radiation, decreasing the percentage of necrotic cells (p<0.01). No mediated cytotoxic effect was found, but the concentration of 200μg/mL was toxic when analyzed at 24 and 48h via the differential staining technique, but not at 72h after irradiation, analyzed with the MTS assay. Differential staining also showed that necrosis was the main death modality in irradiated cells and that apoptosis was induced only at the toxic concentration of propolis (200μg/mL). Concerning the clonogenic capacity, a concentration of 50μg/mL also exhibited a significant stimulating effect on cell proliferation (p<0.001), in agreement with the data from differential staining. Taken together, these data suggest that the use of propolis AF-08 for the prevention of the adverse effects of ionizing radiation is promising. Nevertheless, additional investigations are necessary for a better understanding of potential applications of propolis to improve human health.

  14. Bystander effects and radiotherapy.

    PubMed

    Marín, Alicia; Martín, Margarita; Liñán, Olga; Alvarenga, Felipe; López, Mario; Fernández, Laura; Büchser, David; Cerezo, Laura

    2015-01-01

    Radiation-induced bystander effects are defined as biological effects expressed after irradiation by cells whose nuclei have not been directly irradiated. These effects include DNA damage, chromosomal instability, mutation, and apoptosis. There is considerable evidence that ionizing radiation affects cells located near the site of irradiation, which respond individually and collectively as part of a large interconnected web. These bystander signals can alter the dynamic equilibrium between proliferation, apoptosis, quiescence or differentiation. The aim of this review is to examine the most important biological effects of this phenomenon with regard to areas of major interest in radiotherapy. Such aspects include radiation-induced bystander effects during the cell cycle under hypoxic conditions when administering fractionated modalities or combined radio-chemotherapy. Other relevant aspects include individual variation and genetics in toxicity of bystander factors and normal tissue collateral damage. In advanced radiotherapy techniques, such as intensity-modulated radiation therapy (IMRT), the high degree of dose conformity to the target volume reduces the dose and, therefore, the risk of complications, to normal tissues. However, significant doses can accumulate out-of-field due to photon scattering and this may impact cellular response in these regions. Protons may offer a solution to reduce out-of-field doses. The bystander effect has numerous associated phenomena, including adaptive response, genomic instability, and abscopal effects. Also, the bystander effect can influence radiation protection and oxidative stress. It is essential that we understand the mechanisms underlying the bystander effect in order to more accurately assess radiation risk and to evaluate protocols for cancer radiotherapy.

  15. Radiotherapy in the UK

    SciTech Connect

    Ramsay, S.

    1993-10-09

    What is wrong with radiation treatment in the UK Is it bad practice or merely bad publicity Between 1982 and 1991, 1,000 patients receiving isocentric radiation therapy at the North Staffordshire Royal Infirmary received a substantial underdose of radiation; the clinical report on this incident was published last week. The operator had been using a correction factor for tumor-to-skin distance, unaware that this factor had already been applied by the computer system. Although the report pointed out that it is not surprising that the clinicians were not alerted to the undertreatment, is also noted that there were no resources at the hospital to audit the outcome of radiotherapy.

  16. [Radiotherapy during pregnancy].

    PubMed

    Mazeron, R; Barillot, I; Mornex, F; Giraud, P

    2016-09-01

    The diagnostic of cancer during pregnancy is a rare and delicate situation. As the developments of the embryo and the human fetus are extremely sensitive to ionizing radiations, the treatment of these tumors should be discussed. The studies - preclinical and clinical - based mostly on exposure accidents show that subdiaphragmatic treatments are possible during pregnancy. When radiotherapy is used, phantom estimations of the dose to the fetus, confirmed by in vivo measurements are required. Irradiation and imaging techniques should be arranged to decrease as much as possible the dose delivered to the fetus and hold below the threshold of 0.1Gy.

  17. State of the art of radiotherapy.

    PubMed

    Garrido, Pilar; Olmedo, Eugenia

    2013-06-01

    Locally advanced or stage III disease accounts for ~30% of patients with non-small-cell lung cancer (NSCLC), which means only in the United States, more than 50,000 new patients each year. Stage III is a very heterogeneous disease, the management of patients is complex and several conditions (performance status, weight loss, comorbidities, characteristics of nodal involvement or resectability) must be considered before selecting the best treatment, which in most cases is chemotherapy (CT) and radiotherapy (RT). In this article, we will review key changes in the management of unresectable stage III during the last decades. Also we will highlight some challenges and areas of active research.

  18. [Results of radiotherapy of carcinomas of the retromolar trigone observed at the Varese Regional Hospital].

    PubMed

    Cosentino, D; Lazzati, M

    1988-01-01

    Retromolar Trigone Carcinomas (RTC) are generally diagnosed at an advanced stage in spite of their accessible location. From December 1979 to January 1987 we examined 23 patients with RTC at the Varese Regional Hospital--three women and 20 men, with an average age of 62.9 years. 21/23 patients were heavy cigarette smokers and consumed more than 1 l of alcohol per day. The patients were classified as 1 T1, 9 T2, 9 T3 and 4 T4 on the basis of TNM classification of malignant tumors. At the beginning of the treatment 12 patients had latero-cervical metastatic nodes. Fifteen patients underwent radiotherapy with 60Co with doses ranging from 60 to 70 Gy. The patients without evident metastatic cervical nodes were also irradiated with doses of at least 45 Gy as a precautionary measure. The percentage of cumulative survival of these patients amounts to 41.1% after 3 years, while for relapse-free patients pcs amounts to 40.7% after 3 years. In view of our results, we do not consider radiotherapy alone an effective treatment as a local cure for RTC. We intend to set up a new therapeutic protocol which incorporates surgery with radiotherapy and includes chemotherapy as necessary on the basis of T volume and of the presence of loco-regional metastatic nodes.

  19. Fertility impairment in radiotherapy

    PubMed Central

    Kuźba-Kryszak, Tamara; Nowikiewicz, Tomasz; Żyromska, Agnieszka

    2016-01-01

    Infertility as a result of antineoplastic therapy is becoming a very important issue due to the growing incidence of neoplastic diseases. Routinely applied antineoplastic treatments and the illness itself lead to fertility disorders. Therapeutic methods used in antineoplastic treatment may cause fertility impairment or sterilization due to permanent damage to reproductive cells. The risk of sterilization depends on the patient's sex, age during therapy, type of neoplasm, radiation dose and treatment area. It is known that chemotherapy and radiotherapy can lead to fertility impairment and the combination of these two gives an additive effect. The aim of this article is to raise the issue of infertility in these patients. It is of growing importance due to the increase in the number of children and young adults who underwent radiotherapy in the past. The progress in antineoplastic therapy improves treatment results, but at the same time requires a deeper look at existential needs of the patient. Reproductive function is an integral element of self-esteem and should be taken into account during therapy planning. PMID:27647982

  20. [Hodgkin's lymphoma and radiotherapy].

    PubMed

    Datsenko, P V; Panshin, G A

    2015-01-01

    After a median observation time of 4,5 years, 440 patients with Hodgkin's lymphoma stage I-IV to the Ann Arbor classification were treated with radiotherapy (2200 lymph areas) and ABVD (n=204) or BEACOPP (n=117) or CEA/ABVD (lomustine, etoposide, adriamycine, bleomycine, vinblastine and dacarbacine; n=119) regimens in 1995-2012. Correct allocation of groups with "CR or PR ≥80%" and "PR: 0-79%", after first-line chemotherapy, is extremely important for following RT planning. Adaptation of patients with Hodgkin's lymphoma can take place only after successful treatment, the probability of relapse and fear of repeated courses strongly interfere with this process, especially in the first years after its closure. Duration of remission period, especially in young people, is no less important than the criteria for overall survival. It is impossible to build recommendations for treatment for Hodgkin's lymphoma, based only on long-term survival rates. Importance of radiotherapy in reducing the number of relapses is undeniable, so the idea that the development of the role of chemotherapy in the treatment of the ray method Hodgkin's lymphoma gradually becomes secondary is in serious doubt. Our findings suggest the importance of both maintaining a high disease-free survival and reducing long-term complications in designing treatments of Hodgkin's lymphoma.

  1. [Stereotactic radiosurgery and radiotherapy for brain metastases].

    PubMed

    Tanguy, Ronan; Métellus, Philippe; Mornex, Françoise; Mazeron, Jean-Jacques

    2013-01-01

    Brain metastases management is still controversial even though many trials are trying to define the respective roles of neurosurgery, whole-brain radiotherapy, single-dose stereotactic radiotherapy and fractionated stereotactic radiotherapy. In this article, we review data from trials that examine the role of radiosurgery and fractionated stereotactic radiotherapy in the management of brain metastases.

  2. Role of hypofractionated radiotherapy in breast locoregional radiation.

    PubMed

    Caudrelier, J-M; Truong, P T

    2015-06-01

    Long-term results of randomised trials have confirmed the safety and efficacy of hypofractionated radiotherapy using approximately 2.6 Gy per fraction to lower total doses of 40-42.6 Gy delivered over 3 weeks, for postoperative treatment of early breast cancer. In these trials, hypofractionated radiotherapy was predominantly used for breast only treatment, while there are fewer trials that specifically examined hypofractionated radiotherapy to the breast plus regional nodes. Hypofractionated locoregional radiation is considered a standard of care in the United Kingdom and in some parts of Canada. We aim to review the radiobiology and normal tissue effects of hypofractionated locoregional radiation and to summarize available published clinical experiences using this treatment strategy as adjuvant therapy after breast conserving surgery or mastectomy for women with early breast cancer.

  3. Radiotherapy in Phyllodes Tumour

    PubMed Central

    Sasidharan, Balukrishna; Manipadam, Marie Therese; Paul, M J; Backianathan, Selvamani

    2017-01-01

    Introduction Phyllodes Tumour (PT) of the breast is a relatively rare breast neoplasm (<1%) with diverse range of pathology and biological behaviour. Aim To describe the clinical course of PT and to define the role of Radiotherapy (RT) in PT of the breast. Materials and Methods Retrospective analysis of hospital data of patients with PT presented from 2005 to 2014 was done. Descriptive statistics was used to analyze the results. Simple description of data was done in this study. Age and duration of symptoms were expressed in median and range. Percentages, tables and general discussions were used to understand the meaning of the data analyzed. Results Out of the 98 patients, 92 were eligible for analysis. The median age of presentation was 43 years. A total of 64/92 patients were premenopausal. There was no side predilection for this tumour but 57/92 patients presented as an upper outer quadrant lump. Fifty percent of the patients presented as giant (10 cm) PT. The median duration of symptoms was 12 months (range: 1-168 months). A 60% of patients had Benign (B), 23% had Borderline (BL) and 17% had malignant (M) tumours. The surgical treatment for benign histology included Lumpectomy (L) for 15%, Wide Local Excision (WLE) for 48%, and Simple Mastectomy (SM) for 37%. All BL and M tumours were treated with WLE or SM. There was no recurrence in B and BL group when the margin was ≥1 cm. All non-metastatic M tumours received adjuvant RT irrespective of their margin status. Total 3/16 patients with M developed local recurrence. Total 6/16 M patients had distant metastases (lung or bone). Our median duration of follow up was 20 months (range: 1-120 months). Conclusion Surgical resection with adequate margins (>1 cm) gave excellent local control in B and BL tumours. For patients with BL PT, local radiotherapy is useful, if margins are close or positive even after the best surgical resection. There is a trend towards improved local control with adjuvant radiotherapy for

  4. [Respiratory synchronization and breast radiotherapy].

    PubMed

    Mège, A; Ziouèche-Mottet, A; Bodez, V; Garcia, R; Arnaud, A; de Rauglaudre, G; Pourel, N; Chauvet, B

    2016-10-01

    Adjuvant radiation therapy following breast cancer surgery continues to improve locoregional control and overall survival. But the success of highly targeted-conformal radiotherapy such as intensity-modulated techniques, can be compromised by respiratory motion. The intrafraction motion can potentially result in significant under- or overdose, and also expose organs at risk. This article summarizes the respiratory motion and its effects on imaging, dose calculation and dose delivery by radiotherapy for breast cancer. We will review the methods of respiratory synchronization available for breast radiotherapy to minimize the respiratory impact and to spare organs such as heart and lung.

  5. [Task sharing with radiotherapy technicians in image-guided radiotherapy].

    PubMed

    Diaz, O; Lorchel, F; Revault, C; Mornex, F

    2013-10-01

    The development of accelerators with on-board imaging systems now allows better target volumes reset at the time of irradiation (image-guided radiotherapy [IGRT]). However, these technological advances in the control of repositioning led to a multiplication of tasks for each actor in radiotherapy and increase the time available for the treatment, whether for radiotherapy technicians or radiation oncologists. As there is currently no explicit regulatory framework governing the use of IGRT, some institutional experiments show that a transfer is possible between radiation oncologists and radiotherapy technicians for on-line verification of image positioning. Initial training for every technical and drafting procedures within institutions will improve audit quality by reducing interindividual variability.

  6. Comparative effects of 60Co gamma-rays and neon and helium ions on cycle duration and division probability of EMT 6 cells. A time-lapse cinematography study.

    PubMed

    Collyn-d'Hooghe, M; Hemon, D; Gilet, R; Curtis, S B; Valleron, A J; Malaise, E P

    1981-03-01

    Exponentially growing cultures of EMT 6 cells were irradiated in vitro with neon ions, helium ions or 60Co gamma-rays. Time-lapse cinematography allowed the determination, for individual cells, of cycle duration, success of the mitotic division and the age of the cell at the moment of irradiation. Irradiation induced a significant mitotic delay increasing proportionally with the delivered dose. Using mitotic delay as an endpoint, the r.b.e. for neon ions with respect to 60Co gamma-rays was 3.3 +/- 0.2 while for helium ions it was 1.2 +/- 0.1. Mitotic delay was greatest in those cells that had progressed furthest in their cycle at the time of irradiation. No significant mitotic delay was observed in the post-irradiation generation. Division probability was significantly reduced by irradiation both in the irradiated and in the post-irradiated generation. The reduction in division probability obtained with 3 Gy of neon ions was similar to that obtained after irradiation with 6 Gy of helium ions or 60Co gamma-rays.

  7. Radiotherapy Planning using MRI

    PubMed Central

    Schmidt, Maria A; Payne, Geoffrey S

    2016-01-01

    The use of Magnetic Resonance Imaging (MRI) in Radiotherapy (RT) planning is rapidly expanding. We review the wide range of image contrast mechanisms available to MRI and the way they are exploited for RT planning. However a number of challenges are also considered: the requirements that MR images are acquired in the RT treatment position, that they are geometrically accurate, that effects of patient motion during the scan are minimised, that tissue markers are clearly demonstrated, that an estimate of electron density can be obtained. These issues are discussed in detail, prior to the consideration of a number of specific clinical applications. This is followed by a brief discussion on the development of real-time MRI-guided RT. PMID:26509844

  8. Radiotherapy on hidradenocarcinoma

    PubMed Central

    Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

    2011-01-01

    Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

  9. [Hepatic tumors and radiotherapy].

    PubMed

    Rio, E; Mornex, F; Peiffert, D; Huertas, A

    2016-09-01

    Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose-volume histograms to liver and the hollow organs, including cases of SBRT.

  10. [Radiotherapy for nasopharyngeal carcinoma].

    PubMed

    Maingon, P; Blanchard, P; Bidault, F; Calmels, L

    2016-09-01

    Nasapharyngeal carcinoma is a rare disease. Oftenly, the diagnostic is made for advanced disease. Localized tumors, T1 or T2 NO observed a good prognosis and are locally controlled in more than 90 % of the cases by radiotherapy alone. The standard treatment of locally advanced disease is combined chemoradiation. A special vigilance of fast decrease of the volume of the pathological lymph nodes, sometimes associated to loss of weight might indicate an adaptive dosimetric revision. The treatment of recurrent disease is of great importance. Surgical indications are limited but should be discussed in multidisciplinary tumor board when possible. Surgical nodal sampling has to be proposed for nodal recurrence as well as reirradiation, which could be indicated according to the technical issues.

  11. Pion radiotherapy at LAMPF

    SciTech Connect

    Bush, S.E.; Smith, A.R.; Zink, S.

    1982-12-01

    Clinical investigations of pi meson radiotherapy were conducted by the Cancer Research and Treatment Center of the University of New Mexico and the Los Alamos National Laboratory from 1974 until 1982. Two hundred and thirty patients have been treated for a variety of locally advanced primary and metastatic neoplasms. One hundred and ninety-six patients have been followed for a minimum of 18 months. Crude survival data range from 11% for unresectable pancreatic carcinoma to 82% for Stages C and D1 adenocarcinoma of the prostate. Acute tolerance of normal tissues is approximately 4500 pion rad in 36 fractions over 7 weeks. Severe chronic reactions have appeared with increasing frequency after doses in excess of 4000 pion rad.

  12. Dosimetric Consistency of Co-60 Teletherapy Unit- a ten years Study

    PubMed Central

    Baba, Misba H; Mohib-ul-Haq, M.; Khan, Aijaz A.

    2013-01-01

    Objective The goal of the Radiation standards and Dosimetry is to ensure that the output of the Teletherapy Unit is within ±2% of the stated one and the output of the treatment dose calculation methods are within ±5%. In the present paper, we studied the dosimetry of Cobalt-60 (Co-60) Teletherapy unit at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) for last 10 years. Radioactivity is the phenomenon of disintegration of unstable nuclides called radionuclides. Among these radionuclides, Cobalt-60, incorporated in Telecobalt Unit, is commonly used in therapeutic treatment of cancer. Cobalt-60 being unstable decays continuously into Ni-60 with half life of 5.27 years thereby resulting in the decrease in its activity, hence dose rate (output). It is, therefore, mandatory to measure the dose rate of the Cobalt-60 source regularly so that the patient receives the same dose every time as prescribed by the radiation oncologist. The under dosage may lead to unsatisfactory treatment of cancer and over dosage may cause radiation hazards. Our study emphasizes the consistency between actual output and output obtained using decay method. Methodology The methodology involved in the present study is the calculations of actual dose rate of Co-60 Teletherapy Unit by two techniques i.e. Source to Surface Distance (SSD) and Source to Axis Distance (SAD), used for the External Beam Radiotherapy, of various cancers, using the standard methods. Thereby, a year wise comparison has been made between average actual dosimetric output (dose rate) and the average expected output values (obtained by using decay method for Co-60.) Results The present study shows that there is a consistency in the average output (dose rate) obtained by the actual dosimetry values and the expected output values obtained using decay method. The values obtained by actual dosimetry are within ±2% of the expected values. Conclusion The results thus obtained in a year wise comparison of average output by

  13. Bone Health and Pelvic Radiotherapy.

    PubMed

    Higham, C E; Faithfull, S

    2015-11-01

    Survivors who have received pelvic radiotherapy make up many of the long-term cancer population, with therapies for gynaecological, bowel, bladder and prostate malignancies. Individuals who receive radiotherapy to the pelvis as part of their cancer treatment are at risk of insufficiency fractures. Symptoms of insufficiency fractures include pelvic and back pain and immobility, which can affect substantially quality of life. This constellation of symptoms can occur within 2 months of radiotherapy up to 63 months post-treatment, with a median incidence of 6-20 months. As a condition it is under reported and evidence is poor as to the contributing risk factors, causation and best management to improve the patient's bone health and mobility. As radiotherapy advances, chronic symptoms, such as insufficiency fractures, as a consequence of treatment need to be better understood and reviewed. This overview explores the current evidence for the effect of radiotherapy on bone health and insufficiency fractures and identifies what we know and where gaps in our knowledge lie. The overview concludes with the need to take seriously complaints of pelvic pain from patients after pelvic radiotherapy and to investigate and manage these symptoms more effectively. There is a clear need for definitive research in this field to provide the evidence-based guidance much needed in practice.

  14. ZnFe2O4 nanoparticles as radiosensitizers in radiotherapy of human prostate cancer cells.

    PubMed

    Meidanchi, Alireza; Akhavan, Omid; Khoei, Samideh; Shokri, Ali A; Hajikarimi, Zahra; Khansari, Nakisa

    2015-01-01

    Nanoparticles of high-Z elements exhibit stronger photoelectric effects than soft tissues under gamma irradiation. Hence, they can be used as effective radiosensitizers for increasing the efficiency of current radiotherapy. In this work, superparamagnetic zinc ferrite spinel (ZnFe2O4) nanoparticles were synthesized by a hydrothermal reaction method and used as radiosensitizers in cancer therapy. The magnetic nanoparticles showed fast separation from solutions (e.g., ~1 min for 2 mg mL(-1) of the nanoparticles in ethanol) by applying an external magnetic field (~1T). The ZnFe2O4 nanoparticles were applied in an in vitro radiotherapy of lymph node carcinoma of prostate cells (as high radioresistant cells) under gamma irradiation of (60)Co source. The nanoparticles exhibited no significant effects on the cancer cells up to the high concentration of 100 μg mL(-1), in the absence of gamma irradiation. The gamma irradiation alone (2Gy dose) also showed no significant effects on the cells. However, gamma irradiation in the presence of 100 μg mL(-1) ZnFe2O4 nanoparticles resulted in ~53% inactivation of the cells (~17 times higher than the inactivation that occurred under gamma irradiation alone) after 24h. The higher cell inactivation was assigned to interaction of gamma radiation with nanoparticles (photoelectric effect), resulting in a high level electron release in the media of the radioresistant cells. Our results indicated that ZnFe2O4 nanoparticles not only can be applied in increasing the efficiency of radiotherapy, but also can be easily separated from the cell environment by using an external magnetic field after the radiotherapy.

  15. Patterns of care of radiotherapy in México

    PubMed Central

    Poitevin-Chacón, Adela; Hinojosa-Gómez, José

    2012-01-01

    Aim This survey is performed to learn about the structure of radiotherapy in México. Background Radiation oncology practice is increasing because of the higher incidence of cancer. There is no published data about radiotherapy in México. Materials and methods A questionnaire was sent to the 83 registered centers in the database of the Mexican regulatory agency. One out of the 32 states has no radiotherapy. 27 centers from 14 states provided their answers. Results 829 patients are treated annually with any radiotherapy modality in each center. Two centers have one cobalt machine, 7 have a cobalt and a linac and 10 have more than one linac. Five centers use 2D planning systems, 22 use 3D; 9, conventional simulators; 22, CT based simulation, and 1 center has no simulation. Most of the centers verify beams with films, electronic portal image devices and cone beam CTs are also used. Intensity modulated and image guided radiotherapy are performed in 5 states. Breast, prostate, cervix, lung, rectum and head and neck cancer are the six most common locations. There are 45 public and 38 private centers, 2 dedicated to children. Two gamma knife units, 5 Novalis systems, 1 tomotherapy and 2 cyberknife machines are working. All centers have at least one radiation oncologist, one physicist and one radiotherapist. Conclusions Definitive conclusions cannot be drawn from this limited feedback due to a low participation of centers. This survey about radiotherapy in Mexico shows the heterogeneity of equipment as well as medical and technical staff in the whole country. PMID:24416531

  16. [Adaptative radiotherapy: The case for MRI-guided radiotherapy].

    PubMed

    Maingon, P

    2016-10-01

    The concept of image-guided radiotherapy benefits from the development of magnetic resonance imaging (MRI) associated with different capacities of tissue analyses such as spectroscopy or diffusion analysis. The production of devices allowing the repositioning of patients through MRI represents a strong added value without delivering any additional dose to the patient while the optimization of the adaptative strategies are facilitated by a better contrast of the soft tissues compared to the scanner. The advantages of MRI are well demonstrated for brain tumours, head and neck carcinomas, pelvic tumors, mediastinal malignancies, gastrointestinal tract diseases. Adaptative radiotherapy inaugurates a new area of radiotherapy with different modalities. Several technological solutions are provided or discussed allowing the patients to benefit from thses new technologies as soon as possible.

  17. [Postoperative radiotherapy of prostate cancer].

    PubMed

    Guérif, S; Latorzeff, I; Lagrange, J-L; Hennequin, C; Supiot, S; Garcia, A; François, P; Soulié, M; Richaud, P; Salomon, L

    2014-10-01

    Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery.

  18. [CUDA-based fast dose calculation in radiotherapy].

    PubMed

    Wang, Xianliang; Liu, Cao; Hou, Qing

    2011-10-01

    Dose calculation plays a key role in treatment planning of radiotherapy. Algorithms for dose calculation require high accuracy and computational efficiency. Finite size pencil beam (FSPB) algorithm is a method commonly adopted in the treatment planning system for radiotherapy. However, improvement on its computational efficiency is still desirable for such purpose as real time treatment planning. In this paper, we present an implementation of the FSPB, by which the most time-consuming parts in the algorithm are parallelized and ported on graphic processing unit (GPU). Compared with the FSPB completely running on central processing unit (CPU), the GPU-implemented FSPB can speed up the dose calculation for 25-35 times on a low price GPU (Geforce GT320) and for 55-100 times on a Tesla C1060, indicating that the GPU-implemented FSPB can provide fast enough dose calculations for real-time treatment planning.

  19. Leaf sequencing and dosimetric verification in intensity-modulated radiotherapy

    NASA Astrophysics Data System (ADS)

    Agazaryan, Nzhde

    Although sophisticated means to calculate and deliver intensity modulated radiotherapy (IMRT) have been developed by many groups, methods to verify the delivery, as well as definitions of acceptability of a treatment in terms of these measurements are the most problematic at this stage of advancement of IMRT. Present intensity modulated radiotherapy systems fail to account for many dosimetric characteristics of the delivery system. In this dissertation, a dosimetrically based leaf sequencing algorithm is developed and implemented for multileaf collimated intensity modulated radiotherapy. The dosimetric considerations are investigated and are shown to significantly improve the outcome in terms of an agreement between desired and delivered radiation dose distributions. Subsequently, a system for determining the desirability of a produced intensity modulated radiotherapy plan in terms of deliverability of calculated profiles with the use of a multileaf collimator is developed. Three deliverability scoring indices are defined to evaluate the deliverability of the profiles. Gradient Index (GI) is a measure of the complexity of the profile in terms of gradients. Baseline Index (BI) is the fraction of the profile that is planned to get lower than the minimum level of transmission radiation. Cumulative Monitor Unit Index (CMUI) is the ratio of the cumulative monitor units (CMU) required for obtaining the desired profile to an average dose level in the profile. The dosimetric investigations of the deliverability scoring indices are presented, showing a clear correlation between scoring indices and dosimetric accuracy. Finally, materials and methods are developed for verification of intensity modulated radiotherapy. Dosimetric verification starts from investigations of the developed leaf sequencing algorithm, then extends to dosimetric verification in terms of deliverability, and lastly, dosimetric verification of complete clinical IMRT plans is performed.

  20. Expanding global access to radiotherapy.

    PubMed

    Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

    2015-09-01

    Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

  1. [Head and neck adaptive radiotherapy].

    PubMed

    Graff, P; Huger, S; Kirby, N; Pouliot, J

    2013-10-01

    Onboard volumetric imaging systems can provide accurate data of the patient's anatomy during a course of head and neck radiotherapy making it possible to assess the actual delivered dose and to evaluate the dosimetric impact of complex daily positioning variations and gradual anatomic changes such as geometric variations of tumors and normal tissues or shrinkage of external contours. Adaptive radiotherapy is defined as the correction of a patient's treatment planning to adapt for individual variations observed during treatment. Strategies are developed to selectively identify patients that require replanning because of an intolerable dosimetric drift. Automated tools are designed to limit time consumption. Deformable image registration algorithms are the cornerstones of these strategies, but a better understanding of their limits of validity is required before adaptive radiotherapy can be safely introduced to daily practice. Moreover, strict evaluation of the clinical benefits is yet to be proven.

  2. Inflammatory Skin Conditions Associated With Radiotherapy.

    PubMed

    Hernández Aragüés, I; Pulido Pérez, A; Suárez Fernández, R

    2017-04-01

    Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized.

  3. Radiotherapy supports protective tumor-specific immunity

    PubMed Central

    Gupta, Anurag; Sharma, Anu; von Boehmer, Lotta; Surace, Laura; Knuth, Alexander; van den Broek, Maries

    2012-01-01

    Radiotherapy is an important therapeutic option for the treatment of cancer. Growing evidence indicates that, besides inducing an irreversible DNA damage, radiotherapy promotes tumor-specific immune response, which significantly contribute to therapeutic efficacy. We postulate that radiotherapy activates tumor-associated dendritic cells, thus changing the tolerogenic tumor environment into an immunogenic one. PMID:23264910

  4. Clinical quality standards for radiotherapy

    PubMed Central

    2012-01-01

    Aim of the study The technological progress that is currently being witnessed in the areas of diagnostic imaging, treatment planning systems and therapeutic equipment has caused radiotherapy to become a high-tech and interdisciplinary domain involving staff of various backgrounds. This allows steady improvement in therapy results, but at the same time makes the diagnostic, imaging and therapeutic processes more complex and complicated, requiring every stage of those processes to be planned, organized, controlled and improved so as to assure high quality of services provided. The aim of this paper is to present clinical quality standards for radiotherapy as developed by the author. Material and methods In order to develop the quality standards, a comparative analysis was performed between European and Polish legal acts adopted in the period of 1980-2006 and the universal industrial ISO 9001:2008 standard, defining requirements for quality management systems, and relevant articles published in 1984-2009 were reviewed, including applicable guidelines and recommendations of American, international, European and Polish bodies, such as the American Association of Physicists in Medicine (AAPM), the European Society for Radiotherapy & Oncology (ESTRO), the International Atomic Energy Agency (IAEA), and the Organisation of European Cancer Institutes (OECI) on quality assurance and management in radiotherapy. Results As a result, 352 quality standards for radiotherapy were developed and categorized into the following three groups: 1 – organizational standards; 2 – physico-technical standards and 3 – clinical standards. Conclusion Proposed clinical quality standards for radiotherapy can be used by any institution using ionizing radiation for medical purposes. However, standards are of value only if they are implemented, reviewed, audited and improved, and if there is a clear mechanism in place to monitor and address failure to meet agreed standards. PMID:23788854

  5. Second Malignant Neoplasms Following Radiotherapy

    PubMed Central

    Kumar, Sanath

    2012-01-01

    More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy. PMID:23249860

  6. Chromosome aberrations induced in vitro in human lymphocytes by monoenergetic 2.5 MeV neutrons and 60Co gamma rays.

    PubMed

    Hellin, H; Paulsen, A; Liskien, H; Decat, G; Wambersie, A; Léonard, A; Baugnet-Mahieu, L

    1990-08-01

    The aim of the present experiments was to evaluate the relative biological effectiveness (RBE) of monoenergetic 2.5 MeV neutrons, in view of the scarcity of data on the RBE of neutrons in this energy range. Human peripheral blood lymphocytes from two donors were exposed to doses of neutrons ranging from 0.005 Gy to 0.5 Gy. Gamma rays produced by a telecobalt therapy unit were used as reference radiation. RBE values were of the same order of magnitude, whatever was the model of the dose-response curve chosen for the neutrons (linear or linear-quadratic). As expected, RBE increased markedly with decreasing doses and went beyond 30 at a dose level of 0.2 Gy. The present results, compared with RBE values obtained with neutrons of higher energy (6.5, 14 and 21 MeV), confirm that low energy neutrons are more effective in producing genetic effects, especially at low doses.

  7. [Which rules apply to hypofractionated radiotherapy?].

    PubMed

    Supiot, S; Clément-Colmou, K; Paris, F; Corre, I; Chiavassa, S; Delpon, G

    2015-10-01

    Hypofractionated radiotherapy is now more widely prescribed due to improved targeting techniques (intensity modulated radiotherapy, image-guided radiotherapy and stereotactic radiotherapy). Low dose hypofractionated radiotherapy is routinely administered mostly for palliative purposes. High or very high dose hypofractionated irradiation must be delivered according to very strict procedures since every minor deviation can lead to major changes in dose delivery to the tumor volume and organs at risk. Thus, each stage of the processing must be carefully monitored starting from the limitations and the choice of the hypofractionation technique, tumour contouring and dose constraints prescription, planning and finally dose calculation and patient positioning verification.

  8. Radiotherapy T1 glottic carcinoma

    SciTech Connect

    Zablow, A.I.; Erba, P.S.; Sanfillippo, L.J.

    1989-11-01

    From 1970 to 1985, curative radiotherapy was administered to 63 patients with stage I carcinoma of the true vocal cords. Precision radiotherapeutic technique yields cure rates comparable to surgical results. Good voice quality was preserved in a high percentage of patients.

  9. Influence of phantom materials on the energy dependence of LiF:Mg,Ti thermoluminescent dosimeters exposed to 20-300 kV narrow x-ray spectra, 137Cs and 60Co photons.

    PubMed

    Massillon-J L, G; Cabrera-Santiago, A; Minniti, R; O'Brien, M; Soares, C G

    2014-08-07

    LiF:Mg,Ti, are widely used to estimate absorbed-dose received by patients during diagnostic or medical treatment. Conveniently, measurements are usually made in plastic phantoms. However, experimental conditions vary from one group to another and consequently, a lack of consensus data exists for the energy dependence of thermoluminescent (TL) response. This work investigated the energy dependence of TLD-100 TL-response and the effect of irradiating the dosimeters in different phantom materials for a broad range of energy photons in an attempt to understand the parameters that affect the discrepancies reported by various research groups. TLD-100s were exposed to 20-300 kV narrow x-ray spectra, (137)Cs and (60)Co photons. Measurements were performed in air, PMMA, wt1, polystyrene and TLDS as surrounding material. Total air-kerma values delivered were between 50 and 150 mGy for x-rays and 50 mGy for (137)Cs and (60)Co beams; each dosimeter was irradiated individually. Relative response, R, defined as the TL-response per air-kerma and relative efficiency, RE, described as the TL-response per absorbed-dose (obtained through Monte Carlo (MC) and analytically) were used to describe the TL-response. Both R and RE are normalized to the responses in a (60)Co beam. The results indicate that the use of different phantom materials affects the TL-response and this response varies with energy and material type. MC simulations reproduced qualitatively the experimental data: a) R increases, reaches a maximum at ~25 keV and decreases; b) RE decreases, down to a minimum at ~60 keV, increases to a maximum at ~150 keV and after decreases. Independent of the phantom materials, RE strongly depends on how the absorbed dose is evaluated and the discrepancies between RE evaluated analytically and by MC simulation are around 4% and 18%, dependent on the photon energy. The comparison between our results and that reported in the literature suggests that the discrepancy observed

  10. Mass attenuation coefficients of Clear-Pb[reg sign] for photons from [sup 125]I, [sup 103]Pd, [sup 99m]Tc, [sup 192]Ir, [sup 137]Cs, and [sup 60]Co

    SciTech Connect

    Rivard, M.J. . Dept. of Radiation Oncology); Waid, D.S. . Radiation Oncology Dept.); Wierzbicki, J.G. . Cancer Treatment Center)

    1999-11-01

    The mass attenuation coefficients, [mu]/[rho], for Clear-Pb[reg sign] for photon energies ranging from 10 keV to 10 MeV were determined using Monte Carlo methods and simple equations used to manipulate elemental mass attenuation coefficients. It was determined that the effectiveness of Clear-Pb[reg sign] as a radiation shielding material was greater than plain acrylic for all photon energies, especially those less than 150 keV, and for deep penetration problems where the differences in [mu]/[rho] between Clear-Pb[reg sign] as a shielding material when compared with acrylic was determined for the following commonly used radionuclides: [sup 125]I, [sup 103]Pd, [sup 99m]Tc, [sup 192]Ir, [sup 137]Cs, and [sup 60]Co.

  11. Mass attenuation coefficients of Clear-Pb{reg_sign} for photons from {sup 125}I, {sup 103}Pd, {sup 99m}Tc, {sup 192}Ir, {sup 137}Cs, and {sup 60}Co

    SciTech Connect

    Rivard, M.J.; Waid, D.S.; Wierzbicki, J.G.

    1999-11-01

    The mass attenuation coefficients, {mu}/{rho}, for Clear-Pb{reg_sign} for photon energies ranging from 10 keV to 10 MeV were determined using Monte Carlo methods and simple equations used to manipulate elemental mass attenuation coefficients. It was determined that the effectiveness of Clear-Pb{reg_sign} as a radiation shielding material was greater than plain acrylic for all photon energies, especially those less than 150 keV, and for deep penetration problems where the differences in {mu}/{rho} between Clear-Pb{reg_sign} as a shielding material when compared with acrylic was determined for the following commonly used radionuclides: {sup 125}I, {sup 103}Pd, {sup 99m}Tc, {sup 192}Ir, {sup 137}Cs, and {sup 60}Co.

  12. Severe acute radiation syndrome: treatment of a lethally 60Co-source irradiated accident victim in China with HLA-mismatched peripheral blood stem cell transplantation and mesenchymal stem cells.

    PubMed

    Guo, Mei; Dong, Zheng; Qiao, Jianhui; Yu, Changlin; Sun, Qiyun; Hu, Kaixun; Liu, Guangxian; Wei, Li; Yao, Bo; Man, Qiuhong; Sun, Xuedong; Liu, Zhiqing; Song, Zhiwu; Yu, Chengze; Chen, Ying; Luo, Qingliang; Liu, Sugang; Ai, Hui-Sheng

    2014-03-01

    This is a case report of a 32-year-old man exposed to a total body dose of 14.5 Gy γ-radiation in a lethal (60)Co-source irradiation accident in 2008 in China. Frequent nausea, vomiting and marked neutropenia and lymphopenia were observed from 30 min to 45 h after exposure. HLA-mismatched peripheral blood stem cell transplantation combined with infusion of mesenchymal stem cells was used at Day 7. Rapid hematopoietic recovery, stable donor engraftment and healing of radioactive skin ulceration were achieved during Days 18-36. The patient finally developed intestinal obstruction and died of multi-organ failure on Day 62, although intestinal obstruction was successfully released by emergency bowel resection.

  13. Comment on ‘Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy 125I and 192Ir sources and 60Co cell irradiation’

    NASA Astrophysics Data System (ADS)

    Lindborg, Lennart; Lillhök, Jan; Grindborg, Jan-Erik

    2015-11-01

    The relative standard deviation, σr,D, of calculated multi-event distributions of specific energy for 60Co ϒ rays was reported by the authors F Villegas, N Tilly and A Ahnesjö (Phys. Med. Biol. 58 6149-62). The calculations were made with an upgraded version of the Monte Carlo code PENELOPE. When the results were compared to results derived from experiments with the variance method and simulated tissue equivalent volumes in the micrometre range a difference of about 50% was found. Villegas et al suggest wall-effects as the likely explanation for the difference. In this comment we review some publications on wall-effects and conclude that wall-effects are not a likely explanation.

  14. Tenth value layers for 60Co gamma rays and for 4, 6, 10, 15, and 18 MV x rays in concrete for beams of cone angles between 0 degrees and 14 degrees calculated by Monte Carlo simulation.

    PubMed

    Jaradat, Adnan K; Biggs, Peter J

    2007-05-01

    The calculation of shielding barrier thicknesses for radiation therapy facilities according to the NCRP formalism is based on the use of broad beams (that is, the maximum possible field sizes). However, in practice, treatment fields used in radiation therapy are, on average, less than half the maximum size. Indeed, many contemporary treatment techniques call for reduced field sizes to reduce co-morbidity and the risk of second cancers. Therefore, published tenth value layers (TVLs) for shielding materials do not apply to these very small fields. There is, hence, a need to determine the TVLs for various beam modalities as a function of field size. The attenuation of (60)Co gamma rays and photons of 4, 6, 10, 15, and 18 MV bremsstrahlung x ray beams by concrete has been studied using the Monte Carlo technique (MCNP version 4C2) for beams of half-opening angles of 0 degrees , 3 degrees , 6 degrees , 9 degrees , 12 degrees , and 14 degrees . The distance between the x-ray source and the distal surface of the shielding wall was fixed at 600 cm, a distance that is typical for modern radiation therapy rooms. The maximum concrete thickness varied between 76.5 cm and 151.5 cm for (60)Co and 18 MV x rays, respectively. Detectors were placed at 630 cm, 700 cm, and 800 cm from the source. TVLs have been determined down to the third TVL. Energy spectra for 4, 6, 10, 15, and 18 MV x rays for 10 x 10 cm(2) and 40 x 40 cm(2) field sizes were used to generate depth dose curves in water that were compared with experimentally measured values.

  15. [Stereotactic radiotherapy for pelvic tumors].

    PubMed

    Mazeron, R; Fumagalli, I

    2014-01-01

    Extracranial stereotactic radiotherapy is booming. The development and spread of dedicated accelerators coupled with efficient methods of repositioning can now allow treatments of mobile lesions with moderate size, with high doses per fraction. Intuitively, except for the prostate, pelvic tumours, often requiring irradiation of regional lymph node drainage, lend little to this type of treatment. However, in some difficult circumstances, such as boost or re-radiation, stereotactic irradiation condition is promising and clinical experiences have already been reported.

  16. Intraoperative radiotherapy for breast cancer

    PubMed Central

    Williams, Norman R.; Pigott, Katharine H.; Brew-Graves, Chris

    2014-01-01

    Intra-operative radiotherapy (IORT) as a treatment for breast cancer is a relatively new technique that is designed to be a replacement for whole breast external beam radiotherapy (EBRT) in selected women suitable for breast-conserving therapy. This article reviews twelve reasons for the use of the technique, with a particular emphasis on targeted intra-operative radiotherapy (TARGIT) which uses X-rays generated from a portable device within the operating theatre immediately after the breast tumour (and surrounding margin of healthy tissue) has been removed. The delivery of a single fraction of radiotherapy directly to the tumour bed at the time of surgery, with the capability of adding EBRT at a later date if required (risk-adaptive technique) is discussed in light of recent results from a large multinational randomised controlled trial comparing TARGIT with EBRT. The technique avoids irradiation of normal tissues such as skin, heart, lungs, ribs and spine, and has been shown to improve cosmetic outcome when compared with EBRT. Beneficial aspects to both institutional and societal economics are discussed, together with evidence demonstrating excellent patient satisfaction and quality of life. There is a discussion of the published evidence regarding the use of IORT twice in the same breast (for new primary cancers) and in patients who would never be considered for EBRT because of their special circumstances (such as the frail, the elderly, or those with collagen vascular disease). Finally, there is a discussion of the role of the TARGIT Academy in developing and sustaining high standards in the use of the technique. PMID:25083504

  17. Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma

    SciTech Connect

    Sabolch, Aaron; Feng, Mary; Griffith, Kent; Hammer, Gary; Doherty, Gerard; Ben-Josef, Edgar

    2011-08-01

    Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.

  18. Comparison of image-guided radiotherapy technologies for prostate cancer.

    PubMed

    Das, Satya; Liu, Tian; Jani, Ashesh B; Rossi, Peter; Shelton, Joseph; Shi, Zheng; Khan, Mohammad K

    2014-12-01

    Radiation oncology has seen a rapid increase in the use of image-guided radiotherapy technology (IGRT) for prostate cancer patients over the past decade. The increase in the use of IGRT is largely driven by the fact that these technologies have been approved by the Food and Drug Administration and are now readily reimbursed by many insurance companies. Prostate cancer patients undergoing intensity modulated radiotherapy (IMRT) now have access to a wide variety of IGRTs that can cost anywhere from $500,000 or more in upfront costs, and can add anywhere from 10 to 15 thousand dollars to a course of IMRT. Some of the IGRT options include daily cone beam computed tomography, ultrasound, orthogonal x-ray units using implanted fiducial markers, implanted radiofrequency markers with the ability to localize and track prostate motion during radiotherapy (Calypso 4D), and cine magnetic resonance imaging. Although these technologies add to the cost of IMRT, there is little direct comparative effectiveness data to help patients, physicians, and policy makers decide if one technology is better than another. In our critical review, the first of its kind, we summarize the advantages, disadvantages, and the limitations of each technology. We also provide an overview of existing literature as it pertains to the comparison of existing IGRTs. Lastly, we provide insights about the need for future outcomes research that may have a significant impact on health policies as it comes to reimbursement in the modern era.

  19. Radiotherapy treatment of keloid scars with a kilovoltage X-ray parallel pair.

    PubMed

    Eaton, David J; Barber, Elizabeth; Ferguson, Leila; Mark Simpson, G; Collis, Christopher H

    2012-03-01

    An established treatment for keloids is surgery and radiotherapy, using a single applied field. However, earlobe keloids lend themselves to a parallel opposed pair approach. Delivery with a superficial X-ray unit is practicable and improves homogeneity within the treatment volume. It has been implemented in this centre since 2007.

  20. Track-average LET of secondary electrons generated in LiF:Mg,Ti and liquid water by 20-300 kV x-ray, 137Cs and 60Co beams

    NASA Astrophysics Data System (ADS)

    Cabrera-Santiago, A.; Massillon-JL, G.

    2016-11-01

    Electrons generated in matter by photons could be a fundamental basis for an adequate analysis of radiation effects and damage. We have studied separately the ‘primary electrons’ generated directly by photons from the ‘secondary electrons’ (SE) produced by electron-electron interactions. In this work, track-average linear energy transfer, {{L}Δ,\\text{T}} , of SE in LiF:Mg,Ti and liquid water produced by twelve photon energy beams from 20 kV x-ray to 60Co gamma rays have been investigated using the EGSnrc Monte Carlo Code. The exposure of LiF:Mg,Ti in different phantom materials has been considered. Depending on the photon energy, SE represent 40%-90% of the total electron fluence (TEF) between 1 keV and 10 keV, being higher when the photon energy increases. Independent of the medium, {{L}Δ,\\text{T}} versus mean photon energy displays a local minimum at around 40 keV, followed by a local maximum at ~80 keV-100 keV. The {{L}Δ,\\text{T}} of SE generated by the x-ray beams are of order of 11 keV µm-1 to 19 keV µm-1 in LiF:Mg,Ti and 5 keV µm-1 to 9 keV µm-1 in liquid water which represent 3-5 times those produced by 60Co gamma rays in both media. These values were considerably greater than those of TEF, by factors of 3-8. Furthermore, {{L}Δ,\\text{T}} of SE generated in liquid water by 20 kV-200 kV x-rays are similar to those of 76 MeV-120 MeV 3He ions. Contrary to the TEF, where {{L}Δ,\\text{T}} were independent of the phantom material, at low photon energies {{L}Δ,\\text{T}} of SE was found to be sensitive to the surrounding medium showing higher values within the phantom than in air. This result, which agrees with published experimental results, implies the importance of the SE ionization density for an understanding of dosimeter response induced by photon beams.

  1. Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials-Report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance

    SciTech Connect

    Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T.J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Thomas E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; and others

    2012-07-01

    Purpose: In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods and Materials: Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such as proton beam therapy, and the international harmonization of clinical trial QA. Results: Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Conclusion: Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based.

  2. A treatment planning comparison between modulated tri-cobalt-60 teletherapy and linear accelerator–based stereotactic body radiotherapy for central early-stage non−small cell lung cancer

    SciTech Connect

    Merna, Catherine; Rwigema, Jean-Claude M.; Cao, Minsong; Wang, Pin-Chieh; Kishan, Amar U.; Michailian, Argin; Lamb, James; Sheng, Ke; Agazaryan, Nzhde; Low, Daniel A.; Kupelian, Patrick; Steinberg, Michael L.; Lee, Percy

    2016-04-01

    We evaluated the feasibility of planning stereotactic body radiotherapy (SBRT) for large central early-stage non−small cell lung cancer with a tri-cobalt-60 (tri-{sup 60}Co) system equipped with real-time magnetic resonance imaging (MRI) guidance, as compared to linear accelerator (LINAC)–based SBRT. In all, 20 patients with large central early-stage non−small cell lung cancer who were treated between 2010 and 2015 with LINAC-based SBRT were replanned using a tri-{sup 60}Co system for a prescription dose of 50 Gy in 4 fractions. Doses to organs at risk were evaluated based on established MD Anderson constraints for central lung SBRT. R{sub 100} values were calculated as the total tissue volume receiving 100% of the dose (V{sub 100}) divided by the planning target volume and compared to assess dose conformity. Dosimetric comparisons between LINAC-based and tri-{sup 60}Co SBRT plans were performed using Student's t-test and Wilcoxon Ranks test. Blinded reviews by radiation oncologists were performed to assess the suitability of both plans for clinical delivery. The mean planning target volume was 48.3 cc (range: 12.1 to 139.4 cc). Of the tri-{sup 60}Co SBRT plans, a mean 97.4% of dosimetric parameters per patient met MD Anderson dose constraints, whereas a mean 98.8% of dosimetric parameters per patient were met with LINAC-based SBRT planning (p = 0.056). R{sub 100} values were similar between both plans (1.20 vs 1.21, p = 0.79). Upon blinded review by 4 radiation oncologists, an average of 90% of the tri-{sup 60}Co SBRT plans were considered acceptable for clinical delivery compared with 100% of the corresponding LINAC-based SBRT plans (p = 0.17). SBRT planning using the tri-{sup 60}Co system with built-in MRI is feasible and achieves clinically acceptable plans for most central lung patients, with similar target dose conformity and organ at risk dosimetry. The added benefit of real-time MRI-guided therapy may further optimize tumor targeting while improving

  3. A treatment planning comparison between modulated tri-cobalt-60 teletherapy and linear accelerator-based stereotactic body radiotherapy for central early-stage non-small cell lung cancer.

    PubMed

    Merna, Catherine; Rwigema, Jean-Claude M; Cao, Minsong; Wang, Pin-Chieh; Kishan, Amar U; Michailian, Argin; Lamb, James; Sheng, Ke; Agazaryan, Nzhde; Low, Daniel A; Kupelian, Patrick; Steinberg, Michael L; Lee, Percy

    2016-01-01

    We evaluated the feasibility of planning stereotactic body radiotherapy (SBRT) for large central early-stage non-small cell lung cancer with a tri-cobalt-60 (tri-(60)Co) system equipped with real-time magnetic resonance imaging (MRI) guidance, as compared to linear accelerator (LINAC)-based SBRT. In all, 20 patients with large central early-stage non-small cell lung cancer who were treated between 2010 and 2015 with LINAC-based SBRT were replanned using a tri-(60)Co system for a prescription dose of 50Gy in 4 fractions. Doses to organs at risk were evaluated based on established MD Anderson constraints for central lung SBRT. R100 values were calculated as the total tissue volume receiving 100% of the dose (V100) divided by the planning target volume and compared to assess dose conformity. Dosimetric comparisons between LINAC-based and tri-(60)Co SBRT plans were performed using Student׳s t-test and Wilcoxon Ranks test. Blinded reviews by radiation oncologists were performed to assess the suitability of both plans for clinical delivery. The mean planning target volume was 48.3cc (range: 12.1 to 139.4cc). Of the tri-(60)Co SBRT plans, a mean 97.4% of dosimetric parameters per patient met MD Anderson dose constraints, whereas a mean 98.8% of dosimetric parameters per patient were met with LINAC-based SBRT planning (p = 0.056). R100 values were similar between both plans (1.20 vs 1.21, p = 0.79). Upon blinded review by 4 radiation oncologists, an average of 90% of the tri-(60)Co SBRT plans were considered acceptable for clinical delivery compared with 100% of the corresponding LINAC-based SBRT plans (p = 0.17). SBRT planning using the tri-(60)Co system with built-in MRI is feasible and achieves clinically acceptable plans for most central lung patients, with similar target dose conformity and organ at risk dosimetry. The added benefit of real-time MRI-guided therapy may further optimize tumor targeting while improving normal tissue sparing, which warrants further

  4. Radiotherapy in patients with connective tissue diseases.

    PubMed

    Giaj-Levra, Niccolò; Sciascia, Savino; Fiorentino, Alba; Fersino, Sergio; Mazzola, Rosario; Ricchetti, Francesco; Roccatello, Dario; Alongi, Filippo

    2016-03-01

    The decision to offer radiotherapy in patients with connective tissue diseases continues to be challenging. Radiotherapy might trigger the onset of connective tissue diseases by increasing the expression of self-antigens, diminishing regulatory T-cell activity, and activating effectors of innate immunity (dendritic cells) through Toll-like receptor-dependent mechanisms, all of which could potentially lead to breaks of immune tolerance. This potential risk has raised some debate among radiation oncologists about whether patients with connective tissue diseases can tolerate radiation as well as people without connective tissue diseases. Because the number of patients with cancer and connective tissue diseases needing radiotherapy will probably increase due to improvements in medical treatment and longer life expectancy, the issue of interactions between radiotherapy and connective tissue diseases needs to be clearer. In this Review, we discuss available data and evidence for patients with connective tissue diseases treated with radiotherapy.

  5. Treatment of mandibular squamous cell carcinoma in cats by use of mandibulectomy and radiotherapy: seven cases (1987-1989).

    PubMed

    Hutson, C A; Willauer, C C; Walder, E J; Stone, J L; Klein, M K

    1992-09-01

    Seven cats with squamous cell carcinoma involving the mandible were treated by surgery and radiotherapy. Surgery consisted of hemimandibulectomy or combined rostral and hemimandibulectomy, gastrostomy tube placement, and submandibular lymph node excisional biopsy. Radiotherapy (orthovoltage or 60Co) commenced 2 weeks after surgery. Histologically, the tumor invaded surgical margins in 6 of 7 cats. Nerve infiltration was histologically identified in 2 cats. All cats had stage-3 disease with radiographic evidence of mandibular bone involvement. Age ranged between 8 and 16 years (median, 10 years). Hypercalcemia (2), feline immunodeficiency virus (2), and hyperthyroidism (1), were detected in cats prior to treatment. Survival after surgery was a median of 14 months (range = 3 to 36 months, mean = 15 months). Six cats were euthanatized because of recurrence of disease at 3, 7, 9, 16, 21, and 36 months. One cat was euthanatized at 14 months because of an unrelated disease. Complications of tongue lagging, drooling after meals, mandibular drift, maxillary ulceration, and alopecia of the jaw developed in a few cats. Radiation at the primary site and regional lymph nodes after surgery of curative intent extended survival in cats with mandibular squamous cell carcinoma.

  6. Reasons for reduced activities of 17 alpha-hydroxylase and C17-C20 lyase in spite of increased contents of cytochrome P-450 in mature rat testis fetally irradiated with 60Co.

    PubMed

    Inano, H; Ishii-Ohba, H; Suzuki, K; Ikeda, K

    1990-05-01

    Pregnant rats received whole body irradiation with 2.6 Gy gamma-ray from a 60Co source at Day 20 of gestation. When pups were 4 months old, activities of electron transport system and steroid monooxygenase in tests were assayed. The content of total cytochrome P-450 in the irradiated testes had increased to 170% of that in non-irradiated rats, but NADPH-cytochrome P-450 reductase activity had reduced to 36% of the control. Also, amounts of cytochrome b5 in testicular microsomal fraction were decreased markedly after irradiation, but no significant change of NADH-cytochrome b5 reductase activity was observed in the treated pups. Because both 17 alpha-hydroxylase and C17-C20 lyase activities tended to be decreased by fetal irradiation, testosterone production from progesterone and 17 alpha-hydroxyprogesterone was reduced to about 30% of the control. From these results, it has been suggested that the testicular cytochrome P-450 is radioresistant but steroid monooxygenase activities are reduced after the fetal irradiation. We propose that the discrepancy arises from the marked decrement of NADPH-cytochrome P-450 reductase activity.

  7. Determination of the Sensibility Factors for TLD-100 Powder on the Energy of X-Ray of 50, 250 kVp; 192Ir, 137Cs and 60Co

    SciTech Connect

    Loaiza, Sandra P.; Alvarez, Jose T.

    2006-09-08

    TLD-100 powder is calibrated in terms of absorbed dose to water Dw, using the protocols AAPM TG61, AAPM TG43 and IAEA-TRS 398, for the energy of RX 50, 250 kVp, 137Cs and 60Co respectively. The calibration curves, TLD Response R versus Dw, are fitted by weighted least square by a quadratic polynomials; which are validated with the lack of fit and the Anderson-Darling normality test. The slope of these curves corresponds to the sensibility factor: Fs R/DW, [Fs] = nC Gy-1. The expanded uncertainties U's for these factors are obtained from the ANOVA tables. Later, the Fs' values are interpolated using the effective energy hvefec for the 192Ir. The SSDL sent a set of capsules with powder TLD-100 for two Hospitals. These irradiated them a nominal dose of Dw = 2 Gy. The results determined at SSDL are: for the Hospital A the Dw is overestimated in order to 4.8% and the Hospital B underestimates it in the range from -1.4% to -17.5%.

  8. Microdosimetry of DNA conformations: relation between direct effect of (60)Co gamma rays and topology of DNA geometrical models in the calculation of A-, B- and Z-DNA radiation-induced damage yields.

    PubMed

    Semsarha, Farid; Raisali, Gholamreza; Goliaei, Bahram; Khalafi, Hossein

    2016-05-01

    In order to obtain the energy deposition pattern of ionizing radiation in the nanometric scale of genetic material and to investigate the different sensitivities of the DNA conformations, direct effects of (60)Co gamma rays on the three A, B and Z conformations of DNA have been studied. For this purpose, single-strand breaks (SSB), double-strand breaks (DSB), base damage (BD), hit probabilities and three microdosimetry quantities (imparted energy, mean chord length and lineal energy) in the mentioned DNA conformations have been calculated and compared by using GEometry ANd Tracking 4 (Geant4) toolkit. The results show that A-, B- and Z-DNA conformations have the highest yields of DSB (1.2 Gy(-1) Gbp(-1)), SSB (25.2 Gy(-1) Gbp(-1)) and BD (4.81 Gy(-1) Gbp(-1)), respectively. Based on the investigation of direct effects of radiation, it can be concluded that the DSB yield is largely correlated to the topological characteristics of DNA models, although the SSB yield is not. Moreover, according to the comparative results of the present study, a reliable candidate parameter for describing the relationship between DNA damage yields and geometry of DNA models in the theoretical radiation biology research studies would be the mean chord length (4 V/S) of the models.

  9. Interpretation of cytogenetic damage induced in the germ line of male mice exposed for over 1 year to /sup 239/Pu alpha particles, fission neutrons, or /sup 60/Co gamma rays

    SciTech Connect

    Grahn, D.; Lee, C.H.; Farrington, B.F.

    1983-09-01

    The relative biological effectiveness (RBE) of /sup 239/Pu ..cap alpha.. particles, fission neutrons (0.85 MeV), and /sup 60/Co ..gamma.. rays has been evaluated for the induction of reciprocal chromosome translocations in spermatogonia and of chromosome/chromatid fragments and chromatid rearrangements in the primary spermatocyte of adult male B6CF/sub 1/ mice. Age concurrency was maintained for both internal and external radiations which were delivered at about 1 rad/week for /sup 239/Pu (single intravenous dose of 10 ..mu..Ci/kg), 0.67, 1.67, and 2.67 rad/week for neutrons, and 6.95, 17.4, and 32 rad/week for ..gamma.. rays for at least 60 weeks. In terms of frequency of translocations, the response to the alpha emitter was nonlinear (concave downward) with little dose-response predictability; to cumulative neutron exposures the response was linear, without evidence of a dose-rate effect; and to ..gamma.. radiation the responses were linear, and a significant dose-rate effect was seen. RBE estimates are variable. The overall response to the ..cap alpha.. emitter is interpreted to be a complex function of (a) microdosimetric heterogeneity, (b) a nearly invariant deposition pattern in the gonad, (c) the high sensitivity of differentiating spermatogonia to cell killing, and (d) the capacity of stem cells in relatively radiation-free areas to progressively assume the major spermatogenic role.

  10. [Influence of radiotherapy on lymphocyte subpopulations].

    PubMed

    Ceschia, T; Beorchia, A; Guglielmi, R; Mandoliti, G; Fongione, S; Cereghini, M; Tonutti, E; Sala, P G; Pizzi, G

    1991-04-01

    The authors investigated the effects of radiation therapy on the immune system by studying lymphocyte subsets and other parameters in 32 patients undergoing radiation therapy for solid cancer. With monoclonal antibody techniques, we studied both T- and B-lymphocytes; cell suspensions were analyzed by means of a Facs Spectrum III Ortho (Ortho-Diagnostic) unit. The first control was performed right after the beginning of radiotherapy, when the dose to the patients was 50 Gy or higher. The second control was performed at 40 Gy because all patients received this dose. 30% of the patients exhibited lymphopenia from the beginning of the study; at 40 Gy the number of T-lymphocytes was low and helper/suppressor ratio was altered. A variable response of B-cells was observed, although all patients exhibited restoration of normal values at 6 months. Four patients only suffered from side-effects: a patient with tongue cancer presented oral mycosis, and a woman--treated for breast cancer--presented vaginal mycosis. Two cases of cystitis were also observed, after 18 Gy, in patients with uterine carcinoma undergoing pelvic irradiation. Disease progression was observed in 2 patients with head and neck cancer, while 3 patients died from lung cancer progression. Another one, with head and neck cancer, died because of heart failure.

  11. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, Kevin M.; Doyle, Barney L.

    1996-01-01

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue.

  12. Ion-induced nuclear radiotherapy

    DOEpatents

    Horn, K.M.; Doyle, B.L.

    1996-08-20

    Ion-induced Nuclear Radiotherapy (INRT) is a technique for conducting radiosurgery and radiotherapy with a very high degree of control over the spatial extent of the irradiated volume and the delivered dose. Based upon the concept that low energy, ion induced atomic and nuclear reactions can be used to produce highly energetic reaction products at the site of a tumor, the INRT technique is implemented through the use of a conduit-needle or tube which conducts a low energy ion beam to a position above or within the intended treatment area. At the end of the conduit-needle or tube is a specially fabricated target which, only when struck by the ion beam, acts as a source of energetic radiation products. The inherent limitations in the energy, and therefore range, of the resulting reaction products limits the spatial extent of irradiation to a pre-defined volume about the point of reaction. Furthermore, since no damage is done to tissue outside this irradiated volume, the delivered dose may be made arbitrarily large. INRT may be used both as a point-source of radiation at the site of a small tumor, or as a topical bath of radiation to broad areas of diseased tissue. 25 figs.

  13. Pattern of radiotherapy care in Bulgaria.

    PubMed

    Hadjieva, Tatiana

    2015-01-01

    The paper reveals the changing pattern of Bulgarian Radiotherapy (RT) care after the successful implementation of 15 projects for 100 million euro under the European Regional Development Fund in Operational Programme for Regional Development 2007-2013. The project enables a total one-step modernization of 14 Bulgarian RT Centres and creation of a new one. At the end of the Programme (mid 2015), 16 new Linacs and 2 modern cobalt machines will be available together with 11 virtual CT simulators, 5 CT simulators, 1 MRI and 1 PET CT for RT planning and all dosimetry facilities needed. Such a modernization has moved Bulgarian RT forward, with 2.7 MV units per one million of population (MV/mln.inh) in comparison with 0.9 MV/mln.inh in 2012. Guild of Bulgarian Radiotherapists includes 70 doctors, 46 physicists and 10 engineers, together with 118 RTTs and 114 nurses and they all have treated 16,447 patients in 2013. Major problems are inadequate reimbursement from the monopolistic Health Insurance Fund (900 euro for 3D conformal RT and 1500 euro for IMRT); fragmentation of RT care with 1-2 MV units per Centre; no payment for patient travel expenses; need for quick and profound education of 26% of doctors and 46% of physicists without RT license, along with continuous education for all others; and resource for 5000-9000 more patients to be treated yearly by RT in order to reach 45-50% from current service of 32%. After 15 years of struggle of RT experts, finally the pattern of Bulgarian RT care at 2014-2015 is approaching the level of modern European RT.

  14. [Radiotherapy of benign intracranial tumors].

    PubMed

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects.

  15. Radiotherapy for Pancreatic Neuroendocrine Tumors

    SciTech Connect

    Contessa, Joseph N.; Griffith, Kent A.; Wolff, Elizabeth; Ensminger, William; Zalupski, Mark; Ben-Josef, Edgar

    2009-11-15

    Purpose: Pancreatic neuroendocrine tumors (PNTs) are rare malignant neoplasms considered to be resistant to radiotherapy (RT), although data on efficacy are scarce. We reviewed our institutional experience to further delineate the role of RT for patients with PNTs. Methods and Materials: Between 1986 and 2006, 36 patients with PNTs were treated with RT to 49 sites. Of these 36 patients, 23 had radiographic follow-up data, which were used to determine the tumor response rate and freedom from local progression. Long-term toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Results: The overall response rate to RT was 39% (13% complete response, 26% partial response, 56% stable disease, and 4% progressive disease). A significant difference in the freedom from local progression between the groups receiving either greater than or less than the median 2 Gy/fraction biologically equivalent dose of 49.6 Gy was found, with all radiographic progression occurring in patients who had received <=32 Gy. The actuarial 3-year local freedom from progression rate was 49%. Palliation was achieved in 90% of patients, with either improvement or resolution of symptoms after RT. Of 35 patients, 33 had metastatic disease at their referral for RT, and the median overall survival for this patient population was 2 years. Three long-term Grade 3 or greater toxicities were recorded. Conclusion: RT is an effective modality for achieving local control in patients with PNTs. RT produces high rates of symptomatic palliation and freedom from local progression. Prospective trials of radiotherapy for PNTs are warranted.

  16. Dose-dependent and gender-related radiation-induced transcription alterations of Gadd45a and Ier5 inhuman lymphocytes exposed to gamma ray emitted by (60)Co.

    PubMed

    Tavakoli, Hassan; Manoochehri, Mahdi; Modarres Mosalla, Sayed Mahdi; Ghafori, Mostafa; Karimi, Ali Akbar

    2013-04-01

    Growth arrest DNA damage-inducible 45a gene (Gadd45a) and immediate early response gene 5 (Ier5) have been emphasised as ideal radiation biomarkers in several reports. However, some aspects of radiation-induced transcriptional alterations of these genes are unknown. In this study, gender-dependency and dose-dependency as two factors that may affect radiation-induced transcription of Gadd45a and Ier5 genes were investigated. Human lymphocyte cells from six healthy voluntary blood donors (three women and three men) were irradiated in vitro with doses of 0.5-4.0 Gy from a (60)Co source and RNA isolated 4 h later using the High Pure RNA Isolation Kit. Dose and gender dependency of radiation-induced transcriptional alterations of Gadd45a and Ier5 genes were studied by quantitative real-time polymerase chain reaction. The results showed that as a whole, Gadd45a and Ier5 gave responses to gamma rays, while the responses were independent of radiation doses. Therefore, regardless of radiation dose, Gadd45a and Ier5 can be considered potential radiation biomarkers. Besides, although radiation-induced transcriptional alterations of Gadd45a in female and male lymphocyte samples were insignificant at 0.5 Gy, at other doses, their quantities in female samples were at a significantly higher level than in male samples. Radiation-induced transcription of Ier5 of females samples had a reduction in comparison with male samples at 1 and 2 Gy, but at doses of 0.5 and 4 Gy, females were significantly more susceptible to radiation-induced transcriptional alteration of Ier5.

  17. Interpretation of cytogenetic damage induced in the germ line of male mice exposed for over 1 year to /sup 239/Pu alpha particles, fission neutrons, or /sup 60/Co gamma rays

    SciTech Connect

    Grahn, D.; Lee, C.H.; Farrington, B.F.

    1983-09-01

    The relative biological effectiveness (RBE) of /sup 239/Pu alpha particles, fission neutrons (0.85 MeV), and /sup 60/Co gamma rays has been evaluated for the induction of reciprocal chromosome translocations in spermatogonia and of chromosome/chromatid fragments and chromatid rearrangements in the primary spermatocyte of adult male B6CF1 mice. Age concurrency was maintained for both internal and external radiations which were delivered at about 1 rad/week for /sup 239/Pu (single intravenous dose of 10 microCi/kg), 0.67, 1.67, and 2.67 rad/week for neutrons, and 6.95, 17.4, and 32 rad/week for gamma rays for at least 60 weeks. In terms of frequency of translocations, the response to the alpha emitter was nonlinear (concave downward) with little dose-response predictability; to cumulative neutron exposures the response was linear, without evidence of a dose-rate effect; and to gamma radiation the responses were linear, and a significant dose-rate effect was seen. RBE estimates are variable. For translocations, the n/gamma ratio is between 10 and 24, depending upon weekly dose level, and the ratio is 1 or less for the alpha particle relative to the neutron. For fragments, the n/gamma ratio is 18 to 22, depending upon age factors, and alpha/n is 1.5. For chromatid rearrangements, n/gamma is 7 and alpha/n is essentially indeterminate, but much below one. The overall response to the alpha emitter is interpreted to be a complex function of (a) microdosimetric heterogeneity, (b) a nearly invariant deposition pattern in the gonad, (c) the high sensitivity of differentiating spermatogonia to cell killing, and (d) the capacity of stem cells in relatively radiation-free areas to progressively assume the major spermatogenic role.

  18. Intraoperative Radiotherapy in Childhood Malignant Astrocytoma

    PubMed Central

    Rana, Sohail R.; Haddy, Theresa B.; Ashayeri, Ebrahim; Goldson, Alfred L.

    1984-01-01

    A 12-year-old black male patient with glioblastoma multiforme was treated with intraoperative radiotherapy followed by conventional external beam radiation and chemotherapy. The authors' clinical experience with these therapeutic measures is discussed. PMID:6330375

  19. Imaging Instrumentation and Techniques for Precision Radiotherapy

    NASA Astrophysics Data System (ADS)

    Parodi, Katia; Parodi, Katia; Thieke, Christian; Thieke, Christian

    Over the last decade, several technological advances have considerably improved the achievable precision of dose delivery in radiation therapy. Clinical exploitation of the superior tumor-dose conformality offered by modern radiotherapy techniques like intensity-modulated radiotherapy and ion beam therapy requires morphological and functional assessment of the tumor during the entire therapy chain from treatment planning to beam application and treatment response evaluation. This chapter will address the main rationale and role of imaging in state-of-the-art external beam radiotherapy. Moreover, it will present the status of novel imaging instrumentation and techniques being nowadays introduced in clinical use or still under development for image guidance and, ultimately, dose guidance of precision radiotherapy.

  20. [Conformal radiotherapy for vertebral bone metastasis].

    PubMed

    Faivre, J C; Py, J F; Vogin, G; Martinage, G; Salleron, J; Royer, P; Grandgirard, N; Pasquier, D; Thureau, S

    2016-10-01

    Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication. Analgesic re-irradiation is possible in the case of insufficient response or recurrent pain after radiotherapy. Metabolic radiation, bisphosphonates or denosumab do not dissuade external radiation therapy for pain relief. Systemic oncological treatments can be suspended with a period of wash out given the risk of radiosensitization or recall phenomenon. Better yet, the intensity modulated radiotherapy and stereotactic radiotherapy can be part of a curative strategy for oligometastatic patients and suggest new treatment prospects.

  1. [Hopes of high dose-rate radiotherapy].

    PubMed

    Fouillade, Charles; Favaudon, Vincent; Vozenin, Marie-Catherine; Romeo, Paul-Henri; Bourhis, Jean; Verrelle, Pierre; Devauchelle, Patrick; Patriarca, Annalisa; Heinrich, Sophie; Mazal, Alejandro; Dutreix, Marie

    2017-03-07

    In this review, we present the synthesis of the newly acquired knowledge concerning high dose-rate irradiations and the hopes that these new radiotherapy modalities give rise to. The results were presented at a recent symposium on the subject.

  2. [Radiotherapy of carcinoma of the salivary glands].

    PubMed

    Servagi-Vernat, S; Tochet, F

    2016-09-01

    Indication, doses, and technique of radiotherapy for salivary glands carcinoma are presented, and the contribution of neutrons and carbon ions. The recommendations for delineation of the target volumes and organs at risk are detailed.

  3. Heavy particle radiotherapy: prospects and pitfalls

    SciTech Connect

    Faju, M.R.

    1980-01-01

    The use of heavy particles in radiotherapy of tumor volumes is examined. Particles considered are protons, helium ions, heavy ions, negative pions, and fast neutrons. Advantages and disadvantages are discussed. (ACR)

  4. Intracranial aneurysm formation after radiotherapy for medulloblastoma

    PubMed Central

    Kamide, Tomoya; Mohri, Masanao; Misaki, Kouichi; Uchiyama, Naoyuki; Nakada, Mitsutoshi

    2016-01-01

    Background: The development of an intracranial aneurysm after radiotherapy is rare but secondary effect of cranial irradiation in a primary disease treatment. Case Description: The patient was a 17-year-old male adolescent who was diagnosed as having a posterior fossa medulloblastoma when he was 8 years old. He had undergone tumor resection with radiotherapy and chemotherapy. A distal posterior inferior cerebellar artery aneurysm was identified by magnetic resonance imaging 8 years after radiotherapy and grew rapidly throughout the next 1 year. The patient underwent microsurgical clipping and was discharged without deficit. Conclusion: This experience demonstrates that physicians caring for patients who have undergone intracranial radiotherapy should carefully consider the possibility of an aneurysmal formation when conducting follow-up imaging. PMID:27999713

  5. [Radiotherapy for small cell lung carcinoma].

    PubMed

    Pourel, N

    2016-10-01

    Radiotherapy for small cell lung carcinoma has known significant improvements over the past 10 years especially through routine use of PET-CT in the initial work-up and contouring before treatment. Prophylactic cranial irradiation remains a standard of care for locally advanced disease and is a subject of controversy for metastatic disease. A new indication for thoracic radiotherapy may soon arise for metastatic disease, still confirmation studies are ongoing.

  6. Blisters - an unusual effect during radiotherapy.

    PubMed

    Höller, U; Schubert, T; Budach, V; Trefzer, U; Beyer, M

    2013-11-01

    The skin reaction to radiation is regularly monitored in order to detect enhanced radiosensitivity of the patient, unexpected interactions (e.g. with drugs) or any inadvertent overdosage. It is important to distinguish secondary disease from radiation reaction to provide adequate treatment and to avoid unnecessary discontinuation of radiotherapy. A case of bullous eruption or blisters during radiotherapy of the breast is presented. Differential diagnoses bullous pemphigoid, pemphigus vulgaris, and bullous impetigo are discussed and treatment described.

  7. Radiotherapy in the treatment of vertebral hemangiomas

    SciTech Connect

    Faria, S.L.; Schlupp, W.R.; Chiminazzo, H. Jr.

    1985-02-01

    Symptomatic vertebral hemangiomas are not common. Although radiotherapy has been used as treatment, the data are sparse concerning total dose, fractionation and results. The authors report nine patients with vertebral hemangioma treated with 3000-4000 rad, 200 rad/day, 5 fractions per week, followed from 6 to 62 months. Seventy-seven percent had complete or almost complete disappearance of the symptoms. Radiotherapy schedules are discussed.

  8. Radiotherapy for Vestibular Schwannomas: A Critical Review

    SciTech Connect

    Murphy, Erin S.; Suh, John H.

    2011-03-15

    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  9. Spinal Cord Tolerance for Stereotactic Body Radiotherapy

    SciTech Connect

    Sahgal, Arjun; Ma Lijun; Gibbs, Iris; Gerszten, Peter C.; Ryu, Sam; Soltys, Scott; Weinberg, Vivian; Wong Shun; Chang, Eric; Fowler, Jack; Larson, David A.

    2010-06-01

    Purpose: Dosimetric data are reported for five cases of radiation-induced myelopathy after stereotactic body radiotherapy (SBRT) to spinal tumors. Analysis per the biologically effective dose (BED) model was performed. Methods and Materials: Five patients with radiation myelopathy were compared to a subset of 19 patients with no radiation myelopathy post-SBRT. In all patients, the thecal sac was contoured to represent the spinal cord, and doses to the maximum point, 0.1-, 1-, 2-, and 5-cc volumes, were analyzed. The mean normalized 2-Gy-equivalent BEDs (nBEDs), calculated using an alpha/beta value of 2 for late toxicity with units Gy 2/2, were compared using the t test and analysis of variance test. Results: Radiation myelopathy was observed at the maximum point with doses of 25.6 Gy in two fractions, 30.9 Gy in three fractions, and 14.8, 13.1, and 10.6 Gy in one fraction. Overall, there was a significant interaction between patient subsets and volume based on the nBED (p = 0.0003). Given individual volumes, a significant difference was observed for the mean maximum point nBED (p = 0.01). Conclusions: The maximum point dose should be respected for spine SBRT. For single-fraction SBRT 10 Gy to a maximum point is safe, and up to five fractions an nBED of 30 to 35 Gy 2/2 to the thecal sac also poses a low risk of radiation myelopathy.

  10. Patterns of Radiotherapy Practice for Patients With Cervical Cancer (1999-2001): Patterns of Care Study in Japan

    SciTech Connect

    Toita, Takafumi Kodaira, Takeshi; Shinoda, Atsunori; Uno, Takashi; Akino, Yuichi; Mitsumori, Michihide; Teshima, Teruki

    2008-03-01

    Purpose: To describe the patterns of definitive radiotherapy practice for patients with uterine cervical cancer from 1999 to 2001 in Japan. Methods and Materials: The Japanese Patterns of Care Study (JPCS) working group conducted a third extramural audit survey of 68 institutions and collected specific information on 324 cervical cancer patients treated with definitive radiotherapy. Results: Almost all patients (96%) were treated with whole pelvic radiotherapy using opposing anteroposterior fields (87%). A midline block was used in 70% of the patients. Intracavitary brachytherapy (ICBT) was applied in 82% of cases. Most patients (89%) were treated with high-dose rate (HDR) ICBT. Calculation of doses to organs at risk (ICRU 38) was performed for rectum in 25% of cases and for bladder in 18% of cases. Only 3% of patients were given intravenous conscious sedation during ICBT applicator insertions. The median total biologically effective dose at point A (EBRT+ICBT) was 74 Gy{sub 10} in cases treated with HDR-ICBT. There was no significant difference in total biologically effective dose between stages. The median overall treatment time was 47 days. Concurrent chemoradiation was applied in 17% of patients. Conclusions: This study describes the general patterns of radiotherapy practice for uterine cervical cancer in Japan. Although methods of external radiotherapy seemed to be appropriate, there was room for improvement in ICBT practice, such as pretreatment. A substantial difference in total radiotherapy dose between Japan and the United States was observed.

  11. Adapting radiotherapy to hypoxic tumours

    NASA Astrophysics Data System (ADS)

    Malinen, Eirik; Søvik, Åste; Hristov, Dimitre; Bruland, Øyvind S.; Rune Olsen, Dag

    2006-10-01

    In the current work, the concepts of biologically adapted radiotherapy of hypoxic tumours in a framework encompassing functional tumour imaging, tumour control predictions, inverse treatment planning and intensity modulated radiotherapy (IMRT) were presented. Dynamic contrast enhanced magnetic resonance imaging (DCEMRI) of a spontaneous sarcoma in the nasal region of a dog was employed. The tracer concentration in the tumour was assumed related to the oxygen tension and compared to Eppendorf histograph measurements. Based on the pO2-related images derived from the MR analysis, the tumour was divided into four compartments by a segmentation procedure. DICOM structure sets for IMRT planning could be derived thereof. In order to display the possible advantages of non-uniform tumour doses, dose redistribution among the four tumour compartments was introduced. The dose redistribution was constrained by keeping the average dose to the tumour equal to a conventional target dose. The compartmental doses yielding optimum tumour control probability (TCP) were used as input in an inverse planning system, where the planning basis was the pO2-related tumour images from the MR analysis. Uniform (conventional) and non-uniform IMRT plans were scored both physically and biologically. The consequences of random and systematic errors in the compartmental images were evaluated. The normalized frequency distributions of the tracer concentration and the pO2 Eppendorf measurements were not significantly different. 28% of the tumour had, according to the MR analysis, pO2 values of less than 5 mm Hg. The optimum TCP following a non-uniform dose prescription was about four times higher than that following a uniform dose prescription. The non-uniform IMRT dose distribution resulting from the inverse planning gave a three times higher TCP than that of the uniform distribution. The TCP and the dose-based plan quality depended on IMRT parameters defined in the inverse planning procedure (fields

  12. Radiotherapy Treatment Planning for Testicular Seminoma

    SciTech Connect

    Wilder, Richard B.; Buyyounouski, Mark K.; Efstathiou, Jason A.; Beard, Clair J.

    2012-07-15

    Virtually all patients with Stage I testicular seminoma are cured regardless of postorchiectomy management. For patients treated with adjuvant radiotherapy, late toxicity is a major concern. However, toxicity may be limited by radiotherapy techniques that minimize radiation exposure of healthy normal tissues. This article is an evidence-based review that provides radiotherapy treatment planning recommendations for testicular seminoma. The minority of Stage I patients who choose adjuvant treatment over surveillance may be considered for (1) para-aortic irradiation to 20 Gy in 10 fractions, or (2) carboplatin chemotherapy consisting of area under the curve, AUC = 7 Multiplication-Sign 1-2 cycles. Two-dimensional radiotherapy based on bony anatomy is a simple and effective treatment for Stage IIA or IIB testicular seminoma. Centers with expertise in vascular and nodal anatomy may consider use of anteroposterior-posteroanterior fields based on three-dimensional conformal radiotherapy instead. For modified dog-leg fields delivering 20 Gy in 10 fractions, clinical studies support placement of the inferior border at the top of the acetabulum. Clinical and nodal mapping studies support placement of the superior border of all radiotherapy fields at the top of the T12 vertebral body. For Stage IIA and IIB patients, an anteroposterior-posteroanterior boost is then delivered to the adenopathy with a 2-cm margin to the block edge. The boost dose consists of 10 Gy in 5 fractions for Stage IIA and 16 Gy in 8 fractions for Stage IIB. Alternatively, bleomycin, etoposide, and cisplatin chemotherapy for 3 cycles or etoposide and cisplatin chemotherapy for 4 cycles may be delivered to Stage IIA or IIB patients (e.g., if they have a horseshoe kidney, inflammatory bowel disease, or a history of radiotherapy).

  13. Case study thoracic radiotherapy in an elderly patient with pacemaker: The issue of pacing leads

    SciTech Connect

    Kirova, Youlia M.; Menard, Jean; Chargari, Cyrus; Mazal, Alejandro; Kirov, Krassen

    2012-07-01

    To assess clinical outcome of patients with pacemaker treated with thoracic radiation therapy for T8-T9 paravertebral chloroma. A 92-year-old male patient with chloroma presenting as paravertebral painful and compressive (T8-T9) mass was referred for radiotherapy in the Department of Radiation Oncology, Institut Curie. The patient presented with cardiac dysfunction and a permanent pacemaker that had been implanted prior. The decision of Multidisciplinary Meeting was to deliver 30 Gy in 10 fractions for reducing the symptoms and controlling the tumor growth. The patient received a total dose of 30 Gy in 10 fractions using 4-field conformal radiotherapy with 20-MV photons. The dose to pacemaker was 0.1 Gy but a part of the pacing leads was in the irradiation fields. The patient was treated the first time in the presence of his radiation oncologist and an intensive care unit doctor. Moreover, the function of his pacemaker was monitored during the entire radiotherapy course. No change in pacemaker function was observed during any of the radiotherapy fractions. The radiotherapy was very well tolerated without any side effects. The function of the pacemaker was checked before and after the radiotherapy treatment by the cardiologist and no pacemaker dysfunction was observed. Although updated guidelines are needed with acceptable dose criteria for implantable cardiac devices, it is possible to treat patients with these devices and parts encroaching on the radiation field. This case report shows we were able to safely treat our patient through a multidisciplinary approach, monitoring the patient during each step of the treatment.

  14. An audit of travel and waiting times for outpatient radiotherapy.

    PubMed

    Junor, E J; Macbeth, F R; Barrett, A

    1992-05-01

    The object of this study was to assess the non-medical factors which detract from the quality of outpatient receiving service to a population of 2.7 million in a wide geographical area. We conducted a survey by patient questionnaire of all outpatients receiving radiotherapy in the West of Scotland on a single day in 1990. A total of 216 outpatients attended for radiotherapy with a 92% response rate to the questionnaire being achieved. Median values (and ranges) were: age 58 (4-85) years, number of daily treatments 20 (4-33), distance travelled in one direction 10 (1-60) miles, travelling time 45 (5-130) minutes, waiting time in the unit for treatment 60 (0-200) minutes, and a time away from home of 2 hours 50 minutes (35 minutes-7 hours). Sixteen per cent of patients had a relative who lost time from work by transporting the patient and only 12 of 60 patients who were away from home over a meal time were offered a hospital meal. Sixteen per cent of patients came by ambulance and 73% by motor car. Of 146 travelling by car 27% used a charity service and 20% a volunteer driver ambulance service car. It is concluded that long travelling distances, travelling times and treatment waiting times for many patients require revision of transport provision, a strict appointment system, more treatment machines and hostel accommodation.

  15. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2013-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  16. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2014-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  17. Fiducial marker guided prostate radiotherapy: a review.

    PubMed

    O'Neill, Angela G M; Jain, Suneil; Hounsell, Alan R; O'Sullivan, Joe M

    2016-12-01

    Image-guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogeneous whole-pelvic radiotherapy dose, but these surrogates are not reliable when using reduced margins, dose escalation or hypofractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990s. They require surgical implantation and provide a surrogate for the position of the prostate gland. A variety of FMs are available and they can be used in a number of ways. This review aimed to establish the evidence for using prostate FMs in terms of feasibility, implantation procedures, types of FMs used, FM migration, imaging modalities used and the clinical impact of FMs. A search strategy was defined and a literature search was carried out in Medline. Inclusion and exclusion criteria were applied, which resulted in 50 articles being included in this review. The evidence demonstrates that FMs provide a more accurate surrogate for the position of the prostate than either external skin marks or bony anatomy. A combination of FM alignment and soft-tissue analysis is currently the most effective and widely available approach to ensuring accuracy in prostate IGRT. FM implantation is safe and well tolerated. FM migration is possible but minimal. Standardization of all techniques and procedures in relation to the use of prostate FMs is required. Finally, a clinical trial investigating a non-surgical alternative to prostate FMs is introduced.

  18. A dose comparison of proton radiotherapy and photon radiotherapy for pediatric brain tumor

    NASA Astrophysics Data System (ADS)

    Kim, S. Y.; Cho, J. H.

    2014-12-01

    The purpose of this study was to investigate the effectiveness of photon radiotherapy and to compare the dose of treatment planning between proton radiotherapy and 3D conformal radiation therapy (3D-CRT) for pediatric brain tumor patients. This study was conducted in five pediatric brain tumor patients who underwent craniospinal irradiation treatment from October 2013 to April 2014 in the hospital. The study compared organs at risk (OARs) by assessing the dose distribution of normal tissue from the proton plan and 3D-CRT. Furthermore, this study assessed the treatment plans by looking at the homogeneity index (HI) and conformity index (CI). As a result, the study revealed OARs due to the small volume proton radiotherapy dose distribution in the normal tissue. Also, by comparing HI and CI between the 3D-CRT and proton radiotherapy plan, the study found that the dose of proton radiotherapy plan was homogenized. When conducting 3D-CRT and proton radiotherapy in a dose-volume histogram comparison, the dose of distribution turned out to be low. Consequently, proton radiotherapy is used for protecting the normal tissue, and is used in tumor tissue as a homogenized dose for effective treatment.

  19. Dosimetric Comparison Between 3-Dimensional Conformal and Robotic SBRT Treatment Plans for Accelerated Partial Breast Radiotherapy.

    PubMed

    Goggin, L M; Descovich, M; McGuinness, C; Shiao, S; Pouliot, J; Park, C

    2016-06-01

    treatment times and 50% lower number of delivered monitor units (MU) were achievable with CyberKnife-multi-leaf collimator than with CyberKnife-Iris. The CyberKnife-multi-leaf collimator treatment times were comparable to 3-dimensional conformal radiotherapy, however, the number of MU delivered was approximately 2.5 times larger. The suitability of 10 + 2 mm margins warrants further investigation.

  20. Differences in breast tissue oxygenation following radiotherapy.

    PubMed

    Dornfeld, Ken; Gessert, Charles E; Renier, Colleen M; McNaney, David D; Urias, Rodolfo E; Knowles, Denise M; Beauduy, Jean L; Widell, Sherry L; McDonald, Bonita L

    2011-08-01

    Tissue perfusion and oxygenation changes following radiotherapy may result from and/or contribute to the toxicity of treatment. Breast tissue oxygenation levels were determined in the treated and non-treated breast 1 year after radiotherapy for breast conserving treatment. Transcutaneous oxygenation varied between subjects in both treated and non-treated breast. Subjects without diabetes mellitus (n=16) had an average oxygenation level of 64.8 ± 19.9mmHg in the irradiated breast and an average of 72.3 ± 18.1mmHg (p=0.018) at the corresponding location in the control breast. Patients with diabetes (n=4) showed a different oxygenation pattern, with lower oxygenation levels in control tissue and no decrease in the irradiated breast. This study suggests oxygenation levels in normal tissues vary between patients and may respond differently after radiotherapy.

  1. Oral verrucous carcinoma. Treatment with radiotherapy

    SciTech Connect

    Nair, M.K.; Sankaranarayanan, R.; Padmanabhan, T.K.; Madhu, C.S.

    1988-02-01

    Fifty-two cases of oral verrucous carcinoma treated with radiotherapy at the Regional Cancer Centre, Trivandrum, Kerala, India in 1982 were evaluated to determine the distribution within the oral cavity, clinical extent, and effectiveness of radiotherapy in controlling the disease. The most common site was the buccal mucosa. Fifty percent of the patients had clinically negative regional lymph nodes and 33% were in earlier stages (T1, T2, N0, and M0). The overall 3-year no evidence of disease (NED) survival rate was 44%. The 3-year NED survival rate with radium implant was 86%. We cannot comment on anaplastic transformation after radiotherapy because our treatment failures have not been subjected for biopsy concerning this matter. Because the results are comparable with those of well-differentiated squamous cell carcinoma, we think that the treatment policies advocated for oral squamous cell carcinoma are also applicable to oral verrucous carcinoma.

  2. [Good practice of image-guided radiotherapy].

    PubMed

    de Crevoisier, R; Créhange, G; Castelli, J; Lafond, C; Delpon, G

    2015-10-01

    Image-guided radiotherapy (IGRT) aims to take into account the anatomical variations occurring during the course of radiotherapy, by direct or indirect visualization of the target volume followed by a corrective action. The movements of the target, or at least the set-up errors are corrected by moving the treatment table, corresponding to the simplest and most validated IGRT modality in a standard practice. The deformations of the target volume and organs at risk are however much more common, and unfortunately much more complicated to consider, requiring multiple planning before or during the treatment, corresponding to the adaptive radiotherapy strategies. The planning target volume must be carefully chosen according to these anatomic variations. This article reviews the modalities of IGRT, standard or under evaluation, according to the different tumour sites.

  3. Radiotherapy-induced hypopituitarism: a review.

    PubMed

    Sathyapalan, Thozhukat; Dixit, Sanjay

    2012-05-01

    Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic-pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic-pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic-pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

  4. One hundred years of radiotherapy in Turkey.

    PubMed

    Dincer, M; Kuter, S

    2001-10-01

    The study and practice of radiology in Turkey began in 1897, only 2 years after the discovery of X-rays. A simple X-ray machine was constructed in Istanbul, consisting of a Crookes tube, a Ruhmkorff coil, and a home-made battery. This machine was first used on wounded soldiers, for diagnostic purposes. The first report of X-rays being used therapeutically in Turkey was published in a national journal in 1904. By 1933, the most up-to-date radiotherapy equipment of the time had been installed in every major city in the country. Innovative radiotherapy techniques, such as rotational treatment, were also being tried in 1930s. Today, there are 45 radiotherapy centres in Turkey, and 400 radiation oncologists and 80 medical physicists practise there.

  5. Pelvic radiotherapy and sexual function in women

    PubMed Central

    Froeding, Ligita Paskeviciute

    2015-01-01

    Background During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment. Following cure of cancer allow survivors focus on quality of life (QOL) issues; sexual functioning has proved to be one of the most important aspects of concern in long-term survivors. Methods An updated literature search in PubMed was performed on pelvic radiotherapy and female sexual functioning/dysfunction. Studies on gynaecological, urological and gastrointestinal cancers were included. The focus was on the period from 2010 to 2014, on studies using PROs, on potential randomized controlled trials (RCTs) where female sexual dysfunction (FSD) at least constituted a secondary outcome, and on studies reporting from modern radiotherapy modalities. Results The literature search revealed a few RCTs with FSD evaluated as a PRO and being a secondary outcome measure in endometrial and in rectal cancer patients. Very limited information could be extracted regarding FSD in bladder, vulva, and anal cancer patients. The literature before and after 2010 confirms that pelvic radiotherapy, independent on modality, increases the risk significantly for FSD both compared to data from age-matched healthy control women and compared to data on patients treated by surgery only. There was only very limited data available on modern radiotherapy modalities. These are awaited during the next five years. Several newer studies confirm that health care professionals are still reluctant to discuss treatment induced sexual dysfunction with patients. Conclusions

  6. Meningioma after radiotherapy for Hodgkin's disease.

    PubMed

    Deutsch, M; Rosenstein, M; Figura, J H

    1999-08-01

    The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.

  7. Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

    SciTech Connect

    Nabavizadeh, Nima Simeonova, Anna O.; Waller, Joseph G.; Romer, Jeanna L.; Monaco, Debra L.; Elliott, David A.; Tanyi, James A.; Fuss, Martin; Thomas, Charles R.; Holland, John M.

    2014-10-01

    Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8 Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45 Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4 Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4 Gy, IMRT: 62.4 Gy, and 3D-CRT: 62.3 Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4 Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.

  8. Radiotherapy in the management of early breast cancer

    SciTech Connect

    Wang, Wei

    2013-03-15

    Radiotherapy is an indispensible part of the management of all stages of breast cancer. In this article, the common indications for radiotherapy in the management of early breast cancer (stages 0, I, and II) are reviewed, including whole-breast radiotherapy as part of breast-conserving treatment for early invasive breast cancer and pre-invasive disease of ductal carcinoma in situ, post-mastectomy radiotherapy, locoregional radiotherapy, and partial breast irradiation. Key clinical studies that underpin our current practice are discussed briefly.

  9. The Leicester radiotherapy bite block: an aid to head and neck radiotherapy.

    PubMed

    Hollows, P; Hayter, J P; Vasanthan, S

    2001-02-01

    We describe the construction of a custom-made bite block to be used during external beam radiotherapy to the oral cavity. The bite block is made with standard maxillofacial prosthetic techniques and materials. The design allows accurate and reproducible positioning of the perioral tissues to aid planning of radiotherapy and treatment. The compressibility of this device improves comfort for the patient, while it is in use.

  10. Post-radiotherapy hypothyroidism in dogs treated for thyroid carcinomas.

    PubMed

    Amores-Fuster, I; Cripps, P; Blackwood, L

    2017-03-01

    Hypothyroidism is a common adverse event after head and neck radiotherapy in human medicine, but uncommonly reported in canine patients. Records of 21 dogs with histologically or cytologically confirmed thyroid carcinoma receiving definitive or hypofractionated radiotherapy were reviewed. Nine cases received 48 Gy in 12 fractions, 10 received 36 Gy in 4 fractions and 2 received 32 Gy in 4 fractions. Seventeen cases had radiotherapy in a post-operative setting. Ten cases developed hypothyroidism (47.6%) after radiotherapy. The development of hypothyroidism was not associated with the radiotherapy protocol used. Median time to diagnosis of hypothyroidism was 6 months (range, 1-13 months). Hypothyroidism is a common side effect following radiotherapy for thyroid carcinomas. Monitoring of thyroid function following radiotherapy is recommended. No specific risk factors have been identified.

  11. Breast Cancer Patients’ Experience of External-Beam Radiotherapy

    PubMed Central

    Schnur, Julie B.; Ouellette, Suzanne C.; Bovbjerg, Dana H.; Montgomery, Guy H.

    2013-01-01

    Radiotherapy is a critical component of treatment for the majority of women with breast cancer, particularly those who receive breast conserving surgery. Although medically beneficial, radiotherapy can take a physical and psychological toll on patients. However, little is known about the specific thoughts and feelings experienced by women undergoing breast cancer radiotherapy. Therefore, the study aim was to use qualitative research methods to develop an understanding of these thoughts and feelings based on 180 diary entries, completed during radiotherapy by 15 women with Stage 0-III breast cancer. Thematic analysis identified four primary participant concerns: (a) a preoccupation with time; (b) fantasies (both optimistic and pessimistic) about life following radiotherapy; (c) the toll their side-effect experience takes on their self-esteem; and (d) feeling mystified by radiotherapy. These themes are consistent with previous literature on illness and identity. These findings have implications for the treatment and care of women undergoing breast cancer radiotherapy. PMID:19380502

  12. Bladder Preservation for Localized Muscle-Invasive Bladder Cancer: The Survival Impact of Local Utilization Rates of Definitive Radiotherapy

    SciTech Connect

    Kozak, Kevin R.; Hamidi, Maryam; Manning, Matthew; Moody, John S.

    2012-06-01

    Purpose: This study examines the management and outcomes of muscle-invasive bladder cancer in the United States. Methods and Materials: Patients with muscle-invasive bladder cancer diagnosed between 1988 and 2006 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified according to three mutually exclusive treatment categories based on the primary initial treatment: no local management, radiotherapy, or surgery. Overall survival was assessed with Kaplan-Meier analysis and Cox models based on multiple factors including treatment utilization patterns. Results: The study population consisted of 26,851 patients. Age, sex, race, tumor grade, histology, and geographic location were associated with differences in treatment (all p < 0.01). Patients receiving definitive radiotherapy tended to be older and have less differentiated tumors than patients undergoing surgery (RT, median age 78 years old and 90.6% grade 3/4 tumors; surgery, median age 71 years old and 77.1% grade 3/4 tumors). No large shifts in treatment were seen over time, with most patients managed with surgical resection (86.3% for overall study population). Significant survival differences were observed according to initial treatment: median survival, 14 months with no definitive local treatment; 17 months with radiotherapy; and 43 months for surgery. On multivariate analysis, differences in local utilization rates of definitive radiotherapy did not demonstrate a significant effect on overall survival (hazard ratio, 1.002; 95% confidence interval, 0.999-1.005). Conclusions: Multiple factors influence the initial treatment strategy for muscle-invasive bladder cancer, but definitive radiotherapy continues to be used infrequently. Although patients who undergo surgery fare better, a multivariable model that accounted for patient and tumor characteristics found no survival detriment to the utilization of definitive radiotherapy. These results support continued

  13. Gold Nanoparticle Hyperthermia Reduces Radiotherapy Dose

    PubMed Central

    Lin, Lynn; Slatkin, Daniel N.; Dilmanian, F. Avraham; Vadas, Timothy M.; Smilowitz, Henry M.

    2014-01-01

    Gold nanoparticles can absorb near infrared light, resulting in heating and ablation of tumors. Gold nanoparticles have also been used for enhancing the dose of X-rays in tumors during radiotherapy. The combination of hyperthermia and radiotherapy is synergistic, importantly allowing a reduction in X-ray dose with improved therapeutic results. Here we intratumorally infused small 15 nm gold nanoparticles engineered to be transformed from infrared-transparent to infrared-absorptive by the tumor, which were then heated by infrared followed by X-ray treatment. Synergy was studied using a very radioresistant subcutaneous squamous cell carcinoma (SCCVII) in mice. It was found that the dose required to control 50% of the tumors, normally 55 Gy, could be reduced to <15 Gy (a factor of >3.7). Gold nanoparticles therefore provide a method to combine hyperthermia and radiotherapy to drastically reduce the X-ray radiation needed, thus sparing normal tissue, reducing the side effects, and making radiotherapy more effective. PMID:24990355

  14. Radiotherapy for inverted papilloma: a case report.

    PubMed

    Levendag, P C; Annyas, A A; Escajadillo, J R; Elema, J D

    1984-06-01

    Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore, we present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy.

  15. Results of radiotherapy for Peyronie's disease

    SciTech Connect

    Niewald, Marcus . E-mail: ramnie@uniklinikum-saarland.de; Wenzlawowicz, Knut v.; Fleckenstein, Jochen; Wisser, Lothar; Derouet, Harry; Ruebe, Christian

    2006-01-01

    Purpose: To retrospectively review the results of radiotherapy for Peyronie's disease. Patients and Methods: In the time interval 1983-2000, 154 patients in our clinic were irradiated for Peyronie's disease. Of those, 101 had at least one complete follow-up data set and are the subject of this study. In the majority of patients, penis deviation was between 30 and 50{sup o}, there were one or two indurated foci with a diameter between 5 and 15 mm. Pain was recorded in 48/92 patients. Seventy-two of the 101 patients received radiotherapy with a total dose of 30 Gy, and 25 received 36 Gy in daily fractions of 2.0 Gy. The remaining patients received the following dosage: 34 Gy (1 patient), 38-40 Gy (3 patients). Mean duration of follow-up was 5 years. Results: The best results ever at any time during follow-up were an improvement of deviation in 47%, reduction of number of foci in 32%, reduction of size of foci in 49%, and less induration in 52%. Approximately 50% reported pain relief after radiotherapy. There were 28 patients with mild acute dermatitis and only 4 patients with mild urethritis. There were no long-term side effects. Conclusion: Our results compare well with those of other studies in the literature. In our patient cohort, radiotherapy was an effective therapy option with only very rare and mild side effects.

  16. Neo-adjuvant radiotherapy in rectal cancer

    PubMed Central

    Glimelius, Bengt

    2013-01-01

    In rectal cancer treatment, attention has focused on the local primary tumour and the regional tumour cell deposits to diminish the risk of a loco-regional recurrence. Several large randomized trials have also shown that combinations of surgery, radiotherapy and chemotherapy have markedly reduced the risk of a loco-regional recurrence, but this has not yet had any major influence on overall survival. The best results have been achieved when the radiotherapy has been given preoperatively. Preoperative radiotherapy improves loco-regional control even when surgery has been optimized to improve lateral clearance, i.e., when a total mesorectal excision has been performed. The relative reduction is then 50%-70%. The value of radiotherapy has not been tested in combination with more extensive surgery including lateral lymph node clearance, as practised in some Asian countries. Many details about how the radiotherapy is performed are still open for discussion, and practice varies between countries. A highly fractionated radiation schedule (5 Gy × 5), proven efficacious in many trials, has gained much popularity in some countries, whereas a conventionally fractionated regimen (1.8-2.0 Gy × 25-28), often combined with chemotherapy, is used in other countries. The additional therapy adds morbidity to the morbidity that surgery causes, and should therefore be administered only when the risk of loco-regional recurrence is sufficiently high. The best integration of the weakest modality, to date the drugs (conventional cytotoxics and biologicals) is not known. A new generation of trials exploring the best sequence of treatments is required. Furthermore, there is a great need to develop predictors of response, so that treatment can be further individualized and not solely based upon clinical factors and anatomic imaging. PMID:24379566

  17. In vivo dosimetry with diodes in a radiotherapy department in Pakistan.

    PubMed

    Tunio, Mutahir; Rafi, Mansoor; Ali, Shoukat; Ahmed, Zaeem; Zameer, Asad; Hashmi, Altaf; Maqbool, Syed A

    2011-11-01

    The International Commission of Radiological Units (ICRU) sets a tolerance of ±5 % on dose delivery, with more recent data limiting the overall tolerances to ±3 %. One of the best methods for accurate dose delivery and quality check is in vivo dosimetry, while radiotherapy is performed. The present study was carried out to test the applicability of diodes for performing in vivo entrance dose measurements in external photon beam radiotherapy for pelvic tumours and its implementation as quality assurance tool in radiotherapy. During November 2007 to December 2009, in 300 patients who received pelvic radiotherapy on a multileaf-collimator-assisted linear accelerator, the central axis dose was measured by in vivo dosimetry by p-Si diodes. Entrance dose measurements were taken by diodes and were compared with the prescribed dose. Totally 1000 calculations were performed. The mean and standard deviation between measured and prescribed dose was 1.26 ± 2.8 %. In 938 measurements (93.8 %), the deviation was <5 % (1.36 ± 2.9%); in 62 measurements (6.2 %) the mean deviation was >5 % (5.51 ± 2.3 %). Larger variations were seen in lateral and oblique fields more than anteroposterior fields. For larger deviations, patients and diode positional errors were found to be the common factors alone or in combination with other factors. After additional corrections, repeated measurements were achieved within tolerance levels. This study showed that diode-detector-based in vivo dosimetry was simple, cost-effective, provides quick results and can serve as a useful quality assurance tool in radiotherapy. The data acquired in the present study can be used for evaluating output calibration of therapy machine, precision of calculations, effectiveness of treatment plan and patient setup.

  18. On effective dose for radiotherapy based on doses to nontarget organs and tissues

    SciTech Connect

    Uselmann, Adam J. Thomadsen, Bruce R.

    2015-02-15

    Purpose: The National Council for Radiation Protection and Measurement (NCRP) published estimates for the collective population dose and the mean effective dose to the population of the United States from medical imaging procedures for 1980/1982 and for 2006. The earlier report ignored the effective dose from radiotherapy and the latter gave a cursory discussion of the topic but again did not include it in the population exposure for various reasons. This paper explains the methodology used to calculate the effective dose in due to radiotherapy procedures in the latter NCRP report and revises the values based on more detailed modeling. Methods: This study calculated the dose to nontarget organs from radiotherapy for reference populations using CT images and published peripheral dose data. Results: Using International Commission on Radiological Protection (ICRP) 60 weighting factors, the total effective dose to nontarget organs in radiotherapy patients is estimated as 298 ± 194 mSv per patient, while the U.S. population effective dose is 0.939 ± 0.610 mSv per person, with a collective dose of 283 000 ± 184 000 person Sv per year. Using ICRP 103 weighting factors, the effective dose is 281 ± 183 mSv per patient, 0.887 ± 0.577 mSv per person in the U.S., and 268 000 ± 174 000 person Sv per year. The uncertainty in the calculations is largely governed by variations in patient size, which was accounted for by considering a range of patient sizes and taking the average treatment site to nontarget organ distance. Conclusions: The methods used to estimate the effective doses from radiotherapy used in NCRP Report No. 160 have been explained and the values updated.

  19. Radiotherapy infrastructure and human resources in Europe - present status and its implications for 2020.

    PubMed

    Datta, Niloy Ranjan; Samiei, Massoud; Bodis, Stephan

    2014-10-01

    Radiotherapy (RT) is required for nearly half of the newly diagnosed cancer patients. To optimise the quality and availability of RT, guidelines have been proposed by European Society for Radiotherapy and Oncology-QUAntification of Radiation Therapy Infrastructure And Staffing Needs (ESTRO-QUARTS) and the International Atomic Energy Agency (IAEA). This study evaluates the present status of RT capacity in Europe and the projected needs by 2020 as per these recommendations. Thirty-nine of the 53 countries, listed in Europe by the UN Statistical Division, whose cancer incidences, teletherapy and human resources were available in the Global Cancer Incidence, Mortality and Prevalence (GLOBOCAN), International Agency for Research on Cancer (IARC) and DIrectory of RAdiotherapy Centres (DIRAC) (IAEA) databases were evaluated. A total of 3550 teletherapy units (TRT), 7017 radiation oncologists (RO), 3685 medical physicists (MP) and 12,788 radiotherapy technologists (RTT) are presently available for the 3.44 million new cancer cases reported annually in these countries. The present infrastructure and human resources in RT are estimated to provide RT access to 74.3% of the patients requiring RT. The current capacity in TRT, RO, MP and RTT when compared with recommended guidelines has a deficit of 25.6%, 18.3%, 22.7% and 10.6%, respectively. Thus, to respond to requirements by 2020, the existing capacity needs to be augmented by an additional 1698 TRTs, 2429 ROs, 1563 MPs and 2956 RTTs. With an imminent rise in cancer incidence, multifaceted strategic planning at national and international levels within a coordinated comprehensive cancer control programme is highly desirable to give adequate access to all patients who require radiotherapy across Europe. Specific steps to address this issue at national and continental levels involving all major stakeholders are proposed.

  20. Development of silicon monolithic arrays for dosimetry in external beam radiotherapy

    NASA Astrophysics Data System (ADS)

    Bisello, Francesca; Menichelli, David; Scaringella, Monica; Talamonti, Cinzia; Zani, Margherita; Bucciolini, Marta; Bruzzi, Mara

    2015-10-01

    New tools for dosimetry in external beam radiotherapy have been developed during last years in the framework of the collaboration among the University of Florence, INFN Florence and IBA Dosimetry. The first step (in 2007) was the introduction in dosimetry of detector solutions adopted from high energy physics, namely epitaxial silicon as the base detector material and a guard ring in diode design. This allowed obtaining state of the art radiation hardness, in terms of sensitivity dependence on accumulated dose, with sensor geometry particularly suitable for the production of monolithic arrays with modular design. Following this study, a 2D monolithic array has been developed, based on 6.3×6.3 cm2 modules with 3 mm pixel pitch. This prototype has been widely investigated and turned out to be a promising tool to measure dose distributions of small and IMRT fields. A further linear array prototype has been recently design with improve spatial resolution (1 mm pitch) and radiation hardness. This 24 cm long device is constituted by 4×64 mm long modules. It features low sensitivity changes with dose (0.2%/kGy) and dose per pulse (±1% in the range 0.1-2.3 mGy/pulse, covering applications with flattened and unflattened photon fields). The detector has been tested with very satisfactory results as a tool for quality assurance of linear accelerators, with special regards to small fields, and proton pencil beams. In this contribution, the characterization of the linear array with unflattened MV X-rays, 60Co radiation and 226 MeV protons is reported.

  1. Technical advances in external radiotherapy for hepatocellular carcinoma

    PubMed Central

    Park, Shin-Hyung; Kim, Jae-Chul; Kang, Min Kyu

    2016-01-01

    Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma (HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs. SABR can deliver a very high radiation dose to small HCCs in a few fractions, leading to high local control rates of 84%-100%. Various advanced imaging modalities are used for radiotherapy planning and delivery to improve the precision of radiotherapy. These advanced techniques enable the delivery of high dose radiotherapy for early to advanced HCCs without increasing the radiation-induced toxicities. However, as there have been no effective tools for the prediction of the response to radiotherapy or recurrences within or outside the radiation field, future studies should focus on selecting the patients who will benefit from radiotherapy. PMID:27621577

  2. Stereotactic Image-Guided Intensity Modulated Radiotherapy Using the HI-ART II Helical Tomotherapy System

    SciTech Connect

    Holmes, Timothy W. Hudes, Richard; Dziuba, Sylwester; Kazi, Abdul; Hall, Mark; Dawson, Dana

    2008-07-01

    The highly integrated adaptive radiation therapy (HI-ART II) helical tomotherapy unit is a new radiotherapy machine designed to achieve highly precise and accurate treatments at all body sites. The precision and accuracy of the HI-ART II is similar to that provided by stereotactic radiosurgery systems, hence the historical distinction between external beam radiotherapy and stereotactic procedures based on differing precision requirements is removed for this device. The objectives of this work are: (1) to describe stereotactic helical tomotherapy processes (SRS, SBRT); (2) to show that the precision and accuracy of the HI-ART meet the requirements defined for SRS and SBRT; and (3) to describe the clinical implementation of a stereotactic image-guided intensity modulated radiation therapy (IG-IMRT) system that incorporates optical motion management.

  3. Hippocampal-sparing whole-brain radiotherapy using Elekta equipment.

    PubMed

    Nevelsky, Alexander; Ieumwananonthachai, Nantakan; Kaidar-Person, Orit; Bar-Deroma, Raquel; Nasrallah, Haitam; Ben-Yosef, Rahamim; Kuten, Abraham

    2013-05-06

    The purpose of this study was to evaluate the feasibility of hippocampal-sparing whole-brain radiotherapy (HS WBRT) using the Elekta Infinity linear accelerator and Monaco treatment planning system (TPS). Ten treatment plans were created for HS-WBRT to a dose of 30 Gy (10 fractions). RTOG 0933 recommendations were applied for treatment planning. Intensity-modulated radiotherapy (IMRT) plans for the Elekta Infinity linear accelerator were created using Monaco 3.1 TPS-based on a nine-field arrangement and step-and-shoot delivery method. Plan evaluation was performed using D2% and D98% for the whole-brain PTV (defined as whole brain excluding hippocampus avoidance region), D100% and maximum dose to the hippocampus, and maximum dose to optic nerves and chiasm. Homogeneity index (HI) defined as (D2%-D98%)/Dmedian was used to quantify dose homogeneity in the PTV. The whole-brain PTV D2% mean value was 37.28 Gy (range 36.95-37.49Gy), and D98% mean value was 25.37 Gy (range 25.40-25.89 Gy). The hippocampus D100% mean value was 8.37 Gy (range 7.48-8.97 Gy) and the hippocampus maximum dose mean value was 14.35 Gy (range 13.48-15.40 Gy). The maximum dose to optic nerves and optic chiasm for all patients did not exceed 37.50 Gy. HI mean value was 0.36 (range 0.34-0.37). Mean number of segments was 105 (range 88-122) and mean number of monitor units was 1724 (range 1622-1914). Gamma evaluation showed that all plans passed 3%, 3 mm criteria with more than 99% of the measured points. These results indicate that Elekta equipment (Elekta Infinity linac and Monaco TPS) can be used for HS WBRT planning according to compliance criteria defined by the RTOG 0933 protocol.

  4. Second cancers following radiotherapy for cancer

    SciTech Connect

    Curtis, R.E.

    1997-03-01

    The study of second cancer risk after radiotherapy provides a unique opportunity to study carcinogenesis since large groups of humans are deliberately exposed to substantial doses of radiation in order to cure disease. Detailed radiotherapy records for cancer patients allow precise quantification of organ dose, and population-based cancer registries are frequently available to provide access to large groups of patients who are closely followed for long periods. Moreover, cancer patients treated with surgery alone (no radiation) are frequently available to serve as a non-irradiated comparison group. New information can be provided on relatively insensitive organs, and low dose exposures in the range of scientific interest are received by organs outside the radiation treatment fields. This paper will review several recently completed studies that characterize the risk of radiation-induced second cancers. Emphasis will be given to studies providing new information on the dose-response relationship of radiation-induced leukemia, breast cancer and lung cancer.

  5. [Radiotherapy as primary treatment for chemodectoma?].

    PubMed

    Verniers, D; Van Limbergen, E; Leysen, J; Ostyn, F; Segers, A

    1990-01-01

    Chemodectomas are slowly growing tumours originating in the chemoreceptor bodies. The diagnosis is based on typical clinical symptoms and radiological investigation. CT scanning with contrast enhancement permits to establish diagnosis in most cases and gives a correct idea of tumour size, tumour extension, displacement of arteries and bone destruction. Small tympanic chemodectomas are successfully managed by surgery, without causing additional cranial nerve palsies. Surgery of larger lesions is frequently followed by a high percentage of local recurrence (greater than 50%) and important morbidity (neurologic sequelae). Our present series confirms that these tumours can successfully be treated by radiotherapy. Persisting local control rates can be obtained in more than 90% of cases with moderate doses (45-50 Gy in 5 weeks) of carefully planned radiotherapy.

  6. [Radiotherapy and targeted therapy/immunotherapy].

    PubMed

    Antoni, D; Bockel, S; Deutsch, E; Mornex, F

    2016-10-01

    Thanks to recent advances achieved in oncologic systemic and local ablative treatment, the treatments become more and more efficient in term of local control and overall survival. Thus, the targeted therapies, immunotherapy or stereotactic radiotherapy have modified the management of patients, especially in case of oligometastatic disease. Many questions are raised by these innovations, particularly the diagnosis and management of new side effects or that of the combination of these different treatments, depending on the type of primary tumor. Fundamental data are available, while clinical data are still limited. Ongoing trials should help to clarify the clinical management protocols. This manuscript is a review of the combination of radiotherapy and targeted therapy/immunotherapy.

  7. Perianal Paget disease treated definitively with radiotherapy.

    PubMed

    Mann, J; Lavaf, A; Tejwani, A; Ross, P; Ashamalla, H

    2012-12-01

    Extramammary Paget disease (empd) is a relatively rare cutaneous disorder described as an apocrine gland tumour occurring in both a benign and a malignant form with metastatic potential. The areas of the body affected are the vulva, perianal region, penis, scrotum, perineum, and axilla, all of which contain apocrine glands. When empd affects the perianal region, it is called perianal Paget disease (ppd). All forms of empd, including ppd, are typically treated by wide surgical excision. Perianal Paget disease usually occurs later in life in patients who are often poor surgical candidates, but the available literature is scarce regarding other treatment modalities, including definitive radiotherapy. We contend that ppd can be safely and effectively treated with radiotherapy, and here, we present the case of a 75-year-old woman with ppd who was successfully so treated. A brief review of the literature concerning the diagnosis, natural history, and treatment of ppd is also included.

  8. Proton Radiotherapy for Solid Tumors of Childhood

    PubMed Central

    Cotter, Shane E.; McBride, Sean M.; Yock, Torunn I.

    2012-01-01

    The increasing efficacy of pediatric cancer therapy over the past four decades has produced many long-term survivors that now struggle with serious treatment related morbidities affecting their quality of life. Radiation therapy is responsible for a significant proportion of these late effects, but a relatively new and emerging modality, proton radiotherapy hold great promise to drastically reduce these treatment related late effects in long term survivors by sparing dose to normal tissues. Dosimetric studies of proton radiotherapy compared with best available photon based treatment show significant dose sparing to developing normal tissues. Furthermore, clinical data are now emerging that begin to quantify the benefit in decreased late treatment effects while maintaining excellent cancer control rates. PMID:22417062

  9. Status of radiotherapy in a multidisciplinary cancer board.

    PubMed

    Ichikawa, Mayumi; Nemoto, Kenji; Miwa, Misako; Ohta, Ibuki; Nomiya, Takuma; Yamakawa, Mayumi; Itho, Yuriko; Fukui, Tadahisa; Yoshioka, Takashi

    2014-03-01

    Multidisciplinary cancer boards (CBs) for making cancer treatment decisions have become popular in many countries; however, the status of radiotherapy in CBs and the influence of CBs on radiotherapy decisions have not been studied. To clarify these issues, we reviewed the minutes of our CBs from February 2010 to March 2012, and we classified planned treatments discussed at the CBs into five categories and analyzed decisions concerning radiotherapy in each category. The fraction of cases for which radiotherapy was recommended was 536/757 (71%). These cases included 478 cases (63%) for which radiation therapy was planned and four cases (0.5%) for which radiation therapy was unexpectedly recommended. On the other hand, radiation therapy was canceled in 21 cases (4%) for which radiation therapy had been planned. This study showed that radiotherapy was discussed in many cases at CBs and that CBs have a great influence on decisions concerning radiotherapy.

  10. Postoperative radiotherapy in the management of keloids

    PubMed Central

    Carvajal, Claudia C; Ibarra, Carla M; Arbulo, Douglas L; Russo, Moisés N; Solé, Claudio P

    2016-01-01

    Background The high recurrence rate following keloid resection has generated interest in adjuvant treatments for this disease. Objective This study assesses keloid recurrence when treated with surgery and adjuvant radiotherapy. Methods Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin. Results Around103 keloids were analysed in 63 patients treated with 15 Gy in three fraction radiotherapy which was initiated on the same day as the surgery (75% of cases). The median keloid diameter was 6 cm; the most common site was thoracic (22%); the most common cause was prior surgery (35%); 37% caused symptoms, and several (47%) had received prior treatment with corticosteroids (32%), or surgery (30%). The median follow-up was three years, and 94% of recurrences occurred during the first year following treatment. Uni and multivariate analyses showed that an absence of symptoms was a protective factor for recurrence (OR: 0.24), while the time interval from onset to treatment with surgery plus radiotherapy >4.2 years was a risk factor (OR: 2.23). The first year recurrence rate was 32% and stabilised at 32% by the second year with no recurrences after 15 months. Conclusions The combination of surgery and radiotherapy proved to be a good therapeutic alternative in the management of keloids. Our results are similar to those described in the literature for a dose of 15 Gy. Given these results, our centre will implement a new dose escalation protocol to improve future outcomes. PMID:27994646

  11. Radiotherapy equipment--purchase or lease?

    PubMed

    Nisbet, A; Ward, A

    2001-08-01

    Against a background of increasing demand for radiotherapy equipment, this study was undertaken to investigate options for equipment procurement, in particular to compare purchase with lease. The perceived advantages of lease are that equipment can be acquired within budget and cashflow constraints, with relatively low amounts of cash leaving the NHS in the first year, avoiding the necessity of capitalizing the equipment and providing protection against the risk of obsolescence associated with high technology equipment. The perceived disadvantages of leasing are that the Trust does not own the equipment, leasing can be more expensive in revenue terms, the tender process is extended and there may be lease conditions to be met, which may be costly and/or restrictive. There are also a number of technical considerations involved in the leasing of radiotherapy equipment that influence the financial analysis and practical operation of the radiotherapy service. The technical considerations include servicing and planned preventative maintenance, upgrades, spare parts, subsequent purchase of "add ons", modification of equipment, research and development work, commencement of the lease period, return of equipment at the end of the lease period and negotiations at the end of the lease period. A study from Raigmore Hospital, Inverness is described, which involves the procurement of new, state-of-the-art radiotherapy equipment. This provides an overview of the procurement process, including a summary of the advantages and disadvantages of leasing, with the figures from the financial analysis presented and explained. In addition, a detailed description is given of the technical considerations to be taken into account in the financial analysis and negotiation of any lease contract.

  12. Low-Dose Radiotherapy in Indolent Lymphoma

    SciTech Connect

    Rossier, Christine; Schick, Ulrike; Miralbell, Raymond; Mirimanoff, Rene O.; Weber, Damien C.; Ozsahin, Mahmut

    2011-11-01

    Purpose: To assess the response rate, duration of response, and overall survival after low-dose involved-field radiotherapy in patients with recurrent low-grade lymphoma or chronic lymphocytic leukemia (CLL). Methods and Materials: Forty-three (24 women, 19 men) consecutive patients with indolent lymphoma or CLL were treated with a total dose of 4 Gy (2 x 2 Gy) using 6- 18-MV photons. The median age was 73 years (range, 39-88). Radiotherapy was given either after (n = 32; 75%) or before (n = 11; 25%) chemotherapy. The median time from diagnosis was 48 months (range, 1-249). The median follow-up period was 20 months (range, 1-56). Results: The overall response rate was 90%. Twelve patients (28%) had a complete response, 15 (35%) had a partial response, 11 (26%) had stable disease, and 5 (11%) had progressive disease. The median overall survival for patients with a positive response (complete response/partial response/stable disease) was 41 months; for patients with progressive disease it was 6 months (p = 0.001). The median time to in-field progression was 21 months (range, 0-24), and the median time to out-field progression was 8 months (range, 0-40). The 3-year in-field control was 92% in patients with complete response (median was not reached). The median time to in-field progression was 9 months (range, 0.5-24) in patients with partial response and 6 months (range, 0.6-6) in those with stable disease (p < 0.05). Younger age, positive response to radiotherapy, and no previous chemotherapy were the best factors influencing the outcome. Conclusions: Low-dose involved-field radiotherapy is an effective treatment in the management of patients with recurrent low-grade lymphoma or CLL.

  13. Radiation transport in a radiotherapy room

    SciTech Connect

    Agosteo, S.; Para, A.F.; Maggioni, B.

    1995-01-01

    The photoneutron dose equivalent in a linac radio-therapy room and its entrance maze was investigated by means of Monte Carlo simulations under different conditions. Particularly, the effect of neutron absorbers and moderator layers placed on the maze walls was considered. The contribution of prompt gamma rays emitted in absorption reactions of thermal neutrons was also taken into account. The simulation results are compared with some experimental measurements in the therapy room and in the maze. 13 refs., 5 figs., 5 tabs.

  14. Partial breast radiotherapy with simple teletherapy techniques.

    PubMed

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  15. Hypothyroidism After Radiotherapy for Nasopharyngeal Cancer Patients

    SciTech Connect

    Wu, Y.-H.; Wang, H-M.; Chen, Hellen Hi-Wen; Lin, C.-Y.; Chen, Eric Yen-Chao; Fan, K.-H.; Huang, S.-F.; Chen, I-How; Liao, C.-T.; Cheng, Ann-Joy; Chang, Joseph Tung-Chieh

    2010-03-15

    Purpose: The aim of this study was to determine the long-term incidence and possible predictive factors for posttreatment hypothyroidism in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods and Materials: Four hundred and eight sequential NPC patients who had received regular annual thyroid hormone surveys prospectively after radiotherapy were included in this study. Median patient age was 47.3 years, and 286 patients were male. Thyroid function was prospectively evaluated by measuring thyroid-stimulating hormone (TSH) and serum free thyroxine (FT4) levels. Low FT4 levels indicated clinical hypothyroidism in this study. Results: With a median follow-up of 4.3 years (range, 0.54-19.7 years), the incidence of low FT4 level was 5.3%, 9.0%, and 19.1% at 3, 5, and 10 years after radiotherapy, respectively. Hypothyroidism was more common with early T stage (p = 0.044), female sex (p = 0.037), and three-dimensional conformal therapy with the altered fractionation technique (p = 0.005) after univariate analysis. N stage, chemotherapy, reirradiation, and neck electron boost did not affect the incidence of hypothyroidism. Younger age and conformal therapy were significant factors that determined clinical hypothyroidism after multivariate analysis. Overall, patients presented with a low FT4 level about 1 year after presenting with an elevated TSH level. Conclusion: Among our study group of NPC patients, 19.1% experienced clinical hypothyroidism by 10 years after treatment. Younger age and conformal therapy increased the risk of hypothyroidism. We suggest routine evaluation of thyroid function in NPC patients after radiotherapy. The impact of pituitary injury should be also considered.

  16. Targeting Radiotherapy to Cancer by Gene Transfer

    PubMed Central

    2003-01-01

    Targeted radionuclide therapy is an alternative method of radiation treatment which uses a tumor-seeking agent carrying a radioactive atom to deposits of tumor, wherever in the body they may be located. Recent experimental data signifies promise for the amalgamation of gene transfer with radionuclide targeting. This review encompasses aspects of the integration of gene manipulation and targeted radiotherapy, highlighting the possibilities of gene transfer to assist the targeting of cancer with low molecular weight radiopharmaceuticals. PMID:12721515

  17. Partial breast radiotherapy with simple teletherapy techniques

    SciTech Connect

    Fekete, Gábor; Újhidy, Dóra; Együd, Zsófia; Kiscsatári, Laura; Marosi, Gusztáv; Kahán, Zsuzsanna; Varga, Zoltán

    2015-01-01

    A prospective pilot study of partial breast irradiation (PBI) with conventional vs hypofractionated schedules was set out. The study aimed to determine efficacy, acute and late side effects, and the preference of photon vs electron irradiation based on individual features. Patients were enrolled according to internationally accepted guidelines on PBI. Conformal radiotherapy plans were generated with both photon and electron beams, and the preferred technique based on dose homogeneity and the radiation exposure of healthy tissues was applied. For electron dose verification, a special phantom was constructed. Patients were randomized for fractionation schedules of 25 × 2 vs 13 × 3 Gy. Skin and breast changes were registered at the time of and ≥1 year after the completion of radiotherapy. Dose homogeneity was better with photons. If the tumor bed was located in the inner quadrants, electron beam gave superior results regarding conformity and sparing of organ at risk (OAR). If the tumor was situated in the lateral quadrants, conformity was better with photons. A depth of the tumor bed ≥3.0 cm predicted the superiority of photon irradiation (odds ratio [OR] = 23.6, 95% CI: 5.2 to 107.5, p < 0.001) with >90% sensitivity and specificity. After a median follow-up of 39 months, among 72 irradiated cases, 1 local relapse out of the tumor bed was detected. Acute radiodermatitis of grade I to II, hyperpigmentation, and telangiectasia developed ≥1 year after radiotherapy, exclusively after electron beam radiotherapy. The choice of electrons or photons for PBI should be based on tumor bed location; the used methods are efficient and feasible.

  18. Current concepts on imaging in radiotherapy.

    PubMed

    Lecchi, Michela; Fossati, Piero; Elisei, Federica; Orecchia, Roberto; Lucignani, Giovanni

    2008-04-01

    New high-precision radiotherapy (RT) techniques, such as intensity-modulated radiation therapy (IMRT) or hadrontherapy, allow better dose distribution within the target and spare a larger portion of normal tissue than conventional RT. These techniques require accurate tumour volume delineation and intrinsic characterization, as well as verification of target localisation and monitoring of organ motion and response assessment during treatment. These tasks are strongly dependent on imaging technologies. Among these, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US) and positron emission tomography (PET) have been applied in high-precision RT. For tumour volume delineation and characterization, PET has brought an additional dimension to the management of cancer patients by allowing the incorporation of crucial functional and molecular images in RT treatment planning, i.e. direct evaluation of tumour metabolism, cell proliferation, apoptosis, hypoxia and angiogenesis. The combination of PET and CT in a single imaging system (PET/CT) to obtain a fused anatomical and functional dataset is now emerging as a promising tool in radiotherapy departments for delineation of tumour volumes and optimization of treatment plans. Another exciting new area is image-guided radiotherapy (IGRT), which focuses on the potential benefit of advanced imaging and image registration to improve precision, daily target localization and monitoring during treatment, thus reducing morbidity and potentially allowing the safe delivery of higher doses. The variety of IGRT systems is rapidly expanding, including cone beam CT and US. This article examines the increasing role of imaging techniques in the entire process of high-precision radiotherapy.

  19. The role of radiotherapy in veterinary practice.

    PubMed

    Owen, L N

    1975-11-01

    It is common knowledge today that cancer is by no means an incurable disease and therefore it is no longer necessary to propose euthanasia for all inoperable cases of malignant neoplasia. The veterinary surgeon has a duty to inform his client of current methods of treatment, particularly radiotherapy, which may possibly provide a cure or prolong life without pain for several months. This article outlines the availability and usefulness of this important line of treatment.

  20. Glioblastoma multiforme after radiotherapy for acromegaly

    SciTech Connect

    Piatt, J.H. Jr.; Blue, J.M.; Schold, S.C. Jr.; Burger, P.C.

    1983-07-01

    A case of glioblastoma multiforme that occurred 14 years after radiotherapy for acromegaly is presented. The striking correspondence between the anatomy of the tumor and the geometry of the radiation ports is suggestive of a causal relationship. Previously reported cases of radiation-associated glioma are reviewed, and a brief appraisal of the evidence for induction of these lesions by radiation is presented. The differentiation of radiation-associated neoplasms from radionecrosis is also discussed.

  1. Adaptive Radiotherapy for an Uncommon Chloroma

    PubMed Central

    Majdoul, Soufya; Colson-Durand, Laurianne; To, Nu Hanh; Belkacemi, Yazid

    2016-01-01

    Granulocytic sarcomas, also referred to as chloromas or myeloid sarcomas, are extramedullary neoplasms that are composed of immature myeloid cells. This uncommon disease is known to be radiosensitive. However, the total dose and dose per fraction are not standardized. In addition, during the course of radiation therapy, significant reduction of the tumor is usually obtained. Thus, target volume reduction may require an intermediate radiotherapy plan evaluation for an adaptive treatment. A second plan at mid-dose is highly recommended. PMID:27920690

  2. Medical treatment for biochemical relapse after radiotherapy.

    PubMed

    Quero, L; Hennequin, C

    2014-10-01

    This article's purpose was to review the medical data justifying the use of a medical treatment for biochemical relapse after external beam radiotherapy. The MEDLINE database was searched to identify relevant information with the following medical subject headings: "prostate cancer", "radiotherapy" and "biochemical relapse". Prognostic factors affecting the overall survival of patients with a biochemical relapse after external beam radiotherapy have been identified: short prostate specific antigen (PSA)-doubling time (< 12 months), high PSA value (> 10 ng/mL) and short interval between treatment and biochemical relapse (< 18 months). If a second local treatment is not feasible, timing to initiate a salvage medical treatment is not defined. Particularly, randomized trials did not demonstrate a significant benefit of an early initiation of androgen deprivation treatment. Some retrospective studies suggest that an early androgen deprivation is justified if poor prognostic factors are found. However, if an androgen deprivation treatment is prescribed, intermittent schedule is non-inferior to a continuous administration and seems to offer a better quality of life. Many non-hormonal treatments have also been evaluated in this setting: only 5-alpha-reductase inhibitors could be proposed in some specific situations. In conclusion, the judicious use of a medical treatment for biochemical relapse is still debated. Given the natural history of this clinical situation, a simple surveillance is justified in many cases.

  3. [Influence of radiotherapy on lymphocyte stimulation].

    PubMed

    Renner, H; Renner, K H; Hassenstein, E

    1976-08-01

    More than 300 lymphocyte cultures of 12 patients with seminomas were examined during the prophylactic radiotherapy and, in several cases, during an extended period until 20.5 months after the end of the treatment. The object of this study was to find out by measuring the capacity of the lymphocytes to be stimulated in vitro wheather they could be damaged by the radiotherapy. Among other reasons, the above mentioned patients were chosen because they had been submitted to irradiations of vast volumes of lymphatic tissues at a uniform focal dose of 4000 rad. The different opinions expressed in the literature (stimulation decreassed resp. increased resp. unchanged) are reflected by our results in such a way that we did not find a qualitative loss of the capacity to be stimulated cultures. The problem of the different opinions about the capacity of lymphocytes to be stimulated after a radiotherapy appears; among other things, to be based on different examination methods. According to these methods- morphological determination of the relative number of lymphoblasts, synthesis of DNA by fluid scintillation counting, or determination of the number of surviving cells in vitro -different results are obtained. It seems not possible to use the lymphocyte stimulation in vitro as a method of testing clinical sideefects occuring during the characteristics of immunity and radiation biology are not differentiated in a more precise manner.

  4. Proton beam radiotherapy of iris melanoma

    SciTech Connect

    Damato, Bertil . E-mail: Bertil@damato.co.uk; Kacperek, Andrzej; Chopra, Mona; Sheen, Martin A.; Campbell, Ian R.; Errington, R. Douglas

    2005-09-01

    Purpose: To report on outcomes after proton beam radiotherapy of iris melanoma. Methods and Materials: Between 1993 and 2004, 88 patients with iris melanoma received proton beam radiotherapy, with 53.1 Gy in 4 fractions. Results: The patients had a mean age of 52 years and a median follow-up of 2.7 years. The tumors had a median diameter of 4.3 mm, involving more than 2 clock hours of iris in 32% of patients and more than 2 hours of angle in 27%. The ciliary body was involved in 20%. Cataract was present in 13 patients before treatment and subsequently developed in another 18. Cataract had a 4-year rate of 63% and by Cox analysis was related to age (p = 0.05), initial visual loss (p < 0.0001), iris involvement (p < 0.0001), and tumor thickness (p < 0.0001). Glaucoma was present before treatment in 13 patients and developed after treatment in another 3. Three eyes were enucleated, all because of recurrence, which had an actuarial 4-year rate of 3.3% (95% CI 0-8.0%). Conclusions: Proton beam radiotherapy of iris melanoma is well tolerated, the main problems being radiation-cataract, which was treatable, and preexisting glaucoma, which in several patients was difficult to control.

  5. Anal Cancer: An Examination of Radiotherapy Strategies

    SciTech Connect

    Glynne-Jones, Rob; Lim, Faye

    2011-04-01

    The Radiation Therapy Oncology Group 9811, ACCORD-03, and ACT II Phase III trials in anal cancer showed no benefit for cisplatin-based induction and maintenance chemotherapy, or radiation dose-escalation >59 Gy. This review examines the efficacy and toxicity of chemoradiation (CRT) in anal cancer, and discusses potential alternative radiotherapy strategies. The evidence for the review was compiled from randomized and nonrandomized trials of radiation therapy and CRT. A total of 103 retrospective/observational studies, 4 Phase I/II studies, 16 Phase II prospective studies, 2 randomized Phase II studies, and 6 Phase III trials of radiotherapy or chemoradiation were identified. There are no meta-analyses based on individual patient data. A 'one-size-fits-all' approach for all stages of anal cancer is inappropriate. Early T1 tumors are probably currently overtreated, whereas T3/T4 lesions might merit escalation of treatment. Intensity-modulated radiotherapy or the integration of biological therapy may play a role in future.

  6. Personalized radiotherapy: concepts, biomarkers and trial design

    PubMed Central

    Redalen, K R

    2015-01-01

    In the past decade, and pointing onwards to the immediate future, clinical radiotherapy has undergone considerable developments, essentially including technological advances to sculpt radiation delivery, the demonstration of the benefit of adding concomitant cytotoxic agents to radiotherapy for a range of tumour types and, intriguingly, the increasing integration of targeted therapeutics for biological optimization of radiation effects. Recent molecular and imaging insights into radiobiology will provide a unique opportunity for rational patient treatment, enabling the parallel design of next-generation trials that formally examine the therapeutic outcome of adding targeted drugs to radiation, together with the critically important assessment of radiation volume and dose-limiting treatment toxicities. In considering the use of systemic agents with presumed radiosensitizing activity, this may also include the identification of molecular, metabolic and imaging markers of treatment response and tolerability, and will need particular attention on patient eligibility. In addition to providing an overview of clinical biomarker studies relevant for personalized radiotherapy, this communication will highlight principles in addressing clinical evaluation of combined-modality-targeted therapeutics and radiation. The increasing number of translational studies that bridge large-scale omics sciences with quality-assured phenomics end points—given the imperative development of open-source data repositories to allow investigators the access to the complex data sets—will enable radiation oncology to continue to position itself with the highest level of evidence within existing clinical practice. PMID:25989697

  7. Personalized radiotherapy: concepts, biomarkers and trial design.

    PubMed

    Ree, A H; Redalen, K R

    2015-07-01

    In the past decade, and pointing onwards to the immediate future, clinical radiotherapy has undergone considerable developments, essentially including technological advances to sculpt radiation delivery, the demonstration of the benefit of adding concomitant cytotoxic agents to radiotherapy for a range of tumour types and, intriguingly, the increasing integration of targeted therapeutics for biological optimization of radiation effects. Recent molecular and imaging insights into radiobiology will provide a unique opportunity for rational patient treatment, enabling the parallel design of next-generation trials that formally examine the therapeutic outcome of adding targeted drugs to radiation, together with the critically important assessment of radiation volume and dose-limiting treatment toxicities. In considering the use of systemic agents with presumed radiosensitizing activity, this may also include the identification of molecular, metabolic and imaging markers of treatment response and tolerability, and will need particular attention on patient eligibility. In addition to providing an overview of clinical biomarker studies relevant for personalized radiotherapy, this communication will highlight principles in addressing clinical evaluation of combined-modality-targeted therapeutics and radiation. The increasing number of translational studies that bridge large-scale omics sciences with quality-assured phenomics end points-given the imperative development of open-source data repositories to allow investigators the access to the complex data sets-will enable radiation oncology to continue to position itself with the highest level of evidence within existing clinical practice.

  8. Big Data Analytics for Prostate Radiotherapy.

    PubMed

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose-volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the "RadoncSpace") in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches.

  9. Sacral plexus injury after radiotherapy for carcinoma of cervix

    SciTech Connect

    Stryker, J.A.; Sommerville, K.; Perez, R.; Velkley, D.E. )

    1990-10-01

    A 42-year-old woman developed lower extremity weakness and sensory loss 1 year after external and intracavitary radiotherapy for Stage IB carcinoma of cervix. She has been followed for 5 years posttreatment, and the neurologic abnormalities have persisted, but no evidence of recurrent carcinoma has been found. We believe this to be a rare case of sacral plexus radiculopathy developing as a late complication after radiotherapy. Suggestions are made for improving the radiotherapy technique to prevent this complication in future cases.

  10. MR Imaging Based Treatment Planning for Radiotherapy of Prostate Cancer

    DTIC Science & Technology

    2005-02-01

    treatment planning for radiotherapy : Dosimetric verification for prostate IiMRT" and " Dosimetric evaluation of MRI-based treatment planning for...Shawn M, Ma C-M, Freedman GM and Pollack A. MRI-Based Treatment Planning for Radiotherapy : Dosimetric Verification for Prostate IMRT. International...Freedman GM and Pollack A. MRI- Based Treatment Planning for Radiotherapy : Dosimetric Verification for Prostate ]IMRT. International Journal of Radiation

  11. Genome-wide transcription responses to synchrotron microbeam radiotherapy.

    PubMed

    Sprung, Carl N; Yang, Yuqing; Forrester, Helen B; Li, Jason; Zaitseva, Marina; Cann, Leonie; Restall, Tina; Anderson, Robin L; Crosbie, Jeffrey C; Rogers, Peter A W

    2012-10-01

    The majority of cancer patients achieve benefit from radiotherapy. A significant limitation of radiotherapy is its relatively low therapeutic index, defined as the maximum radiation dose that causes acceptable normal tissue damage to the minimum dose required to achieve tumor control. Recently, a new radiotherapy modality using synchrotron-generated X-ray microbeam radiotherapy has been demonstrated in animal models to ablate tumors with concurrent sparing of normal tissue. Very little work has been undertaken into the cellular and molecular mechanisms that differentiate microbeam radiotherapy from broad beam. The purpose of this study was to investigate and compare the whole genome transcriptional response of in vivo microbeam radiotherapy versus broad beam irradiated tumors. We hypothesized that gene expression changes after microbeam radiotherapy are different from those seen after broad beam. We found that in EMT6.5 tumors at 4-48 h postirradiation, microbeam radiotherapy differentially regulates a number of genes, including major histocompatibility complex (MHC) class II antigen gene family members, and other immunity-related genes including Ciita, Ifng, Cxcl1, Cxcl9, Indo and Ubd when compared to broad beam. Our findings demonstrate molecular differences in the tumor response to microbeam versus broad beam irradiation and these differences provide insight into the underlying mechanisms of microbeam radiotherapy and broad beam.

  12. Biomarkers for DNA DSB inhibitors and radiotherapy clinical trials.

    PubMed

    Liu, Stanley K; Olive, Peggy L; Bristow, Robert G

    2008-09-01

    Major technical advances in radiotherapy, including IMRT and image-guided radiotherapy, have allowed for improved physical precision and increased dose delivery to the tumor, with better sparing of surrounding normal tissue. The development of inhibitors of the sensing and repair of DNA double-strand breaks (DSBs) is exciting and could be combined with precise radiotherapy targeting to improve local control following radiotherapy. However, caution must be exercised in order that DSB inhibitors are combined with radiotherapy in such a manner as to preserve the therapeutic ratio by exploiting repair deficiencies in malignant cells over that of normal cells. In this review, we discuss the rationale and current approaches to targeting DSB sensing and repair pathways in combined modality with radiotherapy. We also describe potential biomarkers that could be useful in detecting functional inhibition of DSB repair in a patient's tissues during clinical radiotherapy trials. Finally, we examine a number of issues relating to the use of DSB-inhibiting molecular agents and radiotherapy in the context of the tumor microenvironment, effects on normal tissues and the optimal timing and duration of the agent in relation to fractionated radiotherapy.

  13. Proton Radiotherapy for Liver Tumors: Dosimetric Advantages Over Photon Plans

    SciTech Connect

    Wang Xiaochun Krishnan, Sunil; Zhang Xiaodong; Dong Lei; Briere, Tina; Crane, Christopher H.; Martel, Mary; Gillin, Michael; Mohan, Radhe; Beddar, Sam

    2008-01-01

    The purpose of the study is to dosimetrically investigate the advantages of proton radiotherapy over photon radiotherapy for liver tumors. The proton plan and the photon plan were designed using commercial treatment planning systems. The treatment target dose conformity and heterogeneity and dose-volume analyses of normal structures were compared between proton and photon radiotherapy for 9 patients with liver tumors. Proton radiotherapy delivered a more conformal target dose with slightly less homogeneity when compared with photon radiotherapy. Protons significantly reduced the fractional volume of liver receiving dose greater or equal to 30 Gy (V{sub 30}) and the mean liver dose. The stomach and duodenal V{sub 45} were significantly lower with the use of proton radiotherapy. The V{sub 40} and V{sub 50} of the heart and the maximum spinal cord dose were also significantly lower with the use of proton radiotherapy. Protons were better able to spare one kidney completely and deliver less dose to one (generally the left) kidney than photons. The mean dose to the total body and most critical structures was significantly decreased using protons when compared to corresponding photon plans. In conclusion, our study suggests the dosimetric benefits of proton radiotherapy over photon radiotherapy. These dosimetric advantages of proton plans may permit further dose escalation with lower risk of complications.

  14. Dysphagia after radiotherapy: state of the art and prevention.

    PubMed

    Servagi-Vernat, S; Ali, D; Roubieu, C; Durdux, C; Laccourreye, O; Giraud, P

    2015-02-01

    Adjuvant radiotherapy after surgery or exclusive radiotherapy, with or without concurrent chemotherapy is a valuable treatment option in the great majority of patients with head and neck cancer. Recent technical progress in radiotherapy has resulted in a decreased incidence of xerostomia. Another common toxicity of radiotherapy is dysphagia, which alters the nutritional status and quality of life of patients in remission. The objective of this review is to describe the physiology of swallowing function, the pathophysiology of radiation-induced dysphagia and the various strategies currently available to prevent this complication.

  15. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    PubMed Central

    2014-01-01

    Background The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Methods Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Results Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Conclusions Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy. PMID:24495453

  16. Dynamic targeting image-guided radiotherapy

    SciTech Connect

    Huntzinger, Calvin; Munro, Peter; Johnson, Scott; Miettinen, Mika; Zankowski, Corey; Ahlstrom, Greg; Glettig, Reto; Filliberti, Reto; Kaissl, Wolfgang; Kamber, Martin; Amstutz, Martin; Bouchet, Lionel; Klebanov, Dan; Mostafavi, Hassan; Stark, Richard

    2006-07-01

    Volumetric imaging and planning for 3-dimensional (3D) conformal radiotherapy and intensity-modulated radiotherapy (IMRT) have highlighted the need to the oncology community to better understand the geometric uncertainties inherent in the radiotherapy delivery process, including setup error (interfraction) as well as organ motion during treatment (intrafraction). This has ushered in the development of emerging technologies and clinical processes, collectively referred to as image-guided radiotherapy (IGRT). The goal of IGRT is to provide the tools needed to manage both inter- and intrafraction motion to improve the accuracy of treatment delivery. Like IMRT, IGRT is a process involving all steps in the radiotherapy treatment process, including patient immobilization, computed tomogaphy (CT) simulation, treatment planning, plan verification, patient setup verification and correction, delivery, and quality assurance. The technology and capability of the Dynamic Targeting{sup TM} IGRT system developed by Varian Medical Systems is presented. The core of this system is a Clinac (registered) or Trilogy{sup TM} accelerator equipped with a gantry-mounted imaging system known as the On-Board Imager{sup TM} (OBI). This includes a kilovoltage (kV) x-ray source, an amorphous silicon kV digital image detector, and 2 robotic arms that independently position the kV source and imager orthogonal to the treatment beam. A similar robotic arm positions the PortalVision{sup TM} megavoltage (MV) portal digital image detector, allowing both to be used in concert. The system is designed to support a variety of imaging modalities. The following applications and how they fit in the overall clinical process are described: kV and MV planar radiographic imaging for patient repositioning, kV volumetric cone beam CT imaging for patient repositioning, and kV planar fluoroscopic imaging for gating verification. Achieving image-guided motion management throughout the radiation oncology process

  17. Left-sided breast cancer irradiation using rotational and fixed-field radiotherapy

    SciTech Connect

    Qi, X. Sharon; Liu, Tian X.; Liu, Arthur K.; Newman, Francis; Rabinovitch, Rachel; Kavanagh, Brian; Hu, Y. Angie

    2014-10-01

    The 3-dimensional conformal radiotherapy (3DCRT) technique is the standard for breast cancer radiotherapy. During treatment planning, not only the coverage of the planning target volume (PTV) but also the minimization of the dose to critical structures, such as the lung, heart, and contralateral breast tissue, need to be considered. Because of the complexity and variations of patient anatomy, more advanced radiotherapy techniques are sometimes desired to better meet the planning goals. In this study, we evaluated external-beam radiation treatment techniques for left breast cancer using various delivery platforms: fixed-field including TomoDirect (TD), static intensity-modulated radiotherapy (sIMRT), and rotational radiotherapy including Elekta volumetric-modulated arc therapy (VMAT) and tomotherapy helical (TH). A total of 10 patients with left-sided breast cancer who did or did not have positive lymph nodes and were previously treated with 3DCRT/sIMRT to the entire breast were selected, their treatment was planned with Monaco VMAT, TD, and TH. Dosimetric parameters including PTV coverage, organ-at-risk (OAR) sparing, dose-volume histograms, and target minimum/maximum/mean doses were evaluated. It is found that for plans providing comparable PTV coverage, the Elekta VMAT plans were generally more inhomogeneous than the TH and TD plans. For the cases with regional node involvement, the average mean doses administered to the heart were 9.2 (± 5.2) and 8.8 (± 3.0) Gy in the VMAT and TH plans compared with 11.9 (± 6.4) and 11.8 (± 9.2) Gy for the 3DCRT and TD plans, respectively, with slightly higher doses given to the contralateral lung or breast or both. On average, the total monitor units for VMAT plans are 11.6% of those TH plans. Our studies have shown that VMAT and TH plans offer certain dosimetric advantages over fixed-field IMRT plans for advanced breast cancer requiring regional nodal treatment. However, for early-stage breast cancer fixed

  18. Effectiveness of Radiotherapy for Elderly Patients With Glioblastoma

    SciTech Connect

    Scott, Jacob; Tsai, Ya-Yu; Chinnaiyan, Prakash; Yu, Hsiang-Hsuan Michael

    2011-09-01

    Purpose: Radiotherapy plays a central role in the definitive treatment of glioblastoma. However, the optimal management of elderly patients with glioblastoma remains controversial, as the relative benefit in this patient population is unclear. To better understand the role that radiation plays in the treatment of glioblastoma in the elderly, we analyzed factors influencing patient survival using a large population-based registry. Methods and Materials: A total of 2,836 patients more than 70 years of age diagnosed with glioblastoma between 1993 and 2005 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry. Demographic and clinical variables used in the analysis included gender, ethnicity, tumor size, age at diagnosis, surgery, and radiotherapy. Cancer-specific survival and overall survival were evaluated using the Kaplan-Meier method. Univariate and multivariate analysis were performed using Cox regression. Results: Radiotherapy was administered in 64% of these patients, and surgery was performed in 68%. Among 2,836 patients, 46% received surgery and radiotherapy, 22% underwent surgery only, 18% underwent radiotherapy only, and 14% did not undergo either treatment. The median survival for patients who underwent surgery and radiotherapy was 8 months. The median survival for patients who underwent radiotherapy only was 4 months, and for patients who underwent surgery only was 3 months. Those who received neither surgery nor radiotherapy had a median survival of 2 months (p < 0.001). Multivariate analysis showed that radiotherapy significantly improved cancer-specific survival (hazard ratio [HR], 0.43, 95% confidence interval [CI] 0.38-0.49) after adjusting for surgery, tumor size, gender, ethnicity, and age at diagnosis. Other factors associated with Cancer-specific survival included surgery, tumor size, age at diagnosis, and ethnicity. Analysis using overall survival as the endpoint yielded very similar results. Conclusions: Elderly

  19. Outcome analysis of 300 prostate cancer patients treated with neoadjuvant androgen deprivation and hypofractionated radiotherapy

    SciTech Connect

    Higgins, Geoffrey S. . E-mail: geoffrey.higgins@luht.scot.nhs.uk; McLaren, Duncan B.; Kerr, Gillian R.; Elliott, Tony; Howard, Grahame

    2006-07-15

    Purpose: Neoadjuvant androgen deprivation and radical radiotherapy is an established treatment for localized prostate carcinoma. This study sought to analyze the outcomes of patients treated with relatively low-dose hypofractionated radiotherapy. Methods and Materials: Three hundred patients with T1-T3 prostate cancer were treated between 1996 and 2001. Patients were prescribed 3 months of neoadjuvant androgen deprivation before receiving 5250 cGy in 20 fractions. Patients' case notes and the oncology database were used to retrospectively assess outcomes. Median follow-up was 58 months. Results: Patients presented with prostate cancer with poorer prognostic indicators than that reported in other series. At 5 years, the actuarial cause-specific survival rate was 83.2% and the prostate-specific antigen (PSA) relapse rate was 57.3%. Metastatic disease had developed in 23.4% of patients. PSA relapse continued to occur 5 years from treatment in all prognostic groups. Independent prognostic factors for relapse included treatment near the start of the study period, neoadjuvant oral anti-androgen monotherapy rather than neoadjuvant luteinizing hormone releasing hormone therapy, and diagnosis through transurethral resection of the prostate rather than transrectal ultrasound. Conclusion: This is the largest reported series of patients treated with neoadjuvant androgen deprivation and hypofractionated radiotherapy in the United Kingdom. Neoadjuvant hormonal therapy did not appear to adequately compensate for the relatively low effective radiation dose used.

  20. Updates on clinical studies of selenium supplementation in radiotherapy

    PubMed Central

    2014-01-01

    To establish guidelines for the selenium supplementation in radiotherapy we assessed the benefits and risks of selenium supplementation in radiotherapy. Clinical studies on the use of selenium in radiotherapy were searched in the PubMed electronic database in January 2013. Sixteen clinical studies were identified among the 167 articles selected in the initial search. Ten articles were observational studies, and the other 6 articles reported studies on the effects of selenium supplementation in patients with cancer who underwent radiotherapy. The studies were conducted worldwide including European, American and Asian countries between 1987 and 2012. Plasma, serum or whole blood selenium levels were common parameters used to assess the effects of radiotherapy and the selenium supplementation status. Selenium supplementation improved the general conditions of the patients, improved their quality of life and reduced the side effects of radiotherapy. At the dose of selenium used in these studies (200–500 μg/day), selenium supplementation did not reduce the effectiveness of radiotherapy, and no toxicities were reported. Selenium supplementation may offer specific benefits for several types of cancer patients who undergo radiotherapy. Because high-dose selenium and long-term supplementation may be unsafe due to selenium toxicity, more evidence-based information and additional research are needed to ensure the therapeutic benefits of selenium supplementation. PMID:24885670

  1. Radiotherapy and breast reconstruction: oncology, cosmesis and complications

    PubMed Central

    Ashton, Mark W

    2012-01-01

    Breast reconstruction plays a highly important role in the management of patients with breast cancer, from a psycho-social and sexual stand-point. Given that immediate breast reconstruction does not impair the oncologic safety of breast cancer management, with no increase in local recurrence rates, and no delays in the initiation of adjuvant chemotherapy or radiotherapy, the need to balance cosmesis in reconstruction with the oncologic needs of breast cancer patients is no more evident than in the discussion of radiotherapy. Radiotherapy is essential adjuvant therapy in the treatment of breast cancer, with the use of adjuvant radiotherapy widely shown to reduce local recurrence after both partial and total mastectomy and shown to prolong both disease-free and overall survival in patients with nodal disease. In the setting of breast reconstruction, the effects of radiotherapy are potentially two-fold, with consideration required of the impact of breast reconstruction on the administration of and the initiation of radiotherapy, as well as the effects of radiotherapy on operative complications and cosmetic outcome following immediate breast reconstruction. The current editorial piece aims to analyze this balance, contrasting both autologous and implant-based reconstruction. The literature is still evolving as to the relative role of autologous vs. alloplastic reconstruction in the setting of radiotherapy, and the more recent introduction of acellular dermal matrix and other compounds further complicate the evidence. Fat grafting and evolving techniques in breast reconstruction will herald new discussions on this front. PMID:25083434

  2. Children Undergoing Radiotherapy: Swedish Parents’ Experiences and Suggestions for Improvement

    PubMed Central

    Mullaney, Tara; Nilsson, Kristina; Wickart-Johansson, Gun; Svärd, Anna-Maja; Nyholm, Tufve; Lindh, Jack; Lindh, Viveca

    2015-01-01

    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80–90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child’s and the parent’s view of the procedure. As part of an ongoing multicenter study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents’ experience when their child undergoes radiotherapy treatment, and to report parents’ suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2–16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people’s lives upside down, affecting the entire family. Further, the parents experience the child’s suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process. PMID:26509449

  3. Children Undergoing Radiotherapy: Swedish Parents' Experiences and Suggestions for Improvement.

    PubMed

    Ångström-Brännström, Charlotte; Engvall, Gunn; Mullaney, Tara; Nilsson, Kristina; Wickart-Johansson, Gun; Svärd, Anna-Maja; Nyholm, Tufve; Lindh, Jack; Lindh, Viveca

    2015-01-01

    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multicenter study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.

  4. Updates on clinical studies of selenium supplementation in radiotherapy.

    PubMed

    Puspitasari, Irma M; Abdulah, Rizky; Yamazaki, Chiho; Kameo, Satomi; Nakano, Takashi; Koyama, Hiroshi

    2014-05-29

    To establish guidelines for the selenium supplementation in radiotherapy we assessed the benefits and risks of selenium supplementation in radiotherapy. Clinical studies on the use of selenium in radiotherapy were searched in the PubMed electronic database in January 2013. Sixteen clinical studies were identified among the 167 articles selected in the initial search. Ten articles were observational studies, and the other 6 articles reported studies on the effects of selenium supplementation in patients with cancer who underwent radiotherapy. The studies were conducted worldwide including European, American and Asian countries between 1987 and 2012. Plasma, serum or whole blood selenium levels were common parameters used to assess the effects of radiotherapy and the selenium supplementation status. Selenium supplementation improved the general conditions of the patients, improved their quality of life and reduced the side effects of radiotherapy. At the dose of selenium used in these studies (200-500 μg/day), selenium supplementation did not reduce the effectiveness of radiotherapy, and no toxicities were reported. Selenium supplementation may offer specific benefits for several types of cancer patients who undergo radiotherapy. Because high-dose selenium and long-term supplementation may be unsafe due to selenium toxicity, more evidence-based information and additional research are needed to ensure the therapeutic benefits of selenium supplementation.

  5. International Patterns of Practice in Palliative Radiotherapy for Painful Bone Metastases: Evidence-Based Practice?

    SciTech Connect

    Fairchild, Alysa; Barnes, Elizabeth; Ghosh, Sunita; Ben-Josef, Edgar; Roos, Daniel; Hartsell, William; Holt, Tanya; Wu, Jackson; Janjan, Nora; Chow, Edward

    2009-12-01

    Purpose: Multiple randomized controlled trials have demonstrated the equivalence of multifraction and single-fraction (SF) radiotherapy for the palliation of painful bone metastases (BM). However, according to previous surveys, SF schedules remain underused. The objectives of this study were to determine the current patterns of practice internationally and to investigate the factors influencing this practice. Methods and Materials: The members of three global radiation oncology professional organizations (American Society for Radiology Oncology [ASTRO], Canadian Association of Radiation Oncology [CARO], Royal Australian and New Zealand College of Radiologists) completed an Internet-based survey. The respondents described what radiotherapy dose fractionation they would recommend for 5 hypothetical cases describing patients with single or multiple painful BMs from breast, lung, or prostate cancer. Radiation oncologists rated the importance of patient, tumor, institution, and treatment factors, and descriptive statistics were compiled. The chi-square test was used for categorical variables and the Student t test for continuous variables. Logistic regression analysis identified predictors of the use of SF radiotherapy. Results: A total of 962 respondents, three-quarters ASTRO members, described 101 different dose schedules in common use (range, 3 Gy/1 fraction to 60 Gy/20 fractions). The median dose overall was 30 Gy/10 fractions. SF schedules were used the least often by ASTRO members practicing in the United States and most often by CARO members. Case, membership affiliation, country of training, location of practice, and practice type were independently predictive of the use of SF. The principal factors considered when prescribing were prognosis, risk of spinal cord compression, and performance status. Conclusion: Despite abundant evidence, most radiation oncologists continue to prescribe multifraction schedules for patients who fit the eligibility criteria of

  6. The role of radiotherapy in the management of cancer--an overview.

    PubMed

    Tobias, J S

    1996-05-01

    Artificial X-rays were first produced in Germany in 1895 and used for cancer almost immediately. During the century since this remarkable discovery, radiation therapy has now become the most imporantant non-surgical modality in cancer: over 50% of all cancer patients now receive radiotherapy at some point during the illness. Radiation therapy has increasingly replaced surgical resection for primary control of a variety of solid tumours, particularly where surgical excision is accompanied by severe long-term tissue loss or psychological morbidity. Frequent examples include cancers of the breast, head and neck (especially larynx, naso- and other pharyngeal sites), and locally advanced cancer of the cervix. Combinations of surgery and radiotherapy are increasing used, for example in the preferred management of most cancers of the breast, by wide local surgical excision, breast preservation and postoperative radiotherapy. In rectal carcinoma as well, there is clear evidence of survival improvement in locally advanced cases when surgical excision is followed by routine pelvic irradiation. In other circumstances, radiation is routinely combined with chemotherapy, as for example in the standard management of small cell lung cancer. Anal carcinoma is also best treated by radical radiochemotherapy, avoiding surgical excision (with permanent colostomy) in the majority of patients. In both the developed and developing world, these are all common tumours, with the result that in 1990, almost half a million patients were treated with radiation therapy in the United States of America. Recent technical advances, both in imaging and therapy beam precision, have greatly improved the therapeutic ratio and accuracy of modern radiotherapy. Radiation therapy continues to progress on a rational scientific basis, with a secure clinical role for the foreseable future.

  7. Cobalt-60 Machines and Medical Linear Accelerators: Competing Technologies for External Beam Radiotherapy.

    PubMed

    Healy, B J; van der Merwe, D; Christaki, K E; Meghzifene, A

    2017-02-01

    Medical linear accelerators (linacs) and cobalt-60 machines are both mature technologies for external beam radiotherapy. A comparison is made between these two technologies in terms of infrastructure and maintenance, dosimetry, shielding requirements, staffing, costs, security, patient throughput and clinical use. Infrastructure and maintenance are more demanding for linacs due to the complex electric componentry. In dosimetry, a higher beam energy, modulated dose rate and smaller focal spot size mean that it is easier to create an optimised treatment with a linac for conformal dose coverage of the tumour while sparing healthy organs at risk. In shielding, the requirements for a concrete bunker are similar for cobalt-60 machines and linacs but extra shielding and protection from neutrons are required for linacs. Staffing levels can be higher for linacs and more staff training is required for linacs. Life cycle costs are higher for linacs, especially multi-energy linacs. Security is more complex for cobalt-60 machines because of the high activity radioactive source. Patient throughput can be affected by source decay for cobalt-60 machines but poor maintenance and breakdowns can severely affect patient throughput for linacs. In clinical use, more complex treatment techniques are easier to achieve with linacs, and the availability of electron beams on high-energy linacs can be useful for certain treatments. In summary, there is no simple answer to the question of the choice of either cobalt-60 machines or linacs for radiotherapy in low- and middle-income countries. In fact a radiotherapy department with a combination of technologies, including orthovoltage X-ray units, may be an option. Local needs, conditions and resources will have to be factored into any decision on technology taking into account the characteristics of both forms of teletherapy, with the primary goal being the sustainability of the radiotherapy service over the useful lifetime of the equipment.

  8. Big Data Analytics for Prostate Radiotherapy

    PubMed Central

    Coates, James; Souhami, Luis; El Naqa, Issam

    2016-01-01

    Radiation therapy is a first-line treatment option for localized prostate cancer and radiation-induced normal tissue damage are often the main limiting factor for modern radiotherapy regimens. Conversely, under-dosing of target volumes in an attempt to spare adjacent healthy tissues limits the likelihood of achieving local, long-term control. Thus, the ability to generate personalized data-driven risk profiles for radiotherapy outcomes would provide valuable prognostic information to help guide both clinicians and patients alike. Big data applied to radiation oncology promises to deliver better understanding of outcomes by harvesting and integrating heterogeneous data types, including patient-specific clinical parameters, treatment-related dose–volume metrics, and biological risk factors. When taken together, such variables make up the basis for a multi-dimensional space (the “RadoncSpace”) in which the presented modeling techniques search in order to identify significant predictors. Herein, we review outcome modeling and big data-mining techniques for both tumor control and radiotherapy-induced normal tissue effects. We apply many of the presented modeling approaches onto a cohort of hypofractionated prostate cancer patients taking into account different data types and a large heterogeneous mix of physical and biological parameters. Cross-validation techniques are also reviewed for the refinement of the proposed framework architecture and checking individual model performance. We conclude by considering advanced modeling techniques that borrow concepts from big data analytics, such as machine learning and artificial intelligence, before discussing the potential future impact of systems radiobiology approaches. PMID:27379211

  9. Our intraoperative boost radiotherapy experience and applications

    PubMed Central

    Günay, Semra; Alan, Ömür; Yalçın, Orhan; Türkmen, Aygen; Dizdar, Nihal

    2016-01-01

    Objective: To present our experience since November 2013, and case selection criteria for intraoperative boost radiotherapy (IObRT) that significantly reduces the local recurrence rate after breast conserving surgery in patients with breast cancer. Material and Methods: Patients who were suitable for IObRT were identified within the group of patients who were selected for breast conserving surgery at our breast council. A MOBETRON (mobile linear accelerator for IObRT) was used for IObRt during surgery. Results: Patients younger than 60 years old with <3 cm invasive ductal cancer in one focus (or two foci within 2 cm), with a histologic grade of 2–3, and a high possibility of local recurrence were admitted for IObRT application. Informed consent was obtained from all participants. Lumpectomy and sentinel lymph node biopsy was performed and advancement flaps were prepared according to the size and inclination of the conus following evaluation of tumor size and surgical margins by pathology. Distance to the thoracic wall was measured, and a radiation oncologist and radiation physicist calculated the required dose. Anesthesia was regulated with slower ventilation frequency, without causing hypoxia. The skin and incision edges were protected, the field was radiated (with 6 MeV electron beam of 10 Gy) and the incision was closed. In our cases, there were no major postoperative surgical or early radiotherapy related complications. Conclusion: The completion of another stage of local therapy with IObRT during surgery positively effects sequencing of other treatments like chemotherapy, hormonotherapy and radiotherapy, if required. IObRT increases disease free and overall survival, as well as quality of life in breast cancer patients. PMID:26985156

  10. Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Spinal Cord Compression From Unfavorable Tumors

    SciTech Connect

    Rades, Dirk; Huttenlocher, Stefan; Bajrovic, Amira; Karstens, Johann H.; Adamietz, Irenaeus A.; Kazic, Nadja; Rudat, Volker; Schild, Steven E.

    2011-12-01

    Purpose: Despite a previously published randomized trial, controversy exists regarding the benefit of adding surgery to radiotherapy for metastatic spinal cord compression (MSCC). It is thought that patients with MSCC from relatively radioresistant tumors or tumors associated with poor functional outcome after radiotherapy alone may benefit from surgery. This study focuses on these tumors. Methods and Materials: Data from 67 patients receiving surgery plus radiotherapy (S+RT) were matched to 134 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for 10 factors and compared for motor function, ambulatory status, local control, and survival. Additional separate matched-pair analyses were performed for patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS) and patients receiving laminectomy (LE). Results: Improvement of motor function occurred in 22% of patients after S+RT and 16% after RT (p = 0.25). Posttreatment ambulatory rates were 67% and 61%, respectively (p = 0.68). Of nonambulatory patients, 29% and 19% (p = 0.53) regained ambulatory status. One-year local control rates were 85% and 89% (p = 0.87). One-year survival rates were 38% and 24% (p = 0.20). The matched-pair analysis of patients receiving LE showed no significant differences between both therapies. In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred more often after DDSS+RT than RT (28% vs. 19%, p = 0.024). Posttreatment ambulatory rates were 86% and 67% (p = 0.30); 45% and 18% of patients regained ambulatory status (p = 0.29). Conclusions: Patients with MSCC from an unfavorable primary tumor appeared to benefit from DDSS but not LE when added to radiotherapy in terms of improved functional outcome.

  11. Basic immunology of antibody targeted radiotherapy

    SciTech Connect

    Wong, Jeffrey Y.C. . E-mail: jwong@coh.org

    2006-10-01

    Antibody targeted radiotherapy brings an important new treatment modality to Radiation oncology clinic. Radiation dose to tumor and normal tissues are determined by a complex interplay of antibody, antigen, tumor, radionuclide, and host-related factors. A basic understanding of these immunologic and physiologic factors is important to optimally utilize this therapy in the clinic. Preclinical and clinical studies need to be continued to broaden our understanding and to develop new strategies to further improve the efficacy of this promising form of targeted therapy.

  12. Characteristics of in vivo radiotherapy dosimetry.

    PubMed

    Edwards, C R; Mountford, P J

    2009-11-01

    The recent discussion and debate about the use of in vivo dosimetry as a routine component of the radiotherapy treatment process has not included the limitations introduced by the physical characteristics of the detectors. Although a robust calibration procedure will ensure acceptable uncertainties in the measurements of tumour dose, further work is required to confirm the accuracy of critical organ measurements with a diode or a thermoluminescent dosemeter outside the main field owing to limitations caused by a non-uniform X-ray energy response of the detector, differences between the X-ray energy spectrum inside and outside the main field, and contaminating electrons.

  13. [Quality and safety management for radiotherapy].

    PubMed

    Pourel, N; Meyrieux, C; Perrin, B

    2016-09-01

    Quality and safety management have been implemented for many years in healthcare structures (hospitals treating cancer, private radiotherapy centres). Their structure and formalization have improved progressively over time. These recommendations aim at describing the link between quality and safety management through its organization scheme based on quality-safety policy, process approach, document management and quality measurement. Dedicated tools, such as experience feedback, a priori risk mapping, to-do-lists and check-lists are shown as examples and recommended as routine practice.

  14. Ichthyosiform scaling secondary to megavoltage radiotherapy

    SciTech Connect

    Ross, E.V. )

    1991-07-01

    Acquired ichthyosis is a rare dermatosis associated with a number of malignancies. Side effects seen on the skin secondary to megavoltage radiotherapy are uncommon but may include fine dry desquamation and tanning. The authors present a case of ichthyosiform scaling limited to the radiation fields in a patient treated for brain metastases of a primary small cell lung carcinoma. The reader is reminded that side effects of megavoltage treatment do occur on the skin. A brief review of these effects is included. 5 references.

  15. Radiotherapy changes of the pediatric hip

    SciTech Connect

    Libshitz, H.I.; Edeiken, B.S.

    1981-09-01

    Significant radiation-induced abnormalities (aseptic necrosis of the femoral heads, slipped capital femoral epiphysis, radiation-induced sarcoma) were identified in eight of 44 patients aged 16 years or younger at the time of radiotherapy and followed for at least 3 years. The incidence is 18% in the entire group and 25% (8/32) if only patients with radiographs of the hips 3 or more years after therapy are considered. The first evidence of abnormality developed 13 years after irradiation in one patient. The need for long term follow-up of therapeutically irradiated children is stressed.

  16. Particle radiotherapy with carbon ion beams

    PubMed Central

    2013-01-01

    Carbon ion radiotherapy offers superior dose conformity in the treatment of deep-seated malignant tumours compared with conventional X-ray therapy. In addition, carbon ion beams have a higher relative biological effectiveness compared with protons or X-ray beams. The algorithm of treatment planning and beam delivery system is tailored to the individual parameters of the patient. The present article reviews the available literatures for various disease sites including the head and neck, skull base, lung, liver, prostate, bone and soft tissues and pelvic recurrence of rectal cancer as well as physical and biological properties. PMID:23497542

  17. Image-Guided Radiotherapy and -Brachytherapy for Cervical Cancer

    PubMed Central

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer. PMID:25853092

  18. Image-guided radiotherapy and -brachytherapy for cervical cancer.

    PubMed

    Dutta, Suresh; Nguyen, Nam Phong; Vock, Jacqueline; Kerr, Christine; Godinez, Juan; Bose, Satya; Jang, Siyoung; Chi, Alexander; Almeida, Fabio; Woods, William; Desai, Anand; David, Rick; Karlsson, Ulf Lennart; Altdorfer, Gabor

    2015-01-01

    Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT), and 2-dimensional intracavitary brachytherapy. Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron-emission tomography and magnetic resonance imaging has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT) may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT), allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  19. Cardiac Side-effects From Breast Cancer Radiotherapy.

    PubMed

    Taylor, C W; Kirby, A M

    2015-11-01

    Breast cancer radiotherapy reduces the risk of cancer recurrence and death. However, it usually involves some radiation exposure of the heart and analyses of randomised trials have shown that it can increase the risk of heart disease. Estimates of the absolute risks of radiation-related heart disease are needed to help oncologists plan each individual woman's treatment. The risk for an individual woman varies according to her estimated cardiac radiation dose and her background risk of ischaemic heart disease in the absence of radiotherapy. When it is known, this risk can then be compared with the absolute benefit of the radiotherapy. At present, many UK cancer centres are already giving radiotherapy with mean heart doses of less than 3 Gy and for most women the benefits of the radiotherapy will probably far outweigh the risks. Technical approaches to minimising heart dose in breast cancer radiotherapy include optimisation of beam angles, use of multileaf collimator shielding, intensity-modulated radiotherapy, treatment in a prone position, treatment in deep inspiration (including the use of breath-hold and gating techniques), proton therapy and partial breast irradiation. The multileaf collimator is suitable for many women with upper pole left breast cancers, but for women with central or lower pole cancers, breath-holding techniques are now recommended in national UK guidelines. Ongoing work aims to identify ways of irradiating pan-regional lymph nodes that are effective, involve minimal exposure of organs at risk and are feasible to plan, deliver and verify. These will probably include wide tangent-based field-in-field intensity-modulated radiotherapy or arc radiotherapy techniques in combination with deep inspiratory breath-hold, and proton beam irradiation for women who have a high predicted heart dose from intensity-modulated radiotherapy.

  20. Contribution of FDOPA PET to radiotherapy planning for advanced glioma

    NASA Astrophysics Data System (ADS)

    Dowson, Nicholas; Fay, Michael; Thomas, Paul; Jeffree, Rosalind; McDowall, Robert; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Bourgeat, Pierrick; Salvado, Olivier; Crozier, Stuart; Rose, Stephen

    2014-03-01

    Despite radical treatment with surgery, radiotherapy and chemotherapy, advanced gliomas recur within months. Geographic misses in radiotherapy planning may play a role in this seemingly ineluctable recurrence. Planning is typically performed on post-contrast MRIs, which are known to underreport tumour volume relative to FDOPA PET scans. FDOPA PET fused with contrast enhanced MRI has demonstrated greater sensitivity and specificity than MRI alone. One sign of potential misses would be differences between gross target volumes (GTVs) defined using MRI alone and when fused with PET. This work examined whether such a discrepancy may occur. Materials and Methods: For six patients, a 75 minute PET scan using 3,4-dihydroxy-6-18F-fluoro-L-phynel-alanine (18F-FDOPA) was taken within 2 days of gadolinium enhanced MRI scans. In addition to standard radiotherapy planning by an experienced radiotherapy oncologist, a second gross target volume (GTV) was defined by an experienced nuclear medicine specialist for fused PET and MRI, while blinded to the radiotherapy plans. The volumes from standard radiotherapy planning were compared to the PET defined GTV. Results: The comparison indicated radiotherapy planning would change in several cases if FDOPA PET data was available. PET-defined contours were external to 95% prescribed dose for several patients. However, due to the radiotherapy margins, the discrepancies were relatively small in size and all received a dose of 50 Gray or more. Conclusions: Given the limited size of the discrepancies it is uncertain that geographic misses played a major role in patient outcome. Even so, the existence of discrepancies indicates that FDOPA PET could assist in better defining margins when planning radiotherapy for advanced glioma, which could be important for highly conformal radiotherapy plans.

  1. Fractionated radiotherapy and radiosurgery of intracranial meningiomas.

    PubMed

    Biau, J; Khalil, T; Verrelle, P; Lemaire, J-J

    2015-06-19

    This review focuses on the role of radiosurgery and fractionated radiotherapy in the management of intracranial meningiomas, which are the most common benign intracranial tumors. Whenever feasible, surgery remains a cornerstone of treatment in effective health care treatment where modern radiotherapy plays an important role. Irradiation can be proposed as first-line treatment, as adjuvant treatment, or as a second-line treatment after recurrence. Stereotactic radiosurgery consists of delivering, a high-dose of radiation with high precision, to the tumor in a single-fraction with a minimal exposure of surrounding healthy tissue. Stereotactic radiosurgery, especially with the gamma knife technique, has reached a high level of success for the treatment of intracranial meningiomas with excellent local control and low morbidity. However, stereotactic radiosurgery is limited by tumor size,<3-4cm, and location, i.e. reasonable distance from the organs at risk. Fractionated radiation therapy is an interesting alternative (5 to 6weeks treatment time) for large inoperable tumors. The results of fractionated radiation therapy seem encouraging as regards both local control and morbidity although long-term prospective studies are still needed.

  2. Cataractogenesis after Cobalt-60 eye plaque radiotherapy

    SciTech Connect

    Kleineidam, M.; Augsburger, J.J. ); Hernandez, C.; Glennon, P.; Brady, L.W. )

    1993-07-15

    This study was designed to estimate the actuarial incidence of typical postirradiation cataracts and to identify prognostic factors related to their development in melanoma-containing eyes treated by Cobalt-60 plaque radiotherapy. A special interest was the impact of calculated radiation dose and dose-rate to the lens. The authors evaluated the actuarial occurrence of post-irradiation cataract in 365 patients with primary posterior uveal melanoma treated by Cobalt-60 plaque radiotherapy between 1976 and 1986. Only 22% (S.E. = 4.6%) of the patients who received a total dose of 6 to 20 Gy at the center of the lens developed a visually significant cataract attributable to the radiation within 5 years after treatment. Using multivariate Cox proportional hazards modeling, the authors identified thickness of the tumor, location of the tumor's anterior margin relative to the equatorward and the ora serrata, and diameter of the eye plaque used as the best combination of covariables for predicting length of time until development of cataract. Surprisingly, the dose of radiation delivered to the lens, which was strongly correlated to all of these covariables, was not a significant predictive factor in multivariate analysis. The results suggest that success of efforts to decrease the occurrence rate of post-irradiation cataracts by better treatment planning might be limited in patients with posterior uveal melanoma. 21 refs., 2 figs., 5 tabs.

  3. Dose masking feature for BNCT radiotherapy planning

    DOEpatents

    Cook, Jeremy L.; Wessol, Daniel E.; Wheeler, Floyd J.

    2000-01-01

    A system for displaying an accurate model of isodoses to be used in radiotherapy so that appropriate planning can be performed prior to actual treatment on a patient. The nature of the simulation of the radiotherapy planning for BNCT and Fast Neutron Therapy, etc., requires that the doses be computed in the entire volume. The "entire volume" includes the patient and beam geometries as well as the air spaces in between. Isodoses derived from the computed doses will therefore extend into the air regions between the patient and beam geometries and thus depict the unrealistic possibility that radiation deposition occurs in regions containing no physical media. This problem is solved by computing the doses for the entire geometry and then masking the physical and air regions along with the isodose contours superimposed over the patient image at the corresponding plane. The user is thus able to mask out (remove) the contour lines from the unwanted areas of the image by selecting the appropriate contour masking region from the raster image.

  4. In vivo dosimetry in external beam radiotherapy

    SciTech Connect

    Mijnheer, Ben; Beddar, Sam; Izewska, Joanna; Reft, Chester

    2013-07-15

    In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

  5. [Antalgic radiotherapy in lumbosacral carcinomatous neuropathies].

    PubMed

    Russi, E G; Gaeta, M; Pergolizzi, S; Settineri, N; Frosina, P; De Renzis, C

    1994-06-01

    Lumbosacral carcinomatous neuropathy (LCN) may be caused by infiltration or compression of the lumbosacral plexi and nerves from intrapelvic or paraaortic neoplasms. The authors submitted 23 patients complaining of LCN with CT documented intrapelvic or paraaortic tumors to palliative radiotherapy. Megavoltage external beam irradiation was administered using a 6-MV linear accelerator. Treatment field sizes ranged from 56 cm2 to 235 cm2 (mean: 150.54 cm2) and encompassed only the site where the disease involved the lumbosacral plexus or its branches. > or = 3 Gy/day fractions were used. Twenty-one of 22 assessable patients (95.4%) obtained LCN pain relief; 19 (86.3%) obtained complete LCN pain relief. The median time to pain progression (TPP) was 150 days (range: 39-510 days). The median survival was 165 days. Seven patients were LCN pain-free at death. Two patients are alive and LCN pain-free. The remaining 12 patients had recurrent LCN pain: four of them were reirradiated at the site of previous neuropathy and only two had partial relief again. The authors conclude that it is advisable to submit to palliative radiotherapy the inoperable disseminated and/or recurrent cancer patients complaining of LCN, to use large fractions not to occupy the extant time of their already short life-expectancy, and to design small fields to avoid acute side-effects.

  6. Cerebral aneurysms following radiotherapy for medulloblastoma

    SciTech Connect

    Benson, P.J.; Sung, J.H.

    1989-04-01

    Three patients, two males and one female aged 21, 14, and 31 years, respectively, developed cerebral saccular aneurysms several years after undergoing radiotherapy for cerebellar medulloblastoma at 2, 5, and 14 years of age, respectively. Following surgery, all three received combined cobalt-60 irradiation and intrathecal colloidal radioactive gold (/sup 198/Au) therapy, and died from rupture of the aneurysm 19, 9, and 17 years after the radiotherapy, respectively. Autopsy examination revealed no recurrence of the medulloblastoma, but widespread radiation-induced vasculopathy was found at the base of the brain and in the spinal cord, and saccular aneurysms arose from the posterior cerebral arteries at the basal cistern or choroidal fissure. The aneurysms differed from the ordinary saccular aneurysms of congenital type in their location and histological features. Their locations corresponded to the areas where intrathecally administered colloidal /sup 198/Au is likely to pool, and they originated directly from a segment of the artery rather than from a branching site as in congenital saccular aneurysms. It is, therefore, concluded that the aneurysms in these three patients were most likely radiation-induced.

  7. Liver-Directed Radiotherapy for Hepatocellular Carcinoma

    PubMed Central

    Keane, Florence K.; Wo, Jennifer Y.; Zhu, Andrew X.; Hong, Theodore S.

    2016-01-01

    Background The incidence of hepatocellular carcinoma (HCC) continues to increase world-wide. Many patients present with advanced disease with extensive local tumor or vascular invasion and are not candidates for traditionally curative therapies such as orthotopic liver transplantation (OLT) or resection. Radiotherapy (RT) was historically limited by its inability to deliver a tumoricidal dose; however, modern RT techniques have prompted renewed interest in the use of liver-directed RT to treat patients with primary hepatic malignancies. Summary The aim of this review was to discuss the use of external beam RT in the treatment of HCC, with particular focus on the use of stereotactic body radiotherapy (SBRT). We review the intricacies of SBRT treatment planning and delivery. Liver-directed RT involves accurate target identification, precise and reproducible patient immobilization, and assessment of target and organ motion. We also summarize the published data on liver-directed RT, and demonstrate that it is associated with excellent local control and survival rates, particularly in patients who are not candidates for OLT or resection. Key Messages Modern liver-directed RT is safe and effective for the treatment of HCC, particularly in patients who are not candidates for OLT or resection. Liver-directed RT, including SBRT, depends on accurate target identification, precise and reproducible patient immobilization, and assessment of target and organ motion. Further prospective studies are needed to fully delineate the role of liver-directed RT in the treatment of HCC. PMID:27493895

  8. Monte Carlo dose calculations in advanced radiotherapy

    NASA Astrophysics Data System (ADS)

    Bush, Karl Kenneth

    The remarkable accuracy of Monte Carlo (MC) dose calculation algorithms has led to the widely accepted view that these methods should and will play a central role in the radiotherapy treatment verification and planning of the future. The advantages of using MC clinically are particularly evident for radiation fields passing through inhomogeneities, such as lung and air cavities, and for small fields, including those used in today's advanced intensity modulated radiotherapy techniques. Many investigators have reported significant dosimetric differences between MC and conventional dose calculations in such complex situations, and have demonstrated experimentally the unmatched ability of MC calculations in modeling charged particle disequilibrium. The advantages of using MC dose calculations do come at a cost. The nature of MC dose calculations require a highly detailed, in-depth representation of the physical system (accelerator head geometry/composition, anatomical patient geometry/composition and particle interaction physics) to allow accurate modeling of external beam radiation therapy treatments. To perform such simulations is computationally demanding and has only recently become feasible within mainstream radiotherapy practices. In addition, the output of the accelerator head simulation can be highly sensitive to inaccuracies within a model that may not be known with sufficient detail. The goal of this dissertation is to both improve and advance the implementation of MC dose calculations in modern external beam radiotherapy. To begin, a novel method is proposed to fine-tune the output of an accelerator model to better represent the measured output. In this method an intensity distribution of the electron beam incident on the model is inferred by employing a simulated annealing algorithm. The method allows an investigation of arbitrary electron beam intensity distributions and is not restricted to the commonly assumed Gaussian intensity. In a second component of

  9. Uses of megavoltage digital tomosynthesis in radiotherapy

    NASA Astrophysics Data System (ADS)

    Sarkar, Vikren

    With the advent of intensity modulated radiotherapy, radiation treatment plans are becoming more conformal to the tumor with the decreasing margins. It is therefore of prime importance that the patient be positioned correctly prior to treatment. Therefore, image guided treatment is necessary for intensity modulated radiotherapy plans to be implemented successfully. Current advanced imaging devices require costly hardware and software upgrade, and radiation imaging solutions, such as cone beam computed tomography, may introduce extra radiation dose to the patient in order to acquire better quality images. Thus, there is a need to extend current existing imaging device ability and functions while reducing cost and radiation dose. Existing electronic portal imaging devices can be used to generate computed tomography-like tomograms through projection images acquired over a small angle using the technique of cone-beam digital tomosynthesis. Since it uses a fraction of the images required for computed tomography reconstruction, use of this technique correspondingly delivers only a fraction of the imaging dose to the patient. Furthermore, cone-beam digital tomosynthesis can be offered as a software-only solution as long as a portal imaging device is available. In this study, the feasibility of performing digital tomosynthesis using individually-acquired megavoltage images from a charge coupled device-based electronic portal imaging device was investigated. Three digital tomosynthesis reconstruction algorithms, the shift-and-add, filtered back-projection, and simultaneous algebraic reconstruction technique, were compared considering the final image quality and radiation dose during imaging. A software platform, DART, was created using a combination of the Matlab and C++ languages. The platform allows for the registration of a reference Cone Beam Digital Tomosynthesis (CBDT) image against a daily acquired set to determine how to shift the patient prior to treatment. Finally

  10. SU-E-T-809: Volumetric Modulated Arc Radiotherapy Vs. Intensity-Modulated Radiotherapy for Locally Advanced Laryngeal Carcinoma: A Dosimetric Study

    SciTech Connect

    Lu, J-Y; Huang, B-T; Zhang, W-Z; Yan, L-J

    2015-06-15

    Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for locally advanced laryngeal carcinoma. Methods: CT datasets of eleven patients were included. Dual-arc VMAT and 7-field IMRT plans, which were created based on the Eclipse treatment planning system, were compared in terms of dose-volume parameters, conformity index (CI) and homogeneity index (HI) of planning target volume (PTV), as well as organ-at-risk (OAR) sparing, planning time, monitor units (MUs) and delivery time. Results: Compared with the IMRT plans, the VMAT plans provided lower D2% and better CI/HI for the high-risk PTV (PTV1), and provided better CI and comparable HI for the low-risk PTV (PTV2). Concerning the OAR sparing, the VMAT plans demonstrated significantly lower Dmax of the spinal cord (planning OAR volume, PRV) and brainstem (PRV), as well as lower Dmean and V30Gy of the right parotid. No significant differences were observed between the two plans concerning the doses delivered to the thyroid, carotid, oral cavity and left parotid. Moreover, the VMAT planning (147 ± 18 min) consumed 213% more time than the IMRT planning (48 ± 10 min). The MUs of the VMAT plans (556 ± 52) were 64% less than those of the IMRT plans (1684 ± 409), and the average delivery time (2.1 ± 0.1 min) was 66% less than that of the IMRT plans (6.3 ± 0.7 min). Conclusion: Compared with the IMRT technique, the VMAT technique can achieve superior target dose distribution and better sparing of the spinal cord, brainstem and right parotid, with less MUs and less delivery time. It is recommended for the radiotherapy of locally advanced laryngeal carcinoma.

  11. Computational and Physical Quality Assurance Tools for Radiotherapy

    NASA Astrophysics Data System (ADS)

    Graves, Yan Jiang

    Radiation therapy aims at delivering a prescribed amount of radiation dose to cancerous targets while sparing dose to normal organs. Treatment planning and delivery in modern radiotherapy are highly complex. To ensure the accuracy of the delivered dose to a patient, a quality assurance (QA) procedure is needed before the actual treatment delivery. This dissertation aims at developing computational and physical tools to facilitate the QA process. In Chapter 2, we have developed a fast and accurate computational QA tool using a graphics processing unit based Monte Carlo (MC) dose engine. This QA tool aims at identifying any errors in the treatment planning stage and machine delivery process by comparing three dose distributions: planned dose computed by a treatment planning system, planned dose and delivered dose reconstructed using the MC method. Within this tool, several modules have been built. (1) A denoising algorithm to smooth the MC calculated dose. We have also investigated the effects of statistical uncertainty in MC simulations on a commonly used dose comparison metric. (2) A linear accelerator source model with a semi-automatic commissioning process. (3) A fluence generation module. With all these modules, a web application for this QA tool with a user friendly interface has been developed to provide users with easy access to our tool, facilitating its clinical utilizations. Even after an initial treatment plan fulfills the QA requirements, a patient may experience inter-fractional anatomy variations, which compromise the initial plan optimality. To resolve this issue, adaptive radiotherapy (ART) has been proposed, where treatment plan is redesigned based on most recent patient anatomy. In Chapter 3, we have constructed a physical deformable head and neck (HN) phantom with in-vivo dosimetry capability. This phantom resembles HN patient geometry and simulates tumor shrinkage with a high level of realism. The ground truth deformation field can be measured

  12. Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy.

    PubMed

    Maruo, Takashi; Fujimoto, Yasushi; Ozawa, Kikuko; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Nakashima, Tsutomu

    2014-08-01

    The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.

  13. Radiotherapy enhances laser palliation of malignant dysphagia: a randomised study.

    PubMed Central

    Sargeant, I R; Tobias, J S; Blackman, G; Thorpe, S; Glover, J R; Bown, S G

    1997-01-01

    BACKGROUND/AIMS: A major drawback of laser endoscopy in the palliation of malignant dysphagia is the need for repeated treatments. This study was designed to test whether external beam radiotherapy would reduce the necessity for repeated laser therapy. PATIENTS/METHODS: Sixty seven patients with inoperable oesophageal or gastric cardia cancers and satisfactory swallowing after initial laser recanalisation were randomised to palliative external beam radiotherapy (30 Gy in 10 fractions) or no radiotherapy. All patients underwent a 'check' endoscopy five weeks after initial recanalisation and were subsequently reendoscoped only for recurrent dysphagia, which occurred in 59 patients. RESULTS: Dysphagia was relieved equally well in both groups and the improvement was maintained with further endoscopic treatment. The initial dysphagia controlled interval and the duration between procedures required to maintain lifelong palliation (treatment interval) increased from five to nine weeks (median) in the radiotherapy group (p < 0.01 both parameters). Radiotherapy was well tolerated in all but three patients. One perforation occurred and two fistulae opened after dilatation in patients who received radiotherapy. CONCLUSION: Additional radiotherapy reduces the necessity for therapeutic endoscopy for a patient's remaining life. It has an important role in relatively well patients who are likely to survive long enough to benefit. PMID:9135526

  14. Cerebral necrosis after 25Gy radiotherapy in childhood followed 28 years later by 54Gy radiotherapy.

    PubMed

    Koot, Radboud W; Stalpers, Lukas J A; Aronica, Eleonora; Andries Bosch, D

    2007-09-01

    The development of brain necrosis is life-long risk of repeat radiation therapy, even after a long time interval and a moderate radiation dose. We report on a 34-year-old patient who had prophylactic cranial irradiation with 25Gy and adjuvant chemotherapy in childhood for leukaemia and in adulthood, 28 years later, therapeutic radiotherapy with 54Gy for an atypical (WHO grade II) meningioma. About 2 years later he developed a contrast-enhancing lesion on MRI-scan that was indicative of a tumor according to a thallium-201 ((201)Tl) SPECT scan. Histopathology of the operated contrast-enhancing lesion showed extensive radionecrosis. Radiation necrosis is a small but serious risk after repeat radiation therapy, even after a very long-term interval, the delivery of small fractions and an average cumulative total dose. Patients undergoing repeat radiotherapy therefore need to be followed life-long for potential late radiation toxicity.

  15. Long-Term Breast Cancer Patient Outcomes After Adjuvant Radiotherapy Using Intensity-Modulated Radiotherapy or Conventional Tangential Radiotherapy.

    PubMed

    Yang, Jen-Fu; Lee, Meei-Shyuan; Lin, Chun-Shu; Chao, Hsing-Lung; Chen, Chang-Ming; Lo, Cheng-Hsiang; Fan, Chao-Yueh; Tsao, Chih-Cheng; Huang, Wen-Yen

    2016-03-01

    The aim of the article is to analyze breast cancer patient clinical outcomes after long-term follow-up using intensity-modulated radiotherapy (IMRT) or conventional tangential radiotherapy (cRT). We retrospectively reviewed patients with stage 0-III breast cancer who received breast conserving therapy between April 2004 and December 2007. Of the 234 patients, 103 (44%) were treated with IMRT and 131 (56%) were treated with cRT. A total prescription dose of 45 to 50 Gy (1.8-2 Gy per fraction) was delivered to the whole breast. A 14 Gy boost dose was delivered in 7 fractions. The median follow-up was 8.2 years. Five of 131 (3.8%) cRT-treated patients and 2 of 103 (1.9%) IMRT-treated patients had loco-regional failure. The 8-year loco-regional failure-free survival rates were 96.7% and 97.6% (P = 0.393) in the cRT and IMRT groups, respectively, whereas the 8-year disease-free survival (DFS) rates were 91.2% and 93.1%, respectively (P = 0.243). Patients treated with IMRT developed ≥ grade 2 acute dermatitis less frequently than patients treated with cRT (40.8% vs 56.5%; P = 0.017). There were no differences in late toxicity. IMRT reduces ≥ grade 2 acute skin toxicity. Local control, DFS, and overall survival were equivalent with IMRT and cRT. IMRT can be considered a standard technique for breast cancer treatment.

  16. Brain necrosis after radiotherapy for primary intracerebral tumor.

    PubMed

    Hohwieler, M L; Lo, T C; Silverman, M L; Freidberg, S R

    1986-01-01

    Radiotherapy is a standard postoperative treatment for cerebral glioma. We have observed the onset of symptoms related to brain necrosis, as opposed to recurrent tumor, in surviving patients. This has been manifest as dementia with a computed tomographic pattern of low density in the frontal lobe uninvolved with tumor, but within the field of radiotherapy. Two patients presented with mass lesions also unrelated to recurrent tumor. We question the necessity of full brain irradiation and suggest that radiotherapy techniques be altered to target the tumor and not encompass the entire brain.

  17. Synergistic Effects of Gold Nanocages in Hyperthermia and Radiotherapy Treatment

    NASA Astrophysics Data System (ADS)

    Zhang, Ai-wei; Guo, Wei-hua; Qi, Ya-fei; Wang, Jian-zhen; Ma, Xiang-xing; Yu, De-xin

    2016-06-01

    Gold nanocages (GNCs) are a promising material that not only converts near infrared (NIR) light to heat for the ablation of tumors but also acts as a radiosensitizer. The combination of hyperthermia and radiotherapy has a synergistic effect that can lead to significant tumor cell necrosis. In the current study, we synthesized GNCs that offered the combined effects of hyperthermia and radiotherapy. This combination strategy resulted in increased tumor cell apoptosis and significant tumor tissue necrosis. We propose that GNCs can be used for clinical treatment and to potentially overcome resistance to radiotherapy by clearly increasing the antitumor effect.

  18. [Endocrine function following cranial radiotherapy of neoplasms in children].

    PubMed

    Couselo Sánchez, J M; Fernández Bujía, M L; Pombo Arias, M; Devesa Múgiga, J; Tojo Sierra, R; Peña Guitán, J

    1984-01-01

    The effect of radiotherapy upon the diencephalo-hypophyseal axis was studied in 14 children that had received cranial radio-therapy (2,400 to 6,000 R) to treat different intracranial tumors. Several hormones were evaluated between 2 months and 3 years after radiotherapy was performed. 35.7 per 100 of the patients were deficient in growth hormone, 37.5 per 100 showed an alteration of prolactin secretion, and 28 per 100 an abnormal response to thyroid-stimulating hormone.

  19. Stromal-epithelial dynamics in response to fractionated radiotherapy

    NASA Astrophysics Data System (ADS)

    Qayyum, Muqeem Abdul

    Radiotherapy is central to the management of a number of human cancers, either as an adjuvant or primary treatment modality. The principal objective in irradiating tumors is to permanently inhibit their proliferative ability. More than half of all malignancies are primarily treated with radiation, but the heterotypic nature of tumor cells greatly complicates their response to radiotherapy. The need for reliable parameters to predict tumor and normal tissue response to radiation is therefore a prime concern of clinical oncology. Post-operative radiotherapy has commonly been used for early stage breast cancer to treat residual disease. There is continued debate as to what might be the proper dose per fraction as well as the total dose of radiation that needs to be prescribed to prevent disease recurrence. Countries outside the US have adopted increased dose fractionation (i.e., hypofractionation) schemes for early stage breast cancer as a standard of practice; however there is a lack of confidence in these approaches in the United States. The tumor microenvironment plays a significant role in regulating the progression of carcinomas, although the mechanisms are not entirely clear. The primary objective of this work was to characterize, through mechanobiological and radiobiological modeling, a test bed for radiotherapy fractionation techniques assessment. Our goal is to understand how the tumor microenvironment responds to dose fractionation schemes for Breast Conserving Therapy (BCT). Although carcinomas are the major concern for oncology, in this project, the goal is to understand how the stromal microenvironment influences behavior of the cancer cell populations. By classifying 3-D cellular co-cultures as having a reactive or quiescent stroma using the mechanobiology profile (culture stiffness,cellular activation, differentiation, and proliferation) we aim to differentiate the effectiveness of various fractionation schemes. The benefits of understanding heterotypic

  20. Radiotherapy dosimetry and the thermoluminescence characteristics of Ge-doped fibres of differing germanium dopant concentration and outer diameter

    NASA Astrophysics Data System (ADS)

    Noor, N. Mohd; Fadzil, M. S. Ahmad; Ung, N. M.; Maah, M. J.; Mahdiraji, G. A.; Abdul-Rashid, H. A.; Bradley, D. A.

    2016-09-01

    We examine the influence of elevated dopant concentration on the thermoluminescence characteristics of novel Ge-doped silica fibres. Basic dosimetric characteristics of the TL media were obtained, including linearity, reproducibility, energy dependence, fading, minimum detectable dose and glow curve analysis, use being made of a 60Co gamma irradiation facility (mean energy 1.25 MeV) and an electron linear accelerator producing photons at an accelerating potential of 6 and 10 MV. The 6 mol% Ge-doped fibres were found to provide TL response superior to that of 8- and 10 mol% Ge-doped fibres, both for fibres with outer diameter of 241 μm and 604 μm. Concerning reproducibility, obtained under three different test conditions, at <10% the 6 mol% Ge dopant concentration was observed to provide the superior coefficient of variation (CV). In regard to energy dependence, the 10 mol% Ge doped cylindrical fibres produced the largest gradient values at 0.364 and 0.327 for the 241 μm and 604 μm diameter cylindrical fibres respectively and thus the greatest energy dependency. Measured 33 days post irradiation; the 6 mol% Ge doped cylindrical fibres showed the least TL signal loss, at 21% for the 241 μm cylindrical fibre and <40% for the 604 μm cylindrical fibres. The results also revealed that the 6 mol% optical fibres provided the lowest minimum detectable dose, at 0.027 Gy for 6 MV photon beams. Evaluations of these characteristics are supporting development of novel Ge-doped optical fibres for dosimetry in radiotherapy.

  1. Intensity-Modulated Radiotherapy for Sinonasal Cancer: Improved Outcome Compared to Conventional Radiotherapy

    SciTech Connect

    Dirix, Piet; Vanstraelen, Bianca; Jorissen, Mark; Vander Poorten, Vincent; Nuyts, Sandra

    2010-11-15

    Purpose: To evaluate clinical outcome and toxicity of postoperative intensity-modulated radiotherapy (IMRT) for malignancies of the nasal cavity and paranasal sinuses. Methods and Materials: Between 2003 and 2008, 40 patients with cancer of the paranasal sinuses (n = 34) or nasal cavity (n = 6) received postoperative IMRT to a dose of 60 Gy (n = 21) or 66 Gy (n = 19). Treatment outcome and toxicity were retrospectively compared with that of a previous patient group (n = 41) who were also postoperatively treated to the same doses but with three-dimensional conformal radiotherapy without intensity modulation, from 1992 to 2002. Results: Median follow-up was 30 months (range, 4-74 months). Two-year local control, overall survival, and disease-free survival were 76%, 89%, and 72%, respectively. Compared to the three-dimensional conformal radiotherapy treatment, IMRT resulted in significantly improved disease-free survival (60% vs. 72%; p = 0.02). No grade 3 or 4 toxicity was reported in the IMRT group, either acute or chronic. The use of IMRT significantly reduced the incidence of acute as well as late side effects, especially regarding skin toxicity, mucositis, xerostomia, and dry-eye syndrome. Conclusions: Postoperative IMRT for sinonasal cancer significantly improves disease-free survival and reduces acute as well as late toxicity. Consequently, IMRT should be considered the standard treatment modality for malignancies of the nasal cavity and paranasal sinuses.

  2. SU-E-T-415: An Ionization Chamber Array with High Spatial Resolution for External Beam Radiotherapy

    SciTech Connect

    Togno, M; Wilkens, J; Menichelli, D

    2014-06-01

    Purpose: To characterize an ionization chamber array technology with high spatial resolution and high charge collection efficiency for external beam radiotherapy. Methods: The prototype under test is a linear array of air vented ionization chambers developed by IBA Dosimetry, consisting of 80 pixels with 3.5mm spatial resolution and 4mm{sup 3} sensitive volume. The detector was characterized in a plastic phantom with {sup 60} Co radiation and MV X-rays from an ELEKTA Agility LINAC (with flattened and unflattened beam qualities). Bias voltage was varied in order to evaluate charge collection efficiency. A commercial array of ionization chambers (MatriXX Evolution, IBA Dosimetry) and an amorphous silicon flat panel in direct conversion configuration were used as references. Results: Repeatability (0.4%) and stability under continuous gamma irradiation (0.3%) are very good, in spite of low active volume and sensitivity (∼200pC/Gy). Charge collection efficiency is higher than 99% already at 150V with ∼2mGy dose per pulse, leading to a ±1.1% sensitivity change with dose per pulse in the range 0.09-2mGy (covering all flattened and unflattened applications). Measured dose profiles are in agreement with MatriXX for fields larger than 2×2cm{sup 2}, in which case the linear array offers a much better characterization of the penumbra region. Down to 1×1cm{sup 2}, measured profiles are in very good agreement with the flat panel. Conclusion: The array represents a valuable tool for the characterization of treatment fields in which high spatial resolution is required, together with the dosimetric performance of air vented ionization chambers. Such a technology would be particularly valuable in association with advanced treatment modalities such as rotational radiotherapy, stereotactic treatments (even with unflattened beam qualities) and proton therapy, due to the insensitivity of the chambers on dose per pulse. In the future, a two dimensional prototype based on this

  3. High-LET charged particle radiotherapy

    SciTech Connect

    Castro, J.R. |

    1991-07-01

    The Department of Radiation Oncology at UCSF Medical Center and the Radiation Oncology Department at UC Lawrence Berkeley Laboratory have been evaluating the use of high LET charged particle radiotherapy in a Phase 1--2 research trial ongoing since 1979. In this clinical trail, 239 patients have received at least 10 Gy (physical) minimum tumor dose with neon ions, meaning that at least one-half of their total treatment was given with high-LET charged particle therapy. Ninety-one patients received all of their therapy with neon ions. Of the 239 patients irradiated, target sites included lesions in the skin, subcutaneous tissues, head and neck such as paranasal sinuses, nasopharynx and salivary glands (major and minor), skull base and juxtaspinal area, GI tract including esophagus, pancreas and biliary tract, prostate, lung, soft tissue and bone. Analysis of these patients has been carried out with a minimum followup period of 2 years.

  4. [Radiotherapy phase I trials' methodology: Features].

    PubMed

    Rivoirard, R; Vallard, A; Langrand-Escure, J; Guy, J-B; Ben Mrad, M; Yaoxiong, X; Diao, P; Méry, B; Pigne, G; Rancoule, C; Magné, N

    2016-12-01

    In clinical research, biostatistical methods allow the rigorous analysis of data collection and should be defined from the trial design to obtain the appropriate experimental approach. Thus, if the main purpose of phase I is to determine the dose to use during phase II, methodology should be finely adjusted to experimental treatment(s). Today, the methodology for chemotherapy and targeted therapy is well known. For radiotherapy and chemoradiotherapy phase I trials, the primary endpoint must reflect both effectiveness and potential treatment toxicities. Methodology should probably be complex to limit failures in the following phases. However, there are very few data about methodology design in the literature. The present study focuses on these particular trials and their characteristics. It should help to raise existing methodological patterns shortcomings in order to propose new and better-suited designs.

  5. TOPICAL REVIEW: Anatomical imaging for radiotherapy

    NASA Astrophysics Data System (ADS)

    Evans, Philip M.

    2008-06-01

    The goal of radiation therapy is to achieve maximal therapeutic benefit expressed in terms of a high probability of local control of disease with minimal side effects. Physically this often equates to the delivery of a high dose of radiation to the tumour or target region whilst maintaining an acceptably low dose to other tissues, particularly those adjacent to the target. Techniques such as intensity modulated radiotherapy (IMRT), stereotactic radiosurgery and computer planned brachytherapy provide the means to calculate the radiation dose delivery to achieve the desired dose distribution. Imaging is an essential tool in all state of the art planning and delivery techniques: (i) to enable planning of the desired treatment, (ii) to verify the treatment is delivered as planned and (iii) to follow-up treatment outcome to monitor that the treatment has had the desired effect. Clinical imaging techniques can be loosely classified into anatomic methods which measure the basic physical characteristics of tissue such as their density and biological imaging techniques which measure functional characteristics such as metabolism. In this review we consider anatomical imaging techniques. Biological imaging is considered in another article. Anatomical imaging is generally used for goals (i) and (ii) above. Computed tomography (CT) has been the mainstay of anatomical treatment planning for many years, enabling some delineation of soft tissue as well as radiation attenuation estimation for dose prediction. Magnetic resonance imaging is fast becoming widespread alongside CT, enabling superior soft-tissue visualization. Traditionally scanning for treatment planning has relied on the use of a single snapshot scan. Recent years have seen the development of techniques such as 4D CT and adaptive radiotherapy (ART). In 4D CT raw data are encoded with phase information and reconstructed to yield a set of scans detailing motion through the breathing, or cardiac, cycle. In ART a set of

  6. Breast cellulitis after conservative surgery and radiotherapy

    SciTech Connect

    Rescigno, J.; McCormick, B.; Brown, A.E.; Myskowski, P.L. )

    1994-04-30

    Cellulitis is a previously unreported complication of conservative surgery and radiation therapy for early stage breast cancer. Patients who presented with breast cellulitis after conservative therapy are described. Eleven patients that developed cellulitis of the breast over a 38-month period of observation are the subject of this report. Clinical characteristics of patients with cellulitis and their treatment and outcome are reported. Potential patient and treatment-related correlates for the development of cellulitis are analyzed. The risk of cellulitis persists years after initial breast cancer therapy. The clinical course of the patients was variable: some patients required aggressive, long-duration antibiotic therapy, while others had rapid resolution with antibiotics. Three patients suffered from multiple episodes of cellulitis. Patients with breast cancer treated with conservative surgery and radiotherapy are at risk for breast cellulitis. Systematic characterization of cases of cellulitis may provide insight into diagnosis, prevention, and more effective therapy for this uncommon complication. 15 refs., 1 fig., 2 tabs.

  7. Radiotherapy and Antiangiogenic TM in Lung Cancer

    PubMed Central

    Khan, Mohamed K; Miller, Meredith W; Taylor, Jeremy; Gill, Navkiranjit K; Dick, Robert D; Van Golen, Kenneth; Brewer, George J; Merajver, Sofia D

    2002-01-01

    Abstract Tetrathiomolybdate (TM) is a potent nontoxic orally delivered copper complexing agent under development for the last several years for the treatment of Wilson's disease. It has been shown to block angiogenesis in primary and metastatic tumors. Therefore, the combination of cytotoxic radiotherapy (RT) and antiangiogenic TM could target both the existing tumor and the tumor microvasculature in a comprehensive strategy. Using a Lewis lung high metastatic (LLHM) carcinoma mouse tumor model, we demonstrate that the combination of TM and RT is more effective than either used as monotherapy. We also show that their therapeutic effects are additive, with no additional toxicity. We show that TM has no significant cytotoxicity in vitro against LLHM tumor cells, further supporting the antiangiogenic mechanism for its action. PMID:11896571

  8. Targeted Radiotherapy of Estrogen Receptor Positive Tumors

    SciTech Connect

    Raghavan Rajagopalan

    2006-08-31

    The overall objectives of the proposal were to develop estrogen receptor (ER) binding small molecule radiopharmaceuticals for targeted radiotherapy of ER positive (ER+) tumors. In particular, this proposal focused on embedding a {sup 186,188}Re or a {sup 32}P radionuclide into an estrogen steroidal framework by isosteric substitution such that the resulting structure is topologically similar to the estrogen (estrogen mimic). The estrogen mimic molecules expected to bind to the ER and exhibit biodistribution akin to that of native estrogen due to structural mimicry. It is anticipated that the {sup 186,188}Re- or a {sup 32}P-containing estrogen mimics will be useful for targeted molecular radiotherapy of ER+ tumors. It is well established that the in vivo target tissue uptake of estrogen like steroidal molecules is related to the binding of the steroids to sex hormone binding globulin (SHBG). SHBG is important in the uptake of estrogens and testosterone in target tissues by SHBG receptors on the cell surface. However, hitherto the design of estrogen like small molecule radiopharmaceuticals was focused on optimizing ER binding characteristics without emphasis on SHBG binding properties. Consequently, even the molecules with good ER affinity in vitro, performed poorly in biodistribution studies. Based on molecular modeling studies the proposal focused on developing estrogen mimics 1-3 which were topologically similar to native estrogens, and form hydrogen bonds in ER and SHBG in the same manner as those of native estrogens. To this end the technical objectives of the proposal focused on synthesizing the rhenium-estrone and estradiol mimics 1 and 2 respectively, and phosphorous estradiol mimic 3 and to assess their stability and in vitro binding characteristics to ER and SHBG.

  9. Use of Postmastectomy Radiotherapy in Older Women

    SciTech Connect

    Smith, Benjamin D. Haffty, Bruce G.; Smith, Grace L.; Hurria, Arti; Buchholz, Thomas A.; Gross, Cary P.

    2008-05-01

    Purpose: Clinical trials and guidelines published between 1997 and 2001 concluded that postmastectomy radiotherapy (PMRT) improves overall survival for women with high-risk breast cancer. However, the effect of these findings on current practice is not known. Using the Surveillance, Epidemiology, and End Results-Medicare cohort, we sought to characterize the adoption of PMRT from 1992 to 2002 and identify risk factors for PMRT omission among high-risk older patients. Methods and Materials: We identified 28,973 women aged {>=}66 years who had been treated with mastectomy for invasive breast cancer between 1992 and 2002. Trends in the adoption of PMRT for low- (T1-T2N0), intermediate- (T1-T2N1), and high- (T3-T4 and/or N2-N3) risk patients were characterized using a Monte Carlo permutation algorithm. Multivariate logistic regression identified the risk factors for PMRT omission and calculated the adjusted use rates. Results: Postmastectomy radiotherapy use increased gradually and consistently for low-risk (+2.16%/y) and intermediate-risk (+7.20%/y) patients throughout the study interval. In contrast, PMRT use for high-risk patients increased sharply between 1996 and 1997 (+30.99%/y), but subsequently stabilized. Between 1998 and 2002, only 53% of high-risk patients received PMRT. The risk factors for PMRT omission included advanced age, moderate to severe comorbidity, smaller tumor size, fewer positive lymph nodes, and geographic region, with adjusted use rates ranging from 63.5% in San Francisco to 44.9% in Connecticut. Conclusion: Among the high-risk patients, PMRT use increased sharply in 1997 after the initial clinical trial publication. Despite subsequent guidelines recommending the use of PMRT, no further increase in PMRT use has occurred, and nearly 50% of high-risk patients still do not receive PMRT.

  10. Statistical process control for radiotherapy quality assurance.

    PubMed

    Pawlicki, Todd; Whitaker, Matthew; Boyer, Arthur L

    2005-09-01

    Every quality assurance process uncovers random and systematic errors. These errors typically consist of many small random errors and a very few number of large errors that dominate the result. Quality assurance practices in radiotherapy do not adequately differentiate between these two sources of error. The ability to separate these types of errors would allow the dominant source(s) of error to be efficiently detected and addressed. In this work, statistical process control is applied to quality assurance in radiotherapy for the purpose of setting action thresholds that differentiate between random and systematic errors. The theoretical development and implementation of process behavior charts are described. We report on a pilot project is which these techniques are applied to daily output and flatness/symmetry quality assurance for a 10 MV photon beam in our department. This clinical case was followed over 52 days. As part of our investigation, we found that action thresholds set using process behavior charts were able to identify systematic changes in our daily quality assurance process. This is in contrast to action thresholds set using the standard deviation, which did not identify the same systematic changes in the process. The process behavior thresholds calculated from a subset of the data detected a 2% change in the process whereas with a standard deviation calculation, no change was detected. Medical physicists must make decisions on quality assurance data as it is acquired. Process behavior charts help decide when to take action and when to acquire more data before making a change in the process.

  11. Intensity-Modulated Radiotherapy for Pancreatic Adenocarcinoma

    SciTech Connect

    Abelson, Jonathan A.; Murphy, James D.; Minn, Ann Yuriko; Chung, Melody; Fisher, George A.; Ford, James M.; Kunz, Pamela; Norton, Jeffrey A.; Visser, Brendan C.; Poultsides, George A.; Koong, Albert C.; Chang, Daniel T.

    2012-03-15

    Purpose: To report the outcomes and toxicities in patients treated with intensity-modulated radiotherapy (IMRT) for pancreatic adenocarcinoma. Methods and Materials: Forty-seven patients with pancreatic adenocarcinoma were treated with IMRT between 2003 and 2008. Of these 47 patients, 29 were treated adjuvantly and 18 definitively. All received concurrent 5-fluorouracil chemotherapy. The treatment plans were optimized such that 95% of the planning target volume received the prescription dose. The median delivered dose for the adjuvant and definitive patients was 50.4 and 54.0 Gy, respectively. Results: The median age at diagnosis was 63.9 years. For adjuvant patients, the 1- and 2-year overall survival rate was 79% and 40%, respectively. The 1- and 2-year recurrence-free survival rate was 58% and 17%, respectively. The local-regional control rate at 1 and 2 years was 92% and 80%, respectively. For definitive patients, the 1-year overall survival, recurrence-free survival, and local-regional control rate was 24%, 16%, and 64%, respectively. Four patients developed Grade 3 or greater acute toxicity (9%) and four developed Grade 3 late toxicity (9%). Conclusions: Survival for patients with pancreatic cancer remains poor. A small percentage of adjuvant patients have durable disease control, and with improved therapies, this proportion will increase. Systemic therapy offers the greatest opportunity. The present results have demonstrated that IMRT is well tolerated. Compared with those who received three-dimensional conformal radiotherapy in previously reported prospective clinical trials, patients with pancreatic adenocarcinoma treated with IMRT in our series had improved acute toxicity.

  12. Applications of synchrotron X-rays to radiotherapy

    NASA Astrophysics Data System (ADS)

    Blattmann, H.; Gebbers, J.-O.; Bräuer-Krisch, E.; Bravin, A.; Le Duc, G.; Burkard, W.; Di Michiel, M.; Djonov, V.; Slatkin, D. N.; Stepanek, J.; Laissue, J. A.

    2005-08-01

    Radiotherapy is among the most useful treatments of cancer. Penetrating radiation (ionizing particles or bremsstrahlung photons) is aimed toward the tumor-bearing target, gradually delivering as high radiation to it as is usefully suppressive of tumor growth, yet tolerated by normal vital tissues inevitably irradiated with the tumor. The high collimation and dose rate of synchrotron X-ray beams, even when monochromatized, favor radiotherapy. Photon activation therapy, tomotherapy, microbeam radiation therapy, and radiosurgery mediated by synchrotron wigglers are conceptually promising for difficult tumors. Radiotherapy of malignant brain tumors in rats has been encouraging, but suitable beam lines exist at only a few research facilities and much basic work must be done before the promise of synchrotron-based radiotherapy can be realized clinically.

  13. [Clinical to planning target volume margins in prostate cancer radiotherapy].

    PubMed

    Ramiandrisoa, F; Duvergé, L; Castelli, J; Nguyen, T D; Servagi-Vernat, S; de Crevoisier, R

    2016-10-01

    The knowledge of inter- and intrafraction motion and deformations of the intrapelvic target volumes (prostate, seminal vesicles, prostatectomy bed and lymph nodes) as well as the main organs at risk (bladder and rectum) allow to define rational clinical to planning target volume margins, depending on the different radiotherapy techniques and their uncertainties. In case of image-guided radiotherapy, prostate margins and seminal vesicles margins can be between 5 and 10mm. The margins around the prostatectomy bed vary from 10 to 15mm and those around the lymph node clinical target volume between 7 and 10mm. Stereotactic body radiotherapy allows lower margins, which are 3 to 5mm around the prostate. Image-guided and stereotactic body radiotherapy with adequate margins allow finally moderate or extreme hypofractionation.

  14. Evaluation of air photoactivation at linear accelerators for radiotherapy.

    PubMed

    Tana, Luigi; Ciolini, Riccardo; Ciuffardi, Eva; Romei, Chiara; d'Errico, Francesco

    2015-06-01

    High-energy x-rays produced by radiotherapy accelerators operating at potentials above 10 MV may activate the air via (γ, n) reactions with both oxygen and nitrogen. While the activation products are relatively short-lived, personnel entering the accelerator room may inhale some radioactive air, which warrants internal dosimetry assessments. This work illustrates a method based on the use of ammonium nitrate solutions for the evaluation of photon-induced air activation and for the estimate of internal doses to radiotherapy personnel. Air activation and internal dosimetry assessments based on our method are presented for some widespread radiotherapy linear accelerator models. Our results indicate that the equivalent dose to the lungs of radiotherapy personnel is negligible for beam energies below 18 MeV.

  15. Stereotactic body radiotherapy in lung cancer: an update *

    PubMed Central

    Abreu, Carlos Eduardo Cintra Vita; Ferreira, Paula Pratti Rodrigues; de Moraes, Fabio Ynoe; Neves, Wellington Furtado Pimenta; Gadia, Rafael; Carvalho, Heloisa de Andrade

    2015-01-01

    Abstract For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique. PMID:26398758

  16. [Radiotherapy and implantable medical device: example of infusion pumps].

    PubMed

    Abrous-Anane, S; Benhassine, S; Lopez, S; Cristina, K; Mazeron, J-J

    2013-12-01

    Indication for radiotherapy is often questioned for patients equipped with implantable medical devices like infusion pumps as the radiation tolerance is poor or not known. We report here on the case of a patient who we treated with pelvic radiotherapy for cervical cancer and who had an infusion pump in iliac fossa. We conducted a series of tests on five identical pumps that insured that the treatment protocol is harmless to the implanted device.

  17. Radiochromic Film Dosimetry and its Applications in Radiotherapy

    SciTech Connect

    Williams, Matthew; Metcalfe, Peter

    2011-05-05

    Radiochromic film can be a fast and inexpensive means for performing accurate quantitative radiation dosimetry. The development of new radiochromic compositions that have greater dose sensitivity and fewer environmental dependencies has led to an ever increasing use of the film in radiotherapy applications. In this report the various physical and dosimetric properties of radiochromic film are presented and the strategies to adequately manage these properties when using radiochromic film for radiotherapy applications are discussed.

  18. Implementing radiotherapy in Africa: Focus on the needs in Rwanda.

    PubMed

    Kamanzi, J-B; Adeduntan, R; Antoni, D; Musafiri, S; Noël, G

    2016-05-01

    Cancer care is a concern in low- and middle-income countries. The needs of structure to treat patients are huge. Because of the cost of radiotherapy, and the need for highly specialized workers, providing radiation therapy in these nations is a challenge. However, some solutions exist that can dramatically improve future care. In this article, we reviewed the plight of cancer treatment organization in Africa, and more specifically, the status of radiotherapy needs and concerns within Rwanda.

  19. PET/CT and radiotherapy in prostate cancer.

    PubMed

    De Jong, I J; De Haan, T D; Wiegman, E M; Van Den Bergh, A C M; Pruim, J; Breeuwsma, A J

    2010-10-01

    Radiotherapy is one of the corner stone treatments for patients with prostate cancer. Especially for locally advanced tumors radiotherapy +/- adjuvant androgen deprivation treatment is standard of care. This brings up the need for accurate assessment of extra prostatic tumor growth and/or the presence of nodal metastases for selection of the optimal radiation dose and treatment volume. Morphological imaging like transrectal ultra sound, computed tomography (CT) and magnetic resonance imaging (MRI) are routinely used but are limited in their accuracy in detecting extra prostatic extension and nodal metastases. In this article we present a structured review of the literature on positron emission tomography (PET)/CT and radiotherapy in prostate cancer patients with emphasis on: 1) the pretreatment assessment of extra prostatic tumor extension, nodal and distant metastases; 2) the intraprostatic tumor characterization and radiotherapy treatment planning; and 3) treatment evaluation and the use of PET/CT in guidance of salvage treatment. PET/CT is not an appropriate imaging technique for accurate T-staging of prostate cancer prior to radiotherapy. Although macroscopic disease beyond the prostatic capsule and into the periprostatic fat or in seminal vesicle is often accurately detected, the microscopic extension of prostate cancer remains undetected. Choline PET/CT holds a great potential as a single step diagnostic procedure of lymph nodes and skeleton, which could facilitate radiotherapy treatment planning. At present the use of PET/CT for treatment planning in radiotherapy is still experimental. Choline PET based tumor delineation is not yet standardized and different segmentation-algorithms are under study. However, dose escalation using dose-painting is feasible with only limited increases of the doses to the bladder and rectum wall. PET/CT using either acetate or choline is able to detect recurrent prostate cancer after radiotherapy but stratification of patients

  20. Treatment of ameloblastoma and ameloblastic carcinoma with radiotherapy.

    PubMed

    Kennedy, William R; Werning, John W; Kaye, Frederic J; Mendenhall, William M

    2016-10-01

    The purpose of this study is to report our institutional experience using radiotherapy in the treatment of ameloblastoma and ameloblastic carcinoma. Three patients with ameloblastoma and 3 patients with ameloblastic carcinoma were treated with radiotherapy alone (2 patients) or surgery and postoperative radiotherapy (4 patients) at the University of Florida between 1973 and 2007. Follow-up ranged from 4.0 to 13.1 years with a median of 7.8 years. Radiotherapy complications were scored using the Common Terminology Criteria for Adverse Events, version 4.0. Local control was achieved in 4 of the 6 patients. One patient treated with RT alone for an unresectable ameloblastoma developed a local recurrence and metastases in both the cervical lymph nodes and lungs, but had excellent response to dual BRAF/MEK inhibition with dabrafenib and trametinib. Another patient treated with surgery and postoperative radiotherapy for an ameloblastic carcinoma recurred locally without metastasis, but was not salvaged. No significant treatment-related complications were observed. For patients with local recurrence or inadequate margins after surgery, adjuvant radiotherapy provides the potential for disease control. In the setting of metastatic disease, targeted therapies may provide an additional opportunity for salvage.

  1. Complete response of myeloid sarcoma with cardiac involvement to radiotherapy

    PubMed Central

    Yang, Wen-Chi; Yao, Ming; Chen, Yu-Hsuan

    2016-01-01

    We present a rare case of intracardiac myeloid sarcoma (MS) of acute myeloid leukemia (AML) and who responds completely well to low-dose radiotherapy. This 19-year-old young man initially presented with AML and received standard chemotherapy followed by allogeneic hematopoietic stem cell transplantation (HSCT). However, he developed intracardiac isolated MS relapse with the presentation of exertional dyspnea and superior vena cava (SVC) syndrome 3 years later. He then received radiotherapy with 24 Gy at a 12 daily fractions using forward “field in field” intensity modulated radiotherapy technique. He dramatically had improved clinical symptoms, and complete remission was achieved one month after completing radiotherapy. Our result is in line with anecdotal case reports showed that radiotherapy with 15 Gy in 10 fractions or with 24 Gy in 12 fractions resulted in good response and less toxicity of 2 cases of MS with cardiac involvement. These results indicate that a modest radiotherapy dose, 24 Gy, achieves good local control of MS with cardiac involvement. PMID:27293853

  2. Monte Carlo role in radiobiological modelling of radiotherapy outcomes

    NASA Astrophysics Data System (ADS)

    El Naqa, Issam; Pater, Piotr; Seuntjens, Jan

    2012-06-01

    Radiobiological models are essential components of modern radiotherapy. They are increasingly applied to optimize and evaluate the quality of different treatment planning modalities. They are frequently used in designing new radiotherapy clinical trials by estimating the expected therapeutic ratio of new protocols. In radiobiology, the therapeutic ratio is estimated from the expected gain in tumour control probability (TCP) to the risk of normal tissue complication probability (NTCP). However, estimates of TCP/NTCP are currently based on the deterministic and simplistic linear-quadratic formalism with limited prediction power when applied prospectively. Given the complex and stochastic nature of the physical, chemical and biological interactions associated with spatial and temporal radiation induced effects in living tissues, it is conjectured that methods based on Monte Carlo (MC) analysis may provide better estimates of TCP/NTCP for radiotherapy treatment planning and trial design. Indeed, over the past few decades, methods based on MC have demonstrated superior performance for accurate simulation of radiation transport, tumour growth and particle track structures; however, successful application of modelling radiobiological response and outcomes in radiotherapy is still hampered with several challenges. In this review, we provide an overview of some of the main techniques used in radiobiological modelling for radiotherapy, with focus on the MC role as a promising computational vehicle. We highlight the current challenges, issues and future potentials of the MC approach towards a comprehensive systems-based framework in radiobiological modelling for radiotherapy.

  3. Nutritional consequences of the radiotherapy of head and neck cancer

    SciTech Connect

    Chencharick, J.D.; Mossman, K.L.

    1983-03-01

    Nutrition-related complications of radiotherapy were evaluated in 74 head and neck cancer patients. Subjective changes of mouth dryness, taste, dysphagia, appetite, and food preferences were determined by questionnaire before and at weekly intervals during curative radiotherapy. Changes in body weight during therapy were also recorded. In addition, 24-hour dietary histories were taken from eight patients at the beginning and end of treatment. Results of the study indicate that patients were subjectively aware of nutritional problems prior to therapy and that therapy exacerbated these problems. As many as 25% of the patients experienced oral complications such as taste loss and/or dry mouth prior to initiation of radiotherapy. By the end of radiotherapy, over 80% of the patients were aware of oral and nutritional problems. Patients had an average weight loss of 5 kg prior to therapy; this loss of weight did not change during therapy. Diet histories of eight patients indicate significant caloric deficiencies early and late in radiotherapy. The oral and nutritional problems experienced by patients, even prior to therapy, support the idea that nutritional evaluation and maintenance are important not only during therapy, but prior to radiotherapy as well. Nutritional evaluation should be made a routine, integral part of therapy for every cancer patient.

  4. Radiotherapy in Glioblastoma: the Past, the Present and the Future.

    PubMed

    Gzell, C; Back, M; Wheeler, H; Bailey, D; Foote, M

    2017-01-01

    The aim of this review is to explore the changing utility of radiotherapy in the treatment of patients with glioblastoma over the past 60 years. Together with surgery, radiotherapy has always been the cornerstone of treatment of glioblastoma, but techniques have significantly advanced over this time. The exploration of early two-dimensional techniques, investigation of dose escalation, concomitant chemotherapy and modern techniques, including intensity-modulated radiotherapy, image-guided radiotherapy, and volumetric-modulated arc therapy will be covered. In addition, current controversies including decreasing margin size, re-irradiation, treatment of elderly patients, and novel imaging tracers will be discussed. Future directions including immunotherapy and tumour treating fields are examined. Radiotherapy-based treatments cannot rely solely on advances in chemotherapy or immunotherapy to improve the overall survival of patients with glioblastoma. Radiation oncology needs to continue to develop and improve the delivery, target definition, and dose of radiotherapy to these patients to improve their survival and the toxicity associated with treatment.

  5. Radiation-induced heart disease in lung cancer radiotherapy

    PubMed Central

    Ming, Xin; Feng, Yuanming; Yang, Chengwen; Wang, Wei; Wang, Ping; Deng, Jun

    2016-01-01

    Abstract Background: Radiation-induced heart disease (RIHD), which affects the patients’ prognosis with both acute and late side effects, has been published extensively in the radiotherapy of breast cancer, lymphoma and other benign diseases. Studies on RIHD in lung cancer radiotherapy, however, are less extensive and clear even though the patients with lung cancer are delivered with higher doses to the heart during radiation treatment. Methods: In this article, after extensive literature search and analysis, we reviewed the current evidence on RIHD in lung cancer patients after their radiation treatments and investigated the potential risk factors for RIHD as compared to other types of cancers. Result: Cardiac toxicity has been found highly relevant in lung cancer radiotherapy. So far, the crude incidence of cardiac complications in the lung cancer patients after radiotherapy has been up to 33%. Conclusion: The dose to the heart, the lobar location of tumor, the treatment modality, the history of heart and pulmonary disease and smoking were considered as potential risk factors for RIHD in lung cancer radiotherapy. As treatment techniques improve over the time with better prognosis for lung cancer survivors, an improved prediction model can be established to further reduce the cardiac toxicity in lung cancer radiotherapy. PMID:27741117

  6. Results of radiotherapy in non round cell spinal metastasis.

    PubMed

    Kraiwattanapong, Chaiwat; Buranapanitkit, Boonsin; Kiriratnikom, Theerasan

    2004-03-01

    Spinal metastases are commonly encountered by physicians in a variety of clinical fields. There are some controversies in choice of treatment between surgery and radiotherapy. This report is a study of the outcomes of radiotherapy for metastatic nonround cell tumors of the spine. Medical records and films of 31 patients who were treated with radiotherapy at Songklanakarind Hospital were retrospectively reviewed. The most common primary tumors were prostate and breast. One patient had spinal metastases from malignant serous cystadenoma of the fallopian tube of which no previous report has been published. This patient had excellent results after radiotherapy. Back and neck pain were the primary symptoms of the patients, while motor or sensory deficits (or both) were found in 58 per cent of the cases. Seven patients had neurological recovery and 18 patients had pain relief after radiotherapy. Cause of compression is the only factor effecting the result from univariate and multivariate analysis. Spinal cord compressed by a tumor had a better recovery than those which were compressed by a bony fragment or intervertebral disc. The authors concluded that radiotherapy remains a good treatment for patient with non round cell spinal metastasis. Cause of spinal cord compression is the only factor predicting the result of treatment.

  7. Pectoral stretching program for women undergoing radiotherapy for breast cancer.

    PubMed

    Lee, T S; Kilbreath, S L; Refshauge, K M; Pendlebury, S C; Beith, J M; Lee, M J

    2007-05-01

    Surgery and radiotherapy commonly cause adverse musculoskeletal problems, particularly loss of strength and range of motion, in the upper quadrant of breast cancer patients. Few well-designed studies have investigated whether these impairments can be prevented. Stretching is an effective technique for increasing range of motion, hence the aim of this study was to investigate whether a stretching program reduced acute musculoskeletal impairments in patients undergoing radiotherapy for breast cancer. Sixty-four women were recruited prior to commencement of radiotherapy following breast cancer surgery. Participants were randomised to either a control or stretch group. Participants in both groups were reviewed by the physical therapist on a weekly basis for approximately 6 weeks, and were given general information about skin care and lymphedema. The control group received no advice about exercise. The stretch group received instruction on low-load, prolonged pectoral stretches, which were to be performed daily and were checked at weekly visits. Shoulder range of motion, strength, arm circumference, and quality of life measurements were taken prior to, and at completion of radiotherapy, and at 7 months after radiotherapy. There was no difference in any outcome between groups. Breast symptoms increased for both groups during radiotherapy, without loss of strength or range of movement. The incidence of lymphedema during the study was low for both groups and did not differ between groups. The pectoral stretching program did not influence the outcomes measured because the symptoms reported by patients were not a consequence of contracture.

  8. Time, space and technology in radiotherapy departments: how do these factors impact on patients' experiences of radiotherapy?

    PubMed

    Merchant, S; O'Connor, M; Halkett, G

    2017-03-01

    Radiation therapists (RTs) plan and deliver radiotherapy treatment for patients diagnosed with cancer. They need to communicate regularly with their patients and may have a role to play in reducing patient anxiety and distress. The objectives were to explore how the environment of radiotherapy departments supports or inhibits communication generally and information giving and supportive care provision in particular. An ethnographic approach was used to gather rich descriptive data through observations and interviews conducted in two Australian radiotherapy centres. Time, space and a technology driven culture was found to negatively affect the quality of interaction that occurred between RTs and their patients. This research has shown design/modification of spaces is needed in the radiotherapy environment to reflect a patient care centred culture and to enhance opportunities for RTs to provide supportive care for their patients.

  9. Antiinflammatory agents protect opossum esophagus during radiotherapy. [Cobalt 60

    SciTech Connect

    Northway, M.G.; Eastwood, G.L.; Libshitz, H.I.; Feldman, M.S.; Mamel, J.J.; Szwarc, I.A.

    1982-10-01

    Eighteen opossums received 2250 rad /sup 60/Co to the entire esophagus and lower esophageal sphincter. Animals received treatment with 600 mg aspirin, 25 mg/kg hydrocortisone, or saline before irradiation and twice daily for 1 week after irradiation. At 10 days postirradiation, animals were evaluated for signs of acute esophagitis by esophagoscopy and barium esophagram. Each animal was then killed and the esophagus removed and evaluated histologically. Animals treated with either aspirin or hydrocortisone had significantly milder esophagitis than control irradiated animals.

  10. EBT2 film as a depth-dose measurement tool for radiotherapy beams over a wide range of energies and modalities

    SciTech Connect

    Arjomandy, Bijan; Tailor, Ramesh; Zhao Li; Devic, Slobodan

    2012-02-15

    Purpose: One of the fundamental parameters used for dose calculation is percentage depth-dose, generally measured employing ionization chambers. There are situations where use of ion chambers for measuring depth-doses is difficult or problematic. In such cases, radiochromic film might be an alternative. The EBT-2 model GAFCHROMIC film was investigated as a potential tool for depth-dose measurement in radiotherapy beams over a broad range of energies and modalities. Methods: Pieces of the EBT-2 model GAFCHROMIC EBT2 film were exposed to x-ray, electron, and proton beams used in radiotherapy. The beams employed for this study included kilovoltage x-rays (75 kVp), {sup 60}Co gamma-rays, megavoltage x-rays (18 MV), electrons (7 and 20 MeV), and pristine Bragg-peak proton beams (126 and 152 MeV). At each beam quality, film response was measured over the dose range of 0.4-8.0 Gy, which corresponds to optical densities ranging from 0.05 to 0.4 measured with a flat-bed document scanner. To assess precision in depth-dose measurements with the EBT-2 model GAFCHROMIC film, uncertainty in measured optical density was investigated with respect to variation in film-to-film and scanner-bed uniformity. Results: For most beams, percentage depth-doses measured with the EBT-2 model GAFCHROMIC film show an excellent agreement with those measured with ion chambers. Some discrepancies are observed in case of (i) kilovoltage x-rays at larger depths due to beam-hardening, and (ii) proton beams around Bragg-peak due to quenching effects. For these beams, an empirical polynomial correction produces better agreement with ion-chamber data. Conclusions: The EBT-2 model GAFCHROMIC film is an excellent secondary dosimeter for measurement of percentage depth-doses for a broad range of beam qualities and modalities used in radiotherapy. It offers an easy and efficient way to measure beam depth-dose data with a high spatial resolution.

  11. External Beam Radiotherapy for Colon Cancer: Patterns of Care

    SciTech Connect

    Dunn, Emily F.; Kozak, Kevin R.; Moody, John S.

    2010-04-15

    Purpose: Despite its common and well characterized use in other gastrointestinal malignancies, little is known about radiotherapy (RT) use in nonmetastatic colon cancer in the United States. To address the paucity of data regarding RT use in colon cancer management, we examined the RT patterns of care in this patient population. Methods and Materials: Patients with nonmetastatic colon cancer, diagnosed between 1988 and 2005, were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate methods were used to identify factors associated with RT use. Results: On univariate analysis, tumor location, age, sex, race, T stage, N stage, and geographic location were each associated with differences in RT use (all p < 0.01). In general, younger patients, male patients, and patients with more advanced disease were more likely to receive RT. On multivariate analysis, tumor location, age, gender, T and N stage, time of diagnosis and geographic location were significantly associated with RT use (all p < 0.001). Race, however, was not associated with RT use. On multivariate analysis, patients diagnosed in 1988 were 2.5 times more likely to receive RT than those diagnosed in 2005 (p = 0.001). Temporal changes in RT use reflect a responsiveness to evolving evidence related to the therapeutic benefits of adjuvant RT. Conclusions: External beam RT is infrequently used for colon cancer, and its use varies according to patient and tumor characteristics. RT use has declined markedly since the late 1980s; however, it continues to be used for nonmetastatic disease in a highly individualized manner.

  12. New Methods for Targeted Alpha Radiotherapy

    NASA Astrophysics Data System (ADS)

    Robertson, J. David

    2014-03-01

    Targeted radiotherapies based on alpha emitters are a promising alternative to beta emitting radionuclides. Because of their much shorter range, targeted α-radiotherapy (TAT) agents have great potential for application to small, disseminated tumors and micro metastases and treatment of hematological malignancies consisting of individual, circulating neoplastic cells. A promising approach to TAT is the use of the in vivo α-generator radionuclides 223 = 11.4 d) and 225Ac 1/2 = 10.0 d). In addition to their longer half-lives, these two isotopes have the potential of dramatically increasing the therapeutic efficacy of TAT as they each emit four α particles in their decay chain. This principle has recently been exploited in the development of Xofigo®, the first TAT agent approved for clinical use by the U.S. FDA. Xofigo, formulated as 223RaCl2, is used for treatment of metastatic bone cancer in men with castration-resistant prostate cancer. TAT with 223Ra works, however, only in the case of bone cancer because radium, as a chemical analogue of calcium, efficiently targets bone. In order to bring the benefits of TAT with 223Ra or 225Ac to other tumor types, a new delivery method must be devised. Retaining the in vivo α generator radionuclides at the target site through the decay process is one of the major challenges associated with the development of TAT. Because the recoil energy of the daughter radionuclides from the α-emission is ~ 100 keV - a value which is four orders of magnitude greater than the energy of a covalent bond - the daughters will not remain bound to the bioconjugate at the targeting site. Various approaches have been attempted to achieve retention of the α-generator daughter radionuclides at the target site, including incorporation of the in vivo generator into liposomes and fullerenes. Unfortunately, to date single wall liposomes and fullerenes are able to retain less than 10% of the daughter radionuclides. We have recently demonstrated that a

  13. GammaPod—A new device dedicated for stereotactic radiotherapy of breast cancer

    PubMed Central

    Yu, Cedric X.; Shao, Xinyu; Zhang, Jin; Regine, William; Zheng, Mike; Yu, Ying S.; Deng, Jianchun; Duan, Zhengcheng

    2013-01-01

    Purpose: This paper introduces a new external beam radiotherapy device named GammaPod that is dedicated for stereotactic radiotherapy of breast cancer. Methods: The design goal of the GammaPod as a dedicated system for treating breast cancer is the ability to deliver ablative doses with sharp gradients under stereotactic image guidance. Stereotactic localization of the breast is achieved by a vacuum-assisted breast immobilization cup with built-in stereotactic frame. Highly focused radiation is achieved at the isocenter due to the cross-firing from 36 radiation arcs generated by rotating 36 individual Cobalt-60 beams. The dedicated treatment planning system optimizes an optimal path of the focal spot using an optimization algorithm borrowed from computational geometry such that the target can be covered by 90%–95% of the prescription dose and the doses to surrounding tissues are minimized. The treatment plan is intended to be delivered with continuous motion of the treatment couch. In this paper the authors described in detail the gamma radiation unit, stereotactic localization of the breast, and the treatment planning system of the GammaPod system. Results: A prototype GammaPod system was installed at University of Maryland Medical Center and has gone through a thorough functional, geometric, and dosimetric testing. The mechanical and functional performances of the system all meet the functional specifications. Conclusions: An image-guided breast stereotactic radiotherapy device, named GammaPod, has been developed to deliver highly focused and localized doses to a target in the breast under stereotactic image guidance. It is envisioned that the GammaPod technology has the potential to significantly shorten radiation treatments and even eliminate surgery by ablating the tumor and sterilizing the tumor bed simultaneously. PMID:23635251

  14. SU-D-BRD-03: A Gateway for GPU Computing in Cancer Radiotherapy Research

    SciTech Connect

    Jia, X; Folkerts, M; Shi, F; Yan, H; Yan, Y; Jiang, S; Sivagnanam, S; Majumdar, A

    2014-06-01

    Purpose: Graphics Processing Unit (GPU) has become increasingly important in radiotherapy. However, it is still difficult for general clinical researchers to access GPU codes developed by other researchers, and for developers to objectively benchmark their codes. Moreover, it is quite often to see repeated efforts spent on developing low-quality GPU codes. The goal of this project is to establish an infrastructure for testing GPU codes, cross comparing them, and facilitating code distributions in radiotherapy community. Methods: We developed a system called Gateway for GPU Computing in Cancer Radiotherapy Research (GCR2). A number of GPU codes developed by our group and other developers can be accessed via a web interface. To use the services, researchers first upload their test data or use the standard data provided by our system. Then they can select the GPU device on which the code will be executed. Our system offers all mainstream GPU hardware for code benchmarking purpose. After the code running is complete, the system automatically summarizes and displays the computing results. We also released a SDK to allow the developers to build their own algorithm implementation and submit their binary codes to the system. The submitted code is then systematically benchmarked using a variety of GPU hardware and representative data provided by our system. The developers can also compare their codes with others and generate benchmarking reports. Results: It is found that the developed system is fully functioning. Through a user-friendly web interface, researchers are able to test various GPU codes. Developers also benefit from this platform by comprehensively benchmarking their codes on various GPU platforms and representative clinical data sets. Conclusion: We have developed an open platform allowing the clinical researchers and developers to access the GPUs and GPU codes. This development will facilitate the utilization of GPU in radiation therapy field.

  15. Postoperative Irradiation of Gynecologic Malignancies: Improving Treatment Delivery Using Aperture-Based Intensity-Modulated Radiotherapy

    SciTech Connect

    Nadeau, Sylvain . E-mail: sylvainn@rrsb.nb.ca; Bouchard, Myriam; Germain, Isabelle; Raymond, Paul-Emile; Beaulieu, Frederic; Beaulieu, Luc; Roy, Rene; Gingras, Luc

    2007-06-01

    Purpose: To evaluate dosimetric and treatment delivery advantages of aperture-based intensity-modulated radiotherapy (AB-IMRT) for the treatment of patients receiving whole pelvic radiotherapy for gynecologic malignancies. Methods and Materials: Nineteen patients undergoing pelvic radiotherapy after resection of endometrial cancers were selected. A 45-Gy dose was prescribed to the target volume delineated on a planning CT scan. An in-house inverse planning system, Ballista, was used to develop a treatment plan using aperture-based multileaf collimator segments. This approach was compared with conventional four-field, enlarged four-field, and static beamlet-based IMRT (BB-IMRT) techniques in terms of target coverage, dose-volume histogram statistics for surrounding normal tissues, and numbers of segments and monitor units (MU). Results: Three quarters (76.4%) of the planning target volume received the prescription dose with conventional four-field plans. With adequate target coverage, the Ballista plans significantly reduced the volume of bowel and bladder irradiated at the prescribed dose (p < 0.001), whereas the two approaches provided equivalent results for the rectum (p 0.5). On the other hand, AB-IMRT and BB-IMRT plans showed only small differences in dose-volume histogram statistics of unknown clinical impact, whereas Ballista plan delivery required on average 73% and 59% fewer segments and MU, respectively. Conclusion: With respect to conventional techniques, AB-IMRT for the treatment of gynecologic malignancies provides dosimetric advantages similar to those with BB-IMRT but with clear treatment delivery improvements.

  16. Feasibility Study of Dual Energy Radiographic Imaging for Target Localization in Radiotherapy for Lung Tumors

    PubMed Central

    Huo, Jie; Zhu, Xianfeng; Dong, Yang; Yuan, Zhiyong; Wang, Ping; Wang, Xuemin; Wang, Gang; Hu, Xin-Hua; Feng, Yuanming

    2014-01-01

    Purpose Dual-energy (DE) radiographic imaging improves tissue discrimination by separating soft from hard tissues in the acquired images. This study was to establish a mathematic model of DE imaging based on intrinsic properties of tissues and quantitatively evaluate the feasibility of applying the DE imaging technique to tumor localization in radiotherapy. Methods We investigated the dependence of DE image quality on the radiological equivalent path length (EPL) of tissues with two phantoms using a stereoscopic x-ray imaging unit. 10 lung cancer patients who underwent radiotherapy each with gold markers implanted in the tumor were enrolled in the study approved by the hospital's Ethics Committee. The displacements of the centroids of the delineated gross tumor volumes (GTVs) in the digitally reconstructed radiograph (DRR) and in the bone-canceled DE image were compared with the averaged displacements of the centroids of gold markers to evaluate the feasibility of using DE imaging for tumor localization. Results The results of the phantom study indicated that the contrast-to-noise ratio (CNR) was linearly dependent on the difference of EPL and a mathematical model was established. The objects and backgrounds corresponding to ΔEPL less than 0.08 are visually indistinguishable in the bone-canceled DE image. The analysis of patient data showed that the tumor contrast in the bone-canceled images was improved significantly as compared with that in the original radiographic images and the accuracy of tumor localization using the DE imaging technique was comparable with that of using fiducial makers. Conclusion It is feasible to apply the technique for tumor localization in radiotherapy. PMID:25268643

  17. The feasibility of using Microsoft Kinect v2 sensors during radiotherapy delivery.

    PubMed

    Edmunds, David M; Bashforth, Sophie E; Tahavori, Fatemeh; Wells, Kevin; Donovan, Ellen M

    2016-11-08

    Consumer-grade distance sensors, such as the Microsoft Kinect devices (v1 and v2), have been investigated for use as marker-free motion monitoring systems for radiotherapy. The radiotherapy delivery environment is challenging for such sen-sors because of the proximity to electromagnetic interference (EMI) from the pulse forming network which fires the magnetron and electron gun of a linear accelerator (linac) during radiation delivery, as well as the requirement to operate them from the control area. This work investigated whether using Kinect v2 sensors as motion monitors was feasible during radiation delivery. Three sensors were used each with a 12 m USB 3.0 active cable which replaced the supplied 3 m USB 3.0 cable. Distance output data from the Kinect v2 sensors was recorded under four condi-tions of linac operation: (i) powered up only, (ii) pulse forming network operating with no radiation, (iii) pulse repetition frequency varied between 6 Hz and 400 Hz, (iv) dose rate varied between 50 and 1450 monitor units (MU) per minute. A solid water block was used as an object and imaged when static, moved in a set of steps from 0.6 m to 2.0 m from the sensor and moving dynamically in two sinusoidal-like trajectories. Few additional image artifacts were observed and there was no impact on the tracking of the motion patterns (root mean squared accuracy of 1.4 and 1.1mm, respectively). The sensors' distance accuracy varied by 2.0 to 3.8 mm (1.2 to 1.4 mm post distance calibration) across the range measured; the precision was 1 mm. There was minimal effect from the EMI on the distance calibration data: 0 mm or 1 mm reported distance change (2 mm maximum change at one position). Kinect v2 sensors operated with 12 m USB 3.0 active cables appear robust to the radiotherapy treatment environment.

  18. GammaPod-A new device dedicated for stereotactic radiotherapy of breast cancer

    SciTech Connect

    Yu, Cedric X.; Shao Xinyu; Deng Jianchun; Duan Zhengcheng; Zhang Jin; Zheng, Mike; Yu, Ying S.; Regine, William

    2013-05-15

    Purpose: This paper introduces a new external beam radiotherapy device named GammaPod that is dedicated for stereotactic radiotherapy of breast cancer. Methods: The design goal of the GammaPod as a dedicated system for treating breast cancer is the ability to deliver ablative doses with sharp gradients under stereotactic image guidance. Stereotactic localization of the breast is achieved by a vacuum-assisted breast immobilization cup with built-in stereotactic frame. Highly focused radiation is achieved at the isocenter due to the cross-firing from 36 radiation arcs generated by rotating 36 individual Cobalt-60 beams. The dedicated treatment planning system optimizes an optimal path of the focal spot using an optimization algorithm borrowed from computational geometry such that the target can be covered by 90%-95% of the prescription dose and the doses to surrounding tissues are minimized. The treatment plan is intended to be delivered with continuous motion of the treatment couch. In this paper the authors described in detail the gamma radiation unit, stereotactic localization of the breast, and the treatment planning system of the GammaPod system. Results: A prototype GammaPod system was installed at University of Maryland Medical Center and has gone through a thorough functional, geometric, and dosimetric testing. The mechanical and functional performances of the system all meet the functional specifications. Conclusions: An image-guided breast stereotactic radiotherapy device, named GammaPod, has been developed to deliver highly focused and localized doses to a target in the breast under stereotactic image guidance. It is envisioned that the GammaPod technology has the potential to significantly shorten radiation treatments and even eliminate surgery by ablating the tumor and sterilizing the tumor bed simultaneously.

  19. Visual Outcome in Meningiomas Around Anterior Visual Pathways Treated With Linear Accelerator Fractionated Stereotactic Radiotherapy

    SciTech Connect

    Stiebel-Kalish, Hadas; Reich, Ehud; Gal, Lior; Rappaport, Zvi Harry; Nissim, Ouzi; Pfeffer, Raphael; Spiegelmann, Roberto

    2012-02-01

    Purpose: Meningiomas threatening the anterior visual pathways (AVPs) and not amenable for surgery are currently treated with multisession stereotactic radiotherapy. Stereotactic radiotherapy is available with a number of devices. The most ubiquitous include the gamma knife, CyberKnife, tomotherapy, and isocentric linear accelerator systems. The purpose of our study was to describe a case series of AVP meningiomas treated with linear accelerator fractionated stereotactic radiotherapy (FSRT) using the multiple, noncoplanar, dynamic conformal rotation paradigm and to compare the success and complication rates with those reported for other techniques. Patients and Methods: We included all patients with AVP meningiomas followed up at our neuro-ophthalmology unit for a minimum of 12 months after FSRT. We compared the details of the neuro-ophthalmologic examinations and tumor size before and after FSRT and at the end of follow-up. Results: Of 87 patients with AVP meningiomas, 17 had been referred for FSRT. Of the 17 patients, 16 completed >12 months of follow-up (mean 39). Of the 16 patients, 11 had undergone surgery before FSRT and 5 had undergone FSRT as first-line management. Tumor control was achieved in 14 of the 16 patients, with three meningiomas shrinking in size after RT. Two meningiomas progressed, one in an area that was outside the radiation field. The visual function had improved in 6 or stabilized in 8 of the 16 patients (88%) and worsened in 2 (12%). Conclusions: Linear accelerator fractionated RT using the multiple noncoplanar dynamic rotation conformal paradigm can be offered to patients with meningiomas that threaten the anterior visual pathways as an adjunct to surgery or as first-line treatment, with results comparable to those reported for other stereotactic RT techniques.

  20. Concomitant use of radiotherapy and two topoisomerase inhibitors to treat adult T-cell leukemia with a radiotherapy-resistant bulky disease: a case series.

    PubMed

    Obama, Kosuke

    2014-01-01

    Concomitant chemoradiotherapy is established as the standard treatment to improve the prognosis of several types of solid tumor, but has not been the general practice for hematological malignancies. Here, I report two cases of adult T-cell leukemia (ATL) with a radiotherapy-resistant bulky disease treated with concomitant radiotherapy and two topoisomerase inhibitors: etoposide (VP-16) and irinotecan (CPT-11). Patient 1 was a 78-year-old man with chemotherapy-resistant inguinal bulky mass. Radiotherapy (total 40 Gy) for this inguinal lesion was started; however, the bulky disease was found to be resistant to radiotherapy and progressed. VP-16 and CPT-11 were administered in addition to radiotherapy (after a total of 20 Gy of radiotherapy). Patient 2 was a 71-year-old man with a solitary bulky mass in left cervical lesion. Various previous chemotherapy and radiotherapy approaches had not been able to control the disease. Six months after first radiotherapy, the bulky disease rapidly progressed with the occurrence of pain. Second radiotherapy (30 Gy) was started with simultaneous administration of CPT-11 and VP-16. In both cases, the bulky disease gradually regressed and completely disappeared by the end of radiotherapy. Thus, flexible adaptation of concomitant chemoradiotherapy including two topoisomerase inhibitors may offer a potential therapeutic option for radiotherapy-resistant bulky diseases, even in hematological malignancies.

  1. Development of three-dimensional radiotherapy techniques in breast cancer

    NASA Astrophysics Data System (ADS)

    Coles, Charlotte E.

    Radiotherapy following conservation surgery decreases local relapse and death from breast cancer. Currently, the challenge is to minimise the morbidity caused by this treatment without losing efficacy. Despite many advances in radiation techniques in other sites of the body, the majority of breast cancer patients are still planned and treated using 2-dimensional simple radiotherapy techniques. In addition, breast irradiation currently consumes 30% of the UK's radiotherapy workload. Therefore, any change to more complex treatment should be of proven benefit. The primary objective of this research is to develop and evaluate novel radiotherapy techniques to decrease irradiation of normal structures and improve localisation of the tumour bed. I have developed a forward-planned intensity modulated (IMRT) breast radiotherapy technique, which has shown improved dosimetry results compared to standard breast radiotherapy. Subsequently, I have developed and implemented a phase III randomised controlled breast IMRT trial. This National Cancer Research Network adopted trial will answer an important question regarding the clinical benefit of breast IMRT. It will provide DNA samples linked with high quality clinical outcome data, for a national translational radiogenomics study investigating variation in normal tissue toxicity. Thus, patients with significant late normal tissue side effects despite good dose homogeneity will provide the best model for finding differences due to underlying genetics. I evaluated a novel technique using high definition free-hand 3-dimensional (3D) ultrasound in a phantom study, and the results suggested that this is an accurate and reproducible method for tumour bed localisation. I then compared recognised methods of tumour bed localisation with the 3D ultrasound method in a clinical study. The 3D ultrasound technique appeared to accurately represent the shape and spatial position of the tumour cavity. This tumour bed localisation research

  2. Waiting time for radiotherapy in women with cervical cancer

    PubMed Central

    do Nascimento, Maria Isabel; Azevedo e Silva, Gulnar

    2016-01-01

    ABSTRACT OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer. METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests. RESULTS Most of the women (72.2%) began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996) to 64 days (2009-2010). The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003) according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively. CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity. PMID:26786473

  3. Radiotherapy physics research in the UK: challenges and proposed solutions.

    PubMed

    Mackay, R I; Burnet, N G; Green, S; Illidge, T M; Staffurth, J N

    2012-10-01

    In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting evaluation of their radiotherapy physics research infrastructure and the strengths, weaknesses, opportunities and threats within their own centre. These departments were brought together with the CTRad Executive Group and research funders to discuss the current state of radiotherapy physics research, perceived barriers and possible solutions. In this Commentary, we summarise the submitted materials, presentations and discussions from the meeting and propose an action plan. It is clear that there are challenges in both funding and staffing of radiotherapy physics research. Programme and project funding streams sometimes struggle to cater for physics-led work, and increased representation on research funding bodies would be valuable. Career paths for academic radiotherapy physicists need to be examined and an academic training route identified within Modernising Scientific Careers; the introduction of formal job plans may allow greater protection of research time, and should be considered. Improved access to research facilities, including research linear accelerators, would enhance research activity and pass on developments to patients more quickly; research infrastructure could be benchmarked against centres in the UK and abroad. UK National Health Service departments wishing to undertake radiotherapy research, with its attendant added value for patients, need to develop a strategy with their partner higher education institution, and collaboration between departments may provide enhanced opportunities for funded research.

  4. Radiotherapy physics research in the UK: challenges and proposed solutions

    PubMed Central

    Mackay, R I; Burnet, N G; Green, S; Illidge, T M; Staffurth, J N

    2012-01-01

    In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting evaluation of their radiotherapy physics research infrastructure and the strengths, weaknesses, opportunities and threats within their own centre. These departments were brought together with the CTRad Executive Group and research funders to discuss the current state of radiotherapy physics research, perceived barriers and possible solutions. In this Commentary, we summarise the submitted materials, presentations and discussions from the meeting and propose an action plan. It is clear that there are challenges in both funding and staffing of radiotherapy physics research. Programme and project funding streams sometimes struggle to cater for physics-led work, and increased representation on research funding bodies would be valuable. Career paths for academic radiotherapy physicists need to be examined and an academic training route identified within Modernising Scientific Careers; the introduction of formal job plans may allow greater protection of research time, and should be considered. Improved access to research facilities, including research linear accelerators, would enhance research activity and pass on developments to patients more quickly; research infrastructure could be benchmarked against centres in the UK and abroad. UK National Health Service departments wishing to undertake radiotherapy research, with its attendant added value for patients, need to develop a strategy with their partner higher education institution, and collaboration between departments may provide enhanced opportunities for funded research. PMID:22972972

  5. Present Status of Radiotherapy in Clinical Practice

    NASA Astrophysics Data System (ADS)

    Duehmke, Eckhart

    Aims of radiation oncology are cure from malignant diseases and - at the same time preservation of anatomy (e.g. female breast, uterus, prostate) and organ functions (e.g. brain, eye, voice, sphincter ani). At present, methods and results of clinical radiotherapy (RT) are based on experiences with natural history and radiobiology of malignant tumors in properly defined situations as well as on technical developments since World War II in geometrical and biological treatment planning in teletherapy and brachytherapy. Radiobiological research revealed tolerance limits of healthy tissues to be respected, effective total treatment doses of high cure probability depending on histology and tumor volume, and - more recently - altered fractionation schemes to be adapted to specific growth fractions and intrinsic radiosensitivities of clonogenic tumor cells. In addition, Biological Response Modifiers (BRM), such as cis-platinum, oxygen and hyperthermia may steepen cell survival curves of hypoxic tumor cells, others - such as tetrachiordekaoxid (TCDO) - may enhance repair of normal tissues. Computer assisted techniques in geometrical RT-planning based on individual healthy and pathologic anatomy (CT, MRT) provide high precision RT for well defined brain lesions by using dedicated linear accelerators (Stereotaxy). CT-based individual tissue compensators help with homogenization of distorted dose distributions in magna field irradiation for malignant lymphomas and with total body irradiation (TBI) before allogeneic bone marrow transplantation, e.g. for leukemia. RT with fast neutrons, Boron Neutron Capture Therapy (BNCT), RT with protons and heavy ions need to be tested in randomized trials before implementation into clinical routine.

  6. Clinical advantages of carbon-ion radiotherapy

    NASA Astrophysics Data System (ADS)

    Tsujii, Hirohiko; Kamada, Tadashi; Baba, Masayuki; Tsuji, Hiroshi; Kato, Hirotoshi; Kato, Shingo; Yamada, Shigeru; Yasuda, Shigeo; Yanagi, Takeshi; Kato, Hiroyuki; Hara, Ryusuke; Yamamoto, Naotaka; Mizoe, Junetsu

    2008-07-01

    Carbon-ion radiotherapy (C-ion RT) possesses physical and biological advantages. It was started at NIRS in 1994 using the Heavy Ion Medical Accelerator in Chiba (HIMAC); since then more than 50 protocol studies have been conducted on almost 4000 patients with a variety of tumors. Clinical experiences have demonstrated that C-ion RT is effective in such regions as the head and neck, skull base, lung, liver, prostate, bone and soft tissues, and pelvic recurrence of rectal cancer, as well as for histological types including adenocarcinoma, adenoid cystic carcinoma, malignant melanoma and various types of sarcomas, against which photon therapy could be less effective. Furthermore, when compared with photon and proton RT, a significant reduction of overall treatment time and fractions has been accomplished without enhancing toxicities. Currently, the number of irradiation sessions per patient averages 13 fractions spread over approximately three weeks. This means that in a carbon therapy facility a larger number of patients than is possible with other modalities can be treated over the same period of time.

  7. Steroid requirements during radiotherapy for malignant gliomas.

    PubMed

    Marantidou, Athina; Levy, Christine; Duquesne, Alyette; Ursu, Renata; Bailon, Olivier; Coman, Irene; Belin, Catherine; Carpentier, Antoine F

    2010-10-01

    Radiotherapy (RT) is the standard treatment for high-grade gliomas. However, toxicity may develop during RT, such as brain edema or worsening of neurological symptoms. Surprisingly, no dedicated study had focused on steroid requirements during RT in adult patients with malignant gliomas. We evaluated prospectively all patients with malignant gliomas treated by RT in a single center from July 2006 to May 2009. Age, sex, initial Karnofsky performance status (KPS), tumor localization and histology, type of surgical resection, clinical target volume, total dose and duration of RT, concomitant treatment with temozolomide, and steroid dosage during RT and at 1 and 3 months after RT were recorded in all patients. Most of the 80 patients (70%) were already taking steroids before RT. Half of them (55%) required initiation or further steroids increase during RT. The median time to steroid increase was 8 days. Only 13% of patients remained free of steroids during RT, and the mean maximal dosage of prednisone was 55 ± 48 mg. At 3 months after RT, 29% of patients were free of steroids, and the mean prednisone dosage was 32 ± 50 mg. Unresected tumors and initial KPS ≤80% were the only variables associated with higher steroid requirements on multivariate analysis. In our series, almost all patients required steroids during RT. Poor initial KPS and biopsy were associated with higher steroid requirements.

  8. [Prostate localization systems for prostate radiotherapy].

    PubMed

    de Crevoisier, R; Lagrange, J-L; Messai, T; M'Barek, B; Lefkopoulos, D

    2006-11-01

    The development of sophisticated conformal radiation therapy techniques for prostate cancer, such as intensity-modulated radiotherapy, implies precise and accurate targeting. Inter- and intrafraction prostate motion can be significant and should be characterized, unless the target volume may occasionally be missed. Indeed, bony landmark-based portal imaging does not provide the positional information for soft-tissue targets (prostate and seminal vesicles) or critical organs (rectum and bladder). In this article, we describe various prostate localization systems used before or during the fraction: rectal balloon, intraprostatic fiducials, ultrasound-based localization, integrated CT/linear accelerator system, megavoltage or kilovoltage cone-beam CT, Calypso 4D localization system tomotherapy, Cyberknife and Exactrac X-Ray 6D. The clinical benefit in using such prostate localization tools is not proven by randomized studies and the feasibility has just been established for some of these techniques. Nevertheless, these systems should improve local control by a more accurate delivery of an increased prescribed dose in a reduced planning target volume.

  9. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas

    PubMed Central

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W.; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J.

    2015-01-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8–54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10–75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  10. Chemically enhanced radiotherapy: visions for the future

    PubMed Central

    Susheela, Sridhar P.

    2016-01-01

    Radiotherapy (RT) is an important part of cancer management, with more than a third of all cancer cures being attributable to RT. Despite the advances in RT over the past century, the overall outcomes in a majority of malignancies are still unsatisfactory. There has been a constant endeavor to enhance the outcome of RT, and this has been in the form of altered fractionation, oxymimetic radiosensitizers, the use of concurrent chemotherapy, anti-angiogenic therapy and anti-growth factor receptor targeted therapies. This article presents a vision for the future, with emphasis upon emerging prospects which could enhance RT outcomes. Positive speculations regarding the use of immunological aspects, the use of nanoscale technology and the adoption of metronomic concurrent chemotherapy have been presented. Also, the potential with the use of low dose hyperradiosensitivity in enhancing chemotherapy outcomes too has been discussed. In this era of evidence based clinical practise, there exists a strong obsession towards the ‘present’ with ‘contempt towards the future’. Accepting the shortcomings of the existing modalities, there must be a strong zeal towards discovering better methodologies to enhance radiotherapeutic outcomes for the sake of a better future. PMID:26904574

  11. Second cancers following radiotherapy for cervical cancer

    SciTech Connect

    Kleinerman, R.A.; Curtis, R.E.; Boice, J.D. Jr.; Flannery, J.T.; Fraumeni, J.F. Jr.

    1982-11-01

    Incidence of second primary cancers was evaluated in 7,127 women with invasive cancer of the cervix uteri, diagnosed between 1935 and 1978, and followed up to 38 years (average, 8.9 yr) in Connecticut. Among 5,997 women treated with radiation, 449 developed second primary cancers compared with 313 expected (relative risk . 1.4) on the basis of rates from the Connecticut Tumor Registry. Excess incidence was noticeable 15 years or more after radiotherapy and attributed mostly to cancers of sites in or near the radiation field, especially the bladder, kidneys, rectum, corpus uteri, and ovaries. No excess was found for these sites among the 1,130 nonirradiated women. The ratio of observed to expected cancers for these sites did not vary appreciably by age at irradiation. The data suggested that high-dose pelvic irradiation was associated with increase in cancers of the bladder, kidneys, rectum, ovaries, corpus uteri, and non-Hodgkin's lymphoma but, apparently, not leukemia, Hodgkin's disease, breast cancer, or colon cancer.

  12. Hypnotherapy in radiotherapy patients: A randomized trial

    SciTech Connect

    Stalpers, Lukas J.A. . E-mail: l.stalpers@amc.uva.nl; Costa, Hanna C. da; Merbis, Merijn A.E.; Fortuin, Andries A.; Muller, Martin J.; Dam, Frits van

    2005-02-01

    Purpose: To determine whether hypnotherapy reduces anxiety and improves the quality of life in cancer patients undergoing curative radiotherapy (RT). Methods and materials: After providing written informed consent, 69 patients were randomized between standard curative RT alone (36 controls) and RT plus hypnotherapy (33 patients). Patients in the hypnotherapy group received hypnotherapy at the intake, before RT simulation, before the first RT session, and halfway between the RT course. Anxiety was evaluated by the State-Trait Anxiety Inventory DY-1 form at six points. Quality of life was measured by the Rand Medical Outcomes Study 36-item Health Survey (SF-36) at five points. Additionally, patients answered a questionnaire to evaluate their experience and the possible benefits of this research project. Results: No statistically significant difference was found in anxiety or quality of life between the hypnotherapy and control groups. However, significantly more patients in the hypnotherapy group indicated an improvement in mental (p < 0.05) and overall (p < 0.05) well-being. Conclusion: Hypnotherapy did not reduce anxiety or improve the quality of life in cancer patients undergoing curative RT. The absence of statistically significant differences between the two groups contrasts with the hypnotherapy patients' own sense of mental and overall well-being, which was significantly greater after hypnotherapy. It cannot be excluded that the extra attention by the hypnotherapist was responsible for this beneficial effect in the hypnotherapy group. An attention-only control group would be necessary to control for this effect.

  13. Stereotactic Body Radiotherapy for Oligometastatic Lung Tumors

    SciTech Connect

    Norihisa, Yoshiki; Nagata, Yasushi Takayama, Kenji; Matsuo, Yukinori; Sakamoto, Takashi; Sakamoto, Masato; Mizowaki, Takashi; Yano, Shinsuke; Hiraoka, Masahiro

    2008-10-01

    Purpose: Since 1998, we have treated primary and oligometastatic lung tumors with stereotactic body radiotherapy (SBRT). The term 'oligometastasis' is used to indicate a small number of metastases limited to an organ. We evaluated our clinical experience of SBRT for oligometastatic lung tumors. Methods and Materials: A total of 34 patients with oligometastatic lung tumors were included in this study. The primary involved organs were the lung (n = 15), colorectum (n = 9), head and neck (n = 5), kidney (n = 3), breast (n = 1), and bone (n = 1). Five to seven, noncoplanar, static 6-MV photon beams were used to deliver 48 Gy (n = 18) or 60 Gy (n = 16) at the isocenter, with 12 Gy/fraction within 4-18 days (median, 12 days). Results: The overall survival rate, local relapse-free rate, and progression-free rate at 2 years was 84.3%, 90.0%, and 34.8%, respectively. No local progression was observed in tumors irradiated with 60 Gy. SBRT-related pulmonary toxicities were observed in 4 (12%) Grade 2 cases and 1 (3%) Grade 3 case. Patients with a longer disease-free interval had a greater overall survival rate. Conclusion: The clinical result of SBRT for oligometastatic lung tumors in our institute was comparable to that after surgical metastasectomy; thus, SBRT could be an effective treatment of pulmonary oligometastases.

  14. Overview of Carbon-ion Radiotherapy

    NASA Astrophysics Data System (ADS)

    Tsujii, Hirohiko

    2017-01-01

    The outcome of radiotherapy depends on potential efficiency of accelerators and their related accessories. In charged particle therapy before the 1990s, accelerators that were primarily installed for physics research had been shared, which however had limited flexibility for clinical use. Therapy-dedicated facility was first constructed at Loma Linda University for PBT in 1990 and at NIRS for CIRT in 1993. Currently, there are more than 56 facilities for PBT, 6 for CIRT, and 6 for PBT/CIRT, and even more facilities are under construction or active planning. CIRT has beneficial property for cancer therapy because, as compared with photon therapy, it offers superior dose distributions by exhibiting a Bragg peak in the body and, as compared with PBT, it has higher radiobiological effectiveness. The number of potential candidates for charged particle therapy is estimated to range from 0.018% to 0.035% of all irradiated cancer patients. In CIRT at NIRS, Japan, more than 9,000 patients have been treated with promising results in non-SCC tumors and photon-resistant types of tumors at various sites. It is of note that in CIRT a significant reduction in overall treatment time and fractions has been successfully achieved.

  15. Radiotherapy treatments using Tsallis entropy statistical approach

    NASA Astrophysics Data System (ADS)

    D, Rodríguez-Pérez; O, Sotolongo-Grau; O, Sotolongo-Costa; C, Antoranz J.

    2014-03-01

    Several radiobiological models mimic the biologic effect of one single radiation dose on a living tissue. However, the actual fractionated radiotherapy requires accounting for a new magnitude, i.e., time. Here, we explore the biological consequences posed by the mathematical prolongation of a previous single radiation model to fractionated treatment. The survival fraction is obtained, together with the equivalent physical dose, in terms of a time dependent factor (similar to a repair coefficient) describing the tissue trend to recovering its radioresistance. The model describes how dose fractions add up to obtain the equivalent dose and how the repair coefficient poses a limit to reach an equivalent dose equal to the critical one that would completely annihilate the tumor. On the other hand, the surrounding healthy tissue is a limiting factor to treatment planning. This tissue has its own repair coefficient and thus should limit the equivalent dose of a treatment. Depending on the repair coefficient and the critical dose of each tissue, unexpected results (failure to fully remove the tumor) can be obtained. To illustrate these results and predictions, some realistic example calculations will be performed using parameter values within actual clinical ranges. In conclusion, the model warns about treatment limitations and proposes ways to overcome them.

  16. System Toward Automation in Radiotherapy Treatment: START

    NASA Astrophysics Data System (ADS)

    Cheng, Andrew Y. S.; Tsoi, Kenneth Y. P.

    1994-10-01

    START is a new automation system invented for nasopharyngeal carcinoma treatment. A laser scanner system capable of non-contact digitization of 3D surface is used to digitize the contours of the patient's face, shoulder and special landmark reference features of the patient. These features are stored in the computer in 3D digitized format. The digitized facial features with traced landmark reference features are used for fabrication of a true sized wood-particle laminates mould by a computer numerical controlled milling system. A Cobex mask is formed on this mould by using vacuum forming technique. With an image analysis and computer aided design system, the X-ray film with treatment window marked is traced automatically and converted to match the prescanned 3D information. A computer controlled 6-axis robot can precisely mark out the required areas on the Cobex cast for treatment. Finally, the patient receives radiotherapy treatment with the Cobex case as a positioning registration device. The new system will replace the manual procedure with better patient comfort, higher efficiency and enhanced accuracy.

  17. Effect of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy alone in nasopharyngeal carcinoma

    PubMed Central

    OuYang, Pu-Yun; Shi, Dingbo; Sun, Rui; Zhu, Yu-Jia; Xiao, Yao; Zhang, Lu-Ning; Zhang, Xu-Hui; Chen, Ze-Ying; Lan, Xiao-Wen; Tang, Jie; Gao, Yuan-Hong; Ma, Jun; Deng, Wuguo; Xie, Fang-Yun

    2016-01-01

    Background Albeit intensity-modulated radiotherapy (IMRT) is currently the recommended radiation technique in treating nasopharyngeal carcinoma, the effect of IMRT versus two-dimensional conventional radiotherapy (2DCRT) alone is still contradictory. Results In the original unmatched cohort of 1198 patients, IMRT obtained comparable 5-year overall survival (OS) (91.3% vs 87.1%, P = 0.120), locoregional relapse-free survival (LRFS) (92.3% vs 90.4%, P = 0.221) and distant metastasis-free survival (DMFS) (92.9% vs 92.1%, P = 0.901) to 2DCRT. In the propensity-matched cohort of 604 patients, no significant survival differences were observed between the two arms (5-year OS 90.9% vs 90.5%, P = 0.655; LRFS 92.5% vs 92.4%, P = 0.866; DMFS 92.5% vs 92.9%, P = 0.384). In multivariate analysis, IMRT did not significantly lower the risk of death, locoregional relapse or distant metastasis, irrespective of tumor stage. Methods Overall, 1198 patients who underwent IMRT (316 patients) or 2DCRT (882 patients) without any chemotherapy was retrospectively analyzed. Patients in both arms were matched at equal ratio using propensity-score matching method. OS, LRFS and DMFS were assessed with Kaplan-Meier method, log-rank test and Cox regression. Conclusions In this propensity-matched study, IMRT showed no survival advantage over 2DCRT alone in nasopharyngeal carcinoma. PMID:27058901

  18. Modeling the Risk of Secondary Malignancies after Radiotherapy

    PubMed Central

    Schneider, Uwe

    2011-01-01

    In developed countries, more than half of all cancer patients receive radiotherapy at some stage in the management of their disease. However, a radiation-induced secondary malignancy can be the price of success if the primary cancer is cured or at least controlled. Therefore, there is increasing concern regarding radiation-related second cancer risks in long-term radiotherapy survivors and a corresponding need to be able to predict cancer risks at high radiation doses. Of particular interest are second cancer risk estimates for new radiation treatment modalities such as intensity modulated radiotherapy, intensity modulated arc-therapy, proton and heavy ion radiotherapy. The long term risks from such modern radiotherapy treatment techniques have not yet been determined and are unlikely to become apparent for many years, due to the long latency time for solid tumor induction. Most information on the dose-response of radiation-induced cancer is derived from data on the A-bomb survivors who were exposed to γ-rays and neutrons. Since, for radiation protection purposes, the dose span of main interest is between zero and one Gy, the analysis of the A-bomb survivors is usually focused on this range. With increasing cure rates, estimates of cancer risk for doses larger than one Gy are becoming more important for radiotherapy patients. Therefore in this review, emphasis was placed on doses relevant for radiotherapy with respect to radiation induced solid cancer. Simple radiation protection models should be used only with extreme care for risk estimates in radiotherapy, since they are developed exclusively for low dose. When applied to scatter radiation, such models can predict only a fraction of observed second malignancies. Better semi-empirical models include the effect of dose fractionation and represent the dose-response relationships more accurately. The involved uncertainties are still huge for most of the organs and tissues. A major reason for this is that the

  19. Assessment of radiotherapy photon beams: A practical and low cost methodology

    NASA Astrophysics Data System (ADS)

    Reis, C. Q. M.; Nicolucci, P.

    2017-02-01

    Dosimetric properties of radiation beams used in radiotherapy are directly related to the energy spectrum produced by the treatment unit. Therefore, the development of methodologies to evaluate in a simple and accurate way the spectra of clinical beams can help establishing the quality control of the treatment. The purpose of this study is to present a practical and low cost methodology for determining primary spectra of radiotherapy photon beams from transmission measurements in attenuators of aluminum and using the method of the inverse Laplace transform. Monte Carlo simulation with PENELOPE code was used in order to evaluate and validate the reconstructed spectra by the calculation of dosimetric parameters that characterize the beam. Percentage depth dose values simulated with a 6 MV reconstructed spectrum shows maximum difference of 4.4% when compared to values measured at the corresponding clinical beam. For a 10 MV beam that difference was around 4.2%. Results obtained in this study confirm the adequacy of the proposed methodology for assessing primary photon beams produced by clinical accelerators.

  20. Conversion coefficients for determination of dispersed photon dose during radiotherapy: NRUrad input code for MCNP

    PubMed Central

    Krstic, D.; Nikezic, D.

    2017-01-01

    Radiotherapy is a common cancer treatment module, where a certain amount of dose will be delivered to the targeted organ. This is achieved usually by photons generated by linear accelerator units. However, radiation scattering within the patient’s body and the surrounding environment will lead to dose dispersion to healthy tissues which are not targets of the primary radiation. Determination of the dispersed dose would be important for assessing the risk and biological consequences in different organs or tissues. In the present work, the concept of conversion coefficient (F) of the dispersed dose was developed, in which F = (Dd/Dt), where Dd was the dispersed dose in a non-targeted tissue and Dt is the absorbed dose in the targeted tissue. To quantify Dd and Dt, a comprehensive model was developed using the Monte Carlo N-Particle (MCNP) package to simulate the linear accelerator head, the human phantom, the treatment couch and the radiotherapy treatment room. The present work also demonstrated the feasibility and power of parallel computing through the use of the Message Passing Interface (MPI) version of MCNP5. PMID:28362837

  1. Neutron measurements in radiotherapy: A method to correct neutron sensitive devices for parasitic photon response.

    PubMed

    Irazola, L; Terrón, J A; Bedogni, R; Pola, A; Lorenzoli, M; Jimenez-Ortega, E; Barbeiro, A R; Sánchez-Nieto, B; Sánchez-Doblado, F

    2017-02-12

    One of the major causes of secondary malignancies after radiotherapy treatments are peripheral doses, known to increase for some newer techniques (such as IMRT or VMAT). For accelerators operating above 10MV, neutrons can represent important contribution to peripheral doses. This neutron contamination can be measured using different passive or active techniques, available in the literature. As far as active (or direct-reading) procedures are concerned, a major issue is represented by their parasitic photon sensitivity, which can significantly affect the measurement when the point of test is located near to the field-edge. This work proposes a simple method to estimate the unwanted photon contribution to these neutrons. As a relevant case study, the use of a recently neutron sensor for "in-phantom" measurements in high-energy machines was considered. The method, called "Dual Energy Photon Subtraction" (DEPS), requires pairs of measurements performed for the same treatment, in low-energy (6MV) and high energy (e.g. 15MV) fields. It assumes that the peripheral photon dose (PPD) at a fixed point in a phantom, normalized to the unit photon dose at the isocenter, does not depend on the treatment energy. Measurements with ionization chamber and Monte Carlo simulations were used to evaluate the validity of this hypothesis. DEPS method was compared to already published correction methods, such as the use of neutron absorber materials. In addition to its simplicity, an advantage of DEPs procedure is that it can be applied to any radiotherapy machine.

  2. Conversion coefficients for determination of dispersed photon dose during radiotherapy: NRUrad input code for MCNP.

    PubMed

    Shahmohammadi Beni, Mehrdad; Ng, C Y P; Krstic, D; Nikezic, D; Yu, K N

    2017-01-01

    Radiotherapy is a common cancer treatment module, where a certain amount of dose will be delivered to the targeted organ. This is achieved usually by photons generated by linear accelerator units. However, radiation scattering within the patient's body and the surrounding environment will lead to dose dispersion to healthy tissues which are not targets of the primary radiation. Determination of the dispersed dose would be important for assessing the risk and biological consequences in different organs or tissues. In the present work, the concept of conversion coefficient (F) of the dispersed dose was developed, in which F = (Dd/Dt), where Dd was the dispersed dose in a non-targeted tissue and Dt is the absorbed dose in the targeted tissue. To quantify Dd and Dt, a comprehensive model was developed using the Monte Carlo N-Particle (MCNP) package to simulate the linear accelerator head, the human phantom, the treatment couch and the radiotherapy treatment room. The present work also demonstrated the feasibility and power of parallel computing through the use of the Message Passing Interface (MPI) version of MCNP5.

  3. Update of the BIPM comparison BIPM.RI(II)-K1.Co-60 of activity measurements of the radionuclide 60Co to include the 2011 result of the CNEA (Argentina), the 2012 results of the BARC (India) and the NRC (Canada), and the 2014 result of the NIM (China)

    NASA Astrophysics Data System (ADS)

    Michotte, C.; Ratel, G.; Courte, S.; Arenillas, P.; Balpardo, C.; Joseph, L.; Anuradha, R.; Kulkarni, D. B.; Galea, R.; Moore, K.; Stroak, A.; Zhang, Ming; Liang, Juncheng; Liu, Haoran

    2017-01-01

    Since 2010, four national metrology institutes (NMI) have each submitted a sample of known activity of 60Co to the International Reference System (SIR) for activity comparison at the Bureau International des Poids et Mesures (BIPM), with comparison identifier BIPM.RI(II)-K1.Co-60. The values of the activity submitted were between about 175 kBq and 1600 kBq. The primary standardization results for the CNEA, Argentina and the BARC, India replace their earlier result of 2003 and 2001, respectively. There are now seventeen results in the BIPM.RI(II)-K1.Co-60 comparison. The key comparison reference value (KCRV) has been updated using the power-moderated weighted mean. The degrees of equivalence between each equivalent activity measured in the SIR and the KCRV have been calculated and the results are given in the form of a table. A graphical presentation is also given. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  4. A software tool of digital tomosynthesis application for patient positioning in radiotherapy.

    PubMed

    Yan, Hui; Dai, Jian-Rong

    2016-03-08

    Digital Tomosynthesis (DTS) is an image modality in reconstructing tomographic images from two-dimensional kV projections covering a narrow scan angles. Comparing with conventional cone-beam CT (CBCT), it requires less time and radiation dose in data acquisition. It is feasible to apply this technique in patient positioning in radiotherapy. To facilitate its clinical application, a software tool was developed and the reconstruction processes were accelerated by graphic process-ing unit (GPU). Two reconstruction and two registration processes are required for DTS application which is different from conventional CBCT application which requires one image reconstruction process and one image registration process. The reconstruction stage consists of productions of two types of DTS. One type of DTS is reconstructed from cone-beam (CB) projections covering a narrow scan angle and is named onboard DTS (ODTS), which represents the real patient position in treatment room. Another type of DTS is reconstructed from digitally reconstructed radiography (DRR) and is named reference DTS (RDTS), which represents the ideal patient position in treatment room. Prior to the reconstruction of RDTS, The DRRs are reconstructed from planning CT using the same acquisition setting of CB projections. The registration stage consists of two matching processes between ODTS and RDTS. The target shift in lateral and longitudinal axes are obtained from the matching between ODTS and RDTS in coronal view, while the target shift in longitudinal and vertical axes are obtained from the matching between ODTS and RDTS in sagittal view. In this software, both DRR and DTS reconstruction algorithms were implemented on GPU environments for acceleration purpose. The comprehensive evaluation of this software tool was performed including geometric accuracy, image quality, registration accuracy, and reconstruction efficiency. The average correlation coefficient between DRR/DTS generated by GPU-based algorithm

  5. Improved outcome of nasopharyngeal carcinoma treated with conventional radiotherapy

    SciTech Connect

    Palazzi, Mauro . E-mail: mauro.palazzi@istitutotumori.mi.it; Guzzo, Marco; Tomatis, Stefano Ph.D.; Cerrotta, Annamaria; Potepan, Paolo; Quattrone, Pasquale; Cantu, Giulio

    2004-12-01

    Purpose: To describe the outcome of patients with nonmetastatic nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy at a single institution. Methods and materials: From 1990 to 1999, 171 consecutive patients with NPC were treated with conventional (two-dimensional) radiotherapy. Tumor histology was undifferentiated in 82% of cases. Tumor-node-metastasis Stage (American Joint Committee on Cancer/International Union Against Cancer 1997 system) was I in 6%, II in 36%, III in 22%, and IV in 36% of patients. Mean total radiation dose was 68.4 Gy. Chemotherapy was given to 62% of the patients. The median follow-up for surviving patients was 6.3 years (range, 3.1-13.1 years). Results: The 5-year overall survival, disease-specific survival, and disease-free survival rates were 72%, 74%, and 62%, respectively. The 5-year local, regional, and distant control rates were 84%, 80%, and 83% respectively. Late effects of radiotherapy were prospectively recorded in 100 patients surviving without relapse; 44% of these patients had Grade 3 xerostomia, 33% had Grade 3 dental damage, and 11% had Grade 3 hearing loss. Conclusions: This analysis shows an improved outcome for patients treated from 1990 to 1999 compared with earlier retrospective series, despite the use of two-dimensional radiotherapy. Late toxicity, however, was substantial with conventional radiotherapy.

  6. [The need for a paradigm shift in radiotherapy].

    PubMed

    Mayer, Árpád; Katona, Csilla; Farkas, Róbert; Póti, Zsuzsa

    2015-11-01

    The status and indications of radiotherapy have significantly changed in the past decade because novel techniques, radiobiological research and major advances in informatics have made better local control possible. Using supplemented marking of the target volume with computer tomography based other image-making methods adapted made it possible to define the tumor and intact surrounding tissues more precisely. With novel radiotherapy techniques the dosage of the homogenity and the covering in the target volume can be raised optimally, especially with intensity modulated arc radiotherapy (volumetric modulated arc therapy) without causing radiation injury or damage to intact surrounding tissues. Furthermore, with novel techniques and target volume marking, new indications have appeared in clinical practice and besides stereotactic radiotherapy for intracranial metastases, the extracranial so-called oligometastic conditions can be maintained close to a curative state (or in remission) for many years. Among these, perhaps the most striking is the stereotactic radiotherapy treatment of liver, lung and spinal cord metastases in one or more fractions, for which the indispensable condition is the image or respiratory guided technique.

  7. Combination chemotherapy and radiotherapy in non-Hodgkin's lymphomata.

    PubMed Central

    Bonadonna, G.; De Lena, M.; Lattuada, A.; Milani, F.; Monfardini, S.; Beretta, G.

    1975-01-01

    The results obtained with intensive chemotherapy and intensive chemotherapy plus radiotherapy in non-Hodgkin's lymphomata are reported. A quintuple drug regimen (mechloretamine, adriamycin, bleomycin, vincristine and prednisone) in histiocytic lymphomata (Stage III and IV) yielded complete remissions in 53% and complete plus partial remissions in 77%. These figures were 44% and 64% respectively in lymphocytic lymphoma. In Stage III complete responders after combination chemotherapy were subsequently irradiated (involved field irradiation). The median duration of complete remission after completion of radiotherapy was 9-5 months in histiocytic and 12-0 months in lymphocytic lymphomata. At 2 years actuarial survival in Stage III and IV was better in patients with the lymphocytic type and with nodular pattern than with histiocytic and diffuse patterns. A more recent trial compares, in Stage IV patients, cyclophosphamide, vincristine and prednisone (CVP) versus adriamycin, bleomycin and prednisone (ABP). Although the number of evaluable patients is still limited, there appears to be no difference in the response rate between CVP and ABP. In Stages I and II, 6 cycles of CVP were given as adjuvant treatment after radiotherapy. At the present moment, there is no statistical difference in the relapse rate between the group of patients treated with radiotherapy alone and that with radiotherapy plus CVP. PMID:52367

  8. Low-dose prophylactic craniospinal radiotherapy for intracranial germinoma

    SciTech Connect

    Schoenfeld, Gordon O.; Amdur, Robert J. . E-mail: amdurrj@ufl.edu; Schmalfuss, Ilona M.; Morris, Christopher G.; Keole, Sameer R.; Mendenhall, William M.; Marcus, Robert B.

    2006-06-01

    Purpose: To report outcomes of patients with localized intracranial germinoma treated with low-dose craniospinal irradiation (CSI) followed by a boost to the ventricular system and primary site. Methods and Materials: Thirty-one patients had pathologically confirmed intracranial germinoma and no spine metastases. Low-dose CSI was administered in 29 patients: usually 21 Gy of CSI, 9.0 Gy of ventricular boost, and a 19.5-Gy tumor boost, all at 1.5 Gy per fraction. Our neuroradiologist recorded three-dimensional tumor size on magnetic resonance images before, during, and after radiotherapy. Results: With a median follow-up of 7.0 years, 29 of 31 patients (94%) are disease free. One failure had nongerminomatous histology; the initial diagnosis was a sampling error. Of 3 patients who did not receive CSI, 1 died. No patient developed myelopathy, visual deficits, dementia, or skeletal growth problems. In locally controlled patients, tumor response according to magnetic resonance scan was nearly complete within 6 months after radiotherapy. Conclusions: Radiotherapy alone with low-dose prophylactic CSI cures almost all patients with localized intracranial germinoma. Complications are rare when the daily dose of radiotherapy is limited to 1.5 Gy and the total CSI dose to 21 Gy. Patients without a near-complete response to radiotherapy should undergo resection to rule out a nongerminomatous element.

  9. A new active method for the measurement of slow-neutron fluence in modern radiotherapy treatment rooms

    NASA Astrophysics Data System (ADS)

    Gómez, F.; Iglesias, A.; Sánchez Doblado, F.

    2010-02-01

    This work focuses on neutron monitoring at clinical linac facilities during high-energy modality radiotherapy treatments. Active in-room measurement of neutron fluence is a complex problem due to the pulsed nature of the fluence and the presence of high photon background, and only passive methods have been considered reliable until now. In this paper we present a new active method to perform real-time measurement of neutron production around a medical linac. The device readout is being investigated as an estimate of patient neutron dose exposure on each radiotherapy session. The new instrument was developed based on neutron interaction effects in microelectronic memory devices, in particular using neutron-sensitive SRAM devices. This paper is devoted to the description of the instrument and measurement techniques, presenting the results obtained together with their comparison and discussion. Measurements were performed in several standard clinical linac facilities, showing high reliability, being insensitive to the photon fluence and EM pulse present inside the radiotherapy room, and having detector readout statistical relative uncertainties of about 2% on measurement of neutron fluence produced by 1000 monitor units irradiation runs.

  10. Concerning Units.

    ERIC Educational Resources Information Center

    Wadlinger, Robert L.

    1983-01-01

    SI units come in two distinct types: fundamental (kilogram, meter) and descriptive (atom, molecule). Proper/improper uses of atom/molecule from historical cases are presented followed by a re-introduction of a light "wave (cycle)" unit and the clearly defined photon model which is deduced. Also examines omission of the fundamental unit "radon."…

  11. Optimization approaches for planning external beam radiotherapy

    NASA Astrophysics Data System (ADS)

    Gozbasi, Halil Ozan

    Cancer begins when cells grow out of control as a result of damage to their DNA. These abnormal cells can invade healthy tissue and form tumors in various parts of the body. Chemotherapy, immunotherapy, surgery and radiotherapy are the most common treatment methods for cancer. According to American Cancer Society about half of the cancer patients receive a form of radiation therapy at some stage. External beam radiotherapy is delivered from outside the body and aimed at cancer cells to damage their DNA making them unable to divide and reproduce. The beams travel through the body and may damage nearby healthy tissue unless carefully planned. Therefore, the goal of treatment plan optimization is to find the best system parameters to deliver sufficient dose to target structures while avoiding damage to healthy tissue. This thesis investigates optimization approaches for two external beam radiation therapy techniques: Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT). We develop automated treatment planning technology for IMRT that produces several high-quality treatment plans satisfying provided clinical requirements in a single invocation and without human guidance. A novel bi-criteria scoring based beam selection algorithm is part of the planning system and produces better plans compared to those produced using a well-known scoring-based algorithm. Our algorithm is very efficient and finds the beam configuration at least ten times faster than an exact integer programming approach. Solution times range from 2 minutes to 15 minutes which is clinically acceptable. With certain cancers, especially lung cancer, a patient's anatomy changes during treatment. These anatomical changes need to be considered in treatment planning. Fortunately, recent advances in imaging technology can provide multiple images of the treatment region taken at different points of the breathing cycle, and deformable image registration algorithms can

  12. Intra-Arterial Infusion Chemotherapy Using Cisplatin With Radiotherapy for Stage III Squamous Cell Carcinoma of the Cervix

    SciTech Connect

    Kaneyasu, Yuko Nagai, Nobutaka; Nagata, Yasushi; Hashimoto, Yasutoshi; Yuki, Shintaro; Murakami, Yuji; Kenjo, Masahiro; Kakizawa, Hideaki; Toyota, Naoyuki; Fujiwara, Hisaya; Kudo, Yoshiki; Ito, Katsuhide

    2009-10-01

    Purpose: To examine the effectiveness of concomitant intra-arterial infusion chemotherapy (IAIC) using cisplatin (CDDP) with radiotherapy for Stage III squamous cell carcinoma of the cervix. Materials and Methods: We analyzed 29 cases of Stage III squamous cell carcinoma of the uterine cervix treated with radiotherapy and IAIC of CDDP from 1991 to 2006. External-beam therapy was given to the whole pelvis using four opposing parallel fields with an 18-MV linear accelerator unit. A central shield was used after 30-40 Gy with external whole-pelvic irradiation, and the total dose was 50 Gy. High-dose-rate brachytherapy was given with {sup 192}Ir microSelectron. The dose at Point A was 6 Gy per fraction, 2 fractions per week, and the total number of fractions was either 3 or 4. Two or three courses of IAIC were given concomitantly with CDDP 120 mg or carboplatin 300 mg. Results: We confirmed excellent medicine distribution directly by using computed tomographic angiography. The 5-year overall survival rate for Stage III patients was 62%, the cause-specific survival rate was 70%, and the local relapse-free survival rate was 89%. Local recurrence, distant metastasis, and occurrences of both were 7%, 38%, and 3%, respectively. The incidence of severe acute hematologic adverse reactions (Grade {>=}3) was 27% for all patients; however, all recovered without interruption of radiotherapy. Severe nonhematologic effects (Grade {>=}3) were 3%, including nausea and ileus. Only 1 patient's radiotherapy was interrupted for a period of 1 week because of ileus. Severe late complication rates (Grade {>=}3) for the bladder, rectum, and intestine were 3%, 3%, and 10%, respectively. Conclusion: A combination of IAIC and systemic chemotherapy should be considered to improve the prognosis of patients with Stage III squamous cell carcinoma of the cervix.

  13. Radiotherapy issues in elderly breast cancer patients.

    PubMed

    Kunkler, Ian

    2012-12-01

    Breast cancer in the elderly is a rising health care challenge. Under-treatment is common. While the proportion of older patients receiving adjuvant radiotherapy (RT) is rising, the proportion undergoing breast-conserving surgery without irradiation has also risen. The evidence base for loco-regional treatment is limited, reflecting the historical exclusion of older patients from randomised trials. The 2011 Oxford overview shows that the risk of first recurrence is halved in all age groups by adjuvant RT after breast-conserving surgery, although the absolute benefit in older 'low-risk' patients is small. There is level 1 evidence that a breast boost after breast-conserving surgery and whole-breast irradiation reduces local recurrence in older as in younger women, although in the former the absolute reduction is modest. Partial breast irradiation (external beam or intraoperative or postoperative brachytherapy) is potentially an attractive option for older patients, but the evidence base is insufficient to recommend it routinely. Similarly, shortened (hypofractionated) dose fraction schedules may be more convenient for older patients and are supported by level 1 evidence. There remains uncertainty about whether there is a subgroup of older low-risk patients in whom postoperative RT can be omitted after breast-conserving surgery. Biomarkers of 'low risk' are needed to refine the selection of patients for the omission of adjuvant RT. The role of postmastectomy irradiation is well established for 'high-risk' patients but uncertain in the intermediate-risk category of patients with 1-3 involved axillary nodes or node-negative patients with other risk factors where its role is investigational.

  14. Predicting radiotherapy outcomes using statistical learning techniques.

    PubMed

    El Naqa, Issam; Bradley, Jeffrey D; Lindsay, Patricia E; Hope, Andrew J; Deasy, Joseph O

    2009-09-21

    Radiotherapy outcomes are determined by complex interactions between treatment, anatomical and patient-related variables. A common obstacle to building maximally predictive outcome models for clinical practice is the failure to capture potential complexity of heterogeneous variable interactions and applicability beyond institutional data. We describe a statistical learning methodology that can automatically screen for nonlinear relations among prognostic variables and generalize to unseen data before. In this work, several types of linear and nonlinear kernels to generate interaction terms and approximate the treatment-response function are evaluated. Examples of institutional datasets of esophagitis, pneumonitis and xerostomia endpoints were used. Furthermore, an independent RTOG dataset was used for 'generalizabilty' validation. We formulated the discrimination between risk groups as a supervised learning problem. The distribution of patient groups was initially analyzed using principle components analysis (PCA) to uncover potential nonlinear behavior. The performance of the different methods was evaluated using bivariate correlations and actuarial analysis. Over-fitting was controlled via cross-validation resampling. Our results suggest that a modified support vector machine (SVM) kernel method provided superior performance on leave-one-out testing compared to logistic regression and neural networks in cases where the data exhibited nonlinear behavior on PCA. For instance, in prediction of esophagitis and pneumonitis endpoints, which exhibited nonlinear behavior on PCA, the method provided 21% and 60% improvements, respectively. Furthermore, evaluation on the independent pneumonitis RTOG dataset demonstrated good generalizabilty beyond institutional data in contrast with other models. This indicates that the prediction of treatment response can be improved by utilizing nonlinear kernel methods for discovering important nonlinear interactions among model

  15. Carbon Ion Radiotherapy for Unresectable Retroperitoneal Sarcomas

    SciTech Connect

    Serizawa, Itsuko; Kagei, Kenji; Kamada, Tadashi; Imai, Reiko; Sugahara, Shinji; Okada, Tohru; Tsuji, Hiroshi; Ito, Hisao; Tsujii, Hirohiko

    2009-11-15

    Purpose: To evaluate the applicability of carbon ion radiotherapy (CIRT) for unresectable retroperitoneal sarcomas with regard to normal tissue morbidity and local tumor control. Methods and Materials: From May 1997 to February 2006, 24 patients (17 male and 7 female) with unresectable retroperitoneal sarcoma received CIRT. Age ranged from 16 to 77 years (median, 48.6 years). Of the patients, 16 had primary disease and 8 recurrent disease. Histologic diagnoses were as follows: malignant fibrous histiocytoma in 6, liposarcoma in 3, malignant peripheral nerve sheath tumor in 3, Ewing/primitive neuroectodermal tumor (PNET) in 2, and miscellaneous in 10 patients. The histologic grades were as follows: Grade 3 in 15, Grade 2-3 in 2, Grade 2 in 3, and unknown in 4. Clinical target volumes ranged between 57 cm{sup 3} and 1,194 cm{sup 3} (median 525 cm{sup 3}). The delivered carbon ion dose ranged from 52.8 to 73.6 GyE in 16 fixed fractions over 4 weeks. Results: The median follow-up was 36 months (range, 6-143 months). The overall survival rates at 2 and 5 years were 75% and 50%, respectively. The local control rates at 2 and 5 years were 77% and 69%. No complications of the gastrointestinal tract were encountered. No other toxicity greater than Grade 2 was observed. Conclusions: Use of CIRT is suggested to be effective and safe for retroperitoneal sarcomas. The results obtained with CIRT were a good overall survival rate and local control, notwithstanding the fact that most patients were not eligible for surgical resection and had high-grade sarcomas.

  16. Volumetric Modulated Arc Radiotherapy for Vestibular Schwannomas

    SciTech Connect

    Lagerwaard, Frank J. Meijer, Otto W.M.; Hoorn, Elles A.P. van der; Verbakel, Wilko; Slotman, Ben J.; Senan, Suresh

    2009-06-01

    Purpose: To evaluate volumetric modulated arc radiotherapy (RapidArc [RA]), a novel approach allowing for rapid treatment delivery, for the treatment of vestibular schwannoma (VS). Methods and Materials: The RA plans were generated for a small (0.5 cm{sup 3}), intermediate (2.8 cm{sup 3}), and large (14.8 cm{sup 3}) VS. The prescription dose was 12.5 Gy to the encompassing 80% isodose. The RA plans were compared with conventional radiosurgery plans using both a single dynamic conformal arc (1DCA) and five noncoplanar dynamic conformal arcs (5DCA). Conformity indices (CI) and dose-volume histograms of critical organs were compared. The RA plan for the medium-sized VS was measured in a phantom using Gafchromic EBT films and compared with calculated dose distributions. Results: The RA planning was completed within 30 min in all cases, and calculated treatment delivery time (after patient setup) was 5 min vs. 20 min for 5DCA. A superior CI was achieved with RA, with a substantial decrease in low-dose irradiation of the normal brain achieved relative to 5DCA plans. Maximum doses to critical organs were similar for RA and 5DCA but were higher for 1DCA. Film measurements showed the differences between calculated and measured doses to be smaller than 1.5% in the high-dose area and smaller than 3% in the low-dose area. Conclusion: The RA plans consistently achieved a higher CI and decrease in areas of low-dose irradiation. This, together with shorter treatment delivery times, has led to RA replacing our conventional five-arc radiosurgery technique for VS.

  17. Predicting radiotherapy outcomes using statistical learning techniques

    NASA Astrophysics Data System (ADS)

    El Naqa, Issam; Bradley, Jeffrey D.; Lindsay, Patricia E.; Hope, Andrew J.; Deasy, Joseph O.

    2009-09-01

    Radiotherapy outcomes are determined by complex interactions between treatment, anatomical and patient-related variables. A common obstacle to building maximally predictive outcome models for clinical practice is the failure to capture potential complexity of heterogeneous variable interactions and applicability beyond institutional data. We describe a statistical learning methodology that can automatically screen for nonlinear relations among prognostic variables and generalize to unseen data before. In this work, several types of linear and nonlinear kernels to generate interaction terms and approximate the treatment-response function are evaluated. Examples of institutional datasets of esophagitis, pneumonitis and xerostomia endpoints were used. Furthermore, an independent RTOG dataset was used for 'generalizabilty' validation. We formulated the discrimination between risk groups as a supervised learning problem. The distribution of patient groups was initially analyzed using principle components analysis (PCA) to uncover potential nonlinear behavior. The performance of the different methods was evaluated using bivariate correlations and actuarial analysis. Over-fitting was controlled via cross-validation resampling. Our results suggest that a modified support vector machine (SVM) kernel method provided superior performance on leave-one-out testing compared to logistic regression and neural networks in cases where the data exhibited nonlinear behavior on PCA. For instance, in prediction of esophagitis and pneumonitis endpoints, which exhibited nonlinear behavior on PCA, the method provided 21% and 60% improvements, respectively. Furthermore, evaluation on the independent pneumonitis RTOG dataset demonstrated good generalizabilty beyond institutional data in contrast with other models. This indicates that the prediction of treatment response can be improved by utilizing nonlinear kernel methods for discovering important nonlinear interactions among model

  18. Carbon ion radiotherapy of skull base chondrosarcomas

    SciTech Connect

    Schulz-Ertner, Daniela . E-mail: Daniela.Ertner@med.uni-heidelberg.de; Nikoghosyan, Anna; Hof, Holger; Didinger, Bernd; Combs, Stephanie E.; Jaekel, Oliver; Karger, Christian P.; Edler, Lutz; Debus, Juergen

    2007-01-01

    Purpose: To evaluate the effectiveness and toxicity of carbon ion radiotherapy in chondrosarcomas of the skull base. Patients and Methods: Between November 1998 and September 2005, 54 patients with low-grade and intermediate-grade chondrosarcomas of the skull base have been treated with carbon ion radiation therapy (RT) using the raster scan technique at the Gesellschaft fuer Schwerionenforschung in Darmstadt, Germany. All patients had gross residual tumors after surgery. Median total dose was 60 CGE (weekly fractionation 7 x 3.0 CGE). All patients were followed prospectively in regular intervals after treatment. Local control and overall survival rates were calculated using the Kaplan-Meier method. Toxicity was assessed according to the Common Terminology Criteria (CTCAE v.3.0) and Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) score. Results: Median follow-up was 33 months (range, 3-84 months). Only 2 patients developed local recurrences. The actuarial local control rates were 96.2% and 89.8% at 3 and 4 years; overall survival was 98.2%at 5 years. Only 1 patient developed a mucositis CTCAE Grade 3; the remaining patients did not develop any acute toxicities >CTCAE Grade 2. Five patients developed minor late toxicities (RTOG/EORTC Grades 1-2), including bilateral cataract (n = 1), sensory hearing loss (n = 1), a reduction of growth hormone (n = 1), and asymptomatic radiation-induced white matter changes of the adjacent temporal lobe (n = 2). Grade 3 late toxicity occurred in 1 patient (1.9%) only. Conclusions: Carbon ion RT is an effective treatment for low- and intermediate-grade chondrosarcomas of the skull base offering high local control rates with low toxicity.

  19. Stereotactic Body Radiotherapy for Primary Hepatocellular Carcinoma

    SciTech Connect

    Andolino, David L.; Johnson, Cynthia S.; Maluccio, Mary; Kwo, Paul; Tector, A. Joseph; Zook, Jennifer; Johnstone, Peter A.S.; Cardenes, Higinia R.

    2011-11-15

    Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for the treatment of primary hepatocellular carcinoma (HCC). Methods and Materials: From 2005 to 2009, 60 patients with liver-confined HCC were treated with SBRT at the Indiana University Simon Cancer Center: 36 Child-Turcotte-Pugh (CTP) Class A and 24 CTP Class B. The median number of fractions, dose per fraction, and total dose, was 3, 14 Gy, and 44 Gy, respectively, for those with CTP Class A cirrhosis and 5, 8 Gy, and 40 Gy, respectively, for those with CTP Class B. Treatment was delivered via 6 to 12 beams and in nearly all cases was prescribed to the 80% isodose line. The records of all patients were reviewed, and treatment response was scored according to Response Evaluation Criteria in Solid Tumors v1.1. Toxicity was graded according to the Common Terminology Criteria for Adverse Events v4.0. Local control (LC), time to progression (TTP), progression-free survival (PFS), and overall survival (OS) were calculated according to the method of Kaplan and Meier. Results: The median follow-up time was 27 months, and the median tumor diameter was 3.2 cm. The 2-year LC, PFS, and OS were 90%, 48%, and 67%, respectively, with median TTP of 47.8 months. Subsequently, 23 patients underwent transplant, with a median time to transplant of 7 months. There were no {>=}Grade 3 nonhematologic toxicities. Thirteen percent of patients experienced an increase in hematologic/hepatic dysfunction greater than 1 grade, and 20% experienced progression in CTP class within 3 months of treatment. Conclusions: SBRT is a safe, effective, noninvasive option for patients with HCC {<=}6 cm. As such, SBRT should be considered when bridging to transplant or as definitive therapy for those ineligible for transplant.

  20. Carotid artery disease after head and neck radiotherapy.

    PubMed

    Thalhammer, Christoph; Husmann, Marc; Glanzmann, Christoph; Studer, Gabriela; Amann-Vesti, Beatrice R

    2015-01-01

    Radiation induced atherosclerosis of the carotid artery is a clinically relevant late complication after head and neck radiotherapy. Improved long-term survival after multimodality therapy in neck malignancies result in an increased risk of carotid artery disease in patients after radiotherapy (RT). This review focuses on the current knowledge of occlusive carotid disease after head and neck radiotherapy and highlights the exceeding morphologic post-radiation vessel wall pathologies. More severe and extensive carotid artery atherosclerosis with plaque in all segments including the common carotid artery is a frequent finding after RT. Therefore, colour coded duplex ultrasound surveillance in patients after head and neck RT is recommended. Some histopathological studies indicate differences to “classical” atherosclerosis, and pathogenesis of chronic radiation vasculopathy is still under discussion.

  1. Could Radiotherapy Effectiveness Be Enhanced by Electromagnetic Field Treatment?

    PubMed Central

    Francisco, Artacho-Cordón; del Mar, Salinas-Asensio María; Irene, Calvente; Sandra, Ríos-Arrabal; Josefa, León; Elisa, Román-Marinetto; Nicolás, Olea; Isabel, Núñez María

    2013-01-01

    One of the main goals in radiobiology research is to enhance radiotherapy effectiveness without provoking any increase in toxicity. In this context, it has been proposed that electromagnetic fields (EMFs), known to be modulators of proliferation rate, enhancers of apoptosis and inductors of genotoxicity, might control tumor recruitment and, thus, provide therapeutic benefits. Scientific evidence shows that the effects of ionizing radiation on cellular compartments and functions are strengthened by EMF. Although little is known about the potential role of EMFs in radiotherapy (RT), the radiosensitizing effect of EMFs described in the literature could support their use to improve radiation effectiveness. Thus, we hypothesized that EMF exposure might enhance the ionizing radiation effect on tumor cells, improving the effects of RT. The aim of this paper is to review reports of the effects of EMFs in biological systems and their potential therapeutic benefits in radiotherapy. PMID:23867611

  2. Dose factor entry and display tool for BNCT radiotherapy

    DOEpatents

    Wessol, Daniel E.; Wheeler, Floyd J.; Cook, Jeremy L.

    1999-01-01

    A system for use in Boron Neutron Capture Therapy (BNCT) radiotherapy planning where a biological distribution is calculated using a combination of conversion factors and a previously calculated physical distribution. Conversion factors are presented in a graphical spreadsheet so that a planner can easily view and modify the conversion factors. For radiotherapy in multi-component modalities, such as Fast-Neutron and BNCT, it is necessary to combine each conversion factor component to form an effective dose which is used in radiotherapy planning and evaluation. The Dose Factor Entry and Display System is designed to facilitate planner entry of appropriate conversion factors in a straightforward manner for each component. The effective isodose is then immediately computed and displayed over the appropriate background (e.g. digitized image).

  3. Endometrial adenocarcinoma, adjuvant radiotherapy tailored to prognostic factors.

    PubMed

    Meerwaldt, J H; Hoekstra, C J; van Putten, W L; Tjokrowardojo, A J; Koper, P C

    1990-02-01

    The optimal adjuvant radiotherapy for surgically treated endometrial cancer has not yet been defined. We report on 389 patients treated between 1970 and 1985 with adjuvant radiotherapy. The treatment was tailored to the known prognostic factors: myometrial invasion and grade of differentiation of the tumor. Ten-year overall survival was 67%, 10-year relapse-free survival 77%; 23% relapse, of which 21% distant and 6% locoregional relapse. In a multivariate analysis, stage (pT), grade, and myometrial invasion were prognostic factors. The number of locoregional failures was very small (n = 23). This small number, the fact that radiation treatment was tailored to prognostic factors, and the absence of a nontreated control group precluded an analysis of the effect of the adjuvant irradiation. Large randomized studies with a control (no treatment) arm should be performed to determine the value of adjuvant radiotherapy.

  4. Role of additional radiotherapy in advanced stages of Hodgkin's disease.

    PubMed

    Meerwaldt, J H; Coleman, C N; Fischer, R I; Lister, T A; Diehl, V

    1992-09-01

    Although radiotherapy is widely used as additional treatment following chemotherapy, its precise role has never been clearly proven. Relapses tend to occur in previously involved bulky sites. Non-randomized studies may suggest a positive effect of the addition of radiotherapy. This effect however, might also be caused by selection. Randomized studies have not resulted in a survival advantage for the patients treated with additional radiotherapy compared to no further treatment or additional chemotherapy. The SWOG study 7808 suggest a 20% benefit in remission duration for the nodular sclerosis histology subgroup. Definitive conclusions have to wait for more mature results of randomized studies including the ongoing EORTC study and the possibility to perform an overview of all studies.

  5. Radiotherapy-induced skin reactions: assessment and management.

    PubMed

    Glover, Deborah; Harmer, Victoria

    Radiotherapy, the use of high-energy rays to either kill cancer cells or treat some benign tumours, is undoubtedly a positive intervention. However, as the primary mode of action in radiotherapy treatment is the killing of cells to prevent replication, other non-cancerous cells may be affected. For example, up to 85% of patients will experience some form of skin reaction, which will range from local erythema to moist desquamation. Such reactions are not only distressing and painful for the patient, if severe enough, they may warrant a halt in treatment. This article outlines the aims and nature of radiotherapy, and then discusses the aetiology of skin reactions, risk factors for reaction, and assessment tools. Management interventions will also be shown, with emphasis on silicone dressings.

  6. The role of radiotherapy in multimodal treatment of pancreatic carcinoma

    PubMed Central

    2010-01-01

    Pancreatic ductal carcinoma is one of the most lethal malignancies, but in recent years a number of positive developments have occurred in the management of pancreatic carcinoma. This article aims to give an overview of the current knowledge regarding the role of radiotherapy in the treatment of pancreatic ductal adenocarcinoma (PDAC). The results of meta-analyses, phase III-studies, and phase II-studies using chemoradiotherapy and chemotherapy for resectable and non-resectable PDAC were reviewed. The use of radiotherapy is discussed in the neoadjuvant and adjuvant settings as well as in the locally advanced situation. Whenever possible, radiotherapy should be performed as simultaneous chemoradiotherapy. Patients with PDAC should be offered entry into clinical trials to identify optimal treatment results. PMID:20615227

  7. Cytogenetic, clinical, and cytologic characteristics of radiotherapy-related leukemias

    SciTech Connect

    Philip, P.; Pedersen-Bjergaard, J.

    1988-04-01

    From 1978 to 1985, we observed eight cases of acute nonlymphocytic leukemia or preleukemia, three cases of acute lymphoblastic leukemia, and three cases of chronic myeloid leukemia in patients previously treated exclusively with radiotherapy for other tumor types. The latent period from administration of radiotherapy to development of leukemia varied between 12 and 243 months. Clonal chromosome aberrations reported previously as characteristic of acute nonlymphocytic leukemia following therapy with alkylating agents were observed in three of the eight patients with acute nonlymphocytic leukemia (5q- and -7) and in two of the three patients with acute lymphoblastic leukemia (-7 and 12p-). All three patients with radiotherapy-related chronic myeloid leukemia presented a t(9;22)(q34;q11). The results suggest that cytogenetic characteristics may reflect the etiology in radiation-induced acute leukemias, whereas radiation-related chronic myeloid leukemia does not seem to differ chromosomally from de novo cases of the disease.

  8. Radiotherapy for extramammary Paget disease of the anogenital region.

    PubMed

    Dilmé-Carreras, Elisabet; Iglesias-Sancho, Maribel; Márquez-Balbás, Gemma; Sola-Ortigosa, Joaquín; Umbert-Millet, Pablo

    2011-07-01

    Extramammary Paget disease is a rare condition that most commonly affects the anogenital region in the elderly. The treatment of choice has been surgical excision of the affected area with adequate depth and lateral margins, criteria that cannot always be fulfilled, especially when the vulva, anal canal, or penis are involved. More recently radiotherapy has been suggested as a suitable treatment when surgical excision or other modalities are not appropriate. We report a case of anogenital extramammary Paget disease and the clinical response to treatment with radiotherapy. The aim of this article is to review relevant aspects of radiotherapy as a first-choice curative treatment in specific situations of anogenital extramammary Paget disease in situ.

  9. Imaging practices and radiation doses from imaging in radiotherapy.

    PubMed

    Siiskonen, Teemu; Kaijaluoto, Sampsa; Florea, Tudor

    2017-03-25

    Modern radiotherapy treatments require frequent imaging for accurate patient positioning relative to the therapeutic radiation beam. Imaging practices in five Finnish radiotherapy clinics were assessed and discussed from the patient dose optimization point of view. The results show that imaging strategies are not jointly established and variations exist. The organ absorbed doses depend on imaging technique and imaging frequency. In particular, organ doses from the cone beam computed tomography can have very large variations (a factor of 10-50 in breast imaging and factor of 5 in prostate imaging). The cumulative imaging organ dose from the treatment can vary by a factor of ten or more for the same treatment, depending on the chosen technique and imaging frequency. Awareness and optimization of the imaging dose in image-guided radiotherapy should be strengthened.

  10. Radiotherapy-induced concomitant coronary artery stenosis and mitral valve disease.

    PubMed

    Akboga, Mehmet Kadri; Akyel, Ahmet; Sahinarslan, Asife; Cengel, Atiye

    2014-04-01

    Radiotherapy is extensively used in the treatment of Hodgkin's disease. One of its untoward effects is on heart. Coronary arteries and heart valves can be adversely affected from radiotherapy. However, co-existence of both conditions is very rare. In this report, we present a patient with Hodgkin's disease who developed both coronary artery stenosis and severe mitral valve regurgitation after radiotherapy.

  11. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery

    SciTech Connect

    Walker, M.D.; Green, S.B.; Byar, D.P.

    1980-12-04

    Within three weeks of definitive surgical intervention, 467 patients with histologically proved malignant glioma were randomized to receive one of four treatment regimens: semustine (MeCCNU), radiotherapy, carmustine (BCNU) plus radiotherapy, or semustine plus radiotherapy. We analyzed the data for the total randomized population and for the 358 patients in whom the initial protocol specifications were met (the valid study group). Observed toxicity included acceptable skin reactions secondary to radiotherapy and reversible leukopenia and thrombocytopenia due to chemotherapy. Radiotherapy used alone or in combination with a nitrosourea significantly improved survival in comparison with semustine alone. The group receiving carmustine plus radiotherapy had the best survival, but the difference in survival between the groups receiving carmustine plus radiotherapy and semustine plus radiotherapy was not statistically significant. The combination of carmustine plus radiotherapy produced a modest benefit in long-term (18-month) survival as compared with radiotherapy alone, although the difference between survival curves was not significant at the 0.05 level. This study suggests that it is best to use radiotherapy in the post-surgical treatment of malignant glioma and to continue the search for an effective chemotherapeutic regimen to use in addition to radiotherapy.

  12. Adjuvant radiotherapy for locally advanced upper tract urothelial carcinoma

    PubMed Central

    Huang, Yun-Ching; Chang, Ying-Hsu; Chiu, Kuo-Hsiung; Shindel, Alan W.; Lai, Chia-Hsuan

    2016-01-01

    There is relatively little literature on adjuvant radiotherapy after radical nephroureterectomy with bladder cuff excision (RNU) for patients with upper tract urothelial carcinoma (UTUC). This study was designed to determine the efficacy of adjuvant radiotherapy for patients with pT3N0M0 UTUC. We retrospectively reviewed 198 patients treated with RNU between December 2001 and January 2015. Postoperative radiotherapy was administered in 40 (20.2%) of patients. Patients who received radiotherapy were younger than those that did not (65.2 vs. 70.5 years, p = 0.023). With median follow up of 29.1 months, Kaplan-Meier analysis with the log-rank test demonstrated no significant differences between those omitting vs receiving adjuvant radiotherapy in regards to 2-year rates of overall survival (72.0% vs. 73.4%, p = 0.979), cancer-specific survival (73.2% vs. 75.3%, p = 0.844), and recurrence-free survival (61.2% vs. 66.3%, p = 0.742). However, in multivariable analysis with Cox regression, young age, absence of chronic kidney disease, negative lymphovascular invasion, negative surgical margin, and adjuvant chemotherapy were also associated with better cancer-specific survival. In conclusion, adjuvant radiotherapy did not offer any significant benefit in terms of overall, cancer-specific, and recurrence-free survivals in patients with pT3N0M0 UTUC after RNU. More effective systemic adjuvant chemotherapy is necessary to improve the outcome of these patients. PMID:27910890

  13. Mathematical Modeling of Cancer Immunotherapy and Its Synergy with Radiotherapy.

    PubMed

    Serre, Raphael; Benzekry, Sebastien; Padovani, Laetitia; Meille, Christophe; André, Nicolas; Ciccolini, Joseph; Barlesi, Fabrice; Muracciole, Xavier; Barbolosi, Dominique

    2016-09-01

    Combining radiotherapy with immune checkpoint blockade may offer considerable therapeutic impact if the immunosuppressive nature of the tumor microenvironment (TME) can be relieved. In this study, we used mathematical models, which can illustrate the potential synergism between immune checkpoint inhibitors and radiotherapy. A discrete-time pharmacodynamic model of the combination of radiotherapy with inhibitors of the PD1-PDL1 axis and/or the CTLA4 pathway is described. This mathematical framework describes how a growing tumor first elicits and then inhibits an antitumor immune response. This antitumor immune response is described by a primary and a secondary (or memory) response. The primary immune response appears first and is inhibited by the PD1-PDL1 axis, whereas the secondary immune response happens next and is inhibited by the CTLA4 pathway. The effects of irradiation are described by a modified version of the linear-quadratic model. This modeling offers an explanation for the reported biphasic relationship between the size of a tumor and its immunogenicity, as measured by the abscopal effect (an off-target immune response). Furthermore, it explains why discontinuing immunotherapy may result in either tumor recurrence or a durably sustained response. Finally, it describes how synchronizing immunotherapy and radiotherapy can produce synergies. The ability of the model to forecast pharmacodynamic endpoints was validated retrospectively by checking that it could describe data from experimental studies, which investigated the combination of radiotherapy with immune checkpoint inhibitors. In summary, a model such as this could be further used as a simulation tool to facilitate decision making about optimal scheduling of immunotherapy with radiotherapy and perhaps other types of anticancer therapies. Cancer Res; 76(17); 4931-40. ©2016 AACR.

  14. Unilateral Radiotherapy for the Treatment of Tonsil Cancer

    SciTech Connect

    Chronowski, Gregory M.; Garden, Adam S.; Morrison, William H.; Frank, Steven J.; Schwartz, David L.; Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon; Kupferman, Michael E.; Ang, Kian K.; Rosenthal, David I.

    2012-05-01

    Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity

  15. ATM Heterozygosity and the Development of Radiation-Induced Erectile Dysfunction and Urinary Morbidity Following Radiotherapy for Prostate Cancer

    DTIC Science & Technology

    2008-02-01

    Unlimited The views, opinions and/or findings contained in this report are those of the author( s ) and should not be construed as an official...Morbidity Following Radiotherapy for Prostate Cancer 5b. GRANT NUMBER W81XWH-04-1-0172 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) Jamie A. Cesaretti...M.D. 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: jamie.cesaretti@frogdocs.com 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND

  16. A new fixation aid for the radiotherapy of eye tumors

    SciTech Connect

    Buchgeister, Markus; Grisanti, Salvatore; Suesskind, Daniela; Bamberg, Michael; Paulsen, Frank

    2007-12-15

    A modified swim goggle holding a light spot as an optical guide for actively aligning the eye in a reproducible orientation has been constructed to perform radiotherapy of ocular tumors. This device is compatible with computed tomography (CT) and magnetic resonance imaging systems. Image fusion of these data sets yielded clinically acceptable results. The reproducibility of the eye's positioning is tested by repeated CT. The eye's alignment during radiotherapy is monitored by an infrared TV camera with individual markings of the eye's position on the TV-monitor screen. From 2003-2006, 50 patients were treated with this fixation aid by radiosurgery with good patient compliance.

  17. Genetics and genomics of radiotherapy toxicity: towards prediction

    PubMed Central

    2011-01-01

    Radiotherapy is involved in many curative treatments of cancer; millions of survivors live with the consequences of treatment, and toxicity in a minority limits the radiation doses that can be safely prescribed to the majority. Radiogenomics is the whole genome application of radiogenetics, which studies the influence of genetic variation on radiation response. Work in the area focuses on uncovering the underlying genetic causes of individual variation in sensitivity to radiation, which is important for effective, safe treatment. In this review, we highlight recent advances in radiotherapy and discuss results from four genome-wide studies of radiotoxicity. PMID:21861849

  18. The use of antioxidants in radiotherapy-induced skin toxicity.

    PubMed

    Amber, Kyle T; Shiman, Michael I; Badiavas, Evangelos V

    2014-01-01

    Radiation-induced skin damage is one of the most common complications of radiotherapy. In order to combat these side effects, patients often turn to alternative therapies, which often include antioxidants. Antioxidants such as those in the polyphenol chemical class, xanthine derivatives, tocepherol, sucralfate, and ascorbate have been studied for their use in either preventing or treating radiotherapy-induced skin damage. Apart from their known role as free radical scavengers, some of these antioxidants appear to alter cytokine release affecting cutaneous and systemic changes. We review the role of antioxidants in treating and preventing radiation-induced skin damage as well as the possible complications of using such therapy.

  19. A new fixation aid for the radiotherapy of eye tumors.

    PubMed

    Buchgeister, Markus; Grisanti, Salvatore; Süsskind, Daniela; Bamberg, Michael; Paulsen, Frank

    2007-12-01

    A modified swim goggle holding a light spot as an optical guide for actively aligning the eye in a reproducible orientation has been constructed to perform radiotherapy of ocular tumors. This device is compatible with computed tomography (CT) and magnetic resonance imaging systems. Image fusion of these data sets yielded clinically acceptable results. The reproducibility of the eye's positioning is tested by repeated CT. The eye's alignment during radiotherapy is monitored by an infrared TV camera with individual markings of the eye's position on the TV-monitor screen. From 2003-2006, 50 patients were treated with this fixation aid by radiosurgery with good patient compliance.

  20. Status of carbon-ion radiotherapy facilities in Japan

    NASA Astrophysics Data System (ADS)

    Kitagawa, Atsushi

    2013-05-01

    Carbon-ion radiotherapy has large physical and biological advantages, and clinical results performed by HIMAC at NIRS awaken a deep interest. Several hospital-specified facilities are recently under commissioning or construction in Japan. Carbon-ion radiotherapy is based on the advanced technology in wide various fields. In order to promote this treatment method to the daily treatment, constant cooperative efforts by public and private organizations are necessary, i.e. providing of abundant clinical data, technology transfer, personnel training, organizing of the specialists' network, and so on. The present status and future prospects in Japan are reported.

  1. The Tumour Microenvironment after Radiotherapy: Mechanisms of Resistance and Recurrence

    PubMed Central

    Barker, Holly E.; Paget, James T. E.; Khan, Aadil A.; Harrington, Kevin J.

    2016-01-01

    Radiotherapy plays a central part in curing cancer. For decades, most research on improving treatment outcomes has focussed on modulating radiation-induced biological effects on cancer cells. Recently, we have better understood that components within the tumour microenvironment have pivotal roles in determining treatment outcomes. In this Review, we describe vascular, stromal and immunological changes induced in the tumour microenvironment by irradiation and discuss how they may promote radioresistance and tumour recurrence. Subsequently, we highlight how this knowledge is guiding the development of new treatment paradigms in which biologically targeted agents will be combined with radiotherapy. PMID:26105538

  2. SU-E-T-808: Volumetric Modulated Arc Radiotherapy Vs. Intensity-Modulated Radiotherapy for Early-Stage Nasopharyngeal Carcinoma: A Dosimetric Study

    SciTech Connect

    Lu, J-Y; Huang, B-T; Zhang, W-Z

    2015-06-15

    Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for early-stage nasopharyngeal carcinoma. Methods: CT datasets of ten patients with early-stage nasopharyngeal carcinoma were included. Dual-arc VMAT and nine-field IMRT plans were generated for each case, and were then compared in terms of planning-target-volume (PTV) coverage, conformity index (CI) and homogeneity index (HI), as well as organ-at-risk (OAR) sparing, planning time, monitor units (MUs) and delivery time. Results: Compared with the IMRT plans, the VMAT plans provided comparable HI and CI of PTVnx (PTV of primary tumor of nasopharynx), superior CI and inferior HI of PTVnd (PTV of lymph nodes), as well as superior CI and comparable HI of PTV60 (high-risk PTV). The VMAT plans provided better sparing of the spinal cord, oral cavity and normal tissue, but inferior sparing of the brainstem planning OAR volume (PRV), larynx and parotids, as well as comparable sparing of the spinal cord PRV, brainstem, lenses, optic nerves, optic chiasm. Moreover, the average planning time (181.6 ± 36.0 min) for the VMAT plans was 171% more than that of the IMRT plans (68.1 ± 7.6 min). The MUs of the VMAT plans (609 ± 43) were 70% lower than those of the IMRT plans (2071 ± 262), while the average delivery time (2.2 ± 0.1 min) was 66% less than that of the IMRT plans (6.6 ± 0.4 min). Conclusion: Compared with the IMRT technique, the VMAT technique can achieve similar or slightly superior target dose distribution, with no significant advantages on OAR sparing, and it can achieve significant reductions of MUs and delivery time.

  3. SU-E-T-302: Dosimetric Comparison Between Volumetric Modulated Arc Radiotherapy and Intensity-Modulated Radiotherapy for Locally Recurrent Nasopharyngeal Carcinoma

    SciTech Connect

    Lu, J-Y; Huang, B-T; Zhang, J-Y; Ma, C-C

    2015-06-15

    Purpose: To compare volumetric modulated arc radiotherapy (VMAT) technique with fixed-gantry intensity-modulated radiotherapy (IMRT) technique for locally recurrent nasopharyngeal carcinoma. Methods: CT datasets of eleven nasopharyngeal-carcinoma patients were included. Dual-arc VMAT and seven-field IMRT plans were created for each case, and were then compared in terms of conformity index (CI), homogeneity index (HI) of the planning target volume (PTV), organ-at-risk (OAR) sparing, monitor unit (MU) and delivery time. Results: The D98% (near-minimal dose) of PTV in the VMAT plans was slightly lower than that of the IMRT plans (P < 0.05), while the CI was higher than that of the IMRT plans (P < 0.05). No significant difference was found in the HI between the two plans (P > 0.05). Compared with the IMRT plans, the VMAT plans demonstrated lower Dmean (mean dose) of the bilateral temporal lobes and the whole surrounding normal tissue (P < 0.05), but slightly higher Dmean of brainstem (P < 0.05). In terms of the other OARs, no significant differences were found (P > 0.05). The MUs of the VMAT plans (672 ± 112) was significantly lower than that of the IMRT plans (917 ± 206), by 25 ± 13% (P < 0.05). The average delivery time of the VMAT plans (2.3 ± 0.1 min) was less than that of the IMRT plans (5.1 ± 0.4 min), by 54 ± 3%. Conclusion: For locally recurrent nasopharyngeal carcinoma, the VMAT technique could achieve equivalent or superior dose distribution of the target and better protect the bilateral temporal lobes, compared with the IMRT technique. Moreover, it could reduce the MU and delivery time effectively.

  4. Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

    SciTech Connect

    Kimura, Tomoki; Nishibuchi, Ikuno; Murakami, Yuji; Kenjo, Masahiro; Kaneyasu, Yuko; Nagata, Yasushi

    2012-03-15

    Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung. Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.

  5. Spectral and Spatial Distribution of the Scattered Radiation of AN Electron Radiotherapy Beam

    NASA Astrophysics Data System (ADS)

    Bartesaghi, G.; Conti, V.; Mascagna, V.; Prest, M.; Mozzanica, A.; Frigerio, G.; Monti, A.; Vallazza, E.

    2006-04-01

    The characterization of the radiation scattered by the collimating system of a linear accelerator for medical applications is becoming a must given the increase in the survival of the radio-treated patients. This paper describes both the spectral and spatial study of the scattered radiation of an electron beam in the energy range 6-20 MeV, produced by a Varian CLINAC 1800 accelerator at the Radiotherapy Unit of the Sant'Anna Hospital in Como. The detectors used are plastic and fiber scintillators characterized by a timing response of ≈ 25 nsec in order to cope with the high fluxes. The results have been compared with a Montecarlo simulation based on Geant 3.21 and are presented both in terms of spectral and dose distributions.

  6. Radiation-Induced Cancers From Modern Radiotherapy Techniques: Intensity-Modulated Radiotherapy Versus Proton Therapy

    SciTech Connect

    Yoon, Myonggeun; Ahn, Sung Hwan; Kim, Jinsung; Shin, Dong Ho; Park, Sung Yong; Lee, Se Byeong; Shin, Kyung Hwan; Cho, Kwan Ho

    2010-08-01

    Purpose: To assess and compare secondary cancer risk resulting from intensity-modulated radiotherapy (IMRT) and proton therapy in patients with prostate and head-and-neck cancer. Methods and Materials: Intensity-modulated radiotherapy and proton therapy in the scattering mode were planned for 5 prostate caner patients and 5 head-and-neck cancer patients. The secondary doses during irradiation were measured using ion chamber and CR-39 detectors for IMRT and proton therapy, respectively. Organ-specific radiation-induced cancer risk was estimated by applying organ equivalent dose to dose distributions. Results: The average secondary doses of proton therapy for prostate cancer patients, measured 20-60cm from the isocenter, ranged from 0.4 mSv/Gy to 0.1 mSv/Gy. The average secondary doses of IMRT for prostate patients, however, ranged between 3 mSv/Gy and 1 mSv/Gy, approximately one order of magnitude higher than for proton therapy. Although the average secondary doses of IMRT were higher than those of proton therapy for head-and-neck cancers, these differences were not significant. Organ equivalent dose calculations showed that, for prostate cancer patients, the risk of secondary cancers in out-of-field organs, such as the stomach, lungs, and thyroid, was at least 5 times higher for IMRT than for proton therapy, whereas the difference was lower for head-and-neck cancer patients. Conclusions: Comparisons of organ-specific organ equivalent dose showed that the estimated secondary cancer risk using scattering mode in proton therapy is either significantly lower than the cases in IMRT treatment or, at least, does not exceed the risk induced by conventional IMRT treatment.

  7. Large Cohort Dose-Volume Response Analysis of Parotid Gland Function After Radiotherapy: Intensity-Modulated Versus Conventional Radiotherapy

    SciTech Connect

    Dijkema, Tim Terhaard, Chris H.J.; Roesink, Judith M.; Braam, Petra M.; Gils, Carla H. van; Moerland, Marinus A.; Raaijmakers, Cornelis P.J.

    2008-11-15

    Purpose: To compare parotid gland dose-volume response relationships in a large cohort of patients treated with intensity-modulated (IMRT) and conventional radiotherapy (CRT). Methods and materials: A total of 221 patients (64 treated with IMRT, 157 with CRT) with various head-and-neck malignancies were prospectively evaluated. The distribution of tumor subsites in both groups was unbalanced. Stimulated parotid flow rates were measured before and 6 weeks, 6 months, and 1 year after radiotherapy. Parotid gland dose-volume histograms were derived from computed tomography-based treatment planning. The normal tissue complication probability (NTCP) model proposed by Lyman was fit to the data. A complication was defined as stimulated parotid flow ratio <25% of the pretreatment flow rate. The relative risk of complications was determined for IMRT vs. CRT and adjusted for the mean parotid gland dose using Poisson regression modeling. Results: One year after radiotherapy, NTCP curves for IMRT and CRT were comparable with a TD{sub 50} (uniform dose leading to a 50% complication probability) of 38 and 40 Gy, respectively. Until 6 months after RT, corrected for mean dose, different complication probabilities existed for IMRT vs. CRT. The relative risk of a complication for IMRT vs. CRT after 6 weeks was 1.42 (95% CI 1.21-1.67), after 6 months 1.41 (95% CI; 1.12-1.77), and at 1 year 1.21 (95% CI 0.87-1.68), after correcting for mean dose. Conclusions: One year after radiotherapy, no difference existed in the mean dose-based NTCP curves for IMRT and CRT. Early after radiotherapy (up to 6 months) mean dose based (Lyman) models failed to fully describe the effects of radiotherapy on the parotid glands.

  8. Radiotherapy and chemoradiation after surgery for early cervical cancer

    PubMed Central

    Rogers, Linda; Siu, Shing Shun N; Luesley, David; Bryant, Andrew; Dickinson, Heather O

    2014-01-01

    Background This is an updated version of the original Cochrane review first published in Issue 4, 2009. There is an ongoing debate about the indications for, and value of, adjuvant pelvic radiotherapy after radical surgery in women with early cervical cancer. Certain combinations of pathological risk factors are thought to represent sufficient risk for recurrence, that they justify the use of postoperative pelvic radiotherapy, though this has never been shown to improve overall survival, and use of more than one type of treatment (surgery and radiotherapy) increases the risks of side effects and complications. Objectives To evaluate the effectiveness and safety of adjuvant therapies (radiotherapy, chemotherapy followed by radiotherapy, chemoradiation) after radical hysterectomy for early-stage cervical cancer (FIGO stages IB1, IB2 or IIA). Search methods For the original review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 4, 2008. The Cochrane Gynaecological Cancer Group Trials Register, MEDLINE (January 1950 to November 2008), EMBASE (1950 to November 2008). We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. For this update, we extended the database searches to September 2011 and searched the MetaRegister for ongoing trials. Selection criteria Randomised controlled trials (RCTs) that compared adjuvant therapies (radiotherapy, chemotherapy followed by radiotherapy, or chemoradiation) with no radiotherapy or chemoradiation, in women with a confirmed histological diagnosis of early cervical cancer who had undergone radical hysterectomy and dissection of the pelvic lymph nodes. Data collection and analysis Two review authors independently abstracted data and assessed risk of bias. Information on grade 3 and 4 adverse events was collected from the trials. Results were pooled using random-effects meta-analyses. Main results Two RCTs

  9. Radiotherapy dosimetry of the breast : Factors affecting dose to the patient

    NASA Astrophysics Data System (ADS)

    Venables, Karen

    The work presented in this thesis developed from the quality assurance for the START trial. This provided a unique opportunity to perform measurements in a breast shaped, soft tissue equivalent phantom in over 40 hospitals, representing 75% of the radiotherapy centres in the UK. A wide range of planning systems using beam library, beam model and convolution based algorithms have been compared. The limitations of current algorithms as applied to breast radiotherapy have been investigated by analysing the results of the START quality assurance programme, performing further measurements of surface dose and setting up of a Monte Carlo system to calculate dose distributions and superficial doses. Measurements in both 2D and 3D breast phantoms indicated that the average measured dose at the centre of the breast was lower than that calculated on the planning system by approximately 2%. Surface dose measurements showed good agreement between measurements and Monte Carlo calculations with values ranging from 6% of the maximum dose for a small field (5cmx5cm) at normal incidence to 37% for a large field (9cmx20cm) at an angle of 75°. Calculation on CT plans with pixel by pixel correction for the breast density indicated that monitor units are lower by an average 3% compared to a bulk density corrected plan assuming a density of 1g.cm-3. The average dose estimated from TLD in build-up caps placed on the patient surface was 0.99 of the prescribed dose. This shows that the underestimation of dose due to the assumption of unit density tissue is partially cancelled by the overestimation of dose by the algorithms. The work showed that simple calculation algorithms can be used for calculation of dose to the breast, however they are less accurate for patients who have undergone a mastectomy and in regions close to inhomogeneities where more complex algorithms are needed.

  10. Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source

    SciTech Connect

    Richardson, Susan; Garcia-Ramirez, Jose; Lu Wei; Myerson, Robert J.; Parikh, Parag

    2012-11-15

    Purpose: To present design aspects and acceptance tests performed for clinical implementation of electronic brachytherapy treatment of early stage rectal adenocarcinoma. A dosimetric comparison is made between the historically used Philips RT-50 unit and the newly developed Axxent{sup Registered-Sign} Model S700 electronic brachytherapy source manufactured by Xoft (iCad, Inc.). Methods: Two proctoscope cones were manufactured by ElectroSurgical Instruments (ESI). Two custom surface applicators were manufactured by Xoft and were designed to fit and interlock with the proctoscope cones from ESI. Dose rates, half value layers (HVL), and percentage depth dose (PDD) measurements were made with the Xoft system and compared to historical RT-50 data. A description of the patient treatment approach and exposure rates during the procedure is also provided. Results: The electronic brachytherapy system has a lower surface dose rate than the RT-50. The dose rate to water on the surface from the Xoft system is approximately 2.1 Gy/min while the RT-50 is 10-12 Gy/min. However, treatment times with Xoft are still reasonable. The HVLs and PDDs between the two systems were comparable resulting in similar doses to the target and to regions beyond the target. The exposure rate levels around a patient treatment were acceptable. The standard uncertainty in the dose rate to water on the surface is approximately {+-}5.2%. Conclusions: The Philips RT-50 unit is an out-of-date radiotherapy machine that is no longer manufactured with limited replacement parts. The use of a custom-designed proctoscope and Xoft surface applicators allows delivery of a well-established treatment with the ease of a modern radiotherapy device. While the dose rate is lower with the use of Xoft, the treatment times are still reasonable. Additionally, personnel may stand farther away from the Xoft radiation source, thus potentially reducing radiation exposure to the operator and other personnel.

  11. SU-E-T-91: Accuracy of Dose Calculation Algorithms for Patients Undergoing Stereotactic Ablative Radiotherapy

    SciTech Connect

    Tajaldeen, A; Ramachandran, P; Geso, M

    2015-06-15

    Purpose: The purpose of this study was to investigate and quantify the variation in dose distributions in small field lung cancer radiotherapy using seven different dose calculation algorithms. Methods: The study was performed in 21 lung cancer patients who underwent Stereotactic Ablative Body Radiotherapy (SABR). Two different methods (i) Same dose coverage to the target volume (named as same dose method) (ii) Same monitor units in all algorithms (named as same monitor units) were used for studying the performance of seven different dose calculation algorithms in XiO and Eclipse treatment planning systems. The seven dose calculation algorithms include Superposition, Fast superposition, Fast Fourier Transform ( FFT) Convolution, Clarkson, Anisotropic Analytic Algorithm (AAA), Acurous XB and pencil beam (PB) algorithms. Prior to this, a phantom study was performed to assess the accuracy of these algorithms. Superposition algorithm was used as a reference algorithm in this study. The treatment plans were compared using different dosimetric parameters including conformity, heterogeneity and dose fall off index. In addition to this, the dose to critical structures like lungs, heart, oesophagus and spinal cord were also studied. Statistical analysis was performed using Prism software. Results: The mean±stdev with conformity index for Superposition, Fast superposition, Clarkson and FFT convolution algorithms were 1.29±0.13, 1.31±0.16, 2.2±0.7 and 2.17±0.59 respectively whereas for AAA, pencil beam and Acurous XB were 1.4±0.27, 1.66±0.27 and 1.35±0.24 respectively. Conclusion: Our study showed significant variations among the seven different algorithms. Superposition and AcurosXB algorithms showed similar values for most of the dosimetric parameters. Clarkson, FFT convolution and pencil beam algorithms showed large differences as compared to superposition algorithms. Based on our study, we recommend Superposition and AcurosXB algorithms as the first choice of

  12. Enhancing radiotherapy for lung cancer using immunoadjuvants delivered in situ from new design radiotherapy biomaterials: a preclinical study

    NASA Astrophysics Data System (ADS)

    Hao, Yao; Yasmin-Karim, Sayeda; Moreau, Michele; Sinha, Neeharika; Sajo, Erno; Ngwa, Wilfred

    2016-12-01

    Studies show that radiotherapy of a primary tumor in combination with immunoadjuvants (IA) can result in increased survival or immune-mediated regression of metastasis outside the radiation field, a phenomenon known as abscopal effect. However, toxicities due to repeated systematic administration of IA have been shown to be a major obstacle in clinical trials. To minimize the toxicities and prime a more potent immune response, Ngwa et al have proposed that inert radiotherapy biomaterials such as fiducials could be upgraded to multifunctional ones loaded with IA for in situ delivery directly into the tumor sub-